Well, what do you know?

I was minding my own business, journaling away last Sunday morning, listening to (yet another excellent episode of) On Being, where Krista Tippett was interviewing Lawrence Krauss, a theoretical physicist. The aspect of their conversation that caught my attention was this comment: 

Mysteries are what it's all about. In fact, not knowing is much more exciting than knowing, right? Because it means there's much more to learn. The search is often much more exciting than the finding. Mysteries are what drive us as human beings. 

He extended the idea by noting:

One of the values of science is to make us uncomfortable. Somehow that's supposed to be a bad thing for many people, being uncomfortable. Being uncomfortable is a good thing because it forces you to reassess your place in the cosmos. And being too comfortable means you've become complacent and you stop thinking. 

As I listened to him I realized something kind of interesting: I think not knowing is what has kept me passionately in this field for so long. 

Think about it a second. 

When we think we know (the answer, what's going on, what someone's problem is, how things should look, who someone should be, and so on and so forth) we are no longer learning, no longer curious. We stop at the surface, and, because we know then we presume there's nothing else to think about or to find out.

When we're new professionals we either think we know or we think we're expected to know most of what there is to know about music therapy. What we often don't realize is that all we know are the very basics- that there's a whole world of knowing we haven't even begun to come in contact with yet!

It took me a lot of years (and a lot of clinical supervision) to finally understand that my real job as a music therapist is to go out there and ask my clients what they need me to know and learn in order to better support them. 

So many times in my younger (pre-clinical supervision) music therapy days I went into sessions knowing what needed to be done to "help" my clients. I didn't ask, I wasn't curious about what was going on or why my clients might need to be or do things the way they were being or doing things. They were disabled. There was a list of things I knew about disabled people. There was a list of ways music was supposed to "help" disabled people. 

So I went in with my music therapy interventions, applied them, and waited for the activities to work. This is what I was taught (or at least this is what I understood of what I was taught). And when my interventions didn't work I was frustrated with my clients and wondered, "what the hell? Why isn't this working? This is what I was told to do!"

Somehow I had inadvertently stepped into the medical model of music therapy: "Here are the symptoms associated with a particular population of people. Liberally apply music therapy activities to alleviate said symptoms and to increase skills. Music is, after all, intrinsically reinforcing. Success." 

In other words, I'd go into sessions with the attitude of "I know what the problem is, and I know the solution." Except that I wasn't having a lot of success.

Finally I got myself some clinical supervision, and I learned about process-oriented, relationally-based music therapy. But when I stopped doing activities and began to use an improvisational approach, I was terrified! I had no idea what to do- ever. I was convinced I'd failed as a music therapist, because I didn't know anything any more! 

Add to that fact that I work in an institution, and institutions are notoriously entrenched in the all-knowing medical and behavioral model of understanding people. Sitting there quietly with someone (because I didn't always know what to do) and singing about what that person was doing or what I thought it might be about (as opposed to gathering everyone in a circle- or trying to- and forcing them to play instruments with hand-over-hand assistance) was an open invitation to criticism and "why are you just sitting there doing nothing, Roia?" 

But I trusted my clinical supervisor who told me "trust the process". 

As time went on, I discovered the joy in finding out who my clients actually were and began to appreciate the opportunity to get to know them in a more authentic and human way. I got more comfortable with the idea of going into a session and not knowing - not knowing what was going to happen, not knowing (yet) the person in front of me, not knowing exactly what music would be needed that day, not knowing if I was hearing my client properly, not knowing if what I offered was going to be accepted or even make sense. 

And that engaged me in the work of becoming and being a music therapist like nothing ever had! I began to understand music therapy from a whole new perspective: 

We are artists, and we are scientists, and art and science are not about knowing. They're about trying something out (an idea, a hypothesis, some direction) and discovering, or messing up, making mistakes, and figuring out better questions to ask. They're about not knowing, about wondering and curiosity, and finding out what we don't realize we don't know. 

That's amazing to me! And waking up every morning with the thought, "I wonder what will happen today with my clients," and being completely curious excited about that, is what drives my passion for music therapy. Even after doing this for 26 years!

To borrow from Lawrence Krauss again:

In fact, what's really beautiful is every time we make a discovery in science, we end up having more questions than answers.

Yes! 

