A book chapter, a presentation, and an interview

Whew! What a fascinating and busy few months it's been! 

Aside from my usual and intense immersion in work, there have been some nifty things happening. Here's what's been up:

First, I am extremely honored to be a part of a new book, edited by Sue Hadley, who is one of the people I greatly appreciate and admire, because she's willing to talk about the stuff nobody else talks about. This time she's talking about race and culture in terms of how it's experienced by music therapists. Here's the description of the book from Barcelona Publishers:

Experiencing Race as a Music Therapist: Personal Narratives is a compilation of critically engaging narratives that grew out of conversations with 17 music therapists living in different parts of the world, from various “racial” groups, about their experiences of their racialized identities in the therapy setting. The music therapists describe the raced and cultural contexts in which they were born and describe the racial demographics of the places they have lived at various times in their lives. The countries in which the individual music therapists spent their formative years include Australia, Canada, Iran, Japan, Korea, New Zealand, Puerto Rico, South Africa, the United Kingdom and the United States, with many of them also having traveled to other countries. The music therapists discussed their specific experiences of their racialized identities when they were studying music therapy and how they experienced their racialized identities in their professional lives. Many of them also described the differences they were aware of in terms of how they experienced themselves as raced or how they experienced the therapeutic relationship when they were working with people of their own “race” compared with working with people who were from a different “race.” From these narratives, we can see that our life experiences shape how we understand ourselves and others, our assumptions and biases, and the effort with which we form relationships with different groups of people. The music therapists in this book have shared their experiences in the hope that we can learn how to sit in our discomfort, without judgment, lowering our defenses, in order to learn more about ourselves and others, so that we can deepen our understandings and our relationships across racialized lines.

I've been slowly reading through the narratives, and they are engaging and thought-provoking. I encourage you to check out this book. It is a wonderful invitation to deeper reflection and conversation about a topic that does not generally come up in our field.

Second, I spent a lot of time trying to organize a presentation I did for the most recent Mid-Atlantic Regional music therapy conference, "Countertransference Songs: Another Way to Listen" (you know- countertransference- one of my favorite topics!). Here is how I described the session:

Far from simply being a means by which to convey skills and the general expression of feelings, music can be used on another level to better understand our clients- especially those who don’t use speech as their main communication modality. Paying attention to the music that emerges in sessions- for example, the sounds we typically use in response to particular clients, or songs that suddenly pop into our minds as we work intensely with someone - can offer us another avenue by which to understand what is going on within the therapy relationship.

Starting from the premise that the therapy relationship is the healing element, the focus and, more significantly, the work of dynamically oriented music therapy is to look at and explore the relationships that develop between the therapist, client and music.

As active participants in the therapeutic relationship, music therapists experience a range of countertransference responses when working with clients, some of which are explored in supervision and some in personal therapy. In this presentation we will start  from the assumption that countertransference includes all of the feelings, reactions, fantasies, thoughts and ideas the therapist experiences in relation to clients, either in response to how a client/group is perceiving him/her, or based on the therapist’s own personal history. Of course, one of the ways countertransference may be expressed within a music therapy relationship is through the music.

Two case studies will be presented, the first of which will describe how musical countertransference became apparent within the context of the type of music improvised in a client’s sessions. The second will follow a lengthy series of countertransference-generated songs that emerged as a part of the therapy relationship. In both cases, exploring the therapist’s musical responses moved the therapeutic process toward deeper understanding of the clients’ internal worlds.

I actually only ended up presenting one case study (since it had all the elements I described). The biggest challenge was trying distill many years worth of therapy (and tons and tons of examples) into 90 minutes! 

As often happens, in the process of reviewing the (volumes of) notes and the songs and the music that came out of this man's sessions, I gained a lot of insight into some of the ways my countertransference reactions caused me to miss some aspects of what may have been going on with him at various points in the therapy. 

Honestly, there was just so much, and it's such a complex topic, I'm wanting to present this material again within a longer context (meaning, maybe a CMTE proposal is in order). 

Meanwhile, the third exciting thing was being a guest on the music therapy world's answer to The View- yes, I got to chat with the lovely ladies of The Music Therapy Roundtable! I mean, look! They even have their very own mug (and, see, they sent me one too). How cool! Heck, how organized! 

