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.
Friday, 6 January 2017
Friday, 4 November 2016
The “stuff of life”
"What we play is life, my whole life, my whole soul, my whole spirit is to blow that horn," Louis Armstrong
There’s an interesting interview with Simon Procter on the Live Music Now website, in which he discusses music therapy as a career choice. Simon, as most of you will be aware, is one of the Directors of Music Services at Nordoff Robbins. In the interview he expounds very eloquently about the kind of things music therapists do, how they might overlap with community musicians, what their special skills are, how they are trained, the kind of people they might work with. It’s very clear, concise and informative, helpful advice for someone who might have had experience of working for Live Music Now as a community musician or performer and is interested in how they might develop their career along a new path, perhaps inspired by their experiences. Not surprisingly he gives the NR training course a bit of a plug. There are other trainings available, but these are easy enough to find online for anyone interested, and he’s in the business of promoting his own course, which seems fair.
Then, in response to the question “How does the NR approach differ from other training courses?”, he says this:
The Nordoff Robbins approach is ‘music-centred’ rather than psychoanalytic or behavioural. We take musicians and teach them to work musically with people. We emphasise musical outcomes for clients: we see music and musical experience as the stuff of life, not just as symbolic of something else.
Here we have two false dichotomies: one is that music therapy must be either ‘music-centred’ or psychoanalytic/behavioural, the other that music is either ‘the stuff of life’ or ‘just symbolic of something else’. Perhaps these are both expressing the same idea in slightly different ways. Procter isn’t here advancing a theory or using the sort of language that is required for an academic article, so perhaps we shouldn’t be too picky. However, he is speaking to prospective music therapy trainees, so it’s important that the language is clear, and not misleading. Of course, ‘music-centred’ is a well-worn phrase in relation to NR, but this doesn’t mean it can’t be challenged (despite the scare quotes).
First, a declaration of personal interest: I went to Guildhall, where I also do some teaching now. Trainees there are also taught how to ‘work musically with people’. As for an ‘emphasis on musical outcomes’, I would say that these are seen as a means to an end, that being the well-being of the client. I strongly doubt that anyone would contest this at NR, at any stage in the history of the institution. Perhaps they might say that musical outcomes and general well-being go hand-in-hand, but surely not that a musical outcome supersedes the client’s well-being. I would also assert that this could happen, having worked in schools where the end product of the school concert does not always take into account the emotional processes of the students, who might very well be put under pressure or stress in order to achieve musical aims. I could also elucidate on the stresses and strains of the professional musician. Involvement with music doesn’t automatically link to wellness.
What does he mean by music being ‘the stuff of life’? Perhaps that music is an intrinsic part of life, a medium that expresses things about being alive, without any need for interpretation or translation into another medium. This seems a fair statement to make, but other things might also be ‘the stuff of life’: human relationships, for example. In which case, psychodynamic processes (leaving behavioural approaches to one side) would also be ‘the stuff of life’, concerned as they are with the development of the individual in relation to others. Being musical would not preclude a thing from being subject to psychodynamic interpretation or understanding. Putting it simply, music could be ‘the stuff of life’ and ‘symbolic of something else’ (as opposed to ‘just…’). Furthermore this focus on being ‘symbolic’ is leaving out quite a bit of psychoanalytic theory as it might apply to music. Attachment theory, Stern’s affect attunement and Winnicott’s theories about play and creativity are not only, or even mainly, about things being ‘symbolic’ of other things. They describe processes of development through relationships, and, as we know, relationships can be expressed musically (would any NR therapist refute that?). One could assert, indeed, that music is relationship, rather than being symbolic of it: the relationship between tones, between rhythms in time, and between the people taking part.
