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Stern, Daniel (2010). Forms of Vitality: Exploring Dynamic Experience in Psychology, the Arts, Psychotherapy, and Development. Oxford: Oxford University Press.
Reviewed by Simon Gilbertson, University of Bergen
 Daniel Stern’s work has played a highly significant role in the field of music therapy for decades. Since the early 1980’s Stern has moved through terms such as vitality affects, temporal feeling contours and vitality contours during over three decades of work on the concept, forms of vitality which is culminating in this 2010 book, Forms of Vitality: Exploring Dynamic Experience in Psychology, the Arts, Psychotherapy, and Development.
At the last Nordic Conference of Music Therapy in Aalborg, May 2010, Daniel Stern held a keynote presentation via video link from Geneva on the topic of this current book. It was Professor Tony Wigram, who most sadly passed away recently on June 24th 2011, who played a tremendously important role as the conference Scientific Coordinator making that keynote possible, transcribing Stern’s presentation into an article in the NJMT (Stern, 2010) and by creating a link, both personally and technologically, so that the wider music therapy profession could have the opportunity to listen to Daniel Stern and learn about ‘forms of vitality’ and the relation to music therapy theory, practice and research (Wigram, 2010).
Stern has organized’ Forms of Vitality’ in three parts, which in total contain seven chapters and a reference list:
- Part I: Introduction and Background
- Chapter 1. Introducing Dynamic “Forms of Vitality”
- Chapter 2. The Nature and Theoretical Framework of Dynamic “Forms of Vitality”
- Chapter 3. Ideas from Psychology and Behavioural Science Leading to Dynamic Forms of Vitality
- Chapter 4. A Possible Neuroscientific Basis for Vitality Forms: the Arousal Systems
- Part II: The Role of the Arousal Systems, and the Example of Music, Dance, Theatre, and Cinema
- Chapter 5. Vitality Forms in Music, Dance, Theatre, and Cinema
- Part III: Developmental and Clinical Implications
- Chapter 6. When do Vitality Forms begin? A Developmental View
- Chapter 7. What implications do Forms of Vitality Have for Clinical Theory and Practice?
All of the sections provide the reader with an almost immediate entrance into a hidden world of the stuff that human experience is made of. At the outset Stern determines the role that “movement, time, force, space, and intention/directionality – taken together give rise to the experience of vitality. As a globality, a Gestalt, these five components create a ‘fundamental dynamic pentad’” (p.4). Stern asserts that, as is obvious in the arts and present but at times hidden by daily routine and habituation, that a complex spectrum of these five components, are the stuff and material of what human experience and inter-relating is made of. As an example, he suggests that the dynamic form of a dancer’s movements can be sensed, perceived and understood and can be extracted from the actual physical event to be available to other dynamic media, music, for example. A contemporary dancer, Steven Paxton, well known for his development of contact improvisation who Stern writes about in this second part of the book, is an excellent example of this. As the developer of contact improvisation, Steven Paxton’s solo dance choreography with Glenn Gould’s recordings of the Goldberg variations or his “Material for the Spine” (Paxton, 2008) are prime examples of the material that is becoming more and more important in my own study and teaching on relational improvisation in music therapy. Stern’s perspective on human action and interrelation is founded in millennia of infant-care giver interaction, music and movement choreographies, and can be seen in such diverse activities such as synchronized underwater swimming, the spontaneous shouts and calls of young siblings playing unattended, and the most sophisticated of hip-hop dance-offs. Stern provides most wonderfully transparent and thought-provoking examples throughout the text for the primacy of the “forms of vitality.”
From this core, the book unfolds layer upon layer of human experience through discussing the dilemma confronting the sciences when dealing with Gestalts, to how psychology, behavioral science and a relational-neuroscientific perspectives are coming closer to dare to consider new and innovative neuroanatomical and neurofunctional and neuro-relational basis of “forms of vitality.” Those convinced of, and on the search for isolated locations of music function in the brain will finish this book empty handed; the book challenges the reader to extend towards new explanations and consider these in place of the old.
Following a feat of mastery in providing a narrative that challenges deeply the heart of reductionist science models while at the same time demonstrating directions of new paths of discovery, the first section leads the reader through a most fascinating consideration of “forms of vitality in music, dance, theatre and cinema” which is to be found in the second part. The section truly opens a kaleidoscope view of time-based human action and experience within the arts and provides exemplar and reflection through modern ballet and film, 20th century music composition and experimental theatre.
The third part of the book is “Developmental and Clinical Implications.” In this third and vital section, it may interest readers from the music therapy profession to find music therapy in the role of a prime example of Stern’s concept of forms of vitality in the section titled, “Vitality forms and intersubjectivity” (p.137). It is music improvisation in therapy that Stern uses to portray how “the role of vitality forms in intersubjectivity leads to a renewed interest in some of the basic notions of non-verbal therapies” and he refers to Tony Wigram’s descriptions of basic therapeutic methods of mirroring, matching, empathetic improvisation, grounding-holding-containing, dialoguing and accompanying, in Wigram’s 2004 book, Improvisation: methods and techniques for music therapy clinicians, educators and students. By focusing on Gro Trolldalen’s writing on music interplay (Trolldalen, 1997), Stern describes how “as the therapist and patient enter the same dynamic flow created by the music, there will emerge moments of ‘mutual recognition’ when they both realize, at the same time, that they are sharing a common experience. This is brought about through affect attunement, joint attention, and mutual confirmation. Such shared moments then act as do ‘moments of meeting’ in changing the relationship and moving it to a deeper level of intersubjectivity (BCPSG, 2008)” (p.140). It is clear that the mechanism of reciprocity is made of forms of vitality. It is then of course, no surprise that in the dance of improvised music, the senses combine and dissolve before our very eyes – ‘forms of vitality’ provides a way of staying with what remains, the essence and source of being human.
Stern closes the book with a succinct summary:
This book calls attention to the domain of dynamic forms of vitality. It demonstrates that such a domain exists, and shows that it is separate and distinct from the domains of emotion, sensation, and cognition. It stands on its own.
The second task has been to describe the scope of the domain of dynamic forms of vitality in psychology, the arts, psychotherapy, development, and neuroscience. It is ubiquitous as a part of all experience.
Finally, it intends to influence some of our current notions and suggest further paths of inquiry into this domain and all that it touches (p.149)
Daniel Stern’s Forms of Vitality is essential reading not only for music therapists, but also for anyone who is prepared to reconsider how humans experience themselves and others in relation. It is so beautifully written it can be read by students, therapists, educators and researchers, parents, and anyone who is willing to learn and grow through change.
References:
Paxton, S. (2008) Material for the Spine. (DVD) Brussels: Contradanse.
Stern, D. (2010). The issue of vitality. Nordic Journal of Music Therapy, 19(2), 88-102.
Trolldalen, G. (1997). Music therapy and interplay. Nordic Journal of Music Therapy, 6(1), 14-27.
Wigram, T. (2004). Improvisation: Methods and techniques for music therapy clinicians, educators and students. London: Jessica Kingsley Publishers.
Wigram, T. (2010). Keynote presentation by Professor Daniel Stern: Preface. Nordic Journal of Music Therapy, 19(2), p.87.
Ridder, Hanne Mette. (2005). Musik & demens: Musikaktiviteter og musikterapi med demensramte. Århus: Klim.
Reviewed by Solgunn E. Knardal, Bergen Red Cross Nursing Home, Bergen, Norway.
The area of music therapy in the care for elderly is becoming increasingly significant. Reflecting demographic changes, we are seeing an increasing number of music therapists working in the field and also more research is being carried out in the area. Hanne Mette Ridder’s Musik og demens provides a thorough and excellently presented overview on music activities and therapy with people with dementia.
This book is divided into three parts. 1: Music Activities 2: Theory 3: Literature Review. In this format it is both easy to read and also simple to use as a reference resource. This is a book to come back to, to reflect, to read again and is a place where the reader can find everything from practical descriptions to relevant references to published material. The book outlines ways in meeting patients suffering from dementia and describes the differential competences that are needed to do this.
Part One, titled “Music activities” is organized and presented very clearly, and takes the perspective on music therapy from a level of using music simply “to make the elderly happy” to provide a deeper understand of the mechanisms of change in music therapy which are grounded in research findings. The ways of working are also presented systematically: basis principles, setting, content, examples, comments and discussion. I imagine that music therapists working with elderly people will nod and recognize the descriptions of the work also some characteristics of the case narratives.
The section describes the diverse use of music in the care for elderly, from meeting a basic need for pleasurable experiences – to finding space for inner peace, something this section portrays very well in addition to describing how music becomes relevant in meeting the patient with dementia in the very last phase of life. The section demonstrates how music therapy with people with dementia is diverse and contrasting. The use of music is one major factor whereby the individual has great possibilities to be clear and to be seen. With the use of music can calm down, relax, stimulate and increase the quality of life for the individual. Several of the surveys show this. The use of music when being around others (fellow patients, relatives, personnel) can also show favorable effects.
Part two, titled “Theory” is divided into three sections: The pleasure of music – constructive regression, the inner space of peace, where making routines in everyday life gets essential. A person suffering from dementia will often have challenges on regulating oneself, and music has been shown in its use in reducing extreme states of arousal. In this section a systematic review is presented of music therapeutic interventions to meet these patients. The section shines with an open attitude towards people suffering from dementia, and how interventions should be considered in terms of providing space for the individual to be a whole human being. Three different types of interventions are shown to be relevant; activities for pleasure, therapeutic activities and psychotherapy. It is suggested that therapy is very beneficial where it is dialogue-based, and the aims are clearly communicated to those involved, including to relatives and caregivers. The chapter on ‘music in the brain’, where studies have been selected to shows that music can “bypass” the brain, and create new links to non-damaged areas, is useful both when working with people with dementia, and also for the music therapist when communicating about work with this group of individuals.