I got to blather on and on with Rachel Rambach (of Listen & Learn Music fame) and Michelle Erfurt (the original Boom Tote designer herself!) - their third partner, Kimberly Sena Moore was in transit so she couldn't join us - about one of my other favorite topics: professional clinical supervision! And you'll be thrilled (I'm sure) to know that I discovered I have a shocking tendency to rely on the word "um" while being interviewed. Oy.

And, if you've taken it to the next level and you're a Music Therapy Pro subscriber, you can listen to yet more of my incessant chatter on their Pro podcast. 

So that's what's been happening in my land. I'd love to hear what's going on in yours! 

Going South!

I know, I  know, where the heck have I been?! 


I'll tell you, it's been busy around here. Mostly, though, I've been preparing to present a five-hour CMTE at the national conference for music therapy in Atlanta next week! I haven't been able to attend a national conference in a few years now (not since 2006 when it was in Kansas City, MO!), so I must shout "hooray" that I'm finally able to go again (meaning, it's within driving distance). 


What will I be talking about (you may well be wondering)? "Developing the Art of Self-Reflection: Exploring the Relationship Between Therapists and Clients" (I mean, how would you recognize me if I didn't have a ridiculously long title?). 


I'm quite excited about it! From what I gather, so far anyway, there will be around ten people there, and that sounds like a very nicely sized group (although I imagine we could work just as well with a few more). I'm planning for a lot of interaction, music-making, and thinking (truly...who wants to sit for five straight hours and listen to me lecture? Well, lucky for you, I can't sit for that long these days). 


Anyway, here's the blurb. If you have any thoughts about the topic, do tell! If you end up coming to the presentation, I'm a fan of feedback!  I'm so looking forward to meeting those of you who are heading down to the conference (especially the lot of you I only know through online adventures). Safe travels!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Developing the Art of Self-Reflection: 

Exploring the Relationship Between Therapists and Clients

The relationship between therapists and their clients is an intimate one. When we add music, the level of intimacy increases. As with any relationship, as the level of intimacy increases, the levels of resistance, uncertainty, and investment also increase- on both the therapist's part as well as that of the client. One the one hand, we may put up unconscious barriers, preventing a deeper connection with our clients. On the other, we may become so merged as to be in danger of violating important therapeutic boundaries. As such, the music therapy relationship can become difficult to negotiate.

In this interactive workshop we will begin by defining countertransference. Using case examples, we will work toward an understanding of: What is it? Where does it come from? How does it affect therapy? How do we begin to identify and use countertransference in our work with clients?

Participants will then be invited to share some of the difficult aspects from their own work with particular clients that challenge them in some way. Through dialogue, journaling and music-making we will process and explore some of the following questions: What are some of the ways we use to avoid looking more deeply at some of the clinical challenges we face as professional music therapists? What are some of the beliefs and ideas we, consciously or unconsciously, hold about ourselves, about music therapy, about our clients? And how do these ideas and beliefs affect our work and our clients? Why are certain topics so difficult to bring up in sessions- even if we know our clients need us to do so? What is it about the topics? What is it about our beliefs and ideas that makes it scary? What kinds of messages are being communicated by us to our clients when we don't address difficult issues? 

Through these workshop experiences, participants will work toward developing the skill of self-reflection, using a variety of techniques to process thoughts and reactions that emerge in relationship to their clients. 

The Joys of Journaling

Image via WikipediaI will be conducting a workshop tomorrow evening (that would be on May 5th, or Cinco de Mayo, as it were) on The Joys of Journaling. It's a part of the Kardon Institute for the Arts Self-Care Series down in Philadelphia.


In honor of this event, I dug out my very first diary which I got for Christmas when I was ten years old. (I know, I know, why the heck is a person with a Jewish mother and a Muslim father getting Christmas presents? What can I tell you? We like giving/getting presents in our family, and we like Christmas songs. I mean, what's not to like?)


Anyway, I've been reading some of the things I wrote back when I was a mere 10, and I have to say they are hilariously funny and sort of poignant from my now forty-five year-old perspective. 


It's interesting (okay, and it's a little embarrassing) to re-visit my younger self and to remember what was so important back then that it caused me all manner of angst. 


