Just Keep Swimming

I had it SO easy as a new grad and young therapist. I lived in an area in which music therapy was relatively well-known, if not universally accepted; and since there were a few college music therapy programs already established, referrals were easy and steady. I literally hit the ground running. With a few dips and valleys here and there, I worked steadily and happily for years. Woot!

Fast forward ten years, and I’m living in a whole different area of the country. For the first time in my life, I am out of the Northeast and I am living in a SMALL. TOWN. The population of the entire town is less than the population of my neighborhood growing up. As if the culture shock wasn’t enough just in everyday life, music therapy is foreign to most people. Some are downright hostile towards the idea of something so  “new” and out-of-the-box. Anyway, I often get the hairy eyeball (what exactly is that, really?!?) when I explain that I am a music therapist.

Add to that angst the fact that this is a military area, and many of my referrals have been military. I love this. There is no greater honor than to serve the families of those who have served and sacrificed. If I can give back in whatever small way, I’m not only happy to do so; I feel compelled to act. However, serving clients from a military installation means that you are serving a highly mobile population.  PCS (Permanent Change of Station) often comes in a wave, with multiple clients leaving at the same time.  So this Boston girl did NOT anticipate this kind of thing, and suddenly found herself looking at a decimated caseload. EEK!

After my traditional bout of catastrophic thinking (you know what I’m talking about; the sky is falling, I’ll never work again, I’ll be a bag lady on the street in short order, my husband will resent me forever {oh, please, he’s my biggest cheerleader!!}), I took a deeeeeep breath and stepped back for a moment. Enter in the big-girl therapist self-talk:

  • You must be willing to educate people about what it is that you do. In other words, you need to present, be a presence at events like Buddy Walks, Autism Awareness Events, whatever. Okay. I’ve done the events.  I will do more. I’ve presented a little bit. As it happened, the week after my caseload was slashed by PCSs, I was invited to speak on-base about music therapy for children and youth. So I beefed up the presentation, committed it to memory (so I didn’t look like a slacker, reading from my notes!!), and pushed the ever-present anxiety over the survival of my tiny practice waaaaay down inside.
  • I needed to remember my first love, the actual practice of music therapy. So what that things were slow now? It was not a reflection upon me as a therapist or a person. Buck up, babe! Remember why it is that you do what you do! Do you believe in the efficacy of music therapy? Without a doubt.  Let your love for the kiddos and your love for the art and discipline of music therapy shine through. It’s really not about how you feel, anyway. In fact, it’s not really about you. Really.
  • Thankfully (SOO THANKFULLY!), our national association (AMTA)  has tons of resources for people  looking to sustain and grow their private practices. This temporary slow period is the perfect time to take advantages of online courses and the scads of publications available. AND–you get continuing ed. credits. BOOYAH.
  • Be willing to expand yourself. My expertise (and my heart) is in special education and pediatric neuro, with some adult psych mixed in. Time to stretch here, and gain skills in other areas, such as geriatrics, and perhaps even medical music therapy. Scary? Um, yes. Worth it? Of course, on so many levels.
  • Be ready and willing to fight for it. I love private practice. I love the freedom, and I love marching to the beat of my own drummer. Above all, I love the autonomy it gives me to practice music therapy the way I believe it should be practiced. As Bruce Cockburn so eloquently stated in a song so many years ago, “Nothing worth having comes without some kind of fight./Gotta kick at the darkness till it bleeds daylight.”
    He’s so right.
  • Be thankful. I am so incredibly grateful for the families whom I have served, and continue to serve. I’m grateful for the trust they have placed in me, I’m grateful for the opportunity to treat their children, and I’m grateful for the enthusiasm with which they have embraced music therapy. I wouldn’t trade it for anything. Even this current down time.
  • Finally…remember  the sage advice in “Finding Nemo.” Just keep swimming.

Yup. Just keep swimming.

Until next time, sing, dance, play and create. Thanks for reading!