You don’t have to use psychodynamic methods of thinking and interpretation, but they don’t deflect you from a musical focus. There is nothing non-music-centred about psychodynamic thinking as applied to music therapy. Thus, it can be music-centred and psychodynamically informed. Throw out psychodynamic thinking (or behavioural approaches) if you like, but to present it as having a focus which is not music-centred could be misleading, particularly to potential trainees, who might not know much about different approaches, and may also be keen to hold onto their identity as musicians. These sorts of concerns might also be relevant when communicating with people about music therapy in other contexts, such as when discussing it with other professionals or service users. The rhetoric of a phrase like the ‘stuff of life’ attempts to romanticise an approach in a way which seems to be more about obscuration than elucidation. Of course music is the ‘stuff of life’, and so is everything else.
Wednesday, 24 August 2016
‘God Only Knows’
In my recent blog post I said that “the half-diminished chord in ‘God Only Knows’ is probably not the active ingredient in music therapy”. This got me thinking. Brian Wilson had a complex relationship with his father and, viewed in this light, the words of the song take on an interesting meaning. “God only knows what I’d be without you”. It sounds like a love song at first, but then when you listen to the words in detail it becomes apparent that they don’t quite fit this narrative. The ‘what’ in particular is a surprise. I’ve wondered about this, whether the song is really addressed to a lover, or a parent. Since the lyrics were written by Tony Asher, the idea that this is Brian Wilson addressing his father seems fanciful, but on the other hand, the idea that there could be a love song where there is ambiguity, not only about who is being addressed, but about the nature of the relationship, is an intriguing one. Taken as a work of art removed of context, ‘God Only Knows’ could fit this model. It may be that the ambiguities running through the lyrics, alongside the harmonic ambiguities underpinning it, are what make the song so moving.
The half-diminished chord comes with the line “I'll make you so sure about it". In fact the function of the chord isn’t the usual II-7b5 as it’s a chromatic transitional chord on the #4 of E major, which leads to an A major chord in the next bar. It’s a moment of intensified harmonic ambiguity within a harmonically ambiguous piece of music. If it’s not an example of the “active ingredient” in music therapy, it’s certainly an active ingredient in some sort of process. It has a harmonic and emotional function, albeit one which might be hard to pin down.
I also said in my recent post that “music therapy doesn’t operate within a performer to audience dynamic”. I was thinking of the analogy of therapist with performer and client with audience which often seems to be an assumption made about music therapy. There might be an idea that the therapist is doing something to the client using music. This is not normally what happens in music therapy, but to say that this is ‘incorrect’ would be to oversimplify. Since the therapeutic process is two-way, the therapist’s music does have certain effects on the client. If we flip the analogy around, however, it becomes even more interesting. What if the client is the performer and the therapist is the audience? This actually works quite well a lot of the time. The half diminished chord in ‘God Only Knows’ becomes the active ingredient in music therapy when it is played by the client. Since actually doing this requires a level of musical sophistication we don’t routinely encounter the analogy might seem a bit absurd. But if we extend the analogy to include any moment of musical intensity then it begins to make more sense. Furthermore, as musical performers we all understand this. Music can be therapeutic when you go to a gig or listen to a recording, but this NEVER approaches the intensity of a meaningful performance in which you are an active participant. Not all performances are as meaningful or rewarding as they could be, but those that are; it’s a reason to be alive, to be frank.
So, ‘music isn’t medicine’? It’s misleading to say that it is, but it might also be misleading to say that it isn’t. That newly qualified colleague I mentioned before who has ‘been doing music therapy for years’. Well, the next question might be – ‘who on?’ The peak experiences that we sometimes have during performances are hard to pin down, but certainly have some quality of sharedness about them, of connection to others. Unfortunately audiences, and fellow musicians, make unreliable therapists. Sometimes they’re right there for us, but sometimes they’re not. Maybe the music therapist is partly analogous to the reliably attentive audience, partly to the sensitive fellow performer. This is still a therapy about making links, and when the links aren’t there in any musical experience, we’re unlikely to shout out ‘music is therapy!’ Maybe all music is really about making links. God only knows… ;)
The half-diminished chord comes with the line “I'll make you so sure about it". In fact the function of the chord isn’t the usual II-7b5 as it’s a chromatic transitional chord on the #4 of E major, which leads to an A major chord in the next bar. It’s a moment of intensified harmonic ambiguity within a harmonically ambiguous piece of music. If it’s not an example of the “active ingredient” in music therapy, it’s certainly an active ingredient in some sort of process. It has a harmonic and emotional function, albeit one which might be hard to pin down.
