Upcoming music and dance/movement therapy workshop in NJ

In case you're wondering if I'm still alive (I am)...I've been preparing to present a five-hour Continuing Music Therapy Education (CMTE) workshop on countertransference with my friend, Mark Bottos, a dance/movement therapist at Kardon Institute for Arts Therapies in Philadelphia, PA. If you're a music or dance/movement therapist, and you're interested in attending, here are the particulars:


Date: Sunday, October 3rd, 2010 9 AM to 5 PM


Location: Kingsway Learning Center; Haddonfield, NJ


Cost: Free for NJAMT Members


Title: "It's Complicated: Exploring the Many Aspects of Countertransference"


Presenters: Mark Bottos, MCAT, DTR and Roia Rafieyan, MA, MT-BC


Therapy can be a complicated process, requiring us to attend to many different elements simultaneously. Learning about the role of countertransference (CT) in the therapy relationship as well as developing an awareness of when we are having a reaction in sessions will not only make us more effect clinicians, but it will also help us find ways to cope with difficult feelings that emerge in the course of our work. Participants are invited to share clinical challenges. Through movement and music experiences and dialogue we will explore ways in which CT manifests in our music, movement and clinical choices. 


6 CMTE credits are available. 

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

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


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


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


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

Questions to ponder

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

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

but actually helps the therapy process?

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

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

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

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

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

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

Resources for Further Reading

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Eating a slice of humble pie

Image by shandopics via FlickrI knew if I waited a while, calmed myself down and thought about it in a peaceful state, I'd have a better idea of how to proceed with C. 


You may (or may not) recall that I wrote about the dreadful session I had with her a couple of weeks ago. I was feeling terrifically annoyed with myself (among other sources of annoyance) because I had allowed my anxiety about staff being upset with my "letting" C strip in music therapy (I mean, really?) cloud my therapeutic judgment. 


Ugh!


So, as I was driving back from Michigan (which is quite a long drive when you're headed to New Jersey) to visit my friend (a music therapist turned music librarian, as it happens), I was thinking about the coming week. Naturally, my thoughts turned to Monday morning, C's scheduled time for music therapy. 


I had (yet) another twinge of guilt as I remembered our last session before I went on vacation (just for the record, it's not unusual to have a horrible session right before a vacation- in fact, it's one of the, er, perks of being a therapist). 


And let me just say, it was not one of my shining moments as a music therapist. 


As I was trundling along the Ohio Turnpike (where they have very nice rest areas, I must say), I wondered what I was supposed to do about the stripping. I didn't want to stop working with her, because, in spite of the exposure episodes, there were moments of actual connection in the music. 


I tried to perceive the situation from C's point of view (something I've tried to do before), considering the idea (again) that she may, in fact, feel exposed. 


Then it suddenly hit me! 


A forty-five minute session is way too intense for her! Sure she may appreciate parts of the experience, and she may even find herself engaged meaningfully with the music (maybe even with me), but she's not even close to being ready to deal with that kind of constant attentive interaction for that long of a period of time!


Of course!


I need to start out with very short sessions (five to ten minutes at most) and gradually learn when C is letting me know she's ready for more time. 


Honestly, sometimes I think I've been at this a bit too long that I could manage to forget something as basic as that. As basic as: can this client tolerate a 45-minute session, or should we start small and work our way up? 


So, today I showed up in the cottage feeling a little more confident (with regard to the staff), and I explained my plan. I'm not sure they were as enthusiastic about my plan as I was, but they were agreeable enough (which I appreciated).


The supervisor (for some reason) decided to get C, and we sat outside of the room where her group was meeting.


The first thing I felt I needed to do was to apologize to C for misdirecting my frustration in the previous session and aiming it at her. Then I acknowledged that I had not remembered that when someone is paying very close, unwavering attention to you for a sustained period of time it can be uncomfortable as hell. 


I told C my plan. "We'll start with a ten minute session. I'll practically be singing 'hello' and then 'goodbye' and then we'll stop, and I'll plan to be here next Monday again."


C, tucked under her blanket, tapped her hand against her leg. I sang "hello", she listened quietly, then I heard her giggle and vocalize with me a little bit. Then I asked if she needed anything else from the music before we ended for today. She vocalized a bit more. I sang "goodbye," put away my guitar, and I escorted her back to her group. 


She was smiling.