Part three, titled ‘Literature review’ includes 92 studies from 12 different countries that were selected with specific inclusion criterion. The review is an excellent resource and provides a solid and reliable basis for understanding themes and topics that have received research attention during the development of music therapy in this area.
Though “quality of life” is often challenging to capture in research, this review shows how there is openness and interest also for this dimension in research in music therapy. In this review, Ridder provides clear and succinct information about the benefits of using music activities and music therapy in the care for people suffering from dementia, and how it can have positive effects on communicative, cognitive, physiological and social domains. Even if active participation reduces as dementia increases, it is possible to observe how people with dementia react positively with and through music. Still, as a conclusion, there is a large amount of research to be done on this significant and valuable topic.
With ‘Musik og demens’ (Music and Dementia), Ridder has provided a most valuable contribution to the literature. It is written by an experienced music therapist, educator and researcher who clearly has great expertise in working and writing about music therapy with people living with dementia. The knowledge and overview of the practice, theory and research is well balanced and integrated and throughout the book, there is a sense of the author’s deep respect for each individual, just as they are. As a result, this is a book that will be of interest to students, therapists and researchers interested in the role music can play in the lives of those with dementia.
McFerran, Katrina (2010) Adolescents, Music and Music Therapy. Methods and Techniques for Clinicans, Educators and Students. London: Jessica Kingsley Publishers.
Reviewed by Philippa Derrington MA. Music therapist at Cottenham Village College and Centre School, Cambridge UK.
 Adolescents, Music and Music Therapy - © Jessica Kingsley Publishers Adolescents, Music and Music Therapy by Katrina McFerran is the fifth book in a methods series published by Jessica Kingsley. The previous publications are: Improvisation (Wigram, 2004); Songwriting (eds Baker, F. and Wigram, T. 2005); Receptive Methods in Music Therapy (Grocke, D.E. and Wigram, T. 2006); and Microanalysis in Music Therapy (eds. Wosch, T. and Wigram, T. 2007).
This book provides a balanced theoretical and practical guide to working with adolescents. Music therapists, whether newly qualified or with experience in the field will find this book useful. It offers detailed explanations for realistic ways of working with adolescents and is packed full of ideas: from the description of an adolescent-friendly instrumentarium to a Symphonic model of music therapy group development – with an introduction, exposition, development, recapitulation and coda. ‘Teenagers exist on the cusp between expression and articulation, and music matches this level of experience very successfully’ (p. 137).
Based on years of experience working with adolescents with very different needs and in a wide variety of settings, McFerran clearly sets out her method and explains her reasons for ways of working including different types of activities she uses. The breadth of her experience is evident in the illustrative vignettes which accompany each section of her clearly defined method. McFerran’s experience with adolescents has included work in a range of community and institutional settings and examples range from work in a hospice and hospital, to special schools. The adolescents may have profound and multiple learning disabilities, emotional and behavioural difficulties, be facing terminal illness, loss or grief.
From the beginning, as the author explains how and why music and music therapy is relevant for adolescents, McFerran’s passion for her work is obvious. Her engaging style draws the reader in and the clarity of the text and layout of each chapter is well designed. The book has four parts:- Background; Song methods and teenagers; Using improvisation with teenagers; and Contemporary approaches.
The systematic view of the literature, chapter 1, includes a look at how many therapists are working in this area, in what settings and what they use in their method. Interestingly, McFerran discovers that, although adolescents spend most of their (weekdays) time in school, the majority of music therapy work does not take place in educational settings but in hospital, inpatient health care settings or hospices. McFerran also uncovers through the literature that there is no significant one way, nor a prescriptive method for any particular setting. The author’s response and intention with this book, underpinned by her doctoral research, was ‘to provide a Map, or a guide, that encourages music therapists to approach adolescents in their own way’ (p. 279). The following chapter leads on to McFerran’s description of her blended eclectic model of music therapy, ‘The real deal on how to work with adolescents’.
The final chapter (3) in part one is an ‘overview of some key ideas in relation to four elements of adolescent health – resilience, identity formation, competence and connectedness’. This is a very useful and welcome chapter for those who have attempted to find out more about adolescents and been daunted by the vast literature on the subject.
Parts two and three encompass the practical material and descriptions of the author’s work. The parts are divided into three sections, when the music therapist’s focus is on 1.Fostering understanding; 2.Offering acceptance; and 3.Facilitating development. Each method she describes has a section for ‘Setting and purpose’, ‘Illustrative vignettes’, ‘Evaluating effectiveness’ and ‘Key points’.
In part two, McFerran explores the use of existing songs (chapter 4) and the composition of original songs (chapter 5). In part three, the author discusses the use of composition with teenagers in both groups (chapter 6) and individually (chapter 7). ‘The unique attitudes and needs encountered with this age group are at the centre of each of these practical chapters’ (p. 22). The reader cannot help but be enthused by the vivacity and clarity of McFerran’s text.
Finally, in part four, McFerran looks at contemporary approaches to music therapy, the need to look at the adolescent in context and with more focus on developmental achievements that take place outside of the music therapy setting. Within the framework of community music therapy (chapter 8) and contemporary practice, McFerran discusses the use of performances and recordings. Again, the author illustrates her approach with vignettes which successfully capture the enthusiasm and energy of the teenagers and therapist.
Chapter 9, ‘Four brief approaches to grief’, sets aside this crucial area for adolescents who may be experiencing all kinds of loss. As well as describing her work with adolescents, McFerran highlights the importance of running workshops to youth professionals and ways of using music with the young people. Her honest and expert reflections on her experiences of this work are valuable. Vignettes from a bereavement support group demonstrate the author’s point concerning preparation for performances (chapter 10) and the therapist’s responsibility to constantly check the impact that this has on the therapeutic process.
This book not only updates music therapy literature, which had lacked such a text that focused solely on adolescents, but has added a wealth of information. McFerran’s writing is genuine, inspiring and certainly reflects her passion and understanding of work with young people. The book will be helpful to music therapists working with adolescents in any setting and should generate further interest and research in this area because, as McFerran’s book makes clear, there is very little research that specifically addresses the value and effectiveness of music therapy for adolescents.
I shall leave the last word to Tony Wigram, whose foreword to this book reflects his high regard for the author, both as researcher and clinician. He writes: ‘Music is an integrating, emotional and highly attractive art form, and Kat McFerran demonstrates here with all her exciting ideas and methods how the power and value of music can be a positive force in the lives of adolescents’.
References:
Wigram, T. (2004) Improvisation: Methods and Techniques for Clinicans, Educators and Students. London: Jessica Kingsley Publishers
Baker, F. and Wigram, T. eds (2005) Songwriting: Methods and Techniques for Clinicans, Educators and Students. London: Jessica Kingsley Publishers
Grocke, D. and Wigram, T. (2006) Receptive Methods in Music Therapy: Methods and Techniques for Clinicans, Educators and Students. London: Jessica Kingsley Publishers
Wosch, T. and Wigram, T. eds (2007) Microanalysis in Music Therapy: Methods and Techniques for Clinicans, Educators and Students. London: Jessica Kingsley Publishers.
Meyer, P., De Villers, J. & Ebnet, E. (2010). Guitar skills for music therapists and music educators. Barcelona Publishers, Gilsum. 143 pp., ISBN 978-1-891278-56-3
Reviewed by Viggo Krüger, PhD Candidate, GAMUT / Music therapist, Aleris Ungplan
 Cover from Guitar skills for Music Therapists - ©Barcelona Publishers I will begin this book review with a personal point of view. As a music therapy student back in 1997, I recall being told by teachers and older music therapy students that most music therapists used the piano in their work, regardless who they were working with. Now, in 2011, the situation of the role of guitar in music therapy seems to have changed. The guitar has a new and altered status in music therapy, at least speaking from the perspective as a music therapist in Norway. As it seems, many music therapists use guitars in their work, and therefore a book about guitar skills for music therapists is particularly welcome.
Meyer, De Villers and Ebnet have published a guitar book that set out to give music therapists and music educators a tool to use in their work. The book is meant to give beginners and intermediate guitar players suggestions and pointers to improve their knowledge base and technique. The text offers material that can be used in functional guitar courses for music therapy and music education majors as well as anyone interested in learning the basics of guitar playing. Topics covered include basic and advanced techniques such as strumming patterns, fingerpicking, flatpicking, barre and power chords as well as authentic stylistic accompaniment in styles such as Pop, Blues, Jazz, Rock and Rhythm and blues. The book is designed to assist the learner in developing his or her practical guitar skills in a format that can be used in both the classroom and for individual self study. The text begins with the very basic exercises of guitar playing and expands into more challenging material as book progresses throughout the chapters. The book has a chapter called music therapy techniques. In the chapter on rules for improvisation, techniques on how to use open tunings and slide guitar are described. The DVD follows up the descriptions with demonstrations so that the reader can both see and hear how the techniques are used.
As a guitar playing music therapist and a teacher in guitar skills for music therapy students, I basically find the book usefully and well made. I think that both the written material and the DVD can function well as scaffolding in learning process whereas the learner is looking for tips on how to play ordinary guitar skills needed for playing western music genres such as rock, pop and blues. However, the book may in some regard seem a little too much as an ordinary guitar book and I miss more material on actual guitar skills for music therapists and also on other “world music” genres from countries such as Asia or Africa. Taken into consideration that all three authors are music therapists, the chapter on music therapy techniques is a little too short regarding content of guitar skills for music therapists. Both descriptions and demonstrations of different modes, open tuning and the slide guitar are useful, but can we really consider them music therapy techniques? Actually there is only one page describing how the guitar can be used in music therapy techniques such as improvisation, questions and answer or how to leave space (page 112).
