Synthesis Sunday: Getting Back Into Music Therapy in Context

I am finally getting back into the swing of things by continuing my practice of reading a music therapy text and then synthesizing it into my world of music therapy. It's been some time since I've done this, so forgive me ahead of time if I stumble a bit. In the interest of full honesty, I must admit that I am concurrently reading, writing, and synthesizing (not what I like to do, but important to get back into my routine). Here we go.

I am currently reading Mercedes Pavlicevic's Music Therapy in Context: Music, Meaning and Relationship. I am currently reading Chapter 11, "Playing with Winnicott's Reality." I am not extremely familiar with Winnicott, so I head over to Wikipedia to see what I am getting into...

(Did you hear that? Every single academician just shuddered reading that last sentence. "Wikipedia?? That's not an appropriate resource!!" Okay. I know, but I find that Wikipedia does a great job of synthesizing things into brief overviews. I now know a bit about Donald Winnicott that I didn't know before - a little context gives me a bit of perspective about what I am reading.)

Here are my notes -
  1. Creativity - Winnicott (1971, 1988, 1990) - "creativity has to do with how we fit in with the world and its details" (p.147). "...the expression of the creative impulse is related to our capacity to perceive the world objectively... (p.148). "The capacity to hold both (capacity to perceive the world objectively and capacity to create our own version of the world) means that we need to be strong enough and confident enough to distinguish the boundary between ourselves and the 'outer' world...and to acknowledge the constantly shifting balance between our inner world and the outer world" (p.148 - with additional clarification put in by me - in the parens).
  2. Autonomy - "In order to distinguish between the inner and outer world, we need a sufficiently developed sense of 'authentic' autonomy, enabling us, as a unique person, to image and create subjectively and to be confident in the authenticity of our images" (p.148). For me, in my work with children and adolescents with psychiatric disorders, this point really hits home. I like the explanation about having to attend so much to an outer world due to the need for constant vigilance for staying safe that the inner world becomes underdeveloped. This is logical explanation for why my students often have very little to no ability to engage in imaginative play. It fits in well with my Trauma-Informed Care viewpoint as well.
  3. Playing in the World - As Ms. Pavlicevic started the chapter, she stated that music therapists liked Winnicott, and this concept makes it clear why he was included in this text. I feel that play is extremely important in the development of human beings, and so does Winnicott (and Pavlicevic does as well!). Winnicott also encouraged the use of transitional objects - something tangible to hold when leaving a sense of security for a place less familiar. "According to Winnicott, mental illness and disturbances in emotional life may be described as the absence of authentic autonomy or as an incapacity to tolerate uncertainty" (p.150). "...artistic people could be said to have more ego strength and are able to tolerate the uncertainty of straddling the inner and outer world" (p.150).
  4. Playing in Music Therapy - "Winnicott's (1971) understanding of playing is a useful analogy for extending our understanding of clinical improvisation" (p.150). "Clinical improvisation - which happens between therapist and client - embodies the joint creation of a mutually accessible and convenient musical space. This musical space exists between therapist and client: it is part of 'me' and 'not me', for each of the partners, and is also 'there' and 'not there' in the sense of being, and also not being, 'the world' (p.151). "...joint clinical improvisations may reveal dynamic forms which are fragmented, inflexible or incoherent to the therapist, who then has great difficulty in mutually creating a musical play-full space with the client" (p,151).
My brain is too full to continue. Time to synthesize.

When I do this on Saturday nights, I use my spiral notebooks and my many colors of pens to collate information and then start to analyze it. I make all sorts of notes in a way that makes sense to me (but may not make sense to someone else). I scribble. I draw arrows all over the page. I use different colors to indicate different things (for example, my thoughts versus quotations from the text).

When I do this on Sunday morning, I just go straight to the computer. It makes my processing a bit different. Train of thought - stream of consciousness - here we go...

My clients are children and adolescents with developmental and psychiatric concerns. Most of them have an extensive trauma history and act out in socially inappropriate manners.

So, for my clients, the concept of play is something that is not readily accessible. For them, play is video games or basketball. They don't pretend very well. They don't create imaginary situations - if they do, we often label those situations as hallucinations and administer medication. The idea of play is something that is separate from their understanding.

In music therapy, though, there are times when they do engage in play. I'm not going to say that this happens every single time a client enters the music therapy room - it doesn't, especially in large group sessions - but I think it happens more often in music therapy than in our educational settings. 

When I do get a chance to interact with a client through music and clinical improvisation, we share a play situation. I have a current client that I am really wanting to get into an individual session. This particular client follows me any and everywhere. The client initiates interaction with me. The client is now requesting singing and is participating in sung responses to sung questions without prompting. I think this client will shine with the addition of individual music therapy in the schedule. I think we will be able to play together through music.

I need to think a little bit more about this.

Time to synthesize. Happy Sunday, everyone! I hope you get to enjoy the day!!

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