After reading Dorit Amir's article, "How Do We Nurture Ourselves?" (See Columnist of the week: June 04-10, 2001), I really began to question what I do to "fill me up." As a college student my life is filled with classes, tests, clinical work and I have recently added a puppy and a husband into my already busy life. So, how do I find the time to take care of myself? One resounding idea for the article kept coming to my mind: How can I give therapeutically if I am running out of gas myself? So I began a journey to make time for myself so I could be nurtured. I took an inventory of my life to see what I actually did in my free time. My free time was filled with mindless activities that involved nothing from me and I desired so much more.
I began a quest to create my own "Hawaiian Experience." Now I make at least a thirty minute block every day to relax and refocus in whatever way I feel is necessary. I strive to usually make this a nonverbal experience. There are times when the music in my wells up and I try to find ways to express it. Singing has been such an uplifting experience for me. I am a flute player and I often find myself hiding behind my instrument. Singing and simply using my voice can leave me feeling vulnerable. I have decided to give myself the gift of singing. Sometimes I sing familiar songs with and without the lyrics and sometimes improvising, allowing myself to have complete creative freedom. I have begun to feel such a cathartic freedom in singing. My experience with nurturing myself has been such a growing experience. I feel my personal time has allowed me to become a better future therapist. I now feel as though I have something to give. I know there are others of you who have been inspired to find personal "Hawaiian Experiences" and I would love to hear how others fill themselves up also. It may be what someone needs to begin their own journey towards and "experience."
Dorit Amir addresses a very important topic in her article “How Do We Nurture Ourselves?”; namely, how we as people who care for others care for ourselves, how do we get the energy to continue doing what we do. There are several enthusiastic responses to this article that reflect the interest most of the music therapy community likely has in this topic. Indeed it is a very interesting topic, and, as mentioned, important. I feel, however, that something crucial is being overlooked in all of this discussion.
Amir’s trip to Kauai revealed a different way of life, a more spiritual way, a more congruent way. Trying to bring a little part of that life back to the city, making a “Hawaii room” to revisit the calmness and awareness achieved on the island, is of course a smart thing to do; it is certainly not a harmful thing to do. If any one of us can do something similar, by all means, I think it should be done.
But something like a “Hawaii room” to refuel, or writing for writing’s sake like Lara Trimpe’s response details as a way to reenergize, is missing what I think is the main point of the discussion, what’s really at the heart of all of this. Why is there a need to refuel? Why is there a disconnect between healing others and healing the self?
We can all agree that the reason Amir’s article was written in the first place is that one cannot truly help others become well if one is unwell himself. It is why we are directed to place the oxygen mask over our own mouths before assisting others in the case of an emergency on an airplane. It is why Amir stated, “I felt that I first had to nurture myself, to give myself before seeing clients. By creating this room and surrounding myself with my Hawaiian music, art and beauty I could both fill and feel myself again. And only then did I feel that I have something to offer to clients, who, surprisingly (or not!) started to come.”
My position is that there should not be a time to heal others and a time to heal the self. These things should be one and the same, part of the process of becoming whole, part of the journey we have undertaken as music therapists. In Cyndi Williams’s response she says, “Every therapist finds what it is that recharges him or her or fuels the flame for being a music therapist.” Isn’t being a music therapist the fuel itself? Isn’t playing music and helping others what keeps us going? We are not bankers or telephone operators or garbage collectors who put on a different face for work every morning; we are doing what we feel we were put on this earth to do—play music—and we are doing what we are all (humans) put on this earth to do—help each other. We shouldn’t have to need to find a way to refuel.
In her response Sharon R. Boyle asks: “How do we teach the next generation of music therapy students the importance of self-care? How do we teach them that this is a priority if they are to fully be open to others … to be present for their clients?” The answer to this lies in the way we should be training music therapists overall, for within that new model answers to such questions as Boyle’s will be inherent. What is that new model? I don’t purport to have the blueprint for a perfect music therapy training rubric, but I can see some problems with the current model in a few of the responses to Amir’s article.
