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Jenseits des Wortes. Musiktherapie mit komatösen Patienten auf der Intensivstation

br2002_14Gustorff, Dagmar/Hannich, Hans-Joachim (2000).Jenseits des Wortes. Musiktherapie mit komatösen Patienten auf der Intensivstation.[Beyond the word. Music therapy with patients in comatose state at the intensive care ward.] Bern: Verlag Hans Huber.

Reviewed by Carola Krautschick

This book gives encouragement and affirmation to the work of all people accompanying and looking after patients in comatose state. Music therapy with comatose patients in intensive care wards often represents a challenge for the therapist. This book is very useful by contributing new ideas to the practical work and encouraging therapists to open up new ways. Besides a comprehensive methodical part this subject is presented from its underlying therapeutic viewpoint. The book is very valuable, closing a gap in musical therapy literature.

For some time, a change in the way of thinking has been observed in the high-tech world of the intensive care ward. This book is directly at the centre of the discourse between traditional biomedical paradigms and a medical approach based on human relations regarded as existential, the establishment of a dialogue between staff and patients. Referring to this topic in the first chapter, the co-author Hans-Joachim Hannich sets out to discuss the prevailing medical paradigms and relates the importance of art-therapy to the patients’ perception and experience in unconsciousness. As a clinical psychologist working at the intensive care ward, he was involved in research projects or was simply there to observe how to establish contact with patients with a clouding of consciousness.

The main part of the book deals with a 3-week music therapy project with patients in comatose state at the University Clinic in Münster, which was documented by Dagmar Gustorff in her dissertation finished in 1992. The main statement of her paper is that without consciousness does not mean without experience. For Ms Gustorff it is important that the family and relatives are included which are often helpless when confronted with the new way patients have to live.

In the 2nd Chapter, Ms Gustorff gives a brief introduction into music therapy and goes on to present the starting point of her music therapy concept. She is the first music therapist to work with comatose patients on the basis of “creative music therapy” (developed by Nordoff & Robbins) and its theory. At the centre is man with his/her natural artistic potential. This approach is very close to the human relation-oriented medical one, thus also referring back to Chapter 1.

After looking through the literature available on this topic, – there is very little written on this topic, highlighting the importance of the book. Ms Gustorff describes the research project and its concepts as well as scientific backgrounds.

The music-therapeutic process is demonstrated using examples of 4 patients – this is interesting for understanding the practical part of her work. In detail, Ms. Gustorff describes her method of working: one way of establishing a dialogue with comatose patients through music therapy.

In the last Chapter Ms Gustorff uses the experience she gained to draw practical consequences for the everyday situation in hospitals. She speaks clearly in favour of a properly thought-out and controlled acoustic environment in the intensive care ward and gives concrete advice. She shows the responsibility and competence of the music therapist regarding this problem.

This book contributes to making people sensitive to the situation of comatose patients and encourages us to look for new ways based on “respect and humility” in dealing with comatose patients.

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