It's been an absolute delight preparing for this workshop, because it's no longer (ahem) 1976, and the options for journaling have expanded exponentially. I mean, with the advent of technology (let alone the gradual expansion of my no longer all that young mind) there are, literally, no limits to the many fascinating and creative ways we can come up with to record and to explore our thoughts, feelings, reactions, ideas, identities, and general...stuff!


Admittedly, even though I very much enjoy writing (and reading!) blog posts, and I've certainly written my share of songs that started out in journal form, I remain true to my favorite form of journaling: I have a big stack of trusty wire-bound, college-ruled notebooks filled with the scribbling of whatever comfortable fine-tipped ball-point pen was serving me at the time. 


Now, the plan for tomorrow is to try out some journaling exercises, and I'm hoping to work some music-making in there as a part of the self-discovery process as well. I'll be taking along my little Flip camera and my tape recorder (yes, I did just say that- it's a great gadget, and I adore it for writing songs), so we can try out some alternative journal forms. 


I truly love the act of journaling (even though I sometimes actively avoid it for a period of time until I'm ready to jump in there and look at my stuff). The way I see it, journaling is a conversation I have with myself. 


In terms of being a music therapist, it's helped me define who I am, what I think about the work I do, and, most importantly, it's helped me to learn how to pay attention.


Writing in my diary gives me a chance to say things I can't say to my clients, and it helps me think about why I want to say those things in the first place. It gives me a chance to think through sessions that confound me, and it's a wonderful way to explore the things within me that make it hard for me to hear what my clients (and the other patient people in my life) are trying to say. 


I'm wondering if there are others of you out there who find journaling to be helpful in terms of deepening your work as a music (or any other kind of) therapist. I'd love to hear of your experiences. 

Can I get a witness?

Maddeningly, I managed to catch a cold the minute I returned to work. Well, I suppose it has to happen once in a while. As such, I've spent the last two days mostly napping and reading (and, of course, feeling guilty about missing work) (so much for my "perfect music therapist" fantasy) (ahem).


So, while I'm sneezing away here, I figure it's a good a time as any to post an update.


Update #1: The two taboo topics presentations seemed to go fairly well. There was a lot of dialogue, and a couple of people came up to me afterward and told me they had continued the conversation (some from last year) at their workplaces (which is very cool). 


Update #2: I submitted a proposal to do the CMTE (the one I just did at the Mid-Atlantic Regional conference) at the national conference (that would be for the American Music Therapy Association). I changed the title though (just the title). I proposed it as "Developing the Art of Self-Reflection: Exploring the Relationship Between Therapists and Clients". We shall see what happens. 


Update #3: I'm in the process of organizing myself (a task, I admit) so I can put a goodly portion of the work I did on the CMTE into a book (or a monograph of some sort).  Why am I telling you this (you may well be asking)? Because now that I've put it out into the blogosphere, I'll be forced to get on with it and do it! 


Update #4: I had a very touching experience (when I got back to work) with a small group of women who usually react to my absences by being quite challenging and doing a lot of testing and such. This time around, when I showed up on Monday, they all gathered closely around me while I sang "hello" to them. It was so sweet! And...


Update #5: ...the whole session was made even more phenomenal by the fact that their staff person (when approached by a client from another group who wanted to come and sing with us) very beautifully and kindly explained to her, "It's really nice that you want to come and sing, but this is a music therapy group, and Roia is working specifically with the ladies in this group on goals and stuff. She'll be here on Thursday to do the singing group, and you can go join her then." Sproing!!! Somebody shout "amen!" because that was probably one of the most respectful moments I've had in my career as a music therapist! I am so sending her boss a  happy note of "check out what your cool staff person said!"


I think that's pretty much the story so far. It was a good conference, I must say. It was particularly lovely to put some faces to names I know via Twitter and the music therapy list serv. And there were some really excellent and thought-provoking presentations. Another delight was gathering with music therapy colleagues and students to just play music togehter. Of course, staying up way too late probably contributed to my ending up catching a cold, but it was worth it. 

In case you were wondering...

...why it's taken me so long to post new blogs, it's because I've been working away at preparing for two workshops, including another five-hour continuing education presentation, at the Mid-Atlantic Regional conference of the American Music Therapy Association. 