For example, Trimpe states “With the vast amount of reading that I had to do for class, I had let reading for enjoyment fall by the wayside.” Why is anything being assigned that is not enjoyable? It’s clearly not essential to the process if it’s not enjoyable, unless Trimpe doesn’t enjoy doing music therapy. A couple of other responses remarked on the stress involved in schoolwork and assigned reading. I don’t advocate a total removal of theoretical training, but clearly a good amount of what reading is assigned in today’s music therapy programs is viewed as something to get through, something that is a hassle. I think the fat needs to be trimmed off and everything, from the readings to the papers to the internships to the classes to the assessments to the licensing process, needs to be congruent, needs to be perfectly streamlined, needs to be essential at a pure, core level for the emerging music therapist.
My belief is that music therapy is not a career, but a path, a way of life, something to be embraced fully and completely, something to be committed to on a very primal level; the music therapist is fueled by that which he does. I would imagine the majority of my colleagues may feel the same, and we might begin to see ways to train for and pursue a more integral way of work and life.
How do we nurture ourselves? I think this is a question that most music therapists, including the students of music therapy, grapple with quite often. As the end of my first semester at Lesley draws near, I am finding that my time to nurture myself is one of the first things to get thrown out the window in favor of having that extra hour or two to finish a paper, work on a project, or maybe even sleep. But at the same time that I think using these extra hours to work on other things besides my own mental, physical, or spiritual health might be beneficial to my end of the semester grades, it could really be hurting my growth as a music therapist. I'm finding more and more that taking care of myself is a huge and inseparable part of becoming an effective music therapist. After all, if I haven't truly spent the time to nurture myself, how can I expect to help my clients to do so? Even as I participate in a yoga class once or twice a week, I frequently find my mind drifting away from breathing and being present to thoughts of papers, emails, and other little odds and ends that I must clear up before the end of the night. I momentarily lose sight of how good it feels to have my mind be completely still and peaceful for an hour, and how wonderful it is to take that peace and stillness into my work as a student of music therapy.
How do we as seemingly endlessly busy students, professionals, family members, friends, etc, carve out regular time in our schedules to breathe, comfort, and nurture ourselves? I don't think I have really found the answer to this question yet, but I did find this essay to be very inspiring in the search for an answer. Perhaps it is less about finding a totally separate time to devote to self care from the rest of daily life, and a little more about integrating the ways we care for ourselves into the spaces that we live and do our work. For the author of this essay it was in the form of adding another room very near to the studio in which clients were seen that existed solely for the purpose of self care. In that way the author was able to integrate the nurturing experience of spending time in Kauai with the experience of living and working as a music therapist in Israel. The author's experience left me with much food for thought as to how I could integrate even small moments of the musical, physical, and spiritual activities that I find nourishing to my soul into the spaces in which I do my daily living and working. Just taking five minutes before a session with a difficult client to breathe, stretch, or meditate could be incredibly beneficial in my being totally present and as helpful as possible for that client.
I'm certain there is no one answer to the question of how to nurture and take care of ourselves on a consistent basis, and there may not be an answer at all. Like many things I've experienced so far about becoming a music therapist, self care seems to be an ongoing process that evolves and changes into different spaces, activities, and amounts of time that I find I can devote to it. But I really appreciate the process that the author of this essay went through to find an adequate space for self care, and the integration of spiritual, musical, and mental nourishment into the daily act of being a music therapist. While it is obviously also important to find separate time and space to devote to self care that is far removed from the spaces in which we do our work, a Hawaiian island for instance, I think it is quite a wonderful concept to have spaces for self care in the places that we do our work as well, and to integrate these two parts of ourselves together in some way.
Coming from a small town, population 4,010, in Oregon, it was quite a leap for me to travel to a big city on the east coast to enter the masters program for music therapy. This choice brought conflicting feelings of excitement and fright. Not long before being accepted into the program, I fell in with the majority of people who wondered, "What is music therapy?" My college didn't offer a music therapy major, nor did it have any courses on the subject, but after doing an independent study using music with an assisted living population, I became intrigued with the concept of music therapy. It was because of this independent study that I began reading books about theories, pioneers, and interventions used in the field.