 

 

Music Therapy for Children with Down Syndrome, Part III– A Recap

In our last post, you met Rachel, who was almost three when I began to work with her in music therapy. We talked about the goals and objectives I had for her, and how she responded and progressed. I gave you some ways to go about finding a music therapist in your area to work with your child. This time I want to give you some things to look for in a potential music therapist, as well as some tips for helping your school-age child receive music therapy services as part of his or her Individual Education Plan. I will also give you some more activities that you can do with your child—not that this could be called music therapy, but because you can never have too many tools in your “toolbox” when you’re working on maximizing your child’s development. Right? Right.

Assuming that you’ve received the names of some potential music therapists, the first thing you want to know is how your child responds to him or her. Is there a connection between them? Does the therapist appear comfortable with your child, even if your little one is having a bad day? How does the therapist deal with meltdowns? How comfortable is your therapist working with the other professionals in your child’s team? Does the therapist have experience (or a desire to have experience) with children such as your child (never discount a new graduate, or someone who is transitioning from another area in music therapy; if they are passionate in regard to learning about different diagnoses, and more importantly, your child, chances are that person will work out just fine.  I never mind when people ask me about my training, and where I did my internship, etc. Most therapists worth their salt are happy to tell you about their background, within polite reason, of course! J

For your school-age child, music therapy can be included in their Individual Education Plan (IEP). Yes, music therapy is a related service under IDEA, the Individuals with Disabilities Education Act. That means that IF your child is shown to truly need the addition of music therapy to their education program (remember, after an assessment by a qualified music therapist), the school must provide that service at no cost to you. However, not all school systems are amenable to this, and you may have to be persistent in your efforts to procure services for your child. There is helpful information on the AMTA website (www.musictherapy.org) for topics such as this.

Here are some more supplemental things for you to do musically with your child. No…of course this won’t turn you instantly into a music therapist…just a creative, involved mom or dad. And that’s really the most important thing for the two of you! J

For infants, we all know that nothing beats rocking. Add soft music, or your own voice, and that is a wonderful way to pair music with comfort, thus creating a nice association. This is especially good for both of you if your baby has medical issues, and is hospitalized because it creates a nice safe space for both baby and parent. Of course this can work wonders well beyond the infancy stage too.

As your baby begins to ambulate, add fun, strongly rhythmic songs to which he can walk. Help your beginning walker walk to the beat –not too fast, though! Best case scenario is for you to sing, because that way you can slow it down to meet your little one at his level. Heck, add a drum and turn it into a parade!

Reinforce communication skills by imitating your child’s coos. Hold your cooing baby close to your own face, and coo back to her. Take turns conversing like this…it’s amazing how much many babies love this. Some babies will engage in this for extended periods of time, and absolutely light up when they realize that they are being “heard.”

You can build social and non-verbal communication skills by taking turns on a single drum. Let your child beat a rhythm, and you imitate her sound. It is a fun way to teach turn-taking and give and take in a social situation.

Build fine motor skills by offering your baby and bigger boy or girl chunky mallets that can be used to play drums (I make adaptive mallets out of sanded wooden dowels). You may need to shorten them, or find other smoothly finished wood or even plastic rods. You can use them just as they are, or you can do what I do, and cut a hole in a small rubber ball. You can hot-glue the ball to the dowel, and you’ve got a sweet mallet! The extra weight and bigger circumference of the mallet provides more sensory input, builds muscle, and is easier to grasp. Win-win.

Encourage singing at all stages! This is especially good for children who are becoming or who are verbal. Just singing to their favorite IPod playlists is uplifting in its own right…but singing can help with articulation too. When you and your child are singing without recorded music, slow down some of your songs. The added time can make it easier for them to articulate more clearly.

I hope that these few suggestions have created a domino effect in your minds, and that you are coming up with all kinds of musical ideas to help your child’s development. If you have any questions, though…I would be happy to respond (midsouthmusictherapy@gmail.com I hope this short series was as much fun for you as it was for me.

So finally, sing, dance, create, and play!

