Friday, 15 November 2019

What I am

Me and my guitar. always in the same mood.
I am mostly flesh and bones and he is mostly wood.
Never does grow impatient for the changes I don't know, no.
If he can't go to heaven, maybe, I don't want to go, Lord.

James Taylor - Me and My Guitar

I remember an inspirational music teacher saying to the youth orchestra that "You always need to remember 'I am a viola player' all the time, even when you aren't playing. When you're on the tube, or hanging out with our friends, or at school, you should still think to yourself, 'I'm a violinist' or 'I'm a trombonist', or 'I'm a saxophone player'. Your instrument is part of who you are". It's certainly true for me even now, many years later. And it's strongly instrument-specific as well. I play the piano, but I would never say 'I am a piano player'. Why not? Because I am a saxophone player. It's become part of me. I even play other instruments professionally as a doubler, but I'm no longer a 'clarinettist' (I used to be, years ago).

What does 'I am a saxophone player' mean? It means, for me, that without this knowledge, I would lose some essential part of myself. I need it to maintain some aspect of my identity. I'm also a 'music therapist', but this doesn't have the same resonance. I work as a music therapist, but I'm not 'a music therapist' in the way that I'm 'a saxophone player'. Maybe some people feel like this about their job, but I'm not sure. I think it might be something about the physical object itself.

Could this be related to transitional phenomena? Is my instrument a kind of transitional object? Does it keep me in touch with some essential internalisation which I need to maintain my sense of self over time, to keep my sense of continuity as a person? This seems plausible. Think about having to give up your instrument. There are people for whom this happens, through circumstances beyond their control. We might acknowledge this as a deep tragedy in many such circumstances, perhaps beyond the misfortune of, say, losing a job, or breaking a leg, and more akin to losing a person, an important attachment figure. I once had to stop playing for a few weeks when I injured a finger, which was a sobering experience. Reconnecting with my instrument after this was a big relief. I'd lost someone I loved and now they were back.

Maybe this connection is something to hold onto as a music therapist. Maybe it's important that the work doesn't take this away. Winnicott talks about decathexis in relation to transitional phenomena, about how they are 'spread out' over 'the whole cultural field' (1971 Playing and Reality page something-or-other). But when you are connected to an instrument perhaps you are able to re-focus, to concentrate your creativity once more, in a similar (but different) way you did with your teddy bear when you were three years old. Keep on cathecting, as the song might go (if you can find a rhyme)...

Wednesday, 12 December 2018

It's not about you

How many singers are really worth listening to? I haven't watched talent shows much in recent years, but to me they're of a piece, whether it's Britain's Got Talent or The Young Musician of the Year, they're all barking up the wrong tree. Artistic expression shouldnt be about competition. The problem is not that the X factor and other talent shows are promoting distorted values. Of course they are. The problem is that they are partly right. I dont want to listen to most people sing, given a choice between that and, say, watching Fargo. This isn't to disparage or discourage, its just my own selfish perspective. Engaging random strangers with your music, building a following, developing as a public artist, these are hard things to do, and most people can't do it. There are a limited number of people who I'll go out of my way to listen to.

The X factor is right. There are only a few singers I really want to listen to. This is ok. They're promoting the concept of 'stardom', which is elitist by definition. An irony of the show is that they're not actually trying to find singers with the 'X factor', which to me, might be those people with marked individuality (Bob Dylan, Billy Holiday, Nick Drake, Stevie Wonder, Bowie), people who don't sound like anyone else, who are idiosyncratic. Maybe a show which really looked for this quality would be more interesting, but this would have to ignore the real aim, which is to make a fast buck out of the winner while their notoriety lasts. Really interesting singers need time to develop their voice and persona.

Where does this leave me as a music therapist? Do I sit there feeling angry with clients because they aren't geniuses? Of course not. The transaction is hopefully more honest. A performer is selling you something, an idea that they might be special, that of all the people in this big room full of people, they might be the one most worth listening to. The exasperation comes from the wrongness of this presumption. A music therapy session begins from a different place. I'm making a commitment to be interested in the client's music, no matter what it might be. Often, it comes from the client's place of self deprecation or doubt. I'm trying to encourage them to explore what they might be able to express if they give it a try, with no expectation. Maybe they will find themselves worth listening to. Maybe I can show them that I find them worth listening to.