Actually, it all started when I was asked to talk about taboo topics again (who'd have thought?), so I decided to split it up and do one version for students and one for professional music therapists. 


Here's where I was hoping to head with the student version ("Taboo Topics in Music Therapy: What They Didn't Mention in School"):

Music therapy training often focuses on helping students to develop techniques and skills in order to support clients’ goals and objectives. It is only when we begin to work, first in field experiences, then in internships and eventually professionally, that we realize there are some topics that weren’t really addressed in our training. How on earth do we deal with clients who masturbate openly in the middle of music therapy sessions? What is the appropriate professional way to work with a client who has a crush on us? What if we are sexually attracted to one of our clients? How do we manage and come to terms with being a music therapist when we are coping with our own mental illness?  What is the best course of action when we are dealing with a client who pushes all of our buttons?


These are the kinds of questions student music therapists ask themselves every day, and the answers aren’t always readily available in journals, conferences, in listserv discussions, or even in life.


As therapists we are taught: what we repress we project. Without a safe space within which to bring up such topics, and without support and guidance from mentors, clinical supervisors or peers, music therapists run the risk of acting out their shame and discomfort. This can lead to burnout or, worse, unethical behavior.


The focus of this participatory workshop will be on providing a forum for student music therapists to give voice to their experiences and to have their concerns validated. This year we will dig a little deeper into why these issues aren’t being talked about and try to come up with some constructive ways we can use to figure out how to get the support we need to address the difficult topics.

The five-hour workshop will be a bit more intense (as it ought to be), and it's geared (of course) to professional music therapists. I don't know about you folks, but remember when I asked what your thoughts were about doing a follow-up workshop? Well, as I looked over "The List (So Far)" I realized that out of 33 items, something like thirty of them (seriously! Thirty!) were related to the therapy relationship in some way, shape, or form!

So.

I decided to go for it and do a CMTE (yes, a whole five hours) where we get to look at the therapy relationship (this one is called "Taboo Topics in Music Therapy: The Intimate Connection Between Therapists and Clients"). Here's the plan of action for the workshop:


The relationship between therapists and their clients is an intimate one. When we add music, the level of intimacy increases. As with any relationship, as the level of intimacy increases, the levels of resistance, uncertainty, and investment also increase- on both the therapist’s part as well as that of the client. On the one hand we may put up unconscious barriers, preventing a deeper connection with our clients. On the other, we may become so merged as to be in danger of violating important therapeutic boundaries. As such, the  music therapy relationship can become difficult to negotiate.


In this interactive workshop we will begin by defining countertransference. Using case examples, we will work toward an understanding of: What is it? Where does it come from? How does it affect therapy? How do we begin to identify and use countertransference in our work with clients?


Participants will then be invited to share some of the difficult aspects from their own work with particular clients that challenge them in some way. Through dialogue, journaling and music-making we will process and explore some of the following questions: What are some of the ways we use to avoid looking more deeply at some of the clinical challenges we face as professional music therapists? What are some of the beliefs and ideas we, consciously or unconsciously, hold about ourselves, about music therapy, about our clients? And how do these ideas and beliefs affect our work and our clients? Why are certain topics so difficult to bring up in sessions- even if we know our clients need us to do so? What is it about the topics? What is it about our beliefs, ideas that makes it scary? What kinds of messages are being communicated by us to our clients when we don’t address difficult issues?


Through these workshop experiences, participants will work toward developing the skill of self-reflection, using a variety of techniques to process thoughts and reactions that emerge in relationship to their clients. 

But I'm wondering if maybe this topic is too taboo. So far I've only got three people signed up (and it's happening in a little over two weeks). When I consulted with a psychiatrist friend to ask her if she thought I ought to cancel if our group was so small she (wisely, I think) pointed out that doing so would convey to people that the subject should and would remain a taboo- never to be looked at by music therapists. 

So, I'm kind of thinking I'd like to go for it. A small but mighty little group can do amazing things, I imagine. 

I'd be curious to hear if you folks out in blog-reading land have any thoughts about this. Do you think I ought to cancel the whole schmear? Might this topic actually be a little too close to home for people? 

So, here's a question for you, happy readers...

Back in April of this year (yes, the one that's passing us by so quickly) I had a series of posts about a presentation I did at the Mid-Atlantic Regional Conference of the American Music Therapy Association on Taboo Topics in Music Therapy (Part I was the Introduction, Part II was the handout, and, of course, Part III- which was The List).



