Tony Wigram – The Early Years: Interview with Tony Wigram January 12th 2011

By Lars Ole Bonde (LO) and Inge Nygaard (IN) – with comments from Jenny Wigram (JW)

Abstract

The interview took place in Tony Wigram's home in St. Albans the day after he returned from Cambridge where he had participated in the annual seminar of the International Consortium of Nine Music Therapy Research Universities. This was more than three months after he was diagnosed with a brain tumour. The themes were Tony Wigram's clinical work at Harperbury Hospital and at Harper House in the 1970's and 80's, his interest in developing systematic music therapy assessment, and his engagement in political and organisational work within the profession of music therapy.

Building a Music Therapy Service in a Large Hospital

LO: Can you tell us about the ideas that guided your work when you started as a music therapist at Harperbury Hospital?

TW: I found that when I was starting the work there was very little guidance on how you actually did the work. It was all intuitive. I felt more comfortable with some sort of structure, and it also felt more comfortable to me that other people who watched me working as a music therapist, could understand what that work was about. Because if you worked in a ward or day centre in Harperbury, people didn't understand, they just saw someone playing music, or someone trying to encourage the children and adolescents to make sounds or play music. But they didn't know what the music making was about, so I found a need to give it some sort of direction. That was important both for the clients and for the staff.

LO: How did you get there in the first place? Why did they want a music therapist?

TW: In Harperbury, there was an inspired psychiatrist, his name was Derek Ricks. He ran a department for children, and he watched my work and thought this was a great way to engage with the children there. That was the main motivation. He couldn't believe that the children were responding so well, that they were playing and using their hands and interacting with you, and you know, he was impressed by that. He wasn't interested in doing some sort of behavioral intervention. He was more interested in the humanistic experience of working with these children and these adults and adolescents. And the interesting thing about Harperbury was that it included people ranging from ages 12 to 70, I mean it was about that age range.

I started working in the children's area. Derek Ricks was responsible for the children's wards. That's where he started his work, and where the music therapy started as well, so I got going with the children's wards first. And it wasn't assessment. The assessment work developed later under people like Barbara Kugler. In some ways, that's where music therapy began to assume some importance. Because when we started to build an assessment protocol, then people started being interested in; "What are you trying to find out?; How do you evaluate him?; and so on." Harper House was the inspiration of that really, I think. It was interesting anyway, also because the two so-called children's wards contained a lot of adults. And at this time of my career, there was almost no information to support the value of music therapy with adults. It was all about children. And of course when you look at - just taking a side step here - when you look at what was going on at the Nordoff-Robbins Centre in London, they were much more interested in children, not so much with adults. It was a question really, that there was a priority on working with children. But of course, as soon as I started working with the older children on those wards, the nursing staff working with adolescents said: "Hang on, we need to have some of this for our populations as well, not just for children. What about the adolescents and adults?" So I got sidetracked into working with these populations. And of course that was very successful because some of the people on the wards, the staff on the wards were looking and saying: "Hang on, these adolescents and these adults are responding just as well". They were very impressed; they could see the adult patients responding to this intervention very, very well. You have to remember at this time, in the 80's I was working on wards where they got almost nothing.

JW: A lot of children went into that sort of hospital in the 50's and 60's, didn't they? Because parents were told: "Oh, just put them in the hospital." And they were very institutionalised.

TW: Yes, but the staff were looking at this and saying: "Hang on, I can see these young adults responding well to this intervention." And they were surprised actually, because there was such a good response; excitement, enthusiasm, alertness, attention, awareness of what was going on, engagement with the staff, engagement with the other clients.

LO: Did you use video already at that time?

TW: Mmmh, I bought one of those big VHS cameras, you know. They're very heavy, but actually they produce very good quality material. I would actually take examples of the clients working with me and show it at the case conferences. Now that might seem totally inappropriate to you, but I had the lead to let the clients' families or carers see what could be done with a particular child. And you couldn't do it unless you actually showed them examples of what could be done. So when I went to case conferences on the ward, I would take along my video camera and say: "I would like to show you all an example of Joe as he was playing this morning, and I would show them that. And they were looking at it thinking: "Wow, this man can interact." And it was a simple thing: "he can interact." So I did that and I would take it on the wards as well, and I would show little things when I was on the wards, so that they could actually see the clients. Because I didn't think that half of them really believed it was going on (laughter). They didn't actually believe that these people could interact and they said that they're too handicapped. But when they saw them interacting, it was a revelation to some of them, and I would of course show it to the staff as well. I would organise it so that we could have a session where other staff were joining with it and starting to realise what was going on with the clients, and that they could engage with the clients as well. So I didn't see any ethical problem with this actually, because I was helping these clients and the staff to get together. That was what it was all about, in those days in the 70's and 80's at Harperbury. I wanted there to be co-therapy sessions where the clients could actually engage. (Editor's note: the videos were shown to parents and staff members involved with the clients. Also, at that time, consent forms for videotaping were not yet required).

