I’ve had supervision at times from non-music therapists, recently, for example, from an art therapist who is a psychoanalyst in training. A few years ago I had supervision from a dramatherapist who was also a cognitive-analytic psychotherapist. Both were very good at reflecting on musical processes during sessions. I remember playing an audio excerpt from a session to the dramatherapist, who listened very carefully and then observed “It’s like a dance”. She immediately understood the attunement process and was able to give me a new perspective on it. In a recent supervision my art therapist supervisor was able to reflect on a moment when a client was instructing me what to play. She pointed out that he felt a need for us to do exactly the same thing at the same time, that this was part of a merging process and connected to his difficulty trusting the ‘other’. This was useful, and directly linked to the music. I’ve also taken part in group supervisions led by psychotherapists and family therapists. They too were able to understand the significance of music and its role within the therapeutic relationship. Daniel Stern, who we have taken so much from as music therapists, used music-like terminology to describe the interactions between mother and infant despite not being a music therapist himself.
If I were asked to say what music therapists do that is unique, I might be inclined so say that we are able to reflect on musical relationship. I might say that we use instruments to develop a relationship with a client, and that music therapy is about encouraging the client to develop their sense of self, their ability to communicate, their confidence, through their use of music. I might point out that we think about attunement and use the template of the mother-infant relationship to think about musical relationship and about attachment. However, all of this would be missing one big important fact, which is that I am, myself, a musician. If I forget this, or I subjugate my ability to play to just one of a set of skills I might use in therapy, then I am underselling the significance of this. While I would place myself firmly in the psychodynamic camp as a music therapist, I would suggest that one of the pitfalls of the psychodynamic approach, and in particular the emphasis during training, is that musical skills can become side-lined. It’s fairly common for music therapists to find that they are not playing much during their sessions. For some this might lead to further training in counselling or psychotherapy. It’s also possible to rationalise this by saying that this is ‘still music therapy’, because we are thinking about the work from a music therapy perspective. Often this is entirely valid, but could it sometimes be because we have allowed ourselves to lose our connection to our own musicianship?
I’ve also noticed that there can be a tendency to play down the musical aspects of the work. Sometimes we might be concerned that other people will find it hard to understand musical terminology, but my experience is the opposite, that people generally do understand musical descriptions and they appreciate the opportunity to gain insight into the musical therapeutic process. We’ve recently, as a service, had to think about the process of making our clinical notes available to other professionals, and we had a very useful CPD session with an art therapist who talked about the importance of describing what we do in sessions, rather than only describing the client’s actions. I’ve starting writing things like “I accompanied X’s drumming on the piano, supporting his pulse and responding to his dynamic level”. This feels like a positive step.
This tendency to minimise our playing abilities may be linked to an important process during training, which is to do with empathy for the client. MTs in training need to gain awareness of the potential destructive power of their musical skills. Some clients can be easily overwhelmed by the therapist’s music and may find the experience belittling. It may play into their already fragile self-esteem and hamper their own ability to play, and it’s really important for the training therapist to be able to reflect on this. However this aspect of training can become an unhelpful superego voice later on. As a practising therapist I have found it necessary to relearn, perhaps to rediscover, my musical personality within a therapeutic context. Sometimes it’s very useful indeed for the client to feel that the therapist has musical skill. Sometimes the omnipotent client needs to be challenged through the music, and we need the resources, both psychological, musical and instrumental, to be able to do this.
During some group work with a very experienced colleague with 3-4 year old children with social communication difficulties we were observed by a senior member of the (NHS) trust. She spoke to us afterwards and was obviously impressed with the session. However she said a couple of things which gave us pause for thought: one was that the skills we were using were transferrable to the SLTs who were running the summer school to which we were contributing; the other was that parents often do ‘this sort of thing’ naturally with their children at home. Both statements were correct in a way, and we didn’t disagree. Perhaps we should have however. My colleague had been leading the session from the piano, using a number of NR play songs as well as some of her own musical structures. She’s a very experienced pianist who trained at music college for 4 years before training as a music therapist, not an easily ‘transferrable skill’ at all! Perhaps this was self-evident, and didn’t need to be said, but I wish I had said it. It might have drawn attention to something that’s easily forgotten, that most music therapists can play the shit out of their instruments and that this is a crucial part of the work. It’s at the top of the list of requirements when we apply for a training course, so let’s not allow it to slip down the list as we develop our professional careers, either through compliance with a restrictive superego or with a desire to ‘speak the same language’ as other professionals. If they can’t play an instrument that’s their loss. We don’t need to make it ours too.
Coming back to my musically perceptive supervisors, perhaps there are two ways of reflecting on this. The first thing that strikes me is that the ability to reflect on musical processes is not something unique to music therapists. Indeed psychoanalytic theorists such as Rose and Meltzer have drawn attention to musical processes within psychoanalysis. We need to make all that musical experience we had pre-training count, otherwise we could just become bad psychoanalysts (or, I suppose, good psychoanalysts, but this is another career path at any rate). Another more positive way of looking at this is that musical reflection is more easily shared than we might sometimes imagine. We can learn about music from non-musicians, and we can talk about music to other professionals. The really important thing that separates us from them is that we can do the music. This is not only about our pre-training experience, but also about our music therapy practice. We know through experience how to use music in a therapeutic context. This is a big skill, and not one to play down. You can transfer it all right, but it takes a few years and a lot of practice time.