I was asked by the conference chairperson if I would do a follow-up, because it was an interesting topic (thank you) and because people felt as if we'd barely scratched the surface of the issue (very true).


So, I'm thinking and agonizing (shocking, I'm sure- I mean, who would have ever thought I, of all people, would think and agonize?) over which aspects of the vast array of taboos to talk about.


Here are some options I've got floating around in my mind: 


*We could take the handout (which I could happily reprise), have people fill it out and use  participants' case examples to look at as a group. 


*Or we could take a specific aspect of The List (So Far) and focus on a particular topic. Some examples of that could be:


*"Feelings for and about our clients and our clients' feelings about us" (which could be an entire graduate class, frankly)


*"Fantasies we have about ourselves and our clients" (these could include fantasies that we'll fix our clients' lives, we'll make them happy, rescue fantasies and beyond)


*"What to do when you make a mistake" (my friend Judy and I did this one a few years ago, "The Myth of the Perfect Music Therapist, or How I Learned to Stop Worrying and Love My Mistakes", and I've been trying- trying, I tell you- to post the handout, but for some reason it's just not working properly) 

*And, a variation on the above theme, "Feelings of incompetence as a music therapist" (which could get awkward).


I'm sure there are more options. I'm thinking that the ones I've mentioned are things I could talk about with some intelligence/experience. I would be willing to tackle, or at least create a forum, for other issues on the list (fears of clients committing suicide, fears of getting attacked, clients and boundary violations- particularly in the age of social media and such, therapist/client prejudices, and so on and so forth). 


Here, of course, is where my question to you, kind blog readers, emerges:  


If you had a choice (and some of you may, because some of you live in this region), which aspects of taboo topics would you want to explore in a presentation?


I'm presuming that I would probably only have about an hour and a half to hash out heavy stuff. It is, of course, possible to put in two proposals and I could ask if I could do two presentations, both of which would be follow-ups to last year's talk.


So have at it, folks. I look forward to your thoughts/comments! 

The myth of the perfect music therapist or How I learned to stop worrying and love my mistakes

Back in 2006 my friend, Judy Belland (brilliant music therapist turned happy music librarian), and I presented at the Mid-Atlantic Regional music therapy conference in 2006 (which was in Pittsburgh that year- seems I keep presenting stuff in Pittsburgh...anyway) on "The Myth of the Perfect Music Therapist or How I Learned How to Stop Worrying and Love My Mistakes".


Recently, my blogging friend, psychotherapist Tamara Suttle (whose blog, Private Practice From the Inside Out is on my hit parade) wrote about making mistakes as a therapist. 


Reading her blog reminded me that I've been meaning (since January, for crying out loud) to post the handout Judy and I put together. So here it is, mistakes and all (just a little perfectionista humor there). Thanks, Tamara, for the reminder/encouragement! 


Note: The original version has a How To Write a Process Paper, which you can find here. 

Questions to ponder

• What is my fantasy of "The Perfect Music Therapy Session"? What does it mean when it doesn't go as I planned/hoped/fantasized?
• What does it mean when our clients fail (about us, about our clients, about music therapy)?
• What do I see as "the rules" for how a music therapist should be, what a music therapist should do, how clients should respond, etc.? (i.e., I should never become impatient with my clients or lose my temper, it's my job to make my clients happy)
• What is a mistake? What do I mean when I say I've made a mistake?
• What kinds of mistakes concern me most (i.e., verbal, musical, interpersonal, procedural, ethical)?
• How do I handle it when I make a mistake? Do I acknowledge that I've made a mistake? Do I even recognize when I've made a mistake?
• How have mistakes I've made affected the therapy relationship?
• What am I modeling for my client(s) when I make a mistake? (i.e., do I address it directly, do I deny that I made a mistake, do I apologize for the mistake?)
• What are my fears in terms of making a mistake? What are my fantasies of what could happen if I make a mistake?
• What might my clients think if I make a mistake? (In other words, what is my fantasy of what my client(s) (will) think(s)?) How do I believe my colleagues would react?