Fifty shades of "no"

I've been sitting and stewing over the fact that one of my clients decided not to come to his session yesterday. Obviously, it's not the end of the world, and it's mostly likely he'll be back. But I know he's upset with me and he's struggling with a lot of feelings because of the difficult work we're doing right now.

Occasionally, clients with whom I've developed a fairly stable relationship (and I can tell you, that has usually come after quite a long time of working together- usually years), who I can almost always count on to be there for their sessions, refuse to come to music therapy. 

And  when I say "refuse to come to music therapy" I mean I've walked over to their building, signed them out, collected their outer gear, walked in to the group where they spend their days (along with the rest of the people who live with them and along with their staff people), and asked, "would you like to come to music therapy today?" 

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I'd like to pause here to say what a vulnerable moment this is- for me anyway- as a music therapist. I mean, I'm standing there, exposed, and, honestly, it's like inviting someone out on a date in front of their entire family. Only it's therapy (which is just as intimate as a date, if not more so at times) and the other people in their group may have feelings about this particular person being invited to go to music therapy (when they themselves are not being invited) and their support staff who usually have their own feelings about the person who's scheduled for music therapy as well as a series of opinions about me and what I represent (sometimes good and sometimes not so much). Additionally, support staff have a series of beliefs and understandings (usually passed down from their supervisors) about their role in clients heading out to programs (such as music therapy). Commonly, those beliefs and understandings involve making sure the person is clean and tidy and goes and does what s/he is supposed to be doing. 

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Now, most of the time, the folks I've worked with for a long time jump up and come over on their own and then pull me to the door. Others go and sit in their wheelchairs, waiting for me to take them out. Some people who have a harder time initiating actions or simply have a lot of physical involvement making it more difficult for them to stand and greet me, wait for me to approach them and let me know they want music therapy that day by making an effort to get up and go with me.

Over the years I've discovered a large (and important) part of my work is figuring out how my clients (most of whom don't use speech) communicate "no".  Some people (the ones who usually hop up to meet me) simply don't get up when I appear and remain seated. Some (who need more physical assistance) let me know by not allowing me- or just not helping me- to put on their coats. Others avoid going toward the door, and I've had a couple folks  pretend (vigorously) to be asleep. A few of my clients will come part of the way with me and then stop repeatedly or keep going in the "wrong" direction, and still others come to the session, wet themselves and have to return to their buildings to get their clothing changed. 

The gentleman I went to pick up yesterday is someone who usually gets up the minute he sees me and comes quickly over to take me by the wrist and pulls me toward the door. His "no" came after a particularly hard series of sessions in which I've been challenging his way of thinking about me and about the role of music therapy. 

His "no" started when he stayed seated, looking at me with a rather unhappy face, leaning his head on his hand. I wondered (out loud to him) if he had a headache (it was pretty loud) or if he was tired (sometimes he doesn't sleep too well). I waited a short time and then I told him I'd go out for a few minutes, come back and check again with him. "If you still don't want to come, that's fine, and I'll check in with you again next week."

So I went and stood in the hallway for three or four minutes and then tromped back in with my armload of sweatshirt, coat, gloves and a hat for him. He still didn't move. 

Mercifully, his support staff didn't tell him to "get up" (which is what usually happens, and, when they do that, he usually stands up and comes with me, but I'm well aware the entire time that he would not have been there had they not told him to be, which, I think we'd agree, is an awful feeling- for both of us). 

I offered to sit with him for a bit, because sometimes he actually needs some more transition time (or to just think about whether he really wants to skip music therapy that day- and it's very rare that he does), but he still didn't get up. 

Just as I was about to turn and leave, he got up and walked past me to the table (where there was more space for me to sit with him and also plastic blocks he likes to hold). He couldn't find any blocks (they were all zipped into a bag, and I guess he didn't want to mess with it just then), and he went to sit down in another chair. This time there was space next to him, so I sat down and pulled off my hat. 

I invited him to let me know if he wanted me to leave by looking toward me and if he wanted me to sit with him to indicate this by tapping my arm. He glanced my way, fleetingly, twice and made no move to grab my hand (which is what he generally does). 

"Okay then. I'll check in with you next week. I'm glad you let me know you didn't want to come today, and I'm glad you let me know you'd rather I don't sit with you right now."  

I wished the guys a decent weekend and headed out into the hall, kind of hoping he'd change his mind and come after me. He did not. 

I headed back to the Music Room, pondering the whole thing, reminding myself that he was likely wanting me to feel as rejected as he'd probably felt in our session. 