I also said in my recent post that “music therapy doesn’t operate within a performer to audience dynamic”. I was thinking of the analogy of therapist with performer and client with audience which often seems to be an assumption made about music therapy. There might be an idea that the therapist is doing something to the client using music. This is not normally what happens in music therapy, but to say that this is ‘incorrect’ would be to oversimplify. Since the therapeutic process is two-way, the therapist’s music does have certain effects on the client. If we flip the analogy around, however, it becomes even more interesting. What if the client is the performer and the therapist is the audience? This actually works quite well a lot of the time. The half diminished chord in ‘God Only Knows’ becomes the active ingredient in music therapy when it is played by the client. Since actually doing this requires a level of musical sophistication we don’t routinely encounter the analogy might seem a bit absurd. But if we extend the analogy to include any moment of musical intensity then it begins to make more sense. Furthermore, as musical performers we all understand this. Music can be therapeutic when you go to a gig or listen to a recording, but this NEVER approaches the intensity of a meaningful performance in which you are an active participant. Not all performances are as meaningful or rewarding as they could be, but those that are; it’s a reason to be alive, to be frank.
So, ‘music isn’t medicine’? It’s misleading to say that it is, but it might also be misleading to say that it isn’t. That newly qualified colleague I mentioned before who has ‘been doing music therapy for years’. Well, the next question might be – ‘who on?’ The peak experiences that we sometimes have during performances are hard to pin down, but certainly have some quality of sharedness about them, of connection to others. Unfortunately audiences, and fellow musicians, make unreliable therapists. Sometimes they’re right there for us, but sometimes they’re not. Maybe the music therapist is partly analogous to the reliably attentive audience, partly to the sensitive fellow performer. This is still a therapy about making links, and when the links aren’t there in any musical experience, we’re unlikely to shout out ‘music is therapy!’ Maybe all music is really about making links. God only knows… ;)
Monday, 22 August 2016
Music Isn’t Medicine
I saw on Twitter recently that someone in the USA had tweeted ‘music is therapy’. They were at a conference and expressing their enthusiasm about an experience they’d had there. I didn’t do anything socially unacceptable, like replying to the tweet with my pedantic objections. I just thought to myself ‘no it isn’t’. But then I thought – what’s the motivation for saying this?
Another thing that happened, related to this, again on social media: a friend and colleague recently qualified as a music therapist, with flying colours in fact. She put this up on Facebook. She’s a highly respected performer of many years’ standing, and another musician wrote ‘you’ve been doing music therapy for years’, which was obviously meant in a nice way. People who don’t know much about music therapy, when they hear the term, tend to think first of all about the potential therapeutic properties of music itself, which is quite natural. On the BAMT website there’s a good video by Kalani Das which explains why this is an error (www.bamt.org ). However, music therapists do sometimes perpetuate the idea that music is intrinsically therapeutic, and that this is part of what we have to offer. It’s a good selling point perhaps.
The problem is partly semantic. Things can be ‘therapeutic’ without being ‘therapy’, just as things can smell nice without being perfume. Furthermore, music isn’t necessarily therapeutic, any more than talking is. Shakespeare or Eastenders might be therapeutic, Newsnight might not be. With music, the effect depends on context, and on what the music is. Some music has an anti-therapeutic effect on me, there being certain musical sounds which can transform my mood markedly for the worse.
