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’!

Wednesday 7 June 2017

Musical expression and 'The Glass Bead Game'

When I was training, back in 2006, I remember having a conversation with another musician on the way to a gig. He asked me what happens in music therapy and I explained that it’s partly about the client having an opportunity to express themselves musically. He replied that he wasn’t sure about this, because in his experience it took him years of practice before he was able to express himself in music. It’s tempting to shrug this off as a misunderstanding. Either I failed to explain music therapy clearly enough, or he failed to grasp it, or both. The problem is that he’s also right. Expression in music requires some degree of instrumental or vocal control, and we can often feel as performers that we’ve failed to quite communicate exactly what it was we were trying to put across. To some degree this is always the case, especially in improvisation. There are always missed opportunities, fluffed notes, moments where the groove doesn’t quite sit, and even if there aren’t, to what extent are we expressing ourselves in the music we make?

Kenny Werner (in Effortless Mastery and in his masterclasses) talks about the ‘freedom from having to sound good’, and Nachmanovitch (in Improvisation in Art and Life) about the ‘judging spectre’. Both espouse ideas about improvisation which are about freeing oneself from judgement. This concept presents an alternative to my diligent colleague, striving for years towards the ideal of self-expression. In music therapy a phrase I’ve often heard is ‘innate musicality’, suggesting that we can connect with the musician in every human being if they are open to this. Nordoff and Robbins famously described the ‘music child’, that entity which can transcend other impediments and express something underlying and positive in any human being, no matter what obstacles might exist to other forms of connection. There is also a link to be made between preverbal parent-infant interaction and clinical improvisation. Music is within us from birth and predates language in our development, so in music therapy we are able to connect with something very early in human development, which has therapeutic advantages, enabling us to go where the talking therapist perhaps may not.

There is an aspect to music, however, which can sometimes be downplayed in the rationale for music therapy, that is, its sophistication and refinement. This is exemplified by Herman Hesse in The Glass Bead Game, where music is a core aspect of the training of students in the elite school where most of the novel is set. The Music Master is a guru-like figure and students of the Game are required to become adept in counterpoint to a high level, along with mathematics, as they strive towards perfection. Another more left-field novel, which explores music’s otherness is Thomas M. Disch’s On Wings of Song. Disch’s book, referencing the poem by Heine, describes a future dystopia where singing is discouraged, but where people prepared to risk it are able to use song as a means for achieving literal (and illegal) out-of-body experiences. Not everyone is able to do this, and the protagonist is a figure who struggles with his inability to harness this potential. Disch, a novelist of boundless pessimism, is using music as a metaphor for something else, a means of escape from an awful reality. But it’s an interesting metaphor, because it fits with a perception of music in our society, that it’s often something elitist, reserved only for the talented, those who are ‘musical’, whatever that might mean.

The requirements for admission onto music therapy training courses include, in part, a high level of musicianship. Why? In music therapy, who is doing the ‘expressing’? If the client can express themselves through music, why do they need a therapist to be proficient to degree level in musical performance on an instrument? This requirement implies that we may be doing some of the musical expressing on behalf of the client. But as music therapists we are also, often, trying to democratise music making, to encourage clients to believe in their own ability to be expressive, regardless of musical skill and experience. We are attempting to prise music out of the hands of the musical elite and make the experience of music making available to all. This is a tricky balancing act, because we can’t deny the role that musical elitism plays in our preparation for this role. We have to acknowledge that we are giving a hand up to our clients when they have less musical skill than we do, that we are doing something for them, as well as with them. (A case in point: Wigram in his book on improvisation techniques describes reflecting, the musical expression of the client’s overall presentation and affect, rather than a direct matching of their music. This is sometimes loosely referred to by music therapists as ‘playing the counter-transference’.) What we are doing and what level of expertise we draw on depends on the client and the context, of course, but our own musical history is always present. There are two sides to the coin: on the one side the potential envy of the client, on the other, the importance of our capacity to contain, reflect, draw out. Our musical skill, our musicality, is an important factor in therapy, and while it might contribute to the client’s ambivalence, we couldn’t do our job without it. The client can’t have it both ways, and neither can we.

