Hello. My name is Yoshie Sasaguri, a graduate student of music therapy in Japan. In one of my graduate classes, taught by Rika Ikuno, the Asian Editor of Voices, we decided that each of the students would choose one column and one main issue from Voices, and use them as discussion materials in this semester. I recently picked up the column entitled "Moments" (http://voices.no/?q=fortnightly-columns/2001-moments) by Mercedes Pavlicevic.
What impressed us first was that the life and musical culture in South Africa were quite different from ours. I asked a question of everyone as to whether we in Japan had any common music that stimulates our body immediately. The response was that the dance music used in our indigenous festivals might correspond to that. But in Japan, our life and musical culture are diversifying and individualizing more and more, so it is getting difficult to find music common to all generations.
As a whole, I wonder what music therapists can do for such distressed children as in South Africa who are threatened by hunger, poverty, and infectious diseases like AIDS, and why it must be music? This is also the question that I would very much like to ask Pavlicevic herself. Because if I face such children whose minimum needs for survival are not even met enough, I will first consider whether there is anything I could do as a human being rather than a music therapist.
Then our professor gave us an assignment to consider what we would do as a music therapist if we faced a client in the most tragic situation that we can imagine. One student answered that if she went to a place like a field hospital, she would croon a song that she wanted to sing at the nook of the room in order to calm herself and not to trouble others at first. As for me, if I face a client like the children in South Africa, I will be tempted to give him money, food, medicine, medical products, and so on. But to my regret, I can't afford to support others now. Besides, maybe such a personal help has no limits. So on second thought, I will decide to have a relationship with him through music as the best option. If he has favorite music that makes him forget about his hardship of poverty or physical suffering, I may learn it from him and sing or play it together. Another way may be to help him to improvise or compose a song in order to express his feeling about his situation rather than suppress it.
We would like to know in what ways other music therapists are grappling with such difficult clients. I would very much appreciate any response to our discussion. Thank you for your attention.
Silence and Violence- Music Therapy in the Heideveld Community
Yesterday, after the mid-year recess I started 2 new Music Therapy groups at a "safe room" in the Heideveld area in Cape Town. Heideveld is situated in the Cape Flats - an area riddled with poverty and ruled by gang violence, some 12 kilometres from Table Mountain and the pristine City of Cape Town. Schools in Heideveld are over-crowded, with pupils often hungry and edgy - and ready to hit the floor at the sound of gunshots. The music therapy groups are with primary school children, most of whom have experienced some sort of trauma: sexual abuse, death in the family, witness to shootings, and other such occurrences of daily life in Heideveld.
I struggle to make sense of this community and of my music therapy work: the pervading sense of violence and resulting hopelessness often paralyses me and I feel incapable of offering the children anything worthwhile. The reflections below are drawn from work with two groups, in the first half of this year.
Chaos and violence:
The younger group members (aged 7-9 yrs) have shown a marked contrast between their verbal and musical expressiveness. While they are afraid to talk in sessions, possibly because of fear of being victimised by the group, their musical contributions are loud, aggressive and feel out of control. Toward the end of our 8-weeks of work together, some of the children's physical movements became more violent, with a number of the boys pretending to beat each other up and on one occasion punching up a teddy-bear sitting in the corner. This feeling of group chaos left me feeling inadequate and unable to offer any sense of safety or cohesion.
It was later in our work that I understood that the way I felt in the midst of the group chaos was a reflection of how I felt about entering the physical community area. For my first few weeks there, I had felt uncomfortable and edgy driving through the streets of Heideveld and found myself watching my back within the primary school grounds. The children in this younger group were not only part of this chaotic community but also victims of its violence, and I understood that within our Music Therapy sessions, they were beginning to use musical expression (instrumental or movement) as a release, and expression of feelings to do with living in such a community. I was seeing and hearing, in musical form, a small portrayal of Heideveld - chaotic, unsafe, aggressive, out-of-control.
Space and Silence:
In contrast to the younger group's chaos and violence, the older group (aged 11-13 yrs) asked to end our first session together with some music relaxation, and this has continued ever since. Tracks from 'Enya' create a peaceful figurative space in which the group re-visits issues that have emerged in the therapy process. My understanding is that where daily life is crowded and the community's chaos pervades the children's internal realities, they need to be shown how to withdraw to a quietness that allows them to deal with issues and make decisions apart from the bombardment of everyday turmoil.
Where the younger group needed a space where they could express the violence of their community, the older group needed a space in which they could retreat from it, even if just for a moment, to re-vision their lives from a place of quietness.