Of course, some music is therapeutic, and can make me feel a lot better than I did before listening to it. This might be where a misunderstanding arises, because most of us have had this experience. If we didn’t, we probably wouldn’t bother listening to music. When we listen to music that we like, we’ve usually chosen it. There might also be something in a piece of music that we feel connects to us on a personal level, making us feel that we have shared emotional experiences with the composer or performers. One interesting question might be, is this feeling of connection intrinsic to the music itself, or is it a side effect? Is the ‘good’ feeling something transferred to us from the performer or is it arising within us? In a music therapy context, it doesn’t really matter; because music therapy doesn’t operate within a performer to audience dynamic, and, in the immediate term, doesn’t necessarily make the client feel ‘better’.
Leaving aside the fact that the music in therapy usually involves active musical participation on both sides, in contrast to a performance, it’s not the aesthetic or emotional content of the music that has the primary therapeutic effect. It’s not about the universality of music so much as the specificity of the therapeutic context. That feeling that you get from the half-diminished chord in ‘God Only Knows’ is probably not the active ingredient in music therapy. Music is a means of connection (among others like talking, body language, turning up on time etc.) but it's not the music itself (and there is such a thing as 'music itself') which is the therapeutic agent. Music therapy is, to a great extent, about the purposeful use of music to make links. These links might be interpersonal, inter-psychic or intra-psychic. The links, whether between the therapist and the client, different group members, the client’s array of internal objects, or the client and their attachment figures, are the therapy. Here it is again: the links are the therapy. So, snappy tag-lines (and magic chords) aside, music isn’t medicine.
Another thing that happened, related to this, again on social media: a friend and colleague recently qualified as a music therapist, with flying colours in fact. She put this up on Facebook. She’s a highly respected performer of many years’ standing, and another musician wrote ‘you’ve been doing music therapy for years’, which was obviously meant in a nice way. People who don’t know much about music therapy, when they hear the term, tend to think first of all about the potential therapeutic properties of music itself, which is quite natural. On the BAMT website there’s a good video by Kalani Das which explains why this is an error (www.bamt.org ). However, music therapists do sometimes perpetuate the idea that music is intrinsically therapeutic, and that this is part of what we have to offer. It’s a good selling point perhaps.
The problem is partly semantic. Things can be ‘therapeutic’ without being ‘therapy’, just as things can smell nice without being perfume. Furthermore, music isn’t necessarily therapeutic, any more than talking is. Shakespeare or Eastenders might be therapeutic, Newsnight might not be. With music, the effect depends on context, and on what the music is. Some music has an anti-therapeutic effect on me, there being certain musical sounds which can transform my mood markedly for the worse.
Of course, some music is therapeutic, and can make me feel a lot better than I did before listening to it. This might be where a misunderstanding arises, because most of us have had this experience. If we didn’t, we probably wouldn’t bother listening to music. When we listen to music that we like, we’ve usually chosen it. There might also be something in a piece of music that we feel connects to us on a personal level, making us feel that we have shared emotional experiences with the composer or performers. One interesting question might be, is this feeling of connection intrinsic to the music itself, or is it a side effect? Is the ‘good’ feeling something transferred to us from the performer or is it arising within us? In a music therapy context, it doesn’t really matter; because music therapy doesn’t operate within a performer to audience dynamic, and, in the immediate term, doesn’t necessarily make the client feel ‘better’.
Leaving aside the fact that the music in therapy usually involves active musical participation on both sides, in contrast to a performance, it’s not the aesthetic or emotional content of the music that has the primary therapeutic effect. It’s not about the universality of music so much as the specificity of the therapeutic context. That feeling that you get from the half-diminished chord in ‘God Only Knows’ is probably not the active ingredient in music therapy. Music is a means of connection (among others like talking, body language, turning up on time etc.) but it's not the music itself (and there is such a thing as 'music itself') which is the therapeutic agent. Music therapy is, to a great extent, about the purposeful use of music to make links. These links might be interpersonal, inter-psychic or intra-psychic. The links, whether between the therapist and the client, different group members, the client’s array of internal objects, or the client and their attachment figures, are the therapy. Here it is again: the links are the therapy. So, snappy tag-lines (and magic chords) aside, music isn’t medicine.