What if making mistakes not only isn’t the end of the world

but actually helps the therapy process?

o    Look at why a particular mistake is being made.  Do I have a pattern of making the same mistake?  (i.e., forgetting someone’s name all the time) What might that mistake be about?

o    Is my mistake related to countertransference (i.e., a client reminds me of my mother) or is it more related to the client (i.e., a lot of people in this client’s life find themselves making this “mistake” with or reacting in a particular way to him/her)?

o    What was going on in the session when this mistake occurred?  How was I feeling about the client(s)?  About how the session was going?  What made me respond in the particular way that I chose?

o    Did I have an expectation—about myself, about my client, or about the therapy—that I wasn’t aware of initially?

o    How can I use an awareness of my mistakes to further develop the therapy relationship?

o    What does it mean to me to be a “good enough” therapist?

Resources for Further Reading

Bruscia, K. (Ed.) (1998). The dynamics of music psychotherapy.  Gilsum, NH:  Barcelona Publishers.

Casement, P.  (2002).  Learning from our mistakes:  Beyond dogma in psychoanalysis and psychotherapy. New York:  The Guilford Press.

Casement, P. (1991).  Learning from the patient.  New York:  The Guilford Press.

Chodron, P. (2002).  Comfortable with uncertainty:  108 Teachings.  Boston:  Shambhala .

Dileo, C. (2000).  Ethical thinking in music therapy.  Cherry Hill, NJ:  Jeffrey Books.

Epstein, M. (1998).  Going to pieces without falling apart:  A Buddhist perspective on wholeness:  Lessons from meditation and psychotherapy.            New York:  Broadway Books.

Figley, C. R. (Ed.)            (1995)            Compassion fatigue:  Coping with secondary traumatic stress disorder in those who treat the traumatized (Brunner/Mazel Psychosocial Stress Series). New York:  Brunner/Mazel.

Forinash, M. (Ed.) (2001).  Music therapy supervision.  Gilsum, NH:  Barcelona Publishers.

Gabbard, G. O. & Lester, E. P. (1995).  Boundaries and boundary violations in psychoanalysis.  New York:  Basic Books.

Hutto, B.  (2001).  Some lessons best learned from psychotherapy supervision.  Retrieved: 2/4/06 from http://www.psychiatrictimes.com/p010753.html.

Kottler, J. A. (2003).  On being a therapist (Third Edition).  San Francisco, CA:  Jossey-Bass.

Kottler, J. A. & Carlson, J.  (2003).  Bad therapy:  Master therapists share their worst failures.  New York:  Brunner-Routledge.

Lovett, H.  (1996).  Learning to listen:  Positive approaches and people with difficult behavior.  London:  Jessica Kingsley.

Mayeroff, M. (1971).  On caring.  New York:  Harper & Row.

Misch, D. A. (2000).  “Great expectations:  Mistaken beliefs of beginning psychodynamic psychotherapists”. American Journal of Psychotherapy, (54)2; 172-203.

Pope, K. S., Sonne, J. L. & Holroyd, J. (1993).  Sexual feelings in psychotherapy:  Explorations for therapists and therapists-in-training.  Washington, D.C.: American Psychological Association.

Saakvitne, K. W. & Pearlman, L. A. (1996).  Transforming the pain:  A workbook on vicarious traumatization. New York:  W. W. Norton.

Schlesinger, H. J.  (2005).  Endings and beginnings:  On terminating psychotherapy and psychoanalysis            Hillsdale, NJ:  The Analytic Press.

Skovholt, T. H. (2001).  The resilient practitioner:  Burnout prevention and self care strategies for counselors, therapists, teachers, and health professionals.            Needham Heights, MA:  Allyn & Bacon.

Van der Klift, E. & Kunc, N.  (1994).  Hell-bent on helping:  Benevolence, friendship, and the politics of help Retrieved 9/23/05 from http://www.normemma.com/arhellbe.htm.

Weinberg, G.  (1996).  The heart of psychotherapy:  A journey into the mind and office of the therapist at work. New York:  St. Martin's Griffin.

Yalom, I. D.  (2002).  The gift of therapy:  An open letter to a new generation of therapists and their patients. New York:  Harper Collins.

Yalom, I. D.  (1989). Love's executioner and other tales of psychotherapy.  New York:  Harper Collins.