Thursday 11 May 2017

Schenker and Heptapods


I’ll play it first and tell you what it is later (Miles Davis)

Sometimes at work we have clinical sharing CPD sessions, where team members present recent work with video or audio clips. This is a process in which the various approaches of the music therapists and the challenges presented by different clients and clinical contexts can be explored and reflected on. During one of these a colleague and I were discussing some group work. We played some audio in which, out of nowhere in particular, I began to play something new on the piano, to which other people in the group responded. Someone on the team, on hearing the excerpt, asked ‘Why did you play that’. My slightly facetious answer of ‘Dunno, why does anyone play anything?’ was probably inadequate. It was a valid question, and I then tried to answer it in a more considered way. The answer was that sometimes, when nothing much is happening musically, I’ll throw something in, to see what response it gets. The decision about what to throw in might be based on something conscious, but it might not. It might arise out of an impulse to fill the space, and it might be based on something that’s in my own head, which may or may not have anything to do with the client. Of course I’ll be considering the client’s needs, their resilience, whether it’s the right moment to add something, but the actual musical content may not have emerged from any clear linear process of decision making. (I’m leaving aside any unconscious reasons I might have for playing a particular thing, since I don’t, at least at the time, know what these are.) This is in contrast to a more typically ‘music therapy’ response, where I might pick up a pulse or a pitch, or a melody from the client, and interpret this through my own music. This could be complementary, or challenging or supportive, or many other things.

But the seemingly random musical interjection can sometimes lead somewhere interesting and new, introducing possibilities that might not have been there before, which might be helpful for the client. It reminds them that you are a separate musical person, and this might be just what’s needed at a particular moment. Also, this is the way music often works. Any piece, improvised or composed, has to start from nothing, from silence, from a moment waiting to be created. Think of any of the great works by the great composers. The mystery of where that initial idea comes from (the D minor Chaconne, Beethoven’s Fifth Symphony, Tristan und Isolde) raises a question, and the rest of the work is spent answering that question (or perhaps delaying answering it).

The science fiction film Arrival is based on the story by Ted Chiang entitled ‘The Story of Your Life’ (beware mild spoilers). In the story the main protagonist, an expert linguist, is called on to try to interpret the language of newly arrived extra-terrestrials (heptapods). This is a long process, but eventually it transpires that the aliens have a conception of language which derives from a different experience of time from our linear one. Like Vonnegut’s Tralfamadorians, they perceive the whole of time as a single entity. Everything that will happen has, in a sense, already happened. Consequently they construct written language in a non-linear way. Rather than left to right, their language representation is more like a picture, where the whole is known before the picture has begun. The ‘sentence’ or ‘paragraph’ gradually emerges as a complete entity before the eyes of the reader, as if Dickens were able to write David Copperfield by adding the words, not in order, but dotted randomly throughout the blank pages of a book, until gradually the whole novel emerged.

Once David Copperfield has been written, you can write it again this way, because you know how it goes. The same goes for a musical work. A symphonic movement is a case in point, because sonata form has a deterministic quality. The opening statement can be heard, in retrospect, to influence the direction of the rest of the piece. This is particularly clear in the great works of the classical era, where there is a feeling of completeness, of inevitability, about the musical argument. But it can also happen in an improvisation. Think of Miles’ famous solo on So What, which, over the course of time, now feels set in stone. It’s regarded as a classic musical statement in a similar way to a well-known composition like the first movement of Beethoven’s Fifth Symphony. The more you dig down into this idea, that music makes sense in retrospect, the more the idea of determinism can take hold. The point of Ted Chiang’s story, that time has a dual quality, that it can be experienced in a linear way, or perceived as a unity, but not both at the same time, incorporates both the idea of a musical work, and also the concept of music in action, as a thing that you do, that takes place in a sequence of moments. Christopher Small, in Musicking, rejects the former and opts for the latter, and as music therapists we might have a tendency to do the same. But when you listen back to the recording of a session, or listen repeatedly to an excerpt when preparing for a presentation, the question ‘Why did you play that?’ is often answered by what happens subsequently, rather than what has happened before.

I don’t know, but maybe this concept of music as a preordained object is part of the deal. The music-moving-through-time perspective is an obvious one, but the idea that it should somehow all fit together is also widespread. Often to my chagrin, I studied musical analysis as part of my degree course. The Schenkerian idea of the Ursatz, the underlying form, is about as deterministic as you can get, but so too is the approach of analysing motive, making links between the melodic fragments that occur throughout a piece. We search for evidence that it all makes sense, even when we didn’t spot it the first time around. In clinical improvisation, we’re trying to make sense not only of the music, but also of the client, and of the relationship. We don’t know what’s going to happen until it’s happened, either in a musical way, or any other, but afterwards we can look back and decide whether it was coherent, and perhaps answer the question, ‘Why did you play that?’

