Thoughtful Thursday: Keep It Together...Even When Things Are Falling Apart Around You

One of my favorite movies in the world is called Bowfinger. It is a silly movie, but it is something that I absolutely adore. It stars Steve Martin (who also wrote it) and Eddie Murphy (in a dual role) along with Christine Baranski, Heather Graham, and Terence Stamp. It's a funny movie about the movie industry, and I have most of it memorized.

One of Eddie Murphy's characters is a famous movie actor who gets involved with everyone else in a con situation, and his character is on the edge to begin with. As part of the story, he is involved in a form of counseling and has a mantra - Keep it Together. During the movie, he repeats this mantra when things get a bit too much for him to handle. You can tell how much he is upset by the pitch and the tempo of his repetitive chant - keep it together, keep it together, KIT, keep it together.

Last week's sessions were a time when I used this mantra. Things were spiraling, and I was coming down with my Jan/Feb ick, and it was all I could do to keep it together. This week has been much better - interestingly, one of the staff members who had such a difficulty with me last week was not present this week and all of the clients who struggled so much had absolutely no difficulties in music therapy this week. Absolutely NONE! It may not be me...hmmm. 

I write about these things because I want people to know, understand, and accept that music therapy sessions do not always go as planned. If this is the first time that you are hearing this in your career, I am so sorry because I think it is something that we should be talking about from the first day of your clinical work if not before then.

Let me say it again.

Music therapy sessions do not always go as planned.
There are times when music therapy sessions go better than planned. Clients who have never verbalized before sing the lyrics to a familiar song. A client who usually doesn't interact initiates a shared music experience. A group of clients learn a concept or skill in one therapeutic music experience and the teacher reports that they have mastered the skill outside of the music therapy session as well.

There are times when music therapy sessions go worse than planned. A client vomits all over an Orff instrument. There is a fight that breaks out between clients based on something that happened in the transition line. There are times when your group members have the flu so the dance marathon that you have planned just isn't going to work. It is an inevitability that music therapists cannot avoid - there will be times when what you have planned cannot work.

In these moments, I will admit it, I tend to have a split second of panic. My mind starts going - "oh crap, this is not working. Now what??" After that split second (because, let's face it, you WILL feel it) though, it is time to start working through what you already know about music and therapy and yourself. If your session plan isn't working, you have to alter the plan to fit the clients' demeanor and attitude and level of energy.

This is one of the reasons that I do so much brainstorming in my strategizing sessions. I spend lots of time thinking over as many scenarios as possible so I can be prepared for every sort of session. Even with all of my practice, experience, and brainstorming, I cannot envision every single situation that can occur with my clients.

Since pre-planning for every single possibility is not possible, I have focused on three possibilities - optimal learning state, withdrawal from learning state, and the overstimulated state. These are the three most common types of states that my clients present. Withdrawal tends to be the times when folks are sick or tired or disgruntled for any reason. Overstimulated states include riots between group members, screaming, goofy behaviors, horseplay - you name it. If I can plan how to use music to work with clients in all three states simultaneously, I can pretty much head into any session with confidence.

How do I do this?

I center myself into the elements of music. If a group comes in in an overstimulated state, then I will play the opening therapeutic music experience (TME) at a different pace than if they enter in a withdrawal from learning state. I will decrease the harmonic and rhythmic complexities, stripping my music to its most basic state of strong meter indications and direct lyrics. If they enter in a withdrawn state, I may slow my tempo down, increase the complexity of the harmonic lines and decrease the amount of lyrics that I offer, allowing the music to be at the forefront. If they enter at an optimal state, then anything goes! I always spend most of my attention on how the group is responding to the music and to each other. The music has to be almost natural in how it comes from me - I can't be thinking about chord changes, I have to be able to feel them without devoting lots of my brain power to them.

Does this sound daunting? I suppose it is, but you get better with practice - I PROMISE YOU THAT!

Here's how I move from thinking about music production to music therapy implementation -

PRACTICE - I memorize almost all music for use in sessions. It is rare that I use any sort of sheet music or lead sheets to play music. With my population, it makes sense to learn music as much as I can rather than depending on a device or book of music. Other music therapists have to use those types of devices, but I still recommend getting out of the music as much as possible. If you need practice with ear training, then do that ear training. It is a wonderful feeling when you can accompany someone on an unfamiliar song - just by listening to what they are singing.

KNOW CLIENT GOALS - Write down client goals - don't just type them, write them using your handwriting. Review those goals before every session so they are foremost in your mind. Review your data collection as well. If you are working on communication goals with your client, then remember how you have set up your goal statements so you offer the types of things that you want to measure. Think about how you will change your data trials if clients are not responding as expected.

BRAINSTORM - Keep thinking about how to adapt things for your client to lead to progress towards individual goals. Do this before every session in the strategizing process and do this after every session. Write your ideas down somewhere (I have, surprise, a notebook where I write these types of thoughts - adaptations and extensions and changes to my TMEs). Again - WRITE them. Do not just type them. There is something more memory forming if you actually sit down and use your entire body to write something than if you type it into your phone. 

DO NOT GET TOO UPSET WHEN THINGS GO DIFFERENTLY THAN EXPECTED - This one is the key to it all! If things don't go as you expected, then it didn't go as expected. If you tried your absolute best to adapt and accommodate client needs and to make things happen for your clients and it didn't work, it is not entirely your fault. We can get into mindsets (I was there just yesterday morning) that the faults and failures of all the interactions are completely due to us and us alone, but that is not possible. Every music therapy session has to include at least two people - the therapist and the client. We cannot control how a client responds to the music we share. We can only control 50% of the interaction. The other 50% is not something we can control. So, if things don't go well, then we can only bear 50% of the fault. There are times when clients just don't want to engage. I can tap dance and whistle and do everything possible and clients STILL don't want to engage with me. As long as I have made every effort available to me, I have done what I need to do as part of the therapeutic relationship.

Keep it together, keep it together, KIT, keep it together.
 

Comments

Popular posts from this blog

Sing A Song Sunday - The Time Change Song (Fall)

Being An Internship Director: Why I Do Very Little Active Recruitment

Dear AMTA