Group Music Therapy

A group analytic approach

Alison Davies, Eleanor Richards, Nick Barwick

• Publisher: Routledge
• Year: 2014
• ISBN:
  9781317618553
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

In Group Music Therapy Alison Davies, Eleanor Richards and Nick Barwick bring together developments in theory and clinical practice in music therapy group work, celebrating the richness of what group analytic thinking and music therapy can offer one another. The book explores the dynamic elements of the processes that take place in both group analytic therapy and group music therapy, exploring both the commonalities and the distinctive characteristics of the two modalities.

To music therapists, psychotherapists and other arts therapists Group Music Therapy offers a body of knowledge and enquiry through which to understand the music therapy group process through some of the central proposals of group analysis; to group analysts it offers insight into the possibilities of non-verbal communication through improvised music and, more widely, invites thought in musical terms about the nature of events and exchanges in a therapy group. Links are made with group analytic theory as well as with other associated theoretical traditions, such as attachment theory and theories of early infant development. The book explores the history of group music therapy and the history of group analysis, looking both at core concepts and at more recent developments. Attention is also given to developmental issues, drawing upon theories of infant development and attachment theory and clinical vignettes drawn from music therapy practice with a wide range of patient groups illustrates these ideas. The book concludes with a discussion of the possibilities of co-therapy and other collaborative working and of the value of experiential groups in training.

Group Music Therapy will be a key text for clinicians and students seeking to expand their theoretical thinking and enrich their practice, and offers a grounding in group analytic ideas to professionals in other disciplines considering referrals to group work.

Part 1

Group music therapy

Historical perspectives

Chapter 1

Music therapy and the development of group work

Alison Davies

This chapter examines some of the significant developments in music therapy during the last half-century. These will be considered with a focus on the practice of music therapy in groups and on the ways in which analytic thinking has evolved within group music therapy.

There is no culture that is without music and for thousands of years music has been known to have been used in the context of healing in groups of people. Religious ceremonies and chanting come to mind, involving singing, drumming and other music as means of connecting to others and voicing shared emotion. The history of music therapy and its potential qualities for healing and restoring wellbeing have been substantially documented elsewhere; here I will focus on how the therapeutic use of music in groups has been introduced in healthcare and other settings and how the beginning of a more clinical and analytical approach to working therapeutically with groups in music has evolved.

Darnley-Smith and Patey (2003: 13), discussing the beginnings of working with music therapeutically, document the work of Dr Sydney Mitchell at Warlingham Park Hospital in the 1940s. This is of particular interest in the context of this book as it involved working with groups of people with music in a psychiatric setting. They also refer to an anonymous article ‘Pioneers in Music Therapy’, published in the bulletin of the British Society of Music Therapy in 1968.

One story exemplifies some of this work taking place in the late 1940s. An account is given of the work done by Sydney Mitchell and others who had conducted research and written ‘many papers’ on music therapy. At Warlingham Park Hospital, Mitchell had formed an orchestra of patients ‘including string players, pianists and percussion instruments’ where ‘the primary object was the treatment rather than a high standard of performance’. He also analysed the effects of recorded music upon his patients, and whilst he found that ‘classical music seemed to give a sense of security’ he also found that ‘the most effective means towards harmony of a group was folk songs and traditional music based upon the most deep-seated and cosmic relationship [which] strikes a psychological chord and brings people together’ (2003: 13–14).

Of interest here is the idea that a certain sort of music is considered to bring harmony to a group and has the effect of bringing people together. This article also describes work where ‘live’ music was used in a psychiatric setting by Drs Zanker and Glatt. Their conclusions were that

patients’ reactions to music can be of diagnostic value as they sometimes enabled the uncovering of unconscious attitudes. By helping to break down defences, fostering abreaction and bringing about emotional release music can be a therapeutic adjunct to other forms of therapy.

BJMT (1968: 18–19) cited in Darnley-Smith and Patey (2003: 13)

In the late 1960s interest in the recognition of music as a therapeutic medium increased in the UK and Juliet Alvin established the first training course at the Guildhall School of Music and Drama in London in 1967. This developed out of an organisation called The Society for Music Therapy and Remedial Music, which was established in the late 1950s to gather together those interested in music therapy and to develop a professional practice. This later became the British Society for Music Therapy, a general organisation for all those interested in music therapy. Other professional training courses followed the one at the Guildhall School of Music and Drama, and the Association of Professional Music Therapists (APMT) was formed for those who had trained as music therapists. The first Research Fellowship was established in 1980 and music therapy, together with art therapy, was recognised by the NHS in 1982. Music therapy was later recognised professionally in 1988 by Social Services in England and Wales. Further and more detailed accounts of these milestones in the history of music therapy can be found in Darnley-Smith and Patey (2003: 16–22), but for the purposes of this chapter I will consider how an analytically informed approach developed and became one way of conceptualising the process and dynamics of group music therapy.