Thursday, 18 August 2016
Hearing and Being Heard
Hard-bitten professional musicians look away now…
I was ‘feeling the love’ after playing in the John Wilson Orchestra Prom last week (still on iPlayer folks…). There’s something affirming about the experience of playing in an orchestra, of being part of that delicate balancing act of creating a performance. What is John doing in the rehearsal process that creates the excitement? It’s partly about communicating attention to detail, an awareness that ‘I’m listening to you’ that keeps everyone on their toes. I felt like every one of my notes could be heard. This apparent aural omniscience is unnerving but also helpful. It implies that he will hear the subtleties of the individual contributions and that they will be appreciated, so that it’s worth making the effort: ‘tenor sax two bars before letter D (accompanying the big trumpet solo); start the vibrato a little earlier on the second minim of the bar please’.
This links to the therapist-client relationship. It’s the ‘I’m hearing you’ aspect of the therapist’s role that is analogous to the conductor. And to the players, the conductor is the representative of the audience, as well as the bridge to it. I’m not thinking too much about the people at the back of the hall because that’s his responsibility. He’s not so much the superego as the link to the other. This is analogous to the mother-infant relationship, where the mother is the connection to the outside world. It’s important not to overstate this in a professional context I suppose, because we’re all, also, just ‘turning up for work’ and ‘getting the job done’, but there’s something that makes a good performance feel really worthwhile, that’s more than just fulfilling a role. You are part of a collective experience which mirrors something fundamental about human relationships, about the need to hear and be heard.
Why do we need to be heard? Because we need to feel first that others are there, and then that they can understand us and that we are connected to them through shared experiences. The conductor, the therapist, the parent; all have a big responsibility, which is to allow this to happen.
I was ‘feeling the love’ after playing in the John Wilson Orchestra Prom last week (still on iPlayer folks…). There’s something affirming about the experience of playing in an orchestra, of being part of that delicate balancing act of creating a performance. What is John doing in the rehearsal process that creates the excitement? It’s partly about communicating attention to detail, an awareness that ‘I’m listening to you’ that keeps everyone on their toes. I felt like every one of my notes could be heard. This apparent aural omniscience is unnerving but also helpful. It implies that he will hear the subtleties of the individual contributions and that they will be appreciated, so that it’s worth making the effort: ‘tenor sax two bars before letter D (accompanying the big trumpet solo); start the vibrato a little earlier on the second minim of the bar please’.
This links to the therapist-client relationship. It’s the ‘I’m hearing you’ aspect of the therapist’s role that is analogous to the conductor. And to the players, the conductor is the representative of the audience, as well as the bridge to it. I’m not thinking too much about the people at the back of the hall because that’s his responsibility. He’s not so much the superego as the link to the other. This is analogous to the mother-infant relationship, where the mother is the connection to the outside world. It’s important not to overstate this in a professional context I suppose, because we’re all, also, just ‘turning up for work’ and ‘getting the job done’, but there’s something that makes a good performance feel really worthwhile, that’s more than just fulfilling a role. You are part of a collective experience which mirrors something fundamental about human relationships, about the need to hear and be heard.
Why do we need to be heard? Because we need to feel first that others are there, and then that they can understand us and that we are connected to them through shared experiences. The conductor, the therapist, the parent; all have a big responsibility, which is to allow this to happen.