But then the inevitable worry began: Did I say something in the wrong way in his last session? Did I accidentally offend him? Did I hurt him by saying something he wasn't ready to hear yet? Is it irreparable? Will he give up and stop coming to music therapy? 

As I was pondering these questions, yet again, this morning, I realized, not only is this the usual litany I go through when a client chooses to not come to music therapy on a given day, but my confusion- my wondering what happened, did I do something wrong, will this person leave- probably very much mirrors the feelings my clients have had with regard to their families placing them in an institution.

Perhaps (along with "no") I was "hearing" his (and many of my clients') experience of ambiguous loss,  which is a loss that doesn't have clear closure and around which there are questions and a great deal of uncertainty. It's often thought of in terms of families' feelings regarding a child who is disabled or mentally ill or a parent or spouse who has Alzheimer's (for example), but there is little, if anything, written about the experience of the person whose family sees them as "gone" or "lost" to them because of their disability. 

When I arrived back in the Music Room, I found myself singing the following song, and once again, I felt amazed at the way our minds speak to each other through music.

"He's not cranky- he's mischievous."

Her exact words were "he hasn't been cranky- he's been mischievous!" 


I was thinking about what she'd said the previous day about S as we started our session.  As his support staff, she probably was finding him to be rather frustrating. But, in my mind, there has to be a reason for it. 


What does it mean when someone's being mischievous? What if he's learning to assert himself? What if this means he now has enough of a sense of 'self' to assert? And he's not there yet, but he's trying to figure out what having a 'self' means?


That's kind of cool!

Now, back to S in his music therapy session. He was very quiet. His music was also quiet- contemplative, more interactive (in contrast to his usual energetic crashing and playing with great energy and a few brief pauses). He didn't play when I played. He was clear that this was a conversation, not a jam session where we play together. 


Self and other. Separate beings.


Wow. A major developmental step!

A modern chorus line (Photo credit: Wikipedia

A part at the very end of the first song from A Chorus Line ("I Hope I Get It") came to my mind as we stood together (a part which, frustratingly, they didn't include in the video I'm linking):

Who am I anyway? 

Am I my resume? 

That is a picture of a person I don't know. 

What does he want from me? 

What should I try to be? 

So many faces all around, and here we go. 

I need this job. 

Oh, God, I need this show.

I sang it for him, and I talked a little bit about the context for the song. It's sung by a man auditioning for a part as a dancer in a chorus line- which, to me anyway, seems to be a sort of anonymous group of dancers in a Broadway play- the goal of which is to be as uniform and in unison as possible. The character who sang this section of the song was thinking about his identity. I interpreted the lyrics as saying here's a man who is trying to come to terms with the face, the persona he has to present in order to get a job as a dancer.

I connected it to how I thought perhaps S might feel as a man with a disability who lives in an instituionalized setting. Having to put on a face (a persona), perceived by people, based on his behaviors and what is written about him in the institutional paperwork. 


Perhaps he too is wondering: who am I anyway? Who or what defines me? How do I define myself? And what does it mean in terms of safety, my identity as a man, as a disabled person?

Again, his musical responses (taps on the drum or tambourine) were very thought out and short.

We had about 5 minutes to go. I invited S to help me know if I'd been on the right track (by glancing my way) or if not (by making a sound). After a while, he looked my way, and he went slowly to the door and walked out.

Thinking he was done with me (and that either I was way off and misunderstood him- or he needed a bathroom, or maybe he felt a bit overwhelmed), I packed up my stuff. 


I was just about to follow him out, when he reappeared at the door!

He came back over, and I took out my guitar again. I sang a goodbye, in it telling him how excited I was for him. This is a truly important, although difficult, period in his life- one with the potential to offer him growth and a deeper self-awareness. He stayed until we finished, tapped the tambourine goodbye, and we walked slowly back to the day area.

Once we got there, he hovered near me (he doesn't usually). Then he reached into my instrument bag and borrowed the tambourine again, tapped it a few more times, put it back in the bag, and he headed off slowly in a different direction. 


See you later, S. 

Behavior? Or unanswered question?

Image via Wikipedia
For at least the twelfth time in the last few years, I sat in a session today with one of my (many) clients who doesn't use speech, asking him if he might put his thoughts and reactions to the fact that we hadn't seen each other in two weeks (because I was away at the music therapy conference) into the music, and I was struck by the thought, "Geez, what if he has questions that he wants me to answer?"


