Development and Prospect of Music Therapy in Japan
The Rapid Development of Music Therapy in Japan
As you can see from the Fact Sheet on music therapy in Japan, Japanese music therapy has developed rapidly during the 1990s and early 2000s. As a result, recognition from the general public has increased, the number of professionals and students has grown, and music therapy activities have spread throughout Japan. This was achieved based on the devoted work of senior generations, bearing the fruits under a rich social background, ready for music therapy.
Sakurabayashi described this background as: The inhuman mental environment in economically-industrially advanced society that raised people's awareness about therapeutic needs; Growing interests in social welfare, so that those at the side of the strong intend to share social resources with those at the side of the weak, and; The maturity and saturation in Japanese musical scene as a result of the early age education boom of Western classical music in 1960's (Sakurabayashi, 1993; Ikuno, 2002a).
However, the extreme rapidity of the development naturally had side effects. Japanese music therapy is not necessarily matured in terms of the "core" for the development, of its own identity. Consequently it is always shaken by the peripheral elements, namely, "social environment", "social welfare", and "musical scene". In other words, if just one of them is weakened, Japanese music therapy will be in danger of loosingits balance. In this regard, the period that Japanese music therapy has grown by the force of circumstances is slowly ending, and it is approaching the important transitional period for further development. Given this circumstance, Japanese music therapists are confronted by the needs to pursue a productive discussion and have the clear visions, facing our own culture.
Japanese Culture: Traditional, Complex, and Transitional
When we talk about this "culture," it is not just the "traditional" culture that has important roles in Japan, but the highly complex and transitional cultural phenomena dominate this society. This complexity must be shared with many Asian countries, I assume. For example, in addition to the traditional customs such as the behavioral codes on both conscious and unconscious levels, Japanese people receive influences from the strong attractiveness of American culture, the significant existence of European culture that played the leadership role for our parents' generation, the casual cultural exchanges within the Asian countries especially among the young generation, which also includes the Japanese culture as the neo-traditional. . All of these are mixed, affect each other, and are changing: Not one of them has primary power in our daily life. It almost seems that Japanese people have as a unique feature the ability to use different cultures to suit different parts in their lives. Aspects which typically demonstrate this phenomenon are our eating styles and music.
Stige defined culture as "the accumulation of customs and technologies enabling and regulating human coexistence" (2002, p. 38). As far as Japanese culture is concerned, the above mentioned reality is "the culture today." In this sense, Japanese music therapists need to use extremely complex insights, challenged by the task to meet the people through music in diverse and transitional cultural layers.
I myself was born and raised in Japan until I started my adult life. I studied European Classical music from an early age and lived 4 and half years in the United States to studying music and music therapy. About 10 years ago I came back to Japan to work as a music therapist. In this process, I have always felt at a loss, wondering "How on earth could I work as a music therapist in Japan!?" In this paper, I would like to look back on some of this wondering, from three different perspectives: clinical/musical, academic, and professional.
Clinical Perspectives on Music Therapy in Japan
The Concepts of the Group and of the Individual
In the clinical perspectives, one of the important themes of Japanese music therapy seems to be the concept of the "group" and also of the "individual." In Japanese music therapy, there have been many good group sessions with sensible qualities. They make use of the Japanese traditional value of "Wa" (harmony) to support the well-being of Japanese people. For example, group singing using the rhythm and songs that represent Japanese collective identity is a common way to approach the elderly population. Japanese people put high and special value on "group", and the emotional/practical history for it is long and deep. Therefore this topic cannot simply be analyzed and concluded by Western methods of music therapy, and Japanese music therapists need special research on and understanding of it.
However, especially after the accelerated growth of the economy, "self expression" and "self realization" have also become important values for many Japanese people. In music therapy too, small groups and individual sessions have been explored, although the number is not too many yet, and the methods are not necessarily matured yet. Needless to say, just transplanting Western methods does not work here.
If we take a close look, the individual orientation of today's Japanese people is not separated from the traditional culture of group orientation, but is strongly grounded by it. On the other hand, a calm united group at first sight conceives the covert and nameless movements of self actualization underneath. The people who live in well-being seem to be those who can feel a good balance between the two orientations, one way or another. In contrast, confusion, such as when a group oppresses an individual or when unhealthy individualism breaks human-relationships, often becomes the themes of therapies.
How can groups and individuals develop through co-existence? How can clinical sessions focus upon this, in a way unique to Japanese culture? Music, which can be very social as well as very individual, has a great potential to be cultivated in relation to this.
The Unique Role of Language and Expression
One of the mysteries I have been feeling in Japanese culture is the unique role of language and expression. It was in the English language and American culture that I first studied music therapy, where language was used to build a logic based upon a straight line of development toward the conclusion, see Figure 1.