Wednesday, 25 May 2016
BAMT Conference Roundtable Report - ‘So what is music therapy then?’ – Talking about music therapy with non-music therapists
I was delighted that Ann Sloboda, Alexia Quin, Sarah Hadley, Karen Sharp and Neta Spiro had agreed to be on the panel for this roundtable discussion. This was an interesting process, as when we met for our pre-conference discussion it became clear that we could talk on the subject for a lot longer than the allotted 90 minutes. I had invited each person because of their particular experiences of having to communicate about music therapy, so we would have perspectives from the course leader, the head of a charity, the NHS service manager, the trainee and the researcher. We decided that, instead of following the usual model of having a series of short presentations followed by a discussion, we would simply introduce ourselves and then launch straight into the latter part. I had certain ideas about what each of the panellists might bring to the table, based on their professional experience and positions. What I certainly didn’t know was how much the rest of the people in the room would bring to the discussion which, as it turned out, was a lot.
We considered whether we even need a definition for music therapy, whether this is a useful concept, or whether it is more helpful to describe what music therapy might achieve in a specific context. Part of this process was stimulated by some attempts at definition which Neta presented to the room. She had a number of these at the ready, but in the event we looked at only two, so lively was the ensuing discussion. These were the BAMT definition, which was relatively succinct, and the definition of the American Music Therapy Association, which was lengthy and seemed to be attempting to cover all bases, perhaps as a response to the legalities of the medical insurance system in the USA. Both definitions had parts which people found contentious, while both had useful content as well. Parts of the American definition were very clear and definite, which was good, but there was a danger of promising too much. Is it still ‘music therapy’ if ‘therapeutic aims’ are not wholly met?
The diversity of contexts in which music therapists find themselves, along with the variety of personal experiences which they bring to the work, both have an impact on the way the work is talked about. One person, who came from a business background before becoming a music therapist, compared our task to that of marketing a product. Do we describe a bottle of Domestos as ‘blue and made of plastic’, or do we say that it ‘kills 99% of known germs’. In other words, is it more useful to talk about what music therapy might achieve than trying to pin down what it ‘is’? Another person described their work in a Steiner school, where the process of music therapy might be described as ‘soul care’, acknowledging that such a formulation is very context-specific and would probably not be useful in a mainstream school or within a ‘medical-model’ culture.
There was some discussion about the importance of the way we talk about music therapy. Do we try to present ourselves as ‘knowledgeable experts’, using fancy language to demonstrate our level of training and experience, or should we always aim for clarity and simplicity? (I think it would be fair to say that the consensus was towards the latter.) Certain statements seemed to be at the core of what most people in the room thought about music therapy, such as the idea of ‘the power of music’ and the idea that ‘music is essential to every human being’. Had we had more time it would have been interesting to explore these assumptions a bit more. I asked, ‘Is music always powerful?’, which met with some acknowledgement of the validity of the question, but we didn’t explore this in depth.
A couple of things seemed clear. One was that music therapists, or at least the ones who came to this roundtable, are pretty good at talking about their work with non-music therapists, and they think carefully about the language they use to describe it, adopting a pragmatic approach which can adapt according to the situation. Another was that an important aspect of this is confidence. People were sometimes uncomfortable with being asked to give a definition, and I put the panel members on the spot a couple of times with his one. The aim of this discussion was never to arrive at an agreed definition, but rather to explore the challenges that the idea presents, and to share approaches. This felt like an appropriate thing to be doing as part of a conference which was exploring the developing identity of the profession. It has given all of us plenty of food for thought. No doubt the discussions will continue.
We considered whether we even need a definition for music therapy, whether this is a useful concept, or whether it is more helpful to describe what music therapy might achieve in a specific context. Part of this process was stimulated by some attempts at definition which Neta presented to the room. She had a number of these at the ready, but in the event we looked at only two, so lively was the ensuing discussion. These were the BAMT definition, which was relatively succinct, and the definition of the American Music Therapy Association, which was lengthy and seemed to be attempting to cover all bases, perhaps as a response to the legalities of the medical insurance system in the USA. Both definitions had parts which people found contentious, while both had useful content as well. Parts of the American definition were very clear and definite, which was good, but there was a danger of promising too much. Is it still ‘music therapy’ if ‘therapeutic aims’ are not wholly met?
