Friday, 29 June 2018

Vitamin C

I’ve written before about whether ‘music makes you feel better’. There might, in particular, be something therapeutic about shared music. This might happen in lots of different contexts: community settings, acute wards, closed groups, individual therapy, and so on. While music therapists might argue about how to frame the work, about whether it’s the music itself, or the relationship with the therapist, or unconscious processes being expressed through music, there seems to be some general agreement that music is an important part of the therapeutic process in music therapy, whatever it might be.

I went to a good gig last night. I try to do this as often as possible, but it never feels often enough. Anyway, I really enjoyed it, hearing Simon Purcell with the great alto player Mike Williams at Oliver’s in Greenwich. I’m missing music at the moment, not getting enough time to practice and not doing that many gigs, absorbed in my current research studies, which I’m enjoying in a different way. Research is creative, but in a more cerebral way than making music. One of the questions arising out of the research is about the perceived effects of music therapy sessions. What do parents observe about their children’s response to music therapy? I hope to tell you more about this soon! One idea that has come up in discussions I’ve had with parents in other contexts, which won't be news to music therapists, is that children are often calmer, less anxious, after their music therapy session. This can last a while, sometimes as long as a day or two. This chimes with my own experience of music. I feel better after playing, or after hearing a live performance. This usually lasts for a little while, but never more than a day or two. The experience fades. If I haven’t been to any live music for a while, I begin to lose interest in listening to recorded music, as if the real experience has to be recent enough to bolster the simulation.

So perhaps music is like vitamin C. We need it, but we need it regularly. Our bodies, or our psyches, don’t absorb and retain it, but it’s essential for our well-being that it’s passing through us. This raises some big questions about music therapy, particularly if we are looking for ‘effects’. If the effects of music itself don’t last, but need to be maintained, then what should music therapy look like? Is it more like asthma medication than antibiotics? Is music an essential balm for the chronic aspects of the human condition? If so, we could never expect music therapy to have good results at, say, six-month follow-up, because it would always have worn off by then. It might instead be about clients learning to use music for themselves, to understand their own relationship to music, so that they can return to it and use it in beneficial ways.

There might be another possibility, that it’s not about the music itself, but about music as a facilitator of relationship. Music simulates pre-verbal communication and thus allows human beings to connect with one another at a deeper level than language. This might help to repair attachments, perhaps. The problem with this is that there are lots of ways to form attachments. Music might assist attachment, but it’s definitely not essential to it. And in any case, as Claire Flower pointed out in her podcast interview, what can we achieve in half an hour a week? Children form positive attachments with other people whom they spend a lot of regular time with, over a long time span; parents, siblings, teachers, teaching assistants, friends, maybe therapists (if they see them for long enough). We might have a real dilemma here. Is it about the music? Is it about relationships? Is it about the interaction between the two? Do we have to choose one of these? You might think I’m being too reductive. Perhaps it’s all just ‘a lot more complicated than that’, or it’s about being holistic, rather than fragmenting these aspects of life into different categories. People, music, relationships; these aren’t things that can be separated out and examined independently. Ok. So why is it called ‘music therapy’ then?

Friday, 15 June 2018

Thinking about thinking

The great drummer Jon Hiseman has just died. This post isn’t a tribute to him, but I was very sorry to hear of his passing. (Here’s an example of his playing, which is brilliant.) I did meet him once, doing a recording for someone in his studio. I forget the details around this as it was a long time ago, maybe early nineties. What really stayed with me is something that he said during a conversation in the studio. He remarked that the best music is played by people who are thinking about something else entirely, or words to that effect. What I believe he meant was that, when you are doing a gig, if you are having to think about the music in order to get it right, then there might be mistakes, or a feeling of uptightness about it perhaps. It’s when you know the music so well that you can play it while thinking about doing the laundry, or taking the car in for a service, or doing your accounts, that the music really sounds good, really flows. It was a remark that has stayed with me ever since. I actually think about it a lot. I think it disturbed me at the time as it seemed to imply some kind of disconnection, maybe something inauthentic about the performance. I feel differently about it now.

Seeing the news was a moment of synchronicity for me, because I’d just been thinking about this idea in relation to some clinical work. I found myself, in a session, thinking about something else, unrelated to the client or the music. This can feel transgressive. We’re supposed to be paying attention to the client, and to the music, to the ‘shared-musical space’, perhaps. I even wrote about Jon Hiseman in my process notes. Later, after writing this, I saw the news of his death.