In my view, Meyer, De Villers and Ebnet have made a book that illuminates the need for elaborations and descriptions on how the guitar is a useful instrument in music therapy. The questions, ‘How?’, ‘For whom?’ and ‘Why?’, they have left for others to describe and explore. From my own experiences with guitar in music therapy processes, and from those I have been talking with about such processes, there certainly lie great potentials and resources to be used and discovered. Maybe now is the time to open up for such stories and knowledge. However, most such knowledge may remain as what Polanyi calls tacit knowledge (Polanyi, 1966). And in relation to the discussion on tacit knowledge, if we don’t give our knowledge names and make stories about our experiences, they will remain silent, but not necessarily useless.
References
Polanyi, M. (1966), The tacit dimension, Doubleday, N.Y and Routledge & Kegan, P. London
Twyford, K., & Watson, T. (Eds.). (2008). Integrated team working: Music therapy as part of transdisciplinary and collaborative approaches. London: Jessica Kingsley.
Reviewed by Alison Ledger, Leeds Institute of Medical Education, University of Leeds, United Kingdom (A.Ledger@leeds.ac.uk)
 The publication of Integrated team working in 2008 marked a significant step in the development of music therapy as an allied health profession. In preparing this text, Twyford and Watson gave due consideration to an important yet frequently overlooked aspect of music therapy practice – working with others. Twenty-four contributors discussed the benefits and challenges of collaborative work in music therapy and reflected on the role of the music therapist in interprofessional teams. This writing exposed teamwork as an essential part of music therapy practice that is not necessarily easily and comfortably achieved. Effective teamwork was presented as an accomplishment that requires considerable time, commitment, flexibility, reflection, and skill. This was significant, as it promoted open discussion of an aspect of practice that many of us have experienced as stressful. Additionally, it allowed exploration of ways in which services for clients could be improved.
Following a helpful introduction to collaborative working by the editors, the book is neatly structured into chapters by client group (children, adults with learning disability, adults with mental health issues, adults with acquired neurological conditions, and the elderly). Short case studies are presented throughout and provide practical examples of music therapists’ collaborations with a diverse range of professionals. Alison Barrington then places collaborative working in a wider historical and political context, before the editors summarise the key themes arising from the book. The writing is scholarly throughout and the contributors demonstrate ways in which aspects of music therapy work can be clearly articulated to others. This is a major contribution of the book, as effective communication has been identified as a core competency of interprofessional working (Suter et al., 2009).
A particular strength is the way in which the contributors locate teamwork in particular contexts. Each chapter or case study begins with a description of the location, the history of the organisation, the needs of the particular client group and/or the theoretical assumptions underpinning the collaborative work. Although most of the work was undertaken in the United Kingdom, by music therapists who trained at Roehampton or the Guildhall, sufficient detail is provided for readers to understand why a particular approach was taken. Readers are then able to determine whether an author’s experiences are relevant to their own particular work contexts. This is critical, because no two care teams are the same and the work of teams is likely to be influenced by a range of complex historical, organisational, and interpersonal factors (Atwal, 2002; Kvarnström, 2008; Suter et al., 2009).
The back cover states that the book is intended for music therapy students and practitioners, as well as professionals who work alongside music therapists. I believe that it is music therapy students and other health care professionals who will benefit most from this publication. Students are provided with a solid introduction to a number of client groups, a range of organisational contexts, and the various ways in which music therapists have worked with other professionals and family members. For health care professionals, the book offers ideas for collaborative work with music therapists and motivates and inspires further collaboration. The clever use of headings and introductions at the start of each section also means that it is not essential to read the book in its entirety. Readers with limited time can extract a chapter or case study that is most relevant to their own work. I discovered this feature during my doctoral research on music therapy service development, when I considered similarities between the strategies needed for collaborative working and the ways in which music therapy services can become successfully established. It was then helpful for me to limit my attention to the “guidelines for good practice” provided at the end of each chapter. Now that I am working in a medical school, I could imagine showing short sections of the book to colleagues to explain how music therapists fit into interprofessional teams.
As an experienced music therapy practitioner and researcher, the honesty of the case studies was refreshing. I appreciated the contributors’ generosity in sharing how their collaborative work was planned and what their experience of team working was like. Many of the contributors described vulnerabilities and uncertainties in working with other professionals. These descriptions resonated with my own experiences and indicated that music therapists are becoming less guarded in discussing their work. The case studies also give a rare insight into other professionals’ experiences of working with music therapists. I was particularly struck by a clinical psychologist’s account of her feelings of anxiety in working with musical instruments for the first time. This account showed that other professionals may be willing and able to collaborate with music therapists if they receive adequate preparation and support.
If I was to make one suggestion, it would be that the contributors could have gone even further in their descriptions of obstacles to collaborative working. Several of the contributors alluded to tensions, hostilities, and competitiveness in their work with other professionals. Claire Miller’s chapter on collaborative working in mental health was especially revealing in terms of the power struggles and rivalries that music therapists have experienced when working in teams. However, the case studies tend to read only as a collection of interprofessional success stories. For experienced clinicians, it would be helpful to read more detailed descriptions of the problems others have experienced and the ways in which interprofessional tensions have been resolved. For example, the broader health care literature indicates that there may be some negative consequences to interprofessional working when professional boundaries become blurred. “Role blurring” has been identified as a potential source of conflict, confusion, and burnout in healthcare teams (Brown, Crawford, & Darongkamas, 2000; Hall, 2005). I would therefore welcome further consideration of the ways in which boundary blurring may challenge music therapy practitioners’ conceptions of what music therapy is and how a music therapist’s identity may become altered through collaborative working. Additionally, I would suggest greater reflection on whether music therapists have played an equal or an adjunct role in their collaborative work. This type of reflection could be a little overwhelming for student readers, but would be useful for practitioners who are grappling with these issues.
The editors concluded with a hope that they will have an opportunity to provide a second volume, to further explore collaborative and transdisciplinary approaches in music therapy. Based on my reading of this pioneering text, I would strongly encourage the publisher and editors to do so. A second volume could include contributions from a wider range of countries and contexts and provide additional examples of ways in which challenges to collaborative work have been addressed.
References:
Atwal, A. (2002). A world apart: How occupational therapists, nurses and care managers perceive each other in acute health care. British Journal of Occupational Therapy, 65(10), 446-452.
Brown, B., Crawford, P., & Darongkamas, J. (2000). Blurred roles and permeable boundaries: the experience of multidisciplinary working in community mental health. Health and Social Care in the Community, 8(6), 425-435.
Hall, P. (2005). Interprofessional teamwork: Professional cultures as barriers. Journal of Interprofessional Care, 19(Supp 1), 188-196.
Kvarnström, S. (2008). Difficulties in collaboration: A critical incident study of interprofessional healthcare teamwork. Journal of Interprofessional Care, 22(2), 191-203.
Suter, E., Arndt, J., Arthur, N., Parboosingh, J., Taylor, E., & Deutschlander, S. (2009). Role understanding and effective communication as core competencies for collaborative practice. Journal of Interprofessional Care, 23(1), 41-51.
Ludtke, Karen (2009): “Dances with Spiders: Crisis, celebrity and celebration in Southern Italy” New York, Oxford Berghahn Books. 254 pages. Series: Epistemiologies of Healing
Reviewed by Simona Nirensztein Katz. MA Tavistock School of London. MT, AD Jerusalem. “Shir”: Psychodynamic Music Therapy Association, Florence Italy.
In her book “Dances with spider”, Karen Ludtke, DPhil in Social Anthropology at the University of Oxford, guides us in the world of past and present Tarantism with passion but without losing the perspective of a contemporary scholar.
The author’s poetical, yet not rhetorical, prose gives the book’s ambitious project a fluent and realistic description that makes you feel as if sitting among the olive trees in Salento or admiring the baroque stuccos of Galatina. These enchanting images are mixed with the ones of perspiring bodies of exhausted dancers and with the pounding sounds of drums and violins. As a reader one is impressed by how respectful and rigorous is the author’s description of the homes of the “Tarantati” and by her attempt to reach their psychic sufferance. At the same time she is fascinated by the “neo-Tarantati” and their search for a generic well being through rhythm and performance.
The book edited by Bergham Books is part of a series titled “Epistemology of Healing” which addresses issues of medical anthropology.
The author’s remarkable passion for the subject has led her on a seven year long field study which constitutes the core of the book. The essay maintains an overview on how Tarantism has been considered, practiced and studied throughout the centuries. Personally, I have found the analysis on the cultural and anthropological aspects of the phenomena, the newest and most stimulating part of the research.
Before entering a more detailed description of the essay it might be useful to define Tarantism. We speak about it as a phenomenon documented since medieval times in Salento in Puglia (the heel of the Italian boot) where a spider called “Tarantola” was supposed to bite and provoke, mostly in women, a complex series of psychic and neuro-vegetative symptoms which could be alleviated only by certain kinds of music.
The principal symptoms included loss of balance, nausea, anxiety, psychokinetic agitation or catatonic depression, closure, variations of appetite, libido and mood.
The spider’s bite, which has rarely been proved, occurred normally in the harvesting period during the long and hot summers. The” bitten” person often was going through a difficult moment of her life which could be a sad love affair, a family crisis, an imposed wedding, or an unwanted pregnancy.
At the propitious moment for the curative ritual a real setting would be prepared; the musicians (tambourine, voice, violin and accordion), the patient, and often a public would gather around scenographical and symbolic elements such as mirrors, colored cloths and sacred images. The musicians would play until they found the appropriate music for the white-dressed patient, and for her “spider”; tarantulas could be of a singing, dancing, frenetic, erotic, but also slow weeping and even funereal kind. At the moment of the musical matching, the patient reacted with a movement of recognition that could be a spasm or fainting or the classic “hysteric arc” where the whole body would become stiff from head to feet. Following this moment usually there was an ecstatic dance until final collapse and then, after a long sleep and rest, there was an improvement of the symptoms.
To ultimate the ritual and bring healing, St Paul’s mercy was necessary, and annually the cured women would go and give thanks in the saint’s chapel. The crisis often would recur in June in the days near St Paul’s day.
Let us now go for an overview of the four parts of Karen Ludtke’s book.
