How wonderful that you're here!

Image via WikipediaWe music therapists are always trying to define what we do. Or, more specifically, help other people understand what it is we do. We write books and articles about it, we blog about it, we put together podcasts- all in an effort to convey to the masses a sense of what makes us go into this profession that seems to defy description!


But, if someone were to have asked me yesterday "what is music therapy and how does it work?", I would probably have said that it's about inviting people to be present to each other, and we use the music to help make that happen. 


Mondays are long days. For me, I go into work a little later and stay a little later. And, I think we can all agree: it's hard for any of us to transition into a Monday, which is, for most folks, the beginning of the work week. And I would say that it requires even more fortitude to get into the Monday spirit of things after a particularly long Thanksgiving weekend, which, of course, marks the beginning of the (dreaded) holiday season.


While staff frantically decorate the cottages and prepare for Open Houses (where everyone's family is invited to come and visit and there's food and music and merriment and so forth), my clients prepare for the annual anxiety of "will my family be coming to spend time with me this year?" 


So, this is a bit of the sense I got when I showed up to work with the group yesterday (Monday) afternoon- "the group" being ten men and me. 


Oh, where to begin? 


Well, let's see. There was a whole lot of messing with chairs (that would be P), switching of seats (that would be R), tossing instruments, trying to pick up instruments and then getting stuck on the floor and needing help to get up (that would be T), repeatedly rearranging and fixing the curtains so the sun wasn't blinding us (um, well, actually, that would be me), coming in, turning off the lights, and then leaving (that would be K), coming in, crying and starving to death and then leaving (a different K who does use some speech), and on and on, all accompanied by a low moaning (courtesy of J), the periodic fist to the head (of B), and the festive crashing of the tambourine (P again).


Can I get a witness? Anyone? Anyone?


Uuuhmmm. Now what?! (And if any music therapist tells you they know exactly what to do when their clients are all freaking out at the same time...just so you know- They. Are. Lying!)


I managed (do not ask me how) to get my thoughts together enough to be aware of the fact that, while the guys were all there, they weren't really There. Nobody was listening to anyone else in the room, we were all kind of...everywhere, but none of us was present to the experience of being in music therapy. 


I pointed this fact out to the guys (who, God bless them, heard me above the drama-filled din), and I asked them, "Gentlemen. What can we do here? How can we use the music? How can we use our thinking, to get ourselves to be here in this room, in music therapy, together? Why don't we just work on that, so that if we do nothing else today, we'll know that we cared about each other enough, that we mattered enough to each other, to notice that we were all here together."


Enter music. 


I moved over next to B, because I didn't want him to be hitting his head, and offered him my hand (he took it). He had been vocalizing while he was hitting himself, in a kind of a hum. So, since I couldn't play guitar with only one hand, I invited the guys to find some kind of way to hum with B to help him settle down.


I started to hum (in B's general key), and it didn't take long at all before the men found ways to join in with their voices and actions. J moved his arm, every few measures, up and then down to the beat. P, in spite of his tambourine prowess (and he really does rock on the tambourine) used his voice- which has more of an "oh" and "ah" quality. Yet another K quietly chimed in on the cabasa he was holding. R stopped moving around and sat, listening, with his eyes closed, breathing deeply. 


B calmed down and kept singing (but stopped hurting himself), so I was able to make use of both of my hands again. I played a very simple progression on the guitar- kind of an Asus4, Cmaj7, to D/F#, B, E (sometimes major and sometimes minor), and I repeated it as we sang and came together.   


It was lovely. 


There was smiling. The moving around and in and out stuff stopped. There was presence. We were looking at and acknowledging each other. 


We managed to be present in the session and we used the music to make it happen. The definition of music therapy on a Monday afternoon. 


And what makes this way of using music so cool is that this particular piece of improvised music  could only have happened on this day and with this group for it to have had any meaning. Taken out of context, it might sound okay, but it will never have the same impact as it did yesterday afternoon as we all sat quietly, after we finished, even after we sang goodbye, nobody wanting to leave quite yet, watching the sun set together.

Back off, lady, I've got this!

Image via WikipediaI tried a different approach with B today.  My usual tendency is to sit there, paying as close attention as I can (without being too obvious) and trying my best to figure out what he is (not) saying by asking him bunches and bunches of questions (and driving both of us crazy in the process). 


Yes, even I realize that asking tons of questions is annoying. 


And, no, he doesn't use speech, but when he truly needs to make sure I hear him, he is quite clever in his communicative style.


