Postmodernism and Music Therapy
The present essay is a short and probably superficial analysis of music therapy and music therapy research. I have to say that by no means do I consider myself an expert or even experienced enough to provide "critiques" about any area of music therapy. This work is a revised version of a term paper presented at the University of Kansas in 2002, and is just the result of my interest in some recent trends of thoughts (e.g. social constructionism), and their impact, if any, on music therapy. I believe in dialogue as a means to forward knowledge, and so I dare to share this work with colleagues.
The main purpose of writing this paper was to have an initial approach to the ideas of postmodernism, more specifically, social constructionism as defined by Kenneth J. Gergen (1999). Another purpose was to explore whether one of its main ideas has permeated the way research is done in music therapy, that being the inclusion of different modes of inquiry as valid research within the field. To achieve this purpose, a (very limited) comparison of the literature was done: The Journal of Music Therapy, first year (1964), with recent issues (2002). I chose 1964 because it is the first edition of the Journal of Music Therapy, first music therapy journal with the strictest standards of scientific research. Therefore, 1964 represents, in my opinion, a crucial point in the development of music therapy research and profession. The 2002 issues were the most recent at the time I first wrote this paper. I am aware that this choice is arbitrary, and that comparisons in other time frames would yield very different results. With regard to social constructionism influence, it can be said that big paradigmatic shifts can take longer to pervade all areas of knowledge, but in this information era, where knowledge is exchanged at a pace not seen before, we might assume that 38 years is not a dismissible time frame for this comparison.
The specific questions to be addressed in this review of the Journal of Music Therapy will be discussed at some length after we explore a preliminary definition of social constructionism. The following section will present the main ideas of this philosophical trend. Most of these ideas are taken directly from Gergen's text (1999), and are presented here to the best of my understanding.
Social Constructionism
Postmodernism is a controversial "topic" that has been understood by some as a "shift in cultural beliefs that is equal in significance to the movement from the Dark Ages of Western history to the Enlightenment" (Gergen, 1999, p. vi). For some, this has proven catastrophic; for others, it is unimportant and non-consequential; still for others, it is filled with potential. So, how can we define "postmodernism"? To begin with, a distinction between different approaches to reality construction in postmodernism seems appropriate here. Deliberations, that is, philosophical exercises, on the way we construct reality have taken many forms over the centuries (e.g. Rationalism, Positivism, Empiricism, Idealism, etc.). The contemporary dialogues in Postmodernism could be summarized as follows:
- Radical constructivism: a perspective with roots in rationalism. The individual mind constructs what it understands as reality, that is, there is no reality "out there", but rather each person constructs (through his/her perceptions) a map of such reality (scholars: Claude Levi Strauss, Ernest von Glazerfeld)
- Constructivism: a more moderate view. The mind constructs the reality within a systematic relationship to the external world. (Jean Piaget, George Kelly)
- Social Constructivism: the mind constructs reality in relation to the world, but this process is significantly modified by social relationships and conventions (Lev Vygotsky, Jerome Bruner)
- Social constructionism: the discourse is the vehicle through which the world and the self are constructed. More of this view will be explained later.
- Sociological constructionism: the emphasis is on how the construction of self and the understanding of the world are influenced by power and social structures. (Henri Giroux and Nicolas Rose)
Now let us explore in some depth one of these views: social constructionism. The main tenet of social constructionism is the inclusion of contrasting, and even opposing, views in dialogue as a means to create and enrich our constructed reality. To try to convey a simple (although hopefully not simplistic) overview of this perspective, I will follow Gergen's (1999) approach to this topic within his book Introduction to Social Construction.
- I. Sense of self in question
- Modernism: self, reason.
- Problems with this view:
- The two-world problem
- The problem of knowledge
- The problem of the inner eye
- c. Truth, rationality and morality
- II. Communal construction of the real and the good
- Language: from the picture to the game
- Social construction of scientific knowledge
- III. Problems of Individualism
- All against all
- Power
- Systemic Blindness
- IV. Relational Selves and Dialogue as an alternative
Sense of Self in Question: Modernism, Self and Reason
In Western culture, within the Modernist tradition, we hold in highest regard a sense of individual self. This idea can be traced to the times of the Enlightenment, when René Descartes, among others, declared that human beings were capable of observing the world as it is, and of deciding the best course of action based on such observations. For the social constructionist there are three inherent problems in this view, namely, a) the problem of two-worlds, b) the problem of individual knowledge of the world, and c) the problem of self-knowledge.
