Thanks Brynjulf for your 'Jambo' essay. I work as a Consumer Project Officer at the Transcultural Mental Health Centre in Sydney, Australia and have just graduated as a music therapist. As I also trained in music therapy at the Instituto de Musica, Arte y Proceso in Spain, I have a few comments to make on culture.
Whether we acknowledge it or not, culture pervades a lot of what we do as music therapists. In a country like Australia, one of the most multicultural societies in the world, we are perhaps more sensitized to issues of culture. For example, in one area of South West Sydney (to be awfully precise!), the percentage of people from 'non-English speaking background' is just over 50%. My work at the Transcultural Mental Health Centre is informed by a view that Western models of psychiatry & mental health don't always work for people from diverse cultures.
Yet in my music therapy training, there was very little reference to cultural contexts. Perhaps that is because culture is a bit like your own nose - its hard to see it when its so close to you. Just a couple of things I have thought about culture, music and mental health.
(1) Mozart is 'world music' just as much as East African music is.
(2) The DSM-IV, the psychiatric diagnostic bible, cites various mental illnesses as being 'culture-bound', ie. they only make sense in the context of a particular culture: I think its 'kodo' which is an illness in some Asian communities where the man is convinced his penis has shrunk. 'Normally', this would be considered to be paranoid schizophrenia, but within certain Asian cultures, it makes sense due to the worldview of ying and yang, whereby an excess of sex with its outpouring of semen is viewed by the man as being an excess of 'male' energy being discharged. Therefore, the man is convinced his penis has shrunk (when in fact it has not).
The Chinese psychiatric diagnostic bible equivalent of DSM-IV has its own ways of dealing with the problem, which while rather interesting, to say the least, deviates me from my point. That is, clinical depression which arises in the West from the spiritual apathy brought about by a culture of consumer-driven meaningless, is just as much a 'culture-bound' syndrome as is 'kodo' in specific Asian cultures.
So, there you go. Greetings from 'Down Under'!
Much Ado About Nothing?
To my surprise the little piece "The 'Jambo' Means 'Hello' in Africa Syndrome" (published as the Voices Fortnightly Column of September 23 - October 7, 2002) brought about three comments in just a few days. I want to apologize for my delay in writing a response (but I'll not wear out the readers with explaining the reasons for this delay).
I want to thank Kristen M. Cole, Jane Edwards, and Carlos Suarez for their commentaries. Most of what they write I resonate with, if not in every detail. The clearest disagreement seems to be with Jane Edwards, concerning the value of the term "community music therapy." In this response I will therefore concentrate on her "Shakespearean piece," even though what she comments upon is not the main errand of my text. My piece was not about community music therapy. I focused upon the need for cultural sensitivity in music therapy, and only used community music therapy as one possible example of an area of practice where this issue is of very high relevance.
Be that as it may, Edward's concerns about this emerging term are important to deal with. The issues she raises are complex and, to my judgment, of high significance for the discipline and profession. I have tried to deal with similar issues in a few recent texts. In order not to make this response too long I will refer to these texts (where more elaborated arguments are presented), and I hope therefore that the readers will forgive the somewhat frequent references to my own work.
In her commentary Edwards writes:
Let me first say that to my mind community music therapy is not another name for being sensitized to culture. In the introduction to the recent book Contemporary Voices in Music Therapy, Carolyn Kenny and I have discussed what we call the "turn to culture" in contemporary music therapy. There is an increasing interest for and awareness about cultural issues in the discipline and profession, and Edwards' own work is probably a good example of this. The implications for music therapy may at least be seen at three levels, which in the above-mentioned text is outlined as follows (Stige & Kenny, 2002, p. 27-28):
1) New areas of practice: Cultural perspectives invite practitioners to explore new areas of practice, by focusing upon the client-in-context. The most established term for this in the literature is Bruscia's (1998) ecological music therapy, while recently the term community music therapy has emerged as a term used by more and more scholars and practitioners.
2) New principles of practice (in new or established areas of music therapy): Culture-specific perspectives become increasingly relevant and important as a large number of music therapists now work in multicultural settings, and they represent important ethical and clinical challenges.
3) New theoretical and metatheoretical perspectives: The turn to culture also implies that culture-centered theories will be developed. An example of an integrative and culture-inclusive theory is Kenny's Field of Play (1989, 1996). Kenny suggests that we must consider all conditions in the environment when designing our theories and practices in music therapy. Culture-centered music therapy represents a quest for new metatheoretical ideas in the field of music therapy, and may inform and challenge some established conceptions (Stige, 2002a).
In my column "The 'Jambo' Means 'Hello' in Africa Syndrome" what I was discussing was at the level of point 2 above (the importance of cultural sensitivity in any area of clinical practice), but I used community music therapy (at the level of point 1 above) as an example when discussing this.
