When I was studying music therapy at Marylhurst University, we discussed transference and counter transference quite a bit in one of my courses. I remember thinking, “Wait, which one is which?” I admit I still have trouble with the distinction, but I understand, more and more each day, how transference affects the environment.
I see a group on Tuesday mornings. This group is almost always very high energy, and I typically spend a lot of time at the end of the session trying to bring everyone together in breath work (which is to say I want everyone to relax a little before they go out screaming down the halls to lunch). A lot of the people in the group use speech, and some of them sing along or contribute words or phrases to improvisations. Many of the people in the group stand and move in the music or play instruments. Almost always, I leave these sessions feeling nearly jubilant, refreshed even; this group infuses excitement in me that I can say I don’t regularly feel in other sessions.
I walked in this morning and was very plainly sad. I set up my instruments and gear on the table as I always do and I wanted very much to be home. I felt homesick and down. I immediately wondered: Is this me, or is this them? If it’s not me, is it the whole group? What have I noticed walking in today? Is there anything unusual happening today? Has someone died? Is someone ill? Why am I so sad?
This heaviness stayed with me for the whole session, even though the group did not reflect this sadness. I did not hear anything that evoked sadness. No one played anything particularly somber during the check-in. But, one group member had re-joined after having been away for several weeks. This person, though they presented cheerful enough, has always had an irregular and erratic home life and has been in group so infrequently that I wondered whether they would ever come back. I know that they don’t have a lot of support.
I wonder, now as I’m writing, whether the sadness was mine today, or whether is was the group’s, or even that individual’s. Maybe it was both. Maybe it wasn’t. What is endlessly fascinating as well as frustrating about group work is that I won’t ever know.
This year has been quite dynamic. I’m still interested in collaborating with other creative arts therapists in writing projects. Next year, a colleague of mine and I are launching a really neat, fun, hopefully interesting and educational project that will be coming out in January. I will be sure to post more about it here, once we have the details entirely considered.
Happy holidays, all.
I have been a recipient of clinical supervision for about two years now. Because I do not work with other music therapists, and because I was starting to burn out working the way I was working, I found a clinical supervisor with whom I have been speaking on a weekly basis. In many of my conversations with her, I ask her for advice, support, sometimes validation, a new direction to take, and often how the quality of the music being shared between my client and me is indicative of progress or resistance (which is not to say that resistance is not progress). Over the past year, I spent most of my time with my supervisor talking and sometimes playing through my work with a particular client. Finally, last week, this client really opened up and I felt an enormous shift in the session. I was both electrified (this is how therapy really feels) and terrified (repeat: this is how therapy really feels) by this change. I believed in our process at that point– that all of the work and supervision and consideration regarding this client mattered. We had moved into another level of work.
The next day, the client was pulled from music therapy because apparently this person’s other therapists reported progress, too, and inexplicably for that reason, music therapy was no longer needed.
I could not believe it. I still cannot.
Here are three steps I’m taking to deal with this blow:
- Talk with my supervisor.
- Write about it, create about it, play about it. Consider my feelings about this abrupt termination. Recognize that this was a therapeutic relationship in which I was a member, and that I can be upset by the fact that my opinion about this sudden termination didn’t change what happened.
- Find peace with it somehow. We’ll see how this turns out.
I wonder what steps I’m missing. This is the hardest termination I have experienced yet.
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Looking for a peer support group? If you’re in the Minneapolis or St. Paul area, and you are a board-certified music therapist, feel free to connect with me and I will let you know about our group.
Sometimes I think of my writing droughts as a period of inhalation. I had a great professor who once talked about the “incubation period” in a process. At the time, I was writing a paper. Really, it was that I wasn’t writing the paper that was worrying me. This professor said I might think of my not-writing not so much as procrastination but as incubation. Perhaps I was compiling ideas or sorting thoughts. This summer, instead of writing, I was surviving; I didn’t have the energy, creative or otherwise, to write. Maybe I was inhaling, sucking in what I could to get on with it all. Maybe I’m starting to let out some. I might be exhaling for a bit.
We’ll wait and see.
Yesterday I started to read some of Tony Wigram’s article, “Music Therapy Assessment: Psychological assessment without words,” published in Psyke & Logos in 2007. I’ve been working with instrumental responses with some of my clients, but also, of course, with their vocal responses. Wigram cites J. Alvin’s list on vocal responses to include, “evaluating the significance of the voice as a revelation of personality,” as well as “evaluating the placement, projection and quality of the voice” and “control of pitch and intonation” (Psyke & Logos, 2007, 28, 339). I absolutely do these things. Nearly all of my clients do not use speech, and I consider the way they use their voice (even if that use is very limited).
How do you consider responses? Do you look at one — instrumental, vocal, or behavioral — with more weight?
Assessment is a practice that continues from session to session and moment to moment. Formally, assessment happens at the beginning stages of treatment. In order to evaluate a client and his or her state on a meaningful level, assessment has to recur; it’s just that sometimes it isn’t termed “assessment.”
