In honor of Social Media Advocacy Month (I never even knew that was a “thing” until now!), there’s a guest post from Judy Simpson, AMTA’s Director of Public Relations, circling the various music therapy interwebs. It is a well-written and thoroughly welcomed message. One part in particular stood out to me:
“For far too long we have tried to fit music therapy into a pre-existing description of professions that address similar treatment needs. What we need to do is provide a clear, distinct, and very specific narrative of music therapy so that all stakeholders and decision-makers ‘get it.'”
I could not agree more. There is absolutely a great need to construct a powerful and compelling narrative that will successfully convince healthcare professionals of our independent and unique contributions, but have we even come to a consensus as to what that narrative is? I’m concerned that we’re far away from a shared message and tone that will effectively establish our field as valid, primary, and integral.
I vividly remember the first time, on some long ago listserv exchange, that I first encountered this idea that music therapy must escape the shadow of the closely related fields we were yearning to be accepted by. At the time I was a new professional, and the notion that we did not require the external validation of other professionals was jarring. It challenged a good number of the pre-existing narratives about music therapy and music therapists I had been carrying around, narratives shared among various collegial circles from student members all the way up to professional leadership. These narratives have continued to ripple, formally and informally, throughout our field, and I feel they present one of our most acute challenges.
These internal discourses are reflections of how we understand both music and music therapy, and they are so stark that they go beyond “agreeing to disagree”. These epistemological conflicts are sharply dividing the American music therapy community and hindering our ability to develop a cohesive narrative that (1) communicates an understanding of music as meaning-based and grounded in the humanities, (2) conceptualizes music therapy as contextual, relational, and interactional, and (3) establishes music therapy as a core, integral practice working in a domain of wellness that no other field does.
Here are four of the discourses that I have found to be particularly damaging to our prospects of being recognized as equals in the healthcare ecosystem:
“Music therapy is the use of music to meet non-musical goals”
Open admission: this one, above all others, drives me crazy. I have literally never heard of any healthcare profession actively denying their patients the domain of health that their entire craft is predicated upon. Do physical therapists meet non-physical goals? Do nurses meet non-nursing goals? Do physicians meet non-pharmacological goals? At what point did we become so disempowered as a profession that we felt the need to decontextualize human wellness from musicality and creativity in order to “prove” ourselves to other professionals, when really we should have been emphasizing our expertise in wellness as musicality and creativity? This goes back to Judy Simpson’s earlier point that we need to be who we are, not who we think somebody may want us to be. I am thankful to the latter day and present day pioneers who have continued to advocate clinically and philosophically for an understanding of humanity as musical. Until we can gather around the idea that to be musical is to be well, I’m concerned that any narrative we offer to other professionals will still suffer from an implicit, if not explicit, need for their validation.
“Music is best understood to the extent that we understand our neurobiological responses to it, and music therapy practice should be founded upon this biomedical construct”
For me, this is a decontextualist approach. What I mean by that is it relocates music from the humanities to the sciences, and distorts music as a meaning-based practice and experience into sound that creates linear cause-and-effect relationships. What is music if not sound that we assign meaning to? There are those who go one step further (which Meghan alluded to in her introductory post) in understanding music as a wholly unique form of human expression that can, and does, manifest as soundless. To be sure, this firmly entrenches music therapy into a grayer construct of intersubjectivity and therapeutic process, but this is where we reside as music therapists.
There’s a reason, for instance, that Neurologic Music Therapy is a training available to non-board certified music therapists: it is a collection of prescriptive techniques and protocols that do not require the musicianship, clinical intuition, and empathic attunement that board certified clinicians possess. It enables the user to wield sound like a tool in order to meet a predetermined outcome.
Music, however, is not so linear, and calling such practices “music therapy” is highly problematic. Music is an organic external manifestation of human expression and consciousness that is co-constructed by the music therapist and all the elements of the surrounding environment. Yes, we can see how music in the moment of meaning-making manifests objectively on a neurobiological level, and that certainly needs to be taken into account in order for ours to be a holistic and progressive practice, but we cannot allow it to be THE foundation or guiding theory informing future practice. If we do so, we’re empowering non-music therapists to claim they can do what we can do (and if we build future practice around these ideas, then they would be right!) while disempowering actual music therapists from developing deeper understandings about the nuance of our craft in the service of fostering greater wellness in our patients.
“Music is noninvasive and nonthreatening”
Whenever I hear this, I ask “To whom?” I don’t even know what “noninvasive and nonthreatening” means. Does that mean music is the equivalent of a massage on the beach in Tahiti? Doesn’t that overlook the fact that we use music at all stages in life, including difficult times such as loss and hardship?
One of the most popular and stirring albums in the past decade (Adele’s 21) was about a breakup – did that not “invade” our emotional centers and “threaten” the idealizations we hold onto in order to avoid actively engaging with such loss? Is that not why, to at least some extent, tens of millions of copies of the album was sold? If Adele was singing about the perfect marriage, I highly doubt the interest would have been there because it would not have resonated so deeply within us.
At the end of the day, I think this turn of phrase is more about us than it is about the music. I think it’s a reflection of our hesitance to engage with that depth of humanity in such an intimate way. I think it speaks to concerns about talking to other professionals about the nature of our work because so few people wish to actively discuss the dangers of musicking when addressing issues such as chronic depression, complicated grief, and trauma. It calls into question our own uses of music, and by extension our own humanity, too sharply.
“Music therapy is a complementary and alternative service”
This discourse is my white whale, the one I wish to dismantle before it rings in a death knell for music therapy in EOL care. This line of thinking always makes me wonder “What are we complementing? Who are we an alternative to? Are we some kind of backup plan for when the ‘real’ professionals aren’t making the progress with a patient that they desire? Are we some kind of wildcard to throw into a clinical situation just to see what happens?”
I once heard the medical director of a branch of a corporate hospice that hires music therapists in multiple sites characterize music therapy as “the icing on the cake”, and I watched several present music therapists nod their heads in agreement. In condescending medical terminology, that means we’re there to make nice and do “happy” after the “real” professionals – y’know, the cake – get the “real” work done. And a part of me cynically wonders why he would think anything else. It’s not like there’s been an active push by our professional organization to resist this categorization among the likes of aromatherapy and pet therapy.
If we’re going to get the foothold in the healthcare community that we are working towards, we need to assign ourselves as PRIMARY care providers that work within a domain of wellness (music) in a way that nobody else does. That’s only going to happen when we stop predicating practice and justifying service on the goals and objectives of other fields, and similarly stop grounding that practice in theory centered in fields other than music.