The first part “Past and present spider webs” sets the scene with a tribute to St Paul. The author brings us to Galatina, cross roads of ancient and new “Tarantati”, and asks how come both the myth and the music of the Taranta have been both preserved and reinvented. The narration fluctuates between an objective, historic tone to a more vivid and cinematographic one. For example when telling about Evelina:
this tiny elderly lady….[…] now she is better but in the past she would faint before leaving the house on St Paul’s day and her family had to drive her to Galatina unconscious […] she was lying on the back seat, giving off muffled sounds. Her fingers were clawed like the fangs of a spider (p. 39).
Ludtke enquires upon an important matter: Does Evelina and the other Tarantati really want to get better, or do their actions reinforce the status quo of the cause of their suffering? These are the kind of questions that are precious for us as music therapists.
In the second chapter through a rich overview of old and new Tarantism, Ludtke gives an historical perspective and confirms that the roots of Tarantism remain a mystery. Although some people search even for satanic origins, Ernesto de Martino (1961), the major scholar on the issue, locates the first Tarantism phenomena between the ninth and the fourteenth century in the period of the Islamic expansions in Apulia. According to De Martino, Tarantism arouse out of the dual need to deal with actual spider epidemics and with the changing socio-political and religious conditions. Other roots can be sought in European dancing manias like St. Vitus or Saint John’s dance in the Netherlands and in Germany in the thirteen and fourteen century A.C. . Even more ancient and interesting parallels to Tarantism have been drawn with the Dionysian and Orphic cults of Greek origins. All these manifestations were characterized by the cathartic use of dance and music. The complex and ambivalent relationship with Christianity is obviously the core of the healing rite.
Ludtke gives place to De Martino’s view that sees the phenomena as a culturally specific response to harsh living conditions of women in Southern Italy:
De Martino proposed a psychoanalytically tinged interpretation viewed within a historical and socio-economic framework. Tarantism was defined as a “religion of remorse” allowing the payment of debts contracted on an existential level (p. 64).
Of particular interest in Ludtke’s broad overview is her underlining throughout different stages of European history, the link between the different perspectives on this issue and different conceptions on human nature and society.
The second part of the book, “The spider’s cult today” brings us abruptly in our present times and begins a very long explanation on how and why the neo-tarantism emerged. The question in itself is fascinating and can be applied to many different musical or healing traditions. What links the ancient ritual to the satellite broadcasted mega concerts taking place nowadays? Why have the sounds and, I would like to add, the setting used as a cure for suffering and oppressed women, become in the last ten years an occasion for mass entertainment? Maybe, as the author suggests, “today’s buzz around the tarantula music and dance can serve to blind us to socio-cultural implications of contemporary afflictions ad to re-appropriated discourses on healing and well-being?” (p.77).
Chapter three reveals that the traditional curative form is almost completely disappeared. Most of the Salentine people are thankful to the eradication of a phenomena that relate them to an obscure and poor past, and only a few of them, in closed circles, still feel that Taranta and St Paul saved them from misery. But everybody is happy about the fact that the music and pathology of the taranta serves now contemporary purposes, which are sometimes connected to personal or social wellbeing and sometimes to the cultural and economical growth of Salento’s society.
Ludtke brings us joyfully through the different summer “taranta nights” that resonates with rhythms and sounds through the wonderful piazzas and beaches. She seems comfortable and absolutely not judgmental even when she observes the exhibitionism of musicians and dancers, that has nothing to do with the true suffering of women that we have seen in De Martino’s documentary films. If to a music therapist this might look as a cheap sale of music’s curative potential and of the musician’s capacities to attune to the woman’s needs, according to the author this is the natural development of the phenomena. Watching a singer on stage swept by the catharsis of music and imitating the spasms and contortions on the Tarantate apparently does not make her uncomfortable.
As the author writes, to some extent also the ancient ritual was used in some manipulative manner and not merely to heal the victim. Today “it is a means of advertising Salento without consideration of its cultural heritage […] but it also represents a key to developing this area according to culturally sensitive and environmentally sustainable parameters […]; a closer looks reveals how tarantula’s music and dance are still, or again, being liked to experiences of recovering well-being.” (p.116).
The third part of the book titles “From ritual to Limelight” and is the longer and in my opinion the less clear and convincing one. In the effort to address the important matter of analyzing “the underlying factors influencing self-perception, human relations, power issues and vision of reality sabotaging or nourishing well being” (p. 137) the reader could feel disorientated.
The author shifts from the attempt of interpreting the symbolic meaning of the spider’s bite, to rapid digressions on the real motifs of the women’s sufferance.
She inserts long interviews with the so called “new Tarantate” women that search in the pizzica’s throbbing rhythm and ecstatic dance the possibility of expressing sensuality and instinctual energies. Often they find in altered states of consciousness provoked by movement and rhythm some kind of well being, and sometimes a shortcut in the search of their real self or of their own roots. Ludtke doesn’t questions about how deep and stable are those states of “well being”, while these rituals might appear hazardous shortcuts to those that work using the deep curative potential of music.
It is surprising that the author does not mention the lack of containment as a possible danger for those that attempt a “do it yourself” kind of therapy. What could be interesting is asking what has changed in the conception and cure of psychic agony in these last decades.
The author’s anthropological perspective has the important role of widening the views we normally have , but in such a vast overview on the subject I feel the lack of a deeper analysis of the curative dimension of such an interesting ritual: in the first place the recognition of the psychic suffering of each single patient, the containment granted by the family and the community which had to name and accept this affliction; the possibility of a woman muted by a poor oppressive catholic society to express her agony using her whole body, and last but not least the capacity of the musicians to attune with voice and instruments to the specific needs of the woman and of “the spider’s bite”, in other words to her distress.
It can be interesting to add Adriano Primadei’s (Primadei, A. and Nirensztein, S. (2007) psychoanalytical view: He makes an association between the spider and “the Uncanny” by Sigmund Freud. Freud (1919) wrote that “the uncanny is undoubtedly related to what is frightening — to what arouses dread and horror; (…) it tends to coincide with what excites fear in general.”(p.81). In Primadei reflections “Karl Abraham (1922, p. p.464) identifies the spider as the oneiric symbol that can arouse the feeling of the uncanny. The spider, according to Abraham, is a “masculine mother” that can penetrate with a poisonous bite.”. He thinks that in a sense “the role of Tarantism as a symbolic order was to create a protection net to prevent the person from drowning into anxiety…. The spider .. gives a symbolic meaning and form to this anxiety…. if the feeling of anxiety cannot be named, and has no meaning, then it cannot be thought or processed. ” (Primadei, A. and Nirensztein, S., 2007. p.7)
In the fourth part of the book “Conclusion”, the author synthesizes the core of the book, as an attempt to understand “how has the tarantula’s dance changed over time and what it reveals about the link between performance practices and well-being” (p. 213).
In the reflections on the role of rhythm and on the role of art as a form of expression of the self and on how “soundness emerges where the sense of self integrates” we find the motifs that make this book worth reading. The large bibliography is really admirable.
The music therapist looking for a detailed discussion on the therapeutic effects of the “pizzica” music on the psychic state of the Tarantati might be disappointed. Nonetheless, this essay is rich of interesting and stimulating thoughts even if sometimes slightly verbose and unclear.
References
Abraham, K. (1922). Il ragno come simbolo onirico. In Opere, vol II. It. ed. 1997
Bollati Boringhieri. Torino
De Martino, E. (1961) La terra del rimorso: contributo ad una storia religiosa del Sud. Il Saggiatore. Milano.
Freud, S. (1919). Il Perturbante. in Opere vol IX. It.ed.1989 Bollati Boringhieri. Torino.
Primadei, A. and Nirensztein, S. (2007) Tarantism in music therapy: a dialogue between traditional music and psychic suffering. Keynote: 7th European Music Therapy Congress. Eindhoven, the Netherlands.
Karkou, Vicky & Sanderson, Patricia (2006). Arts Therapies – A Research Based Map of the Field. London, UK: Elsevier (307 pages).
Reviewed by Lucy O’Grady, University of Bergen, Norway
The relationship between music therapy and other arts therapies is not a ‘hot’ topic at this point in the development of music therapy-specific literature. Apart from some focused exploration of the issue from Smeijsters and Cleven (2006), Faire and Langan (2004) and myself (O’Grady, 2010), it may be fair to say that music therapists are at this time sufficiently occupied with the complexities of their own discipline, let alone the complexities of the arts therapies as a whole. Perhaps a ‘hotter’ topic at this point in music therapy is that of developing indigenous theory and this is where a research-based map of the arts therapies could be a timely contribution. In order to discover what is unique to music therapy, we may be well-served to ask what is shared and what is different across all arts therapies. The book, Arts Therapies – A Research Based Map of the Field, is based on this very premise.
The book really should be called Arts Therapies ‘in the United Kingdom’ – A Research-based Map of the Field since it is based on interviews and survey questionnaires of over 580 arts therapists practicing in the United Kingdom. However, it is only the title which is slightly misleading since in their introduction the authors acknowledge this scope which is defined both by the research sample and reference to predominantly British literature. The authors define the arts therapies field as consisting of four separate disciplines: 1) Music Therapy (MT), 2) Art Therapy (AT), 3) Drama Therapy (DT), and 4) Dance Movement Therapy (DMT). The authors claim to be the first to try to delineate through empirical research the commonalities and the differences between these four arts therapies in terms of theory and practice. The authors also acknowledge the methodological complexity of doing so, however they suggest that it is worth the attempt in order to clarify misconceptions, advance the progress of the profession(s) and to promote collaboration between different arts therapists while strengthening the theoretical positions of each discipline. The authors are clear that their book does not represent a suggestion that all four arts therapies should become one; instead, there is the clear implication throughout that each arts therapy can be strengthened through consideration of the other. Through these ambitious aims, the authors identify three main audiences for the book: arts therapists, lay readers, and other health professionals.