IN: Yeah, I mean Nordoff & Robbins did also videotape everything at that time.

LO: What kind of language did you use to explain to the staff what was going on?

TW: Well, that's a good question. I would try to take the easiest way of explaining what interpersonal interaction was about, I mean social awareness, social intimacy, social sympathy. I mean all the things where you think: "Okay, what's really happening here? Is it about friendship? Is it about fun? Is it about enjoyment?" I remember one case meeting at Harperbury, actually with Mary Priestley. We had little seminars when Mary Priestley was there, and I remember one where Mary was looking at what I was doing and I had showed video of it, and I got the sense that she was thinking: "This isn't real therapy" (laughter) "This is people having fun - this is Tony Wigram having fun with playing songs from the shows." I mean literally playing - I played a lot of different things, songs from the shows and songs that people knew. She actually said it during the feedback after, and I said: "No, sorry, but this is real therapy. This is about how you use any type of music to establish something that clients would know. And if it's a song they know or a melody they know or a rhythmic pattern that they know, what's wrong with that? That's also therapeutic."

LO: Did Juliette Alvin encourage you to think that way?

TW: Yes, when I trained with Juliette Alvin, I was on placement with her at Marlborough Road in London, where there was an autistic unit. She said: "You need to remember Tony, you've got to offer them structure. You've got to offer them something they can hear and work with." And I think even though she had a psychodynamic orientation, when she was working with learning disability children, she didn't push that argument too much, because at Marlborough Road we did lots of playing with simple structures and melodies and rhythmic patterns. It is actually about how you engage clients using good tunes that they know, and using feelings.

IN: I don't think Mary Priestley had any experiences with learning disabilities at all. It was not her business.

TW: No, but there is room for everything. I thought this was working very well. I became quite a character in the hospital, everybody knew me. I got lots and lots of instruments. I had a very big old wheelchair, a hospital wheelchair, that I put wood around and a frame around, and I packed all my maracas and all the instruments I used, and I dragged it around the hospital. And I would set up a schedule to visit wards, lots of wards and I would have aims for my work. I had them all set out - what I was trying to do - so that the staff understood; working on attention with this client, working on physical mobility skills with this client, actually being able to use the instruments and handle them. And I trained a lot of staff on how to do this as well. When I was working on a ward I would say: "Right Jenny and Mary. I want you to know what to do, so I'm going to explain it to you," because the worst thing for clients, for staff, is if they don't know what their role is. That's a really important thing. So I taught them and I encouraged them, and I said: "Well, you don't have to do anything you don't want to do" that's the first thing. "But I'd love you to join in with this and to enjoy it." So I used them as co-workers, co-therapists, you see, and told them what I wanted them to do. And I always said: "The most important thing we need to work on is that you need to let the clients do what they can do and you have to become their assistant, not forcing them to do what you want." So, you know, I used to watch them very carefully to support the clients and to do little, you know, nice little musical interactive things using all their musical skills to try and encourage the clients to play and to be able to hear what they were playing. But I'd also play tunes that the staff knew, so that they could feel that they could join in with something that they would enjoy doing, that they played a tune that they liked - if they played for example: "This is the day the Lord has made" or something that they recognised. And I think that is one of the roles that the music therapist can offer to support what the client does. Not just with free improvisation, but also with well-known melodies, especially in that situation. If I'd do too much free improvisation, I don't think either the clients or the staff would have been able to make sense of it, you see. I don't regret having to use all the resources of music as well as the well-known repertoire.

LO: Haven't you always done that?

TW: I think I have always done that, you know, yeah.

LO: Also with the students in Aalborg?

TW: Oh yeah, yes (laughter).

LO: I think that bringing in the main instruments of people into their work was something new actually. In Aalborg up to 2000, we demanded that the students used mainly voice and piano, and many of them almost forgot to use their main instruments. You really brought that back on track.

TW: Now that was an inspiration from Juliette Alvin again, because she said: "Your main instrument, your main voice of your music is the instrument you're most able to use." And of course it is interesting at Anglia Ruskin University that Helen Odell-Miller has brought this back in again, and I strongly supported this. There is so much emphasis on improvisation, but lots of students at Anglia Ruskin have got very good instrument skills that they can use, and they want to use. And so Helen has always ensured that they used their main instruments and accepted them by the instrument they were most able with. This is of course the thing with Juliette Alvin because her attitude about this was that the instrument you have the most skills on is the instrument - that your main voice is the one you are most able to communicate with. I don't know, maybe you think differently on this?

