Last week I wrote about “Why Music Therapy?”. The idea for this blog post came as I was working on telehealth. During a telehealth session, I realized how important affect was to our relationship. I noticed how much I utilized the means of emotion in the session to even a greater degree than I had previously known.
I can’t say I love telehealth as a means for live music-making. It certainly requires us to do and think differently. It was in this thinking differently when I noticed how much emotion was part of the relationship.
I had been working with a client with an acquired brain injury. The client has some memory and communication loss. This individual also has aphasia. We had been working at the piano, in person, to a great degree with much success. However, during COVID, she had a minor stroke, and it took several weeks before we attempted telehealth.
The stroke had affected her ability to attend. We got through that ok. Although she sits at her piano at home, she can not make the connection to play the piano with me. So her means of relating to me is through her vocals. Her vocals are limited in their range. However, her hour-long session is robust and vibrant! I have to utilize some visuals to get things started. And what is it that makes her Music Therapy sessions online so robust and vibrant? It is the affect that is portrayed in the relating.
Although my client isn’t “playing” an instrument, it does not matter much. She is still relating to me in the means she knows how. It is the affect portrayed between us that keeps us connected and relating. The music guides our work together, and the affect or emotion in our relating is highlighted and moved forward by its use. The music accompanies what she sees and hears in my face and voice. The music’s tempo and dynamic are used intentionally in helping her arousal levels and her ability to balance the ability to attend with the ability to respond in a more regulated manner. We can have longer chains of communication when she can regulate herself as she responds. This enables the relating to dive further and moves towards higher levels of thinking. To move towards higher levels of thinking, she must remain regulated. And when she can’t, we go back and try again, within the warmth, safety, and active emotionality of the musical relationship.
There are not too many things this client can do independently. But she can relate independently in music therapy, even online! Although she watches my face often, it is the music that supports the active and moving expression in relating to her.