The Two-world Problem
The controversy between the "out there" and the "in here" is one that, to this day, we have not been able to settle. How is it that the "mind stuff" produces changes in the "material stuff" (body)? Multiple explanations have been forwarded, and, I believe, we are getting closer to understanding it, but we have not yet been able to understand causality within the mental world. How exactly does an idea (e.g. religion) can create a change in physical (e.g. muscular, hormonal, neuronal) systems? Several traditions have tried to explain it from the most idealistic to the most materialistic ("we are only matter"). Interestingly, the absolute reduction of mind to matter ultimately destroys the idea of an autonomous self: if everything is determined by physical (i.e. physiological) interactions, there is no room for self-determinacy.
The Problem of Knowledge
How is it that the mind (whatever it is) acquires "objective" knowledge of the world? This problem relates to the previous one: if we cannot understand how objective (external) and subjective (internal) worlds are related, how can we know that we have registered the objective world accurately? If all we have is the reflection of the world in our minds, how can we know that the "out there" is actually producing the image?
The Problem of Self-knowledge
How do we distinguish between thought, desire or intention? What part of the mind is observing, and which one is the observed? Can we identify those states (e.g. if we "truly" love someone) by our physiological states? How do we know that what we feel is shared, exactly the same way, by others? We seem to be very able to offer answers to these questions, because they are "self-evident", but more than 2000 years of deliberation on "how we know" have not yet yielded definite answers.
Truth, Rationality and Morality
If the idea of knowledge is under question, how do we define (and accept) those who claim the privilege to knowledge? If truth and objectivity depend on the "knowing mind" and such an entity is questionable, then those definitions become unreliable. In Gergen's words "scientific truths might be viewed as outgrowths of communities and not observing minds" (1999, p. 14). Along the same line, morality comes into question. Our moral order is based on the presumption that the individual (with his/her own reasoning and free will) can be held responsible for his/her actions. If we support the idea of an "individual mind" (self-reflective, undetermined by a relationship with others), we might use this argument as a way to "obscure our own complicity" (Gergen, 1999, p. 16). In other words, by assigning sole responsibility for an action to the individual, we forget the intricacy of causes and consequences, effects and influences, within every relationship and event, being (or hoping to be) oblivious to our own responsibility in such action.
Communal Construction of the Real and the Good
If you are by this time starting to ask how we can live together, progress, or even survive without a sense of self, moral order and truths on which to base our decisions, read on, since Gergen proposes some possible answers to such questions. In the first place, he asserts that such questioning is a transitional phase in comprehending the potential of social constructionist inquiry. The focus is then turned towards language. The first premise is that there is not a single privileged relationship between world and word; that is, in principle, there is no limit to the number of ways we can describe a single situation. Language does not represent the world in a unique and indisputable way; it is not a "photograph" of the world. As Wittgenstein proposes (in Gergen, 1999, p. 34), an alternative metaphor could be language as a game, where words acquire their meaning through the set of relationships they put in motion. If I say "good morning", these words acquire meaning (and can be several) depending on the context, the tone of voice, and, most of all, the reaction they elicit from you. If you ignore the greeting, the words remain meaningless. For Wittgenstein (in Gergen, 1999, p. 35), language games are embedded within broader patterns of interaction: language is not a "mirror of life, but the doing of life itself" (Gergen, 1999, p. 35). In this sense, truth is conceived as a way of talking or writing that is validated within certain forms of life (e.g. science). Certain groups develop a way of describing the world, a "truth" (a "language") which acquires significance and meaning, and is validated by those belonging to those groups.
This assertion leads into a discussion of power, where some "truths" are validated through social structures and then treated as "Truths". This process is one that social constructionism questions frequently. This is not to say that all order, language, or truths should be exterminated. There would be an inherent problem in doing such a thing: by eliminating the options, there would be no choice. As Gergen says, (1999, p. 223) "each commitment to the real eliminates a rich sea of alternatives, and by quieting alternative discourses we limit possibilities of action." The proposal then is to question the current status quo, and incorporate alternative views, retaining those that seem useful, from previous or new traditions, knowing that scientific (and other types of) knowledge is just that: "truths", not "Truths".