LO: Well, we had this big discussion, when we had to stop the individual solo training in Aalborg for economical reasons. What will we do now? I think you amazed some of us by saying: "It doesn't have to be the piano, we can let go of the piano as the only instrument. They must use the instruments they can actually play on."

TW: Yes, yes. And I think that people should be aware, that there is a value in harmony instruments, in instruments they can feel confident with. Of course they need to use the instruments they have the most confidence with. That's the best.

LO: Did you work with groups also?

TW: All the time. It was mainly group work. It was because I was also under pressure to see lots of clients. In my heyday I can say that I was seeing probably 300 clients a week in groups. There were 2000 clients in Harperbury. I had this big trolley I was talking about earlier. It was a big old wheelchair, a big trolley wheelchair, and I had fitted it with wooden sides and I had it packed with lots of different instruments - some ethnic percussion, cymbals, glockenspiels, blowing instruments. The trolley was packed with them, and people could hear me coming down the road (laughter). And they said: "Here comes Tony," and when they saw me coming down the road in the ward, they would get all the clients in that ward into the dayroom, and I'd arrive on the ward to find about 30 clients or 40 clients waiting for me. And I kept saying to them: "I can't cope with quite so many clients in one session." But in fact in a lot of cases they all started joining in really enthusiastically, staff and patients, and it became quite an interesting session. But it meant I had to sometimes say: "I want less, because I can't give them individual attention if there are 30 clients in this room." But it was a great time, and the clients were often very responsive in large groups. The more noise there was going sometimes, the more excitement there was going, the more you saw the smiles, the more you saw the interest and the enthusiasm, and the physical responsiveness.

LO: I guess there wasn't much more they could do together, was there?

TW: No, very little. And it was up to people to give them this enthusiasm. You had to give them something. And I think that's a very big difference about the way I was working at Harperbury and, you know, the more psychoanalytic therapists. I'm not saying that what the psychoanalytic therapists were doing was wrong. They were going at it from a different perspective, but I was aware that when I was trying to promote their enthusiasm for making music and creating music, sometimes the more clients there were, the better it went, because they got more excited. And of course large groups became very popular at Christmas and at times when they could all get together and play together, and some of the staff were also very enthusiastic about large groups, because it meant that they felt they were involved in it, that they were engaged in it as well.

LO: So you were the Pied Piper?

TW: Well almost, yeah. I suppose I ended up playing music that they would recognise, and the staff would engage with it, as well as clients, so you had to use those sorts of inspirations for them. But it worked, that's what I can say, it worked, yeah.

IN: When did you get your first colleague there?

TW: My first colleague there was a lady called Diana Whitelake, and she came with Louise Ridley, She was a great colleague, really a wonderful therapist, working with clients. So Louise Ridley was a classic - now she's a vicar, but she was very able to work with people. I also had one who was rather psychoanalytic, but she didn't last very long (laughter). I'll tell you a funny story about another assistant. Soon after she started, she asked to have an interview with me and she said: "I really can't work any longer here, with the clients, you've got." And I said: "Why not?" And she said: "Because they're not able to do music therapy." I said: "Why not?" and she said: "Because they're not good enough to respond to music therapy." And she asked to have more able clients, she said: "I need more able clients." I said: "Well actually, the clients I have got for you are the most multi-disabled ones, and you'll have to work with them or go away."

Another assistant wouldn't work with a group of clients, because she said that: "They're too disabled, they can't respond." I said: "Have you listened to what they're doing? Have you heard the noises they're making? The sounds they're making? How can you describe these people as not able enough? They're making nice noises - can you hear them?"

LO: Is that an attitude you have met now and then with music therapists?

TW: I think I met people who selected clients, who would selectively take ones who were giving them more back than they could get from other clients. And it wasn't unique to any particular training. Some people just wanted to have clients who were more responsive, which in a way is perfectly reasonable. I mean if you referred a client, and they have needs, then you have to make a decision. "How can I meet their needs," and if you can't meet their needs, then don't work in a place like Harperbury.

TW to LO: My tea has gone very cold, and isn't there any red wine left?

LO: Here's your red wine.

