Category Archives: Music

“I Can’t Work With Normal Kids Anymore”

Imagine my relief, when I blurted this line out, and Y, a wonderful therapist whom I greatly respect and adore, echoed my sentiments and told me that she could totally understand.

“I used to get so frustrated with normal kids as well”, she said. “I’d look at them and think – you have everything you’ll ever need and yet you are not cherishing it. There are kids who have so little, born disabled… and yet they are trying so hard” (I almost started tearing when I heard her say that).

“Yes! I felt that way even before I came here, and now I feel that even more strongly.”

R, who was nearby, also agreed, saying that once you’ve gotten a taste of therapeutic work, it’s hard to go back to whatever we were doing, because it will naturally seem so much more meaningless (he was from the corporate world, imagine that!).

And indeed, I do feel that most of the things I’ve done before has been pretty meaningless. Not all, but most.

Because when you’ve seen how a non-verbal person can communicate through singing and smiling, when you’ve seen a so-called intellectually disabled young woman reach out and give you a high-five in the middle of our drumming improvisation, when you’ve felt the hands of a 4-year old with autism stretch out and hold your arm and bring your fingers to the piano, laughing as she plays the piano through your hands, and then reach out to touch your hair and say your name in a loud clear voice… How can one go back?

How can I go back to the system where days are spent rushing through syllabus, where fancy lesson packages are prepared with no time to carry them out, where obedience and silence are order of the day, where countless events and excursions and enrichment activities are carried out not because they are truly beneficial, but because KPIs need to be met, because portfolios need to be beefed up, because people need to look good on paper.

I just want to pull my hair in despair when I think about it.

As much as I am living in the present and getting the most I can out of this amazing experience, I know that this too shall pass. And then… what?

The Takers and Sound

Reading some articles in this book recently has made me more thoughtful about the way we perceive sound. I recall watching a TED talk by Evelyn Glennie some years ago, in which she speaks about how our ears are simply one way through which we perceive sound – in actual fact our entire body can be developed to become a natural resonator, allowing us a more full experience of sound. This approach is used with Deaf and hearing-impaired children as described in the book, with very encouraging and positive results. Just the simple act of being able to listen opens the door to so many other areas of development: self-awareness, self-perception, physical awareness, communication, acquisition of language, etc.

 

I also recently read this book:

Put two seemingly unrelated books together, and this thought emerged:

Even our culture of sound has become overridden by Taker Culture!

 

What used to be was that music and sound was part of everyday life. If people wanted music, they simply made music. No wait – they did not have the need to WANT music. Sound was simply part of their landscape, their living, their breathing. They took part in the creation of it, as natural as their breathing was a part of them.There was no divide between performers and audiences, players and listeners. Music was Life. For example, we know that many native African tribal cultures (example of leaver cultures) do not have a separate word for Music. To them, it is in inseparable from life and living.

But taker culture has taken it apart, like all other things thought as unrelated to production. In taker culture, sound and music has been transformed into a commodity, an industry, a product, and in some instances, a tool. And to gain full control over this tool and resource, technology has been developed so that takers can use sound at their whim and fancy.

Soundbites to win votes. Hypnotic beats to lure people into clubs. Catchy choruses to entice shoppers to buy more things in the malls. Jingles to make a product look attractive.

There is a positive side, yes. With the technology of recording, availability of speakers and music players, sound has definitely become more accessible. Popular music can connect people, even if they live halfway across the world from each other. Classical music lives on in CDs and box sets. Even the music of leaver cultures can become immortalized through recordings. And everything becomes so convenient – unlike our leaver ancestors, we do not need to physically produce the music – we can simply press a button and our devices do the work for us.

But… at what price?

I can’t help but feel that this convenience, this ready availability of sound and music around us… has dulled our senses.