I think that most music therapists would agree that at least two things are required to become a music therapist. The first is that one must love working with people, and the second is that one must love music. One of the greatest things that music has to offer is that it is universal. It has the power to influence the mind, body, and spirit. After reading testimonials, research studies, and from my personal experience, I knew that I wanted to be a music therapist.
I think too often, we music therapists or music therapy students can get too involved with the world to take time for ourselves. I was given an assignment by one instructor to answer the question, "What has drawn you to this field?" We were to answer it early on in the semester, then again at the end to see how our answers have changed or evolved. To any prospective music therapist, training music therapists, or current music therapists who are going through a stressful time of work, school, or just questioning where he or she should be in life, I would like to refer you to that question. Never let your answer out of sight. Feelings of 'young love' for this career might return, or special memories that you cherish might be triggered. It only takes one moment for us to answer, "That's why."
I am at the end of my undergraduate degree and I have found that the message Dorit Amir expresses in this article is crucial to being a successful student and music therapist. Being legally blind, I have felt overwhelmed, stressed over the intense academic load, and terrified of not being an effective music therapist. I feel that no matter what one’s situation or journey in life, such emotions can trap you and limit your influences in life.
The concept of self-nurture can be easily pushed aside when the demands of school and society seem never ending. I hear people commonly talk about feeling burned-out, tired, and inadequate. I believe we all can fall into these categories when we fail to realize that to give our best in anything, so we must take care of ourselves first.
One of my main fears in earning a music degree was that music would become my job or career instead of my passion and hobby. Because of this fear, I have always made sure that I listen to my music and play guitar so I don’t lose track of why I love music. My school assignments have also helped me by encouraging me to keep improvisation journals and meet with my peers to improvise together. However, this wasn’t enough for me. I still never felt totally recharged and excited about being a therapist. While Dorit Amir needed her own space and room to create music and express herself, I need to take the music I love and create it with others. It is the experience of live performance and being a part of something larger then myself that charges my soul. To achieve this, I joined a Christian band where I am the lead vocalist and now it has became my time to tune into what music does for me. We play everyone’s songs, including my own, in live performances every week and it gives me my joy and originality back.
Dorit stated, "I listened much more intently in a focused way to the music both inside and outside." Being apart of a group that makes beautiful music together allows me to listen to others and add my own creations to it. I felt challenged to grow musically inside and out, so when it comes together I feel fulfilled.
We all have our own reasons for why music plays a beautiful melody in our heart; thus, we all have our own ways of nurturing it. For some it is a simple song, space, instrument, or creating it together. Whatever the case may be, it is vital that every therapist find what it is that recharges him or her or fuels the flame for being a music therapist. If therapists get caught up in giving all the time and never taking the time to recharge, they will never fully be the best that they can be.
Dorit Amir's How Do We Nurture Ourselves was an article in Voices that not only stuck out to me but helped me to think about all of the therapeutic positions on the market that require this kind of self care. I am still in undergraduate school and I'm already realizing that my sanity will also help my sessions with my clients. There are points in people's lives when they cannot give anymore without receiving. In Dorit's case she had been neglected by no one but herself. She discovered that she had to nurture herself before she could give therapy to others.
As simple as this idea sounds, most people at some point seem to forget the concept of caring for yourself before others sometimes. This not only pertains to therapists, whose lives are spent in the concern of others, but anyone who has a consuming life no matter what their position may be. There are those that take this concept for granted and overly nurture themselves (George W. Bush) and then there are the needy who don't often know they are needy of being nurtured.
For Dorit, stepping out of her world into another and learning to embrace another way and culture was awe-inspiring and life changing. Dorit's experience is amazing and inspiring but we can even find simple treasures in our lives that can change experiences for us. I know many pieces of music that remind me of wonderful moments when it felt as if I were an egg yolk and was completely full from the buildup of emotions that was just pricked with the tiniest needle and I'm slowly oozing out of myself into a warm comfort of deep breaths. Most every time that I hear Vivaldi's Spring- Four Seasons, this very experience happens to me. I am momentarily put in another world and transported just like Dorit was while she was in Hawaii. Very different experiences but I can say that piece of music has changed my life just as much.