Tuesday 7 March 2017

Why I hate being a ‘therapist’


In my relationships with persons I have found that it does not help, in the long run, to act as though I were something that I am not.
Carl Rogers

“It sounds like you’re angry. I wonder what you might be angry about.”

“There seem to be some really difficult feelings here around being able to play. Perhaps playing can feel awkward sometimes.”

“Mm, mm. It seems like you’ve identified something really important”.

“You REALLY don’t want me to play. You want to be IN CHARGE today!”.

“That felt like a sad piece. You’re feeling sad about something”.

“Perhaps the drum stick hitting the drum reminds you of accidentally witnessing, as a young child, your parents having sex?”

Ok, the last one’s a joke, but you get the idea. And here’s something I have heard music therapists say outside the session: “I was enjoying the music, but maybe that’s wrong”, and on other occasions, “My client wants to talk a lot, but I don’t feel qualified. I feel like they need a counsellor”. When I was training I once brought an excerpt from a session to supervision where the client was playing on the white notes of the piano. I harmonised in the lower register, interpreting the melody in A minor, then using the chord progression A7b9/C# to D- to give the melody harmonic impetus. The client said ‘Mm, you make it sound good’. My supervisor and I interpreted this as an indication of envy, that this was the client’s defence against feelings of inadequacy, and that I should bear this in mind, and try to meet the client at their level, without bringing my own needs, for colour, excitement, perhaps validation, to the music.

None of this is wrong, but there’s a flavour to all this stuff which smacks of trying very hard to be a THERAPIST, writ large. It’s easy to slip into something which feels like one of Eric Berne’s ‘games’. For example, there’s a game called ‘Greenhouse’, described as a tendency for recently qualified therapists “to have an exaggerated respect for what they call ‘Genuine Feelings.’ The expression of such a feeling may be preceded by an announcement that it is on its way. After the announcement, the feeling is described, or rather presented before the group, as though it were a rare flower which should be regarded with awe. The reactions of the other members are received very solemnly, and they take on the air of connoisseurs at a botanical garden. The problem seems to be, in the jargon of game analysis, whether this one is good enough to be exhibited in the National Feeling Show.” I turn once again for wisdom to my 15-year-old daughter, who would probably respond with ‘Oh my god, it’s just not that deep!’ when presented with such a thing. Like the kid noticing that the Emperor’s naked, she’d be closer to the truth than those ‘clever’ therapists.

I suppose what I’m trying to identify here is a tendency I’ve noticed in myself and others to want to be a ‘good therapist’. During training, all sorts of natural impulses, to reassure, to respond with emotion, to enjoy the music, to disclose personal experiences, are questioned. We are encouraged to re-examine what we do, to treat our own motives with skepticism. We are attempting a paradigm shift into a new way of being, called ‘being a therapist’. The intention is to open us up to the client, to avoid getting in our own way, so that we can at least entertain the possibility of being with another person without trying to make them into something we want them to be. But, as with any shift of perspective, new dangers can emerge. We can get stuck in a sort of therapist persona, which is just a version of what we imagined a therapist was supposed to be like, based on observed behaviours and a desire not to get it horribly wrong. An idea came into my mind after hearing bits of the Radio 4 series ‘In Therapy’, which is that the more I sound like Susie Orbach, the worse the therapy is going. No disrespect intended, because Susie Orbach is entitled to sound like herself, but I can’t do the strokey-beardy, noddy-heady therapist thing, because it’s just not me: it’s me pretending to be a therapist. This has nothing much to do with client groups or adapting to different personal needs, it doesn’t work in ANY situation.

There are musical manifestations of this tendency too. If you find yourself deliberately not feeling the groove, not allowing your body to respond to the music happening in the here-and-now, then you’re stuck in the ‘game of music therapy’. If you force yourself to sing ‘Johnny’s playing the drum’ because you saw someone do that on a video or at a conference, but you can feel it’s not right; if you sit there, paralysed, doing nothing, because you’re wary of angering the client with your music, or your ‘training superego’ is looming over you; above all, if you feel the complete absence of any sense of humour from your music; these are all signs that you’re stuck in ‘the game’. Relax, remember who you are, and re-orient yourself in the present moment. Perhaps the musical therapeutic process, from the perspective of the therapist, should be about becoming more yourself. In this sense, you are hopefully mirroring the client’s process. As soon as I feel I can make a joke with a client, or I find myself moving my body to the music as we play, or I’m able to express a feeling without laying a heavy significance on it, but just seeing it there and letting it drift past, these are signs that it’s going ok. The less you feel like a ‘therapist’, the better therapist you’re probably being.

