Music therapy in Cyprus is represented by a multiplicity of approaches and practices. They are part of a more multi-faceted culture, as will be analyzed in this article. Arts therapies in general are relatively new to Cyprus, and this is reflected by the absence, so far, of professional associations in any of these professions. Music therapists, however, are increasing in number and the need for the creation of such an association has arisen. The establishment of a professional music therapy body is now in process, and will hopefully be completed in 2008.
Cyprus is an island of 9,251 square kilometers (3,572 square miles) lying on the eastern side of the Mediterranean sea. It is the third biggest island of the Mediterranean sea, with a strange shape, within which you can see the violin if you are artistically inclined. Geologically, it is characterized by two mountain ranges, the Pendadactylos range in the north and the Troodos range in the south, which take up the largest part of the island. Politically, these two mountain ranges also have significance, as one lies in the south, Greek Cypriot part of the island, while the other lies in the north,Turkish-occupied part.
The year 1974 was a landmark in Cyprus’ long history of occupations. In that summer, a coup against the Greek Cypriot president, instigated by the then Athenian junta, led to a Turkish invasion of the island and the occupation of 38% of its territory. One third of the island’s population was displaced. This was followed by an exchange of populations, with the Greek Cypriot inhabitants fleeing to the southern and the Turkish Cypriot inhabitants to the northern part of the island.
The island’s habitation, which began in Neolithic times, had never before suffered ethnic cleansing to such a degree and this has left its imprint on the current culture and mentality of the Cypriots. Lying at the crossroads between East and West, the island fell successively under Assyrian, Persian, Egyptian and Roman domination in ancient times; later it became part of the Byzantine Empire, soon to fall under the Arabs, the Franks and the Venetians until it was conquered by the Ottoman Turks in 1571. It was still part of the Ottoman Empire, when it was bought by Great Britain in 1878, becoming a Crown Colony in 1925. In 1960 it gained its independence, and for the first time in millennia it was ruled by its own people (Panteli, 1990).
The Greeks first arrived in Cyprus before and after the fall of Troy, with the decline of the Mycenean kingdoms (from around 1400BC). In spite of all the occupations, the Greeks have left the strongest impact on the island’s inhabitants. Greek language and culture characterize the majority of the island’s inhabitants, numbering at the present moment approximately 780,000 people.
The years between 1960 and 1974 are considered by the Greek Cypriots as their golden period, when everything suddenly flourished and when they had more control over their own affairs than at any other time before. The Turkish Cypriots, however, feel that this was a time of unfair discrimination against them. At the time, the Turkish Cypriots represented the 18% of the island’s population. Now their numbers are approximately 265, 000, including the Turkish settlers who immigrated to northern Cyprus as a result of the Turkish occupation.
The southern two thirds of the island are now governed by an official and world recognized Greek Cypriot government, which, however, has no control over the occupied northern third of the island, administered by Turkish Cypriots. The Turkish Cypriot administration does not bear world recognition.
From 1974 until 2003 there was little contact between the Greek Cypriot and the Turkish Cypriot parts of the island. While not in touch with the reality of a growing community in the northern, occupied part of the island, the Greek Cypriots were constantly dreaming of returning to their homes and hoping to bring back the golden pre-1974 times. With the opening of the cease-fire line in 2003, when the two peoples traveled and saw each other for the first time in almost 30 years, another reality had dawned. This reality is experienced very differently by the different individual personalities and comprises something of what I consider the Cypriot mosaic culture. Some people, Greek and Turkish Cypriots, have re-found in each other a lost and forgotten “brother” and have reconsidered their history, believing that peace and a shared life is better than the fragmentation of their island. Others have found it difficult to come to terms with the issue of lost homeland and have not yet crossed the line. Others, still, have discovered only differences and experience the co-habitation between the two communities as an impossible scenario.
The year 2004 was another landmark in Cyprus’ history, when it entered the European Union.
