Thursday 10 March 2022

It's not about me

When I interviewed Gary Ansdell we talked about the question of psychodynamic and music-centred approaches to music therapy, and the problematisation of this within the UK profession. I’ve written about my perspectives on this elsewhere, and maybe there’s no need to keep going on about it. Gary himself said that this had been framed as a binary, and that ‘binaries are boring’. The idea being that if we stopped talking about it for a while, maybe we could just get on with the job of ‘doing music therapy’, rather than solipsistically examining our theoretical stances as if the answers to how to do the actual work with actual people in real life lay somewhere buried in the ‘theory’, whatever that might be.  

‘Binaries are boring’. My response was scepticism. Maybe binaries are also interesting. Maybe there’s something about the framing of this problem that gets to the heart of what it means to be a music therapist, as opposed to a musician. David John spoke intriguingly about the need for music therapists to develop their therapist identity, because when they come on the training they often already have a well-developed musician-identity, which they put to good use in their therapeutic practice. On the other hand, I’ve noticed that trainees often have anxiety about their musical capabilities. They’ll say, ‘I don’t know what to play’, or ‘I don’t know how to improvise’, sometimes. Training can involve trainees confronting their own musicianship and subjecting it to challenging questions. What can they do already? But also, what do they need to be able to do in therapy which they can’t yet do? This is a different experience for each individual.

Another idea which Katrina McFerran put forward is that, ‘if the music is working, then the therapy is working’. I like the simplicity of this, and it has a ring of truth. The difficulty for me is that it’s easily refuted with the response, ‘except when it’s not’. Because I’ve definitely had experiences in music therapy where the interactions were lively and expressive and communicative, and all that we might hope to expect when the music in a session is ‘going well’, and the nub of the problem, the ‘reason for referral’, was not being addressed - yet. I’ve also worked with people where the music never got going, but where the assertion of this by the client was crucial to the progress of some important work. I think Katrina was right, for most of the time, but it's a rule of thumb which doesn’t always apply (in my experience).

So far this has all been old ground. Gary, if he’s reading this, will have skipped through these paragraphs, I suspect. (Hi Gary, if you’re reading this!) Onto my next point - binaries may be boring, but paradoxes are interesting. There is a paradox at the heart of music therapy, which is that music(ing) is both a way of making connection and a way of avoiding it. And it’s possible to do both at the same time. People are multi-faceted (stop the press), and so it’s possible for the music to be working, and relationships to be formed, while important stuff is being avoided. A therapeutic relationship isn’t one thing. Anyone who has done work with groups in which conflict gets played out knows this. We can have intentions as therapists which are not realised, but it’s in the failure to realise them that the development takes place. For example, I have found that my intention to facilitate musical cohesiveness through improvised interaction comes crashing to a halt, leading to important conversations about what went wrong.

Here’s another paradox: it’s possible to feel bad while doing good work, and vice versa. The Nordoff and Robbins (2007) concept of the ‘music child’ suggests a simple idea, that underneath all the difficulty and pain and suffering is a musical being that can transcend all that and connect with another on a deep level, which feels meaningful and, perhaps, ‘whole’. This is an alluring idea, because it feels true, and is often borne out by experience. It’s also (arguably) ableist. It potentially denies the disability or illness in search of the ‘true’ person ‘underneath’. A romantic idea about music therapy is that transcendent experiences can emerge, that client/participant and therapist can find themselves together ‘in flow’ and that they can come to life in the music. But this would be an unhelpful ‘aim’ in therapy, because it would mean that the client who is stuck or in pain, or monotonous in their expression is ‘wrong’, and that it is our job to change them into, or 'uncover', someone else, rather than to be with them where they are. 

Whenever we are presented with ‘wonderful’ musical interactions in therapy, or ‘amazing’ songs composed by a client, we can of course celebrate these, but we can also remember that it’s not these moments that encapsulate what therapy is about. The therapy was happening all the way along, and we’re seeing an edited highlight, a punter-friendly moment suitable for public consumption (assuming permissions are in place etc. etc.). We could also ask, what happened next? When the music stopped, where did this leave the client and therapist? Did the therapist feel good? The client? If we are looking for a pivotal moment, was it in the music, or was it in the inflection of the client’s voice when they said something after the music stopped?

Another paradox - it’s when you stop wanting to help that you start helping. So much of our egos can get tangled up in fantasies about that ‘therapist identity’ that David John was talking about. If we want to ‘be a good therapist’ or to ‘achieve therapeutic aims’, we are less likely to do so, because our desires get in the way. Achievements become all about us, not about the people we are working with. If we want the music to sound good, then it might, but for the wrong reasons. If we want the client to respond, then they might, but they might be responding because we want them to, which would only be useful if we then figured out how to set them free. We would have to untangle this web of therapist and client need and just be together wherever we found ourselves. (It might have been more efficient to do this a bit earlier, before we started searching for the ‘music child’, or reaching for a peak experience.) So the final paradox is that music is play, but that music and music therapy are also work*. When I feel stuck or depressed or trapped in the session, I may be doing my job. When I feel elated or free or expressive, I may be running away from it. How do I tell the difference? Stop trying and start noticing. And realise that it's not about me.

*This might also boil down to 'play is work'.

(All references to interviews are from Music Therapy Conversations)


Nordoff, P., Robbins, C., & Marcus, D. (2007). Creative music therapy: A guide to fostering clinical musicianship. Barcelona Pub.