Jane Edwards has more to say about the notion of community music therapy, however:
To this I want to say that I very well understand that in Edwards' university center, where she is working in a department that also trains community musicians, a term such as community music therapy could create confusion, at least in the beginning. The (Irish/British) term of community music is institutionalized in a way that, to my knowledge, has no parallel in any other countries. But, since community music therapy is emerging as an international term, I think that it could be problematic to have it "banned" because of specific Irish/British language problems. In a literature review of German, Norwegian, and North American music therapy literature (supplemented by British texts), I suggest that community music therapy is not (only) a mixture of community music and music therapy, but that at least five (growing and changing) roots are visible: 1) community healing rituals of traditional cultures, 2) practices of conventional modern music therapy, 3) traditions and activities of community music, 4) models of sociotherapy and milieu therapy, 5) approaches to community work (Stige, 2002b).
The last issue I will try to deal with in this response is the conclusion of Edwards' comment:
Keep the name of what? Of the discipline, the profession(als), and/or the practical work? As I have discussed in Chapter 7 of Culture-Centered Music Therapy, these are conceptual levels in defining music therapy that often are confused:
I am not saying that Edwards' conception of music therapy is confused. I am only saying that her critique of the term community music therapy to my judgment does not clarify the distinctions between discipline, profession, and practice. I have not advocated community music therapy as name for neither discipline nor profession. What I suggest is that the practice of music therapy is so broad that several areas of practice need to be developed, and that community music therapy is emerging as one such area. The need for definition and discussion of areas of practice is no new or radical suggestion. The most important contributions to this discussion are the areas of practice as outlined by Bruscia (1989, 1998).
"Music therapy by any other name would smell as sweet" is the title of Edwards' commentary. I assume she is paraphrasing Shakespeare's famous line in Romeo and Juliet. A rose by any other name would smell as sweet? I must confess that I never knew what that should mean. Are names and phenomena that separate? I grew up in a small town of western Norway, called the "Town of Roses." The name, first suggested by the poet and writer Bjørnstjerne Bjørnson in the beginning of the twentieth century, gave little meaning in the middle of the century, when the town was bombed to pieces and all you could smell was smoke. After the war the town was rebuilt in the architecture of the 1950s, as boring and sterile as boring and sterile can be. Gone were all the small wooden houses with their sweet rose gardens. The local politicians did want to give up the "pet name" of the town, however, and built a few parks with thousands of public roses in them. The name "Town of Roses" seemed to have a sweet smell of its own. As a boy I always found this forced sweetness somewhat amusing. You could take your boat and row out to any of the islands of the fjord and smell flowers as sweet or even sweeter than any rose, but these were tiny and less well-known flowers. No politician would care to use any of them when trying to put the town on the map. Names seem to matter as much as sweetness, or rather; the narratives to which names belong are not completely separated from our perception of phenomena.
References
Bruscia, Kenneth (1989). Defining Music Therapy. Spring City, PA: Spring House Books.
Bruscia, Kenneth (1998). Defining Music Therapy, second edition. Gilsum, NH: Barcelona Publishers.
Edwards, Jane (2002). "Music Therapy by any Other Name Would Smell as Sweet" or "Community Music Therapy" Means "Culturally Sensitive Music Therapy" in Our Language. [online] Voices: A World Forum for Music Therapy. Retrieved December 14, 2002, fromhttp://voices.no/?q=content/context-and-culture#comment-620
Kenny, Carolyn B. (1989). The Field of Play. A Guide for the Theory and Practice of Music Therapy. Atascadero, CA: Ridgeview Publishing Company.
Kenny, Carolyn B. (1996). Cultural Influences on Music Therapy Education, In: David Aldridge. Papers for the Eighth World Congress for Music Therapy, Hamburg, Germany, CD-ROM, Universität Witten/Herdecke, Germany.
Stige, Brynjulf (2002a). Culture-Centered Music Therapy. Gilsum, NH: Barcelona Publishers.
Stige, Brynjulf (2002b). The Relentless Roots of Community Music Therapy [online] Voices: A World Forum for Music Therapy. Retrieved December 14, 2002, from http://www.voices.no/mainissues/Voices2(3)Stige.html
Stige, Brynjulf & Carolyn Kenny (2002). Introduction - The Turn to Culture. In: Kenny, Carolyn & Brynjulf Stige (eds.). Contemporary Voices in Music Therapy. Oslo: Unipub.