Mary Priestley was among the first to develop an analytic approach to music therapy. She worked in a psychiatric setting with patients with emotional and psychological disturbances. She and her colleagues pioneered their analytic approach to music therapy in the 1970s and 1980s at St. Bernard’s Hospital in Middlesex. A century earlier, when this hospital was known as Hanwell Lunatic Asylum, its forward-thinking approaches to psychiatric care were already well established. St. Bernard’s was known as early as 1955 for its linking of music therapy with psychotherapy; it was an ideal setting for Priestley to pioneer her analytical work. Priestley called her method Analytical Music Therapy (AMT) and described it as ‘analytically-informed symbolic use of improvised music by the music therapist and client’ (1994: 3).

Describing the early stages of Priestley’s work, Darnley-Smith and Patey (2003) write:

There was also a weekly music club, open to all on a voluntary basis. Patients heard about the sessions by word of mouth and came to find out what was happening, rather than by formal referral. The music club sessions contained a mixture of spontaneous performances of singing and playing from the therapists and patients, as well as improvisation.

Darnley-Smith and Patey (2003: 25)

Priestley underwent her own psychoanalysis whilst she was undergoing her music therapy training. Her analytic approach developed out of her understanding of her own psychological processes. She believed that having personal analysis was important if the therapist was to have insight into her patient’s inner world. On the whole, up until then, music therapists practised without necessarily thinking actively about the complexities of the psyche. During the 1980s, however, it became increasingly common for students to have their own therapy. In due course it became a mandatory requirement for training.

Mary Priestley wrote:

As I was in analysis with Dr Wooster at the time [of music therapy training] I was being made aware of subtler, more problematic, and often more conflicting workings of the psyche, with conscious and unconscious moving in different directions, sapping the vital energy and causing confusion in the thinking and subsequent behaviour.

Priestley (1994: 129)

She goes on to describe some of the Kleinian and Freudian concepts as well as the language of dreams that influenced her analytical thinking. During her training she was also greatly influenced by Alfred Nieman, a composer and teacher of improvisation on the music therapy training at the Guildhall School of Music and Drama.

She quotes Nieman, who during her training said:

Music faces us with the realisation that there are two worlds: the inner and the outer. The inner is often incommunicable, a spiritual world which is difficult to enter from the outer world where we normally speak to one another. Music is a bridge for us by which we can reach this inner world. That is why free improvisation is so vital for music therapy. You are privileged people to be able to communicate with this deepest part of human beings.

Priestley (1994: 31)

Priestley found this a very significant statement in the light of her future work as a music therapist. Like Nieman, she focused on music’s capacity for wordless articulation of feeling and its potential for bringing unconscious material into awareness. Here she describes her own quasi-therapeutic group with colleagues and how it was informed by her understanding of psychoanalysis.

Analytical Music Therapy (AMT) was developed while I was working as a music therapist with three colleagues in a large psychiatric hospital and while having my own Kleinian psychoanalysis … We met in the basement flat weekly for ninety-six sessions trying out different experimental techniques using improvised music, usually on instruments but sometimes including vocal expression. We usually used a focus in the form of a title with which the mind could direct the emotions … Although most of the techniques were developed out of our desire to help our patients with their problems, some were the clarification of our own problems following up work that had been done in our own analysis. Occasionally something would come from a workshop one of us had attended, thus there were some techniques which nod to Gestalt Therapy and Psycho-synthesis. We gave each other feedback on the results of the experimental techniques and I took careful notes in my diary …

Priestley (1994: 1–2)

Mary Priestley called this way of working ‘Intertherap’ and her main focus was to use music as a creative way of accessing and exploring aspects of emotional life that may be obscured, rather than clarified, by language. This experience helped her and students in training to develop ways of working analytically. She said that to practise in this way the music therapist needs to know how to translate what is explored verbally and felt emotionally into musical expression. She emphasised the difference between how we relate in words and how we relate in music. She stated that music, or ‘sound expression’ as she called it, allows a greater closeness and openness to feelings in the therapeutic relationship.

Music therapists have subsequently drawn upon many of these aspects of Priestley’s work when working analytically. Thinking with her clients about their improvised music was often in very symbolic terms. She believed that this acted as a creative tool through which to ‘explore the client’s inner life so as to provide the way forward for growth and greater self knowledge’ and she speaks of

the joy of being able to share non-verbally with the therapist a life-enhancing inner and outer happening, the experience of harmonious and beautiful rhythms, interactions, or the reassurance of being able to survive a wildly chaotic or dissonant musical interaction and end in peace and friendship.

