Why it was hard for me to participate in this year's social media advocacy month

One of the things that doesn't get talked about enough when you're on your way to becoming a music therapist is how deflating it can be to have to define, to defend, to prove your work almost every single day for the rest of your music therapy life.

I need to admit to you (because I think it's important to say it out loud, because I truly believe that looking at the challenges means finding a way to get through them or at least come to terms with them): I am weary - bone weary - of advocating for music therapy right now. Will I still do it? Yes, probably I will. Do I still believe in what I do? Absolutely! Do I think I make a difference in my clients' lives? God, I hope so! I know they make a difference in mine. Am I still learning about music therapy? Always. 

But am I sick to death of explaining and re-explaining, and re-re-explaining what I do to people who already "know" what I do? Who incessantly belittle and demean my work (and, by extension, my clients' efforts)? Who still, after 27 years of this, see me as "the entertainment," treating me like a radio that nobody's really listening to anyway? Damn skippy! 

Today's comment: "No offense or anything, Roia, but I think having gross motor and music out at the pool is more beneficial for the guys than just listening to music with you..." (hmm, now how could that possibly be offensive to me?). This came from a co-worker who arrives in the middle of our Community Music Group, starts yelling out names (with a quick "oh, sorry, Roia"), bustling people into coats, and taking out the majority of the group to go to another activity. Nice.

I've had bosses who've said (and I'm quoting here), "Roia, I honestly don't see how what you do is any different from someone putting a CD in a CD player," interrupting my invitation to come and observe a session with "I'm afraid we're just going to have to agree to disagree, because we have different views on this." I guess getting that Master's degree was an insane waste of time, money, and effort. Oh, and probably the twenty years of paying for clinical supervision (and a whole lot of other trainings outside of music therapy), learning everything I could about disabilities and psychotherapy and figuring out ways to make sense of all of this so I can offer my clients a form of music therapy that hardly anybody else really does...that was probably a bit of overkill.

It's hard when many of your professional colleagues think that all you're doing is "playing nice music for people." It's hard to listen to support staff tell you they don't like the music you're playing and that you're not doing music therapy "right."

The bottom line here is this: if you're going to be a music therapist (and I really want you to be), it's important to love what you do and believe in what you're providing to your clients with every fiber in your body. It's important to make music, to get clinical supervision, to get your own therapy, to have an amazing support system of people who love, respect and believe in you and in the work that you do. Because you will run into these people. And you're good and likely to feel squashed sometimes.

Being a music therapist is hard work, especially when you're trying to find a way to musically sit with people who are struggling, whose lives aren't going the way they wish they would, who are in pain, who are frightened, who throw instruments at you, who scratch your face, who are disorganized, who feel powerless, who are grieving, who are dying....All of this is hard to do. But we do it, because we know - deep in our souls we know - that the experience of being together in music means something, the musical and human relationships we painstakingly develop with people who've had chronic trauma, who've been discriminated against in every way imaginable (and in many ways we don't even have a clue about) means something.

So what the heck am I saying anyway? I guess what I'm trying to say is I've advocated until I'm blue in the face. Oh, I'll advocate when someone really cares to listen. Until then, I'm keeping my focus on helping the people whose understanding of music therapy is most important to me, and that's my clients.  

5 Reasons Why You Need To Process in Music Therapy

I was off listening to a terrific podcast on processing over at the Music Therapy Round Table (and I highly recommend you go over and give them a good, solid listen). Well, I wanted to make a comment, but it turned out to be, like, six paragraphs, so, um, I figured I'd better head back to my own blog home and write it all out here and link it back to the hardworking Round Table folks: Kimberly Sena Moore, Rachel Rambach, Michelle Erfurt, and Matt Logan! 

As Michelle mentioned (either in the Round Table podcast or the Music Therapy Pro podcast), this business of processing (especially in clinical supervision) is kind of my "thing" (which makes it all sound a little...suspect) (but, really, it's not). I mean, if we're going to be honest (and I think we must), this whole blog is about me processing my experiences as a music therapist. 

I'm determined (determined, I say!) to convince the  music therapy world that we need to make processing a regular part of our work routine. And, yes, I'm sure I've probably said all this before, but I'm saying it again. And this time I'm going to try to be more succinct (stop snickering, I can do this). Okay. Here goes:

5 Reasons Why You Need to Process in Music Therapy:   

1. Processing helps you move your work to a deeper level.

Put simply: processing helps you move beyond observation to trying to understand what you’re seeing, experiencing, hearing, noticing in a session. Matt Logan wisely pointed out that a part of processing is looking at the relationships between the therapist, the client(s) and the music. It's so easy to get caught up in “what do I do? What should I do next?” and completely forget to look at what’s there in the session in a deeper way.