Inevitably in what follows I shall be focusing on music therapy as practiced in the areas controlled by the official government of Cyprus. One of the reasons is that, despite the freedom of movement, it is still not easy to keep in close contact with everyday matters in the northern part, and particularly with institutionalized structures. Another reason is that, to the best of my knowledge, there is no practicing music therapist there. Thus, in what follows, when I mention Cyprus, I mean the officially recognized southern part.
The Republic of Cyprus has created its own university only in 1992. Independent universities have just been awarded state recognition. The Cypriots, however, have not, in their vast majority, abandoned their custom to study abroad. Every year, for generations now, thousands of young people leave the country to study in Greece, England, USA, Central Europe, Russia, to mention some of the old favourite locations. Turkey has been, of course, a favourite choice for the Turkish Cypriots.
This multiplicity of approaches, created by the variety of educational backgrounds, is also reflected in the practice of music therapy. The thirteen or so professional music therapists currently working in Cyprus have studied in the USA, England, Germany, Italy and Australia. Apart from bringing with them the particular characteristics of the country of their study, they also employ different approaches of music therapy practice. Among the five music therapy approaches acknowledged at the Ninth World Congress of Music Therapy in 1999 (Bunt, L. and Hoskyns, S, 2002), the only one that is not practiced in Cyprus is the Guided Imagery and Music approach. Moreover, some music therapists employ a combination of approaches, described for example as a humanistic method (Papaioannou, Charilaos, personal communication) or a client-centred approach (Panayides, Marina, personal communication).
In their majority, music therapists work with people with learning disabilities. In fact, the first music therapy work position was created at The Nea Eleousa Institution for people with severe learning disabilities in 1988 by the present author. At the time, there was no other practicing music therapist on the island and it was extremely difficult to convince any professional that music therapy was indeed a discipline worth any serious attention. Years of case-study presentations taken from that solitary work in the institution and given to medical and paramedical professional organizations, alongside media interviews and newspaper articles led to my appointment, as a music therapist, to the Special Education Committee in 1992. This Committee was appointed by the Minister of Education and Culture with the purpose of studying ways of improving the educational provision of people with learning disabilities. As a result of the Committee’s report, major improvements were implemented for the first time in the field of Special Education. Among these were: a) a new ‘Law on Special Education’ safeguarding mainstream education for some students with learning disabilities; b) the employment of psychologists and arts therapists in special schools.
Thus, the first official jobs for music therapists were created in special schools. The difficulties encountered by music therapists working there reflect a state mentality which is still unprepared to accommodate the needs of the students or the requirements of a music therapy service. Two USA trained music therapists, Christiana Koutsoupides and Magda Papadopoulou – Kantaris, have kindly contributed an in-depth account on the state of music therapy in special schools. Through this, one can witness the perseverance and determination of school music therapists to establish the profession against all odds.
The first official appointment of music therapists in the public special schools of Cyprus took place in September 2001. There are seven public special schools throughout Cyprus serving the needs of children ages 6 to 21 with a variety of disabilities. The therapists are employed by the Ministry of Εducation and Culture, with yearly contracts based on a list of candidates where the order of appointment follows the order of application date. Currently, five music therapists are employed in these seven schools providing treatment in the form of individual or group sessions.
Being such a newly introduced profession in the area of special education, music therapy still faces a few vital problems that interfere with the efficiency of the services provided. For example, the fact that the therapists are employed by the government with yearly contracts binds the therapy into a specific time line caused by the uncertainty of being rehired, or being transfered to a different school from year to year. In view of the nature of the population served and considering that one school year lasts only from September to June, this might also interfere with the needs of specific clients who require stability or longer treatment periods.
Furthermore, the therapists are appointed to work for a specific number of hours in a week, which are not enough to cover the needs of the students of an entire school. In some cases, a therapist is hired to serve two schools, which limits the hours of services even more.
This shortage of staff is caused by a limited budget for the hiring of music therapists in the special school system. The combination of the staff shortage and the ever growing needs, causes music therapists to be expected unfairly to carry out unusually large group sessions in a hasty attempt to offer music therapy to as many students as possible, thus playing down the therapeutic subtleties between individual and group sessions.