Problems of Individualism
Other problems from the individualistic tradition discussed at length by Gergen are the "tragedy of all against all," "the power problem," and "systemic blindness." Let us briefly discuss each one. If the individual mind is responsible for its products, accountability and responsibility of such products seems desirable. Unfortunately, paired with them comes the competition and lack of trust between different individual minds. The world becomes a place where no one can be completely understood (and maybe trusted), and where legal order is required to control the individual's acts. This is what the author calls the "tragedy of all against all." (Gergen, 1999, p. 120)
Some thinkers have argued that through the process of "extreme individuation" (e.g. assigning numbers to every aspect of the person's life), extensive amounts of information are available in different ways (what they call "the fiduciary subjects") (Gergen, 1999, p. 121). This provides a few with extreme power (through knowledge) over the individual, threatening our freedom. (This might be an oversimplification of the argument, please refer to the original source for a better explanation).
For the author, the self-contained individual provides an adequate way of understanding "bad actions". But if we consider how every act is influenced by the environment and society, this account may act as a blinder to our responsibility as a society. It is easier to declare someone "mentally ill", than to try to understand the complexity of the environment under which such behaviors developed and to maybe assume some responsibility for them.
So far, social constructionism seems to derogate all those traditions that we hold as most valuable. It is a major concern of social constructionism, however, to provide an alternate view to each tradition. So, how does social constructionism offer a possibility of a different construction of reality? A major idea is that social constructionism traces commitments to "the real" and "the good" to social processes. That is, all that we hold as "true" (the real) and "valuable" (the good) is determined through a combination of relationships within and between groups. No truth is then devoid of value. "Objective" statements (that is, statements without personal beliefs, influences and paradigms) are impossible. The mind is inseparable from social processes. And, as said before, the meaning of any communication is defined through relationships. For some authors (Bakhtin, in Gergen, 1999, p. 131), in fact, "to be means to communicate", in that there is no meaning outside of a relationship. Language becomes a performative act, and not a representational one. It does not represent a world "out there", but creates a world of relationships, and thus a world of meanings. In this way, social constructionism proposes dialogue as the means to incorporate different voices and even opposing constructions of the world. Although throughout history, dialogue has been the way of constructing reality, the main difference (as I understand it) is that social constructionists are aware of the limitations of their "truths", and their modes of inquiry. There is not a presumption that one mode of inquiry is "better" or more "truthful" or even more "objective", since such qualities are questionable in themselves. Some examples might help to clarify this point.
Some areas that have been especially influenced by these ideas are psychotherapy, education and academic work. Narrative therapy, to name one, is based on the idea that through narratives, therapist and client can engage in the creation of new meanings that can empower the client. By "reconstructing" their past in a more useful way, clients find the resources to live better lives, in any way they might define "better", and not in a prescribed way, determined by the "professional expert". Brief therapy, another perspective based on these ideas, focuses on the principle that problems are not "out there", but appear in the way we negotiate reality (Gergen, 1999, pp. 168 - 175).
Another very interesting area, where these ideas have found resonance is in the academic world: there has been an increasing tendency towards what Gergen calls the "polyvocal author" (p. 186), that is, authors who allow different views within themselves to permeate their written work. Personalization and self-reflection have also become more evident. All these changes stem from the notion that our accounts are not maps of the world, but rather "operate performatively" allowing us to "do things with others" (Gergen, 1999).
Much more needs to be said in this respect, but this might not be the place. So, coming back to the original question of this project: given the impact that social constructionist proposals have had in other areas, can we trace some of these ideas in the literature of the main research journal in music Therapy in the United States, the Journal of Music Therapy (JMT)? More specifically, can this journal, in a very limited sample, show the inclusion of "alternative" modes of inquiry in the research published? The hypothesis is that most research will be under the empiricist or rationalist tradition. The assumption too is that this will be more clearly evident in the journals of 1964. How many articles within this year are experimental, compared to the 2002 issues? How many are historical, or philosophical? How many authors allow or even suggest within their conclusions another mode of inquiry as more or equally appropriate to their topic (phenomenological or other)? How many authors include in their review of literature sources of a different mode of inquiry than their own? These questions will be addressed next.