We are so used to hearing music through speakers and headphones that we are less sensitive to the vibration of an acoustic instrument, less likely to become immersed in those subtle vibrations. We have forgotten the depth of connection possible when we sing or dance in a group, as we are so used to directing our attention to the performer on stage. We have become so convinced by Mother Culture that to make music needs “specialized training”, that we cannot imagine what it is like to live otherwise. To sing and dance uninhibitedly would be considered barbaric, a reminder of our leaver ancestors, and we don’t want to go down that road again, do we? So we shut ourselves in on this side of the divide, and continue to deny ourselves the full experience of sound, content to let our machines and devices do the job.

Ironically, it may be those who are denied the normal function of their ears who get to really experience the full subtlety and beauty of sound and all its layers of acoustics and vibrations.

Expression and Interaction

MQ is one of the new clients I saw for the first time this recent Tuesday. She has Tuberous Sclerosis – a condition I honestly have never heard of until last week. As there is no cure for this condition, the main therapeutic goals for her are simply expression and interaction.

At the start of the session and up till slightly after the mid-way point, MQ was showing apprehension about my presence, being resistant to changes and unfamiliar people. She refused to sit in the chair next to the piano when I was there, and at one point she even took my arm and gestured for me to stand further away so that she could have more physical space. While we complied with all these, E was constantly trying to re-introduce the physical proximity between us, trying to make MQ comfortable with me being near her.

At the start, while E and MQ improvised on the woodblocks, I was tapping on the xylophone, 2 meters away. Then E tried to introduce the wind chimes.

Picture Source

MQ resisted greatly to this, presumably because it sounded too clashing for her. But when E started to play a gentle piano accompaniment, and I softly tinkled the high notes, MQ stopped resisting and seemed to pause to listen.

Halfway into this exchange, E whispered to me to get the hand chimes, while she continued the piano accompaniment so as not to break MQ’s focus.

Picture Source

This was the instrument which MQ seemed to really identify with. I held 2 in my hands at first and played to her. She seemed to enjoy the sound and started swaying from side to side in wider motions. When E suggested to her that she take one and play it herself, MQ allowed me to hand her one, and allowed me to stand closer to her in the process. That was when things really started to take off. It was as if the instrument allowed MQ to unleash all the musical expression within her. With E still playing the comforting accompaniment on the piano, MQ was swaying more vigorously than ever, smiling, laughing, vocalizing. And… She had finally allowed me to stand face to face in front of her, without pushing me away!

We remained like this for the rest of the session – the 2 of us with a hand chime each, swaying together, smiling.. and E supporting with the piano.

E later commented that it is unusual for MQ to allow a totally new and unfamiliar person to stand that close to her within the time span of 1 session. No doubt the music helped to make her feel less threatened when confronted with change and unfamiliarity.

Expression and interaction – achieved – at least for this session.

Nod Of Approval

Recently thrown into the deep end again – 5 minutes before the adult intellectual disability group started, R said it’d be good if I could try leading the instruments improvisation segment on the piano. Up till this week, I had always been the co-therapist in this segment, trying to facilitate the individual clients’ playing and engagement while R had always been the one doing a fantastic job on the piano, creating music to match each client’s percussion instrument, their character, styles of playing, etc.

I had big shoes to fill.

Sensing my trepidation, R gave me some pointers –  Take more initiative here and there, anchor them with a steady pulse, sense the balance between leading and following, vary musical elements like dynamics and note registers to add more color to your playing…

“And don’t think too much, just think of it as having fun with them.”

Wise words.

Among this group is Ti – an amazingly musical non-verbal person, who intuitively anticipates musical phrases (Eg: He knows exactly when to come in), hums songs in perfect pitch, and grasps rhythm with surprising accuracy. Of all the clients in this group, I felt most excited, yet nervous about working with Ti, as I recognized his musical sensitivity and did not want to disappoint him.