Marybeth

Music Therapy and Down Syndrome: A Case Study, Part II of III

Rachel was 2 years old when she began music therapy with me. She was tiny for her age, alert, friendly and affectionate. She also OWNED the staff at the community music school within about 5 minutes of her arrival. You know how captivating these babies (excuse me, BIG GIRLS) are!
According to her parents’ reports, Rachel had only begun walking and babbling   weeks prior to her music therapy assessment; almost immediately after she’d had tympanostomy (tubes installed in her ears) surgery. She’d had a TON of fluid in her ears, which is common in kids with DS. It was no wonder she was delayed in reaching those milestones!

When I assessed Rachel, I found that she had not only had areas of need (communication, balance, motor skills, decreased upper body strength, attending skills); she also had areas of great strength She was, and continues to be, like I said earlier, a very happy, emotionally stable child who was incredibly social and secure. She was inquisitive and curious, eager to please, and aching to communicate. W
Rachel really loved music…so in short, she was a music therapist’s dream.

I created a treatment plan for Rachel based on what I found in the assessment. Since music therapy, like most other therapies, strives to treat and honor the WHOLE person, I tailored it to meet her developmental needs as well as to capitalize on her very real strengths. Rachel was also blessed with a loving and invested family, and an amazing Early Intervention team that worked aggressively on helping her gain all those early skills that we all need for life. The most important thing about her Early Intervention team was that they were using a Total Communication approach with her—spoken words, objects (with the intention of graduating to picture symbols), and sign language. Since it is always good to carry over what other therapists are doing in therapy, I joined them in using this, giving her choices between objects, developing songs that used sign language, and encouraging her to use her signs (and words, when possible) when making requests. This turned out to be a therapeutic triumph for Rachel in more than communication; she was also able to develop her fine motor skills, cognitive skills, and behavioral (attending) skills.

I addressed issues like core strength by having her sit (supported, of course), on a peanut ball while I held a drum out for her to play. This activity required her to stretch, balance herself, and develop eye-hand coordination. Adding a mallet that was heavy for its size helped her develop arm and upper body strength. At first, she needed quite a bit of support, and even some hand-over-hand guidance to strike the drum. However, as she got stronger, she needed less and less help, and a few months later was even sitting independently, with my presence behind her simply for safety purposes . We practiced turn-taking (always a good social skill to develop, even this early on) and “nice waiting” with a song that requires the participants to play a drum/stop/offer the other participant the mallet. Her favorite activity of all was being swung rhythmically to a “Swinging Song”. Since this kind of movement is so beneficial to children’s nervous systems, this became our first activity after the “Hello Song.” On a hunch, I omitted it one session, and found that she was less attentive, and less communicative that day. Never underestimate the power of movement, or rocking, or swinging! I didn’t have a swing like you may have seen in your Occupational Therapist’s treatment room, but fortunately she was tiny enough to be swung in my arms; at least for a while . We had a large mirror in my studio, so normally we would swing in front of the mirror, where she could see herself, and I could ask her to sign for “more” and “stop” during this exercise.

Her motor skills and balance improved quickly, as did her cognitive abilities. Her verbal speech was much slower to evolve, which is not uncommon. However, she was able to sign for most of her needs, and used the objects, and later, a few picture symbols to communicate with me. As she matured, we began to use songs to encourage verbalization. I would start to sing a song, and then pause, leaving the last word of the line out. I would continue to strum the guitar or play a chord on the piano, waiting for her to fill in the blank, so to speak. When she responded, either with the word, or an approximation of the word, we would continue singing the next line, with Rachel supplying the ending word of each line. As this was probably the most difficult thing for her to do, I always planned this activity so that it was after an easy, preferred activity, and before a favorite one. Gotta have the reward after the work, right?

We tend to think that the fun, pleasurable, entertaining aspects of music are what make music therapy work. While that is a nice side-effect, it is really NOT the reason that it works. We are neurologically hard-wired to respond to music and sound. Music with lyrics stimulates the language centers in the brain. Music stimulates us physiologically—our pulse, respiration and blood pressure can all change in response to hearing music. These are the reasons why music therapy can be beneficial. And this is the reason why I think I have the best job in the world.