This isn’t a post about synchronicity however, although you can have that one too if you like it. What it really got me thinking about was what I think about when I’m playing. I’ve have so many discussions with other musicians and music therapists about this. Some people have said that, when improvising, thought gets in the way. You need to be ‘in the zone’, where you’re not tripping yourself up with concerns about what ‘should’ be happening, where you can be ‘in flow’. The music flows along, and we stay with it, riding it like a wave, trusting the process. As soon as we think, ‘is this right?’ or ‘is this good?’ or ‘what shall we do next?’, we are getting in our own way. Mercédès Pavlicevic talked about the problem of thought in clinical improvisation in her podcast interview, expressing a similar idea. She said it might go something like, ‘Why am I in F sharp?’, and then the moment’s lost. She’ll be missed too, very much.

There may be a difference, of course, between the role of thinking in improvised or in tightly rehearsed music. Jon Hiseman may have been talking about the phenomenon of playing music that’s been well played-in, perhaps where a band is really gelling, some way into a tour. I’ve certainly experienced this. It doesn’t necessarily feel good to the performer. It can feel routine. But for the audience it might be a thrilling experience hearing a band playing really tightly together, giving the impression of total unity, where the individual musicians are just firing neurons within a complex whole that’s not perceived by any one of them as an entity, but by the listeners. You can listen to a recording of a gig you were on and feel like it was someone else playing, because the experience is so different to being part of the process of producing the sound.

While going through the motions might produce a tight performance, could the same be said for improvisation? Well, yes, I think it could. Kenny Werner talks a lot about this a lot in Effortless Mastery. When you let go and just let yourself play without trying to critique or edit, that’s when the best stuff happens. Thought gets in the way. Maybe there are differences between these two phenomena, maybe they are the same, maybe there are overlaps, but it doesn’t matter, because that’s not what concerned me when thinking about what happened in the session.

The question that came to my mind when thinking about my moment of drifting off, of thinking about something else, was, if I’m not thinking about the music, then what am I thinking about? I’m usually thinking about something. I’m not a yogi. This might be worth exploring. It may be that I need to work on my capacity to be in the here-and-now. Perhaps all music therapists should practise meditation in order to work on this, to enter a more thoughtless, mindful state. Probably not a bad idea. I don’t think it’s the answer though. I think the process of thinking, getting in the way of the music, being with the client some of the time, attuning, failing to attune, drifting off, playing good music or bad music, I think it’s all the process. The idea that we are attentive to the client, and that we are sharing in the musical process together, connecting in the music, is nonsense, or, at least, it’s not realistic. We are in some kind of music-making process with the client, and the two of us are failing to connect with each other in one way or another. We might be trying to connect, but we’re never going to make it, because our experiences will always be different. Even when the music comes together, it’s coming together in at least two different ways (I’m not going to even try to talk about group work). But this, I hope, is ok. I hope it is, because I’m never going to pay total attention to the client, not for a whole session. I’ll keep trying, but occasionally I’m going to drift off. I wish I hadn’t mentioned ‘doing your accounts’. What was I saying?

Monday, 19 February 2018

Music therapy in 2068

So, after the BAMT 2018 conference, which was full of positivity and new ideas, with a great spirit of openness, there’s lots of different possible blog posts that could be written. But I have to go with one idea that’s inescapably in the foreground for me. During the ‘Question Time Debate’ Gary Ansdell made a couple of provocative comments. There’s a danger of me misquoting, for which I apologise in advance. (Hopefully the recordings will be available to check in on later.) First he said something about the alignment of music therapy with a psychotherapeutic model being an ‘old chestnut’, which is now well and truly ‘roasted’, and that music therapy has restricted itself as a profession by identifying with this model. Then, in the round of closing statements, he said that we should do away with ‘music therapy’ within the next 50 years, by which time enough musicians will have been trained appropriately to replace the role, because ‘there will never be enough music therapists’.

There’s something about the provocative statement that stays with you. It’s a real talent, to come out with those soundbites that annoy people just enough that they can’t quite let go of them, but not so much that they can simply dismiss them. If he’d said ‘5 years’, for example, that would have been easier to let go of.