The book is divided into two main sections, with four chapters in each. Section 1 considers the field as a whole in terms of its historical development, boundaries and definition, common features and common theoretical frameworks. Section 2 addresses the arts therapies as separate modalities and focuses on the uniqueness of each discipline, illustrating through case examples presented in table format. The authors state that they do not intend to offer in-depth accounts of each discipline in this section, but enough that the reader may have “the possibility of a first, comprehensive understanding of the field” (p 4). Each chapter follows a clear format, with the overall structure and key issues highlighted at the beginning of the chapter and much of the text illustrated through tables and diagrams.
Chapter 1 presents an overview of the professional development of the arts therapies as a whole. The role of western traditions in the development of arts therapies is largely emphasised, while the use of the arts by shamans and within indigenous cultures is mainly relegated to pre-historic times. The emphasis on western historical influence is reiterated in chapter 2, where arts therapies are delineated from traditional therapies such as acupuncture based on the assumption that “arts therapies are a product of western society” (p. 36). This rather simplistic emphasis and brevity of discussion begins to clarify just how large and potentially over-ambitious the scope of this book may be. In this sense, the first chapter seems most to serve the lay person or the beginner-reader. A potentially more interesting discussion for arts therapists in chapter 1 concerns how up until now the different disciplines have been separate due to the fear that merging them would develop practices with questionable depth in understanding the art form and thus questionable therapeutic value. This idea is supported recently by Gold, Wigram & Voracek (2007) whose statistical analyses indicated that clients showed greater health improvement when music therapy was limited to discipline-specific music therapy techniques and did not include media from other arts therapies disciplines. The authors of the book note exceptions to the current status of separate arts therapies disciplines through the ‘expressive arts therapies’ movement in the USA and the Institute for the Arts in Therapy and Education in the UK. They do not mention the Netherlands as another major exception to the rule, where the different arts therapies are served by the professional Dutch Association for Creative Therapy (Smeijsters & Vink, 2003). Nevertheless, the first chapter in the book highlights an interesting trend across the arts therapies, in that the most common area for arts therapists to work in terms of client difficulties is with emotional\behavioural issues (59%).
In Chapter 2 the authors discuss the boundaries of the field in relation to the therapeutic arts (arts in health), arts education, other therapies and other health practices, a discussion which then culminates in a definition of the arts therapies as a whole field. One of the differences between the therapeutic arts and the arts therapies, reiterated throughout the chapter, is that the therapeutic arts emphasise the product while the arts therapies value instead the process. This is arguably an outdated assumption and an unnecessary split between process and product, since there are examples of artists working in health who also recognise the importance of process and attempt to balance the two (O’Grady, 2010). The privacy and inward processes of arts therapies as well as their dyadic or small-group constituents are also emphasised in this chapter, which is interesting to consider in the light of Community Music Therapy discourse where “out and around processes” (Stige, Ansdell, Elefant & Pavlicevic, 2010) are also valued and whole communities may be worked with (Stige, 2002). After discussing the boundaries of the field, the authors in this chapter examine past definitions of each arts therapy and track changes in emphases over time. For example, from 1989 to 2004 MT definitions are interpreted as changing from a humanistic emphasis to more of an acceptance of a diversity of approaches and practices. Chapter 2 culminates bravely by presenting a definition of the arts therapies as a whole field.
The third and fourth chapters are among the most valuable in the book because of the interesting commonalities they present. In chapter 3 the authors suggest that there are five main assumptions common to MT, AT, DT and DMT: 1) the ‘arts’ are defined in broad terms, 2) there is a focus on the process, 3) there is a belief in the preverbal development of engagement in the arts, 4) the arts are holistic and, 5) the arts offer therapeutic potential. Furthermore, the authors suggest that the main features across the arts therapies are an emphasis upon creativity; imagery, symbolism and metaphor; non-verbal communication; the triangular relationship between the client, the art-form and the therapist; the therapeutic relationship as both transferential and real; and finally, the formulation of therapeutic aims that reflect overall psychotherapeutic orientations of either behaviourism, humanism or psychoanalysis. This final idea is developed further in chapter 4, where six theoretical trends are identified across MT, AT, DT and DMT:
1) Humanistic, 2)Psychoanalytic\Psychodynamic, 3) Developmental, 4) Artistic\Creative, 5) Active\Directive – which the authors relate to Wheeler’s (1983) first level of music psychotherapy as well as to behaviourism, and 6) Eclectic\Integrative. The prevalence of these particular theoretical approaches for different client groups is identified. For example, the psychodynamic\psychoanalytic approach is predominantly used for clients with mental health issues. In terms of developing indigenous theory in music therapy or across the arts therapies, the artistic\creative theoretical trend is perhaps the most relevant but is also presented by the authors as the least theoretically developed so far.
As an arts therapist (music), I find the second section less interesting to read. Perhaps this is because the focus upon the idiosyncracies of each particular arts therapy in terms of its pioneers and their myriad collection of diverse and sometimes unrelated theoretical ideas renders it difficult for me to gain a coherent, concise picture of the uniqueness of each arts therapy. I cannot imagine which of the identified audiences would benefit most from this section. Instead, I find the introductory page to each chapter where key issues are highlighted the most helpful and interesting part of Section 2.
The idiosyncracies of MT are addressed first as Chapter 5. In this chapter it is interesting to learn that in some ways MT leads the arts therapies, since it was the first discipline of the arts therapies to form a professional body and also receive early recognition. The authors explain that this may be in part due to the high value accorded to music in western traditions compared with other art-forms. It is also interesting to learn that music therapists in the UK predominantly work through improvisation and with children who have learning difficulties. The authors link this to the early pioneers of music therapy in Britain, Alvin and the Nordoff-Robbins partnership. The authors also highlight their findings that there are comparatively few music therapists working with people whom they label ‘normal neurotics’ and few in private practice. They also emphasise the divide between active and receptive techniques in music therapy as well as the importance of the ‘iso’ principle, an idea which dates back to Plato and that, in music therapy, relates to matching a person’s mood with music. Of interest to the move to develop indigenous theory in music therapy, the authors also suggest that “MT, in comparison with other arts therapies, draws less heavily upon related fields in order to provide a theoretical justification of its practice” (p. 124). Case examples, presented in table format, from Oldfield, Bunt, Ansdell, Sobey, Levinge and Odell-Miller are used to highlight different theoretical approaches to music therapy that have developed from Alvin, Nordoff and Robbins, and Priestley. The authors also briefly discuss GIM and behavioural approaches to music therapy but suggest that these are less popular in the UK. A similar format is used for the following three chapters, of which I will only highlight a few points concerning the relationship between the arts therapies. This is because for those readers who are interested in learning about each discipline in particular rather than how they relate to each other, I recommend reading this book or, for more depth, other books that are focussed on the particular arts therapy discipline of interest.
Chapter 6 presents AT as a unique arts therapies discipline. The authors highlight how art therapists in the UK emphasise psychoanalytic\psychodynamic thinking and value much less an artistic\creative theoretical framework. The authors also discuss the heated debate in AT surrounding directive vs. non-directive approaches which stems from the move to distinguish AT from the more directive use of arts in occupational therapy.
Chapter 7 focuses upon DT as a unique arts therapy. It is interesting to learn in this chapter that a relatively large proportion of DTs in the UK work with people who do not present an apparent difficulty (more than 10%). The authors suggest that this may be partly due to the verbal nature of DT which makes it better suited to clients with some degree of cognitive\physical\emotional skills. It is also interesting to learn that DTs place more emphasis on humanistic theories and artistic\creative principles and are less in agreement with psychoanalytic\psychodynamic thinking than other arts therapists. In chapter 8, it is interesting to learn that DMT is the most recently established arts therapy in the UK and that these arts therapists place a comparatively higher value on humanistic understandings of their work.
The authors offer a concluding chapter in which they suggest that arts therapists from each separate discipline can look to the strengths of the other disciplines in order to work on the weaknesses of their own. For example, they suggest that “MT can offer knowledge and experiences of undertaking extensive research work in MT practice and creating a public profile that can be useful for all arts therapists. In terms of clinical practice, the relative aversion of music therapists to eclectic\integrative principles can remind arts therapists that within a postmodern era that values diversity, it is important to retain a clear sense of professional identity that is not in danger of fragmentation or diffusion and at the same time does not lose essential flexibility” (p. 276). Furthermore, the authors’ conclusions point toward the need to explore commonalities and distinctive practices amongst different arts therapies in order to begin to develop indigenous theory for each discipline.
Due to the ambitious scope and variety of intentions underlying this book, the three identified audiences (arts therapists, lay readers and health professionals) are not consistently addressed throughout. Different audiences may prefer different parts of the book. For example, chapter one may be particularly useful for lay people or prospective arts therapies students, whilst chapters 3 and 4 may be of most interest to arts therapists who are wondering how they might collaborate with other arts therapists. The second section may also serve this purpose but is probably most useful for other health-care professionals who are questioning the relevance of the arts therapies to their own work or which arts therapy may be particularly appropriate in their workplace. I suggest that the key issues highlighted at the beginning of each chapter in the second section will be the most helpful in this regard. More obviously, this book will probably be of most interest to arts therapists, lay readers and health professionals in the UK, however it is also a useful starting point for considering the commonalities and differences amongst the arts therapies in other parts of the world. For music therapists in any country, the fact that this book is grounded in research makes it a useful tool for continuing the development of indigenous music therapy theory and for considering our part in the development of indigenous theory for the arts therapies as a whole.
References
Faire & Langan (2004). Expressive Music Therapy: Empowering Engaged Citizens and Communities. Voices: A World Forum for Music Therapy. Retrieved February 8, 2010, from http://www.voices.no/mainissues/mi40004000159.html
Gold, C., Wigram, T., & Voracek, M. (2007). Predictors of change in music therapy with children and adolescents: The role of therapeutic techniques. Psychology and Psychotherapy: Theory, Research and Practice, 80m 577-589.