Well. He was reclining (as he does) on the couch in the Music Room, and he was very specifically looking off in the distance (read as: "I am not looking at you! NOT looking at YOU!"). Okay. Got it. We are not looking at me. Fine. Onward. 


I, of course, started to leap in with my usual round of questions ("Rough day? Too noisy in the cottage? Feeling off because we changed our session time last week? Blah? Blah blah blah? Blah, blah, and more blah?"). Okay, I'm not really proud of the fact that I did this, but I did. So. There it is. B's response? Stay the course. Keep staring straight ahead. 


Hunh. That was effective. 


I stopped (thank God). And I thought, "Try again, Roia. Settle it down, and try again."


So I said to him, "You don't really seem to be ready to be dealing with stuff right now. Why don't I just play piano over here, and when you're ready, you let me know."


I rummaged through the stack (really- there's a stack) of (countertransference) songs I've used in his sessions, and I pulled out the Beatles' song, "Don't Bother Me". I hemmed and hawed (internally) for a bit and decided to just play it on the piano rather than sing it. It didn't seem right to break the silence with words just yet. 


I played through. Aside from tossing the bells he was holding and then picking up the mallet, there wasn't much (visible) change. Moving right along. 


I rummaged some more, and I found "Out Here On My Own" (from the movie Fame). (Anyone else sensing a theme here?) I really wanted to sing the words, but it still didn't feel like it was time to do that, so I played through it with just the piano. 


I feel as if I need to explain two important things here:


One is that the songs I chose were intentional- not as random as it may seem when you read my writing. I wanted to reflect his need for some emotional space, but I also know that he's been struggling with trying to come to terms with what our relationship is and is not (which is a gentle way of saying that I'm trying to help him understand that "we don't have that kind of a relationship.") He has not been happy about that, and although I think that, on some level, he gets why it is the way it is, he still feels very abandoned by me right now.


The second thing is that B spends a part of almost every single session, pulling me to the door and flicking the light switch off and on (you may draw your own conclusions as to what that particular habit may be helping B to say to me). 


Great. So you're up to date. Back to the music...


This time the mallet was tossed, but B still sat quietly listening with his gaze firmly averted. 


I sat quietly for a while (even I can sit quietly sometimes) and waited. 


B leaned forward and tossed the maraca (which he uses to express anger) and tambourine (to express uncertainty) on the floor and was ready to hurl the cabasa (for conveying disappointment and sadness) as well, but I managed to stop him just in time (did I mention he can make sure he's heard when he has something to say?). 


"Maybe," I suggested, "I'll play the song I just played again, only this time I'll sing through it with the words. B, why don't you sing it with me. You can use your voice, you can pick the bells back up and use them, you can move...just pick a part of the song that feels right, and join in." 


So I went back to the piano and started (again) with "Out Here On My Own" 
(Lyrics: Lesley Gore, Music: Michael Gore; Copyright 1979)

Sometimes I wonder where I've been,

Who I am, do I fit in?

Make believing is hard alone, out here on my own.

We're always proving who we are-

Always reaching for that rising star

To guide me far and shine me home,

Out here on my own.

(Chorus)

And when I'm down and feeling blue

I close my eyes so I can be with you

Oh, baby, be strong for me, 

Baby, belong to me. 

Help me through. Help me need you...

The minute I started singing the chorus, B joined in! He got up, started to hum in a low tone and rock back and forth. Then he headed over to the light switches and started to flick the lights up and down in time to the music (I could tell, because he paused so he could stay with the beat)!!


He stuck with me- moving, vocalizing and light switch flicking- until I got to the very last words of the song ("out here on my own."), at which point he came over and stopped me from playing any more by pulling me to the door (not because he wanted to leave, but because he wanted me to stand with him). 


Wow. Just...wow. He was glorious.


Clearly, the strong feelings of loneliness and longing are still very present for him. The beauty of this profound musical moment (as I see it) is that B now feels safe enough to fully participate in the experience of actually making music. And I do need to point out that this has taken quite a lot of years. For much of the first twelve years of our work together, he largely avoided using music- often barely even allowing me to use music!


The fact that B was not only willing to sing with me (and in such a creative way), but to make sure it had meaning when he did it, is what makes this work so amazing!


I guess the question (for me) now becomes: knowing that when you back off and allow your clients to say what they have to say, they will not only do it but do it beautifully (and you don't need to worry them along), what's preventing you, Roia, from backing off so much of the time? And what is it you're afraid of hearing when your clients do "speak" to you through their music?