This is part of the (very much partially roasted) ongoing discussion which some people, for some reason, wish would go away. A few thoughts have been occurring to me. First of all, on the idea that there might be something restrictive about the psychotherapeutic model; I wonder what psychotherapists would have to say about this. Do psychoanalytic, person-centred, transpersonal, Gestalt, integrative, existential, systemic or cognitive analytic (etc. etc.) psychotherapists find their models restrictive? Music therapists have drawn on ideas from all of these perspectives and many more. I also struggle, in certain senses, to see any fundamental difference between music therapy and psychotherapy, especially if we take both as rather broad terms. This may be a bias connected to the type of work I do, which is often with children and young people in a time-boundaried, confidential, attachment-based context, where the therapeutic relationship is central to the work. But actually I’m not so sure about this: I think psychotherapy, if it is ‘treatment by psychological rather than medical means’ (OED), covers a broad spectrum.

My own experience of (psychoanalytic) psychotherapy, as a client, is that it provided containment for feelings, emotions, wellings-up, that were difficult to manage in day-to-day life. The importance of having a space to take aspects of self that it can be difficult to fully contend with is not easy to assess, but it’s not to be underestimated. And I wouldn’t describe my own personal struggles as anything out of the ordinary. The verbal, cognitive aspects of this were important, but they were only a part of the whole experience, in which the presence of a supportive ‘other’ was really the key factor. (I almost wrote ‘non-judgemental’, but it’s not as simple as that in a transference relationship.) I would suggest that the overlap between what was going on in my own psychotherapy and what generally goes on in music therapy was substantial. You don’t even have to factor in the verbal aspects of music therapy for this to be the case. The supportive other, listening, reflecting back, partially understanding, and trying to understand more, over time – these, in my experience as a client were/are/will be the important therapeutic factors.

This is such a significant experience, so fundamental in the way it operates, that a word like ‘restrictive’ feels baffling. I can imagine an answer, along the lines of, ‘it depends on the client group, aims of therapy, setting, social context’, and so on, but you can say the same thing about psychotherapy, with its array of models which adapt to different individual and group settings. Of course, you could also argue from the other side, that verbal psychotherapy restricts itself by not having music as a medium of expression, although it can use attunement, inflection, silence, body language, facial expression, all the various modes of communication of which we’re often not fully aware.

This is too complex a topic to contend with fully in a blog post, and I hope to hear Gary say more on it, perhaps to correct my own (at best) partial understanding of what he meant. Maybe I'm repeating old arguments, but if I worried too much about that, this blog wouldn't exist in the first place...

I do welcome these kinds of statements, because without them we’d just be agreeing with each other. The other statement, about there only being 50 years left for music therapy, I can only respond to with a hunch, which is that, to me, it feels like we’re just getting started.

Monday, 8 January 2018

Failures of imagination

It’s been some time since I wrote an entry for this blog. This is partly because I’ve been acclimatising to a new challenge: training in clinical research on the NIHR MRes scheme at City, University of London. I’ve been trying to get to grips with concepts such as systematic review, research ethics, statistical models, implementation of findings… I could go on. It’s a fascinating journey and I’m the only music therapist on the course, my fellow students coming from health professions such as physiotherapy, speech and language therapy, nursing, midwifery and OT, amongst others, none from a psychotherapeutic background. The course is strongly focused on evidence-based medicine, and, for a music therapist, this could be a welcome thing. We need more evidence for music therapy, both for efficacy and for process. We need to know whether it ‘works’, and, where it does, how it works. Of course, a lot of work has been done on this already, but it’s all relative. We’re a small profession and clinical trials of music therapy are still comparatively thin on the ground. Even the recent Cochrane review into music therapy for depression, with positive findings and statistical significance in the meta-analysis (I know what those words mean now!), is drawing on total numbers, for all the studies combined, of below 500. It’s a fine achievement, but that reality suggests we still have plenty of work to do.

But there’s also the valid question of whether clinical trials are the right way to go about researching efficacy in music therapy. I became involved in a discussion on twitter recently where some music therapists were talking about the need for ‘standardised measures’ and the importance of analysing ‘multi-site data’ in order to make our case to commissioners and funders, to show that what we are doing is ‘effective’. This could be a good thing, but it made me nervous. I remember Mercedes Pavlicevic, in her interview for Music Therapy Conversations, referring to her PhD research and saying that ‘I knew it worked, but I wanted to know how it worked’. I’ve heard this a lot, that we ‘know it works’. I’ve said it myself. In fact, her PhD goes some way towards answering both of these questions, in a particular context.

But, more generally, do we ‘know it works’?