Figure 1: The Language Process in Western Culture
When I returned to Japan, I was aware of how the Japanese culture was using language as if drawing a spiral, drifting and adjusting within atmosphere, balance, and cultural aesthetics. And strangely enough, the conclusion appearing in the center of the spiral is often swallowed and not verbalized, see Figure 2.
Figure 2: The Language Process in Japanese Culture
Japanese people tend to deepen one's existence by "refraining words", and to talk most expressively by "keeping the silence". These tendencies appear in a unique way when clients verbalize their inner world or family members verbalize the therapy perspectives. For Japanese, not only what has been said and the way it has been said counts; what has carefully not been said and the actions taken when saying and not saying are included in the area of "expression."
Needless to say, music has a great potential here as a nonverbal medium, but I think even within music itself, this Japanese characteristic creates a unique phenomenon of expression. For example, I had an experience as a music therapist singing to a bedridden old man who had no verbalization due to the after-effect of the stroke. Even in the limitation of expressive tools and verbal, cognitive construction, he showed his changing emotions greatly through his eyeballs, mouth, and facial expressions. And interestingly enough, he seemed to be "expressing himself" not only by releasing his emotion but also by refraining from expressing it (Ikuno, 2002b).
Western theories of music therapy tend to position "expressing" as the greatest tools and objectives, but Japanese music therapy cannot always be analyzed that way, and we need to develop the original clinical theory here.
Objectives of Therapy: "Doing" Value and "Being" Value
Now I would like to refer to the objectives of therapy from my experiences of trying to get into the practicing field as a music therapist, the newcomer professional. When music therapists work with related professionals, sometimes we can share the same document form to record the achievement, but at other times we simply cannot. When we cannot, we feel badly since it seems that the music therapists wasted time. Why? After long "anguish," I came to rationalize our achievement by using the labels "doing" and "being." The health in "doing" means "functions recovered, abilities developed, and growth measurable through use of quantitative data." On the other hand, the health in "being" is "the person is becoming happier and fuller, the existence is approaching a greater well-being, even though the functions and the abilities have not changed."
For example, I once had a child with cerebral palsy as a client and approached him from several different aspects of his "wholeness". For one of the "doing" objectives, we did rehabilitation by playing four hands piano, structuring his playing spot in a musical piece. On the other hand I also included the "being" activity, using a song composed and sung by myself. The words take the perspective of this nonverbal child, talking about his life, disabilities and family:
I was born in the autumn 9 years ago.
My mother was looking forward to seeing me so much.
She is the Mother who is always gentle, cheerful and hard working,
And gave me a birth, sending me into the bright light.
My limbs are a little hard to move,
Even though I have so many things I want to do,
And so many places I want to go.
I wish I could walk, I wish I could run,
Because I have a lot of great dreams to chase.
However I have a wonderful wheelchair,
And I myself became strong enough to challenge climbing stairs.
With my Dad, my Mom, and my brother Hiro,
I will walk the long, long roads, toward my endless dream!
In this session, the child and the mother just listened to the therapist performing. The lyrics were all imagined and made by the therapist, so the clients even did not participate in "composing/creating" parts. They did not verbalize their impressions either, and the only results were that the child seemed to be fond of this song and requested it often, and the mother sometimes secretly wiped her tears (but said nothing... the typical Japanese expression!). Still, I think this activity gave them the sense of "Being" as they were, and had a considerable value in their therapy process.
Japanese medicine, which had committed itself to only "doing" in the past few decades, is now also introducing the concept of "QOL" (Quality of Life). However I feel something even more static, introspective, or "non-purposeful" as a quality in music therapy. This quality might be related to a life view buried deeply in Japanese' mentality, not only "Ikiru" (to live purposefully), but also "Ikasareru" (to be made to live by a greater purpose.) Japanese music therapy should develop means to recognize, deepen and communicate ways of well-being, across the doing and the being.
Academic Perspectives on Music Therapy in Japan
The area most left behind in the Japanese music therapy development in the 1990s to the early 2000s seems to be the academic field. I see here the Japanese' cultural habit for growth; "to accept and imitate the models" rather than "to think and create one's own form." This teaching-learning attitude is deeply rooted in our culture. For example in the education system of Japanese traditional performing arts such as Kabuki, the students (disciples) are trained from early age to "carefully watch" and "imitate" the precursors' performance. Here, it is a kind of taboo to question the models or to create his own style until he is really approved as an independent professional. This kind of educational style was emphasized even when I studied Western Classical music as a child, and it infiltrates Japanese "teaching-learning" culture as an unspoken rule; not to question and not to make up self-taught styles.