At times, even when I have little sense of what Music Therapy sessions provides children from such deprived communities, it is these moments that feel precious: moments where music can carry both the loudness of fear and violence, and the silence of an imagined retreat and distance from daily life.
Cape Town
August 2002
How Can Music Therapy Help? Response to Yoshie Sasaguri
Yoshie Sasaguri raises questions to do with helping children in dire situations - such as those with HIV/AIDS - in South Africa. She reflects on the dilemma facing any young music therapists whose souls are quickened and alarmed by profound human suffering: in other words, shall we first be a human being or a music therapist in such situations? What is the greater need?
One of the difficulties in considering situations in cultures so very different from our own, is that often we don't have the images or the social knowledge to help us begin to formulate questions (and answers!). This, in spite of access to the internet, television documentaries, and other sources of information that give an illusion that we 'know' about such places - if not in person then by 'informing' ourselves about them.
I offer here a few reflections for helping Yoshie and her peers to 'imagine,' since without this we can't begin thinking about 'helping.'
The first things that Yoshie considers for the desperate children are money, food, medicines - the basics in terms of 'helping.' This would make any of us feel that we have 'done something,' and hopefully, we would feel the better for it. A larger issue emerges here: that disease has a tangible link to poverty and hunger. As human beings, our initial impulse may be to address these, and by doing so, acknowledge that the tangible territory of music therapy is the tip of some unhappy icebergs. Medicines and Money - we all know - are short term solutions. Possibly, where there is social fragmentation, they may create other problems which are not to do with the intentions of the 'donor,' but rather with roots deep in the complexities of Southern African social norms.
Then we come to music - our tool as music therapists. A wonderful idea. I start to think, well, what music might we sing with this child (as in Yoshie's reflections); how might we find out what music is his favourite? And before asking this, how would this child make sense of the idea of 'favourite' music? Favourite music implies a choice between several musics .... here we come face to face with the Sub-Saharan notion of music which is that music is not this 'thing,' this 'object' that you can 'use' when you think you need it, but rather, music is part of being together when you are in a place with your family, friends, your siblings, your clan. And the music that you 'do' is music that belongs to that very collection of people in that very situation. So to think of 'music' as transferable or transportable - something that we might use in therapy ...... doesn't quite work. How, then, shall we do 'music' in order to 'help' this child dying of HIV/AIDS?
Lest all of this begins to sound dissuasive of the impulse to 'do something' - which is, after all, the remit of most caring professions - I now want to switch tracks.
What I have learnt, living in South Africa, is that the overwhelming issue, in terms of 'helping,' is to find a territory for 'helping' by mutual consent. In other words, to find a position where what I think of in terms of helping coincides with what you need, and with what you understand by 'being helped.' Usually as music therapists we make use of social institutions to create mutual territories. For instance, schools define what it means to learn, and hospitals and clinics what it means to be ill - and to be cured. Within these contexts, we practice music therapy. Remove these contexts and the territory becomes complicated.
In South Africa, (and incidentally, in other parts of the world) the institutions themselves are not homogenous in their understandings of 'illness' and 'curing.' There are complex social and cultural issues to disentangle. For example, a child in the middle of chemotherapy is suddenly whisked off because the traditional healer in her village (100s of miles away) needs to see the child with her family. Doctors and nurses explain to the family that this is not the time to take the child away from the hospital - in any case chemotherapy will only last another 6 days. The family is adamant: the traditional healer says that he needs to see the child tomorrow at the latest - else the spirits will not speak. The child leaves hospital and goes home. The child dies.
Is the child cured? Is the child healed? And from what premise do we ask these questions?
So - how helpful is 'music therapy' (or medicine for that matter) in instances such as these? How much energy shall we, as music therapists, spend in considering where and how our work 'fits' with traditionally embedded norms and beliefs - knowing full well that traditional medicine and 'modern' (or Western) medicine themselves are uncomfortable neighbours?
All of these deliberations begin to sound - and feel - overwhelming, and perhaps here we give up. We lose heart, forget it all, for the problems are too vast, too complicated, and simply too far away. We'll just get on with doing music therapy. (And feel better for doing so.)
At this point I am reminded of a story which goes like this. The young novice asks the old wise monk, 'tell me, most knowledgeable sir, the mountains, the rivers, the moon - where do they all come from?' To which the old wise monk replies, 'your questions, young man, where do they all come from?'
Perhaps by answering too specifically the questions raised by Yoshie and her student peers, I prevent her from continuing to seek and ask more questions. More important, perhaps, is that trainee music therapists continue to ask: how can we help; how can we make sense of this or that; in such and such a situation, what might be the way to think; - as music therapists, what is our task; what is our role. And critically, as music therapists, how are we needed.