Thursday 2 March 2017

Why music therapy is the best job in the world

The other day my wife and I got into a ‘heated debate’ with my father-in-law. On the surface, this was the old left vs. right, caring vs. capitalist, young (well - …ish) and idealist vs. older and more cynical dynamic, although I’m sure he’d want to frame this differently. There was something quite exhilarating about this, even if the location of the debate, the pub, meant that the robustness of the argument became more questionable as the evening wore on. It boiled down to this: his argument – people who have greater ‘scope and scale’ in their role at work, where, if they screw up, more money and jobs are at stake, should rightly be paid more; our argument – there is a danger that ‘paid more’ ends up equating to ‘deserves higher status and respect’, and by extension, leads to assumptions about other things, like ability and intelligence. I gave the entirely self-serving example that being an effective music therapist requires just as much skill and intelligence as being the CEO of a company, but that this doesn’t stop some CEOs, or other people high up the corporate ladder, adopting, shall we say, an air of authority that can extend beyond the workplace.

I was reminded of another family event, when our generation of my wife’s extended family used to gather for dinner at Christmas time. These events were a lot of fun, despite the black-tie formality. But I recall at least one occasion when it was announced that a (male) member of the family had been ‘made a partner’ in their bank, or some such, and we all applauded. I had my own reservations about this implied slight to all those other people in the room (mostly women) who were doing equally demanding jobs, but pulling in less cash, and presumably, deemed to be lower down on the ‘scope and scale’ chart, hence, no applause for them (or me…). Nothing against those prestigious ‘partners’ per se, you understand ;)

I used to work on a project with a domestic violence charity. When we started this in 2009 there was a woman who I’ll call Catherine, who was the main point of contact in the charity for the project. She had a job title of ‘Children’s Support Worker’. She’d developed relationships with families over a long period of time, which meant that she was trusted by people in times of the most extreme stress of their lives, when they feared for their own safety and that of their children. She knew them well and was able to provide me, and the other music therapist on the project, with all of the most crucial information about the child and family, as well as helping them through the process of the child’s referral to music therapy and providing all of the emotional and practical support which that entailed. I hope she was getting paid ok, but I’m willing to bet that whatever it was, it was nowhere near her real value, not only as a human being, but also as a skilled practitioner of her craft. Frontline work is the basis on which all other work happens. Without her, and others like her, we’d all be nowhere. Needless to say, I didn’t think of this example in the pub the other day.

I recently made an application for some biggish funding for a clinical project in which music therapy would have teamed up with other health teams, charity workers, and social care. It was a long shot, and we didn’t get it. We’re a tiny profession, and we’re on the front line, which isn’t the place big funding bids normally achieve success from. My rationale was a ‘bottom-up’ approach. Therapeutic work, involving as it does the connection between the internal worlds of the client and therapist, could be seen as the bedrock of the client’s psychological wellbeing, as far as health interventions go. It’s the psychological and emotional front line. And improvised music takes place on the interface between the affectual worlds of the people using it to communicate. Music, and other non-verbal communicative channels, are at the coalface of human connection. And human connection is everything. Without it, there’s no thought, there’s no language, there’s, in a sense, no world-out-there. So it all depends how you look at it. We’re either at the lower end of the health hierarchy, a small profession, looking up at those consultant paediatricians, psychiatrists, heads of services and so on, or we’re constantly involved in a collaborative process of recreating the universe. I prefer the second one – it’s got more ‘scope and scale’.

Friday 13 January 2017

Good advice


“When I was young, people told me: you’ll see when you’re fifty. I’m fifty. I’ve seen nothing”
Eric Satie


There’s a meme that crops up on social media with some frequency where older people give advice about life. What’s really important, when it comes down to it? Here’s an example. It’s mostly good quality. You know, don’t focus too much on work. The simple things are the best things. The moments of connection with those you love are worth more than your professional successes. Floss. Stuff like that. Here’s one I’m not so sure about: “Don't marry someone just because you love them. Make sure your lifestyles, dreams and plans are compatible in addition to loving them. Those little quirks and character flaws you overlook for love can become huge problems later in a long-term relationship, especially if they conflict with what you planned or where you want to go with your life.” Not terrible advice, but I found myself reacting to it negatively. What about trusting your instincts, being spontaneous, taking a chance on an intuition? Life can’t always go to plan, but seize the moment, right? You might disagree, but I’m hoping that some of the people I love aren’t too bothered by my ‘little quirks and character flaws’, or I could be in trouble…

