Here is the second post in our new ongoing series (to be posted on the 15th of each month) about how music therapists began work in end-of-life and palliative care settings. It is our hope that the telling of these stories will promote new perspectives from the storyteller, new introspection for the listeners, and a shared understanding of the privilege that it is to be working in EOL and palliative care. If you work in end-of-life care, please consider submitting your story.
My origin story, the one about how I ended up working in end-of-life care, has two components. One is the surface component, which is fairly boring, to be honest. The deeper version of my origin story is deeply personal, sort of a lot to share publicly, but I have decided that it’s worth writing about here anyway. I think it might represent a different way of thinking about countertransference to this work, which others might, in deep-dark-hidden or maybe fully-acknowledged-worked-through places, relate to as well.
The surface origin story is that end-of-life care fell into my lap. I had avoided it during undergraduate training because it was my best friend’s clinical interest and I didn’t want to step on her toes. In grad school at Drexel, I did psych placements and my internship in a medical hospital. I was drawn to more long-term work, which in internship frequently landed me with the very sickest medical patients, usually people who were terminal – but I still wasn’t identifying end-of-life care as a clinical interest. When I finished grad school, I wanted to work in a setting that would allow me to focus on psychotherapeutic approaches to music therapy, and I imagined myself in a general hospital or psych hospital setting. But then a full-time job at a hospice, in my back yard, building a program almost from scratch, just fell into my lap. Literally, I got an email asking me if I would please come work for this agency. So I went.
And it fit. My particular musical strengths of repertoire and nice but not expert-level vocal/guitar skills were a perfect match for what the patients and families I met seemed to need. My introverted temperament and my interest in deep psychological work were both more than compatible with the clinical opportunities that I was presented with. And working with dying people came easily to me. I never struggled with the “death” part of this work. Being with people as they suffered and grieved and said goodbye always felt good to me, even when I felt sad with them, for them, and for me, in my loss of patients I felt close to.
And I wondered why. As Jillian mentioned earlier, people who don’t work in end-of-life care tend to want to congratulate you or look at you in awe or think that you’re strange (or all three) when they hear what you do. I thought it was odd that being surrounded with death was so easy for me, when it’s such a human thing to struggle with. I found death comforting, in a way, and uplifting, right from the beginning, and that seemed to be unusual. I began to sit with the question of what my personal relationship to the work might be, and I was aware that it didn’t have any of the direct lines of correlation of which many of my colleagues would speak. I’ve had very important people in my life die, but none of those felt like “the reason” that end-of-life care appeals to me or works for me. I started this work several years before my own mother got sick and died on hospice.
Sometimes we are taught to look at things too concretely in our field, in my opinion. You don’t have to have experienced a death of a loved one to have experienced a deep loss of a loved one. One can feel the reality of abandonment without ever having been physically left — psychological abandonment is very real, in other words. Through years and years of my own therapy and deep internal work, I gradually learned that, paradoxically, helping people leave this world was so comforting for me because I had already been acquainted with that feeling of being abandoned. I was emotionally abandoned as a young child, even though neither of my parents ever physically left me (and in some ways were extremely devoted parents). I had brushed with psychic death, and I had suffered the most painful kinds of loss when I was too young to understand what I was experiencing. And somehow that helped me to grow up and be a perfect fit for working in end-of-life care. Developing a relationship with people who I know will one day leave me, and being with that, being with it musically, talking about it, helping people with it, is a fit for the internal needs that I bring to the work. And “needs” is the right word here… we all have needs that we bring to the work and that we hope to heal, often at an unconscious level. Carl Jung and other theorists have spoken about this in great depth.
I usually only tell the surface story of how I ended up in this work. When you only hear that part of the story, it all just seems like a coincidence. But I’m telling you that there was more to this than that. The way that this field fell into my lap was a Jungian synchronicity, and in that way has really helped me on my own path of growth and individuation.