[Original Voices: Interview]
An Interview with Lisa Summer: Discussing GIM and its Adaptations
By Erin Anne Montgomery
Context
When I began my music therapy studies in 2000 I was immediately drawn to the Bonny Method of Guided Imagery and Music as well as Lisa Summer's work. I read everything about GIM that I could get my hands on at that time. It was a “match” for me.
My first encounter with Lisa occurred in 2006 at the AMTA conference Come to the Source: A Wellspring of Innovation in Music Therapy in Kansas City, MO. I saw Lisa present twice at that conference; once in The Music Therapy Innovator Series where she presented on her adaptation to the Bonny Method: re-educative music and imagery, then again with Barbara Hesser, Joanne Loewy, Paul Nolan, and Clive Robbins during the session Existential/Humanistic Music Therapy: Toward Developing A Model. Her passion for her work left a strong impression on me.
In 2005 I attempted to organize what I believe would have been the first Level I GIM training on the east coast (Halifax) of Canada with Liz Moffitt. Our numbers were still too small and so I began looking for a training program. I was thrilled to find that the closest training to Halifax was actually in Paxton, Massachusetts at Anna Maria College and was led by Lisa Summer.
It’s impossible to put into words how much I have benefitted from GIM training, and specifically Lisa Summer. She has been a brilliant teacher and now supervisor for my Level III practicum. This interview is my small way of giving something back. Through it I hope to share some of her insights and broad experience with a larger audience.
Interview
Erin: What brought you to the profession of music therapy?
Lisa: As I look back at my rebellious adolescence, I can see how therapeutic music was for me, and I think it was this use of music that ultimately brought me to music therapy. In adolescence I felt I couldn’t go to my parents with my very strong, negative feelings. I played piano at that time, and I think for me music was a kind of auxiliary parent that gave me what my parents couldn’t: understanding and empathy for my strong feelings. Music was like a third parent - and that parent was the one with whom I could share my anger.
But it took me four years of college before I found the profession of music therapy. I studied music education at Temple University, music performance (on French horn) at the New School of Music in Philadelphia, music therapy at Western Michigan University (undergrad), Hahnemann University (now Drexel University; grad), and Aalborg University in Denmark (PhD).
E: What brought you to study GIM?
Lisa: I heard Helen Bonny speak at an NAMT conference in 1976. She spoke about classical music with such depth - I could feel that she had an extraordinarily deep appreciation for it and right away I knew that I wanted to study with her. I have always felt closest to myself when I am in classical music. Somehow it really feels like a home; I feel like I can be myself in it. So when I met Helen I was already very connected to the core idea of GIM: the deep listening to classical music.
E: What is your personal definition of music therapy?
Lisa: In my undergraduate Introduction to Music Therapy course the basic definition I give is “the use of music to improve health.” In my clinical work with adult psychiatric clients, I think the defining feature of my approach has been to help clients use music as a supportive resource in their daily lives. I think that music can be a personal resource for everyone. It’s like food. A music therapist is like a dietician who helps a person to activate conscious awareness of their daily diet.
E: Can you trace the development of what you have come to term supportive or resource-oriented music and imagery?
Lisa: In 1979 I began adapting the Guided Imagery and Music (GIM) method at Northwestern Psychiatric Hospital in Philadelphia for clients diagnosed with depression and drug/alcohol addiction. In a parallel process, Fran Goldberg was also adapting GIM for her patients who were psychotic at Langley Porter Psychiatric Hospital in San Francisco. Fran and I developed our different strategies independently for years. Then we met in 1988 when I was Coordinator of GIM Training at the Bonny Foundation in Kansas. Helen Bonny and I extended an invitation to many GIM fellows to give short presentations about their GIM work because we wanted to survey the clinical work taking place with GIM. Fran’s approach to GIM felt synchronous with ours and we invited her to join the training faculty at the Bonny Foundation. Fran and I became close colleagues and we began developing our ideas about these adaptations together. We decided upon the term “music and imagery” (MI), to reflect both of our approaches and to clearly differentiate them from GIM.
