I must admit, when I saw the title "Spiritual Music Therapy" I leaped for joy, expecting to read an article which articulates the language of giving credit to God for the support and/or healing that can take place in spiritual music therapy work. Upon reading, I saw yet another document that is careful not to give an identity to any one specific higher power. The author uses such language as feeling one with the whole universe, having experiences that contain sacred, healing moments. While these are safe expressions and true for many people, it’s helpful to give credence to those who claim expressions of an identity to God as their higher power, relevant in their therapeutic process. [For me, god is the higher power. Others identify someone else.] Let me make it clear that I am not suggesting that this author is denying any identity to higher spiritual powers, I only want to acknowledge the perception of avoiding the language.

Once I got passed the above mentioned disappointment, I was able to appreciate the information the author was presenting from her experiences which contribute to the plausibility of opening ourselves to spiritual qualities that are possible in music therapy. When Dorit Amir reflects on the ability for Bach’s Mass in B minor to lift her up and touch her spirit, I recall that Mozart’s choral work, Ave Verum, does the same for me. The spiritual element of the melody has a perfect connection to the text which adds to the experience for me, taking me to a place that is comfortable, safe, calm, and held away from fear and pain. The rising to the climax of the final phrase, "Imortis examine," brings shivers of pleasure to my body. Unlike Dorit Amir, I don’t feel that I am the music nor the music is me. I am one with God who provides the music to hold me and distract me. Could not the same happen for a patient wanting relief from pain and suffering?

Dorit Amir mentions a book by Pir Vilayat Inayat Khan. It’s interesting that she points out the documentation of feeling that she found difficult to articulate. I need to read it because I wonder if Khan goes into depth on the source of the divine inheritance and the role of creativity in the journey of discovering this within oneself.

I would love to have been a part of the Phoenicia group which Amir mentions. To be able to explore the creative and spiritual elements of music and human beings with like minded people would have been valuable to understanding its place in the therapeutic setting.

Spirituality is part of being human as much as music, suffering, etc... With that, I also applaud the organizing committee of the 10th world congress of music therapy in Oxford for recognizing and bringing music, spirituality and healing as one of the three main areas that are central to our global music therapy profession. I agree whole heartedly with Dorit Amir’s belief "that introducing spiritual elements, principles and terminology in our work will give us a deeper understanding of our work and allow us to build theories that will resonate more fully with what we do." If we are to move forward in providing a wider umbrella for the practice of music therapy, we’ve got to go deeper in to understanding various religious choices of clients so that the experiential elements of their religion can be wedded with the spiritual power of music made available.