I don't know whether anyone else ever wonders about this, so I'm throwing it out into the blogosphere, because it bugs me. 


All of us have questions, and when we're little kids we have about a million of them! And we ask our parents (and aunts and uncles, and any adult person, frankly) at least nine hundred thousand of the many gazilions of questions that happen to come into our excited little curious minds.


But...my clients who don't use speech can't do that! And who's to say they don't have a million questions of their own? Yet, how do you ask all your questions when talking isn't your thing?


So, as I've given this some thought, my theory is that the folks I work for are sort of forced to come up with other ways to get their questions answered. And those ways may involve doing some unusual things- maybe we could call them experiments- although more likely we call them "behaviors"- which often seems to imply "doing something that someone finds aversive, offensive or annoying and must attempt to stop".


Hm.  


Well, what if those "behaviors" and unexpected and odd things that this person is doing are really about asking questions that s/he needs to have answered? And what if instead of listening and collaborating to try to help figure out the question/answer, we're focusing on the fact that the "behavior" must go? 

Journal Prompt #5: A person of interest

Image by On Being via Flickr
...And are we not of interest to each other?


The very last line of Elizabeth Alexander's poem- to which I'd only been half listening as I prepared breakfast with the radio on- came into my consciousness in such a profound way that I literally tripped over the garbage can, knocking it over, on my way to the computer to go and find it and re-read the whole thing.   


And I again came to rest on the last line:


...and are we not of interest to each other?


How beautiful!


You are by now, I'm certain, well aware of my love of good questions. So, as you can imagine, on principle, I love Elizabeth Alexander's ideas about poetry and how it leads to inquiry. Here is what she had to say about the matter in the interview she did with Krista Tippett from On Being:


I was thinking about the act of asking real questions in poems as a kind of spiritual practice. I ask questions relatively often in poems and I ask them because I don't know the answer. And I ask them because I think that poems are fantastic spaces with which to arrive at real conundrum kinds of questions, to go as far down the road as you can of understanding something and then sometimes that road ends with a real question.


I wonder if one might describe the process of music therapy (and, indeed, maybe someone already has) as a form of collaborative poetry-making and inquiry- an effort to create an evolving piece of relational art- one that often ends with more questions than answers. And one that invites deep self-reflection and, as my mother (who is a poet) often points out, frequent editing. 


...and are we not of interest to each other?


Elizabeth Alexander elaborates:


[The question] ...to me isn't about, oh, you know, I like her shoes or ...he has a fascinating job. It's much deeper than that. Our human beings who are in community, do we call to each other? Do we heed each other? Do we want to know each other? And I think reaching across what can be a huge void between human beings.

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As you consider your work as a music therapist (and as a participant in life), you might ask, not only do we interact with each other, but how do we interact with each other, who are we to each other, and in what ways are we with each other?


More questions to ponder: 
*Are my clients "of interest" to me? In what ways are my clients "of interest" to me? As in, what do I mean when I think of someone as being "of interest" to me? How do I define "interest"? Is it as "you're an interesting person"? Or is it deeper than that? And how deep am I willing to go?


*Are my clients "of interest" in terms of how I am defined when I am with them? Are they "of interest" in terms of: "This is who I think you are in relation to me"? In other words, is the "interest" defined largely by the roles we play? And how willing/comfortable am I to look beyond the assigned roles?


*Does being "of interest: mean that I know certain things about you as my client? And how does that affect the power dynamics in our relationship? On another level, what and how much am I willing to know about you? 


*What do I, as your music therapist, want you, the person called my client, to know about me? Are there things I wish you could know about me? And whose need am I meeting in wanting that?  


*What if our clients don't hold our interest? What then? 


My deepest thanks to Elizabeth Alexander for her inspiring poem and to Krista Tippett for the willingness to "go there" in her interviews! 


You can read the entire poem and learn more about Elizabeth Alexander and her books of poetry here. And you can listen to (or read) the entire conversation (and many other engaging interviews) with Krista Tippett here.

Journal Prompt #2 (Who are you again?)

Image via WikipediaWow! First, let me thank all of you who were kind enough to join me in this path of self-reflection and exploration! It has been so neat to hear from you and read your thoughts and responses. I've truly been honored that you've taken the time to share your experiences, and I'm excited to hear/read/see more as we progress!