One of the most interesting parts of Dorit's posting is how she mentioned coming back from her sabbatical, only three weeks later, and finding herself on the other extreme of her new found happy place. She says, ".the Intifada started again, and the tension started to increase." I find it so true that when we think we've found this new place in ourselves of peace and tranquility that seems to solve all of the answers at the time, we often find ourselves back in that area that we worked so hard to run away from or to cure. I believe this is our spirituality coming back down to reality and our inner selves learning to cope and understand that there will be tense times but after our new experience, perhaps we can cope better with the (what seems) impossible moments in our lives.
Dorit found ways to capture the new layer of herself so that she may hold on to that experience in other places than her memories but also in her body, smells, tastes, sights, and most importantly (for such an aural person) sounds. We all have our different outlets and different likes. Finding a way to capture and balance all of these things in our lives can help us to create an experience that betters not only ourselves and minds that we can control (our conscious) and the inside parts of us that we cannot control (our subconscious), but also everyone we may encounter in our lives.
I was very happy to read Dorit Amir's "How do we nurture ourselves?" essay, as this is an issue that I have explored personally, both as an educator and music therapist. I have been a clinician for nearly nine years and when working as a full-time clinician, I experienced periods of emotional and physical exhaustion, as well as the beginning of "burn-out". I realize now, in looking back at that time, that I rarely, if ever, spent time with music for myself. During this period, I began to struggle vocally and issues arose related to both physical and emotional reasons. I no longer performed vocally (I had been a classically trained singer) for fear of the inconsistency of my own voice. So, I slowly allowed my own relationship with music to dissipate (I would practice and play guitar and piano, but only with the focus of my work). I realize now that I should have been taking the time to reconnect with music in a different way, for my own healing. It never ceases to amaze me how caregivers, in general, forget about themselves. We become "caught up" in helping others and we so easily dismiss our own needs.
When I became a music therapy educator, I experienced so many doubts about my musical self. The expectations I tried to meet were overwhelming and I sometimes allowed myself to work musically to meet those expectations. I was trying to use music "appropriately" and in the context of teaching students only. My vocal issues remained and I felt a deep sense of sadness at the loss of my "inner music". I felt "too busy" and overwhelmed by my day to day responsibilities, that I did not make time for my own music. I began to realize, in the past couple of years, that what I was teaching my students was to develop the same disregard for their own music making (although I spoke often about the importance of it). I realized that I needed to model "self-care", not just talk about it. As I began practicing yoga in my first year of teaching, I would experience an inner calm that had eluded me for so long. When I felt physically present in my own body, I felt connected, both spiritually and toward others. This was the beginning of my self-care journey (and recovery).
One of the most rewarding and eye-opening experiences I had musically was while taking a class with Alan Turry (Advanced Improvisation for Music Therapists). During this intensive class, I had to work through my fears, inhibitions, self-doubt and own high expectations and just learn to explore the music. I had taken the class with the intention of just learning new ways to teach my students. I was surprised to come out on the other side open and renewed by my own music making. The experience is one that helped me to reconnect with my own musical self and was extremely rewarding.
I feel that now, through my own music-making, I am so much more renewed and open to my clients, as well as to my students. I still struggle to take time to do this, but it is something I cherish and try to uphold daily. My challenge now is encouraging my overworked and tired students to take time to make her own music and just take time for the self. Trying to teach students that making music outside of their "practice" times and outside of improving their "instruments" and musicianship is so very difficult. This also sometimes seems to conflict with the more formalist view of music schools and some applied music faculty (which is a whole other issue). Music therapy students (and music majors in general) struggle daily with full schedules, lack of time, and high academic stress.
How do we teach the next generation of music therapy students the importance of self-care? How do we teach them that this is a priority if they are to fully be open to others...to be present for their clients? I think we can start by taking this philosophy to heart, by modeling self-care, and by helping them realize that we value self-care as much as any other component in their busy curriculum.