We got off to a rocky start – he was hitting the snare and hi-hat with a rather irregular pulse, probably because I had yet to make a connection. Slowly, we established a steady beat. Then he started speeding up! I followed, bouncing chords off on the piano as quickly as he was bouncing his sticks off the snare and hi-hat. That was when I felt that a firm connection had been established. R then signaled for me to slow down, to see if Ti would pick it up on the change. He did – with R’s visual cues, Ti managed to match the new pulse with exact accuracy. Then, as if he knew that his turn was going to be over soon, Ti doubled the speed again, as if saying: “Alright, enough of the slow stuff. Let’s end with a bang!”

And that was what we did.

Ti’s carers were impressed with Ti and the music. R gave some encouraging praise, enough to make me feel good about myself. But what really made my day was Ti – when R turned to him and asked if he liked my music, Ti responded with an affirmative nod of his head.

I felt my heart swell with emotion when I saw that nod. I had not disappointed him. I had his nod of approval. His silent, non-verbal nod.

Reviewing the video recording, I hear and see many things I can improve on. But when I see that nod from Ti, I feel reassured. It not only implies his contentment with the experience, it is also a personal reassurance, that I’m on the right track and I’m improving in my clinical musicianship. And if I continue to work hard, I will get there.

Gabrielle

Caught this amazing Canadian French film at the recent Sydney Film Festival.

The choir voices and arrangements are a beautiful backdrop to a moving storyline – young adults with varying intellectual disabilities, wanting to lead independent lives, trying to discover and experience Love in their own ways, dealing with concern from their family members and society who view them in different ways.

Knowing that filmmaker Louis Archambault used authentic actors and settings for this film made it even more inspiring. The authenticity of the characters gave me more to contemplate and reflect on. How do we view the mentally challenged in our societies? Are we guilty of assuming that they do not know or understand certain things, just because they have different intellectual capacities? It can be so easy to gloss over their desires and thoughts, because they do not articulate. However, receptive language is very different from expressive language – just because a person does not (is not able to) express herself does not mean that there is lack of emotions or understanding within. 

The film does a beautiful job of portraying the inner life of Gabrielle, as well as her sister – her carer – highlighting the challenges and fears they face in an ever-changing world. It does not judge, and neither does it ask viewers to come to any moral conclusion or decision – it simply allows us to experience a glimpse of the life of someone with different needs, and asks that we open our minds and hearts that little bit more, to empathize, understand, accept.

Session’s End

I’m happy to note that connecting with M on the piano in this recent week felt a lot easier and smoother. I feel like I’m beginning to understand his musical personality, recognizing certain quirks and patterns which emerge in the way he plays. For example, he likes heavy chords, and seems to like it when the therapist validates his heavy treble playing with equally heavy bass chords, gradually transiting to an anchoring bass pattern which he can continue to play above and build on. Also, if he feels that he has run out of things to play, he might start pressing all the keys one by one, until he has covered the whole range of the piano, until he has touched every single key. “It’s one of his autistic traits”, R told us, referring to M’s need to make sure that every single note on the piano is accounted for.

This need to make sure everything is in order is also reflected in his actions. When he walks into the room, the first thing M usually does is to switch off all the electrical switches he can see, and makes sure all the windows are closed. After the session, he also automatically makes sure that all instruments and chairs are put back in place. No one’s complaining about that, of course 🙂

At the end of our most recent session, M did something which made us really tickled, yet at the same time highlighting just how observant he is of his surroundings and how much he understands of it, even if he doesn’t know how to articulate it.

“Well done today, M”, R congratulated him as we all stood up after the Goodbye Song. Apart from piano improvisation, we had also spent the session getting M to emulate the action words of a song, and play bells and drums alternately, all of which he did beautifully. “Well done”, R repeated.