For my part, I have started to make short videos after some of my sessions (particularly with clients who challenge me or about whom I find I have a lot of feelings) in which I share my thoughts and reactions regarding the therapy experience on that particular day and then play a musical improvisation describing what it was like to be in the session.


It has been interesting for me to hear how being with different clients "sounds" (at least from my own musically and verbally expressed point of view). Of course, it's hard not to hear my own issues and musical patterns creeping into the music (oh, yeah, therapy 'til I'm dead, baby). 


I'm sort of wanting to share some of the videos, but I want to be sure I'm not violating any ethical rules and/or regulations in order to do so.

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Meanwhile, it got me to thinking about Journal Prompt #2:


For most of us, during our busy weeks, we see lots of clients. And there are always the people we work with who stay with us and stick in our minds. 

But there are also clients we completely forget until we see them the next week.
And I started to wonder, why?

Who am I forgetting? Do I forget this person/group all the time? Or is there something going on with this particular client/group that I just want to avoid? Or that I don't like dealing with for some reason? 

What is this person triggering within me? Is it something about this person? Or is something going on with me? Why is it this person/group that I forget?

What is it about this person that feels "forgettable" to me? What might the fact that I'm forgetting this person/group be helping me know/learn/wonder about how this person perceive(s) him/herself? 

How does my forgetting this person/group have meaning in the context of this individual/group's life?

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As you can (plainly) see, it was kind of difficult for me to formulate the questions, but, for me anyway, that's part of the process- figuring out better questions to ask myself. If you come up with a better question to ask (or simply find a better way to word the questions I already tried to ask), do tell.


As always, if you feel comfortable sharing, you're welcome to use the comments section to offer your thoughts or (if you blog) post a link to your blog post or You Tube video. Perhaps you might want to play contrasting musical portraits (a Ken Bruscia suggestion) of a client you think of often and a client you tend to forget, and either video or audio tape the improvisations. Or write a song about a client you've forgotten and share it with us. 


I so look forward to your latest installments!

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. 

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? 

The Act(ion) of Thinking

Image via WikipediaI've been thinking about RD of late (well, particularly today, because we had a session this morning). 


RD is a very sweet young man on the autism spectrum (he does not use speech to communicate), and he is very particular about things. And by this I mean that he seems to believe that all things should have a place (I think I can thank one of his family members for his excellent manners and his tidy nature.)


It so happens, that we work in a terrifically messy room in his cottage (oddly enough, it's the, um, "sensory room") (yes) (well). 


Anyway. 


No matter how much I try to clean up all the clutter in the place before I go and pick him up for his session, he still finds things to, er, tidy. 


He also likes checking out all kinds of objects. He has a collection of action figures with giant feet (I don't want to know!), and his staff people find him books and various things that have moving parts to them. He keeps them all in a big box with his picture on the front. Great! 


So. Back to the aforementioned "sensory room"...


Because this is, apparently, a full service sensory room, there are almost always broken battery-operated sorts of things lying around in varying states of function and dysfunction. This means that the batteries are lying around (lovely), and the little parts that keep the batteries quietly tucked inside the gadgets are also roaming about freely.


RD, being the tidying kind of guy he is, and being the kind of person who likes to bond with objects, has been picking up these little plastic parts that were supposed to hold in batteries. He just turns them over and over in his fingers and holds them close to his face so he can examine them.


While he's doing that, he sings. He hums little melodies (I've come to learn that he repeats specific melodies with small variations here and there). I either sing them back to him or play them on the guitar (with my own variations and chords). And while he's scurrying about the room arranging things, we sing and play back and forth with each other. 


The other thing you need to know is that, when he borrows an instrument from me (to check out as described) he often puts it back in the closet that's in the sensory room. As such, I have to go and retrieve the instrument quickly because otherwise it'll be there for all eternity (I have reached the official limit on my brain's memory card, and, let's face it: some things are just going to have to go!). 


Now, not only does he take my stuff and put it in the cottage closet, but he puts stuff he picks up in the cottage on my music cart or in my instrument bag. I am forever pulling things out of my bags (after his session) and putting them back in the room (back in circulation, as it were).


Okay.


So, as I mentioned above, I was thinking about RD, and I was wondering: why does he keep putting cottage things in my bags? And why does he keep putting my stuff in the sensory room closet? What's that about? Is there something he might want me to know? Or that I should be noticing about this?