How can you find a music therapist? Simple. If you’re in the US, the American Music Therapy Association is your first stop. You can contact them at http://www.musictherapy.org/contact/ or 301.589.3300. They can help you find a music therapist in your area who has the experience that you want for your child’s needs. If you are outside the US, chances are that there is a music therapy association where you live. A simple internet search will help you find it, and get you on your way to finding a qualified clinician.

Next time—a recap of music therapy for children with Down Syndrome, questions to ask a potential music therapist, and more supplemental activities that you (yes, YOU!) can do with your child even without being a music therapist yourself.

Until then, sing, create, and play!

Marybeth

Music Therapy for Children with Down Syndrome: A Three-Part Series

                       March 21 is 3:21! In honor of Down Syndrome Awareness Day, here is a three-part series on Music Therapy for Children with Down Syndrome. This first  post  describes music therapy, and what it is. From there. we will go on to talk about how music therapy can benefit children with DS, how you can find a therapist, and what to expect from music therapy. 

                   Part I: Music Therapy? What, Who, and the Beginning of How It’s Done

Music Therapy, as defined by the American Music Therapy Association, is “…the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.”
So what does that mean to the new parent, or parent of a school-age or older child/adult with special needs, who is already on information overload?
Simply put, Music Therapy is a real, clinical profession. It’s so much more than going in, playing nice music, and making people happy (although if that is a side effect, great!  ). But what does “clinical” mean? What about “evidence-based?
When we say that Music Therapy is a clinical discipline, we mean that music is applied for therapeutic purposes, rather than music education, or solely for the purpose of pleasure. There is always a reason behind the interventions that a music therapist presents in a music therapy session. Evidence-based means that the therapist is using the best research available in the field (this applies to all therapeutic/health professions, not just music therapy). It also means that the music therapist brings his or her own clinical expertise to the table, and uses it accordingly; and finally, we take the needs, desires, and values of our clients (and families) into serious consideration in the course of treatment. It’s the respectful, ethical thing to do.
We are indeed professional musicians, but our training goes beyond the instrument. Here is a brief synopsis of how we are trained. Music therapists have at LEAST a bachelor’s degree; most go on to obtain master’s degrees and beyond. In addition to collegiate musical training, we study psychology (general, educational, abnormal), anatomy and physiology. Internship follows…1200 hours worth, or about six months. New grads are supervised by a clinical training director, and like other internships, we get our hands-on, full-time experience in the field here. After that comes the Board Certification exam…and then we are ready! Yes, we constantly take continuing education courses…and YES, we are board-certified—because really, would you want to trust your child to someone who didn’t have the credentials behind his or her name? I don’t mean to speak ill of musicians who might go into hospitals and play for patients (that is how music therapy began—but that’s another post)—but if one is going to work with individuals with very special, sometimes complicated needs—one absolutely, positively, needs the training and the certification.
Now that you know what a music therapist is, what do we do, and where do we work? We work in schools, hospitals, psychiatric facilities, day treatment programs, in community music schools, and in private practice. We provide assessments and direct services to our clients, we in-service staff and allied professionals, and we sometimes get to co-treat with other therapists (my favorite thing to do!!). We are members of treatment teams, we are consultants to schools and other facilities, and occasionally we get to coach music educators who are learning how to include children with disabilities into their regular music classes. These are places in which you may find music therapists.
But what is a music therapy session like? The answer is there is no single type of music therapy session. It is as individual as your child. Music therapy is administered individually, and/or in small or large groups. In both individual and group settings, though, a music therapy session begins with some kind of greeting or Hello song/exercise, made to greet the child and orient him or her to the session, followed by music and activities that will address the goals and objectives defined in the music therapy assessment (that will be covered in our NEXT post this week!). Some therapists will structure the session so that the activities/exercises get progressively more challenging, but once they’ve reached the height of difficulty, then the demands made on the child will lessen, like a cool-down period in a workout. The session ends with a closing, or Goodbye song/activity that lets the child know that music time is done, and helps with the transition from music therapy. Obviously a 1:1 music therapy session is going to be more intensive than a group session, since the therapist can focus in on the client’s individual needs. However, group sessions are great for those who enjoy and/or need to practice social interaction. In a perfect world, my clients would have both individual AND group music therapy, because there are so many different benefits to each type of therapy.
Okay, now, let’s say you don’t have a music therapist just yet…but you know your child loves music and sound, and you’re just itching to do something creative with him or her. Here are some tips on what you can do at home to encourage your child’s love for music, and boost their development. You may be doing most of them instinctively, because we are neurologically hard-wired to respond to music and sound. Really we are! See how many of these things you may already do with your child. True, you may not be a music therapist, but I want to encourage you to do these things with your child, and see how much fun it can be. You may even find that music is another way to bond with your little one.
• Rock your baby. It’s comforting, it’s organizing to their nervous systems, and the rocking motion is helping their brains develop, even laying the groundwork for future motor and social development. Add a soft lullaby (and YES, your baby LOVES the sound of your voice, even if you think you sound like Scuttle from The Little Mermaid) and you’re on the road to developing some parent-child quality time activities.
• Again, sing to your kiddo. Make silly voices and faces, add movement and just be plain silly and playful. Your baby/child is no different than any other little one. They love this kind of interaction with you.
• As your child gets older, introduce them to musical instruments. Sit at a piano or keyboard, and take turns playing on the keys. Imitate their attempts to play—let them lead you. This kind of call-response music develops social awareness, and of course, playing on the keyboard develops fine motor skills {oh—don’t worry if they “bang” or only play with their fists. That’s developmentally normal. However, it is a great way to start teaching the difference between “too loud” and “pretty music!”}