Another problem that emerges is the fact that the hiring of music therapists is governed by a teacher-centered system, which the therapists are obliged to follow. Consequently this interferes with standards of clinical practice relating to scheduling and responsibilities of the therapist. For example, a therapist might be required to work throughout the year with the students of a class just to cover the break-time of the teacher in charge, placing aside the clinical needs of the students.
The limited time that a therapist may have at a specific school also creates difficulties in the treatment planning related to the frequency of sessions that a student can attend. In some cases one weekly session is not adequate for the treatment of a student but the scheduling allows only that.
Moreover, a music therapist working in a special school takes over certain responsibilities that are shared between the school staff (teachers and other therapists) which may also interfere in the treatment process of certain students. The therapists are obliged to guard the children during break time and escort them in varied school activities, in and out of the school environment. This mixing of roles (therapist, escort, guard at the school playground) may cause confusion to some of the students who have to relate to the music therapists in such different environments.
Another problem that arises from the fact that the music therapy discipline is newly introduced in the special school system is the lack of adequate space and equipment for the music therapy room. Even though the Ministry of Education and Culture decided to include music therapy as one of the therapies that are available to the students, there was no preliminary preparation about where the sessions would take place or what instruments and other equipment are needed.
Overall, there are quite a few complexities for music therapy in the special school setting and the music therapist must approach these in two different ways a) confront the difficulties from day to day by adjusting to the environment in order to achieve the most efficient running of the program and b) plan for long term changes -such as the foundation of a national association and registry that will give a voice to the profession- thus ensuring the provision of better quality services.
The psychiatric services have only recently decided officially to use the services of professional music therapists. Having advertised their intention to buy services from music therapists in the private sector for short-term contracts, the work conditions are still unclear, as there are yet no music therapy rooms available in the various psychiatric establishments. This is, however, a major turning point for music therapy in Cyprus, as it is the first time that music therapists are officially being sought to work in the mental health sector.
A number of growing music therapy practices are gradually appearing. In the southern city of Limassol, a Music Therapy Clinic was established in 2004 by two USA trained music therapists, Georgina Charalambous and Panayiota Rotsidou. The Clinic is part of a Special Education Centre for children between the ages of 2 and 18. The music therapists apply, to a large extent, a behavioural approach through the use of improvisation. Music therapy is often the first therapy offered to a child entering the Centre, so that s/he is readier emotionally for his/her other therapies. For children with learning disabilities, however, music therapy is offered after their lesson with the Special Education teacher, and it aims to enhance the previous lesson through appropriate songs and musical activities.
In the capital, Nicosia, a Psychodynamic Music Therapy Centre was created in 2003 by the present author. It is housed in purpose-built premises and offers music therapy to children and adults. The music therapy approach is based on the principles and concepts of psychoanalytical psychotherapy. The Centre also collaborates with The Arte Musical Academy [see below under Academic courses], offering some practical experience to students taking their Bachelor’s Degree in Music and desiring to get some clinical experience in music therapy.
A Benenzon Centre is currently being created in Nicosia and co-ordinated by music therapist Maria Vasiliou. Apart from the clinical work carried out by Maria, the centre is also due to host a weekend seminar by Professor Rolando Benenzon in February. This will be the first professional visit of Professor Benenzon to Cyprus.
As from May, 2007, a new Centre of Music Therapy and Creative Expression has been set up and run in Limassol by German-trained music therapist Marina Panayides. The Centre focuses mainly on people with psychosomatic disorders, psychiatric illnesses, physical pain, tinnitus, and with children with speech disorders or selective mutism.
Apart from such private practices, some music therapists are also employed on a sessional basis in special day centres.