Some thoughts on Music Therapy in the Ecozoic Era: A Spirituality Journey

1. I am thankful that we have this forum to discuss issues of importance and interest in our global community. I have been reading all of the discussions but have been particularly attentive to the Community, Cultural and Spirituality topics. I feel compelled to contribute.
2. I have been passionate about Music Therapy for thirty years now with 23 years of professional experience behind me. (I always capitalize Music Therapy.) I have also been passionate about spirituality, quality of life, meaning, culture and celebration of differences, compassion, humor, and nature. I finally went back to graduate school and earned a Master's degree in Culture and Spirituality so that I could more fully integrate these areas into my practice as a Music Therapist.
3. Dorit Amir challenged us in her Nov. 11, 2002 VOICES discussion to share our spiritual experiences. "Introducing spiritual elements, principles and terminology in our work will give us a deeper understanding of our work and allow us to build theories that will resonate more fully with what we do."
4. In this year's AMTA conference program I see a few offerings listed in the area of spirituality. That is a good thing but what, I always wonder to myself, is going to be the context. Is it going to be anchored in religion? From the East or West? From a Judeo-Christian perspective? "New Age"? I submitted a proposal for a continuing education course, "Spirituality and Music Therapy: Expanding Concepts in the Emergent Ecozoic Era", that tackled the inclusion of Music Therapy in the context of a growing global movement. I would like to share some of my thoughts about spirituality and culture.
5. (The term "Ecozoic Era" refers to the promise of a coming era when humans live in a mutually enhancing relationship with the larger community of life systems. It could also be called the "ecological age." It is based on eco meaning house and zoic meaning life. Put together it means: "House of Life.") FYI - We are currently at the end of the Cenozoic era that began on Earth at the time of the mass extinction of dinosaurs.
6. Spirituality does not exist in a vacuum within a religious context yet, in my experience, it is usually something that is not only discouraged in discussions and treatment with clients but also prohibited. The Ecozoic concept may be broad and difficult to understand but it does give a context within which to discuss spirituality. That context is the Universe and the study or discipline is Cosmology. You may not understand all of it, and I may not explain it very well to your satisfaction, but it is a beginning, a journey. Expanding the concept of Spirituality is not so easy as we might like to think. Some may be content with a limited view that defines spirituality only in terms of a religious context. But there is so much more and it is interesting and exciting. The new context has such great potential for instilling much needed meaning and inspiration in our lives.
7. On the weekend of September 24th, 2004 I was privileged to be an invited participant at the first International Conference on Engaged Cosmology. Though you may not have been aware of it the profession of Music Therapy was represented at the gathering. The conference had delegates from many cultures and parts of the world including Asia, Europe, North America, Africa and the South Pacific representing such diverse fields as theology, biology, cosmology, astronomy, physics, social science, medicine, creative arts, women's studies, architecture, education, ecology, Earth literacy, social activism, politics, peace studies and Music Therapy.
8. Specifically we are looking at ways that all of our areas of inquiry can help to shape our local and collective cultures so that we can more effectively integrate care for our Earth home and all creatures both human and non-human. Our context for meaning is the New Story of the Universe - a fifteen billion year unfolding of creativity and life of which we are an integral part. This is a new context, an expanded framework within which to live a meaningful life in communion with the cosmos - all that we can know and experience - without exclusions. We seek to tell this story informed by science and including all voices. This is a deeply spiritual context. It is Spirituality in the fullest sense. It is also convergent with community or cultural Music Therapy that starts in one to one sessions - microcosm - and builds exponentially toward involvement with our communities and culture at large - macrocosm.
9. One of the primary outcomes of the conference was the creation of the Ecozoic Council. A key feature will be a website dedicated to sharing information and projects related to the transformation of our culture at large using all the wisdom of our respective fields of study as a Spiritual journey. Together we can be a prophetic community dedicated not only to the improvement of each person's quality of life but also of the quality of our Earth home with all its human and non-human inhabitants. This focus recognizes Earth as our primary context for life and meaning and helps us to understand goals, from a therapist's perspective, that go beyond the therapeutic setting to include the family, community, city, county, state, region, country, and planet as bioregions and socio-political constructs. Many of us treat clients in a sheltered setting where we experience wonderful results but I always felt bad about the kind of world to which they had to return.
10. "Improvisation is the saving skill. We play a crucial role in selecting the melody, setting the tempo, establishing the way and inviting the players - when it works we sit back amazed and grateful." -Margaret Wheatly