Next time we meet—we’ll look at a brief case study of a child with DS in music therapy, and how you can find a music therapist in your area. Until then, sing, dance, play and create!

Of Parents, Attachment, and Surprise Outcomes-Part I of II

Well! Happy New Year! Months have gone by since a coherent blog has been posted. Blame it on trying to get the practice up and running, or grant researching and writing, or whatever…Good old writer’s block and a lack of inspiration is the culprit here. Hopefully the New Year will bring more inspired topics to the table!

Thanks to an SOS call that I put out on Facebook, that renowned digital town square, I was gifted with some topics that my would-be readers requested to see here in the Studio. So in order to respond to everyone’s feedback, here is part one of two…actually, it’s more of a hodgepodge of topics that I have gladly embraced (thank you, Tonya and Bob!)to start a conversation again about music therapy.

Part one of this “series” is actually just my tribute to parents of special needs children. Next to military wives, these people are my heroes (If you happen to be a military wife AND the parent of a special needs child, you rank quite close to sainthood, in my book!).

I’ve sat in my share of tense IEP meetings, watching the battle lines being drawn. Parent vs, SPED director, parent vs. principal, and most unfortunately, sometimes, parent vs. teachers and/or therapists. Sometimes it’s just barely civil. Sometimes it’s openly ugly. Sometimes one side is the aggressor, other times the hostility is mutual. It’s always agonizing.

Over the years, though, I’ve become tenderized, if you will, to the parents. Yes, even the hostile, aggressive ones. Certainly I understand budgets, program limitations, funding dead-ends (Music therapy is often the first thing to go in the SPED arena, when budgets are crunched). I understand the frustration of not having the right staffing, the right equipment, the proper training to give a child what she so desperately needs. It’s frustrating…and it is a helpless feeling to have to look a parent in the eye and say, “I’m sorry. We can’t provide that (service, one-to-one assistant, increase in service time, etc.)” I know that we cannot, realistically, meet every single need in the school setting. It’s an imperfect system. I get that.

But-the frustration and feelings of inadequacy pale in comparison to what parents of special needs children experience on a daily basis. I can only imagine the day to day struggle for every little thing. Going shopping is a major undertaking, whether you have a child on the autism spectrum who melts down because of the hustle and bustle of your local grocery–or a multiply-handicapped child who requires a wheelchair, needs to be tube-fed and diapered before you walk out the door, and who might have a grand mal seizure (or many) without any warning. Having a moment to enjoy the adult company of a spouse, relative or friend is a luxury. A full night’s sleep? Forget about it. Not if you have a child who doesn’t sleep–or has MORE seizures. AND–isn’t it funny how some friends and family step back after a diagnosis? Hmm. So the support system is cut down even more drastically. On one hand, this does separate the wheat from the chaff…but that pruning is always painful. It leaves scars.