"Music Therapy by any Other Name Would Smell as Sweet" or "Community Music Therapy" Means "Culturally Sensitive Music Therapy" in Our Language
Reading Stige's article I was troubled by the reference to community music therapy as if this is a way of practicing that is a type of music therapy. My sense of what has started to be referred to as 'community music therapy' is that is a 'brand', or 'agenda' as Sige calls it, that has been inappropriately placed on some practices of music therapy for some reason known to people who keep using this term. If community music therapy means that we are sensitised to culture and context then I can't help observing that this new 'community music therapy' that we are to understand is going to become increasingly 'crucial' in the years to come according to Stige, seems to be rather like the 'music therapy' I have observed in many places and have taught for a decade (and practiced for longer). Stige is right though, teaching cultural awareness is not about learning a few words or about gross generalisations, it is about many dimensions of openness to others' experience. It is helping students and practitioners to achieve a greater understanding, and also to reflect on, their own experience of 'otherness' with reference to etic and emic perspectives.
I am not sure I see the need for suggesting that there will be a new wave of practice that will need to be branded as 'community music therapy'. I have supervised many practitioners who seem appropriately sensitised to cultural and contextual issues including the context of the family system of the patient without calling their work community music therapy. I have been to many case presentations and conference papers where music therapists from different countries seem perfectly able to respect and be sensitive to the context-bound and culturally-laden aspects of their perceptions and ways of knowing about a patient or a community group as well as their promotion of certain ways of working within communities.
I have worked with many patients and groups from non-English speaking backgrounds and I have worked with many English-speaking people who do not have Western European backgrounds. I have worked with community groups as a music therapist while seeing my work as distinct from community music and I have worked with families while seeing my work as intrinsically and entirely within the remit of the music therapy practitioner. However, I don't want to call my work or my teaching 'community music therapy' and I don't want others to think of my work that way.
As I have indicated elsewhere, I teach in a university centre that offers a one year full-time Master of Arts in Community Music. This brings me into regular contact with community musicians and community music educators and researchers. A community music practitioner in my region came past my office door the other day and we started to chat. He is troubled by the lack of identity among community musicians and the inability of others as well as the practitioners themselves to find a working definition of what they do. We began a very interesting dialogue. One of the ideas we explored in terms of identity was that community music can happen whether or not a community practitioner is present however music therapy as been defined by us as over time as an interaction which includes a music therapist, music and client or client group. In addition we discussed that it may not be imperative that the project be lead by a community musician in order to receive funding as community music. Community music is distinct and unfamiliar in every situation and the practitioner in a way reinvents the practice of community music every time they run a programme. At the same time 'community music' can have a stand-alone identity or be a brand applied retrospectively to experiences and community events with music at their centre. That is part of the nature of the work. I just cannot see the direct similarity in music therapy. I have to express my reluctance at the mix of these two approaches to working musically with people; while my respect and interest in community music continues unabated.
In conclusion, I take issue with the idea that there is a phenomenon such as 'community music therapy' that we are supposed to embrace and understand. We are qualified as 'music therapists', not 'community music therapists'. All music therapy work by its nature involves interaction with a community, therefore cultural and contextual awareness and sensitivity is required of us. This practice that we do is called music therapy and almost all parts of the world that offer training call it this. Perhaps it is a kind of 'hello' that can be recognized across the world even when it is practiced so differently in different countries. Let's keep the name and let's be proud of the name of our work.
I found Stige's column (http://voices.no/?q=fortnightly-columns/2002-jambo-means-hello-africa-syndrome) both fascinating and thought-provoking. As I continue to examine my own multicultural music therapy practice I ask this question: Can I make the same comparison to community music therapy as I do to multicultural music therapy? And in that I mean that the ideal is that we do not need to make a specification as to what type of music therapy we practice in regards to community, context, and culture, but rather it is an understanding amongst professionals and clients that our work will address such aspects of practice automatically when we say "I'm a music therapist."
My hope as both a therapist and client is that I will be given treatment that includes and addresses my role in the various contexts and cultures that make me who I am. Unfortunately, much of the current "cultural" work that is happening today is based on stereotypes and generalizations. For example, how many times can I read that Latino-Americans are have smaller personal space areas that Caucasian Americans? Or that Asians tend to show little emotion and are not as receptive to speaking about their feelings. Although it is important to understand cultural differences, we most certainly cannot make assumptions for all persons from diverse cultures based on what a book or article tells us is the "cultural norm." As a part Asian woman, I would not want my therapist making assumptions solely based on what s/he read about the Asian culture. We could study all aspects of culture, including language and music, and still not provide cross-cultural care.
In concordance with Stige, I agree that skills involving the integration of context and culture in clinical practice will be essential to music therapist qualifications. I strongly believe that music therapists must continually engage in self-reflection and self-evaluation as part of their everyday practice. Music therapists must have a vast palate of colors to paint from. If we limit ourselves to certain types, styles, or even scales of music, we will limit whom we can serve. Clients must be welcomed into our sessions without their "portrait" already painted.
If we continue to embrace the "Jambo" means "Hello" in African Syndrome (http://voices.no/?q=fortnightly-columns/2002-jambo-means-hello-africa-syndrome), we will continue to do our clients a disservice.