I’ve encountered a lot of discussion on social media about religion. I need to get better at staying out of it! There’s a clip of Stephen Fry being very critical of the Christian concept of God, which has been very popular amongst people who want to critique religious authoritarianism. It’s an effective smackdown of the ‘all-knowing, all-seeing, yet empathic’ idea of God which he takes as inherently contradictory. By way of contrast, I heard the TV producer and presenter John Lloyd, in a TED talk, talking entertainingly about ‘Ignosticism’. The way he puts it (at 4:24) is that ‘I refuse to be drawn on the question of whether God exists until somebody properly defines the terms’. This is a quick way of extinguishing a lot of the confrontational ‘theological debate’ that you might find on social media, or in the pub, or wherever, if only people paid attention (which they usually don’t). It’s a useful concept, and if we narrow the focus down from ‘God’, to ‘music therapy’ (why not?), it highlights the core of the problem. Since we haven’t decided what music therapy is, saying that ‘it works’, can only ever be referring to one particular example of music therapy, or, at best, one approach (if we can define what we mean by ‘approach’). Tia De Nora (2006) has already identified this dilemma.

One step at a time, I suppose. One interesting question I’m not sure has been fully answered yet is, ‘What makes a good music therapist?’ Another question, ‘What is musical relationship?’, has been explored somewhat, but is such a huge topic that it has plenty more to offer. Measuring stuff can be useful, but we need to make absolutely sure it’s the right stuff. Empiricism could be what sets music therapists free, or what constricts us if we measure the wrong things. If we can figure out what can’t be measured, this might lead us back to where we started, with a big mysterious question mark about what it all means, and this might be a good thing. The calls for ‘standardised measures’ might betray an anxiety and perhaps a failure of imagination, because this mystery at the heart of existence, and at the heart of music, might be vital to the practice and understanding of music therapy. Perhaps, whether we’re talking about ‘God’ or ‘music therapy’, defining our terms might be one of those journeys where it’s better to travel than to arrive. Either that, or we need to remain ‘Ignostic’ about music therapy, and decide, very clearly and precisely, what it is, before we make any attempts to test whether ‘it works’. How ‘clearly and precisely’? Very. And if De Nora’s right, this might mean that each therapist/participant combination requires its own unique definition. Hmm, let’s hope not…

Wednesday, 13 September 2017

Having fun?

I heard a story about a conductor of a well-known orchestra who used some rehearsal time to play some pieces ‘for fun’, much to the irritation of the musicians. All professional musicians, above all, want to get to the end of the rehearsal as soon as possible, and the idea of playing something ‘for fun’ is anathema. Perhaps I’m generalising too much, but, if I am, not that much. Rehearsing is work, and work is nice when it stops. That’s not to say that rehearsing is never fun, but if you start to call it that, it annoys people. The ‘fun’, if it’s there, should be a side effect, not the rationale for the rehearsal. Sometimes jazz musicians get told how much ‘fun’ it must be to play jazz, by people that don’t. Maybe there is some envy of the perceived spontaneity of jazz, as well as the feeling of joy that the music sometimes conveys. There’s a quote attributed to Johnny Griffin – ‘Jazz is music made by and for people who have chosen to feel good in spite of conditions’. But you could apply this to a lot of music, since the initial impetus for getting involved in music in the first place is to feel good in some way, whether it’s through self-validation, connection to others, enjoyment of the music itself, or perhaps a feeling of being uplifted or enlightened.

I remember an interesting comment my father, a big jazz aficionado and a talented musician himself, made about Bud Powell, that he wasn’t surprised that the ‘psychological minefield of bebop’ might be linked to mental health problems. Bud Powell, dogged by mental health problems and alcoholism throughout his career, was a musical pioneer of great artistic integrity. The link between great art and mental health problems is well documented, and my father’s comment further implied that there may be something perilous in the content of the style, perhaps something psychologically dangerous about musical innovation, especially where what is being expressed feels darker and more difficult than what went before, as was the case with bebop.

Also, ‘feeling good’ and ‘having fun’ might not be the same things. But even if they are, music doesn’t always lead to one or other. Music can explore difficulty and express ugliness, pain, frustration, things which don’t necessarily make for an evening out. Of course, these difficult emotional worlds might be part of a larger narrative, one that is ultimately meaningful and transformative. Dissonance might be experienced in the moment as unsettling, but then in context as creating tension which leads to resolution. Music has to have a dark side, even when it is ultimately expressing something positive or joyful.