M understood from R’s words that the session was officially over. He jumped up from his chair like he had just been given permission to move, ran across to an obscure corner of the room, where a stack of chairs stood, slightly slanted away from the wall. In 2 seconds, M was beside the chairs and had made sure that they were shifted that 2 centimeters so that they stood parallel to the wall. We, still standing beside the piano, realized that he must have noticed that stack of displaced chairs earlier and was just waiting for the session to end so that he could run to them and put them right. If this teenager could speak, we surely would have heard him yell: “FINALLY! That stack of chairs had been bothering me since I noticed them! I can’t believe no one else noticed they were not parallel to the wall!!!”

With the chairs in place, everything was right in M’s world again, and he happily bounced out of the room.

And because M had the last slot for the day, this is what I remember most from this week’s sessions: The gratification of musical communication. Our tickled laughter.  The feeling of pure joy and affection for this special kid.

Creative Time

“When listening to music we have available the possibility of experiencing ourselves as both familiar and changed. We lose a momentary sense of time, space and personal identity, while also retaining an overall sense of being and feeling. When we connect with a process of receiving internally a music from outside ourselves, the past and present sit together in relationship, in and through time, as the music moves along with its and our past, newly experienced in the present, in motion towards a future that is being experienced as it is being shaped. So this is creative time I’m talking about…

This is Alfred Brendel playing the slow movement from the Emperor Piano concerto. I want you to listen to the first piano entry. I think Alfred Brendel does this thing with time when he plays this, because it is actually impossible to tell where the phrase is going to end as he’s playing it.”

– Julie Sutton and John Alderdice

(Source)

“Listen To The Bell”

“Mr B” is one of the clients who attends the community music group for adults with intellectual disabilities once a week. He is in a wheelchair and is accompanied by his carer, “Van” – a lovely lady with the sweetest personality.

Mr B usually sits and stares into the space in front of him. He doesn’t make eye contact with anyone, and his lips seem to always be in an inverted U shape. His eyebrows are also always knitted together, giving the impression that he is constantly unhappy about something. He doesn’t speak, and I can only imagine how difficult it must be to take care of someone who does not want to or know how to articulate their needs and/or emotions.

In recent weeks, Mr B. started making little breakthroughs. Slowly but surely, he started showing awareness of the activities we were doing in the sessions, making little gestures and movements to indicate his willingness to participate. Gestures like reaching for the guitar and making strumming motions instead of simply sitting still, making a choice regarding which bell he wants to play instead of letting Van choose for him, making brief but solid eye contact with people instead of staring at nothing in particular – small gestures and actions which are huge milestones in Mr B’s journey to communication.

In the recent week, we witnessed something so beautiful, I still get goosebumps when I think about it and watch the video recording.

After a session of upbeat music making, R wanted to end the session on a calmer energy level, and chose to do “Listen To The Bell” – a wonderful piece of work by Julie Sutton. The song invokes a sense of contemplation and calmness simply by use of open intervals and timbre of the hand chimes/bells.  R was playing the piano, and I was asked to “facilitate” each client’s interaction through the bell in their hand.

“Facilitate” – anyone who has taught anyone else before would know what a huge word that can be. I knew I did not want to simply stand in front of them and tell/prompt/encourage them to ring their bell – though that was what I did at first. Then, on a whim, I started to use the other readily available instrument I had with me – the voice. Improvising along to R’s playing, I used the voice to create melodic lines (though when I watch the video I realize I tend to stick to “safe” intervals – something I should work on) to form a musical relationship with the individual playing the bell – it certainly sounds texturally more interesting than simply telling/prompting/encouraging the person to play their bell. And since R didn’t stop me when I started doing that (as I know he would when he thinks things are not working out), I assumed it was ok to continue.

We moved from individual to individual in the circle in this manner, making music with voice, piano, and bell. Finally, I knelt in front of Mr B’s wheelchair. “It’s your turn,” Van prompted, using her hand to guide his hand in a rocking motion so that his bell made a soft ringing sound. As she continued doing that, and I continued singing, and R continued playing, it happened.

Mr B. SMILED.