Analysis of JMT issues
A careful reading of the Journal of Music Therapy 1964 and 2002 revealed some tentative answers to these questions. In the first place, the methodology of each article was analyzed. Table 1 (with its corresponding graphic) shows the results.
Table 1. Comparison of methodology used in JMT articles, 1964 & 2002
| 1964 | % of 1964 | 2002 | % of 2002 | |
|---|---|---|---|---|
| Experimental | 1 | 6.7% | 6 | 50% |
| Descriptive | 7 | 46.7% | 3 | 25% |
| Historical | 1 | 6.7% | 3 | 25% |
| Philosophical | 6 | 40.0% | 0 | 0% |
| TOTAL | 15 | 12 |
Figure 1. Methodology used in JMT articles, 1964 & 2002
The category "philosophical" was used rather loosely, including statements of opinions and transcriptions of presentations during professional meetings (Wescoe, 1964; Gaston, 1964b; Stanford, 1964). The latter were included in this category since the authors would normally state or imply their opinions, visions, thoughts and logical discussions of the music therapy field.
Within the historical category three articles were included (Lipe, 2002; Gregory, 2002a; Sears & Sears, 1964) that correspond to a review of literature. Despite the differences in specific methodology among them, they all try to trace the evolution of music therapy practice in relation to a specific topic. Lipe (2002) reviewed the literature pertaining to health, music and spirituality. Gregory (2002a) focused on behavioral research designs in the Journal of Music Therapy; and Sears & Sears (1964) made an extensive effort in putting together a (maybe first) bibliography of research in music therapy up to that point.
The experimental category includes one article of the 1964 issue which does not have a "strict" experimental design, as would be taught today in a Research Methods class (Isern,1964). The relation to this methodology can be deduced by the author's implied intention (purpose statement), description of techniques, use of music on a subject to alter behavior, and "precautions" (in the place of a discussion section). Brownell's article (2002) was also included in this category, despite the fact that a more orthodox categorization would warrant it a place in the descriptive category (being based in four case studies). The reason for this decision was that the author actually applied an experimental protocol with his subjects with the intention of modifying behavior (social stories with autistic children), with an Ncommon occurrence in music therapy research.
On the other hand, the descriptive category included an article (Wolfe, O'Connell & Waldon, 2002) that had an experimental design but in which the author's intention was to describe the ratings of the music recordings of musicians and non-musicians (as a survey).
These are some of the elements involved in the categorization of the articles. A comparison in percentages of each category with respect to the total number of articles yielded the following results (Table 1. third and fifth columns)
As can be observed, 50% of the articles in 2002 were experimental, whereas only 7% of the 1964 issue. The rest of the articles were equally distributed between the historical and descriptive category (25%) in the 2002 issues; during 1964, the percentage of historical articles were 7% and the descriptive accounted for the majority of the articles (47%). The philosophical category was most notoriously different, with a 40% during 1964 and a 0% during 2002.
A notable exception to this apparent trend, which would indicate the predominance of experimental literature in the 2002 issues, is the special issue of June 1964, which was completely constituted by the Sears and Sears' compilation of research abstracts. There are several interesting features of this compilation. In the first place, there is no specific methodology for this review. Admitted by the authors, there is a lack of intention to create a "review of literature". This publication started as a contribution to the work of the National Association of Music Therapy (NAMT) Research committee, of which one of the authors was a member. The criteria for selection of articles were: no article from the NAMT yearbooks was to be included, since the committee already had access to them; the most recently dated articles should be included first and then work backwards; the article's pertinence to research in music therapy (inferred by the title only); and time limitations of the authors and the project. As can be observed, this is far from being representative, but the mere fact that it was published gives it an influential place in the development of the music therapy literature (and research, maybe?). From this compilation, the following categorization of abstracts was obtained.