11. Organizations, groups and individuals not directly involved with the promotion of the New Story as the context for our evolution but that are nonetheless striving to integrate compatible principles and vision are considered Friends of the Council. Music Therapy as a profession, indeed all the creative arts therapies (though I have a particular fondness for music), is a perfect example of a friend. Music Therapists for Peace, Hospice Music Therapy and Music Therapy as a Response to Crisis and Trauma are fine examples of movements aimed at recognizing and healing our pain as a society. Music Therapists have many parallels with indigenous wisdom found throughout the world.
12. There were many renown participants* at the conference giving us updates on the global level and sharing their research and ideas for bringing spirituality to the forefront of their respective fields. And they all heard from me speaking about Music Therapy as a creative art used in the service of healing others. My ongoing research over the past few years involves the use of music in and as therapy applied to culture. It is interesting that I began my studies in earnest at about the same time but before I first read about Cultural and Community Music Therapy as new models.
13. The profession of Music Therapy is poised to make a tremendous contribution to the current transition into this new era where the institutions of society as we know them must change drastically if we are to thrive as a species, an era characterized by compassion versus exploitation and including historically repressed wisdom traditions and a deeper trust in the creative process. Music Therapy has been a part of the expanding consciousness exemplified in trends in the literature with such minds as Carolyn Kenny, Ken Aigen, Gary Ansdell, Barbara Crowe, Brynjulf Stige, Dorit Amir, Joe Moreno, Helen Bonny, Edith Hillman Boxill and others.
14. There is an ongoing discussion as to whether or not Music Therapy in a cultural or community context can be considered a legitimate application. I say, of course it can be. And like a quantum particle-wave it is not an "is" or "is not" but a "both and". I have mentored many Music Therapy Interns over the years and I like to think I gave them all a gift by enabling their independent thought, by advising them to listen to their own inner voice and not to listen to anyone tell them they can't do something, and by reminding them that anyone can create and develop a new theory, technique, method or model. I represent the Universe when I say go ahead, give it a try, let's see what happens. The MTs noted above are also unique voices poised to embrace and nurture a vision of therapy with music outside the traditional medical model "box".
15. Music Therapy can become a focused tool to aid in the expansion of consciousness and help create a story wherein all VOICES, human and nonhuman, are heard and of equal value. Community or Cultural MT in this case refers to the use of music to effect cultural change on the whole. It is the directed use of music with our exterior material structures and interior dimensions. Lesley Blunt wrote of Telling Our Stories in VOICES. It is, actually, another way we as MTs can tap into the new cosmology by finding a place for our personal stories within the context of the stream of evolution. Of particular interest for us is the importance and revelation of music in our lives. What is your earliest connection with music? How did this come about? What inspired you to become a music healer? How does music sustain and inspire you?
16. All of this is a movement toward an engaged cosmology - a functional, viable context for everything - and finding our place. It involves the integration of the wisdoms of our classical traditions (e.g. educational institutions, religions), women's voices (historically repressed yet so necessary for balance), science (fantastically interesting, significant and beautiful discoveries) and indigenous cultures (interconnected with Earth in a meaningful cosmos, belonging, healing). Ultimately our entire Western culture would become indigenous, balanced, and wise in its ways. Actually, we are already indigenous to our planet but we have not fully recognized this fact or we might not have plundered our limited resources over the years to the point where our home is fast becoming so toxic that our time on Earth as a species is being cut short. We have been taught over and over again that we are in exodus, but when do we get to go "home"? And worrying about the afterlife is no way to live through this one. I don't recall who said that but I like it.
17. Religions are pertinent to spirituality because they exist primarily to serve spiritual needs, motivations and questions. But think of all the voices over the years that have been repressed or excluded in the name of belief and dogma. Any religion that excludes diversity in its scope is limiting its potential growth and ability to incorporate ultimate wisdom that may develop from such diversity. When all voices and perspectives are not heard - including those of our voiceless non-human companions - we are depriving ourselves of the full range of human expression and wisdom. Diversity is a key principle of the universe and as such the number and variety of different "things" is an integral part of what is so special about what we know to be our world. It is also much more interesting.