He tilted his head back, turned sideways a little, and SMILED. His inverted U lips simply inverted back. The sides of his lips turned upwards. His eyes became smaller. The creases in his forehead looked a little less deep. He was SMILING.

It took us all about a second to realize what he was doing. Maybe we just couldn’t imagine that face of his ever looking like anything else!

“B’s smiling!” Van exclaimed softly, when she saw.

“Wow, that’s a beautiful smile, B.” R responded ever so calmly as he continued playing.

I was trying to keep the singing going and making sure that the intervals were in tune with R’s playing, so I think my reaction was the least reactionary at that moment, but wow, I was really blown away too. Who would have thought that Mr B was capable of demonstrating such a solid facial expression?

“He’s never done that before”, Van continued, awed.

Mr B. kept that smile for about 3 seconds, then it gradually faded, but somehow the inverted U lips and knitted eye brows didn’t make him look as unhappy anymore. It could have been my positive imagination, but I thought he looked a little more… at peace.

Someone once wrote (need to search for the source again) that the role of the music therapist is to create the musical experience which the client is unable to create for themselves, and then use that experience to bring them to their goals, be it in communication, emotional balance, or physical improvements, etc. I suppose, because of the role we play, it’s easy to get all self-important and think that we’re indispensable in our client’s lives, and I admit that for a moment or two after I saw Mr B’s smile, I was really pleased with myself. But then I also realise that it could have easily been anyone else doing what we were doing, and it could have easily been someone else standing in front of his wheelchair and seeing Mr B smile that day. His smile was not a miracle we pulled out of a bag through OUR efforts – it was the result of the music which was already in him, the musical experience being felt within him, and the fact that we happened to be there when he made the connection between the music and the people around him. And we were fortunate enough to have witnessed it.

Still many thoughts and feelings about this, but that’s the gist of what I think so far. And the journey continues.

The Goodbye Song

We have a new addition to our Thursday line-up: “Ax”, a 12-year old boy with severe autism.

As we settled into the observation room to watch R and Yani (Yes, Ax is so challenging to work with that he needs two therapists!), Ax’s mother came in and sat next to us.

Throughout most of the session, while R and Yani were doing their stuff, converting Ax’s mono-syllable vocalizations into song, using the momentum from his ever-moving hands to beat in pulse, all the while trying to get him to articulate vowel sounds which might eventually lead to speech, Ax’s mother made small talk with us. She seemed light-hearted and was even able to laugh when her son had bouts of non-cooperation, only to bounce up, full of energy a second later.

When it was time for the Goodbye Song, Yani decided trying to get Ax to say “bye”, or at least something similar to it.

“Goodbye…” she sang, pointing to herself.

“Goodbye…” R joined in as Yani gestured to him.

“Good…” Both of them looked expectantly at Ax, waiting for him to finish the word.

The first time went unresponded, but the second time, Ax made a clear “AYE” sound, so distinctly different from his default “Mmmm” that Yani and R burst into an enthusiastic “YES!”

Determined to elicit another greeting from him, the Goodbye Song was repeated. Third, fourth, fifth, sixth time. But Ax seemed either unable or unwilling to produce the word again.

In the observation room, we watch in silence as the last line refrains again and again, with Yani’s beautiful soaring voice, R’s gentle piano accompaniment, and that expectant silence at the end of every phrase, each time heavier than the last.

Ax’s mother has also fallen silent, and from the corner of my eyes, I can see her watching the scene unfolding before her like a hawk. In her stillness and silence, I sense her hopes and expectations, as heavy as the space at the end of those phrases Ax did not fill.

A simple wish from a mother – to hear her child speak. To be able to communicate with him. To know what he is thinking. To know that her child will be able to take care of himself and survive in the world when she is no longer around. Silently, she watched.

When Yani finally had to give up due to time constraints, Ax’s mother stood up to go too. Before she left, she said to us in an almost-apologetic tone: “You see the challenge of working with him.”

