According to Gary Ansdell's criteria, I am a Community Music Therapist (See the essay "Community Music Therapy" in Voices 2(2) 2002.) Yet unlike Gary, I am also someone who works in a very psychodynamically oriented way. I want to comment on a few of his discussion points from this standpoint.
I work in a large UK psychiatric hospital for adults where we have just completed our third musical of the year. The latest, 'The Teaching of Edward', is a (fictionalised!) account of the young Elgar's 'discovery' of music therapy through his experiences as Bandmaster of Worcester County Asylum in the 1890s. All were written by a professor of psychiatry at the hospital.
Perhaps part of the reason this sort of work is kept 'underground' is that it engenders a mixed response. The musicals have been very difficult and almost dangerous professionally for me. An art therapist commented to colleagues about my dubious approach - especially for encouraging performance, which is what patients 'have to do all the time'. I was challenged by some colleagues on the multi-disciplinary team for breaking Day Hospital boundaries and the project was largely ignored by all but the manager and one nurse from the Day Hospital team (although it helped taking these problems of splitting to be at least partially worked through in the staff support group and now everyone is eager to see the video!).
Even my Nordoff-Robbins-trained colleague was deeply uneasy about rehearsals for a long time. The Day Hospital did not include the rehearsals on their leaflet, programme or posters even though we had a large number of participants sometimes twice a week. (Even the main protagonist, a long-term inpatient said nervously, 'It's a bit breaking of boundaries isn't it, singing with staff I mean?' I replied, 'Yes, it is' and he paused, then suddenly his eyes lit up and with a grin he said, 'Oh yeah! It is isn't it?')
So yes, some of us do work across the continuum - I'm not sure how many of us - but personally, I have found that it has been a very difficult experience to enthuse about amongst colleagues - verbally or on paper.
Practically, I could not have run rehearsals without my expertise at engaging and managing (and having some dynamic insight into) a frequently unwieldy group of staff and patients. We had doctors singing with the patients they'd sectioned, who were acting alongside managers who'd chaired their tribunals. It took all our experience as therapists (two music, one drama, one occupational) to keep everyone in the room!
Also, the material that came up in the songs and the play (1890s long-stay asylum etc - themes of chronicity, inprisonment, institutions, sanity and insanity) got people talking about their experience of mental illness, of performing, and of staff-patient dynamics, and to reappraise their perception of themselves as 'always ill' and staff as 'always sane'.
Even though it was precomposed, improvisational approaches to the music and the words were encouraged by me, although they were met with some resistance from the staff. It was 'therapy' partly because the rehearsals were as important as the performances (although it was interesting to see how some people were liberated by the performance itself, whilst others did not wish to perform, just rehearse). The rehearsals would sometimes go on for two and a half hours - amazing given the level of disturbance of many of the cast.
Lastly, it was crucial that, as far as possible, the core team involved with the project were 'available' as therapists, and that we communicated and took time together to think about the work. Also, follow up has been important - both in terms of reflection sessions around the video, and by taking on those participants who wish to continue to work in individual or group music therapy.
This approach, of being an 'available resident musician therapist' does not sit too uncomfortably with recent and not-so-recent trends in psychoanalytic theory - most obviously of course, with the idea of the integrative therapeutic community. Janssen, in 'Psychoanalytic therapy in the Hospital Setting' (Routledge; 1987) writes:
'Psychoanalysts working in hospitals used to ignore the group dynamic element of clinical life, taking a highly restrictive view of their clinical remit. This is no longer feasible.there are a growing number of inpatient analysts willing to concede the artificial nature of the divide between therapeutic and social space. Every day they are confronted with the interweaving patterns of hospital life; little by little the idea is penetrating that ward life and analysis are not perhaps so inimical to one another after all.' (p 40)
The problems I had anticipated around therapy patients attending rehearsals did not occur. (Neither did any of my patients stop attending therapy - which had been a fear of mine.) Rehearsals were mainly attended by a group of chronically and severely mentally ill patients. My feeling was that the institution is very important for a particular type of patient and the musicals acknowleged this REALITY (so often 'outside' the music room in individual work) and challenged from within the infantilising and pathologising dynamics that play a role in preventing people getting better.
In conclusion, then, I think that Gary Ansdell's call for a reappraisal of the current agreed paradigm is interesting and timely. But it need not be restricted to music-centred work, nor indeed necessitate a shift away from analytically-informed practice. I would be excited to see this debate continue around what the parameters of a psychodynamic community music therapy model might need to be - the implications of 'product' and 'performance' for example. How can we be alive to the demands of the social/cultural/institutional context without compromising our therapeutic effectiveness?
On the Politics of Community Music and Music Therapy: The Same or Different?
Pavlicevic might seem to want to close the discussion, and appeal directly to practice. A surprising move, I would have to say, coming from a representative of those now wanting to redefine the field of music therapy. But Pavlicevic points out that the discursive fields themselves are "hugely political", and of course she is right about this. This is probably a main issue, if not the main issue here. Because what is proposed, is done by people who have considerable defining power within the field, as highly profiled practitioners, educators, authors, journal editors, and researchers, all at the same time. People outside of this "circle of power" within the field might feel disempowered, finding that their own views on the matter have become marginalized. And this is maybe what the "confusion" is about, not only having difficulties in understanding what is said, but also finding it difficult to present one's own point of view, having one's own voice actually heard. The specifically political aspect of making a plea for "fuzzy recognition", proposing a "non-definition", or even presenting an "anti-model" could - critically considered - be seen as applying manipulative argumentative devices for having people with objections effectively "silenced". - Thus considered a matter of politics, in the sense of having to do with distribution of power and conflict of interests, within the discipline itself.[1]
Still I would like to elaborate somewhat more on the important issue of politics, because this is also crucial to the matter of what "community music therapy" is about, and which has been much stressed too. The question for me, particularly, when defining a practice as therapy, which the people receiving it, or even their representatives, do not consider to be so, is this: In who's interest is it to define it this way? - The "client" or the "therapist"? This is not merely a theoretical matter, but certainly a political one. There has been some discussion regarding the health services, as to whether or not the interests of professions are in the best interests of the clients. And concern has been raised as to whether it is in the best interest for all to have the population to an ever larger extent become defined and treated as "clients". One might ask then: Where is "community music therapy" actually placed within this political topic of concern?
Political awareness has been called for by several writers. Even Ruud, for some time now, has propagated the relevance of a political perspective on music therapy (see Ruud 1998). Recently Michel Forinash, in a column here in Voices, sparked off by the US presidential elections, asks a series of very relevant political questions related to the field (Forinash 2004). Randi Rolvsjord has quite recently published an article in NJMT, in which she, on the background of a feminist stance, considers therapy practice itself to be a political discourse (Randi Rolvsjord 2004). What I would like to draw attention to here is a difference between the fields of community music and music therapy, regarding their political implications. Community music has, as Ansdell (2002) makes clear, taken a stance politically to be placed outside of established institutions. In communities, where people live, oftentimes working with people who are disadvantaged. Music therapy on the other hand has been very much concerned with becoming included within established institutions in society. Questions of politics consequently become somewhat different for these two fields of practice.
If the matter is about becoming accepted, then a whole series of issues come up. Like Evidence Based Medicine. And cost-benefit analysis. - And how these might be related. Is a higher score on in a cost benefit analysis what will ensure that music therapy will be offered to patients? That is to say as long as, on the one side, public spending decreases, or, on the other, private profit increases? Is this the development that music therapy should strive for? Music therapy being offered only to the extent that insurance companies, according to established documentation, make more money - or alternatively, that public spending gets reduced. Is this in the long run the sole measure to go by? Or should other measures, other scales of value be set up? Maybe what is needed is rather turning it the other way around, a different politics inside established institutions. Maybe music therapy should raise its political flag as value-based. - Addressing questions of human dignity and care, rather than, merely, cost-efficiency and profit. It might be high time for more politics, both inside and outside of established institutions.
On the other hand the political question is: Why take "therapy" into community? Why turn practices that are outside of the institutions into therapy. Why define the roles between participants as being between "therapist" and "client" in some way. - Explicitly or - if this is at all possible to claim - implicitly. To repeat: In who's interest is it to be defined this way? My question then is as to whether this is, not only theoretically, but also politically sound.
I do want to make it unequivocally clear though, that community music practice, involving music therapists or not, and if involved, making a qualified difference, has my full support. And also bringing therapy "proper" outside the limits of individualized treatment within the confinement of a therapy room, when called for, or as an alternative route of practice altogether. I furthermore want to state that the discussions are bringing out new aspects and potentials of practice, not least though all the examples now being reported. The "discourse" is what I have been addressing, discourse in the sense of people talking together about matters they care about, to increase understanding, to become better prepared to act.
Note
[1] I have to grant though, that this "interpretation" is not necessarily true. It may be difficult and rather challenging to deny, once put forward, but actually even harder to substantiate. I do not really want to claim it. What I do think is that the discussions are very much about politics of discipline, and that this naturally does imply differences of power, and of interest.
References
Ansdell, Gary (2002). Community Music Therapy & The Winds of Change. [online] Voices: A World Forum for Music Therapy. Retrieved February 10, 2004, from https://normt.uib.no/index.php/voices/article/view/83/65
Forinash, Michel (2004). Music Therapy and Politics- Do They Mix? [online] Voices: A World Forum for Music Therapy. Retrieved February 10, 2004, from http://voices.no/?q=fortnightly-columns/2004-music-therapy-and-politics-...
Rolvsjord, Randi (2004). Therapy as Empowerment: Clinical and Political Implications of Empowerment Philosophy in Mental Health Practises of Music Therapy. Nordic Journal of Music Therapy vol. 13(2), 99-111.
Ruud, Even (1998). "Pathways to Music Therapy". In Bruscia. Music Therapy: Improvisation, Communication, and Culture. Gilsum, NH: Barcelona Publishers.
Community Music Therapy: Anyone for Practice?
Like many, I have been following the Community Music Therapy moderated debate in VOICES, but unlike some, perhaps, I have felt somewhat perplexed: all this talk about what's been written, defined described, explained - has left this empiricist and practitioner somewhat uncomfortable and dissatisfied, particularly since, as I understand it, Community Music Therapy - apart from being something we talk about (or, to put it more elegantly, a discursive field) is also something that we do.