TW: Oh, good. (...) So I think that music therapy, the way I was working with it, had a lot to offer in many different genres that weren't at the time typical, but I was able to feel I could convince the staff that this therapy was fun, it was enjoyable, that the clients were responding to it. You could see the pleasure; you could see the interaction going on. Derek Ricks, who was my great guru there, was a phenomenal doctor and also very interested in music. In fact, I teased him sometimes, because he would come down to the ward, and as soon as he turned up, I would start playing some pieces by Mozart because he loved Mozart, and then he would come on the ward, and he would go: "What's that you're playing Tony?" And you know, I played - and he could see then how the clients would respond to Mozart. It was great for music therapy.

LO: You said in the beginning that it was very much about finding the right structure for the work. And I mean, it must have been quite chaotic with all these big groups? So how did structure come into it?

TW: Okay, well the chaos was because people wanted me to see a lot of clients. I saw lots of clients, lots of children at the same time, and some of these clients were very handicapped, very intellectually disabled, and you needed to have several things in place: you needed to have staff who could help you, but you also needed to have enthusiasm for the energy level of the music, right? And you could see this beginning almost as soon as they started working, when I started playing some strong exciting tuneful music for example, they would respond to this. And the staff could see that. And the structure was built into that, because I would emphasise for example the first beats and strongly accentuate parts of the music, so that it became very clear when the clients could hear, and you'd actually see their bodies start to move, when they could hear both the tempo and the melody. It would stand out to the clients, and you could actually see the movements, the dancing and their eyes becoming bright and enthusiastic, and I think that's where I got the impression that they were able to immediately respond to music in this way. And the music therapist could facilitate that. We could help that happen for the clients.

LO: It was like an amplification of the musical elements.

TW: Yes, exactly. And you used the music to reinforce their responsiveness to the intervention; that was the most important thing. That they could hear you encourage in them musical responsiveness. That was the critical factor I think. So that they could - you'd actually see them starting to, you know, engage with you and make movements that were related to it, which was where I got started with music and movement methods, which I was doing then with Lyn Weekes and other people. I began to get interested in the physical responsiveness of clients to music. So then I began to think: "Okay, now I need to work with people who can also work with that" and they were the physiotherapists. But I also worked a lot with educators. We had a hospital school at Harperbury, and I was working with people like Dave Hewitt who did the gentle teaching programme, did you ever hear of his work?

IN & LO: No.

TW: Okay, there was a track called gentle teaching, in the literature, or intensive interaction actually it's now being called. And Dave Hewitt was a pioneer of this. And he was into engaging really closely with the clients at the tempo they could cope with. And he was working with very handicapped people, and he would gently draw out the things that they wanted to do. So we had this track going as well, but I actually encouraged him a lot, and he drew a lot of his ideas from some of the things I was doing from the gentle teaching, because they were so synchronous with music therapy. It was exactly what we had been doing. And he was in charge of a hospital school, but when he came he started looking at what we were doing, and he said: "What you're doing, it makes perfect sense to me." And he immediately started all the programmes at the hospital school, and immediately started them doing gentle teaching. It's all in the literature: gentle teaching. And so, we got a good team there that worked well with that, and I was very satisfied with that phase in the development. But it was still down to us, you know, using music was the foundation for engaging in the relationship with the clients, and I kept emphasizing to staff there, whether they were ordinary nursing staff or they were music therapists: "Your fundamental objective here is to build a musical relationship with the clients." That came from Juliette Alvin. She was very good at that; picking up things that the client liked doing, and following up on them. So I think we made a nice development at Harperbury. That was actually the best of my work I think.

LO: It was fantastic. Do you still have some of the recordings?

TW: I compiled a tape of all sorts of my work at Harperbury including the famous one with the handicapped boy with the athetosis: Raymond. Raymond was his name, and I remember he was going out - he was driving his wheelchair and singing. And it was actually with Ann Sloboda. We were doing a film for the BBC actually, and we did several films for the BBC. That was another thing I did. BBC and ITV material. They came along to film "A day in the life of Tony Wigram" for one of those five-minute things they did for BBC. That was in the 70's or in the 80's, because when I started making the films on Viboacoustics and those things, then they all piled in, and we got the BBC and then we got ITV, and many different programmes would come in and make films of us working. And some of it was sometimes stressful - I remember one producer who wanted us to do the same excerpt ten times (laughter). And I said to him: "Listen, this is spontaneous improvisation, and I can't reproduce the same thing ten times, because the clients are getting bored with it actually, and bored with you." But I could remember that some of the people doing this were actually quite good doing this. Gosh, you could really look into my history and see a lot of interesting things there. It was actually one of the things it was good to do. I mean I did that deliberately. I had to get special permission from the hospital, the ethics people and all the rest of it. But I argued strongly, and I don't know if all my co-therapists believed it was a good idea, because some of them felt that the therapist's work is private to the client. But I think I argued successfully that this was actually working okay, and it was bounded and it wasn't dangerous. I said: "I'm sure that the clients actually enjoy the therapy sessions enough to want other people to watch how they are enjoying it. And you can understand that if they enjoy it well enough, then it will become something that other people will say 'We need to do more of that.' 'We need to see these clients have the opportunity to access these therapies more.'" Which was what happened, in some ways - I don't know what you think, but of course there could be people who said: "This is bad, because it's not bounded; these people are being exploited." But I didn't believe that. Not for a minute.

