Beginning Work at Decreasing Trauma Symptoms
The 40-year-old man came to the intake session explaining that he is a different person than before the accident. The unexpected accident left him in the hospital for a couple of months. He spent that time there recouping not only from the accident injuries, but also the several invasive procedures and surgeries afterward.
When the gentleman came anxiously in the therapy room, the light had to be lowered to accommodate the discomfort the extreme brightness his eyes perceived. The therapist needed to keep the level of auditory input soft and uncomplicated. Playing music was wanted, but the therapist knew that there needed to be plenty of space in the music also, this was all he could tolerate for now.
The therapist began with simplicity, 2 notes with lots of space. He played in a very limited range, closing his eyes as he did so. After playing, he described to the therapist the images, and colors he perceived as he was able to play this way. Aware of the anxiety and heightened sensory sensitivity, the therapist first began to create a musical atmosphere of safety, accommodating, for now, only what the gentleman’s body and mind could tolerate.
As they continued their musical play, the therapist watched and accommodated the music the gentleman played himself. The therapist was, very slowly, able to open sparse but consistent musical play. The gentleman was able to stay focused and remain in the present moments this way. The therapist would alter only 1 element slightly, at a time, very slowly and subtly to aid and stretch the gentlemans’ tolerance, according to only what he could handle.
As the gentleman was able to stay in the open music, he began to contribute more to the play, and then describe to the therapist, the colors and shapes of what his mind saw as he relaxed. He continued to attend more deeply, and, little by little, to contribute to the play more and more. He was taking control of his own creation now. This gentleman was most comfortable at the piano with the therapist at this time.
This is not always the story, in fact, frequently not. Many of the children’s sessions looked drastically different, however, both often started by gaining attention, begining to relax in the safetly and thereby gaining some regulation. The first step is to create that safe, predictable, sensory informed musical environment that fits the client at the moment.