In a bid to address the absence in this debate by eminent theorists in our discipline, I would like to recount a recent experience, which I understand as Community Music Therapy in action. First I shall narrate it, and then comment.
...........
At the end of 2004, I was approached by a friend to ask whether I would be willing to 'do some music' at the end of year AGM (Annual General Meeting) of the Executive Board of BOHARENG: a Women's Spirituality Centre in Johannesburg, which is registered as an NGO (non-governmental organization). First would be the business part of the meeting: the annual report, the accounts, plans for 2005, and a closing discussion. There would then be a tea break, and then 'some music'. 'Anything special?', I asked; 'it is up to you, for about 90 minutes', I was told. I arranged to be a part of the entire morning, to get a sense of the organization, their business, and the people present. I brought along a few instruments, my guitar, a CD player, some CDs - hoping that by tea-break I would receive some divine inspiration as to how to do some music together. There were about 14 people there, ranging in ages from 30 to 70 yrs; some were outgoing and vociferous during the meeting, some were dreamy, some intense, and there was a lot of laughter and teasing, especially when the accounts were discussed. (At this point I realised that I would be offering to do this free of charge). During tea-break I had a thought that doing a song might work. The group felt lively and fun enough to do this, and they seemed to know one another well.
After tea, we did a game of saying whatever words came to mind, to do with the morning, and with BOHARENG. The words, scribbled onto a large sheet of paper on the wall, included, 'joyful, hard work, women, money, building, playing, planning, cooking, hot weather, friendship, creativity.. We then together did a quick clustering of words, and decided on four BOHARENG themes. The group was then divided into four, with each tasked to develop a four-line verse on one of the themes. One of the groups had to develop a 'refrain', with the other three did verses. They had 20 minutes to do this. I strolled around the room while they worked, helping with phrases and words (a number of people were not English speakers although English was the lingua franca), and while I listened, I began putting together a tune, strumming my guitar, walking around, trying out the bits of phrases with the various groups. .. the morning ended with a wild and raucous performance and dance of the song 'Bohareng! Bohareng! We are the women of Bohareng! Wild and creative, quiet and still, together we listen to. Bohareng! Bohareng!', and so on'.
Much laughter and thanks all round, and that night, as I sat in the plane headed for London, I kept hearing and seeing in my mind some of the old women singing and dancing like dervishes....
..............
So here was an event to which I was invited as someone's music therapist friend, to 'do a little music', with a group of people with common values, some of whom I knew through social networks. There seemed to be an implicit understanding in the request that doing music was a good thing - something that would be fun, creative; an engaging way to celebrate the end of the year, their work, and their friendships. Music would in some way bring all of these things together.
I now consider some aspects of the event, without attempting to 'fit' into a neat Community Music Therapy definition (or even contributing to it) - as befits the notion of an anti-model (Ansdell 2002, 2003, Stige 2004); and the limitations of defining (Ansdell 2002, 2004). If I choose to use some of some of the Community Music Therapy anchors suggested by Pavlicevic & Ansdell, (2004) and by Stige (2004), then I could write about this event as music-centered - in the sense that the group musicing generated a sense of group empowerment, creating a song that was very much about being women, about alternative spiritualities, and about enjoying their sense of belonging and together creating BOHARENG. If I were to consider this event as ecological - both in terms of sites and boundaries (Pavlicevic & Ansdell 2004) and in terms of responsiveness of practice (Ruud 2004), then I would talk about the context being an everyday one, happening in a large city, in the daily business of life. The request for 'some music' was made through an informal social network, and my response was to an agenda suggested by BOHARENG - which included an Annual General Meeting and a presentation of accounts and other organizational 'business'. In my role as a community music therapist, being part of the entire morning felt comfortable, inclusive, and also enabled me to consider various options for 'some music'. This grew naturally out of the morning's 'business'.
Another Community Music Therapy anchor is that of renegotiating our identities and roles (Pavlicevic & Ansdell 2004), and here is a context in which, as the music therapist, I was also someone's friend, the sister of so-and-so, the patient of someone's GP husband, and a former student of someone else. A lot of the tea-break time was taken up in catching up on gossip, and these multiple social identities and relationships from other life spaces were included in the event, rather than being left at the door. In music, the women generated and performed both their individual and group identity (Ruud 1998), transcending their organizational roles (of being the Chair, secretary, treasurer, and so on) (I didn't know I could dance like this. I didn't know I could write a song.), and also performed - and generated another collective identity for BOHARENG (..I didn't know we were wild women.) . Their experience through musicking seemed to be about experiencing their organizational roles and relationships in a different way. All of us, it seems, renegotiated our personal and professional roles during this event.
Finally, the anchor of 'assumptions and attitudes' (Pavlicevic & Ansdell 2004) returns us to this business of 'talking about' the work we do - which after all, is what this moderated discussion seems to be about. I'd like to suggest that an ecological practice draws from, and contributes to, an ecological discourse. In other words, in talking about this event, it would seem inappropriate to draw from a more 'generic' and conventional or historical music therapy discourse. It would seem inappropriate to reframe it in terms of health, of the group as a system, or of group dynamics: this would feel like a compromising of that event - as negotiated by all those wild dancing women, in that place and at that time. It does, however, seem appropriate to talk about it in terms of roles, organizational identity, growing community, since this is how that group talks about itself. No, I am not suggesting that we always need to talk the same talk as the people and places with whom and where we work - but I am suggesting some ecological alertness to discourses we generate - assuming that we are interested in these being connected to practice.
To conclude - Community Music Therapy is something that happens in, with - and hopefully transforms - socio-political 'real life' contexts, and also individual experiences within these contexts. Of course, discursive fields are also 'real life', and hugely political. But I can't help wondering whether, in debates such as these, we are at risk of creating stories about stories, stories for their own sakes, at the expense of some very work that seems to be happening somewhere outside these discussions.
References
Ansdell, Gary (2002). Community Music Therapy & The Winds of Change. [online] Voices: A World Forum for Music Therapy. Retrieved December 8, 2004, from https://normt.uib.no/index.php/voices/article/view/83/65 ( A revised version is published in Kenny, Carolyn B. & Brynjulf Stige (eds.) (2002). Contemporary Voices of Music Therapy: Communication, Culture, and Community. Oslo: Unipub forlag).
Ansdell, Gary (2003). Community Music Therapy: Big British Balloon or Future International Trend? In: Community, Relationship and Spirit: Continuing the Dialoge and debate. London: British Society of Music Therapy Publications.
Pavlicevic, M. & Ansdell, G. (Eds.) (2004). Community Music Therapy. London: Jessica Kingsley Publishers.
Ruud, Even (1998). Music Therapy: Improvisation, Communication and Culture. Gilsum, NH: Barcelona Publishers.
Ruud, Even (2004). Defining Community Music therapy [online]. Voices: A World Forum for Music Therapy, Moderated Discussion. Retrieved December 10 from http://voices.no/?q=content/debating-winds-change-community-music-therap...
Stige, Brynjulf (2002). Culture-Centered Music Therapy. Gilsum, NH: Barcelona Publishers.
Stige, Brynjulf (2004) On Defining Community Music Therapy. [online] Voices: A World Forum for Music Therapy. Retrieved January 3 12, 2005, from http://voices.no/?q=content/debating-winds-change-community-music-therap...
Fusing (or Confusing?) the Terms "Music Therapy" and "Community Music": A Plea for Clarification
A new round of discussion has come up recently, on the concept of "community music therapy", and what this means and does not mean, and how it can, and cannot be defined.
The issue seems rather confusing, and this in itself, apparently, is how it is supposed to be, according to the proponents of this allegedly "new" point of view. A "fuzzy recognition" rather than "final definition" is required, according to Ansdell (2004).
Poor Wittgenstein
Reference is made, once again, to Wittgenstein, who was concerned about the limitations of too exact definitions. Wittgenstein, of course, started out trying to sort out once and for all what could be said about the world, and what could not be said, and what one therefore had to be silent about, in his famous Tractatus Logicus. Giving up on this exalted task, and turning towards meaning in language as found in the manifold ways it was actually used, what Wittgenstein most of all wanted to avoid, after all, was confusion. His obsession with language was all the time geared in that one direction, of trying not to get entangled in the myriad problems and questions that confused language caused, in so many philosophical debates. I do not think Wittgenstein, pointing out that it sometimes is not possible to get clear cut definitions of all terms - in a clear opposition to views on the status and usefulness of definitions within logical positivism - should be taken as giving a licence to create confusion by mixing terms in various more or less congruent ways.
Confusion is hardly some kind of desirable or particularly interesting state in itself, like wandering around in a thick fog, (in which you might get lost); though at times it may be inevitable. Being confused is rather something you would want to get out of. And certainly if someone complains about being confused, or that something said seems confusing, this is not in itself a reason for reproach. In a debate claiming confusion as the "right thing", and being on "your side", if someone should have difficulties comprehending what you have just said. well, I don't think Wittgenstein is the one to put on the stand as a witness here, for support.
A Systemic Approach
In attempts to clarify, Ruud (2004a, 2004b) has presented some possible objections to the term Community Music Therapy (Ruud has written a more elaborate account in the Norwegian journal Musikkterapi 4, 2004), and proposes to regard this kind of practice as systemic. Responding to this Ansdell also recognizes this as a crucial feature. Systemic therapy, of course, is not something new, it has been used for instance as an approach in which the whole family of the client is actively involved in the therapeutic process. Music therapy though, offers some interesting features regarding systemic therapeutic work, not the least the aspect of performance, as Ruud underscores. Performance makes possible relating the client actively to an even wider setting. In other words, the performance aspect of musicking may offer some rather unique opportunities for a systemic approach to therapy. Without considering this as a "final" definition, it clearly points to a practice of music therapy. And quite seriously, why not just call it this: Music therapy? Whether it be systemic or some other approach.
Not getting too engrossed in defining may be a sound advice, and not expecting too much from making definitions likewise. But is not the issue of debate here precisely this, a defining or "redefining" as Stige (2002, 2004) has put it, of music therapy? I mean, who started it? "Community Music Therapy" proposed as a new term, within a new definition of the field of music therapy as a whole. Is not this maybe why people become concerned and engaged (or upset even), because definitions after all contribute to establish identity? Not only for oneself, but also towards others, as Ruud appropriately reminds of.