Some of my favourite performers are able to retain this feeling of vulnerability even in front of an audience, as if they are playing or singing to themselves, not assuming their own greatness, but finding the greatness in the music itself - Miles, Bill Evans, Coltrane, Andras Schiff, Abbey Lincoln, Martha Arberich, Laura Veirs. 'It's not about you' might be something they understood on a deeper level some time ago.

The honesty of the musical transactions that can happen in music therapy can result in more satisfying musical experiences than in many performer/audience relationships. In music therapy, it is 'about you', the client, and it's about you and me. As Andy Lale said in his 'Music Therapy Conversations' interview, the fantasies of stardom might be a good starting point, but only as a stepping stone towards something more real and honest. Neither of us is 'gonna be a star', but who cares? We might get to be something more interesting: a person.

Monday, 12 November 2018

Curiouser and curiouser

"she was so much surprised, that for the moment she quite forgot how to speak good English" (Lewis Carroll, Alice's Adventures in Wonderland)

In one of Gareth Malone’s programmes where he encourages people to sing who normally wouldn’t, there was a bit where he criticised someone for singing in an American accent. He was working with a talented young man in a school, who he was preparing for a ‘big solo’ in the choir. Gareth was being nice about it, but he took the mickey out of him a bit, impersonating him. Then he showed him how to sing properly, with a ‘normal’ voice, using his own accent. A similar thing happened to my daughter, who is a singer songwriter and was writing songs and singing jazz standards when she was at school. The head of music used to similarly berate her for singing American. I was never quite clear why, but it seemed to be an accepted narrative that this was just not the way to do things properly. It was also clear that the students he most admired were the ones taking classical singing lessons and singing with a ‘trained’ voice. Perhaps it was just musical snobbery, but it wasn’t presented as such. Neither Gareth Malone nor the school teacher had any problem with popular or jazz styles per se, they just seemed to have a problem with the accent.

First of all, I would argue the case for singing songs with an American accent on purely stylistic grounds. If you’re singing songs from the Great American Songbook, or songs in a soul style, if you’ve been listening to a lot of Billy Holiday or Stevie Wonder, then it would be natural to sing in an accent appropriate to the style. I presume neither Gareth Malone nor the music teacher would have had any problem, for example, with singing Puccini in an Italian accent. This also plays, perhaps, into my own chip on the shoulder about being a jazz musician and experiencing snobbery towards this during my own musical education, particularly when studying music at university. I’ll bracket that however, because, well, who cares…

Maybe the problem is with singing in a bad American accent, so that it sounds inauthentic, and that singing with one’s natural accent would be preferable to this. I feel this when I hear Robbie Williams, for example (but I might be alone in this), or even Elton John. I don’t feel it when I hear Laura Marling, who is definitely English, definitely sings with an American accent, and has been embraced as a performer in the US. She even talks with an American accent in at least one song, which is sort of comic, but also makes sense. An English voice would just sound wrong, so it probably felt like the only option. So perhaps if you get the accent right, Gareth would be happy. I don’t think so, but I’d be really interested to know how singing teachers perceive this. I should have asked Joanna Eden.

Doesn’t matter, because none of this is the important bit. Now we come to music therapy. The difference between a music therapist and Gareth Malone, or my daughter’s music teacher, is that a music therapist would first of all accept the song as it came out. They wouldn’t try to correct the accent. Perhaps even more importantly, they would also be curious about it. Why sing the song in this way? What has the client/participant/singer been listening to? What is their musical and personal history? Does the song have a personal significance for them? If they have written the song, what, or who was their inspiration? When they sing in a certain accent, are they thinking of a particular person, a particular recording, do they have a musical hero? Is there someone they want to be like, and does singing make them feel a bit more like this person? When you think about it like this, from, if you like, a ‘clinical’ perspective, then criticising someone’s choice of accent could feel damaging, belittling. It could feel like you’re not really paying attention, but instead seeking your own musical agenda, to get things ‘right’, the way you, and the ‘musical establishment’, want things to be.

In other words, not exploring where the music comes from, what it’s expressing about the person, could be a failure of curiosity. I like the word ‘curious’. It leaves things open. If we were to stop being curious about the client in therapy, we’d have lost our way. This is why the music in music therapy might not always sound how you want it to sound, because the therapist isn’t making any corrections. Instead, they are discovering where the client, and the music, leads us next. This is likely to be somewhere interesting, as long as no-one is adjusting their vowels.

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…