And I thought, hm. So I mentioned to him during his session that maybe he needs to have me hold on to a small piece of him when I go (i.e., don't forget me, please). And maybe putting my stuff in the cottage closet is a way for him to keep a piece of me as well. 


When I gave it some more consideration, it occurred to me, again, that here's a guy who likes everything to have its own place- whether it's the "right" place or the "wrong" place. And I remembered that he himself grew up in a few different places, being sent around to various family members, because his mother died when he was an infant. 


And now here he is with us, in an institution.  


And it made me think about objects. And about having a place to be. And I wondered (out loud to him) if maybe it was important to him that he have a specific place to be. And what his thoughts are about being in the "right" place or the "wrong" place. And which one he feels the institution might be.


RD's response was to increase his singing. He and I sang back and forth for ten more minutes than usual today (we usually make it for 20 minutes, but today it was 30!) before he hopped up and began pulling the guitar off of me to indicate that we were finished.


So, I'm thinking this is veeeery cool. 


Definitely warrants some more thinking...

So you want to become a music therapist...

Image by doug88888 via FlickrI, rather regularly, receive emails and blog comments from people who are interested in becoming music therapists.  And I regularly send back big, long emails with information I hope they'll find to be useful. Well, suddenly, one of my slower neurons fired, and I thought, "why on earth haven't you written a blog with this advice in it, so you don't have to keep repeating yourself?!" 


Somewhere a dog barked. 


Aaaand, we're back.


Okay. So you want to become a music therapist. Fabulous! And you want to know what it will take, what kind of advice I can offer, whether you'll ever have an actual salary, what to write for that research paper that's due in 13 hours...and so forth.


(Stand back. I'm about to jump into list-making land.) (Actually, even though my blog posts aren't usually in list form, I have a deep and abiding love of lists.) (But I digress.)


1. It helps to be a fairly good musician.That said, it also helps if you learn to play guitar and piano.
Different schools that offer music therapy as a major have different requirements. I think, ultimately, the more skill you have as a musician, the more you have to offer your clients. If you're busy focusing on yourself trying to play a song or a particular instrument, you're no longer focusing on your client, and that sort of defeats the whole purpose of therapy. You know? You don't have to know how to play guitar and piano before you go to school, because that is part of the music therapy curriculum. Those are, however, two instruments that are used an awful lot in the course of a music therapist's day/week/life, so it's worth getting to a point where you're relatively comfortable with them.


2. And, while you're at it, get comfortable with using your voice.
When I first started out as a music therapist I was really shy, and I found it difficult to sing in front of anyone. Mercifully, I managed to move beyond that. We don't have to be brilliant singers, but it's important to carry a tune and be comfortable improvising and playing around with vocal sounds. I still remember a client I worked with who tore up an entire room and threw my entire music cart on the floor. For a good solid year I had to go and do his sessions with nothing but me and my voice. 


3. Be careful of your "helpful" intentions. 
When you're trying to figure out what you want to do with your life, it's not unusual to think, "you know, I really want to do something that helps people." We all have our reasons for wanting to somehow be useful in this world, and they're all valid and important. When we come to a profession like music therapy, though, I think it's important to be mindful of the various implications of being "helpful" (in terms of power, control, what it means to be "the helped", etc.). Because Norman Kunc and Emma van der Klift said it a lot better already, I  highly recommend reading their article, "Hell-Bent on Helping: Benevolence, Friendship, and the Politics of Help". It will, I hope, give you a whole new perspective on being "helpful".


4. Learn to pay close attention. Notice stuff.  
So much of my job is about paying attention. Whenever I have students come to do their practicum experiences with me, I have them fill out an observation form that I developed. It's an insanely complicated form, because in a music therapy session there is so much going on at any given moment and on so many levels. You have to be aware of your client (s), the music, yourself, the environment, the history...there's a lot of stuff happening. This is what makes music therapy so completely fascinating! You can practice at an activity level and be quite effective, and you can also decide that you want to go deeper and explore the therapy relationship, the dynamics within it, and how it's all expressed within the music, and that's really nifty as well! 


5. Expect that this will be a life-long learning experience. 
Music therapy is a growing and evolving field. Because there's so much to know (and you can't cram it all in at school!), so much to pay attention to, and because you can work at a lot of different levels, there's always something new you can be learning. For that reason, getting professional clinical supervision in music therapy after you've graduated is extremely helpful to your growth as a new clinician. Moreover, there are lots of trainings that music therapists can take to deepen their knowledge/skill in specific areas (GIM, Nordoff-Robbins Music Therapy, Neurologic Music Therapy, NICU Music Therapy, Hospice Music Therapy, Austin Vocal Psychotherapy, and I'm sure there'll be more sooner or later). 