LO: How could it be exploitation?

TW: By just filming them and showing them on ITV and BBC. But you only had to talk to parents and staff to see that they weren't being exploited, because they thought that it was wonderful to see what they were able to do. And that was my argument, I said: "If you want to see what clients with learning disabilities can do and actually for people to have more belief in them as human beings who can benefit from therapy and benefit from these sorts of things, make a video of it." And it worked extremely well. Well this is mostly anecdotes, you know, but I still go back to the beginnings, when I was inspired by Juliette Alvin and how we were working with clients and how we were working with other staff also. She was quite a dominating French lady. Did you meet her?

IN: Yes, once, for an interview once.

TW: Then she would come and say: "No, Tony, you must do this - you must work hard with this." With this French accent she had, but she was extremely supportive of different styles of music therapy. She wasn't analytical all the time. And she wasn't behavioral all the time. She was quite varied in her work. When she worked at the Marlborough Road Autistic Centre in North London, she was quite able to be structuring with autistic clients.

LO: You wanted to tell another story about Juliette?

TW: It was the time when I was busy trying to establish good enough pay scales for music therapists in London. I spent a lot of energy trying to build up a good enough pay-structure for music therapy. Anyway, we had the Music Therapy Association in London, and Juliette Alvin came to one meeting, and it was preparing for a conference in London. She was proposing that the music therapists would all make a workshop, right? So when she proposed that, I said: "That's fine Juliette, as long as you pay them." She said: "I don't understand what you mean, Tony," and I said: "Well if you're asking people to do a three hour workshop on a Saturday afternoon, you need to pay them." Her face was a picture: "I don't understand why I should have to pay them? After all I am giving them a fantastic opportunity." I said: "Yes, but after all it costs money, doesn't it?" We argued about it at this meeting, and in the end she agreed. I said: "These people are giving up their Saturday afternoon, they need £70 for what you want them to do, especially when you're bringing in 40 people to take part in this conference. And they're all paying, so why shouldn't…?" She said: "You have the mentality of a trades official." I said: "That's good Juliette, I like that." So we had these really funny arguments actually. And she knew damn well what I was talking about anyway.

Assessment: Documenting the Effect of Music Therapy

LO: When did the assessment come in? Was it already at Harperbury, or when did you start being interested in assessment?

TW: From the very beginning. I was trying to count numbers - trying to count up how many times the client played for a period of seconds on a particular subject. You know I was trying to measure how much their attention was going on, how much their engagement was going on and how good their rhythmic patterning was. I had loads of forms I used to fill in with numbers on them. Ann Sloboda called me "the numbers man" (laughter). But I was actually trying to keep a record of what was going on. And I thought: "Well, one way of doing it is measuring how well they're able to play in patterns and how much they are able to play for a period of time before they stop playing, how long their attention span is, how long their engagement with us is," and I was keeping a lot of records.

LO: Did you publish anything on that in those days?

TW: No, I think I just had loads and loads of pages with tables in them (laughter). I have some of these forms I was filling in, yes. They are papers like registration forms of how much clients played, how much time they played for before they stopped. How many times they played rhythmic patterns, and all sorts of things like that. I wanted people to know that music therapy wasn't just playing around. I wanted them to know it was a serious way of collecting data and of helping people and recording what they were able to do. I kept records of all of that, because I wanted to demonstrate that music therapy was a way of calming people down or relaxing people or all those sorts of things.

IN: I remember you and Leslie [Bunt] presented that, isn't that true. In Paris 1983?

TW: Yes, well I presented it in Paris in '83, the music and movement protocol, that I'd developed, which also documented how people were working, how long they were able to manage music and movements. It was, for me, a period where I started to get into documentation and felt it was important to show what they were able to do by counting to a certain extent. And it was of course not very interesting, for some people who were more interested purely in the emotional dynamic response people were making.

LO: Was it your idea to document the progress? IN: or the attention span?

TW: Yes, attention span, interest and rhythmic pattern ability - lots of different aspects. I was trying to show how the progress was coming in the way you could document it. I realised quite early on, that the people in Harperbury - the doctors - they were becoming more interested in when I could actually show a number. This client played for this period of time and concentrated for this period of time, and showed this level of interest in what the therapist was doing and the session lasted this long compared to this long. You know, simple things, not complex. I thought it was quite important actually.