After reading Dorit Amir's "How do we nurture ourselves?" essay, I am inspired to consider my own relationship with music and the ways it has comforted and guided me at various times in my life. As a performing musician since childhood, I have embraced music as my foundation, my strength, and my constant. Over the years when I have explored other forms of expression, I have found that none compares to the depth and familiarity of the expression I find in making music. With its sometimes gentle trickles and other times raging rapids, my music has evolved throughout each new bend in this winding river of life. And so have I.
Three months ago I began my graduate training to become a music therapist. These new steps in my journey have been large and I am realizing an increased need for self-care that I have not known before. Or possibly the need has always been there and I am now learning to more clearly recognize it. I am experiencing a refreshed perspective on some well-known sentiments: in order to care for others you must first care for yourself; to have compassion for others you must first have compassion for yourself; and to help others achieve their potential you must first be willing to explore your own. At times this can be a challenging if not mammoth task for the one who is client, therapist, or human.
Amir beautifully describes creating and maintaining internal balance, calm, and peace amid an unpredictable external environment. Self-care is a necessary part of preservation. I am finding it especially critical as I learn to adapt my work within my new [clinical] setting of music [therapy]. Amir's essay reminds us to create a space for ourselves and to "touch and rediscover [our] own beaut[ies]." For this I am grateful.
Caring for the Caregiver-How do we Nurture Ourselves?
I am excited to read about ways that music therapists can nurture themselves. Dorit's writing inspires me especially -I am comforted to read that she creates a space for herself as I find myself worrying about colleagues, particularly in the Middle East. Having had a tiny bite of terror with 9-11, and more frequent bouts of experiencing trauma in the work I do (medical center in New York City), I have found it to be critically essential to develop ways of taking care of myself. I train interns in this philosophy, calling on them to observe and nourish their inner-needs as clinicians and as human beings faced with traumatic situations, sometimes on a daily basis.
Several years ago, upon working with children with HIV and upon some significant losses, I created a healing circle at work, right on my unit - a place where all staff could come together, using music, candles, prayers, telling stories...and to sing as a community of caregivers...at that time the focus was coming together - to grieve a loss - to honor our lives. This was well appreciated, and I began to lead weekly groups for staff---that soon became more than simply 'experiential training' for them to understand music therapy...(which I had done in the past).
Noticing the level of depression on our Oncology Unit-I put together a group for the nurses. Every other week we come together and sing, improvise, talk, create music visualization experiences - and become a community for ourselves. This has been appreciated and so needed. Steve Schneider (music therapist), Amy Bobo (fabulous former intern from Utah State) and our Director of Chaplaincy have been qualitatively studying the effects of this group. We are using the Compassion Fatigue Scales (Figely, 1999) as well as dialogue (transcriptions from audio taped interviews) and surveys to understand how music serves to affect change intra and inter personally.
But this is not the final quest...what about me? What about the burn-out in our field? Is it enough to put it together for others? "If I am not for myself, who will be for me? If I am only for myself, what am I? If not now when????" (Pirke Avot ancient text)
In doing trauma work, I instruct my interns to use countertransference....to feel and experience...NOT to defend with a huge metal door that separates their hearts from others....and NOT to soak up the energy of others as a huge cotton ball---which would be apt to create symptoms of illness from becoming 'overly-resonant' with a patient-We use the image of a sponge-that can take in desired amounts--and then we work to squeeze out-to be able to release or clean out the energy once the session is over...
What an art this is...and this is where it is now for me. How do I care for myself? How can I use the music in a way that is therapeutic and nurturing, for my own purposes. I am not speaking of playing or improvising to process a session...I am questioning the essence of how I can nurture myself and care for this caregiver???
In 2002, AMTA provided generous funding (through the Recording Academy) for us to create a space to learn in NYC as a community of personal and professional caregivers (those with direct loss and those with secondary-or work-client related losses of 9-11) how music can assist grief and trauma. We studied with trauma experts who were non-music therapists and with our deepest selves and others, what was inherently provoking and healing about music. We learned a great deal, and the music therapists who were part of this training wrote about their experiences (Caring for the Caregiver-The Use of Music and Music Therapy in Grief and Trauma-2002, AMTA Press).