After she left, I sat there for a few seconds more, just recovering from one of the most beautiful and intense Goodbyes I’ve ever seen or heard.

So far.

The First Meeting

In Creative Music Therapy, the act of the therapist and client initially getting to know each other is known as a Meeting. This Meeting is not about physically saying Hello or HowDoYouDo – more often than not it may not even be verbal – it’s more about coming to a mutual understanding, acceptance and acknowledgment of each other’s presence and abilities. For the therapist, this means getting a sense of the client’s ability to communicate and their dominant emotions. For the client, it may mean feeling validated by how the therapist responds to them, getting used to the setting, feeling safe enough to express freely.

After weeks of observation, our supervisor (henceforth known as R) dropped a fine bomb on us on the recent Thursday, suggesting that we physically step into the session with M, a sweet 16-year old boy with autism. He doesn’t speak, with the exception of single words, usually popping up at the end of song phrases and sentences. He loves songs that have actions to go along with them, and recently started saying words AND doing the actions at the same time. He is also very routinized, and we were initially worried that the presence of strangers in the room might throw him off. Fortunately, M seemed relatively comfortable, and even shook our hands when told to. Five minutes into the session, R suggests that I start by Meeting M at the piano.

So I sit on the piano bench, hesitant but excited, and wait for M to make the first move. “Just use what he offers you musically and try to respond accordingly”, R tells me. In other words, clinical improvisation. Improvising, but in a clinical context, to Meet M and show him that his sounds are being validated and that he is being accepted as a person. From the observation room, watching R do it, it seemed like the most natural thing in the world. Just respond to what the client offers you. Take what he plays and return it. Call and respond. Basic musical concepts. Right? Except that from the moment my fingers hit the keys, my brain started screaming: “This doesn’t sound right! How do you know if you’re playing correctly?! What’s the correct way to do this?!” The extreme need to know whether I was right or wrong meant that my intellectual brain was working in overdrive, and that, was certainly no way for spontaneous improvisation to take place.

There is a phrase: “Creative Moments” – used to describe that moment when a true and pure connection has been made . When it happens, the therapist knows it, the client knows it (presumably). I felt such a moment for about 3 seconds, when I chose to play sustained, open chords in the base, to support M creating a rhythmically denser melody on the higher register. The intervals of 4th and 5th suggest openness and provides room for expression, inviting the music the develop and grow. We worked this way for the duration of about 5-6 chords, before my intellect kicked in and I thought: “Hey, this may be getting boring for him. What if I try to spice things up by adding some accidentals?” The moment my fingers hit those black keys, I cringed inwardly, for it was then I realised that M was only playing with the white keys, and there had been no need to add any accidentals at all! By trying to “spice things up”, instead of continuing to trust my feelings and obvious observation, I had ruined the Creative Moment for us. I tried to go back to whole-tone chords, but the moment felt lost, and M had proceeded to another mode/musical motive which I then had to catch up with.

That was just one example out of numerous in the session in which my intellect came in and got in the way. R was very encouraging after the session, saying that we did not too badly for the first time, pointing out the fact that clinical improvisation is something that can be learnt, and he would be more than happy to share some tips with us for the future. He just needed to throw us into the deep end for awhile to see how much we could do. And while I’m no olympic swimmer, I’m also happy I didn’t drown, and somehow managed to stay afloat long enough to experience the beauty of the ocean.

As one of our lecturers told us recently, it is possible to have a Meeting extend over a few sessions – she shared how she was still Meeting a client even after 3-4 sessions, and only felt that she had finally Met him in the 4th session, after which more focus could be given to the planned clinical goals. She added that we should not constrict our relationship with clients within sessions (not unlike how a teacher may think of a child’s development in terms of school terms and semesters), something bureaucracy tends to do to us. After all, a person’s development is never compartmentalized.

I’ve been thinking about M and this experience with him over the past few days. I don’t think I’ve ever reflected this deeply as a teacher.

I really want to do this.