 2. It helps you gain a better understanding of what you're doing and why. 

Thinking through your sessions and trying to understand what happened in your sessions helps you get a stronger grip on the ever-present question:

 What is music therapy?

The longer you practice, the more your understanding of the work you do evolves and your answers to that question change and grow more meaningful. Processing asks you to consider: what is the role of music in my work? What is therapy? Who are the people I'm supporting? 

The more deeply you understand your work the better able you are to communicate why a client, a facility, an organization, a state, a country, the world needs music therapy.  

3. We all have feelings about our clients, and it's important to consider their impact on the therapy process. 

You have feelings about your clients, I have feelings about my clients. It's a normal part of therapy called countertransference. It doesn't matter who you work with (infants right on up through elders) and it doesn't matter how long you've been working and it doesn't even matter what approach you use. It's all part of the process. 

And the things is: just because you aren't necessarily having strong feelings or reactions you might think of as being "negative" (sad, angry, frustrated) it doesn't mean that your feelings aren't getting in the way of your clients' growth. Of course, I'm not saying that they are - just inviting your awareness that they have the potential to do so. 

I'll use myself as an example:

When I pause and reflect on the folks who are in my caseload, I notice there are some clients who stick with me all the time, because the work with them is difficult (or because they appeal to me in some particular way), there are some folks who I avoid thinking about, some who I forget about entirely, and some whose sessions I truly enjoy. 

Processing helps me step back and look at the larger picture of what’s happening. Otherwise, I can easily get bogged down in the "session notes version" of things (you know...what happened first, then what happened) and never move beyond it. 

Processing means I start to be curious and ask questions: 

Hm, why do some of my clients appeal to me more than others? Why do some not? What is it about some people that makes me completely forget about them until I see them in a session? Why is a particular client frustrating me so much? What's my role in this? Is s/he reminding me of someone else in my life? Is my complete joy in working with a particular group of clients making it hard for them to explore feelings of anger they may be feeling toward me (whether it's about me or not)? Is my discomfort about a specific topic obvious to my clients to the point that they're they avoiding looking at it to "please" or protect me? 

4. Processing helps you realize that music therapy doesn’t usually happen in one single session 

Well, okay, depending on where you provide services, sometimes it does. In general, though, processing helps you start to put things together (from one session to the next, over a period of time of working with someone, etc.). If you’re someone who tends to use an activity/therapeutic music experience approach, it’s important to think about what’s going on from moment to moment in a session that you might not have thought to look at. A process paper can help you do this and encourages you to ask questions, such as:

What happened? What patterns am I noticing in our sessions?  Then you move on to: What was I hoping to do with this particular person/group? How did it go? What do I think about that? 

5. Processing with a clinical supervisor helps you see your blindspots.

You don’t see your blindspots. That’s why they’re called blindspots. You don’t know what you don’t know! And, like anybody else, you don’t think to ask yourself something you wouldn’t have thought or known to ask yourself.

And that's okay! That's why there's such a thing called professional clinical supervision!  Yaaay!

Processing with a clinical supervisor helps you begin to see things you might not have looked at before. It doesn't mean you're a bad therapist. It just means that having an extra set of eyes and ears (who happen to have more experience) will help you think about things you hadn't thought to think about before. (Shout out to Michelle Erfurt for your great point that you didn’t really look at stuff to the extent you did until you had supervision!)

So, lovely music therapists: What new and unexpected thoughts are you thinking about your clients and about your work? 

Celebrating National Psychotherapy Day

It's National Psychotherapy Day today- the first one ever- and I'll be celebrating by heading, just as I do every other week, to my therapist's office. Why? Because I firmly believe getting my own therapy is an important part of my job as a music  therapist. 

Knowing who I am and what kind of emotional baggage I'm carrying around with me helps me be present and attentive to the clients I serve when I show up to provide music therapy.

When my clients do their best to avoid hearing me invite them to look at a belief they're strongly committed to (sometimes even going so far as to literally stick their fingers in their ears), when they fall asleep mid-session because something we're addressing feels way too overwhelming, when they fight mightily against change...I have a pretty good idea of what it's like. I've felt and done the same (okay, maybe I don't actually stick my fingers in my ears or fall asleep in therapy, but I can be pretty darned noisy if I don't want to know something). 

I'll be honest with you: I am uncomfortable recommending any music therapist I know who hasn't spent at least some time looking at his/her own issues in therapy. I mean, what are we communicating to our clients if we think we're above getting our own therapy? If we, essentially, perpetuate the attitude of stigmatization associated with taking care of one's emotional and mental health? 