This kind of advice is famously lampooned by Shakespeare in Hamlet, through the character of Polonius. In his speech to Laertes he gives lots of good advice, but in that sanctimonious tone that could drive anyone to distraction. Polonius is an old bore, to put it bluntly. Of course it’s a good idea to “Take each man’s censure, but reserve thy judgment”, but don’t keep going on about it… There are at least two responses to ‘good advice’: 1 listen carefully, because you might learn something and 2 ‘Whatever Grandad’. The first is probably the more sensible, the second the more adolescent. Thing is, I like that second response. It appeals to the adolescent in me and it’s much more expressive. It’s an assertion of individuality, the wish to make up one’s own mind about things, to learn from experience, the hard way, which, when it comes down to it, is probably the only real way. As a parent of teenagers I’ve often found myself in the Polonius role, bored by the sound of my own advisory voice, imparting the best course of action to an eye-rolling 15-year-old (when they’re being polite).

Richard Frankel, in The Adolescent Psyche, talks about the transition in adolescence from prohibition to inhibition, in other words, the development of what you might loosely call a conscience. This transition is where the eye rolling comes in. Once you’ve started to figure certain things out for yourself it’s unbearably tedious to have them pedantically explained to you by an old bald bloke. My capacity to connect with that feeling is, I hope, the piece of floating driftwood that sometimes helps me not to sink, as I negotiate other people’s adolescence. I read ‘older people’s advice’, feel irritated, and can then empathise with the teenagers I know. And they’re not only understandable, they’re also often right. Older people are full of it, and younger people have often got to the solution first. This also helps when working therapeutically. The therapist might be in a position of power in the therapeutic dyad, but they’re not much use to the adolescent client unless they can empathise, unless they can understand how irritating they are, just sitting there. One client I was working with was appalled to discover that I was the same age as a certain pop icon they identified with, because of their adolescent stance. Maybe this was a moment of realisation for them – ‘I’m on my own, because even Eminem is old now’.

Advice to my younger self? I’m with Eric Satie: ‘Relax. When you’re older, you still won’t know anything’.

Friday 6 January 2017

The Flip Side

It's pretty grim for anyone on the left right now, or indeed for anyone not on the extreme right. How could all this stuff be happening? There are lots of explanations of course. The big puzzle for me was that people could vote for Trump once he'd crossed that line. Once the recording came out I assumed it was all over. No matter someone's policies or other appeals (bit vague on those too myself to be honest) surely the blatant misogyny would be the end of it. But if you're looking for a saviour, then you can become complicit in the con. That infamous recording contained the clue as to why it wouldn't be Trump's undoing. The key is the ignored first part of the statement, so distracted were we by the description of sexual assault - "when you’re a star, they let you do it. You can do anything". 'They' being the women he was boasting of assaulting, but perhaps also, metaphorically, the voters. 'When you're a star...'. What clearer description of idealisation, of positive projection, could there be? Here's someone who understands how to abuse power. Once those projections have been elicited you're invulnerable. It's not that you can do no wrong, but whatever wrong you do will be forgiven, because now you're the man. You're a 'star'.

I have often worked with victims of domestic abuse in music therapy. Children with abusive fathers feel enormous ambivalence towards the perpetrator. Often, they want to believe the best about him (it's usually a 'him') despite evidence to the contrary. It's a terrible 'Catch 22' situation. The person they want to attach their hopes to is not someone who has their best interests at heart, but it's almost impossible to let go. This kind of therapy is slow work because just as it's difficult to disengage from unrealistic hope of the father, so it's also difficult to form new attachments based on a more integrated view of the other.

As music therapists, we have to be very mindful of the dangers of idealisation, as it can flip very quickly the other way. The client who loves you is a hair's breadth from disappointment, envy, hatred. If the music is exciting and fun it can easily become empty and repetitive, and if your music is admired it can equally be resented and suppressed by the client when they hit idealisation's brick wall. There's no future in idealisation, but in the meantime the idealiser is vulnerable to exploitation. It's only by repeatedly not choosing to exploit our position of power as therapists that we gradually build trust over time with the trauma victim. They know really that their illusions are fragile, so they try to maintain control. The play can be rigid, stultifying, accompanied by a feeling of stuckness. As a therapist you can start to lose your sense of identity. But this is better than being idealised. It's the beginning of the next step. The path to integration is tortuous and takes place incrementally, and disillusionment is an inevitable and healthy part of the process. Donald Trump would make a terrible therapist.