When sessions go to hell (yes, Virginia, in a hand basket!)

Image by jamelah via Flickr

Damn! I was all set to wax lyrical about what a wonderful first session I had had with two new clients, C and J, two Saturdays ago. 


I'd even started the blog already. I had a nice little picture all picked out and everything. There was a little singing bird. It was downright idyllic, if I do say so myself.


Well. 


That little gloat-fest sure didn't last too long. 


When I showed up this past Saturday, it all went to hell. (Please observe said hand basket above and to the right.)


First, the room we'd used the previous week was completely unavailable. Apparently, it had just been painted and they didn't want anyone in there until the paint was dry.  It was a nice, relatively quiet room with space, with a big water-bed looking thing (that looked like a cross between this, this, and this), where last week C, who seems to experience a lot of sensory discomfort, tucked herself in under her blanket and her giant beanbag and sang along with her series of sweet little "bee bah" sounds. 


Okay. "So the room isn't available," I thought. I can work around that. I think.


Then, while I was checking out other room possibilities, I noticed that the other person in our small music therapy group, J (who became "the other person in our small music therapy group" simply because she kept walking in to the room last week, and I finally said, "why don't you just join us on a regular basis?"), was unavailable, because she was having some behavioral issue that required a lot of people to stand around her and look concerned. And not too happy. 


Hunh.


No problem, I'll just work with C in the vestibule where she's sitting (tucked under her blanket with her giant beanbag) (is anyone else noticing a theme here?). I'm flexible. I can do this. 


Two seconds into singing "hello" to her (after her staff kindly unplugged the radio that had been playing), C got up and left. 


And that was that.


After that we moved into a whole following around (me following C), pulling (C pulling me, because I guess my following her wasn't going the way she'd expected), stripping (C's, not mine, thank God), bathroom going (again, not me for a change), insisting I put the radio back on (you guessed it, C wanted the radio), irritated "BEE-BAH" sounding...thing. 


There were two (maybe two) blissful (okay, maybe it wasn't blissful, but we're talking comparatively here) minutes in which C sat and smiled as I played and sang with her. 


Then we were back off and running.


Heavy sigh.


A few years back (in 2006, I believe) my friend, Judy and I did a presentation at the Mid-Atlantic music therapy conference which we called "The Myth of the Perfect Music Therapist, or How I Learned to Stop Worrying and Love My Mistakes". 


I think this would definitely qualify as one of those bummer sessions that are more "part of the process" or "grist for the mill" (as the sayings go) than shining examples of moments in therapeutic gloriosity.


I suppose, if there's anything for me to have learned from this, it's that if we music therapists can't own and acknowledge our lousy sessions/days and accept them as part of life, then our clients won't be able to do that either. 


Not that it's any kind of easy.


Well. There's always next week.

1/26/10 Quote- Developing a relationship through music with someone who doesn't use speech

Image by alles-schlumpf via Flickr

I am slowly reading through a book called, "Music Therapy: Intimate Notes" by Mercedes Pavlicevic (1999, Jessica Kingsley Publishers). It describes, of all things, what it's like to be a music therapist in relationship with one's clients. 

Hmm. Where have I heard that before...

Anyway, I'm not sure why I haven't looked at this book until now. It's been around for ten years. I guess books come in to your life when you're ready for them. 


So I just finished the first chapter. Each chapter seems to be organized around a particular story shared by a music therapist. Mercedes Pavlicevic then adds her comments. 


Which is great, because her comments are beautifully put.


Here, for example, are some excerpts in which she very nicely describes the process of building a music therapy relationship, clarifying for readers (presumably not music therapists) what has just been shared in the story and why it's significant:

How do you respond to a child who does 'nothing'? The void that he presents, and his absence from the music therapy room, challenges a deeply natural aspect of human communication: that for communication to happen between people, we need the responsiveness of another person, we need them to show their responsiveness, whether in speech, movements or facial expressions, and we ourselves need to have a sense of their sensitivity to our influence- to mutual influence. We cannot communicate with someone who does not show any signs of being susceptible to us, influenced by us; who appears vacant.