A "Hidden" Therapy
Here Stige's distinctions between the levels of practice, discipline and profession may serve a purpose. Is the practice of a professional music therapist, having studied the discipline of music therapy, necessarily music therapy? This depends on the setting. The question is: Does a music therapist, as a trained professional, working within a "community" of some sort, thereby practice music therapy? Clearly not. There has to be some kind of contract between those involved about this being therapy for it to be therapy. And here I am not talking about an essentialist definition, but of daily usage. If the people involved do not consider that they need, or want, or that they are receiving, or paying, for music therapy, how can you actually argue that this is what they are getting? Or is the brand of "community music therapy" something different? - Therapy in a sense beyond daily usage, which people as yet do not themselves realize? And nor society at large.
Distinguishing Between Community Music and Music Therapy
As Jane Edwards (2002) points out, there is already an established practice and a discipline, with training programs for professionalisation, of Community Music. The dimension of community is nevertheless also present within in music therapy, and has clearly been all along. Edwards still wants to keep the terms music therapy and community music apart, and I agree. Why mix these two? What is actually some kind of "community therapy" - music or otherwise? Is this at all a meaningful term? (- And please, do not say that being "meaningful" here is really not what should be required.) A music therapist may work in a community setting, but this does not by itself make it some kind of "community therapy". - Maybe not even "therapeutic community music". But if it is not therapy, in any generally recognized way, ("fuzzy" recognition left aside), does this make it less valuable? I think not. Could not a trained music therapist work in a community music setting, doing a great job at just this, and not "define" it as therapy, whether or not anyone else actually would agree with this?
Multiple Approaches
In other settings of practice the contract by which the music therapist works may naturally imply that it is therapy. Stige (2004) holds that a main characteristic of what (of late) has been termed community music therapy is that it is music centered, which also Ruud emphasizes. Ansdell poses an opposition to the "consensus model", which is psychodynamically oriented music therapy. It seems the terms used are really covering that old schism of psychodynamic versus music centered therapy. Why not just accept that one will not be subsumed within the other? From both sides. Not claiming "exclusive rights" to therapy from neither a psychodynamic, nor a music centered position. These different approaches will have different assets and qualities to offer, as therapy. The challenge, I believe, is to embrace multiple approaches to music therapy, not attempting to give new, all embracing essentialist definitions or redefinitions, designed to include or exclude one or the other, or trying to establish hegemony of one at the expense of others.
Developing a Conception of Therapy
Still each will have to develop its own conception of therapy, and if psychodynamic therapy has a tradition to build upon, music centered approaches still have a way to go to establish their own frame of reference. Not so much definitions as a conception, a theory of therapy is needed, for a music centered approach, within a systemic oriented practice, following Ruud's suggestion, and which I think is actually to quite some extent missing. I think it would be better to start focusing directly on this - a "missing link" in the pattern which connects, if you like, to enhance the understanding and further the development of these kinds of music therapy practice.
References
Ansdell , Gary (2005). Community Music Therapy: A Plea For "Fuzzy Recognition" Instead sof "Final Definition". [online] Voices: A World Forum for Music Therapy. Retrieved January 13, 2005, from http://www.voices.no/discussions/discm4_07.html
Edwards, Jane (2002). Debating the Winds of Change in Community Music Therapy - #2. [online] Voices: A World Forum for Music Therapy. Retrieved September 15, 2004, from http://www.voices.no/discussions/discm4_02.html
Ruud, Even (2004a). Defining Community Music Therapy. [online] Voices: A World Forum for Music Therapy. Retrieved December 12, 2004, from http://www.voices.no/discussions/discm4_04.html
Ruud, Even (2004b). Defining Community Music Therapy II. [online] Voices: A World Forum for Music Therapy. Retrieved January 3 12, 2005, from http://www.voices.no/discussions/discm4_06.html
Stige, Brynjulf (2002). Culture-Centered Music Therapy. Gilsum, NH: Barcelona Publishers.
Stige, Brynjulf (2003). Elaborations toward a Notion of Community Music Therapy. Faculty of Arts: University of Oslo.
Stige, Brynjulf (2004) On Defining Community Music Therapy. [online] Voices: A World Forum for Music Therapy. Retrieved January 3 12, 2005, from http://www.voices.no/discussions/discm4_05.html
Community Music Therapy III
It seems that Gary Ansdell and I do not disagree so much about the nature of CoMT - both "performance" and "systems thinking" seem to resonate well with Gary's understanding. His own way of "defining by giving examples" or "prototypes" does not seem to contradict my attempt at definition. Concerning the role of performance, I certainly did not "add performance", but I write about "performance within a systemic perspective". Therefore, I find Gary's elaborations on "network" and what he calls "Woods' matrix" quite relevant in understanding how perfomance is linked to systems theory. Thanks Gary. If not definitions clarify, indeed this discussion does, at least to me. And, of course, definitions will never come even close to a corresponding description of a "real CoMT" existing out there somewhere. My effort was more interpretative, tracing some of the salient features of CoMT which makes it distinct from other approaches or discourses within our field.
I am more concerned with Garys attitude towards definitions in general - or rather, I suppose we have taken different positions within the field when arguing. I agree with the positive ideas that may come out of "fuzzy recognition" and how this can contribute to the development of the discipline of CoMT or MT. But if we are discussing music therapy as a profession or practice, being fuzzy is not a good way to communicate with clients, parents, health authorities or students of music therapy?
Community Music Therapy: A Plea For "Fuzzy Recognition" Instead of "Final Definition".
A few months ago when I was in Oslo Even Ruud told me that he'd come up with a good definition of Community Music Therapy. I was intrigued. In his recent Response, "Defining Community Music Therapy" Even remarks that watching the field of CoMT grow in the last few years has been an interesting study in the construction of a new discourse (which may or may not say anything new about practice). He suggests that if it does say anything new it is a revalidation of performance within music therapy, on which grounds he proposes the following new definition of CoMT:
I'm happy that Even has got this particular discussion section going again, and as usual, his view is tempered by a wryness about passing fashions within the discipline. But I find myself disappointed that even Even has made as his contribution to the debate an attempt to define CoMT. As such his comments are characteristic of many in the previous year who are trying to get to grips with this Community Music Therapy thing by attempting to arrive at a final definition - rather like the taxidermist pinning the butterfly to secure it in a glass case. Typical definitional strategies are either: (i) If it's x it can't be y, or (ii) Out of w, x, y, z it's 'really' z. I realize that my disappointment is not just with Even's particular definition of CoMT (which I'd like to partially argue against below), but also with this definitional approach per se. These two aspects I'd like to address in this response[1].
Just Add Performance?
Firstly, is not Even's characterization of CoMT as a 'performance-oriented' approach a good one? After all, in a recent research session on CoMT[2] I gave a presentation in which I claimed that 'performance' was indeed a 'core concept' of CoMT. In this I presented some work by a music therapist in London who works with a group called "Musical Minds", made up of people living with chronic mental health problems. They employ the music therapist to help them (musically and socially), but do not define the group as 'music therapy' as such. Musical Minds consists both of the process of meeting weekly to sing together, but also in order to rehearse for occasional performances, which clearly have psychological and social benefit for all. Is this project not 'typical' CoMT? And isn't performance its defining feature?
Yes, and no. Somehow even for this group (which may seem a classic performance-based project) this characterisation feels too simple. Having researched it closely now I rather think that it is in the relationship between the performance and non-performance aspects of the group that its identity (and effect) lies. The therapist also works skillfully with individuals, parts of the group and with the context and surrounding structures of the local community. It's somehow the network of these various interactions that characterises the group. This of course has many parallels to pioneering music therapy - particularly Nordoff and Robbins' work in special education settings[3].
If you look through the recent book Mercedes Pavlicevic and I edited (Community Music Therapy, 2004) you'll find that all the clinical projects documented there do indeed include performances, or at least public or semi-public musicing (and as such stand out from much conventional music therapy in the last 20 years). However, this is not necessarily to say that they are best defined as "just add performance" music therapy, or that ' reflexive performance' is their single 'identity element'. This would be rather like defining GIM as 'reflexive listening to recorded classical music'. Surely exactly the same point applies to both these traditions of music therapy: is it not the relationships between the various aspects of practice (and their accompanying theoretical components) that characterizes them - not extracting one single functional element?
Networks & Matrices: "the Pattern Which Connects"
Even also mentions in his Response that perhaps a more explicit metatheoretical perspective would help CoMT, and that systems theory would clearly be the appropriate option. I agree: we could certainly give more emphasis to this, and connect recent developments more with the pioneering thought of those 'wise colleagues' Even mentions, such as Caroyn Kenny (1985, 1989) - or, I might add, David Aldridge (1996, 2004) - both of who taught us long ago to view music therapy from a systemic perspective. More recently, however, it seems to me that this perspective is also inherent in Bynjulf Stige's 'culture centred' approach to music therapy (Stige 2002, 2003), where he often writes of a social or musical 'ecology'. However, perhaps a more explicitly systemic modeling of CoMT could indeed help clarify its aims, practices and assumptions.
We are of course increasingly immersed in varieties of systems thinking now, through ecological or technological discourses. Recent accessible accounts such as Fritjof Capra's two books, The Web of Life (1997) and The Hidden Connections (2003), clearly reflect this. Capra's latest book, on what he calls a 'systems view of life' is also characteristic of recent trends to emphasise a systemic interpretation of social and cultural life, where traditional thinking - about hierarchies of material objects and structures - shifts towards communications, relationships, contexts, patterns and processes. Instead of just fixed things and structures, we have fluid nodes, networks and links. As Fritjof Capra explains:
CoMT is I think giving some good examples of socio-cultural networks, where it's the relationships between that matter (what Gregory Bateson called "the pattern which connects"). The relationships between.notes, people, institutions, cultures.,an idea that will probably remind many of you of Christopher Small's argument in Musicking (1998) - an interesting link to systemic or ecological thinking[4]!
