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’.