The diversity of contexts in which music therapists find themselves, along with the variety of personal experiences which they bring to the work, both have an impact on the way the work is talked about. One person, who came from a business background before becoming a music therapist, compared our task to that of marketing a product. Do we describe a bottle of Domestos as ‘blue and made of plastic’, or do we say that it ‘kills 99% of known germs’. In other words, is it more useful to talk about what music therapy might achieve than trying to pin down what it ‘is’? Another person described their work in a Steiner school, where the process of music therapy might be described as ‘soul care’, acknowledging that such a formulation is very context-specific and would probably not be useful in a mainstream school or within a ‘medical-model’ culture.
There was some discussion about the importance of the way we talk about music therapy. Do we try to present ourselves as ‘knowledgeable experts’, using fancy language to demonstrate our level of training and experience, or should we always aim for clarity and simplicity? (I think it would be fair to say that the consensus was towards the latter.) Certain statements seemed to be at the core of what most people in the room thought about music therapy, such as the idea of ‘the power of music’ and the idea that ‘music is essential to every human being’. Had we had more time it would have been interesting to explore these assumptions a bit more. I asked, ‘Is music always powerful?’, which met with some acknowledgement of the validity of the question, but we didn’t explore this in depth.
A couple of things seemed clear. One was that music therapists, or at least the ones who came to this roundtable, are pretty good at talking about their work with non-music therapists, and they think carefully about the language they use to describe it, adopting a pragmatic approach which can adapt according to the situation. Another was that an important aspect of this is confidence. People were sometimes uncomfortable with being asked to give a definition, and I put the panel members on the spot a couple of times with his one. The aim of this discussion was never to arrive at an agreed definition, but rather to explore the challenges that the idea presents, and to share approaches. This felt like an appropriate thing to be doing as part of a conference which was exploring the developing identity of the profession. It has given all of us plenty of food for thought. No doubt the discussions will continue.
Friday, 20 May 2016
Your Supervisor is Always Wrong
Don’t get me wrong, supervision is very important. I’ve been supervising for a few years and always find it a privilege to be involved in the shared process of thinking about a client. In music therapy we have this unique ingredient of listening back to audio or watching video. It doesn’t happen often enough, usually for logistical reasons, but when it does it can throw new light on the work. We can also make suggestions about what to do musically, based on our musical impressions of the client. ‘You could try matching the pulse here’, ‘perhaps the client would respond to your voice’, ‘try playing a bit less; wait to hear what the client does with the silence’. There’s an imaginative process where the supervisor tries to get a sense of the client, probably picturing them a certain way, thinking about what it might be like to be with them. There might be some elements of role play in supervision. Sometimes I might imagine what I would say to a client, and say this, in the tone of voice I might use, so that the supervisee gets an idea of what I’m driving at, of the affect as well as the intention.
As a supervisee I usually feel these moments, when the supervisor imagines what they might do with this client, making suggestions or acting out a scenario, to be off the mark. I almost always think, to some extent, ‘No you haven’t quite got it’, or even ‘Seriously? That’ll never work’. This is such a consistent thing, with every supervisor, that it’s either about me (always possible – maybe I just hate getting advice) or about the process of supervision. Winnicott (1958) has this to say: “What matters to the patient is not the accuracy of the interpretation so much as the willingness of the analyst to help, the analyst’s capacity to identify with the patient”, and perhaps this applies to supervision as well, since we are mirroring something about the therapeutic process.