18. Think of the pattern whereby we repeat - over and over again throughout an entire lifetime - the lyrics to hymns that may be holding us back from inner growth, aiding us to be set in our ways. It is time to break the pattern, just as one would do following a cognitive-behavioral approach, because we are losing our home environment and it is essential to understand that it is not just beautiful nature but also our primary connection to the epic story of life, our story, our place. Who better to get involved than a Music Therapist? Breaking and rebuilding are essential aspects of the creative process and as therapists we can help to give a direction to this creativity. Music is a perfect tool since it is not static but dynamic and process rather than product oriented.
19. Religions are not static either; they have grown and changed over time and continue to evolve today. One of my mentors was fond of reminding me that our worldview at this particular time in history, with all of our unique perspectives, is only "somewhat adequate for now". This basically means that we will gradually come to know and understand our predicament in history and come closer to resolving our dilemmas but we don't really know how to now. Our societies function, we are aware that there are problems, and we attempt some solutions but, generally, we get along as best we can. This same frame of reference applies to any image of God - or any term for a higher power - you may have in that the image we have or need changes over time in relation to our maturity and wisdom.
20. Music Therapy is also needed to help staff within what might be termed the medical model box of our western culture, one of the only systems left in the world that is still thinking from a Cartesian perspective and not very well integrated. Hospice is perhaps the best model so far of a balanced system: clients are not helpless but empowered, family and significant others are involved, holistic medicine is practiced and, perhaps more importantly, thought, emotions and intentionality are essential considerations.
21. Creative Arts Therapists are caught in the same dysfunctional medical system but like all true artists, many of us know it and are able to express our frustrations or ideal view of culture through and with our medium. We as therapists can also have a profound impact, albeit gradually, on the system as a whole. From the quality of our work with clients to the empowerment of staff to express themselves and start to think outside the box, to discussions and activities with our families and friends to the transformation of our communities and so forth. Along the way we bring beauty as a companion in the form of music. We seek to create it, to help others to connect with it and through it, and to use it to enact some greater influence on our world around us. We have no choice. We are compelled by a primary revelation from deep within and this inspiration is interconnected - in communion - with all that we know to be our Universe, our true home.
22. We live in an urgent time of change. Destruction and depletion of our Earth resources, violence in the name of God and religion in the form of genocide, terrorism and ongoing struggles for land and ideas, world hunger (soon thirst) and discrimination. All of these are symptoms of disease, disease of thinking, of belief, of spirit - the shadow side of existence. And we are therapists who use music, this same creative energy of the universe, to help in the healing process of, essentially, itself since we are the Universe, too.
23. We humans are the best source for alleviating our suffering but, conversely, also capable of creating the bulk of it. The recent focus of Music Therapy and Trauma is a good example of a new way of thinking about how we can aid not only suffering individuals but also a suffering community in a very direct manner. To be sure, bringing therapy to marginalized people who need it in facilities and institutions is, and has been, our primary and noble focus but to bring therapy to our communities and broader institutions may be our work of the future. Know this: our future is here and many therapists alongside thinkers in a variety of fields are already mindful of the emergent consciousness required for this new journey, the journey into the Ecozoic era. We are at the threshold.
24. "In a way, we could say that the practice of geo-justice is an improvisational practice. It is the work of the cultural artist." -James Conlon. Perhaps a new role for us will be as Cultural Arts Therapists.
25. As old institutions and ideas fall apart and die, making a way for newer forms to rise, hospice workers will be necessary to ameliorate the suffering and pain, therapists to ease the transition and help us to remain connected and functioning, and artists to nurture our creative impulses, remind us of who we are and challenge the direction of emergent growth. We are the hospice workers, therapists and artists. If the only thing you understand, the only thing you can do is to help another to heal and to make beauty, that's great! The direction is positive, embraces an evolving consciousness and targets compassion as its highest aim. But you can have a deeper understanding. And that is why we are now as a profession sensing a need to give spirituality another look. That is why I created a continuing education course: to help others to continue their education.
26. The direction of the Universe seems to be to discover your creativity and find ways to express it. To follow this impulse is awfully difficult in our current society; there are many obstacles, distractions, and aspects of our lives that need to be unlearned. To recapture the sparkle of life as viewed from the perspective of a child is not so easy as an adult when most of our creative energies have been suppressed or ignored. But once again, who better to get involved than a Music Therapist? Someday we will explore together a language and an understanding of the New Story of Music Therapy as a spiritual journey at a conference or workshop. I hope to see you there.

