The Story of Anna: A Case Study using Music Therapy, Gestalt, and Guided Imagery & Music
Liz Moffitt, M.A., R.C.C., MTA, Fellow, Association for Music and Imagery
Music Therapists are the most recent participants to join the table with the R.C.C.’s and others in the Health Professions Act discussions. As an R.C.C. since 1993 and a long time music therapist and Gestalt therapist, the author would like to introduce you to some of the ways music therapy can be utilized as a psychotherapy and also can be effectively combined with other therapeutic techniques.
Who doesn’t love one sort of music or another? Music therapy is effective with a wide variety of populations due to music’s vast appeal. It can easily be adapted to meet individual needs and can be practised in many different ways; from active music making on easy-to-play instruments, to listening and imaging to music, to using the voice for singing and expressing the depths within. Because of its non-verbal nature, music can often express what language cannot initially reveal. In B.C. many music therapists work with seniors, or in palliative care, or with children with disabilities. A small, but growing number of us are doing music psychotherapy in private practice.
Following is a short example of a combination of music therapy styles and Gestalt therapy used in working with an adult client. Anna, a woman in her 50’s, initially came for music therapy because she had experienced very upsetting images of sexual abuse while listening to music at a conference session. She knew she had been raped several times in her teen years, the last occurrance being a rape at a party where she had been drugged. These events had left her with many emotional scars to be healed and due to her lack of consciousness she had been unable to express and release her resulting emotions. Anna was seeing another counsellor at the time and she felt she additionally wanted to experience music therapy, given her response while listening to music.
In our first session we began with a method known as the Bonny Method of Guided Imagery and Music (GIM). This method, which uses specifically programmed, mainly classical music, has the potential to tap the creativity of deeper conscious states which can open pathways to integration and healing. It works from the premise that the full spectrum of human experience is inherent in great music. This music can thus trigger images and experiences which are paced by each individual’s needs and readiness in the moment. The therapist maintains an active role throughout the sessions providing focus and encouragement for the experiences which occur. As Anna began to listen to the music her body suddenly started to pulsate, her breath became shallow and her mouth moved into very exaggerated contortions, emitting repeated high-pitched words, “Get out, get, get…”. I immediately turned off the music and asked Anna to open her eyes and look at me. She had some sense of what was happening but had no control over the reactions of her body. We ended the session after some discussion, agreeing that it was not the time for GIM work yet. Consultation with her other counsellor confirmed my belief that Anna was not ready for work that can so easily access unconscious awareness.
In an effort to assist Anna to feel more in control we began the next session by each playing a large drum. At first Anna played with a slow unsteady beat. Her arms and shoulders were tight and rigid. As I accompanied her with a steady beat, she began to speed up her playing, while gasping for breath. These music experiences were obviously triggering her into spontaneous body responses which seemed completely out of her control. I intervened by asking Anna to listen to my beat and play exactly when I did, beat for beat. When she started to accelerate I called her name and asked her to look at me while playing. For the first time Anna was able to maintain control of her music making and of her own body responses.
As we continued to work together improvising on the drums and later piano and voice, Anna was contained by the structure of the rhythm in music. Gradually she took more control of the tempos and with that, felt more able to feel her emotions without needing to escape. With this strength she was able to release rage at significant people from her past. Using the Gestalt Empty Chair experiment, she smashed out her fury on the head of the drum while shouting outrage at her attackers. She was able to shed many painful tears. She roared with laughter feeling the freedom of yelling, “you bitch!” at her unloving mother. At the end of many sessions Anna left with a renewed zest for life.
Recently we returned to the GIM work after she had several recurring dreams of the gang rape. In the last session she imaged details of this event while being supported by the music’s stable harmony and stringed timbres. By the end Anna felt something had been truly cleansed from her.
Her work is ongoing, however she feels that the combination of methods has certainly helped to free her more, and to increase her awareness so that she can be in more contact with herself and others and experience more pleasure in her life.
This case study is an example of how music can have a profound healing effect, whether by providing a safe container for emotions, by providing a structure and sense of order, or by stimulating images that can provide new creative solutions.
As with Anna, music can reach deeply within all of us, and can address our human need for the aesthetic experience, for beauty, to touch the numinous, as Jung would say. In my experience, this is an essential ingredient in the healing process.