6. Get used to advocating for yourself. 
Music therapy isn't the huge mystery it once was. These days when I say I'm a music therapist, people are way less likely to say "a what?!" than they were back when I first started out. Now I'm usually greeted with something along the lines of "oh, how cool!" As nice as that is, people often think they know what we do, but they really don't. Co-workers who've known us for years may still not have a clear idea of what happens in a session. I'l be straight with you: It can be quite frustrating when you see that someone who hasn't gone through the years of training you have is calling him/herself a music therapist (or being called one by the media). It can be even more challenging when supervisors, colleagues, and various other people/organizations who fund our services (who aren't music therapists) feel compelled to tell us how we should do our job.  Having said that, I would still maintain (and I think my music therapy colleagues would agree) that being a music therapist still far outweighs the difficult stuff. 


7. You'll need to figure out a semi-quick way to explain what it is you do for a living. 
Given that you'll have to spend some time advocating for yourself and showing people what music therapy is, it's important to have your "elevator speech" prepared shortly after you graduate from your program. I usually tell people I use music to listen to people. That usually makes them curious enough to want to know more. Then, depending on how much time they're willing/able to spend, I can expound until they're sick of me. Ahem.  


8. It's not likely you'll be rich beyond your wildest dreams, but you can definitely make a living as a music therapist.
A few months ago, our Rabbi at work asked me, as nicely as he could, on behalf of one of his congregants, "can music therapists make a living doing this work?" I assured him that we could. We can find jobs (we've been doing a lot of advocating- trust me), we can get health benefits, and we can make enough money to live peacefully. We'll never get the kind of money that, say, a computer programmer or a financial analyst would make, but most of us aren't starving. And if this is truly what you want to do, then you should do it. [2024 Update: Having written this some time ago, I want to acknowledge that these days it may be a bit more of a challenge, given the financial realities of the current day. And a lot of younger music therapists have expressed dismay when they can't find full-time jobs, they can't afford housing, and they are often expected to have a Master's degree. This is decidedly problematic, and I will not deny the situation can be quite frustrating. At the same time, there are also a LOT more music therapist-owned businesses, and people are actually familiar with music therapy (or know a music therapist) (of have had their own music therapist) (or have at least heard of it). So, I believe, still, with some flexibility, you'll probably be able to find a job. It may not be where you hoped/expected to work, but it may end up being the right place. Or, like many people do nowadays, you can get some experience and move to an employment situation that feels more in line with who you are.]


9. Get used to not knowing what's going on and sometimes being uncomfortable or awkward. Or at least come to terms with it. 
I would have to say that it's rarely dull being a music therapist. Sometimes your clients will do unexpected sorts of things, or you'll find yourself dealing with really uncomfortable feelings. And sometimes you can go for a really long time and not be at all sure you're on the right track with a client/group. Again, this is what makes this work so fascinating and so completely worthwhile! It's difficult when your own issues are triggered, but, heck! Your issues will be triggered no matter what you do. You may as well have an interesting job within which to notice them. 


10. Consider getting your own therapy (or your own music therapy, if you can). 
Being a therapist is hard work. Being a client is also hard work. If you've never gone through  your own therapy, and if you've never struggled in a big way with your own problems and emotional baggage, it will be hard for you to have a real understanding of what it's like to see yourself in a new way (which is not always a pleasant experience at first). Making changes in our lives is something most of us resist mightily. Looking at our resistance- ugh! It's not always fun. It's a long, bumpy road. And we ask our clients every day to allow us to stumble along that bumpy road with them. We owe it to ourselves and to our clients to at least bring along the map we saved from our own journey (even if they decide to take a different route). (Okay, I'm getting a bit nuts with the metaphors here, but you get the idea, yes?)


So there you have it. That's the list I have going in my head when people ask me for advice on becoming a music therapist, and now here it is! In blog-land! And if any of you music therapists out there in the world have other advice to offer, bring it on!


The good news (well, to me anyway) is this: I worked as a music therapist for 34 years. Even on the worst of days, I have never regretted my decision to do this work! Much good luck to you as you go forth and consider whether or not the life of a music therapist is one you'd like as your own.