On a practice level music therapist Stuart Wood's pioneering project reflected these ideas beautifully (see Chapter 2 in Pavlicevic & Ansdell, 2004). He developed a CoMT project for patients rehabilitating from neurological damage, which was characterized by a matrix[5] of different musical opportunities (or what Tia DeNora would call musical affordances) tailored to the stage and needs of their rehabilitation, but also of participants' musical interests and abilities. These possibilities included traditional 1:1 music therapy, group music therapy, instrumental learning, music workshops (eg jazz piano, African drumming), and included not only patients but also staff and carers [see Fig 1].
Figure 1: 'Woods' Matrix'
There are consequently multiple potential pathways between these nodes, that any individual or various subgroups of people can follow, appropriating various musical/social experiences as they travel. One of the nodes is performance, and it is indeed an important node. But the 'matrix model' makes it clear that performance is not central, but related to all the other nodes in a fluid way (i.e. the role or presence of performance may shift, wax or wane at different times). It is the multiple relationships between which are modeled by the matrix that characterizes this music therapy (and its effectiveness).
A systemic analysis of this project would emphasise these aspects of connectedness, relationships and context, and the nature of the connection between parts and whole. It would show in particular, as Capra suggests, how:
So any definition of such a CoMT project, or perhaps of CoMT as a whole, will probably need to take this axiom of systemic thinking into account: the whole is prior to the parts. The traditional way of establishing the identity of something through describing a hierarchy of the parts of a system ('this is more fundamental than that') is challenged by systems thinking. Instead we may have to look at the whole system and say: this pattern is what connects.
So I'm not sure Even can both eat his systemic cake, and also satisfy his definitional hunger!
Does Defining Clarify?
But anyway. why define? Does the 'craving for clarity' really help as much as we think? I remembered that Wittgenstein had some useful things to say on the subject.[6] In his later work (in the Blue & Brown Books, and in the Philosophical Investigations) there are a number of nice passages tackling the question: Does defining clarify? Wittgenstein is arguing here against the positivist tradition of analytic philosophy:
Wittgenstein shows how, in normal everyday language (rather than in 'analytic' philosophical language) we often use vague, 'fuzzy' definitions - but that these actually work quite nicely if seen as indicators of what you might do, rather than precise analytical descriptions that have been taken out of a specific context or use. We do not necessarily improve communication by keep sharpening boundaries and definitions separately from contextual use. Wittgenstein gives the example of St Augustine asking "What is time?". The saint famously tripped himself up when he abstracted the phenomenon of time from its normal place - say the instruction he gave his cook as to when he wanted dinner! Wittgenstein summarises the problem with these definitional 'what-is?' questions:
A reason why definition doesn't necessarily clarify is that defining one term in a 'language game' leads to having to (re)define another, and you realize that separately from the whole communication there are many 'fuzzy' terms. Seen from an analytical or positivist perspective this is a bad state of affairs! But again Wittgenstein makes an interesting point:
What, then, are the implications of all of this for the matter in hand: whether it helps to try to define CoMT more, and whether some of us are being disingenuous in our reluctance to do just this. Two key aspects here are:
Beyond 'Definition Anxiety'?
VOICES itself is a fascinating example of the network metaphor in relation to these questions. What can we learn from how the CoMT construct has been variously and rather rapidly appropriated by many different individuals and groups around the world? What does this tell us? Partly I think something interesting about disciplinary movements within our time - based as they are on globalising forces such as the web[7]. But perhaps this is just a speeded up process of conceptual affordance and appropriation: local uses of global discourses. This surely argues against attempts to find a central definition, to draw boundaries for everyone, everywhere.
Do I have any alternative to 'definition anxiety'? Well, Wittgenstein had an interesting suggestion: that instead of abstract synoptic definition of a phenomenon (achieved by hovering above it), we instead make a horizontal, 'on-the-ground' characterization: in terms seeing the pattern of it in everyday use, within its local contexts (which themselves shift constantly). This is a form of understanding by seeing what everyone actually already sees, but then emphasising its key elements so the pattern really stands out. So instead of saying 'the central defining element of CoMT is either x, y or z' we instead look at how the pattern of its elements is rearranged in new relationships within any given context. So CoMT is not defined by anything new, or anything 'particular' - but by a new arrangement of known elements: in short, a new pattern (or, perhaps to avoid this also sounding too fixed, new patterning within a specific context, or need, or use).
What such a new pattern requires is not then definition but pattern recognition. We might call this fuzzy recognition. Whether there "is" any such thing as 'Community Music Therapy' is then largely beside the point! The idea is not to reify some object called 'CoMT' (just as the idea of the term musicing is not to turn a process into an object). Rather, 'fuzzy recognition' can perhaps serve well enough as a guide to action, reflection, comparison, elaboration, recontextualisation, transformation, improvisation. in short, as recognition of what Gregory Bateson called the pattern which connects.
Notes
[1] Aspects of my response here also relate to the more recent responses to Even's piece by Brynjulf Stige (December 20, 2004) & Even's counter-response (December 30, 2004).
[2] This was the November 2004 London meeting of the Sandane/Pretoria/London International Music Therapy Research Collaboration, "Music Therapy in Late Modernity", led by Brynjulf Stige & funded by the Norwegian Research Council. Partial Project 2 is an exploratory study of Community Music Therapy in Norway, Israel, South Africa & the UK.
[3] In both Therapy in Music for Handicapped Children (1971) and Music Therapy in Special Education (1975) Nordoff & Robbins give descriptions of musical performances and 'plays with music'. These were usually public, and very much in the 'theatrical' convention: they talk about rehearsals, 'the cast', costumes, programmes for the audience, and the psychosocial benefits of these occasions for the children.
[4] Another interesting link is the recent uses of ecological psychology by music psychologists identifying a musical phenomenology which is reciprocally constituted in relation to both the ecology of the environmental affordances and by the projects (appropriations) of actors (see Ansdell, in Pavlicevic & Ansdell 2004).
[5] A matrix being a totally connected form of a network, which could be more informally organized.
[6] Brynjulf Stige mentions some of the following argument too in Culture Centred Music Therapy (2002).
[7] Again, See Stige's thesis (2003) for a nuanced version of this argument.
References
Aldridge, D. (1996). Music Therapy Research & Practice in Medicine. London: Jessica Kingsley.
Aldridge, D. (2004). Health, the Individual, and Integrated Medicine. London: Jessica Kingsley.
Capra, F. (1997). The Web of Life: A New Synthesis of Mind and Matter. London: Flamingo.
Capra, F. (2003). The Hidden Connections: A Science for Sustainable Living. London: HarperCollins.
Kenny, C. (1985). 'Music: A Whole Systems Approach'. Music Therapy, Vol.5, No.1, 3-11.
Kenny, C. (1989). The Field of Play: A Guide for the Theory & Practice of Music Therapy. Atascadero, CA: Ridgeview Publishing Company.
Small, C. (1998) Musicking: The Meanings of Performing & Listening. Hanover, NH: Wesleyan University Press.
Pavlicevic. M. & Ansdell, G. (eds) (2004). Community Music Therapy. London: Jessica Kingsley Publishers.
Ruud, E. (2004). Defining Community Music Therapy [online]. Voices: A World Forum for Music Therapy, Moderated Discussion. Retrieved December 15 from http://www.voices.no/discussions/discm4_04.html
Stige, B. (2002) Culture-Centered Music Therapy. Gilsum, NH: Barcelona Publishers.
Stige, B. (2003) 'Elaborations towards a Notion of Community Music Therapy'. Unpublished Phd thesis. Faculty of Arts, University of Oslo.
Wittgenstein, L. (1958/69) The Blue & Brown Books. Oxford: Blackwell.
Defining Community Music Therapy II
If community music therapy is a subfield of music therapy, as Stige writes, its defining characteristics must be different from those of the mainfield as well as delimited from other subfields. Stige highlights three such aspects, its ecological character, how cmt is music centered and how it is value driven. Concerning its ecological character, we seem to agree, although I chose "system theory" as an over-arching theory in order not be kept within a narrow frame, to use Stige's own rhetorics. Concerning the notion of being music centered, I find that cmt have to share this with many other approaches within the fields of music therapy, and as such it is to me not valid as a defining characteristic of cmt. The same holds for "value driven", since I cannot see how it is possible to do therapy without values. If Stige means that cmt is driven by specific values, for instance "social change", as he suggests, I can see his point. Although I would then ask how this is compatible with a cmt which advocate "communal singing"?
Stige prefers cmt to be music-centered rather than "performance-based" in order to keep the field open to many kinds of musical activites. i.e. listening, singing together or improvisation. My point is that in cmt all these apporaches are valid, but they need to be taken into a context of performance in order to be negotiated within the larger social context. This is because, to me, the essence of cmt lies in the use of music to negotiate the space between the private and the public, the client and the institution/other staff, or the client and the community. Without this negotiation, there is no cmt. Group listening, for instance, becomes group GIM if this space is not negotiated. I therefore still maintain my definition: "Community music therapy is the reflexive use of performance based-music therapy within a systemic perspective." Maybe that "reflexive" should not only inluce an awareness of cultural/contextual matters, ethical concerns for the client/therapist relationship, but also those specific values Stige mentions.
On Defining Community Music Therapy
"What is going on here?"
This is the opening question of Pavlicevic and Ansdell's (2004) book Community Music Therapy. Even Ruud's recent contribution to the Voices discussions about community music therapy seems to me to be written as a response to this book and to the fact that there is no definite definition of community music therapy given in it.
Ruud writes:
I agree with Ruud that the increasing use of the term community music therapy invites us to discuss what the concept of community music therapy could be. In this situation, a contribution from a veteran scholar such as Even Ruud is of course very welcome, and I will try to develop a response to it, after haven given it a context.
Why any Definition in the Garden of Trees and Baloons?
It could be argued that the whole business of defining community music therapy is somewhat suspicious, since a) community music therapy is about sensitivity to context and therefore must be defined in context, and b) the discourse on community music therapy is only beginning to develop, so any definition runs the risk of narrowing things down before the dialogues have even started.