As a music therapist, I’m often told “That must be so rewarding”, by people who aren’t music therapists. Sometimes, as I collect a child for their session, a teacher, or parent, says to the child, “Have fun”. Music has this association with enjoyment, entertainment, diversion, that talking doesn’t. Nobody would say to someone going into their psychotherapy session, “Have fun!” If they did, it would immediately be recognised as deadpan humour. The capacity of music to express the difficult, the painful, is forgotten about in these moments. Bud Powell, perhaps, was one of those gifted human beings who could transform his personal pain into a kind of beauty, without taking away the underlying truth in what he played, or perhaps he was using music to ‘feel good, in spite of conditions’, but either way, he was bringing joy to others. The client in music therapy doesn’t have this responsibility.

The therapist, of course, has another kind of responsibility, which is to accept the client’s music (or lack of music), beautiful and rewarding or not. Then also to respond, to meet what the client brings, which can include the absence of music, the avoidance of music, the creation of music which is aggressive, confrontational, disruptive, destructive, nullifying, or, of course, expressive, emotive, poignant, communicative or even, indeed, beautiful. But whatever it is, it’s there. It’s the challenge the music therapist has to meet. Occasionally, this might be fun, and we can welcome this, but don’t expect it. The dark side of the music in music therapy doesn’t always resolve, or find a meaningful context. Sometimes it can express things you wouldn’t choose to hear, if you were using the music for entertainment, and it can be left hanging, or unclear, or it can feel empty. So it could be argued that music therapy has discovered, or revealed, a particular use for music, as the effective conduit for a darkness which can’t be expressed in any other medium. Have fun, kids…

Tuesday, 8 August 2017

Right here, right now

In a recent session I had one of those moments of doubt. The thought came to my mind that music therapy just doesn’t work. A child I am working with because of some particular difficulties was able to talk about them a bit, and was able to make music, to respond and interact, to be expressive. But I didn’t feel there was any link between the two. I felt that the supposed thread running from reasons for referral through the music therapy intervention itself, to some kind of positive outcome, was nothing more than a fiction, possibly even a con. The idea grew in my mind: music therapy is an activity, a way of people spending time with each other possibly, maybe an enjoyable experience, but the proposition that it has the potential to effect change, particularly change of any specificity, seemed ludicrous. How on earth could this child, by spending time with me hitting a few percussion instruments and then maybe singing a goodbye song, reach any kind of resolution of their broader difficulties? It was bordering on dishonest to claim anything of the sort.

Then I dropped it and got back in the room. I let go of the idea of fixing the problem and returned to the present moment. From then on the session changed dynamic. Things started to happen, including symbolic things, like the child talking about the way they would like things to be, the things that they miss in the session, which they wish were in the room. They became more expressive and imaginative.

Quelle surprise! But it’s easy to forget this tendency, and it’s tempting to assume that big sweeping thoughts are about big sweeping things, rather than really about what’s happening right now. Perhaps this is a good example of counter-transference, or projective identification. Perhaps I took on something from this child unconsciously and it was abstracted and expressed in my own psyche as a negative, particular thought. It would be possible to view this as a dangerous moment, where the potential to rubbish music therapy presents itself, a moment of final disillusionment with the process, and even with the profession. More useful, however, is the idea that moments like this are vital to the process of therapy, that we have to allow the client to take us to this empty place before we are able to press the reset button and experience the present moment anew. Bion was right about memory and desire, but knowing this doesn’t stop them creeping into the session, especially when we have care plans and evaluation forms and ‘aims of therapy’ rattling round our heads. In the room you have to forget that stuff, just as Mo Farah has to forget about winning while he’s actually running.

And what’s the point of music anyway? As soon as you have to ask that question you know you’re off track. I was at a concert of Bach last week. I knew it was good, but I couldn’t get into it. For a moment I thought ’What’s the point of Bach?’ But then, what’s the point of there being a point, and does there need to be a point, and why all this worrying about the point? Is this a superego thing? Is there a voice inside there somewhere asking about aims and purposes and outcomes all the time, which gets louder or quieter, depending on the level of meaning of whatever is happening right now? Maybe there is this for the client, too. Maybe the better it’s going for both of us, the less we are likely to be asking ourselves stupid questions, or making big empty internal pronouncements. But I don’t think there’s any escape from this. It’s part of the role, and the job, to keep questioning. Just so long as the questions can make way for the real work when the time is right, ‘the time’ being right now.