Smeijsters, H., & Cleven, G. (2006). The treatment of aggression using arts therapies in
forensic psychiatry. The Arts in Psychotherapy, 33, 37-58.
Smeijsters, H., & Vink, A. (2003). Music therapy in the Netherlands. Voices: A world
forum for music therapy, Retrieved 01/10/2009, from voices.no/country/monthnetherlands_september2003.html
Stige, B. (2002). Culture-centered music therapy. Gilsum, NH: Barcelona Publishers.
Stige, B., Ansdell, G., Elefant, C., & Pavlicevic, M. (Eds.). (2010). Where music helps:
Community music therapy in action and reflection. Surrey: Ashgate.
Wheeler, B. (1983). A psychotherapeutic classification of music therapy practices. Music
Therapy Perspectives, 1(2), 8-16.
Reviewed by Julie Sutton, PhD. Works with severely disturbed adults at the Centre for Psychotherapy Belfast, for John, Lord Alderdice (consultant psychiatrist) and Prof Paul Williams (psychoanalyst).
It is always welcome to open a new book written by an experienced colleague. Diane Austin’s much anticipated publication details not only her theoretical and clinical practice, but is also packed full of her years of work and life experience. I think it is an intensely personal book, and on reading it, one feels close to her passion and commitment to the work, to music, and to people.
Austin structures her book as implied in her title, in terms of theory and clinical practice, but beyond this the content is complex. In the first half she draws upon the physical, philosophical, theoretical and technical aspects of vocal work, viewed from the different stances she has integrated into her method. In the second part practical and specific areas are addressed, and a range of questions posed about vocal psychotherapeutic work. I think these questions are also relevant and pertinent to music therapeutic work in general and I will return to this later in the review.
Characteristic of Austin’s work, the client is always present and there are case examples throughout her book. I discovered that the ‘songs of the self’ in the title are not only those of her clients, but also of herself, and clinical material is presented along with Austin’s personal reflections upon the ways in which she makes use of her own ‘self’ in the clinic room. This depth of the therapist’s personal engagement and its contribution to the therapeutic process is a fundamental characteristic of our work, but detailed reflection about this is often absent from music therapy publications. It is well represented here.
Austin’s theoretical chapters are presented through clinical examples and reflections upon this work within different perspectives. Chapter 1 gives a developmental view of ‘voice’ and its place in our lives, after which is a section about the concept of ‘breath’, including practical ideas about breathing and ‘toning’. This is taken further into musical thinking about the prosodic qualities of the speaking voice, drawn together with more clinical material. In Chapter 2 we are given a sense of her discovery of and linking with Jungian analytic work and particularly the artistic ideas that arose from this, in for example, the use of myth, archetypes, and the concept of the wounded healer that has been such an important influence on her work. There is then a shorter chapter relating to object relations theory, with reference primarily to Klein, Winnicott and Miller. Austin describes developmental needs and the place of play in exploring different perspectives of ‘self’. This is reflective of Austin’s post-training exploration and willingness to engage in life-long learning, an important message to students and recently-qualified therapists as well as experienced practitioners. Chapters 4-6 focus on the theory of trauma, intersubjectivity and counterfransference, again brought to life with clinical material, while raising a number of questions that relate to developing one’s identity as a therapist. Austin’s chapter on countertransference is a strong statement about her therapeutic stance and takes a broad definition encompassing many aspects of the effect of the client on the therapist and vice versa, re-visiting theoretical influences noted earlier in the book.
The second part of the book is as varied as the first, with thoughts about setting up private practice (Chapter 7), the use of song (Chapter 12), and technical aspects relating to resistance, intervention, vocal holding and free association (Chapters 8-11). The book ends by bringing the focus back to the therapist’s responsibility in the therapeutic process (Chapter13). Throughout this half of the book clinical material again introduces and illustrates the technical area being explored, and there are many practical ideas, thoughts and advice. Austin’s style and method of work are evident throughout, along with her reasoning and process of discovery. She pays due attention to the importance of assessment and the central place of music in her initial conversations with prospective clients. She also touches on the tension between music and words, proposing a musical model with an interweaving of both elements, where the one can “overlap and complement” the other (p118).
Integrated into the clinical material that runs as such a strong thread through Austin’s narrative are many important technical and theoretical observations and questions. A few of these are outlined below:
In the taking of Cindy’s history (Chapter 1), Austin stresses the need for space and time for the traumatised individual to tell their story, and how a slowing down of time in the room is important to ensure that the client does not become too overwhelmed and flooded with sensations and feelings. Her words, “going slowly helps them to digest the feelings that emerge” (p17) seem to me to relate to theories of mentalisation and intersubjective space, here appearing jargon-free, and given simply and clearly. Later in the book, Austin indicates that she agrees with Bion, another object relations theorist, in the sense of remaining open to what may emerge unexpectedly, allowing her attention to be caught throughout a session by different thoughts and sensations, but not necessarily acting on them (p119), and further develops this idea in relation to the therapist’s personal desire to intervene (p129-130). Austin takes the final part of Chapter 4 to consider the bridge that music can open up between the conscious and unconscious inner world, noting the ways in which defences can be breached, and touching on the complex issues of temporality and repetition that are pertinent to traumatic material (p78). In one paragraph are separate theoretical ideas that in themselves merit detailed exploration, introduced directly and clearly. I felt this left the reader free to remain there, or to think on, without being shown a particular route via references. At other points, references are provided, allowing the reader to investigate further, such as in thinking about the therapeutic relationship and intersubjectivity in Chapter 5. In this same chapter Austin challenges some analytic ideas about therapeutic stance and boundary, making a case for how and when to use self-disclosure, and how the therapist utilised their personality, referencing in the next chapter Yalom’s observation that “the most elegant and complex instrument of all – the Stradivarius of psychotherapy practice – the therapist’s own self” (p99).
All of these examples show how Austin is talking about complex processes in everyday language. This directness and clarity of text makes the book immediately accessible and increases one’s sense of connection between reader and author. It is important to note that however informed by a variety of analytic stances, music is never far away, and Austin’s descriptions of musical material are vivid, with musical examples available from her website. There are also musical ideas and musical thinking underlying the text throughout the book and in Austin’s own writing style.
One critique of this book could be that it is primarily concerned with individual work. While there is enough depth and detail of the method to suggest how vocal psychotherapeutic work can be appropriated for groups, perhaps a further volume might address and also do justice to this lack (for example, Austin’s workshop and training methods). There are also many different technical and theoretical ideas in each chapter, and while Austin’s personal stance is a strong linking factor, for some readers this may be distracting. It is part of the challenge of a single text about a method of work and range of clinical experience that so much information is available. Personally, I felt that Austin was successful in relaying her position and attitude to the work, but I read the publication over an amount of time that enabled me to work with the material in digestible portions. I am also familiar with Austin’s work and I think this gave me another insight into the text.
Austin is a passionate voice about the voice and sometimes this could suggest a neglect of other forms of therapeutic connection, such as in her statement, “the most healing connections seem to occur through the voice” (p19). As Austin is concerned about communicating her views and methods of vocal psychotherapy it is understandable that this focus is present. Her personal links with the voice are also a significant influence on this stance. However, once or twice this did leave me wondering about other kinds of ‘healing connections’ that are non-vocal and yet powerfully present. In this way, I found Austin’s book stimulating and leading to further thinking, because many descriptions of her clinical work were not only concerned with ‘voice’, but more with essential therapeutic presence. In Austin’s case, perhaps this is achieved primarily through an embodied voice, whereas for other therapists, it might be an embodied pianist, or percussionist, or cellist, and so on. The common feature linking all music therapists is what I would describe as the embodied listener. This idea is a significant part of her book, present in and between the lines of the text, and something that, for example, she touches directly on in her memory of her own therapeutic work (p182-3).
The extent of Austin’s clinical experience makes this a book packed and alive with information, ideas, clinical material and reflections. At times the confines of single chapter make it a task to keep strictly within the topic, and Austin’s enthusiasm and passion comes through at these points, taking the reader into related areas, or expanding further via clinical material. Rather like her work, the theme develops, variation evolves and the theme becomes transformed. I rather enjoyed these changes of melody, and I suggest treating the text as essentially musical and free-flowing, bearing the overall theme in mind, and remembering that it is indicative of Austin’s method that her theoretical underpinning is as varied as her experience. I believe this to be true of all experienced practitioners, and it is very welcome to see a publication where this is recorded. With a growing amount of edited, multi-authored texts, a book so closely identified with one therapist is a welcome edition to the international music therapy library.
Austin’s style is her own, and particularly if unfamiliar with her work, this may or may not be to everyone’s taste. I personally can see no problem with this, because of the clarity of clinical material and the stance taken, and I value Austin’s honesty and openness. As noted previously, much of this book is written in jargon-free language, which would make it accessible to any reader, whether familiar or unfamiliar with psychoanalytic theory. It is also grounded in experience and theory, and for this reader provided stimulus for further reflection and questioning. The directness of style in Austin’s writing keeps the reader’s interest and has passages that are deeply moving. There is also a richness in aspects of the stories of the people we are introduced to (Cindy, Susan, Terry, Peter, Courtney, Brenda, Sandy, Jill, Akiko, Ann, Donna, Fred, Phyllis, Pam, Karen, Liz, Jon, Deb, Sandy, Lauren, So-Jin, Emily, Courtney, Joseph, Vicky, Lynn, Michelle, Julie, Nan, Suzy, Yuriko, Sara, Sarah, Marie, Karaar, Tania, Leslie, Sue, Jenna, Mary, Meg,) as well as, of course, Austin’s invitation for us to view her own travelled path.
I would recommend this book to those wanting a publication that makes links between the human condition, music, music psychotherapy, therapeutic stance and the necessary inner work of the therapist. It is also the story of clients met and worked with in private practice over two decades. There is, rightly, an American flavour to this work, but while writing styles, work settings and structures differ in other countries, Austin’s emphasis on what takes place in the space between and within therapist and client are directly relevant to any practising therapist.