Personally, I welcome new definitions of community music therapy, since objection a) already in itself includes an implicit definition and since my response to objection b) is that new definitions could also operate as food for thought and dialogue. I would, however, suggest that new definitions are more helpful if they are based in a review of existing literature. What are the qualities and shortcomings in the existing definitions of community music therapy?
Ruud's contribution is given in the context of an internet discussion, so it would be unreasonable to request that it included a complete literature review. I still find it somewhat problematic that the context he develops for his definition is the forest of metaphors that has grown in the recent literature on community music therapy. This forest - which by the way would be an interesting object of study in itself - is hardly about defining community music therapy. As far as I can see, the wide range of metaphors that has been developed represents attempts of illuminating various experiences and aspects of community music therapy. Previous attempts of defining community music therapy do exist, however. I have therefore chosen to develop an appendix, where a list of some existing definitions is given. As I have been involved in the process of defining community music therapy myself, I do not present this list with the purpose of discussing which definition is the more helpful or suitable. My intention has been a) to illuminate that community music therapy is more established as a term than what Ruud indicates when he launches his definition, and b) to use the list as a foundation for a new reflection upon how some of the basic ideas behind the idea of community music therapy could be communicated.
A History of Community Music Therapy?
Ruud suggests that the term community music therapy was born in Rachel Verney's kitchen in 2000. For all I know, this kitchen and the moment referred to may have been important in the British context (see Pavlicevic & Ansdell, 2004, p. 19) and I do consider the current British initiatives for community music therapy to be vital and stimulating. We should not forget, however, that the term community music therapy was already in use in the 1960s and 1970s and then (after a period with much relevant practice but with less documentation and discussion) had a revival in the 1990s. What is new since 2000 is a) there is now an international dialogue and debate about the concept and the practices it refers to, and b) research and theory development is now being done and published in relation to community music therapy. A mutual process seems to be established, where the ongoing debate informs the research and theory development that is being done, and vice versa.
In "The Relentless Roots of Community Music Therapy," previously published in Voices (Stige, 2002), I have tried to show how community music therapy has roots in the work of music therapy pioneers such as for instance Schwabe and Seidel in the German context, Ruud and Aasgaard in the Norwegian context, and Tyson and Kenny in the North American context. There are also community-oriented aspects in the work of international pioneers such as Juliette Alvin, Nordoff & Robbins, and Mary Priestley. In addition, strong community-oriented traditions exist in both the Australian and the Canadian contexts, and recent developments in all continents (including Africa and Asia) are also highly relevant. My impression is that the emerging international discourse on community music therapy may have potentials for building connections between previously separate discourses and practices in the broader field of music therapy.
I do not think, then, that community music therapy could be written off as a new fancy idea or as a fancy name for what most music therapists have been doing most of the time anyway. To me, it is more plausible to suggest that community music therapy may be understood as a set of responses to challenges given by contemporary (international) developments in society and culture, such as the processes of modernization (including aspects such as individualization, specialization, and professionalization). If this thesis makes sense, we should expect to find similar developments in related disciplines, and I do think it is possible to find this. If we take a look at a larger and more established discipline such as psychology, we will see that it has had a subfield called community psychology for more than 40 years now (Nelson & Prilleltensky, 2005).
Some Thoughts on Ruud's Definition
Even Ruud's new definition of community music therapy is:
Having established the context in which I read this definition, I will develop a response to it. My first thought is that it is impressively short and distinct. In this respect it is only surpassed, I believe, by Stuart Wood's description of community music therapy as "joined-up music therapy" (see the appendix).
Some of the points that Ruud makes are, in my view, obviously central, such as the relevance of systems theories and the importance of reflexivity. My concerns relate to his focus upon performance as a defining characteristic of community music therapy, and I will concentrate on this issue. Ruud writes that a performance-based approach is not new, but that:
If we compare Ruud's definition to the other existing definitions of community music therapy (see the appendix), we will see that his definition is unique in that it is referring to a specific method or type of activity. I don't think this is a detail. Rather, I think it is a problem, and I have three arguments to support this contention:
1) There is more at stake than the acknowledgement and inclusion of a method or type of activity. Two of the aspects that I find more central are a) the ethical and practical boundaries of music therapy practice are being negotiated within a new framework of thinking, b) the role of clients and music therapists (in relation to each other and to society at large) is being negotiated in new ways and within new contexts.
2) It is too narrow to link specific methods or types of activities to specific areas of practice. Music listening is not limited to medical music therapy, improvisation is not limited to music psychotherapy, performance is not limited to community music therapy, etc. Music listening, group improvisation, community singing, and dance are among the other methods or types of activity that could generate a sense of community and therefore be of relevance for community music therapy. I simply do not think it's precise to claim that "without the public performance, there will be no exchange with the community" (but see my comment below about the concept of performance).
3) The clinical hazards involved when therapists and clients line up for public performance (Ruud refers to Turry's interesting discussion of this) suggests that it would be ethical dubious to establish performance as the defining method of community music therapy. It is a suitable method for some clients in some contexts, while it is irrelevant or unhelpful (or worse) in other situations. In this respect I find Ansdell's (2003) "anti-definition" of community music therapy as an "anti-model" helpful. It doesn't exactly define community music therapy, but it conveys values that I find central. In encouraging "therapists to resist one-size-fits-all-anywhere models" Ansdell's statement, to me at least, suggests a participatory approach.
I agree with Ruud, however, that the potential value of performance is one of the things that have been brought to the foreground in the texts about community music therapy. In order not to restrict the focus to just one form of musical activity or method, I would suggest, however, that it would be fruitful to link the idea of performance more explicitly to a sociological conception. In the same way as we have a narrow and broad concept of culture as the arts and culture as a way of living, we have a narrow and a broad concept of performance as presentation of art for an audience and performance as presentation of the self in everyday contexts. The latter meaning is especially linked to the sociology of Erving Goffman (1959/1990), and I suggest that a broader concept of performance is probably more central to community music therapy than the narrower one (important as it may be). A broad conception of performance would of course not exclude the interest for the narrower conception and the practices it refers to.
This suggestion is of course foreshadowed by Small's (1998) discussion of music as performance and of Aldridge's (1996, p. 20) idea of health as performance. And, as most readers of Voices will know, the work of Ruud himself (1980, 1998) has been crucial for the integration of sociological perspectives to music therapy.
Defining Values
I have read Ruud's contribution as an attempt of challenging the emerging discourse on community music therapy by offering a narrow and specific definition of the field. While I find aspects of his definition problematic, I acknowledge the need for clarifying and communicating central ideas on what community music therapy is or could be. In reviewing the existing definitions (see the appendix), I will therefore conclude by offering some suggestions in relation to this.
Community music therapy is ecological: This is explicit in Bruscia's (1998) discussion of community music therapy, and implicit in most definitions (as in Wood's phrase "joined up" and in Ansdell's phrase "follow where the needs of clients, contexts and music leads").
Community music therapy is music-centred: This is made explicit in the first statement of Ansdell, Pavlicevic, Procter & Verney, quoted in Ansdell (2002, p. 120) and it is implicit in most other definitions (by music-centred I do not refer to any specific notion of how to use music in music therapy, I simply suggest that interpersonal and social change through musical change is central to community music therapy).
Community music therapy is value-driven. This is explicit and implicit in most definitions, such as in Bruscia's (1998, p. 237) focus upon inclusion and valued participation in a community, in Ansdell's (2002, p. 120) critique of overly individualized treatment models, and in Stige's (2003, p. 254) focus upon collaboration and a participatory approach.
In sum, then, I suggest that (as practice) community music therapy is ecological, music-centred and value-driven. This statement is not intended as a new definition, but as a phrase highlighting three of the keywords I find central for reflection on future developments. I am of course not suggesting that these keywords are exclusive to community music therapy (other practices may also be music-centred, for instance), but I am suggesting that these keywords are central to community music therapy in a specific way.
Some may find it controversial to suggest that a field of professional practice is value-driven. In response to this, I suggest that a comparison with the discussion on values in psychology could be relevant. Nelson and Prilleltensky write:
In striving to become a science, psychology, particularly applied psychology, has ignored the moral, ethical, and value dimensions of its work. Failure to attend to value issues has led to psychology upholding the societal status quo . and to the continued oppression of marginalized people (Nelson & Prilleltensky, 2005, p. 32).
In response to this, Nelson and Prilleltensky suggest that community psychology should aim at taking a critical and constructive role in promoting equity, social change, and liberation. Going back to community music therapy, I think it would be presumptuous to suggest that it represents equity, social change, and liberation, but if our critique includes some self-critique we could try to change the world, if only a bit (Stige, 1993/1999).
References
Aldridge, David (1996). Music Therapy Research and Practice in Medicine. From Out of the Silence. London: Jessica Kingsley Publishers.
Ansdell, Gary (2002). Community Music Therapy & The Winds of Change. [online] Voices: A World Forum for Music Therapy. Retrieved December 8, 2004, from http://www.voices.no/mainissues/Voices2(2)ansdell.html ( A revised version is published in Kenny, Carolyn B. & Brynjulf Stige (eds.) (2002). Contemporary Voices of Music Therapy: Communication, Culture, and Community. Oslo: Unipub forlag).
Ansdell, Gary (2003). Community Music Therapy: Big British Balloon or Future International Trend? In: Community, Relationship and Spirit: Continuing the Dialoge and debate. London: British Society of Music Therapy Publications.
Freesearch Dictionary [online]. Retrieved December 8, 2004, from: http://www.freesearch.co.uk/dictionary/joined-up.
Goffman, Erving (1959/1990). The Presentation of Self in Everyday Life. London: Penguin Books Ltd.
Nelson, Geoffrey & Isaac Prilleltensky (2005). Community Psychology. In Pursuit of Liberation and Well-being. New York: Palgrave MacMillan.
Pavlicevic, M. & Ansdell, G. (eds.) (2004). Community Music Therapy. London: Jessica Kingsley Publishers.
Ruud, Even (1980). Music Therapy and its Relationship to Current Treatment Theories. St. Louis, MO: Magna-Music Baton.
Ruud, Even (1998). Music Therapy: Improvisation, Communication and Culture. Gilsum, NH: Barcelona Publishers.
