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Music Therapy and Trauma

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Last week, I received a call from a caregiver who was inquiring about some trauma work with a child. She asked if I addressed the trauma during the sessions. I replied that I would do so only if the individual brought it up, on his or her own terms. Sometimes our clients come with this diagnosis or knowing that this is the issue. Other times, our clients come with different diagnoses, labeling the “response” which qualifies their symptoms into one specific category.

Trauma symptoms develop out of a sense of helplessness and loss of power. The symptoms that result from our response to fear reside in our autonomic nervous system. Autonomic responding, knee-jerk reactions happen in the part of our brains and the nervous system that is not conscious. This stored trauma and energy gradually leads to erosion of the individual’s physical health. Many times, revisiting the “story” is so terrifying, that it can retraumatize the individual.

Establishing a sense of safety and empowerment is fundamental for the start of therapy. Why can music therapy tend to be a very safe avenue for trauma? Can musically relating to another, aid in the recovery from trauma symptoms?

Relating musically can be an emotional avenue of relating, non-topic-specific. It can be a safe, non-threatening avenue to gradually access the “body or emotion shrapnel”.  These unregulated responses or emotions are results of trauma and fear. Musically, we can access the sensory system. That is often where the trauma “alarms” resides. Then the process can be titrated in a manner that is manageable for the client.

Clients who display trauma symptoms can sometimes come with different diagnoses. The diagnosis often labels and qualifies their symptoms into one specific category. In my previous two articles, I discussed a nonverbal client with a very different diagnosis than trauma. Both articles discuss the topic of “working with anger”. The label here is not really that important; however, attending to what the individual presents is of the utmost importance.

The articles “Working with Anger” and “Misconceptions about Working with Anger II” explored the therapy and what happened in the music. The initial goal was to create essential accommodations for the client, within the context of relational musical play experiences. Music Therapy then becomes a “microcosm” for how the individual acts or relates outside of Music Therapy.

Music Therapy addressed cognitive, sensorimotor, emotional, communicative conventional health domains simultaneously as the client engaged. They were embodied within the experience without the client having to “work” at any of those areas.

As the client begins to repeatedly relate for elongated periods of time, the client continues to communicate with the therapist. The client is able to have the time and conditions to;  express, self-regulate and manage their response.

Simultaneously, while relating, the client begins to sustain the ability to engage in relation to another. The client can begin to manage “how much is too much” with the therapist’s musical assistance. As the client does this, the client can begin to experience him/herself differently and the need to “escape” extinguishes. He/She can gain control over the situation that they did not have initially. That sense of control balances the original sense of fear brought on by the helplessness of the traumatizing experience. The client can begin to experience him/herself in relation to another in a new manner.

In the previous articles, initially, the referred client had difficulty relating at all. This was due to an oversensitive sensory system. The lights were too bright and the sound was too loud. Physical space between individuals needed to be comfortable. The sensory issues overwhelmed her ability to remain in the interaction.

Altering the play conditions to this is where we began to open doors for the client. Persistent observance in client needs, development, and individual differences clarify these needs. We can begin by enabling him/her to feel comfortable enough to simply remain in the room. Initially, the physical set up needed altering for the client’s sensory system to relax. Therefore, the lighting was lowered. We utilized very soft dynamics and used open music. Open music consisted of single-toned timbres and simple harmony. We accommodated with extra space for the client to feel safe enough to physically and comfortably remain in the room. The emotional anger surfaced next. In a proceeding, the client exhibited the desire to defend herself. This was an autonomic response to previous experiences. She exhibited this by throwing instruments and making attempts to push the connection with the therapist away.

Sensory and emotional overload was carefully monitored.  Accommodating and musically attending to this, enabled the client to work safely. She was able to navigate through the obstacles that got in the way of the desire to relate at all. This began a new, healthier, avenue of relating to others.

Generalization can occur when we examine and alter conditions that enable a client to relate. It is nearly impossible when we look at and treat behaviors in a vacuum. For example, looking at sensory issues as a “form of autism,”  may change how we view the client. Therefore, altering our responses to the client. Exterminating the behavior of throwing the drumstick perpetuates the reason for this response. Viewing the behavior as a response to fear helps us to accommodate to aid the client to begin to interact.

Look at what is getting in the way of healthy and positive relating. Then work for the best possible environments. The client needs to interact our of her own desire. Then we can slowly and safely begin to alter the musical environment to help the client with flexibility and adaptability. Life will not continue to provide optimal conditions. We can do our best to provide those in the safety of therapy to begin. Once we have interaction, then we can begin to work on the ability to adapt.

Trauma work can be made tolerable for the client. This can enable the client to once again regain a sense of autonomy, and control. The time frame is up to what the client can best tolerate. Familiarity and trust is built into the thematic music.  This music can be utilized and brought back and altered to help the client navigate more intense moments. Back Mountain Music Therapy invites and encourages any thoughts, views, questions, or discussion on articles in the comments sections below.

 

Antoinette Morrison

Back Mountain Music Therapy

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