She goes on to say:

     Communication between Oksana and Daniel is a two way process: Daniel begins to vocalize and at first he makes occasional short sounds. Oksana vocalizes too, but not just in any way: she listens to the quality of his voice, how short the sounds are, how high or low they are, whether she can hear any rhythm, any shape in what he does. And she adapts her own vocalizing in a way that is related to him, to his sounds. This is the beginning of interpersonal influence. She is influenced by what he does and by how he does it- no matter how tiny and apparently haphazard his sounds are at first- and her sensitivity to him sounds in her voice. He hears this, and feels her awareness of him in the song that she is singing, and in session four, this triggers something in him. Suddenly, he begins to vocalize much more intensely: he makes longer sounds, and immediately she responds, matching his longer, more intense sounds. In these moments, Oksana and Daniel connect with one another in a way that they have not been able to until now. What is interesting here, though, is that Oksana does more than just match, or mirror what he does. She begins to extend what he does.

     This is crucial: in order for Daniel to extend himself, to grow, to develop, he needs to be shown where he can go with his voice. Now that he and Oksana have 'met', now that each has a sense of the other, through their vocalizing together, Oksana keeps close to what Daniel is doing: she continues to match his singing closely. In this way, he knows- he has a sense- that her singing is related to his. And when she does a bit more- sings for longer, or louder, or quicker- he then hears where he needs to go in order to remain connected to her. (pp. 20-21)

Is that not gorgeously and articulately said?


She so nicely captures why it's so important to have a relationship with our clients. Without the relationship, there is no investment or interest in, heck, no meaning to what we present in a session. 


The very last sentence says it perfectly: "...he [Daniel, the client] then hears where he needs to go in order to remain connected to her [Oksana, the therapist]." 


In other words, the relationship now matters to Daniel, and he now has a reason to learn new things and a context within which he feels acknowledged and heard so he can feel safe enough to venture outside of himself. 


And, that, my friends, is music therapy. 

"I'll Fly Away"

The last thing I remember about K is how worried I was about his health. He had been coming to music therapy and literally crying, "ow, ow, ow". I'd gone straight to the nurses and told them (again), "there's something very wrong with K. I've known him for 20 years, and this is not a sound I have ever heard him make." They assured me they were looking into it.

It was heart-breaking to listen to him. It was difficult to focus when I knew something was wrong. I felt powerless to help him and angry because I had been expressing concern about his health for at least a year.

When I got back to work last Wednesday after a week-long vacation, I heard he was in the Intensive Care Unit at the local hospital. I made plans to go and visit him on Thursday.  

It was too late.  K died Wednesday night.

Alone.

P, one of his regular support staff, also devastated, asked if I would sing the song "I'll Fly Away" for his memorial service. I didn't know the song, but I found the music and started to learn it.

***************************

D was a bit draggy when I went to pick him up for his session this past Saturday. But he got right up to come with me. 

As soon as we got to the Music Room he moved all the instruments off the couch and parked himself there, in a reclining position, facing me. 

He looked sort of glum as I sang a greeting to him, and we spent some time just breathing quietly together. D stared out the window, as he often does, and as I watched him, my mind started to sing, "I'll Fly Away".

I played it for him- painstakingly, since I had only barely begun to learn the song. It seemed to offer a powerful message for him.  He turned to look my way, and he listened intently as I sang.

Some glad morning when this life is o'er,
I'll fly away;
To a home on God's celestial shore,
I'll fly away.

[Chorus]
I'll fly away, Oh Glory
I'll fly away; 
When I die, Hallelujah, by and by,
I'll fly away.

When the shadows of this life have gone,
I'll fly away;
Like a bird from prison bars has flown,
I'll fly away

[Chorus]
I'll fly away, Oh Glory
I'll fly away; 
When I die, Hallelujah, by and by,
I'll fly away.

Just a few more weary days and then,
I'll fly away;
To a land where joy shall never end,
I'll fly away

[Chorus]
I'll fly away, Oh Glory
I'll fly away; 
When I die, Hallelujah, by and by,
I'll fly away.

(written in 1929 by Albert E. Brumley)

The best way I can think of to describe it is that it seemed as if D's eyes, gazing out the window, were singing this song.

A thought crossed my mind as I shared "I'll Fly Away" with D- a song I will be singing for K's memorial service in a couple of weeks. K taught me, as well as many of my practicum students, about being a music therapist (he was a part of the "Sick and Tired" crew I described in my last post). As a result of his death, I've now had occasion to learn this powerful song, and what's more, to share it with another of the people I support.

So, in a way, K remains present, and he continues to share his gift. 

I hope it's true for you, K, wherever you are...that "like a bird from prison bars [you have] flown" and that you're in a state of being in which "joy shall never end".

"That was so much fun!"