"In the future, there is certain to be dire need for leaders and citizens who can cope with the never before experienced challenges and opportunities of the changing local and global contexts. The level of consciousness demanded in this moment of our evolutionary history goes beyond that which we have inherited from any of our ancestors. We are in uncharted territory. In my view, we urgently need new institutional forms for accelerated social learning that can simultaneously expand individual consciousness at the same time they could expand group and societal consciousness." - Carl Rogers in O'Hara, Maureen (2003). Cultivating Consciousness: Carl R. Rogers' Person-Centered Group Process as Transformative Androgogy. Journal of Transformative Education Vol. 1 No. 1, pp. 64-79.

There, I wrote God, religion, wisdom, cosmology, ecozoic, spirituality and Music Therapy in the same article. Are we still talking?

*Some of the participants at the Conference on Engaged Cosmology: Thomas Berry: theologian and ecologist who gave the Ecozoic Era its name, James Conlon: sociologist, educator, spiritual activist and founder of the Sophia Center Graduate program, Steve Dunn: founder of the Elliott Allen Institute for Theology and Ecology, John Grim and Mary Evelyn Tucker: coordinators of the Harvard University Forum on Religion and Ecology, Patricia Mische: founder of Global Education Associates and Professor of Peace Studies Antioch College, Sr. Helen Prejean: author of "Dead Man Walking", social justice and youth activist, Richard Register: Eco-City Builders of "green" architecture, Rosemary Radford Ruether: foremost author and educator of feminist theology, Brian Swimme: cosmologist, educator and author of "The Universe Story", Charlene Spretnak: educator and founder of the Green Party.

Further Reading

The following list represents only some of the more interesting aspects related to Spirituality as an evolving concept, the most compelling of which is The Dream of the Earth by Thomas Berry.

Aigen, Ken (1991). Voice of the Forest. Music Therapy, Vol.10, No.1, pp. 77-98.

Berry, Thomas (1988). The Dream of the Earth. San Francisco: Sierra Club Books.

Conlon, James (2000). The Sacred Impulse. New York: Crossroad.

Fox, Matthew (1983). Original Blessing. Santa Fe: Bear and Co.

Goldman, Jonathan (1988). Toward a new consciousness of the Sonic Healing Arts: The therapeutic use of music for personal and planetary health and transformation. Music Therapy, Vol.7, No.1, pp. 28-33.

Grimm, John and Mary Evelyn Tucker, Harvard Forum on Religion and Ecology book series: 1997 - 2004, Cambridge, MA: Harvard University Press.

Hart, Mickey and Fredric Lieberman (1999). Spirit Into Sound. Petaluma, CA: Grateful Dead Books.

Kenny, Carolyn (1998). Embracing Complexity. Journal of Music Therapy, Vol.35, No.3, pp. 201-217.

Kenny, Carolyn and Brynjulf Stige, (Eds.) (2002). Contemporary Voices in Music Therapy: Communication, Culture, and Community. Oslo: Unipub forlag.

Lipe, Anne (2002). Beyond Therapy: music, spirituality, and health in human experience: a review of literature. Journal of Music Therapy, Vol. 39 No. 3, pp. 209-240.

Reck, David (1977). Music of the Whole Earth. New York: Charles Scribner's Sons.

Reuther, Rosemary Radford, (1992). Gaia and God. SanFrancisco: Harper.

Stige, Brynjulf (2002). Culture-Centered Music Therapy. Gilsum, NH: Barcelona Publishers.

Swimme, Brian and Thomas Berry (1992). The Universe Story. SanFrancisco: Harper

Williamson, Marianne, ed. (2000). Imagine. Daybreak/Rodale.

Music therapy and spirituality; A transcendental understanding

There has indeed been an emerging interest in spirituality in the field of music therapy, particularly for those working in palliative care that predates the Oxford Congress (Aldridge 2000; Aldridge 1995b; Bailey 1997; Lowis and Hughes 1997; Magill 2002; Marr 1999; West 1994). In "Music therapy in palliative care: New voices" (Aldridge 1999), several authors reflect the need for spiritual considerations when working with the dying (Hartley 1999; Hogan 1999). Nigel Hartley has developed this work particularly in hospice settings (Hartley 2001) and with Gary Ansdell ensured that the theme was prominent at the last Music Therapy World Congress in Oxford. In the world of music therapy, the importance of spiritual considerations is evident in the early work of Helen Bonny as a central plank of her approach (Bonny and Pahnke 1972) and Susan Munro's pioneering work in palliative care (Munro and Mount 1978).

Lucanne Magill responded to Michael Mayne at the World Congress in Oxford, July 26, 2002. She reflected on what she believes is really the heart of what we do, music therapy in spirituality. As she says, "So much of what we do is beyond words and it is really because of this transcendental nature of music that important healing in music therapy can and does occur". Her response, in full, can be found at http://www.musictherapyworld.net online.