LO: Was it both individual and group work?

TW: It was a mixture of group and individual. I was then working a lot more with individuals, but also with groups, because I wasn't prepared to just work with groups. I needed time with individuals, so I could actually have some more case studies to present. And after a while you get a bit tired of group work. It becomes a bit overwhelming, even though people like it. It's just too much to do it all the time. I built an argument about the group work anyway, saying that you were sometimes more likely to get good responses in group work than in individual work.

LO: And it was also a way to engage the staff?

TW: Yes, it's a way to engage the staff when a lot of people start working together in a group situation. Then sometimes people get fired up about it and find it, you know, a good experience. And if you're careful about it, you can draw everybody in. And I was trying to be careful about it. I wasn't just bashing out old numbers and waiting to see who'd join in with the tempo. Many of my music therapy colleagues didn't really think it was such a good way of working. They felt that group work was not good enough to pay attention to the individual, that you couldn't give individual attention. It was better to just work with four clients and give them intensive individual attention, rather than working with 10 or 20 clients, and I would sometimes say: "No, I can see that the clients working in groups were actually doing better than when you were trying to work with them as individuals, because they just couldn't handle that type of individual attention." It was an argument I built for the autistic population, and for clients with learning difficulties, who had difficulty with being in too much attention. Because when they were in groups, they didn't have to deal with too much pressure. It may sound odd, but the point is that if you had groups of people with autism and challenging behaviour, if they got too much individual attention they'd simply go: "Go away please, go away," because they couldn't cope with it. And I got hit several times, you know. So it was sometimes worth working in smaller groups. That was actually why I went to the USA. I got a fellowship to investigate the effect of music therapy on people with aggressive and difficult behaviour. So I went to the USA to find out how the therapists there dealt with it. And of course all I found out was that they worked totally behaviourally, whilst I was doing the opposite. I was doing it psychodynamically, so if clients got aggressive with me, there had to be a reason for it, and I had to engage with them and find out what they could cope with, and what I could help them cope with. Aggressive and challenging behaviour is very difficult for anybody to deal with, and the staff had to deal with it. There was a lot of biting and scratching and kicking there. I had actually set up groups of therapy sessions for clients with aggressive and difficult behaviour. I set up special therapy groups, including clients who had problems with hearing and clients with very severe and odd syndromes, many different syndromes. So this was the story of many of my clients at Harperbury. And every single group I had to find ways of dealing with.

LO: But when you came to America, you found that no one was working that way?

TW: There wasn't anybody working the way I was working with aggressive and difficult clients, because what they were doing was behavioural control to stop them being aggressive. And MY argument with them was that you have to build up an emotional relationship with the clients, and a musical relationship with the clients. THEN you might have a chance of helping them cope with behaviours that they couldn't deal with. Because, I mean, they couldn't help it. And I was just busy trying to help - especially help my staff realise that building an emotional relationship was likely to be more successful than establishing a behavioural management strategy, which was what the Americans did. I enjoyed working with the clients, and I think if you get kicked a few times, it's good therapy for you.

LO: It's an expression of love isn't it?

TW: Yes, exactly. And that's why, you know, I was trying to give to the staff my attitude: "They're people, that's all they are. It's not their fault they kick people." You know?

IN: So this means that you sometimes had a group of aggressive clients together? Didn't they attack each other?

TW: No, no it depends on how you manage them. I had groups including clients who were self-aggressive, you know, self-injuring, self-harming patients. I think the music helped them cope with it a lot. And I do also believe that the structure in the music is important. When people hear the structure in the music, they become more contained. So I did a lot of that. And I do believe the music did, not control, but enable people to hear structure that they could use, and not be offended by. But there was another aspect I suppose, it was if you over-stimulated, you'd also get the opposite reaction. The music and movement thing was also interesting. Lyn Weekes (who was a physiotherapist I worked with for many years) and I built a whole programme of music and movement, because I actually knew I had to learn about body movements and music and movements. You can't make people do difficult movements with their bodies unless you understand what they're trying to do. And, you know, you have to be careful about that. That's another level of professionalism I think. I'm certainly experiencing it now with my physiotherapy.