"That was so much fun!"  Well!  I don't usually hear that from the direct support staff who take part in music therapy groups with me.  Actually I don't usually have any staff with me when I'm doing music therapy.  Long ago I decided to work alone when I do sessions, because the direct support staff and I tend to...work in very different ways.  Ahem.  

As such, you may be wondering why I actually decided to include the staff when I started a new music therapy group with the women in Group 2.  Well, for one thing, this can be a pretty rough crowd- I've seen one of these women tear apart an entire bathroom, ripping down shower curtains, tossing clothing and bathing items asunder, and then shred her clothing in a matter of seconds (let me tell you- that's a talent).  Another woman tends to yank hair, scratch, and bang her head on the floor.  As you might imagine, having their support staff around could be a very good thing.  

Another reason I wanted the staff in this group to come with me is that they are consistently with that specific group on Monday evenings.  Most importantly (to me anyway), these three group leaders (as they are referred to in our facility) really seem to like the ladies they support (I'm not being nasty here- sadly, I don't always see this attitude in this line of work).  They were very enthusiastic when I asked them if they were interested in our doing a music therapy group.  

We agreed to move the ladies from their usual living area (a room with no outside windows, in the middle of the cottage, surrounded by a lot of noise from neighboring day areas) to a room across the hall where the recreation staff works.  It's generally a quiet room, it's contained, it has chairs (even though various members of this group like to be mobile or recline on beanbags), and we can use fewer lights (the fluorescent lights are quite horrible) because it has windows.  

I also wanted the staff to understand the point of music therapy- give them a context within which to interpret what they might experience in the sessions.  I wanted to give them an idea of what I'm doing, why I'm doing it, what I'm watching and listening for, and how I'm going to do what I do. So I gave each of them a copy of a detailed memo I wrote a long time ago for supervisors who periodically come to observe sessions.  

I also gave them the Music Therapy Observation Form I've been working on for quite a while.  It's a complex form which I usually have my practicum students fill out  on a weekly basis.  It asks a lot of questions meant to provoke thought with regard to what the music therapist is seeing, sensing, hearing, and musing about during the group.  It also encourages attention to the relational qualities and dynamics within the group and how these might be expressed (or avoided) in the music.  It also notes some of the elements which might be going on (or ongoing) for clients in addition to the experience of being in the music therapy group (illness, sensory issues, motor planning problems, traumas, family stuff, etc.).  

We've had three sessions so far.  If all of the group members (minus their staff) show up we have seven women- which may end up being a lot, but we'll see how it goes.  The best we've managed so far is to have six women and two staff people. Sometimes the ladies decide to go to bed early, sometimes they head out with the teachers, and sometimes they need a break from the group and want to do their own thing.  

All but one of the women in the group are somewhere along the autism spectrum.  And, again with the exception of the one woman (who is dealing with mental illness along with her developmental disability), none of the ladies use speech to communicate.  They are, however, women with voices.  Quite a range of voices, I might add.  From low and gruff to high and sweet.

One of the things I noticed with regard to the group leaders is that they tend to chatter almost constantly with the women in their group.  This is actually, in many ways, a very good thing.  So I didn't want to discourage their natural tendency to want to interact, but their conversation, while animated and pleasant for the most part, was making it awfully hard to actually hear the group members.

Last night three of the women were present in the group.  I gently invited their support staff to listen- reminding them, "this is your opportunity to hear the ladies you work for in a completely different way."   They were quiet, and they listened. And it was great!  

I offered V a maraca.  She had come in to the room using her wheelchair, because her staff, M, was concerned she'd grab at and scratch everyone (and, indeed, she did seem headed in that direction as she began to pull roughly at M's shirt).  V held the maraca, evidently curious enough that she was able to settle herself down. In fact, she didn't grab anyone else for the rest of the session.

K was awake (last week she slept on a cushion we had brought for her- this time she had a big long beanbag and a blanket).  K is often asleep during the day, because, from what I can gather, she doesn't sleep well at night. I sang a greeting to her (and to her housemates). I invited her to turn toward each woman in the group (she is also visually impaired), asking them to alert her as to where they were located in the room by making some form of sound (her staff included).  She listened quietly as each of us made a sound or greeted her with a "hi, K" and turned her head to acknowledge that she had heard us.  

M switched chairs a number of times, making sure to stay near me, even maintaining visual contact.  She sang through much of the 30-minute session, quietly, a high-pitched and delicate collection of short little four and five note melodies and bursts (for lack of a better word).  