These considerations of spirituality are not unique to music therapy, there is, and has been, over the last decade, an increasing vigorous debate over the need for spiritual considerations in health care delivery (Aldridge 1987a; Aldridge 1987c; Aldridge 1988; Aldridge 1996; Bailey 1997). There is an overlap between music therapy and several other integrative medicine approaches particularly in the use of breath and how this is applied in altering consciousness (Aldridge 2002). Based on this published work, Nigel Hartley asked me to speak at a series of symposia held at the hospice where he works in Oxford, and we have presented together at various venues. Our intention has been to sponsor the discussion of spirituality as a legitimate topic in music therapy, just as I have tried to do in the field of medicine (Aldridge 1987a,b and c; 1991a and b) and healing in religion (Aldridge 1986) over the last fifteen years.

My thesis is that health, like music (Aldridge 2002), is performed. Indeed, the process of "healthing" can be understood as an improvised process of "musicking". How health is performed depends upon a variety of negotiated meanings, and how those meanings are transcended. As human beings we continue to develop. Body and self are narrative constructions, stories that are related to intimates at chosen moments. These meanings are concerned with body, mind and spirit. My intention is to set about the task of reviving a set of meanings given to the understanding of human behaviour that is termed spiritual. It is legitimate to talk about spirituality in a culture of health care delivery. Human beings perform their lives together in meaningful contexts of significant others that are nested within broader social contexts. The difference contexts of performance are related to an ecological understanding of what it is to be a human being amongst other human beings and will argue for a return to a sacred understanding of human beings and nature. In these instances, "God", "the divine", "the cosmos" or "nature" may be the name given to a meaningful immanent context in which life is performed.

Spiritual meanings are linked to actions, and those actions have consequences that are performed as prayer, meditation, worship, healing and in our approaches, music healing. What patients think about the causes of their illnesses influences what they do in terms of health care treatment and to whom they turn for the resolution of distress. For some people, rather than consider illness alone, they relate their personal identities to being healthy, one factor of which is spirituality. The maintenance and promotion of health, or becoming healthy, is an activity. As such it will be expressed bodily, a praxis aesthetic. Thus we would expect to see people not only having sets of beliefs about health but also actions related to those beliefs. Some of these may be dietary, some involve exercise and some prayer or meditation. Some will be musical. In more formal terms they may wish to engage in spiritual healing and contact a spiritual healer amongst the health care practitioners that they consult. Indeed, some medical practitioners refer patients to spiritual healers (Aldridge 1986; Aldridge 1987b) or develop holistic concepts of health care (Aldridge 1988).

There is a link between religion and spirituality, that I argue extensively in my book Spirituality, healing and medicine (Aldridge 2000) although the two are often confused. The same difficulty has prevailed in the medical and nursing literature where spiritulaity and religion are confounded.

All major religions recognise a spiritual dimension and that is the relationship between the human being and the divine. We see this reflected in the Yin and Yang symbol of Traditional Chinese Medicine that emphasises the vertical relationship between the human and the divine, each in their manifestation containing a seed of the other and uniting together to form a whole. Similarly, the Christian cross reflects both the realms of horizontal earthly existence and vertical divine relationship. The difficulty lies in the explanations that are used for understanding when either a sacred ecology or the divine relationship is used, one is assumed to supersede the other according to the interpreter of events. Both are partial. Indeed, what many spiritual authors seek is to take us beyond the dualisms of material and spiritual, beyond body and mind, to realise that in understanding the relations between the two then we leap to another realm of knowledge. Indeed, the Buddhist concept of the "Middle way" is not to find some mid-point between the two, but to transcend the two ideas unifying them in a balanced understanding. This leap that goes beyond dualism is the process of transcendence. In its simplest form, there is a change of consciousness to another level of knowledge; in short, the purpose of spirituality is achieved.

Spirituality in a late modern sense is used consistently throughout the literature related to medical practice as an ineffable dimension that is separate from religion itself. A person may regard herself as having a spiritual dimension but this may not be explored in any religious practice. Central to these arguments is the concept that spirituality lends a unity and purpose to life.