One of the (many) reasons I loved the HBO show In Treatment was that the writers made sure the therapist, Paul Weston, went (even though he was kicking and screaming the whole way and was more of a pain in his own sessions than any of his clients ever were in theirs)  for his own therapy! 

Psychotherapy for therapists goes beyond the usual nice, self-care sorts of things we tend to talk about in music therapy circles (you know...the whole getting a massage, taking regular vacations, taking a bubble bath and the like). It's an ongoing commitment to self-discovery, a recognition that, yes, we can and do get in our own (as well as our clients') ways, and figuring out how to (much as we may bravely resist) make changes in our perceptions and ideas about our selves, our lives, and our relationships. 

So, good people, with a grateful nod to Ryan Howes (a blogging buddy who shares his insights over at the Psychology Today blogs as well as being a contributing editor at the Psychotherapy Networker), I invite you to consider how you might join in the acknowledgement and celebration of National Psychotherapy Day. 

After all, mental health and self-awareness are most certainly worthy of celebration!

Sharing an excellent TED Talk with you

True, this doesn't really count as a blog post. But you need to hear this. Trust me.


I first heard Brene Brown on Voices in the Family with Dr. Dan Gottlieb (one of my favorite ways to spend Sunday morning is to listen to my local NPR station, WHYY in Philadelphia). And I loved what she had to say! She is a researcher (cool!) who studies shame and vulnerability (wow!). 


In this TED talk, she tells us about how being vulnerable is an act of courage. More importantly, she reminds us that shame is diminished with empathy. 


I have a lot to say (shocking, I know) about both vulnerability and shame, but enough of my blather!  I want you to listen to this talk, because it's important. 

Last chance lost...

I noticed this song- "Last Chance Lost"-  running through my mind over and over again as we struggled to come to some kind of....okay-ness, an okay space today in our session. My client has some very strong feelings toward me, and although he knows "we don't have that kind of relationship" it's hard for him to hear it. Over and over.  

Yes, and it's hard for me to keep having to say it, because I feel cruel. I mean, I realize I'm not being cruel. I'm being truthful (and a therapist), and I know it would be more cruel to lie to him and pretend I don't see how much he wishes this weren't "just music therapy" and it was a better version of his life. 

And I'd be lying to you if I didn't say the rescue fantasies on my end can be intense. If I weren't so used to this happening it would be freaking me out. But this is something I go through, and it's more so with some people than with others. 

But here he was, this man who doesn't use speech, working so hard to be heard- using his voice even (which is rare)- and there I was...rejecting him again. 

When I step away from the session for a while and think about it, I have an idea of how to proceed and what we need to look at: Where are the feelings for me coming from? What might they be helping him to avoid feeling? What relationship(s) might he be trying to create or re-create in our sessions? And so forth. 

But...right there in the session...I feel like such a jerk. 

It's not that I'm afraid he'll be angry with me- although it would mean the beginning of the long period of anger. 

There always seem to be stages in the music therapy process- at least with the folks I work with individually. Initially there's a long period of "I don't trust you." That's usually followed by "okay, maybe you're not so creepy," which eventually works its way into "must we leave now?" Then we get into the "I like you/I can't let you know how much I like you" period which gradually becomes "I love you and you should never leave me!"  

I think my client and I are in that latter period right now. And I'm in the complicated "be firm but kind and figure out a way to reject without being rejecting/remember you're trying to help him realize how he's relating to people that's not really working for him/come on, Roia, you can do this" part of the work. 

And I know. The big anger is coming. Okay, so maybe I'm a little afraid. It's hard to give up being loved. Not that the anger indicates an absence of love. It's just easier, I'm sure you'll agree, when your client is in the "you totally rock" phase versus the "you rejected me and you are horrible and cruel" phase. 

Anyway. We struggled. He was sad. I was sad on his behalf. 

It was hard for him to return his instrument at the end of the session, and he insisted on carrying it back with him to his cottage- where he finally gave it back to me after a brief, gentle tug to make sure I understood he wasn't happy about relinquishing me or the instrument. 

The only part of the song I remembered as we worked through this session was "last chance lost". When I read the lyrics I was fascinated (for the hundredth time) by how our minds create musical connections with people, with moments and experiences. 