Ruud, Even (2004). Defining Community Music therapy [online]. Voices: A World Forum for Music Therapy, Moderated Discussion. Retrieved December 10 from http://www.voices.no
Small, Christopher (1998). Musicking. The Meanings of Performing and Listening. Hanover, NH: Wesleyan University Press.
Stige, Brynjulf (1993/1999). Music Therapy as Cultural Engagement. Or: How to Change the World, if Only a Bit. Paper presented at the 7th World Congress of Music Therapy, Vitoria-Gasteiz, Spain. Reprinted in: Aldridge, David (ed). (1999). Music Therapy Info, Vol. II, CD-Rom.
Stige, Brynjulf (2002). Culture-Centered Music Therapy. Gilsum, NH: Barcelona Publishers.
Stige, Brynjulf (2003). Elaborations toward a Notion of Community Music Therapy. Oslo: Unipub.
Turry, Alan (no date). Performance and Product: Clinical Implications for the Music Therapist [online]. Retrieved December 8, 2004, from http://www.musictherapyworld.de/modules/archive/stuff/papers/perforprod.doc
Tyson, Florence (1968). The Community Music Therapy Center. In: Gaston, E. Thayer (ed.). Music in Therapy. New York: Macmillan Publishing.
Appendix: Some Existing Definitions of Community Music Therapy
Below I have developed a chronological list of some definitions that have been given of community music therapy. The list does not claim to be comprehensive, but should illuminate some of the ideas that have been in circulation (in addition there is a long series of related contributions where the specific term "community music therapy" is not used but where related ideas are discussed, see "The Relentless Roots of Community Music Therapy (Stige, 2002). For references to the definitions given below, see the reference list above.
In Defining Music Therapy, Kenneth Bruscia (1998) presents six different areas of practice in music therapy. A summary of his notion of area of practice would be that an area is defined by what the primary clinical focus is, that is; by what the foreground of concern for the client, the therapist, and clinical agency is. Of particular relevance are: The priority health concerns of the client and of the agency serving the client, the goal of the music therapist, and the nature of the client-therapist relationship (Bruscia, 1998a, pp. 157-158). Bruscia then treats community music therapy as a sub-area to the area (at the intensive level) of ecological practices:
To my knowledge, this is the first formal definition of community music therapy given in the literature. What Bruscia refers to, however, is not his own creative innovation, but a sub-tradition to music therapy with some quite old roots. Bruscia's definition is, by the way, narrower than those that have been produced after 2000, which I assume some will see as an asset and others as a limitation.
The text that probably more than any other text did put community music therapy on the international agenda of music therapy, was Gary Ansdell's (2002) "Community Music Therapy and the Winds of Change." In this essay Ansdell suggests that community music therapy is about exploring a broader spectrum of the individual-communal continuum, in response to the needs of their clients. Ansdell launches community music therapy as a "third way" between community music and what he calls the consensus model of music therapy, and presents the following definition:
In Culture-Centered Music Therapy, which was published the same year, community music therapy is defined in the following way:
In the thesis Elaborations toward a Notion of Community Music Therapy, published a year later, this is examined critically and a conclusion suggesting that implications for discipline and profession needed to be included in a definition is developed:
One of the most recent contributions to the community music therapy literature, Pavlicevic and Ansdell's (2004) book Community Music Therapy, interestingly does not include any very specific definition. Instead, Ansdell refers to a (anti-)definition he gave in the Voices discussions in 2003:
Pavlicevic and Ansdell's book also includes striking characterizations and "mini-definitions," such as one given by Stuart Wood:
The most recent definition, then, is given by Even Ruud:
By Even Ruud, Dr. Philos, University of Oslo (even.ruud@imt.uio.no):
Defining Community Music Therapy
Our wise colleague in Philadelphia, Ken Bruscia, once remarked in one of his lectures that music therapists need boundaries. That was one of the reasons he wrote his Defining Music Therapy. Witnessing the remarkable expansion in the discourse field someone has named "community music therapy" (in Rachel Vernay's kitchen) one must clearly admit that this main character trait of the music therapist once again has been demonstrated. Community music therapy (cmt) has been presented being/not being a model, a paradigm, a tree, a ripple effect, a performance oriented approach, an ecological model, a system theory based approach, a group of people marching under a new banner, a musical mileu therapy, a balloon, and so on. In this rhetoric, followers around the world are standing up, witnessing how for years they all have been practicing community music therapy without really knowing it.
Of course we have - and have not.
A Discourse Field
Looking at the literature on community music therapy during the last few years, one can learn much about how a new field of discourse has been forming, who are the protagonists, how ideas are integrated and how new theories are being formed and proliferated. In this new discourse on music therapy, some of the recurrent themes have been the importance of culture, context, an anthropological concept of music, new roles and expanding working arenas for the music therapist, the abandonment of the psychotherapeutically informed consensus model of doing music therapy and the upgrading of the performance-based approach to music therapy. It is easy to demonstrate that none of these ideas are really new to music therapy, not only in Norway.
The focus of cmt seems to lie in its insistance upon therapy becoming more relevant to the actual social life of the clients and specifically his/hers partaking in the society at large. Ansdell's cmt speaks about circumstantial communities while Brynjulf Stige talks about social change in cmt. Ansdell stretches the concept of "community" into a the state of "communitas", while Stige speaks about the importance of the welfare state and translates cmt to "societal music therapy" in Norway, probably for lack of a better word. (When I lectured about cmt in Brazil last year, my translator had the same problems finding the right Portuguese word.) In sum: how can we name something with the label "community" when there is no agreement about what the word means, or in fact if communities actually exists, if they are actual real places or imaginary or utopian brother- and sisterhoods in a world of estrangement? From this discussion we learn how cmts are borrowing from what we previously have named "humanistic music therapy", as well as social participation theories. Confusing?
Performance-based Music Therapy
What makes cmt different from other approaches? Certainly not the awareness of culture and context - which after Brynjulf Stige's book Culture-Centered MT demonstrates how culture and context are crucial aspects of all forms of music therapy. Nor would I stress the deviations from the consensus model, which is too often presented as traditional psychotherapy. At least in Norway, mt has been offered mostly in non-psychotherapeutic settings.
What is left then is the performance- based approach. This, of course, is not new. But many of us have constructed improvisation and listening as the main forms of doing music therapy, thus downgrading the importance of performance and product. Cmt gives credibility to a performance -based approach. I am aware that cmt also applies other methods of mt. However, without the public performance, there will be no exchange with a community.
Systems Theory
What is distintive for cmt is its ecological character. What is needed then, is a philosophical backcloth which could establish cmt as a distinct model. Critical theory does not seem to grasp the ecological nature of work carried out under the cmt umbrella. Systems theory, since its introduction into music therapy by another wise colleague, Carolyn Kenny, has been available to us to help us understand how phenomena are related, how we may influence one part of a system by working in or with quite another part.
Definition
Community music therapy, then, may be defined as "the reflexive use of performance based- music therapy within a systemic perspective".
The word "reflexive" is important. It covers the awareness of culture/context as well as seeing the clinical hazards involved when therapists and clients are lining up for perfomance in the public arena, as Alan Turry has written about with much insight - cf: http://www.musictherapyworld.de/modules/archive/stuff/papers/perforprod.doc
Do We Puncture the Balloon or let it Fly?
Some Thoughts by Gary Ansdell on the Reception of his Article 'Community Music Therapy & The Winds of Change'
John Cage once said: "I can't understand why people are afraid of new ideas. I'm afraid of the old ones!". The problem here, of course, is that for some people so-called 'new ideas' are old ones, whilst for others these 'old ones' are news to them!
Perhaps this is at the core of the bewildering variety of reactions I've had to my article "Community Music Therapy and the Winds of Change" in the last few months. These have ranged across almost the whole possible spectrum: gratitude, hostility, puzzlement, understanding, misunderstanding, enthusiasm, weariness. People have been irritated, saddened, inspired; it has clarified a situation for some but confused others; has given some people permission to do things and think things they had thought taboo; others baulk at my naivety, audacity or (just occasionally) mendacity! Overall I'd say the response was 50:50: the positive response I could summarise as that the article and the construct 'Community Music therapy' is a useful (perhaps temporary) way of clarifying a current developmental shift in some quarters of music therapy; the negative response is that I have both re-invented the wheel and thrown out the baby with the bath-water.
Given that the article was hot off the press just before the World Congress in Oxford in July, I got a lot of immediate feedback from a fairly global perspective. Then there was the Keynote Forum on Community Music Therapy chaired by Mercedes Pavlicevic1, where several hundred participants and an international panel of therapists involved in thinking around varieties of this concept and its practices gathered and agreed, disagreed and agreed to disagree. Again the verdict was mixed: people were confused, enraged, inspired... but, interestingly, not bored! This energy suggested to us that perhaps something is there of relevance and import to current practitioners at an international level. One delegate, however, suggested Community Music Therapy was a 'Big British Balloon' - with the covert suggestion, I think, that it be deflated as soon as possible!
What am I to make of all of this? I've waited a time to respond in order to collect as many reactions as possible. I happen to be on sabbatical in New York at the moment, so I'm also hearing responses from some of the American music therapy community, as well as those involved in overlaps between these ideas and music education and performance arts. There have also been two formal responses to my article on VOICES by Anna Maratos and Jane Edwards, and also on the subject was Thomas Wosch's fortnightly column 'Four Thoughts about Community Music Therapy' (August 26-September 8 2002). Finally, Brynjulf Stige has published on the latest edition of VOICES the most comprehensive international survey and analysis of Community Music Therapy yet available2. This will considerably improve the informed comparative discussion of this construct and variety of practices in the future.
I'll try here to respond to some of this. I'm sorry that the many people who have contacted me informally have not made their thoughts more public - I still appeal to them to do so. These were often to do with how the disciplinary pressure of the 'consensus model' was felt by them to be professionally discriminatory or limiting. Part of any debate such as this should involve an airing of the ethical dimensions of 'disciplinary strength' as represented by 'consensus' theoretical models. Public debate helps clarify the ethical complexities of these matters.
One thought I've had about the disparity of the responses is that these reflect a very new situation in music therapy dialogue and debate - epitomized by the VOICES website itself: the obvious fact that aspects of the music therapy dialogue and debate are now global. Only a few years ago most theorizing was distinctly local or national - with just a few books and articles schlepping across the borders, and the occasional combustion at international conferences! Now, however, I think we are seeing the complexities the global debate entails.