A year later, our group is into a second level training. This time we are only professional caregivers-music therapists, psychologists, social workers, a dance therapist---and we are studying the impact of music, with partial funding, for our researcher, Benedikte Scheiby. We are charging ourselves as a community of caregivers to learn (thru our writing, art and video) about how we can care for ourselves and one another with music. There is a great amount of grief that is emerging, especially now, at the anniversary of 9-11.
In this precious community, I can tell you that I am risking everything, like I never have before. I am opening my heart and soul to the instruments, the songs and sounds...and to this trusted community. Together we are venturing into learning about how the music can help us take care of ourselves and one another. And for me, this is the answer...quite simply---doing it for myself, and figuring out how the music can touch the deepest part of my soul, heart, body and mind, with a community of experienced therapists; talented clinicians (a mileu of healthcare professionals), who all seek to embark on this same journey....Let's continue to explore the meaning that music has for our own purposes, for our own gain. Let's take the risk to go where we encourage our patients to go, for our own needs, amongst one another. Onward...
Joanne Loewy September 11th, 2003
References
Hudnall Stamm, Beth & Figley, Charles R. (1995 -1999). Compassion Satisfaction and Fatigue Test.[online] Retrieved September 11, 2003, from http://www.isu.edu/~bhstamm.
It includes articles and psychometric review. It may be freely copied as long as (a) authors are credited, (b) no changes are made, & (c) it is not sold.
Loewy, J. & Frisch-Hara, A. (2002). Caring for the Caregiver: The Use of Music and Music Therapy in Grief and Trauma. Silver Spring, Maryland: AMTA.
Self care and self-nurture are things I have become very aware of in recent months. Being a university student, particularly a music student, requires an enormous amount of time and energy spent on school. One semester, I calculated that I spent nearly thirty hours sitting in class or rehearsal, this did not include clinical time. I personally am involved in extra curricular activities as well as the normal tasks of study and practice, so, after sleep and meals, there is little if any time left for things such as self-care.
As I went through school several months ago, I began to lose the spark so many of my friends and myself admired. I was rotely going through the motions of class, clinical work, and other activities in a disinterested and somewhat passionless way. I was not putting any emotion into what I was doing, and my music was reflecting it. Passionless music is hardly worth playing, and it is not worth listening to, so I began to lose my desire for music. My classwork was getting completed on time, but I was not learning from it or being enriched from it at all. I was completing it for a grade, nothing more. My clinical work, while I don't think I harmed any of my clients, I did not give them as much help as I think I would have otherwise.
Why was I doing this? Why was I acting this way? I was spent, dried up, dim. My spark had gone out because I hadn't re-lit it. I needed to find myself again.
Then came the question: What lit me up? My first response was music. Of course that's my first response, I'm a musician; I wouldn't be one if I didn't have some passion for music. I decided that I might need a break from music; I reasoned that the constant bombardment of music might have been one of the reasons my spark had died. I didn't have to look very hard to discover what else I have a passion for. Words. I love to read and I love to write. I used to read everything I could get my hands on. With the vast amount of reading that I had to do for class, I had let reading for enjoyment fall by the wayside.
Now, I sit for half an hour - at least - every day and either read a non-required novel, or write a story or part of a story. Occasionally, the mood will take me and I will go longer than a half an hour. I do NOT let myself feel guilty should this happen. If I did these activities for longer than half an hour, it was because it was what I needed to do to take care of myself, and keep myself from putting out my spark.
More and more I realize the importance of this task. What if I become passionless again in my music therapy practice? If I feel no passion for the music, how can I help my clients experience any? As I do these activities, I have also found it easier to leave outside life behind me when I am in my sessions; the reading and writing serves as an emotional outlet for me, and I am better able to concentrate on my clients' issues.
Self-care is still something I am perfecting. I am grateful that I have realized this at this point in my life, and not later when it may have had the potential to cause someone harm other than myself.