I did actually do some things with trying to develop a speech and language method, and I did things like using amplified microphones for example in order to help clients hear better what they were doing. So if you put an amplified microphone in front of one or more clients, and they make noises and they hear their sounds, then they would start to respond to their sounds, and then you could make your sounds. I did all sorts of funny things with that - they would hear the amplification of their sound, and they would laugh at it, and then I would play it back to them so I recorded the amplification they made. And they would hear their amplified sounds. And this was, of course, very amusing and interesting for them as a recording of their sounds, because I realised early on that the clients needed to hear the sounds they were making, because they couldn't hear them. So I had to make them louder. And the reason that they needed to hear them is they needed to hear themselves, you know, and the music. And it was better for them to hear an amplified recording of those sounds that I'd made, than for me to try and artificially make a copy or something. So these things were actually quite good, and we spent a lot of time trying to make these sorts of technology into the work we were doing. Quite interesting.

IN: Did you ever work with building instruments for multi-handicapped people?

TW: No. Do you know why? Juliette Alvin told me not to (laughter). I'm not joking, it's serious. The point was, when I first went to Harperbury, I bought lots of instruments, and I always argued to the staff, because they said: "Why do you need so much money for instruments." And I said: "Because I have to buy good quality instruments for them." Something I learned from Juliette is that if you give them bottles with stones in them, they very quickly know what the difference between bottles with stones in and a nicely sounding beautifully resonant Djembe or something like that. I said: "You can't give people, even the very handicapped, rubbish instruments. You don't fill bottles with stones. It's not good." So we had to raise money for that. But as soon as the staff at Harperbury found out how interesting it was with the music, the first thing they did was to go out and buy stupid little instruments, stupid little tambourines, which make stupid little jingle sounds, you know, and I said: "Don't buy those," and they said: "But we can get ten tambourines and six small drums for this much money." And I said "Yes, but it will have NO meaning to these clients." I had to teach them that the power of a good quality sound is better than lots of stupid little sounds.

Politics: Building a Framework for the Profession

TW: The other role I suppose I haven't told so much about - but you probably know quite a lot about it anyway - is my political role in the services in North West Herts and all the political responsibilities I had as the head of the service there. And this isn't something music therapists are often doing. Some music therapists do this, but I was doing it right from the beginning. And I became, quite early on, the principal music therapist for the service there and for the hospital management service. And I had responsibilities as a sort of music therapy politician. I was quite happy to do that, and I became known for that work. And I think that was important, because then people could see that my job as a music therapist was far extended beyond purely banging on drums and playing cymbals, you know. This also gives you more status, as I think people realise that you've got more to do than just your clinical work.

LO: Early on you engaged yourself in building international professional associations – the World Federation (WFMT) and the European committee (EMTC). Did you have specific goals for the political work?

TW: It came from a little group of therapists that met at Harperbury, people like Helen Odell-Miller, Gianluigi di Franco, myself and Patxi del Campo. And we all sort of put our hands together and said: "We're now forming the European Music Therapy Committee." And why were we doing it? Well, probably to build a powerbase for ourselves. And there's nothing wrong with that. People always criticise that sort of thing, but I'll say: "Yeah, well actually we are, but we're doing it to build something. There's nothing wrong with that as long as people aren't excluded from it - which they weren't." And what was it really for, the EMTC? It was to build structures - we made lists, we made committees, more committees, and we tried to make something that worked out. European Music Therapy Committee, what a name! So it was a committee, it was a group of people who were trying to build a sort of direction for music therapy amongst well meaning colleagues, which included quite a lot of people, so I think it was inclusive rather than exclusive. A lot of people signed up to it, said: "This is a good idea." And our first few meetings had, you know, a lot of people. And of course it was built on the idea that there would be a representative from every one of the countries of Europe on the EMTC - I said: "We need that." But the difficult thing about that was of course that it was very difficult for people to agree who that representative should be. Some stupid power people actually didn't contribute anything to it. All they wanted was to have their name on the paper and to have their place on the committee, arguing. And at one point I did lose it a bit. I said to people: "You can't just come to the committee in this room and sit there and expect people to listen to you, if you don't do any work for it." I get fed up with people who want to have a position of power, but actually don't do any work. And I made that very clear to some people, so probably I was unpopular. And I was probably unpopular because I could be quite argumentative with people in committee meetings, if I thought they weren't doing much or if I thought they weren't really giving any inspiration.

LO: How much did you discuss the cultural diversity? I mean there are so big differences between music therapy traditions in the different European countries. How much was that discussed in the early days?

TW: Never, never in the early days, I don't think. It came up later, but it wasn't really an issue. People like Gianluigi were very aware of it, and he would talk about it. And we talked about the differences in the way people worked to some extent, but I would say not to a great extent, which was a shame. We were all too busy trying to build up a structure, you know, trying to build up a concept and a group of people who were prepared to work together, to actually get into any depth about the cultural diversity. But I think people did talk a little bit about it, but not as much as they should have done.