Add to that the never-ending medical appointments, therapies, hospital stays. Insurance claims, denials, re-submission of said claims, and fighting with yet more people who don’t know your child who are making decisions based on a bottom line. Are you kidding me?

At last, there is the school system, once the child turns 3. And no, I’m not bashing, nor biting the hand that feeds me and my family. I love working in school settings, and I’ve met more dedicated professionals than not. However, consider the IEP process…more people involved in the care and education of your child. More assessments, more talk about deficits and needs and behaviors, and the list goes on. It’s enough to make your head explode!

When all has been peeled away, I don’t care who has the PhD, or the title. Yes, we all may be the experts IN OUR FIELDS, but you, the parent, are the expert on your child. We, as the experts in our chosen disciplines, need you. We need your input, we need your partnership. Of course there will be disagreements here and there–but it is my hope and prayer that you all find the best educational settings for your children. AND–my hat is off to you, for the situation you are in is most likely not of your choosing, yet you tuck your chins, move forward, and fight like warriors for the most precious people in your lives. May we, as professionals, treat that with the respect and care that it deserves.

Of Parents, Attachment, and Surprise Outcome, Part II

A friend asked me recently, “How do you work with the children you have and not get attached?”

Oh, this is such a good question. It takes me back to my earliest undergrad classes, to my earliest work experiences where the mantra was “Keep your distance. Don’t get attached.”I will admit, a certain amount of detachment is clinically necessary when one is assessing and treating a client, whether child or adult. You can’t let your wishes for that person cloud the very objective data of what he or she is truly capable of at that moment, even if it is far below where we wish they were. That’s why we do therapy; to increase their levels of functioning to an optimal level. I once had a tender-hearted freshman music therapy student who was having trouble separating a child from his disability. In her youth and inexperience, she felt that making note of “negative behaviors” or “inability to perform certain tasks” was a personal affront on the child as a whole. I tried to explain to her that the objective, clinical words were what we used to describe the manifestations of the disability, not the child as a person, but I could tell she wasn’t buying it. It took some weeks, and a lot of processing, before she could even begin to think of separating the clinical versus the personal. In one supervision session, she almost defiantly told me, “But I’m still going to like him. That can’t be changed!”

Well, of course not. I assured her that it was more than acceptable to like this little boy, and in fact, that made me feel confident about her ability to eventually work with him therapeutically. The trick, I told her again, was to be cognizant of her subjective feelings, and to remember to keep her clinical judgement first and foremost. Difficult? Especially for the novice, yes. Doable? You must. If you cannot separate your “wishlist” for the client from what is reality, you will be ineffective as a therapist.

Back to the aforementioned mantra from my bright but emotionally disconnected first music therapy prof: “don’t get attached…don’t get attached.” Um, are you for real? If I did not get attached–in other words, if I didn’t care beyond my goals and objectives for each client with whom I came into contact, exactly what good would I be? Does that mean that I am going to develop a symbiotic relationship with the client, and his or her family? Of course not. That would be counter-therapeutic.
So is it counter-therapeutic to enjoy my clients, to be moved by their personalities, their cuteness? No, not as long as I remember why I’m there. Have I had my heart torn out? Absolutely. I’ve lost tens of children over the past 15 years. I’ve seen horrible abuse, cruel injustice. For sure, it will happen again, and again. I accept this as part of the package. So I try to keep myself healthy, to find colleagues with whom I can trade reality checks, and to have as solid a marriage and social support system as I can. When something bad happens, I have to face the bad feelings, and yes, the grief. Then I have to move on and continue to be a therapist. To me, that is the most honest thing to do.