Austin’s ‘final thoughts’ open up again the personal narrative of the therapist, called to or summoned up by the client. This transference area is one that we know requires of us great care and delicate attention. We are all aware of the need for therapeutic boundaries in order to ask ourselves honestly, whose music are we playing? When it is only ‘our music’, we are no longer present for the client. When it is only the client’s music, we disappear, and we can also ask, how is my music being heard? As Austin noted in Chapter 8, when we play too much, or too little, or too fast, or too slow, the client may not be able to be present, but only through our depth inner listening will we be alerted to the meaning of such spaces in the room. Being affected by our clients is integral to our work. Our countertransferential responses and struggles are the work and Austin does not shy away from this area, yet never departing from the music.
At the end of the book a challenge is presented to us: can we move beyond our trust of theory and technique, to connect with a truly spontaneous part of ourselves? We cannot be in this place without having studied and integrated theoretical thinking. It is a place where we no longer ‘know’, where we might be surprised, shocked, taken aback or amazed, where we may also be genuinely of service both as a musician therapist and human being, and become changed by the experience. It is where self-insight and theoretical grounded-ness is essential, why supervision is a fundamental part of our work (eg p91), and why our own personal therapeutic work is, as Austin noted from her introduction onwards, indispensable.
References
Bion, W. (1967) “Notes on memory and desire” In: Melanie Klein Today, Vol.2, Mainly Practice ed. E. Spillius. London: Routledge 1988, pp17-21
Sutton, J. & De Backer, J. (2009) ”Music, Trauma and Silence: The State of the Art” The Arts in Psychotherapy 32(2) pp75-83 (Special Edition: Trauma)
Williams, P. (2007) “The worm that flies in the night” British Journal of Psychotherapy 23(3) pp343-364
Epstein, Irwin. (2010). Clinical data-mining: Integrating practice and research. London. Oxford University Press. Pages: 228. Cost: US$24.96
Reviewed by Clare O’Callaghan Phd RMT, Music Therapist at Peter MacCallum Cancer Centre & Caritas Christi Hospice, St Vincent’s Health/Department of Medicine & Faculty of the VCA and Music, The University of Melbourne, Australia
In multidisciplinary health care, the “practice research divide” is a phrase used to signify researchers’ frustration that practitioners may be reluctant to use research findings to inform their work, and practitioners’ frustration with difficulties using some research findings to inform practice. For example, intricate descriptions of elements involved in music therapy relationships are essential before one can consider research findings’ relevance to their own work contexts, however, these may not be detailed. While scepticism between social work practitioners and researchers described in Prof Epstein’s, “Clinical data-mining: Integrating practice and research”, may not be representative of music therapist researchers and practitioners, the book, nonetheless, offers exemplarily guidance for how therapists and researchers can work together, or therapists can work as researchers, to develop research knowledge highly relevant to practice. Importantly, the book illustrates how this can be done with data already existing in our workplaces. Through clinical data-mining (CDM), music therapists can do low or no cost research which can make work-life more satisfying, interesting, accountable, and professional.
I first came across Prof Epstein’s work when I attended a lecture he gave on CDM for allied health professionals in Melbourne, Australia, some years ago. In the book, Prof Epstein describes a 40 year history of teaching traditional research methods to social workers, wherein he published some seminal texts for his field. Concerned about the aforementioned “practice research divide” ten years ago, Prof Epstein focussed on seeking ways to engage practitioners in research. Certainly his description of CDM studies immediately engages this practitioner-researcher: “CDM studies are conducted by practitioners, are driven by practice-questions, and make use of practitioner-generated information, their primary purpose is to inform clinical, programmatic, or administrative decision making” (p. 12).
In the past decade, Prof Epstein has conducted many international CDM workshops for health carers, including in Australia and New Zealand. After distinguishing between practice-base research and research-based practice in the book, CDM is defined:
Clinical data-mining is a practice-based, retrospective research strategy whereby practitioner-researchers, alone or with the assistance of a research consultant, systematically retrieve, codify, analyse and interpret available qualitative and/or quantitative data from their own and other agency records in order to reflect on the practice, program and policy implications of their findings. (p. 71)
CDM as a method is located within Prof Epstein’s advocacy that health care work needs to be “evidence informed”. Evidence informed practice (EIP) is methodologically, structurally, and culturally pluralistic: “it values all ways of knowing and seeking useful knowledge – everything from RCTs to qualitative case studies … it values practice wisdom as well as research-based knowledge (and) positions practitioners as knowledge producers alongside academic producers” (p. 34).
Methodologically, three types of CDM studies are described. Those that begin with: (a) available quantitative data (e.g., work statistics) which is converted into a quantitative database for statistical analysis; (b) narrative data (e.gs., case notes, diaries) which is converted to a quantitative database and analysed statistically; and (c) qualitative data used for subsequent qualitative analysis. These may also be combined.
Prof Epstein then describes research studies, mostly postgraduate dissertations, to illustrate the CDM types. (Prof Epstein includes a study from my own Phd, which is described as a qualitative CDM.) This book made me realise that much of my music therapy research is CDM, including: qualitative research on practitioners’ wisdom through analysis of their journals or stories, and song lyric analysis. Content analyses on lyric analyses would be examples of narrative data being converted to quantitative. Also in my experience, CDM studies do not necessarily need tangible “records”: qualitative CDM studies can be conducted on music therapists’ practice wisdom through the transformation of clinical memories and reflections into text for analysis. Other music therapists’ research may also be conceptualised as the CDM of departmental and hospital records. Two apparent examples include Horne-Thompson, Daveson, and Hogan’s (2007) analysis of music therapy referral trends from palliative care team members, and Hilliard’s (2004) post-hoc analysis of music therapy services for nursing home residents receiving hospice care. Now I am wondering what other records in my own and other music therapists’ practices could be harnessed for research to enhance service provision. Potential univariate (e.g., service requests and presenting problems), bivariate (e.g., relationship between interventions and outcomes), and multivariate (e.gs., relationship between interventions, outcomes, and diagnostic or demographic factors) analyses suggested for social workers (pp. 127-8) are certainly also applicable for music therapists.
Prof Epstein is aware that, like all research methods, CDM has some “drawbacks”, such as “missing data” and discrepancies amongst workers about how work is described and records maintained (in CDM studies on departmental records), which affects the reliability and validity of practitioner-generated information. But, Prof Epstein questions, if practitioners’ records concerning clients’ attributes and outcomes and practitioner interventions are regarded as unreliable and invalid, “what justification is there for practitioners to work with and make intervention decisions about patients or clients in the first place?” (p. 66)
CDM is advantageous because of cost savings in using existing data within practices compared with creating data for prospective analysis. Perhaps there should be more endeavours to channel research grants into practice-based research, to maximise capacity from the health care/research dollar. I was, however, disheartened to read Prof Epstein’s frustrations with securing funding for CDM research. While music therapists may encounter similar frustrations, the good news is that: hospital ethics review committees are approving CDM studies; CDM studies are getting published in peer reviewed journals; and A/Prof Lynette Joubert from The University of Melbourne (who has done extensive work with Prof Epstein) was recently appointed as Honorary Senior Research Fellow in the Social Work Department at Peter MacCallum Cancer Centre (Melbourne, Australia) to develop research practices, including CDM. Perhaps music therapists could work toward the funding of comparable researcher-practitioner partnerships. I was fortunately involved in such partnerships in recent post-doctoral research. Shared research on music therapists’ practice wisdom can be a valuable learning and team building process:
This reflexive group supervision process changed the way some of the therapists worked with (palliative care) clients. In the final group …, some spoke of coming to regard music therapy sessions more as single sessions, because many patients could die at any time. They also felt more comfortable about using unpaid time to help patients to complete legacies when they felt it was important …. The therapists learned from hearing about each other’s practice styles. … people felt respected and not judged …. Three colleagues from one organization thought that the process had helped them as a team and felt more confident that the other therapists could work effectively with their own clients, if necessary. (O’Callaghan, Petering, Thomas, & Crappsley, 2009, p. 202)
This is a highly engaging book with interesting CDM research descriptions spanning widely varied clinical populations (e.gs., paediatric diabetes, adolescent mental health, domestic violence, liver transplantation, geriatrics, palliative care) across the lifespan. Some music therapists may question: “Why do we need such a book if we are doing some of this kind of research already? Do we need more jargon?” I found that the book’s research framework extended my thinking about how to justify the merits of my research, as well as furthered my thoughts about research possibilities. I believe that many music therapists – practitioners, researchers, and practitioner-researchers – could also find something useful and inspiring in this text. I recommend that you read it and imagine the rich data that awaits harvest for CDM studies in your own clinical contexts.
References
Hilliard, R. E. (2004). A post-hoc analysis of music therapy services for residents in nursing homes receiving hospice care. Journal of Music Therapy 41(4), 266-281.
Horne-Thompson, A., Daveson, B., & Hogan, B. (2007). A project investigating music therapy referral trends within palliative care: An Australian perspective. Journal of Music Therapy, 44(2), 139-155.
O’Callaghan, C., Petering, H., Thomas, A., & Crappsley, R. (2009). Dealing with palliative care patients’ incomplete music therapy legacies: Reflexive group supervision research. Journal of Palliative Care 25(3), 197-205.
 Malloch, Stephen & Trevarthen, Colwyn (Eds.) (2009). Communicative Musicality. Exploring the Basis of Human Companionship. Oxford: Oxford University Press.
Reviewed by Ulla Holck, PhD, Associated Professor, Head of the Music Therapy Programme, Aalborg University. Her Ph.D. thesis from 2002, ‘ComMusical’ Interplay in Music Therapy, relies heavily on infant research.