Table 2. Sears & Sears' Research Abstracts Compilation, JMT 1964, PART A.
| Part A | % | |
|---|---|---|
| Experimental | 49 | 70.0% |
| Descriptive | 19 | 27.1% |
| Historical | 1 | 1.4% |
| Philosophical | 1 | 1.4% |
| TOTAL | 70 | 99.9% |
Figure 2. Distribution of Abstracts in categories, Part A (Sears & Sears 1964)
Table 3. Sears & Sears' Research Abstracts Compilation, JMT 1964, PART B.
| Part B | % | |
|---|---|---|
| Experimental | 7 | 7% |
| Descriptive | 59 | 60% |
| Historical | 6 | 6% |
| Philosophical | 27 | 27% |
| TOTAL | 99 | 100% |
Figure 3. Distribution of Abstracts in categories, Part B (Sears & Sears 1964)
The distinction between PART A and B was done by Sears and Sears (1964). Interestingly, PART A was described as including the "controlled experimental research or, in few cases, especially well-written summaries of research". Part B, on the other hand, includes articles "of a more general nature and not falling under the first category". This distinction will be commented on.
Another line of analysis of this literature was the style, format and layout of the publications. The most obvious differences are as follows:
- The 1964 articles all included personal opinions, and even "I" references. None of the articles in 2002 had such "personalized" opinions. All were written in the third person.
- All articles in the 2002 issues are data-based. Some of the articles of the 1964 articles are data-based, and most of these data are either anecdotic or based on clinical practice, not in a formal research protocol. The rest are philosophical discussions or statement of opinions.
- All 2002 articles were written in accordance with the APA format, based on a scientific tradition. None of the 1964 articles would qualify for publishing under such a format. In other words, all articles in the 2002 edition have a clear format: abstract, introduction, statement of purpose, method, results, discussion. (The method and results are omitted in the historical article, but the "normal" sequence of historical research is followed). None of the articles in 1964 follows this format, with the notable exception of Isern's article (December, 1964), as previously discussed.
On a more "subjective" analysis of content, some themes arose. The emphasis of several authors of the 1964 towards the movement of Music Therapy into a research-based, scientific foundation, was notorious. Although most of the articles in this year were not scientifically-based, most of the authors recognized the need and urgency to push the music therapy field in that direction. Wescoe (1964), while addressing the Fifteenth Annual conference of the NAMT, urged music therapists to "make music a science." The next step in our field, he said, was to turn to research. "Without a theory, a profession can never be more than an art." (Wescoe, 1964, p.118). Italics are mine. He also remarked "It would be an exaggeration to let the thought cross our minds that music therapy deals with the whole man, but at least, it deals with the handicapped man." (p. 118). Again, italics are mine. Schneider (1964), president of NAMT in the same year, foresaw the music therapist becoming "a more professional member of the treatment team." (p. 122).
Another salient theme in 1964 was the idea of the individual in a modernist view. Leland (1964) talks about "mentally retarded children" as a diagnosis apart from social concerns, and "independent functioning", "levels of personal responsibility", and "levels of social and civic responsibility" as main goals for therapy. "Maladaptation", music to teach conformity to social rules, "realistic expectations" and mental illness were all constant constructs throughout this literature.
In noticeable contrast with the previous, the 2002 issues refer to individuals as separated from conditions. "Children with autism" and not "mentally retarded" are common expressions (change of language - and views—which happened in all therapeutic and education professions working with people with disabilities, as we know). "Social interaction" (and not "maladaptation"), "inability to manage powerful negative affect" (Layman, Hussey & Laing, 2002), "relaxation" as a therapeutic goal against "stress" [not considered a diagnosis, but a "complex reaction pattern" (Burns, et al., 2002, p. 102)] are constantly mentioned. The inclusion of socioeconomic variables in the results of an experiment (Burns, 2002) is a feature not even considered in the 1964 issues.
Another important difference of the 2002 articles was the inclusion of alternative explanations to their hypotheses in the discussion section. Magee & Davidson (2002) commented on the need to include qualitative data to highlight the differences between individual responses, as well as "exploring data from standardized measures." (2002, p.27) At least one of the researchers (Brownell, 2002) includes an interrater reliability rate, which talks about the awareness of the observer's influence on the results. Gregory (2002a), in her review of literature, also found an increase in "observation reliability" which started in the 1980s and increased during the 1990s. (p. 60).
