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Trust, Respect Resistance, But Persist Towards Growth – Part IV

 Resistance, Growth, Persistence,

Persist Towards Growth

We know that resistance can look like negative behavior sometimes if we don’t look deep enough at the why. We also know that repetitive behavior is remaining stuck. So how do we respect this, yet persist towards growth?

We have already spoken about building trust and what that may look like, the process and time it may take. As the trusting relationship unfolds and the client starts into new areas of being, it may be uncomfortable and unfamiliar. The known is often preferable. Unfortunately, remaining with the known often aids a path towards isolating behavior. The familiar, no matter how unpleasant, can often be preferable.

Our autistic client has been doing very well in therapy. She has been paying attention to the therapist and the play in a persistent manner, without direct supports. Suddenly, this feels unfamiliar, unknown. Being and interacting with another is unpredictable. She instantly stops and leaves the interaction, and appears to lose interest. She begins her self isolating behaviors.

The therapist must alternate the elements of the music. If this does not work, she may need to use more affect. She may possibly need to ask more from the client,in order to regain attention. This new playful place, although enjoyed, is unfamiliar and therefore unpredictable. The client begins her self perseverative behaviors, in order to go back inside herself where it is familiar. The client lashes out in order to go back to her known isolation.  The therapist continues the theme tune, allowing the client’s movements to organize it’s rhythm. The therapist continues to ask for a response (perhaps a drum tap to end the phrase ). This is a new way of being, however, the theme music is familiar and the therapist is familiar. This new way of being, although pleasant, is not yet familiar. Resistance is respected, but growth must persist.

Perhaps we are seeing the child with a trauma history. The child has a long time relationship with the therapist, however, during that time, experiences more of the unexpected. The preteen names the tunes she likes. She expresses why she likes them. She begins to sing these tunes very softly.

This young girl previously loved to belt out her music. As the client gets a little more comfortable, she raises her volume slightly. The client expresses more affect by beginning to move to the music somewhat. She has completed her comfort level for the day. She demonstrates this by pulling her phone out and scanning it. This might be a good sign, that it is enough of this for today.

The child’s trust with the therapist remains, although her comfort with expressing herself is not what it use to be. She tells the therapist she has 2 more songs for her. These tunes will be ready for the client to continue her process next week.

The therapist will not push the girl where she is not ready to go today. The therapist will titrate this process week to week. Time, trust and predictability in this manner may help bring back that comfort level. The girl reaches out and asks for more songs, but no more singing for today. Trust had existed. The unexpected in life has interrupted the process. This child will move through her resistance slower, at a more comfortable place for now. This is not yet a time to ask more of the client than she is ready to express. It is time to titrate the experience. Singing for this week has ended. However, the client has asked to continue this, by asking for another song

The next case is a young boy. This boy enters his first session. He displays exuberance with the music. He is excited about all the new items in the room. Participation in this first session was easy. The next week, he is just as excited to come in, however, there is nothing new in this room.

The therapist alters every element of the music, She uses affect in her voice and face. She attempts to alter the play. Inattentiveness is displayed; by asking to go to the bathroom, pretending to cry, and pretending to fall asleep. The therapist plays along with the sleep and tosses a small blanket on the boy. This makes him a little irritated. His typical escape technique wasn’t working.

His sensory system is seeking a momentary jolt of excitement. Adding more and more new items in the room is only going to continue the inability to grasp attention. The therapist will have to try harder. Although the therapist is new, this little guy is very comfortable with her. His own sensory system is limiting his ability to attend and enjoy. It is not allowing him to get what he needs. He constantly needs new sensory to excite that system.

Mom enters the room and suggests that he does well if you tell him what to do. Experience has demonstrated to me, that compliance can be a form of escape. Compliance is a great way of pleasing the other, staying out of trouble, and being able to exit the growth. No development occurs when this happens.

The therapist waits for this little guy to run out of resistance techniques. Eventually, he does. This is when the boy begins to relate to the music. He censors the therapist out of the corner of his eye while the music continues to follow his lead.  The therapist notices the stationary movement to the music. This is the first time she has seen him relate to music affectively and respond to the rhythm

He begins to play and looks at the drum stick as if he has never seen it before. He taps it out of curiosity. The therapist incorporates the tap into the theme music. He begins to tap with her on occasion. In this instance, trust, respecting the resistance and growth occur together in the process.

Our last scenario is the adult client whose symptoms to his trauma have been labeled as an OCD diagnosis. The therapist listened as he described his perpetuating, distracting inner life, keeping him stuck in time. Although he tries to new things, nothing helps this loop of this distraction. It persists throughout all his attempts to do new things.

He asks for the same music each week.  The client consistently picks up the tempo at the same point. He then begins to move to the music. Shortly thereafter, he slows it down and improvises a combination of lyrics and vocal sounds. The session continues. He begins to move more. The client, self- admittedly, produced vocals he didn’t even know he had. These sounds were new. He began to smile in the session for the first time. His music is no longer parallel to the therapist’s music but now is more responsive to hers. He builds his responses off of the elements she plays. He is beginning to partner his musical responses in accordance with what she is doing.  This is a new feeling, coming out of the loop momentarily, and beginning awareness of the other.  It becomes scary. “When I leave here, I just go back.”

This new feeling and the sense of losing it becomes too scary to continue. The client comes to the next session and doesn’t want to make music. He continues his old loop of thought. The therapist plays a quiet, consistent tap behind this. She works to ground the client a bit and hopes to be able to move slowly back into making more productive music together and moving forward.

Back Mountain Music Therapy invests in creating a trusting environment for each client. All the client brings to the session is accepted and brought into the created musical interactions. Resistance occurs in many different forms and in the growth process. After all, change is never easy. However, it is part of the process and must be gently moved through.

Antoinette Morrison MT-BC

 

 

 

 

 

 

 

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