In 1979, Colwyn Trevarthen did an acoustic analysis of video recordings of mother-infant interactions, among others of Laura, a 6-week-old girl, and her mother. The analysis took place in his laboratory at Edinburgh University, and showed how the mother joined her daughter with imitative sounds that were modulated emotionally to invite the infant’s coos and to acknowledge them in shared time. Seventeen years later, in 1996, in the Psychology Department at the very same university, Stephen Malloch listened to tapes of mothers and their babies ‘chatting’ with each other, recorded by Trevarthen in the 70’s. One of the first tapes was the vocal interaction of Laura and her mother.
As I listened, intrigued by the fluid give and take of the communication, and the lilting speech of the mother as she chatted with her baby, I began to tap my foot. I am, by training, a musician, so I was very used to automatically feeling the beat as I listened to musical sounds.… I replaced the tape, and again, I could sense a distinct rhythmicity and melodious give and take to the gentle prompting of Laura’s mother and the pitched vocal replies from Laura. .. A few weeks later, as I walked down the stairs to Colwyn’s main lab, the words ‘communicative musicality’ came into my mind as a way of describing what I had heard. (Chapter 1, p.3-4)
Through Malloch’ further work with spectrographs and pitch plots of the interactions of mother infant dyads, the theory of communicative musicality found precise formulation in terms of the parameters: pulse, quality and narrative. This was first reported in Malloch (1999/2000), in the Special Issue of Musicae Scientiae, known to many of NJMT’s readers.
With their new book Communicative Musicality – Exploring the Basis of Human Companionship, Malloch and Trevarthen have elaborated extensively on the concept by inviting 35 authors from a very broad spectrum of research areas, such as musicology, music therapy, dance therapy, psychology, child and adolescent development, psychiatry, psychopathology, anthropology, applied linguistics, psycholinguistics, neuroscience and behavioural biology.
The book consists of 27 chapters, divided into the following five sections:
- The origins and psychobiology of musicality
- Musicality in infancy
- Musicality and healing
- Musicality in childhood learning
- Musicality in performance
When talking of ‘musicality’ the editors point to the innate human abilities that make music production and appreciation possible. They give the following definition of musicality, which can be seen as the essence of the book’s idea:
We define musicality as expression of our human desire for cultural learning, our innate skill for moving, remembering and planning in sympathy with others that makes our appreciation and production of an endless variety of dramatic temporal narratives possible – whether those narratives consist of specific cultural forms of music, dance, poetry or ceremony; whether they are the universal narratives of a mother and her baby quietly conversing with one another; whether it is the wordless emotional and motivational narrative that sits beneath a conversation between two or more adults or between a teacher and a class. In the coordination of practical tasks, a shared, intuitively communicated understanding is necessary for success. It is our common musicality that makes it possible for us to share time meaningfully together, in its emotional richness and its structural holding, and for us to participate with anticipation and recollection of pleasure (p. 4-5).
Musicality’s nature of engaging one with another, or many with many, intersubjectively, is intrinsic to musicality’s healing potential (p.6).
In part one, the authors address central questions such as: Why and how are we musical? What is the evolutionary history of the hearing and production of our musicality? If musicality is an intrinsic aspect of being human, how does it express itself in our living, feeling, thinking and being? What is the basis for this in our psyche and biology?
The proposed answers come from different scientific areas: evolutionary theory and archaeological evidence (Brandt; Dissanayake; Merker), investigation of human and animal/ape cultures (Merker; Panksepp & Trevarthen), semiotics (Brandt), biology (Cross & Morley; Panksepp & Trevarthen) and brain science (Lee & Schögler; Panksepp & Trevarthen; Turner & Ionnides). All authors emphasize the vital role innate musicality has played and continues to play in creating and sustaining human social relationships, that enable us to achieve, think, and imagine more than we could alone.
In part two on musicality in infancy the concept of Communicative Musicality is taken back to its origins. It is shown how rhythmic organization between mother and infant allow both partners to sustain a coordinated relationship in time (Mazokopaki & Kuguimutzakis), and that vowel sounds expressed in musical ways engage emotions and serve as a vehicle for enculturation as to how to use feelings to share activities (Powers & Trevarthen). Spontaneous communication between babies can also be said to be musical (Bradley), and action songs and related games with a formal structure seem in particular to be the infant’s primary gate for cultural learning (Eckerdal & Merker). From a clinical point of view, mental illness in the way of depression strongly affects the ‘musicality’ of a mother’s voice, (Marwick & Murray), but culturally grounded loss of confidence, as seen in some immigrant mothers, also has a strong impact on infant care practice (Gratier & Apter-Danon).
In part three the reader is presented with different ways of using music as vehicle for healing and development. First from a psychobiological perspective; music used with children in Sarajevo and Mostar with post-traumatic stress disorders (Osborne). Then from a relational perspective; the power of music therapy in aiding the creation and restoration of meaning for a sexually abused child (Robarts), and fostering communication in children with autistic spectrum disorders or with Rett Syndrome (Wigram & Elefant). Communicative Musicality is also shown in dance therapy with a group of children, born partially deaf and blind with disabilities (Bond). In addition to the clinical examples, part three provides a meta-theoretical model of the continuum between communicative musicality and what is called ‘collaborative musicing’ (Ansdell & Pavlicevic).
In part four the focus is on musicality in childhood learning. By presenting the evidence for continuity between the musicality of infancy and childhood, all of the authors in this section present convincing arguments for treating the musicality of children with respect. The reader is given a thorough review of the literature on musicality in infancy leading to the childhood (Bannon & Woodward), followed by concrete examples of musicality between teacher-pupil exchanges in ordinary classroom settings (Erickson), examples of teaching music based on the here-and-now inputs of the children (Frölich), and a view of music education as an interactive social phenomenon that requires a responsive and receptive attitude towards both the student and the musical material (Custodero).
In part five, focus is on musicality in performance, and here the authors consider performance as ceremonial ritual (Dissanayake), as expressing biological rhythms (Osborne), as embodied coordination (Davidson & Malloch) and as facilitating enthusiastic, passionate creativity (Rodrigues, Rodrigues & Correia).
As can be seen, the book provides the reader with a broad perspective on Communicative Musicality. As my background for doing this review is music therapy related to infant research – and as the review is written to NJMT readers – the following critique will concentrate on the book as an edited whole and on subjects related to music therapy.
The many approaches to Communicative Musicality are the strength of the book and also clearly an acknowledgement of the editors’ concept, since it can be investigated meaningfully within so many research areas. Due to the editors’ wide perspective, some chapters investigate the basic essence of Communicative Musicality from an evolutionary, neurological or psychological perspective, whereas others serve as examples of Communicative Musicality seen in practice: in music therapy, dance therapy, class teaching etc. This difference, though, is not clearly explained for the reader, and at least this reviewer became a bit confused along the road. In the light of this critique, chapter 7 on the neuroscience of emotion in music is very central for understanding both the essence of the concept and the underlying choices for the rest of the book.
For many years, Colwyn Trevarthen has provided grounds for a strong belief in and support for the use of music therapy (e.g. Stige 1997), and in 2000, Trevarthen and Malloch stated their findings, including Communicative Musicality, to be “a foundation for a theory of music therapy” (Trevarthen & Malloch 2000, p.5). This reviewer’s Ph.D. thesis from 2002, ‘ComMusical’ Interplay in Music Therapy, relies heavily on this point of view. Pavlicevic & Ansdell also give support for viewing Communicative Musicality as a cornerstone for music therapy, but argue at the same time that it “needs further theoretical architecture on top of this foundation to provide an adequate working account of the full phenomenology of music’s power” (p.373).
They use the opportunity to present a model that combines musicality, musicianship and musicing. According to Pavlicevic & Ansdell, musicianship involves the skillful coupling of musicality to specific musical cultures, whereas musicing is a universal activity of musicianship in action. The model is clearly interesting for the music therapy field, but for this reader it is not clear why the model presents an argument for Community Music Therapy as a ‘new approach’ in contrast to ‘traditional’ music therapy, which they claim tends towards a narrow view of the mother-child dyad (Malloch & Trevarthen) or client-therapist dyad.
This critique of Malloch and Trevarthen seems already resolved in the book, as there is quite a bit of space devoted to musicality in rituals and performance in the ‘temporal arts’, including music. (This points to the difficulty of editing anthologies, since the individual author doesn’t have the opportunity to read the other chapters, before they write their own!)
When it comes to what is here called ‘traditional’ music therapy, one can easily argue that work with children with severe communication disorders, for example, (such as autism or Rett Syndrome described in Wigram & Elefant’s chapter), at best provides progress from (1) developing early communicative musicality by augmented use of cultural musical parameters, (2) to the mastering of children songs (musicianship) and further (3) to the process of taking this ‘back’ to the child’s own social context of family, kindergarten or school (Holck 2002; 2004).
Pavlicevic and Ansdell certainly have a point, when arguing against viewing music in music therapy as purely protomusic. But with Malloch & Trevarthen’s focus on musicality as the innate human abilities that make music production and appreciation possible, this discussion can easily move on.
These and many other essential discussions await us – thanks to this comprehensive – and demanding – book of Malloch & Trevarthen.
References
Holck, U. (2002). Kommunikalsk’ samspil i musikterapi. [ComMusical interplay in music therapy. Unpubl. PHD thesis, Aalborg University, Denmark]
Holck, U. (2004). Turn-taking in music therapy with children with communication disorders. British Journal of Music Therapy, 18(2), 45-54.
Malloch, S. (1999-2000). Mothers and infants and communicative musicality. Musicae Scientiae, Special Issue, 29-57.
Stige, B. (1997). Music and infant interaction. Colwyn Trevarthen interviewed by Brynjulf Stige. Nordic Journal of Music Therapy, 6(1), 61-65.
Trevarthen, C., Malloch, S. (2000). The dance of wellbeing: Defining the musical therapeutic effect. Nordic Journal of Music Therapy, 9(2), 3-17.
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