A final line of analysis was the inclusion of alternative modes of inquiry in the authors' methodology. As noted before, the 1964 articles did include anecdotic, non-scientific data to support their arguments. What is interesting to me is their constant and repetitive argument towards scientifically-based research as the only mode of inquiry that would make music therapy a respected field.
In contrast, at least two articles in 2002 (Magee & Davidson, 2002; Brownell, 2002) derive part of the support for their findings on "qualitative" and anecdotic information. Noticeably, spirituality, long neglected in the scientific realm, is the object of a scientific analysis within the Fall issue of this year (Lipe, 2002). The next section will address possible interpretations of these results.
An Invitation to Dialogue
The previous "analysis" must be taken with caution. As was exposed in the former discussion, any interpretation of information is subject to an alternative understanding. The present account makes no claim whatsoever of being definite or undebatable. No "conclusions" are drawn from it. Instead, it is my intention to start a dialogue that might be of interest to some music therapists. In this dialogue we might try to read into previous research, trying to understand the social, political and ideological motives that inform music therapy practice and research. Considerations of conventions of understanding and the values associated with that research might also be of interest.
As I read the issues discussed before, part of my surprise was created by the misleading aspect of the format and layout. That is, in a first analysis, it seemed that the 1964 editions were much more inclusive of alternative modes of inquiry and explanations of music therapy (anecdotic, personal opinions, references to English literature), whereas the 2002 issues were clearly scientific and exclusive of other possibilities. On the other hand, while reading the articles, and attempting to analyze the content, other aspects became evident. The fact that within the scientific model, an observation interreliability measure is increasingly included is for me the manifestation of an awareness of our fallible "Truths". The inclusion of "qualitative" data, even within an experimental design, speaks to me of an opening of new avenues to create meaning and knowledge. The inclusion of spirituality as a valid scientific "object of study" is another important factor. The study of human beings as a complex composite of influences (biological, psychological, social and spiritual) points toward the inclusion of different and even opposing constructions of the world.
Would it be possible to frame these differences within the political and ideological changes of the time? I believe that 1964 was a crucial moment for the development of Music Therapy. After almost 20 years of existence as an academic discipline, its leaders began to talk about the need to align with the dominant culture. At this point, music therapy was mostly related to the psychiatric tradition. Such tradition was undergoing profound structural changes, moving from long-term institutions into short-term facilities (Stanford, 1964). The growth (and even survival?) of music therapy depended on its professionals' ability to account for it. A scientific model was the only mode of inquiry that could guarantee the inclusion of the profession in governmental and institutional budgeting. Other reasons may have had an important effect on this development, I am sure, but I believe this was one of the main reasons.
On the other hand, the present times are full with alternative explanations of the world. The explosive growth in communications systems has provoked the exchange of opinions, knowledge, and worldviews that make a single explanation hardly sustainable. It is in this world that a multitude of alternative treatments and approaches towards health, illness and wellness have occurred. It is my belief that Music Therapy is not alien to this process. The unification of different (opposite?) views in a single American Music Therapy Association can be a manifestation of this shift. It is through the awareness of other explanations that music therapy research has started including alternative modes of inquiry. In fact, the Fall 1998 issue of the Journal of Music Therapy, not analyzed in this work, but relevant to this discussion, is solely dedicated to qualitative research, as part of the merging process between different approaches in music therapy. I believe that this process will continue and expand, as new generations of music therapist students come in contact with different ways of doing therapy.
In summary, through this analysis, I observe that music therapy and music therapy research, in particular, are undergoing a process of change towards a more inclusive methodology, one that will allow us to "listen more and better." As music therapists, I believe this is a quality we might consider valuable. Another proposal for dialogue addresses the "thinking about research": could we say that research might not be so much about "finding meaning" in the music therapy interventions examined, but rather the creation of such meanings, through assigning importance to certain theories and excluding alternative explanations? Does that mean that we should stop doing research? I definitely think not. I truly think that science can give us a lot of valuable answers and ways of doing things. In my opinion, the "true" value of approaches lies more in the usefulness of our explanations, the thoroughness of our distinctions, and the magnitude of our accountability, and not so much in the name of the approach. The present paper is only an invitation to the consideration of what we do and why we do it, with the understanding that other explanations are always possible and valid.
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