Taboo Topics in Music Therapy- Part II- The handout

Here, as promised, is the handout from the presentation. If you'd like to use it in some way, please do. Just kindly give me credit, eh? 

Taboo Topics in Music Therapy

March 26^th, 2010

Mid-Atlantic Region Music Therapy Conference, Pittsburgh, PA

It’s the stuff we don’t look at and we don’t talk about that gets us into trouble.

Identifying Personal “Taboos”

Part 1

Clues that something may be going on in sessions that needs exploring (some parts of the following list have been taken directly from Pope, Sonne, and Greene’s book What Therapists Don’t Talk About: Understanding Taboos That Hurt Us and Our Clients):

• Avoiding certain topics
• Changes in how you are using the music in your sessions (i.e., using more music than usual, less music than usual, noticing a particular musical pattern, etc.)
• Doing the same thing with every client/group
• Finding yourself bored or unusually tired/drowsy during sessions
• Having a particularly strong reaction to a specific client
• Obsession
• Seeking repeated reassurance from colleagues
• Creating a secret
• Fantasizing or daydreaming about a client
• Increase in physically handling or touching a client
• “Forgetting” the therapy goals
• Feeling extremely uncomfortable with a client
• Feeling embarrassed by your reactions to a particular client

Part 2

In the process of exploring, ask yourself a lot of who/what/why/how/when/where questions, such as the following:

• What’s going on for me in this situation? What is my reaction to this client/group/staff person/situation? What’s going on in my life?
• Why am I reacting in this particular way? To this particular client/group/situation? What’s going on in the session?
• Whose need am I meeting?
• What information do I have/need to try to figure this out?
• Do I have this reaction to all of my clients or is it just with this person?
• How has my use of music with this client changed?
• Has there been an overall change in how I interact with this client?
• Has there been a role reversal (where I feel as if my client is acting more like a therapist than I am)? Why might that be?
• What is different about the way I’m interacting with this client versus how I interact with my other      clients?
• When did my behavior with this client shift? Was there a specific incident that I recall?
• Has a client (or have I) ever done something that put me in a very awkward or uncomfortable position? Have I worried that other people would find out?
• Have I ever tried to justify my behavior with a particular client?
• Have I been avoiding discussing this situation/my feelings with a trusted colleague or clinical supervisor? Or have I only talked about it peripherally or in an “edited” way?
• With whom can I discuss this situation and get some guidance/support?

Part 3

Situations/encounters/issues I’ve had in my experience as a music therapist that I have avoided talking about, feel ashamed about, I’m not sure how to handle, or that have made me very uncomfortable:

1.

2.

3.

Referring back to each of the situations you described above:

When (Situation #1) _______________________________________________happens/happened I feel/felt:  ________________________________________________. This affects/has affected me/my work in the following ways (i.e., made it difficult for me to work with a particular client/group, created an uncomfortable work situation, kept me from doing something I should have done, led me to do something I wouldn’t otherwise have done, or I don’t know if it has affected my work):

Some of the actions I take/have taken to address the situation/encounter/issues are:

a.

b.

c.

When (Situation #2) _______________________________________________happens/happened I feel/felt:  ________________________________________________. This affects/has affected me/my work in the following ways:

Some of the actions I take/have taken to address the situation/encounter/issues are:

a.

b.

c.

When (Situation #3) _______________________________________________happens/happened I feel/felt:  ________________________________________________. This affects/has affected me/my work in the following ways:

Some of the actions I take/have taken to address the situation/encounter/issues are:

a.

b.

c.

Looking at our resistance

Some of the reasons I have had for not talking about the above situations/encounters/issues are (try to be as specific as you can in describing your feelings and beliefs):

a.

b.

c.

Identifying Resources

Here are some people with whom I feel safe enough to discuss these situations/encounters/issues (i.e., a clinical supervisor, a music therapist whose work I admire, a current or former professor, a trusted colleague, a personal therapist, a group of peers, an online community- in all cases, bearing in mind the matter of client confidentiality, other resources, etc.):

a.

b.

c.

---

References, Books, and Articles I’ve Found That Are Helpful or Thought-Provoking

Bridges, N. A. (1998). Teaching psychiatric trainees to respond to sexual and loving feelings: The supervisory challenge. Journal of Psychotherapy Practice and Research. 7, 217-226.