At one point, L agreed to come in to join us.  She still had a cold, but she accepted the tube shaker from T (her staff), and she shook it vigorously for about 30 seconds, set it down, picked it up to give it one more good shake, and handed it back to T and left.  

V eventually decided she wanted to get out of her wheelchair and sit on the beanbag with K (apparently they like each other well enough and are used to sharing this space).  There was no scratching or grabbing.  K decided to stand and move to the music (I too got up to sing and rock across from her while I followed her rocking on the guitar).

It was hard to have to sing "goodbye" to them all, because it truly was enchanting to watch the group transform into this lovely music-making collective.  T was astonished and excited (having assured me when we began that she had read all the papers I'd handed her the previous week and found them fascinating).

As we sang "goodbye" V, who had been holding the maraca so quietly, decided to join in with her voice.  Indeed, "that was so much fun."

     

Beautiful voices

One of the things I didn't know I missed when I was away from work for the summer was the collection of little and big sounds that go along with my music therapy groups.  When I hush and listen (and sometimes I have to give myself a mental nudge to remind myself to do so) I can hear the voices and sounds made by the people who don't use speech to communicate.  

On Thursday afternoon, we had quite a crew gathered (I honestly don't know how so many people keep ending up in our group).  There were at least ten men, and we were all sitting (or standing) in a sort of long circle in various forms of chairs.  Everyone who wanted to use an instrument (well, all three guys) had their preferred objects to sound, and even though we looked (more or less) prepared for action, we couldn't seem to get any kind of a musical improvisation going.  

To be truthful, there was some unrest.  T, who was sitting next to me, was a bit agitated, and he was up and down a bit- biting at his hand and then taking my hand and pumping my arm up and down a few times.  The recreation person came in and asked if he could borrow one of the guys, so they left together.  B wanted to sit in the windowsill- which, on principle, I'm not against, but his staff have asked that I not let him do that, because he tends to urinate all over the windowsill area, and, well, you get the picture- so I usually ask him to not sit there.  P, who usually wants to be in the session before anyone else and stays longer than almost anyone else, decided to return the tambourine he likes to use and left the room entirely.  

I think it was in between dramas that I finally quieted down, uncertain as to how I should proceed, and that was when I noticed the sounds:  R's quiet, breathy "hah, hah, hah" (accompanied, as always, by his quick forward rocking motion), B's- also quiet- melodic humming (he usually uses a very small range, and it's often in a minor key), and S's consistent, somewhat higher pitched, "ee-mmm-aaahh-mmm-eee-aaah", punctuating his sounds with gentle clapping sounds placed at various intervals.  K had the seed pod rattle, and, as always, he held it tightly in one hand, making it difficult for the seed pods to actually rattle, and he used his other hand to tap at it very softly.   

I listened with such pleasure, suddenly aware of how much I'd missed these sounds and these moments.  I tuned my low and high E strings down to D (the sounds felt very open and D-ish to me), and I joined in with my quiet sounds too.  The energy in the room shifted, and we were all able to settle down and play together.   

Walking slowly together

On Saturday (I work on Saturdays) I went to pick up D from his cottage.  I hadn't seen him for two and a half months, and I wasn't sure how he would react when I showed up after all this time. I mean, I told him I'd be on a leave of absence, and I explained that I would be returning at the end of August, and we would resume music therapy.  Since D doesn't use speech, and he's rather a quiet man (at least he is when he's with me), I wasn't sure how he had experienced my announcement.  

Anyway, he smiled when he saw me this past Saturday, and I must admit I was glad to see him too.  He pulled me to the door, and we were off.  It was a quiet morning, and D tends to walk- more like an amble actually- very slowly and deliberately.  His heel always goes down firmly first and then the rest of his foot follows along in sort of a rolling motion, his toes always pointed out. He holds on to me- to my hand- with his right hand, and his left hand usually goes up and rests gently on his chest or on the drawstring from his jacket (or the drawstring on his shorts).

A good word to describe D's pace, I'd say, is "leisurely".  Very.  I have often found it difficult to walk with him because I have to slow down quite a bit in order to not end up dragging him along. The thing about this particular day was that I had just returned from taking my own "leisurely" break.  As we walked slowly together, I immediately noticed how much less hurried I was, and how it was so much easier than usual for me to adjust myself to D's gentle rhythm rather than indulging the tendency I have to move along at my usually frantic trot.  

As we strolled along D hummed quietly, and I enjoyed listening to his singing- not a particularly wide range, but he was very present and lovely to hear.  Nice... to slow down and pay attention.