While courses on Psychology have been run in the State University of Cyprus and in private colleges for some time, a Higher Diploma in Music was first created in Cyprus in September 2002. It was the devotion and determination of Pitsa Spyridakis, a piano teacher and director of a private music school, which led to the establishment of the first Musical Academy for Tertiary Education in Septemeber 2002, soon accredited to offer a Bachelor’s Degree in Music (September 2006). It is called the Arte Musical Academy, directed by Spyridakis and situated in a historic building at the centre of Nicosia Spyridakis always kept an active interest in music therapy and was thrilled with the idea to include a course on the Introduction to Music Therapy for the Academy’s music students. The course was first given by myself to the third year students in 2004. Believing that the course was benefiting the students in all respects (musically and emotionally), Spyridakis did not only offer the course as a compulsory component, but also expanded my services as a music therapist to include the running of two more courses: a) A course on The Psychology of Music and Performance (compulsory); and b) A course on Clinical Experience of Music Therapy (optional).
Possibly following this paradigm, a private University, the University of Nicosia, is also offering an Introduction to Music Therapy as an optional course to students studying for their Bachelor’s Degree in Music. The music program there started in 2005, so the course has not yet been taught.
Though the number of music therapists in Cyprus is very small, a few have already created research work at a Master’s or Doctoral level. The following theses, listed in chronological order, have been submitted to Universities in Europe and the USA:
Research that was conducted on the basis of clinical work that was carried out exclusively in Cyprus, includes my doctoral thesis mentioned above. As a result of that work, I created a DVD documentary in 1999, translated into English in 2000. This was initially distributed by the British Association of Music Therapy, primarily at the 10th World Congress of Music Therapy held in Oxford, England, in July 2002. The details of the documentary are as follows:
Title: Sounds and Meaning: Group Music Therapy with People with Profound Learning Disabilities and their Carers.
Research – Senario – Narration: Dr Anthi Agrotou
Director: Diomemdes Nikitas
Producer: Anthi Agrotou
Production executed by: Lumiere Services Ltd
Description: The documentary concerns some pioneer music therapy work, which took place in an institution for profoundly learning disabled people. It focuses on a particular, innovative application of music therapy, whereby residents and carers together participate in therapeutic groups. A non-interventional and a specific use of music, based on the principles of psychodynamic thinking, facilitates both residents and carers towards emotional awakening and the creation of attachment bonds between them for the first time in their lives.
As an example of this work, the film follows the history of a particular music therapy group, consisting of three residents, four carers and the music therapist. By using the original video-recorded excerpts of stable therapeutic work, taken over a four-year period, the film traces the process of individuals from their complete isolation towards their newly-found externalization of their inner world.
The introduction to Sounds and Meaning from Gamut, Uni helse on Vimeo.
In the area of research, it may be worth mentioning two published music therapy studies carried out in Cyprus in the early 1990s. The first one (1993) concerned patients’ ritualized behaviour and tried to make a connecting link between this, ritualized play and religious rituals. It also suggested ways of understanding the patients’ ritualized behaviour and outlined music therapy methods which can facilitate these patients to shift into more creative ritualized play with the music therapist.
The second one (1994) was an in-depth case study which explored areas of difficulty and uncertainty when working with a person with multiple disabilities. It described the therapy process as a two-way phenomenon, both in what it brings in the patient and in all the questions, doubts and rethinking that it evokes in the therapist. The case-study analysis indicated that the patient’s evolving repertoire from complete isolation towards creative communication was interconnected with the therapist’s evolving music therapy techniques and approaches.
The 1974 war, with the consequent loss of life, home and homeland, gave rise to a multiplicity of social and psychological problems. Though the economy of the Cyprus State recovered surprisingly fast, considering the huge loss of the island’s resources, this was not the case with the array of social and emotional difficulties that unfolded since then. In the Greek part of the island, hastily-built refugee settlements housed the displaced Greek Cypriots, which numbered one third of the island’s population. Receiving little psychological support, a whole generation of people has already been reared there. Unworked grief has left its marks on the old and the young alike.
Other areas of the island have seen an unbelievably speedy development, wherein poor people became suddenly very rich and enchanted by the “magic” of money and the newly-arrived tourists from the West. There, materialism prevailed over psychological depth.
Within the last thirty years, the cities have seen such a vast development, that little of their previous character has remained. The need to accommodate in the remaining free part of the island the needs of 30% more people than in the pre-1974 years, meant that the cities expanded beyond recognition. As an unfortunate consequence, the villages have been abandoned by their younger populations. Thus an old culture, that of the extended family living fairly closely to each other and providing an irreplaceable support system for its members, has also been vanishing.