My position is that if spirituality is about the individual, ineffable and implicit, religion is about the social, spoken and explicit. Such definitions are an attempt to explicate the practices whereby spirituality is achieved. Spirituality lends meaning and purpose to our lives, these purposes help us transcend what we are. We are processes of individual development in relational contexts, that are embedded within a cultural matrix. We are also developing understandings of truth, indeed, each one of us is an aspect of truth. These understandings are predicated on changes in consciousness achieved through transcending one state of consciousness to another. This dynamic process of transcendence is animated by forces or subtle energies, and music is a primary example, in some contexts, of such subtlety.

To remain authentic to both traditional texts and to the earlier part of this commentary, I would suggest the use of truthing rather than truth, in the way that I have used healthing rather than health. Truth(ing) being a cosmic activity related to the breathing out and breathing in of the creator, thus my previous remarks about life being analagous to music; "living as jazz" where we are constantly being performed as living beings (Aldridge 2000). Thus, truth is an activity; truthing constantly being performed, and we are its examples.

"Religious" is used as an operationalization, or outward manifestation of "spirituality". There are spiritual practices that people engage in, these often take place in groups and are guided by culture. As a cultural system, religion is a meaning-seeking activity that offers the individual and others both purpose and an ability to perceive meaning. We have not only a set of offered meanings but also the resources and practices by which meanings can be realised. However, as Idries Shah reminds us that we must be wary of confusing "spirituality" with what is manifested outwardly.

"The poetry and the teaching to which you have referred is an outward manifestation. You feed on outward manifestation. Do not, please, give that the name of spirituality" quoted in the story of "The Cook's Assistant" Idries Shah (1969), p. 115.

The social is what is common to all religions, it offers forms for experiencing nature and the divine; for transforming the self that is the goal of human development. Consciousness, achieving truth, is a social activity dependent upon its embodiment in individuals. Culture is the specific manifestation of such social forms in symbols, language and ritual localised for temporal and geographical contexts, thus specific cults and cultures. In globalization, we have the dissemination of culture but without social forms related to human contact. Therefore we may spread the idea of spirituality but offer no forms for the achievement of spiritual understandings, which is the traditional role of religious forms in everyday life. The same goes for the idea of music therapy, the idea of musicking as a performative health practice is useless unless we find cultural forms (as in perFORMance) such that healthing may be achieved. This may be at the heart of the current Community Music Therapy debate where music therapy has become a globalized activity and there is a need for negotiation of what forms it will take. (No doubt the mullahs, ayatollahs, bishops, high-priestesses of music therapy will all have their say about what form is has to have). The process of truthing behind the spirit of music therapy will be expressed socially in its religious forms. These forms will be inevitably corrupted, like all religions, as they appear at specific times, in specific places for particular peoples (even though the time may be centruies, the places inter-continental and the peoples varied). Only spirit remains.

Beyond meaning - Transcendence

Medicine, from the Latin root medicus is the measure of illness and injury, and shares the Latin metiri, to measure. Yet this measurement was based on natural cycles and measures. To attend medically, Latin mederi, also supports the Latin word meditari from which we have the modern meditation, which is the measuring of an idea in thought. The task of the healer in this sense is to direct the attention of the patient through the value of suffering to a solution which is beyond the problem itself. In this sense, the healer encourages a change in the sign of the patient's suffering from negative to positive. We are encouraged to see the benefit of suffering in bringing us beyond our present understandings, which is also an understanding of the transcendental. This, I argue, is what happens in music therapy, particularly in the context of palliative care.

Transcendence is a "going beyond" a current awareness to another level of understanding. This does not necessarily imply a conventional set of beliefs, it is based upon an innate capacity that we have as human beings to rise above the situation. Boyd (Boyd 1995) makes his argument for a consideration of the term "soul" as separate from "spirit". "Soul" is the subjective or inner person as a whole in the natural state, including the body as an inseparable part, and relates to the word "psyche" (p151). "Spirit" however refers to that which could be both inside and outside a person. Soul focuses on the secular self, spirit refers to that which brings the soul to transcend itself, from without or within.

The process of spiritual development can be seen as a "quest" or a journey, In medieval times, the quest for the Holy Grail was not for a material chalice but symbolised the search for knowledge as a vessel in which the divine may be contained. However, what confounds this issue today is that we equate questioning as an activity rather like the chatter of infants. Many spiritual traditions emphasise the importance of silence and non-activity where the appropriate question may be framed, an as importantly, the answer may be heard. Meditation, prayer and music have both been used to fulfil these functions.