Clearly much debate (especially dispute) is very local: about the history and current situation in any one music therapy community. And as Even Ruud has said, theories in music therapy are always connected to social, cultural and intellectual contexts. So with this enhanced global communication between us it is not surprising that the global and local can get confused or misinterpreted. Specifically, I can see quite well that my argument for Community Music Therapy partly relates to a peculiarly local British concern (based on history and disciplinary politics). I said very clearly at the beginning of the article that I comment from a British perspective and wonder how far my questions, arguments and proposals apply, are relevant or even comprehensible, to international colleagues. I asked people to contrast and compare with their own local and national traditions. I understand of course that these sentences in the article are not the ones first read or quoted! This situation, however, has brought home to me the sense of writing for a different audience now - a 'glocal' one. This is something all of us (as well as our journals) are going to have to come to terms with.
Ironically, one of the things many of us wanted a Community Music Therapy construct to stimulate was precisely the need for local, context-sensitive practice, following local needs of therapists, patients and music - certainly not for it to be yet another prescriptive and authoritarian theory. So perhaps I could put it like this: Community Music Therapy is an anti-model that encourages therapists to resist one-size-fits-all-anywhere models (of any kind), and instead to follow where the need of clients, contexts and music leads.
Having said that I'll address the major comments and critiques people have communicated to me:
Reinventing the Wheel?
I understand how music therapists who have always worked within a flexible continuum of practice read my article and wonder how 'Community Music Therapy' is anything new or unusual. For instance, Jane Edwards' response comes from a useful perspective, Jane having trained and practiced in Australia, but currently training students in Ireland, with a Community Music department next door to her. She writes: "...many of us in music therapy already work (or in fact have always worked) with an understanding of our clients in their broader context and consider their needs and our responses as music therapists with reference to that broader spectrum". Or, as David Aldridge said to me: I've just missed the fact that 'Community Music Therapy' is what music therapy is; it would be better instead to re-name my tradition of music therapy as 'Clinical Music Therapy', rather than rename what most others already do worldwide as 'Community Music Therapy'.
I take the point, and apologise for re-inventing anyone's wheel! And yet... these comments do not quite match up with the response I'm getting from quite a wide sample of readers. For example, someone is using my construct to help model a communal project of post 9/11 care here in New York3; another is using it to compare to his own formulation of the continuum between therapy and performance in a community psychiatric facility. Another simply said that after the Oxford Congress it was such a relief to feel able to talk publicly about community and spirituality in music therapy. My feeling is still that whatever people have been doing in practice, they seem to have spoken, written or taught little about it. Why not?4
It is true that outside the British and some European traditions there has seldom been an active professional taboo concerning working communally, or outside of a narrow therapeutic frame. However, what I am also hearing is that until recently there has also not been much dialogue between music therapists concerning ways of thinking about, and modeling, this active continuum between private and communal work (or, alternatively, this has been seen as outdated practice reflecting earlier 'recreational' models of music therapy). Secondly, it seems there is little in the current literature to set such practices in relation to wider theory - for example, congruent models of a socio/cultural psychology of personhood, or a social psychology or sociology of music. So either the extant music therapy literature here is thin, or hidden in pockets, or unknown to at least a sizeable section of the international community.
So I'm very much not saying my formulation is any better or more useful than anyone else's. I carefully entitled my article 'A Discussion Paper' given my chief aim was simply to initiate a discussion, centred on a simple model that I hoped my colleagues could compare and contrast to their own practices and formulations.
In this way Thomas Wosch's response was constructive and informative. He sketched out the interesting scenario of the tradition coming from the former East Germany - where pioneer Chistoph Schwabe practiced and taught a 'social music therapy' that emphasized how "...the social dimension is very strongly connected with the individual dimension of the human being". Wosch asks whether such a 'therapy of society' is still a viable proposition. Here is a clear example of 'local theory' that can nevertheless inform international discussion. At the Community Music Therapy Keynote Forum at the Oxford Congress we had similar 'glocal' reverberations from Israel (Nechama Yehuda), Norway (Brynjulf Stige), and the UK (Leslie Bunt, Emma Wintour and Rachel Verney). Nobody here claimed Community Music Therapy to be new - but the renewed debate on the relationship of music therapy to the social, cultural and communal did seem to be useful to people.
After Rachel Verney and I came up with our own formulation some years ago (as a logical point of arrival for our own practice and thinking) I quickly discovered that Brynjulf Stige came to the same point years before this - and now I'm told that half of the music therapy world considers it common practice! Formulations very often seem to come to the same conclusion in different places, each independent of the other (serialism in music and the identification of autism come to mind). I'll deal with the naming issue later, but surely what's significance is not who arrives at what formulation when, but what use such various formulations serve, and when they becomes useful. So what I'd like ask is: what's the significance of the obvious interest in a more international formulation, modeling and validation of Community Music Therapy now?
Throwing out the (Analytic) Baby with the Bathwater
A British (and partly European) issue in the debate is whether Community Music Therapy is compatible with a psychoanalytic model of therapy. My 'declaration' in the Oxford panel (we each had to 'declare' a position on the subject) was that it isn't. Some of my fellow panelists disagreed. The response by Anna Maratos (VOICES - July 16 2002) discusses this further. Anna writes that, according to my criteria she is "...a Community Music Therapist. Yet unlike Gary, I am also someone who works in a very psychodynamically oriented way". She then describes the production of a musical she, her patients and colleagues put on in the psychiatric hospital she works in - a fictionalized account of Edward Elgar's work as a bandmaster in a psychiatric hospital. I've seen the video of this - and it's an inspiring piece of music therapy, with Anna superb as the 'available resident musician therapist' (her term!). She openly acknowledges the problems she's had doing this project - problems stemming from the prejudice of a consensus theory concerning roles, boundaries, sites and attitudes. She acknowledges that this sort of work is 'kept underground'. To her great credit she simply went on with the work she knew was right for her patients, colleagues and hospital.
Anna makes two central points from her stance on this work. Firstly that her therapist expertise ('dynamic insights') and her and her colleagues' 'availability' as therapists helped the difficult process of mounting the performance to happen without undue mishap - and in fact to great human effect for all concerned. I'm absolutely with her here, and seeing the video you see these skills in action. This is not to say however that any one theoretical model has a monopoly on the kind of 'people knowledge' that any therapist builds up through experience. This knowledge can (but need not be) 'analytic' per se. Indeed a lot of what I observed was musical knowledge-in-action: or, rather, the kind of musical/personal skill that music therapists of any persuasion develop to reconcile individual and group flow by listening, to dispel potential problems and tackle those that arise. The Community Music Therapy model I proposed never said that we stop being therapists in this work - but not 'therapists' in the loaded way that psychoanalytic theory has traditionally prescribed - the very attitude that created the problems that she had to work against! Her point that 'It was "therapy" partly because the rehearsals were as important as the performances' I don't understand. Under this logic the choir I sing with is doing covert therapy! Indeed I smell some desperation to preserve the notion of 'therapy' here!
Her second point relates to this, and is that the work she did '..does not sit uncomfortably with recent and not-so-recent trends in psychoanalytic theory' (those of 'integrative therapeutic community' theory). My thought is that in terms of music therapy as practiced it's not what psychoanalysis is, or believes, but how the model is used in any circumstance that matters - that is, what possibilities of action it admits or frustrates. For Anna this model seemed as limiting as it is for many music therapists in terms of its normative 'rules' concerning sites, roles, boundaries and attitudes5. Her working around these and her excuses for them lead me to ask how far you massage a theory and its basic assumptions before you've preserved only the name? It reminds me of the story of the Oxford don who had a dog, and the college wanted to make him master but only cats were allowed in college. So they called the dog a cat, and all was fine. Using similar logic, we can ask what's preserved if we conveniently 'spin' the basic assumptions of psychoanalysis (and in this case the limiting factors coming from these assumptions) in order to retain a cherished theory?
I come back to my perhaps rather simplistic formulation: that whilst Community Music Therapy is opening the door for a flexible practice of music therapy, psychoanalysis is still closing it. Now you can't open and shut a door at the same time without confusion or injury!
Pluralist Paradise? Theory and Practice
A word that's kept coming up in responses is 'pluralism'. Thomas Wosch felt that the 'acknowledged pluralism' in the Oxford Keynote Forum was 'a freedom', a 'lightening', with nobody claiming that Community Music Therapy is exclusively this or that. For him it gave an orientation point for many different traditions and views, with the caveat "Could Community Music Therapy become a too much light model of music therapy?". For Jane Edwards there were postmodernist resonances: "... a pluralistic approach has helped music therapy to be open to wider ways of working". Part of this for her is a move away from more 'ideological' ways of framing the processes or aims of music therapy - as for example, 'personality change' or 'transcendence'. A pluralist perspective is wary of grand theoretical claims, and "...one of the gifts of postmodernism is the ability to embrace the uncertain and the unfixed while celebrating (or perhaps 'staying with' is more appropriate in a therapy discussion of this) the frailty of our human state...".
These comments connect with some thoughts I have about the reception of my article specifically as a theoretical discussion. Especially how people take a new (or 'new/old') theoretical formulation in relationship to tradition or innovation in music therapy. One style of response comes from what could be seen as the still-dominant European ideological tradition - which views theory as an accumulating disciplinary edifice, rather like a coral reef. After construction such theory must be true because it has lasted so long! Consensus in this tradition is cosy, correct and enough! It tends to hold facts as values and to consider debate personal. Such theory tends to be modernist and anti-pluralist in its uncritical assumption that present conclusions are for all people, at all times, in all places.
Another style, in contrast to this, more resembles the American pluralist/pragmatist tradition, where ideas and beliefs are seen to be transparently and honestly in the service of (local) interests. Here theory is seen as a tool, new theoretical formulations seen as useful guides to thinking and potential action, and very much not a reflection of the 'way things really are'. The basic assumption, following the philosophical tradition of William James and John Dewey, is that almost by definition, no one way of thinking about things can be true or useful. As James wrote: "Everything is many directional, many dimensional [...] nothing includes everything, or dominates over everything. The word 'and' trails along after every sentence"6. Theory here is performative or improvisational - a way of coping, a guide to acting.