Priestley (1994: 3–4)

Attending to the atmosphere and sense of the relationship in therapy Priestley goes on to say that sometimes the experience encountered together with patients was that of just ‘sitting together in chosen silence, feeling the harmonious non-necessity of words until the time feels right to speak’ (1994: 5). Priestley is describing a ‘being together’ with neither words nor music where the atmosphere containing a kind of ‘music’ in itself is of value in the growing relationship. What is being communicated is a different, wordless understanding or knowingness between the therapist and patient. This other place of relatedness that she describes, waiting in silence until the moment when the time feels appropriate to speak, seems to have come from her own experience in analysis. This is interesting when thinking about times in groups when no words are said or music played and where there may be many different versions of the same silence going on at the same time for group members.

Priestley’s intention was that the therapeutic relationship, articulated through shared improvisational music, would lead to a better way of relating outside therapy. She was helping the client’s growing ability, through the music, to trust an intimacy and closeness which had the potential to lead to a more authentic way of relating to others. In what she describes as ‘guided expression of the music’ (1994: 7) she noticed that the patient’s resistance to denied or split-off feelings and emotions could be reduced because the threshold of consciousness was lowered. She felt that emotions expressed symbolically through sound or movement might allow the experience to be less painful and that these emotions could lead to ‘vivid memories and inner images’ (1994: 7). Music, she felt, enabled repressed material to surface, thus allowing it to be worked through to consciousness. She pointed to the idea that an impulse released in music could be understood or expressed in various ways. It ‘can either be accepted or partly accepted, or it can be sublimated, used in a constructive and creative way and harmless way or it can be consciously condemned’ (1994: 7).

Another interesting approach described by Priestley, this time linked to negative transference, relates to how aggression might be held in the music:

through the musical expression aggressive and auto-aggressive tendencies can be externalised in sound without the therapist succumbing to the assault. This relieves the patient of the guilt of having to create verbal channels of hate and destructiveness which might be better left unverbalised

Priestley (1994: 7–8)

She describes this as positive use of anger rather than its negative assertion. It is as if the instruments take the force of the transference.

Central to Priestley’s way of working was the training of students by giving them the experience of their own Intertherap as part of their personal development as music therapists. Students would improvise music together taking turns in being the patient and then the therapist. This way of working in music therapy did not really take root in the UK in the way that it did in Germany, where it was developed by Johannes Eschen, one of the first to be trained in Intertherap by Mary Priestley.

Paul Nordoff, an American pianist and composer, and Clive Robbins, a teacher, were also pioneers in music therapy practice in the UK, taking a rather different approach. Their musical partnership originated in collaborative work, primarily with children with special needs. Although their work in groups focused on a more social and educative approach, aspects of the ways they were working are important to consider in relation to this book. They had no single method that they regarded as gospel; instead they emphasised the necessity to find and meet the needs of the child in the music of each individual.

They wrote: ‘all the techniques we give you must be modified, adapted, even ignored, depending on the children you work with. Otherwise music therapy becomes a prescription and a dogma and an uncreative activity’ (quoted in Aigen 1996: 32).

Working together, they helped the child with learning difficulties to participate musically. Paul Nordoff played improvised music on the piano, whilst Clive Robbins helped to facilitate the child’s musical interactions. The music (which included the singing voice) mirrored, responded to, and amplified the sound contributions of the child.

Nordoff, interviewed for BBC TV in 1976, said:

We meet the tempo in whatever the child is doing, the tempo of his walking, his head banging, his pacing up and down, his rocking. We take the sounds he might make, whether it is screaming or screaming-crying, and we give this back to him in music so that he has a new experience of what he does habitually. And then, gradually, the goals we have to work for emerge as the child shows us. ‘Here I am, this is me, I can only do this.’

Nordoff (1976) quoted in Darnley-Smith and Patey (2003: 31)

Nordoff and Robbins often composed music in the form of songs that reflected the natural rhythms of the child’s speech. This enabled the child to learn the songs and their melodies easily. The child’s movement was also mirrored in the music. Attention was paid to the harmonies and rhythms that supported the music in both song and music for movement. Thoughtful use of dissonance to reflect mood were also important and they considered that this enabled the child to move with determination as well as helping them to...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Contents
• Notes on contributors
• Foreword—Bill Lintott
• Preface—Eleanor Richards
• Acknowledgements
• PART 1 Group music therapy Historical perspectives
• PART 2 Group therapy A group analytic perspective
• PART 3 Group music therapy Developmental perspectives
• PART 4 Group music therapy Clinical perspectives
• References
• Index