Wednesday, 19 July 2017

To Boldly Go

First, a joke:

Q Why is there no jazz in Star Trek?

A Because it’s set in the future

Thanks to my friend Matt Regan for reminding me of that one the other day. You have to be a jazz musician to tell it, otherwise it’s just mean.

If you’ve read this blog before and are inclined to feel there are too many references to science fiction, then best to skip this post. I’m a big science fiction fan. At its best, it’s full of beautiful metaphors, which it uses to amplify the themes and dilemmas of real life. I also like watching spaceships fire lasers at each other, and cool monsters, so it can connect me to my 8-year-old self too. Some people were critical of the new Star Trek reboot, because it contains a bit too much crash-bang and not enough consideration of the socio-political or philosophical issues which you find in the TV series. I liked it. I particularly like the symbolism at the beginning of the first one, where Captain Kirk’s father has to sacrifice himself by crashing a starship directly into a sun, in order to save the lives of everyone else on board, including his wife, who is in labour, giving birth to the future Captain Kirk. The silliness of a lot of sci-fi in TV and film is usually a long way from the masterpieces of Philip K Dick or Kurt Vonnegut, but it can often be saved by the use of powerful symbols which drive the narrative. So, here we have the young Captain Kirk, trying to atone for his failure to live up to the myth of his absent heroic father.

Then, in Dr Who, we have the archetype of the wise old man in the form of the Doctor. Even when he manifests as a younger man, as has been a recent tendency, we are frequently reminded that he’s over 900 years old. Kids hide behind the sofa during the scary bits, but they keep watching. The Doctor is almost as scary as the monsters at times, but we know that he will always ultimately prevail, and that he’s on our side. I’ve continued watching Dr Who recently, even as the storylines have buckled beneath their own grandiosity and hyper-complexity. Some episodes have been ludicrous, but every now and then you get a gem of a science fiction idea. The episode, ‘Blink’, where the marooned Doctor communicates with people 20 years in the future through a videotape, and the weeping angels are first introduced, is a great science fiction short story. The recent episodes in which a huge spacecraft is trapped on the event horizon of a black hole, so that time passes much faster at one end of the ship than another, cleverly uses Einstein’s theory of relativity in a playful and inventive way.

Then, after a disappointing Wimbledon men’s final the other day, we Dr Who fans were introduced to the new forthcoming female manifestation of the Doctor. It was an image of a male archetype transformed into a woman. Whatever the socio-cultural context, and bracketing the fact that this is essentially a fairly silly children’s TV programme, this is a powerful idea. For me, someone who has watched Dr Who since the 1970s, it was full of resonance. The father figure reveals the feminine, the anima perhaps. Male and female roles, sexuality, identity, are fluid things. They can change. So, on one level, the Doctor can be a woman, and little girls can have someone new to identify with, on another level, the Doctor always had the potential to be a woman.

As a therapist this fluidity is important. The transference relationship in therapy is gender-fluid. Sometimes my role embodies paternal function, sometimes there are maternal aspects to it, or even sibling aspects. Sometimes I have to be serious and focused, at other times I have to engage in imaginative creative play with a 5-year-old, pretend to be the ‘evil baddie’, the ‘rescuer’, or the ‘rescued’. ‘Male’ and ‘female’ can blur within these imaginary roles. Before I was a music therapist I was (and still am) a freelance musician in the jazz and commercial world, as well as a teacher. I went from a corner of the music scene which was largely male-dominated (increasingly less so now) to the music therapy scene, which is the opposite. This required some flexibility of identity and thinking. As a male music therapist I’m taking on a role that is sometimes stereotyped as female, similarly to a male nurse, perhaps. This is a positive challenge. It involves letting certain ideas go, but not throwing out the baby with the bathwater. ‘Paternal’ and ‘maternal’ roles, whatever they might be, and whether taken on by men or women, are both important, and therapists have to be able to encompass both at different times.

I’m sticking with science fiction as a genre with plenty to offer in the way of symbolism and philosophical thought experiments. And it’s good to see that the ‘wise old man’, or the ‘young hero’, can be female, and that the ‘damsel in distress’, or the ‘glamorous assistant’, can be male, or that they can all be both or neither, depending on the context and on perception.

And, by the way, the irony of the joke is that while there might not be any jazz in Star Trek, Star Trek is pretty popular amongst jazz musicians. Check out the Phil Woods version of the theme from the original series – swingin’!