Music therapy, which is a relatively new field in education, has been no exception. For example in the practices, I often see junior therapists automatically follow the exterior structure of the seniors' sessions, and tend to miss the therapeutic meaning that is the foundation of practice. And in the academic conferences, there is a strange kind of self-satisfactory feeling in some presenters merely to imitate the form of scientific medicine papers, without thoroughly discussing the "content" of the therapy process.
My opinion here is that there are no established models in music therapy yet that fit to our traditional educational style of imitating. Everyone should have the attitude "to question and to construct one's own ideas, even if they are still immature," from the very first day of the clinical experiences. And the academic conferences should be opportunities for bringing new ideas into the discussions.
So I see a big academic challenge for the students, but of course it is not only the beginners and the students that need to grow. First of all, many of the Japanese music therapists have not had enough opportunities to learn the basic academic research methods. Secondly, for the subjects unique to Japanese music therapy, as those I mentioned above, there are few research methods established. As a result even very experienced practitioners start to feel distance from the academic field.
For the academic development of Japanese music therapy, we need to acquire more knowledge and skills of the existing academic methods, as well as to explore the new methods not separated from the daily practices in Japan.
Professional Perspectives on Music Therapy in Japan
Now, the professional perspectives, "the establishment of music therapists' social positions," must be the main subject, especially the economic situation. Most of the Japanese music therapists work part time with instable payment or even with no payment (not even with compensation for directs costs for transportation, musical instruments, etc.), somehow making it with non-music therapy jobs or family support. This situation affects not only the earning of a living, but also the mental stability as a music therapist.
Generally speaking, many of the Asian countries are "economy-centered societies" in a different sense from the Western countries. Because of historical circumstance, economic development has had the first and most urgent priority. Things like music therapy can easily be despised with the prejudice that "it is something that does not contribute to the economic wealth." Therefore it has low value in the society. In such an environment, serious music therapy professionals feel even more pressured to establish a higher position in economic society not only for his/her own living, but also for the sake of music therapy itself.
However, "social position" cannot be achieved by economic independence alone. What about the competency and the maturity as a profession? Beneath the developments in professional appearance, there are still many gaps that Japanese music therapists have to face. Relating to it, let me refer to the educational realities are another distortion of the rapid development.
Japanese academies of music introduced music therapy one after another in the last half of the1990s, and it created many more educational opportunities compared to when there were only the choices of self-educating or studying abroad. However, some of those new schools demonstrate examples of commercialism, by recruiting students without giving correct information about the area, or not providing adequate personnel as educators. In particular, there is a lack of music therapy supervisors.
This kind of distortion directly affects the professional situation out in the field. In general, we have to admit that there is a gap between the music therapy "boom" in the higher educational institutions and the situation in the field of professional practice. Many of those who finished music therapy courses cannot get jobs in the area, or the new graduates just cannot deal with the severe realities of the field. If these conditions continue, the position of music therapists in the society might become even worse.
Another challenge in the establishment of our social position is the political authority, namely the bureaucracy, and the historical system that political decisions are made through emotional/collusive connections. A totally new field like music therapy has to face very complicated obstacles here. For example, the Japanese Association for Music Therapy worked energetically in seeking state certification around 2000-2004, but we hear that this was an extremely difficult process. JAMT was even asked to modify the definition of music therapy, the very identity of our work, to adjust to the existing political system. There has been a big controversy about it in the association.
Conclusion: Music Therapy as Suggestions of New Values in Society
In this situation, we often hear arguments such as "We will not follow the path of foreign countries, because Japan has its own unique way in politics." However, as a person who has walked between Western and Japanese music therapies, I do not think it is the matter of "foreign countries versus Japan." I have a strange sense that music therapy is something that never fits completely into an existing society, regardless of Western or Asian context. Just aiming at being accepted by society will only drive us to a dead end. Rather, music therapy could conceive the possibility of shaking (aspects of) an existing society and could suggest new (or deeper) values of music in relation to human-beings.
For this purpose, we need to cultivate our insights about the culture-specific elements and the universal elements in all areas of clinical, academic, and professional practice. By doing so, we can accomplish "independence" in a true sense, including economic independence some day.
References
Ikuno, R. (2002a). Music Therapy Growth in Japan - The Richness and the Confusion of Transition. In Kenny, C. & Stige, B. (Ed.). Contemporary Voices in Music Therapy. Oslo: Unipub Forlag.
Ikuno, R. (2002b). Music as an "Expressive" Therapy. In Kenny, C. & Stige, B. (Ed.). Contemporary Voices in Music Therapy. Oslo: Unipub Forlag.
Sakurabayashi, H. (1993). Ongak-ryoho towa [What is Music Therapy?]. In Sakurabayashi, H. (Ed.). Ongakuryoho Nyumon [Introduction to Music Therapy]. Tokyo: Gendaigeijyutu-sha.
Stige B. (2002). Culture-Centered Music Therapy. NH. Barcelona Publishers.