One of the facilitators of the clinical improvisation course I took at our Great Lakes Region conference sent along an article on assessment called “Music Therapy Assessment: Psychological Assessment Without Words,” by Tony Wigram. The article, published in Psyke & Logos in 2007, looks at the reasons behind assessment, and how assessment can be defined and categorized. Admittedly, I’ve not read the whole article yet, but I was struck by one list that was shown (page 339). Wigram shows music therapy pioneer Juliette Alvin’s lists for assessing responses to music therapy. Specifically, the list “instrumental responses” was what I enjoyed the most; I’ve been working with instrumental responses with some of my clients a lot lately, and this list helps me clarify even better what I have been doing. Some items on the list include, “the clients’ understanding of cause-effect relationships on the instruments,” “whether obsessions or compulsions are expressed through the instruments,” and “whether instrument playing is purposeful or random” (Psyke & Logos, 2007, 28, 339).
Of course there are several other items on the lists that I consider to be really important, but these are some that I might look at with some more care.
What kind of assessment tools do you use? I’m curious.
I’ve just returned from my regional music therapy conference, held in Rosemont, Illinois. We got home earlier today, and I went to see clients this afternoon. Surprisingly, I’m tired.
I attended a number of fascinating presentations, but the most immediately applicable in terms of functional knowledge that I employed even today was the CMTE (continuing education) course on clinical improvisation. Of course we spent time developing our technical knowledge of modes and how to easily access them on piano (among myriad other techniques), but what I found the most useful, confusing, and encouraging was the time we spent translating our goals into music-centered goals. In other words, how, in the music, would we clinicians know a goal has been met? How would the music achieve the goal? How would the accomplishment sound? Music therapy cannot be compared to any other therapy, because the music in music therapy is an entity and a language all in itself.
One of the conversations had in this course was surrounding music therapists’ definitions of our work, especially when we’re describing our work to someone who assumes we are music teachers. “Music therapy uses music to achieve non-musical goals” is a succinct and often-used way to speak about our therapy, but is it really accurate? Why do the goals we address have to be “non-musical?” How can we own the music in music therapy?
What are your thoughts? I would love to continue this conversation.
I have written before that I am in transition between working in two different music therapy approaches. I’m trying to become more and more comfortable with the process-oriented approach (which, in turn, leads me to feeling a lot of discomfort within sessions, but this could be a topic for another day). When I’m working with my clients now, I use a lot of improvisation. My principal instrument is voice, but I tend to use a variety of rhythm instruments with many of my clients.
I have some small groups of adults, with whom I am working on group improvisation. Today, I look back at Tony Wigram’s Improvisation, published in 2004. One goal I have in working with one group is to develop a stronger sense of cohesion in order to improve some social skills. Wigram writes about “rhythmic dialogues” on page 167. This kind of dialogue is something I’m hoping to facilitate.
Important potentials when trying to develop rhythmic improvisation are:
- improvising using a rhythmic figure, but without pulse;
- improvising with the same rhythmic figure using a pulse;
- rhythmic dialogues — where a rhythmic theme is used to build dialogue between two players
- establishing a pulse but without imposing a meter on it where random accents can disrupt any sense of meter;
- establishing a steady pulse with a meter where the accents can accentuate the meter…
I use the dialogues, as I mentioned, the most, and then maybe the first two bullet points as well. Sometimes I’m able to experience a nice back-and-forth with this group, which is encouraging.
How do you feel about this book? Do you use rhythmic thematic improvisation or melodic thematic improvisation most often?
I love this work I get to do.
I love that one of my clients came up and hugged me today, when he’s never done that before.
I love that I always feel full of life when I go to a particular day center.
I love that sometimes my face hurts at the end of the day from smiling so much, sometimes out of joy or happiness, but mostly out of fulfillment.
I love this work I get to do.
What about you?
I’ve been looking at Kenneth Bruscia’s Defining Music Therapy (second edition) over the past few days in order to research a little for a project a colleague of mine and I are doing. I am, again, struck by how lovely vision (and clarity of said vision) can be. For more than a year, I’ve been transitioning into and therefore learning about another way of practicing music therapy. Should you happen to own this particular Bruscia book, I’m specifically interested in pages 116 and 117. Page 116 lists some of the clinical goals of improvisation:
- Establish a nonverbal channel of communication, and a bridge to verbal communication
- Provide a fulfilling means of self-expression and identity formation
- Explore various aspects of self in relation to others
- Develop the capacity for interpersonal intimacy
- Develop group skills
- Develop creativity, expressive freedom, spontaneity, and playfulness with various degrees of structure
- Stimulate and develop the senses
- Develop perceptual and cognitive skills
I am especially drawn to his first, second, third, and sixth bullet points. Nearly all of my clients do not use speech, and, in music, I am hoping to facilitate a “channel of communication” (page 116).
To you readers who are not music therapists: Do any of these goals surprise you? How so?
To you readers who are music therapists: How do you remember this text? I’m back in love with it.