Bright, R. (1996). Grief and powerlessness: Helping people regain control of their lives. London: Jessica Kingsley Publishers.

Corbett, A. (2009). “Words as a second language: The psychotherapeutic challenge of severe intellectual disability” (45-62) in (Cottis, T., Ed.) Intellectual disability, trauma and psychotherapy. New York: Routledge.

*Corey, G, Corey, M. S., & Calllanan, P. (1998). Issues and ethics in the helping professions (5^th Ed.). Pacific Grove, CA: Brooks/Cole Publishing.

Davies, A. & Sloboda, A. (2009). “Turbulence at the boundary” in  Odell-Miller, H. & Richards, E. (Eds.) Supervision of music therapy: A theoretical and practical handbook, in Schaverien, J. (Series Ed.) Supervision in the arts therapies, New York: Routledge. 

*Dileo, C. (2000). Ethical thinking in music therapy. Cherry Hill, NJ: Jeffrey Books.

Dileo, C. (2001). “Ethical issues in supervision” in Forinash, M. (Ed.) Music therapy supervision. Gilsum, NH: Barcelona Publishers.

Foster, N. (2007). ’Why can’t we be friends?’ An exploration of the concept of ‘friendship’ within client-music therapist relationships. British Journal of Music Therapy. 21(1), 12-22.

Gabbard, G. O. & Lester, E. P. (1995). Boundaries and boundary violations in psychoanalysis. New York: Basic Books.

Gabbard, G. O. (1996). Love and hate in the analytic setting. Northvale, NJ: Jason Aronson.

Hunter, M. & Struve, J. (1998). The ethical use of touch in psychotherapy. Thousand Oaks, CA: Sage Publications.

Kim, J. (2009). First love- An idealized object in music therapy. Voices: A World Forum for Music Therapy. Retrieved from http://www.voices.no/mainissues/mi40009000333.php

Koo, M. B. (2001). Erotized transference in the male patient-female therapist dyad. Journal of Psychotherapy Practice and Research. 10, 28-36.

Kottler, J. A. (2003). On being a therapist (3^rd Edition). San Francisco, CA: Jossey-Bass.

Kottler, J. A. & Carlson, J. (2003). Bad therapy: Master therapists share their worst failures. New York, NY: Brunner-Routledge.

Misch, D. (2000). Great expectations: Mistaken beliefs of beginning psychodynamic psychotherapists. American Journal of Psychotherapy. 54(2), 172-203.

Oosthuizen, H. (2009). “Some thoughts on being a white music therapist” Voices: A World Forum for Music Therapy. Retrieved from http://www.voices.no/columnist/coloosthuizen021109.php

*Pope, K. S., Sonne, J. L. , & Holroyd, J. (1993). Sexual feelings in psychotherapy: Explorations for therapists and therapists-in-training. Washington, DC: American Psychological Association.

*Pope, K. S., Sonne, J. L., & Greene, B. (2006). What therapists don’t talk about and why: Understanding taboos that hurt us and our clients. Washington, DC: American Psychological Association.

Richards, E. (2009). “Whose handicap? Issues arising in the supervision of trainee music therapists in their first experience of working with adults with learning disabilities” in  Odell-Miller, H. & Richards, E. (Eds.) Supervision of music therapy: A theoretical and practical handbook, in Schaverien, J. (Series Ed.) Supervision in the arts therapies, New York: Routledge.

Rolvsjord, R. (2006). Whose power of music? A discussion of music and power-relations in music therapy. British Journal of Music Therapy. 20(1), 5-12.

Searles, H. F. (1979). Countertransference and related subjects: Selected papers. Madison, CT: International Universities Press, Inc.

Van der Klift, E. & Kunc, N. (1994). Hell-bent on helping: Benevolence, friendship, and the politics of help. Retrieved 9/23/05 from http://www.normemma.com/arhellbe.htm

Ulman, K. H. (2001).  Unwitting exposure of the therapist: Transferential and countertransferential dilemmas. Journal of Psychotherapy Practice and Research. 10(1), 14-22.

Yalom, I. (1989). Love’s executioner and other tales of psychotherapy. New York, NY: Perennial Classics.

* Books that are particularly useful.

Copyright 2010 Roia Rafieyan