IN: But you made registers, for example the music therapy research register.

TW: Yeah, that's right, and there were of course arguments about what criteria you had to have involved, to be registered on some of these things. But, on the whole, it was open. I can say that. If people could present some good enough documentation, if they had done a music therapy qualification of some sort - and that was difficult of course - then they were included. We were more open than closed, I can say. We always had lots of people who hadn't done a music therapy qualification, so what would you do with people like them? I knew, in the back of my head, that I was facing lots of people saying: "Why are you letting these people be involved?" And: "Why are you recognising these people -these Italians and these Dutch and other people who haven't got qualifications?" And I just said: "Because it is better to recognise that they are trying, or something, than to exclude them. We'll only end up with a disaster if we say: You can't be in it, you'll be excluded."

LO: Looking back at it, was that the right way to do it? Do you think that today?

TW: For Europe and for UK and for what we were trying to do here, I think it was the right way to do it. Because if we had said: "Right, now we are going to make a whole list of criteria you have to produce in order to have your name on the list and to be recognised," we wouldn't have got anywhere, nowhere at all. I strongly believe that, and people will probably always criticise me for being too permissive in that sense and for not establishing good enough standards. And if I had to do it again, I probably would of course know better what to do in terms of establishing standards, but in the 1980s we had to allow some things. Even Juliette Alvin would allow a lot of things as a form of music therapy. That's the way it was then. You can't just exclude people, you have to work with them, and encourage them, is my attitude.

IN: I think a lot of people will be thankful to you Tony. Thankful that you were so permissive.

TW: Yeah. I hope so.

LO: So you mean that starting with defining the standards and then excluding everyone who does not live up to that - is a bad way to build an organisation?

TW: Well, it is until you actually have got agreed things in place that everybody signs up to. You know, you don't have to keep inventing the wheel. You can say: "What we know now, what it is and what it should be, so let's do what it should be." But at that moment in time, we didn't have [that knowledge].

LO: One of the really big achievements of EMTC has been the European conferences. And looking back at all the conferences you've attended, what do you think it has evolved into? What is the situation today as compared to 20 years ago?

TW: I think the situation we've got to is a level of inclusivity certainly, whereas we can say 20 years ago there were people who were not prepared to be inclusive. On the other hand that leads to another problem which is, as I said just earlier, that people will be sometimes critical of who is being included, but I don't mind that so much. I would often say to people who had presented papers at these conferences: "I really thought your intervention was good, and I think it's great you made it." And I was always very, you know, enthusiastic about what people were prepared to contribute. Because it takes time to write a paper, and it's putting your head on the block, because you can always get chopped down by people who are either jealous or don't want to listen to what you've got to say. But almost always I've complimented people, especially people who been have prepared to present their clinical work. Because I know that people really want to hear about the clinical work. So we've always put an emphasis on people presenting their video excerpts and things like that, and that's terribly important. A lot of people have put lots of good things into these European conferences. And it's taken a lot of effort from people, and I'm sure that people haven't always agreed with some of the stuff that goes into those papers. But if they formulated a case presentation or if they formulated a good enough video presentation, I am willing to listen to it and always would. You know. It's good.

LO: I think indeed - I haven't been to all conferences, but I remember that in the early years, you could hear case presentations that were purely anecdotal. Nobody does that anymore I think. They come with their documentation, video or audio or other material, and give a proper presentation of what they've done.

TW: I think that's very important, I think that's been one of the biggest developments over the last ten years - the stakes are being raised, and people certainly say: "Yes, we've got to do good here because, well, our work is being presented in front of quite a few different people." I think that that's one of the best things that has developed: raising the level, without being competitive. But the quality of some of the papers even at the early EMTC conferences was still good, I think. People thought carefully about what they wanted to say, and they said some good things - our early keynotes for example.

IN: And you did a great keynote in the latest European conference in Cadiz 2010. We heard yesterday that people were so impressed, maybe it was the best you've ever done.

TW: Yes, the one I put together for Cadiz I was really pleased with. I've done lots of different keynotes in my time. Some of them I've been pleased with, and some of them haven't been so good. One of the ones I liked best was actually the one I did for the Norwegian conference in Bergen 2007. They invited me to present all my old clinical work, with my videos of my work with music and movement and my work with the learning disability population – all the things I have been talking about here. That was a really nice keynote to do, and I think it actually hit the Norwegians. That was really the sort of work they liked anyway.

LO: Would you say there has been an improvement in the discussion culture over the years? More respect?

TW: I think definitely more respect in terms of the discussion and more respect in terms of when people are trying to argue a point. People will listen more, too. I hope they do anyway.