The mental health and educational services were overwhelmed and unprepared to deal with such multiplicity of problems. New posts and structures have been created in the last thirty years, but these are still insufficient. The widely varied educational backgrounds of psychologists and psychiatrists may have contributed to the slow rhythm with which new structures are introduced.
All these are contributing factors to the fact that there are no music therapists officially working in any of the national hospitals yet, including such special units as oncology departments or palliative care.
As written in a previous profile of Music Therapy in Cyprus (Agrotou, 1993a, p. 187), the musical culture of the majority of Greek Cypriots lies within the realm of the wider Greek world. A great preference are the Greek popular songs, created by untrained composers and reciting such misfortunes of life as poverty, unrequited love, forced emigration, loss of loved ones, etc. These songs have their roots in the music of the Byzantine church and the rembetico song. “Rembetico is the name given to a small, simple song created” at the turn of the 19th century “by poor people who were excluded from the European-influenced life of the aristocracy. Though primarily love songs, they also contain references to deeper social issues. Based partly on Greek folk song, their basic instrumental accompaniment is the buzuki” (ibid: p. 196; Petropoulos, 1972).
Greek artistic songs won the hearts of Greeks and Cypriots since they first appeared in the 1950s. Manos Hadjidakis and Mikis Theodorakis are among the founders of these songs and their influence still holds over younger generations of composers. Hadjidakis and Theodorakis took their lyrics from poetry written, among others, by Nobel Prize winners George Seferis and Odysseas Elytis, while their music bore the influence of the Greek popular song tradition, Byzantine church music and western classical music (Notaras, 1991).
The younger population of Cypriots loves rock, pop and, to a lesser extend jazz music, and listens to everything that is prevalent and fashionable in other European cities. Lovers of classical music are increasing in number, partly due to an ever-improving State Orchestra and Youth Orchestra and a continuously upgraded level of music education offered at music schools. In one way or another, music is in the hearts of the Cypriots, and parents who bring their child to music therapy invariably declare “S/he loves listening to music, so we thought music therapy might help.”
A number of factors signify that music therapy will function within wider and more supportive environments in the future. For one, the arrival of twelve or so music therapists over the last eight years will certainly have an impact on the music therapy scene in Cyprus. As so many music therapists are currently putting a lot of their energies and time into educating the environments where they work or live, there are bound to be changes in the way music therapy is received.
The awareness between music therapists that they need to come under the umbrella of a professional association will also benefit the profession. The preliminary work towards such an association has already been done, and will hopefully be completed within the year 2008.
Cyprus’ entry into the European Union may also facilitate the mental, social and educational systems to widen their sphere of services and include music therapists under appropriate conditions. For sure, the decision of the Mental Health Services to buy music therapy services has paramount importance for the establishment of the profession.
As I sit here, in the capital city of Nicosia, I gaze dreamily at the Pentadactylos mountain range, now in the northern occupied part of the island. In a similar way, the Turkish Cypriots gaze at the Troodos range, from their corners at the northern part of the island. These impressive mountains, standing still in time, acquire an ever growing significance, as they are for certain unaltered masses in this ever-changing island. They become focuses of nostalgic reminiscences of something more integrative that once existed, or at least we thought it existed.
Yes, this is an article on music therapy; I have not forgotten! Yet, somehow, music therapy is part of the mosaic that presents itself as the current Cypriot reality: Separate communities live in it, the Turkish and the Greek, with no substantial interaction, while at the same time, forming two different political and social worlds. Their differences concerning a peaceful settlement still torment the political scene. Tourist and economic development has shifted known social and ecological systems. Mental health professionals, including music therapists, come from diverse backgrounds – as any other professional on the island - carrying with them a part, for example, of the American, British, German or Russian mentality. In contrast, a history of diverse occupations has probably left in the collective unconscious of the Cypriots something that is resilient, yet slow moving: a vital survival mechanism in times past. All this may explain the fact that, though present on the island for twenty years, music therapy is not yet established in Cyprus. The official and private movements towards acknowledging its contribution have been timid, to say the least.