Techniques of questioning, as embarking upon a quest, are a the heart of both science and spirituality in the search for knowledge. However, both demand a discipline if answers are to be found. These appropriate methods of questioning have to be learned and the approaches taught. The answers however cannot be learned for they appear new to each generation and to the appropriate contexts.

While the spiritual dimension may be separate from the religious, religious practices are said to provide a bridge to the spiritual, thus assuming that the spiritual is a realm beyond the religious (Lukoff, Provenzano, Lu et al. 1999). This spiritual dimension is seen as a relationship with a higher power experienced as internal and intensely personal that need not be associated with the formal external aspects of religion; transcending sense phenomena, rationality and feelings leading to a heightened state of consciousness or awareness. The danger is that what may be seen as "spiritual illuminations" in the raw condition of altered states of consciousness are imagined to be spiritual experiences . These can become addictive (Shah 1983; Shah 1990) preventing any developmental change. Thus the need for a spiritual guide, emphasised in the great traditions, and reflected too in secular psychotherapy as a wise counsellor, to prevent the interpretation of emotions as spirituality. the same confounding of emotion and spirituality may also occur in the use of music, hence the prohibition of musical experiences in some religions and at some stages of spiritual teaching.

The ability to rise above suffering, to go beyond the present situation to a realm where life takes on another, perhaps deeper, significance is an important factor in palliative care , in the long term management of chronic illness and as central plank of psychotherapy. In the treatment of alcoholism, it is the recognition of personal suffering and the need to transcend the limitations of the self, to understand that we are "Not-God"(Kurtz 1979), as a process of spiritual awakening that brings about one of the vital steps in recovery. Deborah Salmon (Salmon 2001) refers to music therapy as a containing or sacred space that facilitates the process of connecting to that which is psychologically and spiritually significant for the patient, thereby transforming experiences of suffering into those of meaning.

Transcending the current situation

From the literature it is possible to piece together a process of spiritual change where there is a need to transcend the current situation. To achieve this there has to be a change both in thought and feeling accompanied by appropriate actions. This is expressed as a process of questioning, as a search for meaning. Such meanings take the searcher beyond what she is to a higher consciousness, or state of awareness, that is connected to the truth, which people refer to as "god", "the divine", "the supreme power", "that". This is a circular process of development based on revealed personal understandings achieved through transcendence, which lead to other understandings. Idries Shah refers to this process as a removal of veils to the Truth (Shah 1978). These veils that obscure the truth are formed either through indoctrination, that blinds us, or through the base aspirations of our subjective selves preventing subtle perceptions and higher visions. Religion itself may be a veil that hides the truth, although it offers a public perspective into the truth. The task we face is how to make those veils transparent , or remove them. A further task is how to cope with the truth thus revealed.

The whole concept of pluralism, often invoked for justifying differing positions within the world of music therapy, is itself a term borrowed from theology. The basis of the understanding is that no one of us as human beings can begin to claim a full understanding of the divine (or what ever you may choose to call him or her), thus in all modest we have to recognise that we have only parts of the picture. A challenge is for us all to come together and merge those various understandings. This is recognised in the Christian perspective of 2Though we are many, we are one body".

Central to this process of transcendence is the recognition of a higher power. The argument surrounding powers, forces and energies appears to be a common denominator in varying explanations of spiritual healing (sometimes expressed as vibrations). Even where spiritual energies are not mentioned directly in term so healing, they are described as the driving force behind the specific search for meaning (Aldridge 1995a). So when we want to understand the process of healing, then perhaps we can use a coarse metaphor and ask how this process is fuelled. As we saw earlier, the whole person as "soul" is transformed from within or without by "spirit". My suggestion is that what is sometimes called "mind-body" medicine may be more accurate in referring to "soul" medicine leaving room for an invigorated concept of spiritual healing.

In the same manner, what may be termed the spiritual in music therapy, may be better referred to as "soul music", which is only an excuse for me to get out my Otis Redding song book. And heaven forbid a new movement "Spiritual Music Therapy".

References

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