Last Chance Lost

by Joni Mitchell

Last chance lost

In the tyranny of a long good-bye
Last chance lost
We talk of us with deadly earnest eyes
Last chance lost
We talk of love in terms of sacrifice and compromise
Last chance
Last chance lost

Last chance lost
The hero cannot make the change
Last chance lost
The shrew will not be tamed
Last chance lost
They bicker on the rifle range
Blame takes aim
Last chance
Last chance lost


© 1994; Crazy Crow Music 

Music therapy at the boundaries

It happens I'm a part of a group on LinkdIn for psychologists, counselors and coaches. Not that I'm a psychologist, counselor or a coach, mind you... 


But anyway.


We've been enjoying (okay, I've certainly been enjoying) a robust discussion with regard to the question of "how much of our personal selves do we share with our clients?"


To the best of my recollection (which is a bit, er, well, let's just say it's not what it used to be), Rachelle Norman has tackled this question (a couple of times, actually) in her blog, Soundscape Music Therapy. A while ago she wondered how much should she share regarding the birth of her baby (who is awfully darned cute, if you must know), and, in a more recent post, she talked about The Top 10 Rules to Break. A big hooray to you, Rachelle, for addressing this complex and apparently rather heated issue!

So, back to the conversation going on at LinkdIn...


I've been sort of surprised at how many counselors and therapists seem to believe, rather ardently, that the "rule" regarding the "therapist as blank slate" is too stringent. A large majority advocate sharing more of themselves as a way of "being authentic" with their patients. If I'm understanding them correctly, they seem to feel, "that's what our clients are really looking for- for someone to be authentic with them."

Interesting.

Among the questions that came up for me in reading comments along these lines was: are we really being inauthentic with our clients if we don't share on a personal level with them? And does being authentic with someone always mean being transparent? 

When I looked up the word, I learned that being "authentic" is associated with being genuine, or being truthful. Which is not the same as being self-revealing. Hm.

For me, I think the question of what and how much to share of ourselves boils down (as most things in the therapy situation seem to do) to another central question: whose need am I meeting in this situation?

As many music therapists are aware, simply because of the nature of our profession, we actually share quite a bit of ourselves through the music-making we do with our clients during sessions. Just as we learn about our clients through their musical expression, they learn an awful lot about us when we interact with each other musically.

Obviously, we do our best to keep to professional boundaries- for many legitimate reasons. One very large reason is the power inequity. It is (usually) a paid relationship. Therapy isn't meant to be a friendship, and, whether or not we choose a fairly egalitarian approach to our work as music therapists, we can't control (or ignore) our clients' perceptions that we have a certain amount of power, authority and influence in their lives. 

As an example, in my particular line of work (with people who have intellectual and developmental disabilities), I often remind myself of the fact that I have keys to my clients' homes, and they don't.

I wonder if, in the end, it's about coming to terms with the duality (maybe it's a plurality?) we are asked to hold as music therapists (or any kind of psychotherapist, I imagine). Yes, our clients often do come to us in pain and in a tremendous state of need- for, among other things,  friendship and for people to be 'real' with them. Simultaneous to that, we are bound to uphold our code of ethics, to maintain an awareness of our own unmet needs (and our rather human tendency to want to take care of those needs in all of our relationships- including those with our clients), and an awareness of the power dynamic that exists in the therapy space.

It certainly isn't easy to keep track of these various elements. Of course, as my supervisor often reminds me, "that's why they call it work."


What are your thoughts on boundaries and being authentic with clients? Does it depend on the situation? Or on the particular group of people receiving services? Are you likely to have more "flexible" boundaries with certain groups of clients and not as much with others? And what does that fact say in terms of the ideas and beliefs we hold about the particular groups of people we serve? 

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. 

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! 

"Rescue me!"

Image by cotton_man via Flickr

Okay, this may seem like a weird thing to blog about, but I'm doing it anyway. 


I was contemplating the fact that I have periodic rescue fantasies that involve my clients. 


I don't know what else to call them. And there seems to be an element of "Rescue me!" in them, so there you have it. 


I'm sure it has nothing to do with my clients who avoid leaving at the end of their sessions. Or find the longest and/or slowest way back to their cottages possible. Or the fact that as soon as I drop some people off after their sessions, they are pulling me back to the door to leave with me. 


No, I'm sure that's not it.


Cup of guilt anyone?


Anyway, I was thinking about the fact that the rescue fantasies that seem most prominent in my mind always seem to involve thinking about driving with my clients (not going anywhere in particular- just driving) and cooking for my clients (I spend a lot of time in the kitchen).


Escape from the life they have and being nurtured and fed.


I just thought that was interesting. 