One evening a couple of years ago, I was sitting in a coffee shop near the occupied coast of Kyrenia, when I suddenly heard the traditional wedding music that used to be played at Greek Cypriot weddings. This music is particularly dear to me, as I improvised variations on it for my audition into the music therapy course at the Roehampton Institute of Higher Education in London, back in 1986. I turned around searching for Greek Cypriots and wedding dresses, for a moment forgetting that Greek Cypriots are no longer to be found in Kyrenia. Suspecting my puzzled state, a Turkish Cypriot turned towards me and said ‘It’s a Turkish Cypriot wedding! We have the same traditional song in Turkish and sing it for our weddings; in fact, a lot of the traditional Greek Cypriot songs are also Turkish Cypriot traditional songs!”
So for all my forty-five years, I had not known such a simple truth about the traditions of the Turkish Cypriots and their deeper links with the Greek Cypriots. In fact, the mosaic need not have been a mosaic, but an integrative whole, just like the traditional songs. If one could only hear the sounds.
As this is a forum for different voices, I would like to write something about the case of a little Turkish Cypriot boy who came to my private practice once. Accompanied by his parents and grandmothers, the family had the bravery to cross the cease-fire line and trust a Greek Cypriot professional for their child’s emotional growth. The co-operation between all of us was superb and the child soon developed speech and had no need for music therapy. Yet he and I had no common language, and his parents were not fluent in English. It helped that the grandmothers remembered some Greek, which they spoke before they were displaced from their homes in the southern part. Working with this extended family was one of the moving experiences in my career in Cyprus, bringing home to me the capacity of music therapy to open up boundaries.
Cyprus is a challenging place for music therapy to play a tune that embraces its complex diversities and contrasts. It is a place where things unexpectedly happen … or fail to happen. The first verse of the wedding song comes to my lips … “Good hour, golden hour, blessed hour …”
The Cypriot Wedding Song from Gamut, Uni helse on Vimeo.
The excerpt from the wedding performance is taken from the following:
Today there is a wedding” performed by the Cultural Workshop of Ayioi Omoloyetes at the Cultural Centre of the University of Cyprus, Archontiko Odou Axiotheas, Nicosia, 19 September, 2007.
Agrotou, A. (1993a). “Music Therapy in Cyprus”. In C. D. Marnato (Ed.), Music Therapy: International Perspectives. New Jersey, USA: Jeffrey Books.
Agrotou, A. (1993b). “Spontaneous Ritualized Play in Music Therapy: a Technical and Theoretical analysis”. In T. Wigram & M. Heal (Eds.), Music Therapy in Health and Education. London: Jessica Kingsley
Publishers.
Agrotou, A. (1994). "Isolation and the multi-handicapped patient: an analysis of
the music therapist-patient affects and processes." The Arts in Psychotherapy 21 (5):359-365.
Bunt, L. & Hoskyns, S. (2002). The Handbook of Music Therapy. UK, USA, Canada: Brunner-Routledge.
Christodoulou, M. N. & Ioannides, C. D. (1987). Cypriot Folk Songs. Volume 1. Nicosia: Centre of Scientific Research.
Notaras, G. [(1991). The Greek Song of the Last Thirty Years. Athens: Nea Synora – A.A. Livane.
Panteli, S. (1990). The Making of Modern Cyprus. From Obscurity to Statehood. Hertfordshire, England: Interworld Publications Ltd.v
Petropoulos, E. (1972). The Rembetica Songs: A Folkloric Study. (2nd Edition). Athens.v
Report of the Special Educational Committee for the Study of Ways to Improve the Educational Provision for Children with Special Needs. (1992). Nicosia.
Agrotou, Anthi (2008). Music Therapy in Cyprus Music Therapy in Cyprus. Voices Resources. Retrieved January 15, 2015, from http://testvoices.uib.no/community/?q=country-of-the-month/2008-music-therapy-cyprus
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