I’ve had these experiences in peer supervision too. One sticks in my mind, when I was describing a client who would go running out of the therapy room, and a colleague suggested singing about this, reflecting the client’s actions in the music. This seemed so far-fetched in relation to this young man that it was almost comical. I tried to imagine his reaction if I started singing ‘You’re running out of the room’ in a light baritone, perhaps with a Schubertian accompaniment – ludicrous! But perhaps there was something useful about the process. Imagining what my client might do with a certain response put me back in the room for a moment. The incongruity of the suggestion helped to highlight something, even if it was just that this client might not be someone who would respond to sung reflection. Generally, of course, it’s not such a far-out idea. With some clients, particularly younger children, singing about what they’re doing can make a useful connection. With this person the idea threw his personality into sharp relief. There was no way he would connect with this approach, but it was useful to think about why.
When the supervisor ‘gets it wrong’, this is really an important part of their job. Perhaps as a supervisor myself I’m looking for a get-out clause, but as a supervisee I can feel the helpfulness of this idea. As well as providing a sort of reverse image of the client (is this akin to Bion’s ‘intense beam of darkness’, helping to support our negative capability?) it also reminds me that the supervisor is with me now, but in the session I’m on my own with the client. I can get support, but the clinical work is still my responsibility. Furthermore it emphasises the time differential. In supervision you are either imagining yourself back into the past or projecting yourself into the future. What could I have done? What did this mean? How could I respond next time? Anything the supervisor says, to state the obvious, they are saying now, in supervision. If you try to freeze-frame and carry this forward into the next session it probably won’t work. Bion again – ‘without memory or desire’ – including the desire to implement suggestions from supervision. Listen to your supervisor, absorb their words, experience the containment, then forget about it all, clear your head, and do the next session.
As a supervisee I usually feel these moments, when the supervisor imagines what they might do with this client, making suggestions or acting out a scenario, to be off the mark. I almost always think, to some extent, ‘No you haven’t quite got it’, or even ‘Seriously? That’ll never work’. This is such a consistent thing, with every supervisor, that it’s either about me (always possible – maybe I just hate getting advice) or about the process of supervision. Winnicott (1958) has this to say: “What matters to the patient is not the accuracy of the interpretation so much as the willingness of the analyst to help, the analyst’s capacity to identify with the patient”, and perhaps this applies to supervision as well, since we are mirroring something about the therapeutic process.
I’ve had these experiences in peer supervision too. One sticks in my mind, when I was describing a client who would go running out of the therapy room, and a colleague suggested singing about this, reflecting the client’s actions in the music. This seemed so far-fetched in relation to this young man that it was almost comical. I tried to imagine his reaction if I started singing ‘You’re running out of the room’ in a light baritone, perhaps with a Schubertian accompaniment – ludicrous! But perhaps there was something useful about the process. Imagining what my client might do with a certain response put me back in the room for a moment. The incongruity of the suggestion helped to highlight something, even if it was just that this client might not be someone who would respond to sung reflection. Generally, of course, it’s not such a far-out idea. With some clients, particularly younger children, singing about what they’re doing can make a useful connection. With this person the idea threw his personality into sharp relief. There was no way he would connect with this approach, but it was useful to think about why.
When the supervisor ‘gets it wrong’, this is really an important part of their job. Perhaps as a supervisor myself I’m looking for a get-out clause, but as a supervisee I can feel the helpfulness of this idea. As well as providing a sort of reverse image of the client (is this akin to Bion’s ‘intense beam of darkness’, helping to support our negative capability?) it also reminds me that the supervisor is with me now, but in the session I’m on my own with the client. I can get support, but the clinical work is still my responsibility. Furthermore it emphasises the time differential. In supervision you are either imagining yourself back into the past or projecting yourself into the future. What could I have done? What did this mean? How could I respond next time? Anything the supervisor says, to state the obvious, they are saying now, in supervision. If you try to freeze-frame and carry this forward into the next session it probably won’t work. Bion again – ‘without memory or desire’ – including the desire to implement suggestions from supervision. Listen to your supervisor, absorb their words, experience the containment, then forget about it all, clear your head, and do the next session.
Reference
Winnicott, D.W., 1958. Child analysis in the latency period.
The maturational process and the facilitating environment, pp.115-123.
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