Tears, Healing, and the ISO Principle

A good friend shared some very deep and insightful thoughts on how she uses music when she’s feeling down…and thus I have been inspired to write about the actual therapeutic use of music.Early on in my work, a child was brought to the music therapy room by an educational aide for her music therapy session. A snapshot of this child (We’ll call her “C”): C has Rett Syndrome (for info: http://www.rettsyndrome.org), resulting in very limited hand usage, no verbal communication, and other various and sundry issues. Suffice it to say, not a muscle in her body cooperates with her. So…look at it this way, C has no words, cannot use her hands purposefully, has balance and perception issues; and neurologically, she is so overly sensitive that she often cannot process tactile, visual, and auditory stimuli, and that causes her to either 1) panic and start to cry, 2) completely shut down and withdraw.

On this day, C had a bad bus ride into school–an aggressive older boy, lots of noise, a new bus monitor who hadn’t been trained that yelling over a group of eight special needs children was probably not in their best interests. By the time she got to school, she was disturbed, by the time they got her coat off and backpack hung up, she was inconsolable. I could hear her crying as she and her assistant made their way up the stairs to the music therapy room. When they arrived, C immediately sat at the piano with me, and I began to improvise some music that matched the pitch and intensity of her vocalizations. Yes, she was still wailing, and still quite anxious. Our music was intense, but probably not what an outsider would call beautiful. Looking back on it, though…it was rich in emotion, and grist for the music therapy mill.

I wasn’t paying attention to the assistant who was sitting behind us; so I was startled to hear her exclaim at one point, “Stop! Oh, my God…this music is SO SAD!!!”

Well, yeah. I was reflecting the sad and anxious vocalizations of a little girl who was sad and anxious. She had no words to express herself. No way of seeking validation because she could not verbally communicate her emotions (Can you say “TRAPPED?”).

Long story long, we did not stop playing at the assistant’s request…we continued until C finally stopped crying, and was more calm. When we finished, she was quiet; really, she was spent. Interestingly, the rest of her music therapy session was good– and she had a better day after that. No–there was no magic in the music that took away her sadness and her fears; the music was simply a vehicle that allowed her to express it, work through it, come out on the other side.

After the session, the assistant confronted me again. “Why would you put her through all that? She was sobbing!”
I hadn’t thought of this before, but apparently the assistant was a victim of a popular misconception. Music is supposed to make you happy. Right?

Yes. And no.

Have you ever been so depressed that all you wanted to do was listen to really bad breakup songs? Did they make you cry more? What teenager in the throes of adolescent “sturm und drang” hasn’t holed up in her bedroom playing dark metal or other music until that boy finally called (or didn’t)?

Conversely, what’s a party without music? What’s a road trip without a CD player full of whatever songs support that feeling of freedom and expectation? Are you with me?

Clinically, it’s called the ISO Principle. ISO is Latin for “same,” and what it entails in music therapy, is a “matching” of the client’s feeling state. The theory behind this is simple; I could not MAKE C change her feelings. That would be disrespectful and futile. Look at it this way–have you ever been really down about something? Has some well-meaning friend completely dismissed your angst and implored you to “cheer up?” Gah. We’ve all done that, admit it. It comes from a longing to make things better, but also a fear of strong and unpleasant emotions. Some people are better than others at confronting those feelings, but it is never fun. However, it’s a part of life. I explained this to the assistant, but she was having none of it at that time. Over time, she came to understand it better, and even reluctantly agreed that it was a good tool. A minor victory for Music Therapy!

That day, C was able, with the help of the music, to work through her feelings. BUT– it didn’t end there. When C looked like she was ready, I played music that was lighter in timbre and tonality. Therapeutically, you do not want to stay in that dark space. Gradually, I lightened the music according to her cues–body language, eye contact, vocalizations.

C had many more sessions in which the improvisations we did were sad, or angry–or JOYFUL!! YES! Joyful! She is a fully alive human being who just happens to be trapped in her own body by the Rett Monster. Music just happens to be the key to her soul, and I was humbled to have worked with her in this way. Like all of the children, she gave me more than I could ever give her. Special times, for sure.

So the next time you’re feeling badly…be brave! Put on some music that matches how you’re feeling. Remember, though, you need to be mindful that when you start feeling a bit better, you need to switch to some lighter music. Hopefully by the time you’re done, your own dark clouds will have parted, even if only temporarily. I hope you can put this technique into your self-care toolbox for those stressful times.

Stay tuned!