Taboo Topics in Music Therapy- Part III- The List (so far)

Here's a list of taboo topics I generated. I found I had to keep adding to it as I went along. I also included many of the offerings of the conference participants. Feel free to comment and add your own. I dare say there are quite a few taboos to be found in music therapy as yet. 

Taboos (I have known and loved)

1. Sexual feelings and/or arousal

a. for clients

b. dreams about clients

c. our clients feelings about us

2. Fantasies

a. that we will be the one person who makes a difference in our clients’ lives (or that we are the be-all and end-all in their lives)

b. sexual fantasies

c. fantasies of taking clients home and taking care of them, also known as “rescue fantasies”

d. dreaming about clients

3. Mistakes on the part of the music therapist

4. Fee disasters/money/financial transactions

5. Hatred for/anger toward a patient

a. hating a patient’s music

b. clients who are hurting/frustrating us

6. Getting sick and not being able to do your job for a while

a. can include mental illness as well as physical (i.e., needing to take a break from work)

b. music therapists who have mental illness

c. fear of getting sick when working with clients who have communicable diseases

7. Feelings of incompetence

a. not knowing what to do in a session

b. feeling lost

c. feeling uncertain musically

8. Feeling that we need to be all-knowing, all loving (a.k.a. “Music Therapist Syndrome”- the belief that we must always be nice and cheerful, and that it is our job to make our clients feel better, and that we should never be “mean” and confront them or push them in any way or to talk about “sad” subjects.

9. Feeling bored or tired/sleepy during sessions

10. Clients who gross us out or offend us

11. Therapist’s fears/terrors

12. Therapist’s personal issues around shame/guilt

a. May include therapist’s own abuse history

13. Being fired

14. Issues with staff/co-workers/clients’ families

a. having to report staff/clients’ families for abuse/neglect/etc.

b. fears of retaliation should we report abuse

c. dealings with staff regarding clients (having differences of opinion)

d. staff undermining our efforts as therapists

15. Being uncomfortable with the system within which we work

a. disagreeing with the way client services are provided

b. having to represent a facility we don’t always feel comfortable with

16. Boundary violations

a. treating clients or their families as friends

b. hugging/touching clients as a matter of course

c. violating client confidentiality

17. Guilt over terminating/guilt over not terminating

a. “I should have tried harder.”

b. not working on closure

c. difficult endings

d. ending because we don’t know what else to do

18. Fear of violent clients or those who act out in other ways

a. constant anxiety when having to go and work with a particular client

19. Clients who fall asleep in sessions

a. leading to fear that we are inept or ineffective therapists

b. that we’re doing something wrong or boring

20. Having favorites

a. when we admit it we’re less likely to act on it than if we deny it.

b. also the belief that we have to love all of our clients

21. Fear that a client may commit suicide

a. along with the fear that we will miss the warning signs and it will be our fault

b. and the corresponding fantasy that we will be the one to save this client

22. Being in the role of “helper”

a. discomfort with being in the role of ‘helper’

b. not being aware of the power difference between client/therapist

23. Seeing clients as more disabled than they are

a. sometimes leads to an attitude that “they don’t understand what we’re doing, so it won’t hurt them” (this is the kind of belief that can lead to situations like the one with Corey Brown, the music therapist who molested his clients)

24. Working with someone your own age

a. Or working with someone you’ve known in a different context (including survivor guilt)

25. Running into clients outside of the therapy context

a. Clients who want to connect through various online social networks

b. Clients asking for sex/marriage/personal phone numbers

c. Clients who grope themselves/who try to grope the music therapist

26. Clients who are better musicians than we are

27. The myth of music as a “non-threatening” medium

28. Guilt over privilege

29. Assuming our clients are heterosexual, or identify as a particular gender

30. Hating a particular style of music and/or refusing to learn or play a particular style in music therapy sessions

31. Clients dying or getting seriously ill (sometimes in the middle of a session)

32. Racism, sexism, able-ism, heterosexism (in all of their infinite varieties and forms)

33. Music therapists who do not dress in a professional manner (i.e., whose dress is seductive or overly casual)

Why we don’t talk about these things (some of these reasons are taboos in and of themselves, I would say):

• We don’t always know the answer
• We don’t want to look unprofessional/bad
• Ashamed/embarrassed/fear of being blamed
• Music therapy students who are over-protected/over-directed
• Not always recognizing countertransference
• Helplessness
• Not wanting to deal with repercussions
• Competition between colleagues
• Not having a supervisor/mentor/safe resource
• The need to constantly “prove” that music therapy is a valid therapy
• Wanting to be a good example
• Diminishing the impact of an issue (i.e., making light of a difficult topic)
• Fear of being seen as a fake/incompetent