I'm not trying to compare two modes of two continents here. What I am contrasting is two modes that any individual, group or national tradition might hold, or cultivate (and I've received examples of both of these). This has led me to think what music therapy could achieve were it to integrate more its cardinal principles of practice into its theoretical life; namely, theory as provisional, improvisational, context-bound, risky, challenging, sometimes confrontational, always dialogical and in-the-making. What's old somewhere is new somewhere else; we sometimes need old formulations for new circumstances; global comparisons with local; local with global. People have said most things before; sometimes we just need to say them again, in a different way, standing on a new street corner.
Naming and Dividing? Conflict and Companionship
This brings me to a last point concerning the 'community of music therapists', which delegates at the Community Music Therapy Keynote Forum in Oxford asked us not to forget. Thomas Wosch was impressed by the community organization of Leslie Bunt's 'MusicSpace' organization, which fosters a spirit of community amongst music therapists. Others have suggested that broader thinking about the communal aspects of music therapy may lead us to think more about our own communal needs as music therapists.
On the other hand, I think that a sub-text lies beneath this theme (and some of the comments I've received) concerning the role of conflict and consensus in our discipline. People are concerned that 'Community Music Therapy' is an unnecessary re-naming, and that such re-naming threatens a hard-won consensus. Jane Edwards, for example, writes: "I am just not comfortable with adding a word to Music Therapy [...] I prefer a separate identity when working in the same department as Community Music lecturers" (though Jane is very much for dialoguing between these two traditions). Others respondents have communicated more general concern about the wisdom of the kind of theoretical debate and dispute which relies on establishing difference over what is shared in common within the discipline. The threat I suppose is schism. I think it's very important that both fears are openly discussed.
It seems to me that re-naming has always been part of the process of theoretical elaboration within our discipline, as part of the necessary critical method of making distinctions. First there was 'music', then 'music therapy' - then, when a suitable measure of stability had been attained, came 'music psychotherapy', 'Nordoff-Robbins Music Therapy', 'psychodynamically-informed music therapy', 'GIM' etc. Notice that re-naming is mostly additive - a further defining by forging cross-disciplinary alliances and syntheses. Technically such re-namings construct different discourses of music therapy: ways of talking which actively represent and construct ways of thinking, which are in turn responses to contexts of time, place and action. Seen this way, re-naming is a sign of a practice and discipline not stagnating.
I indeed meant my heuristic characterization of the 'consensus model' to challenge - since for me the current consensus in some quarters is working against possibilities of action - for clients, clinical contexts and therapists. Characteristic of pluralism is such a space for critique and dissent within a wider consensus - but also with the view that antagonism is a temporary stage on the route to a common goal. Ironically, this is actually the message of psychoanalysis - that antagonism be given a creative space. As the psychoanalyst Adam Phillips has ruefully commented, it's very odd that therapists ever lament the antagonism or schismatic tendencies of therapeutic movements - given this process is central to their basic understanding of human dynamic life.
Yet we do have more in common than not as music therapists of whatever variety. I came across this passage of Rumi the other day:
I think of the long tables in those beautiful dining halls at Oxford, where just this happened. Names and distinctions serve a purpose, but there's also time to drop them. I'll be only too happy when we can drop 'Community' from the name again - whether this is sooner or later... Not before, however, it's said whatever it has to say.
Notes
1 A summary account of this will be published with the Conference Proceedings.
2 Stige, Brynjulf (2002). The Relentless Roots of Community Music Therapy [online] Voices: A World Forum for Music Therapy retrieved from https://normt.uib.no/index.php/voices/article/view/98/75.
3 Benedikte Scheiby (2002) - 'Caring for the Caregiver: trauma, improvised music and transformation of terror into meaning through Community Music Therapy Training. In: Loewy, J. & Hara, Andrea Frisch (Ed.) Caring for the Caregiver: the Use of Music Therapy in Grief & Trauma, American Music Therapy Association.
4 One answer here of course is that it's simply that some of us are not looking far enough; the literature is there if you know where. Here Stige's new survey is invaluable in completing this multi-faceted picture.
5 See section "Discussion: Community Music Therapy and the Consensus Model" in my original article.
6 In Louis Menand, The Metaphysical Club. (Flamingo 2002).
7 Rumi (2002). "The Indian Tree". In: Barks, Coleman (Ed.) The Soul of Rumi, HarperCollins.
I have read Gary Ansdell's article about community music therapy and also Anna Maratos' response. Thanks to both contributors for an interesting and thought-provoking discussion.
[1] I agree with Anna that many of us in music therapy already work (or in fact have always worked) with an understanding of our clients in their broader context and consider their needs and our responses as music therapists with reference to that broader spectrum. Gary doesn't argue with this however he seems to be suggesting that using ideas that are fundamental to community music offer a way forward to further acknowledge and embrace this perspective in the work of music therapy. I am not so sure. I consider that as a music therapist I have always practiced in a wider context of thinking about patients and clients and unlike Gary's assertion about the distinction between community musicians and ourselves, I have not always used traditional music therapy spaces in work with clients. (I wrote a short justification of this as part of a paper in BJMT (Edwards, 1999) but it has also been reflected in some of the Australian work developed in other contexts (Daveson& Edwards, 2001)). Like Anna, I have received concerned comments that some of my work is not music therapy. I have, however, thought of myself as primarily using my best knowledge to help patients and clients within the contexts we have encountered each other rather than applying a formal, perhaps structuralist response based on some idea of what I had been 'trained' to do as a music therapist. I do not disagree that consistent time and space is important for certain types of therapy work but I also think that flexibility is required in applications of this imperative in some contexts. I have both found myself arguing with managers that a designated music therapy space is required and equally arguing to be able to attend hospitalised children during procedures or in their isolation rooms.
[2] Certainly as a manager of a day service for people with Alzheimer's Disease and their carers for two years in Melbourne in the early nineties, I worked within a community practice frame; using my music therapy skills to conduct regular group sessions for programme participants but also using this same skills set to offer counselling and support to family members in home visits and phone calls. I learned some of the approach I used in that work from my experience on placement at Fulbourn Hospital in the mid 80s that was just moving away from the therapeutic community model (the in-house community of patients as a focus of treatment change) and towards a broader community model of conceptualising patient needs, particularly with regards community supports that could decrease admissions.
[3] I think that what this practice that Gary is trying to describe may represent is a move away from humanistic (or perhaps modernist) ideology towards one that is more informed from postmodernism (for want of a better term). I am sure we have all become a little tired as to how many times one has to read about the gift of postmodernism being pluralism however at the risk of boring the reader/myself let me state I do think it is true that a pluralistic approach has helped music therapy to be open to wider ways of working. However, I also think that one of the gifts of postmodernism is the ability to embrace the uncertain and the unfixed while celebrating (or perhaps 'staying with' is more appropriate in a therapy discussion of this) the frailty of our human state, not trying to overcome or triumph over it the way a modernist or humanistic approach might perhaps suggest (and in music therapy we sometimes hear these themes in work where the music is considered to offer an opportunity to access a previously unknown creative self or an opportunity to transcend reality).
[4] I would argue that music therapy is always a socio-political work - in simple terms, what we do with our clients and their families in turn affects our society simply by being part of the warp and weft of the fabric of our community behaviour. In this way, it makes sense that some of the contributions of postmodern (again that word) theory resonate with me. I guess I grew up at a time when the women's movement was at a particularly lively phase of debate within my own family and community and the slogan 'the personal is political' entered my consciousness and has stayed with me. Since the civil rights movement and the movements that followed, including the many strands of feminist theory and feminism, I think it is impossible to live without consciousness of the ways in which our society and community shape our perspective to 'other' whether we understand that in Marxist terms or perhaps even with reference to Kristeva's useful notion of abjection. (Kristeva, 1982)
[5] In some ways the descriptor 'community music therapy' evokes a reaction that might occur if I were described as an educational music therapist because I have found some ideas from education (eg student centred learning) inspiring and informative. Perhaps I might be called a narrative music therapist because Michael White's work is filled with such generosity and authenticity I long to emulate it (White, 1995). I am not happy with these descriptors. I am just not comfortable with adding a word to music therapy. Perhaps there is, or will be, a Kuhnian style paradigm shift as Gary suggests but I propose that we keep our title clear from additional words. I am a music therapist with all the problematic baggage that accompanies that role. Of course we should keep thinking about our work and practice and perhaps those of us who seem not to 'fit' exactly with the general community in the way we practice and feel 'disapproved of' should have more courage to express and explain our ideas and approaches rather than keeping on somewhat in secret hoping that we won't get in trouble!
[6] Finally, and perhaps most pragmatically, as the Course Director of a two year postgraduate university music therapy programme that is taught in the same centre as a community music MA, I am reluctant to use the term 'community music therapy'. I prefer a separate identity when working in the same department as community music lecturers. I have always welcomed the various community musicians who have come into the Irish World Music Centre over the three years I have worked here. Many of my students have had successful collaborations with the community music students and I have given guest lectures in the community music programme. I wholeheartedly support this continuing however I am not comfortable with the descriptor 'community music therapy' although I agree with some of Gary's ideas regards what we might have to talk about together and share with our colleagues from that closely related world of informed professional music practice.
[7] I note that Urie Bronfenbrenner's nested model of the environment (described as micro-system, meso-system, macro-system and exo-system) was referenced to Stige. I include the original reference for interested readers (Bronfenbrenner, 1979).
References
Edwards, J. (1999). Music therapy with children hospitalised for severe injury or illness. British Journal of Music Therapy, 13(1), 21-27.
Daveson, B. A. & Edwards, J. (2001). A descriptive study exploring the role of music therapy in prisons. The Arts in Psychotherapy: An International Journal, 28(2), 137-141.
Kristeva, J. (1982). Powers of Horror: An Essay on Abjection. New York, Columbia University Press.
White, M. (1995). Re-Authoring Lives: Interviews and Essays. Adelaide: Dulwich Centre Publications.
Bronfenbrenner, U. (1979). The ecology of human development. Cambridge, MA: Havard University Press.