My MI sessions had been designed to confront the verbal, intellectual defenses of clients with drug addiction and/or depression. So they used very evocative classical music paired with drawings to evoke and examine the client’s symptoms and positive resources. Fran’s MI sessions, simplified so as not to raise psychotic symptoms, used non-classical music, and during the music she led the client in a “talkover” to stimulate positive resources. Although the session procedures differed, we had a common intention: to narrow the client to one image, as opposed to GIM, which stimulates many images. We also separated out the supportive (resource-oriented) work from the re-educative (symptom-oriented) work. In the last few years, Fran has shortened the terminology to “music imagery,” and I’ve utilized the term “resource-oriented” MI interchangeably with supportive MI (the term resource-oriented music therapy is in common usage in European music therapy where I was studying).
E: Can you trace the development of what you have come to term re-educative music and imagery?
Lisa: When I completed my GIM internship I was so ready to apply what I had learned, but I found myself at a psychiatric hospital leading groups of clients with alcoholism and mood disorders and I found that GIM was too exploratory, it was too indirect. When I used GIM, of about eight group members, usually only one person would come out with some kind of insight that was directly related to the symptoms they were experiencing. I realized that the GIM method, developed for people who were well-adults, was too open-ended for psychiatric clients. With GIM, it took too much time and energy to hone in on the specific symptoms that the client was showing. And time was a really important consideration because my clients were only in the hospital for 30 days. Actually, today hospital stays are even shorter and short-term therapy is the norm. So it became essential to find a direct route to address core symptoms through the use of music and imagery. In regard the music, what I did first was to shorten it to 3 -10 minutes - both for group and individual sessions. My first adaptations included music from the Romantic era filled with tension. I wanted the music to stimulate images about the clients’ dependence on alcohol, images that were immediately understandable to them, images that would be so clearly emotionally and cognitively relevant to their alcoholic behavior that they couldn’t avoid facing it. It was really all about helping my clients to be honest with themselves. So that way of adapting GIM: using short pieces of evocative music paired with drawing or writing to help a client confront specific symptoms is now called re-educative music and imagery.
Fran Goldberg and I developed and named the three levels of music and imagery methods using the terminology: supportive, re-educative, and reconstructive (GIM) music and imagery to align with Barbara Wheeler’s levels of music therapy practice. We called it a continuum of MI and we taught this continuum at the Bonny Foundation GIM training.
E: You have facilitated many GIM trainings. In your opinion how have Bonny Method GIM trainings changed over the years?
Lisa: In the first GIM training in the 1970s at the Institute for Consciousness and Music in Baltimore, MD, Helen Bonny taught contraindications for GIM, but at that time there were no adaptations, nor alternative techniques, to utilize with those clients who were contraindicated for GIM. In the 1980s and 90s, the second generation of GIM therapists - those of us who were trained by Helen Bonny - began to include GIM adaptations as an alternative to use with contraindicated clients at the advanced level of training (Level 3). At the Bonny Foundation, Helen Bonny, Fran Goldberg and I taught these adaptations and developed them into a continuum of music and imagery practice. I think these were the first two phases of development in GIM training.
By the early 2000s Fran and I created a new educational paradigm that allowed us to teach the continuum of MI practice in a developmentally sound order beginning with MI at Levels 1 and 2.
I can explain the paradigm change by using a parallel with the Nordoff-Robbins training. Imagine a music therapist attempting to master the complex aesthetic considerations of becoming an NR music therapist using piano, without ever having practiced simpler forms of improvisation on percussion instruments and/or guitar. I think that’s the same idea - that it is easier to master the simpler forms of a music therapy method before attempting to master the most complex ones.
E: In your opinion what was the essence of Helen’s life work?
Lisa: When Helen Bonny developed GIM, she wanted to emphasize a deeply receptive experience with classical music. Whereas most music therapy methods emphasize expressive methods, Helen’s idea was to slow down, and deepen a person’s process of listening. The idea is that the more deeply we listen to music, the more deeply we can listen to our inner world. Her main idea was to shed light on the receptive surrender to classical music.
Her work is so fascinating if you think about it. Music therapy strategies usually use the principle of accommodation: when we make music with the client, we spontaneously accommodate to the client’s immediate responses. In fact, the power of making music with a client lies in this immediacy. Yet the Bonny Method ignores this basic client-centered principle in favor of a music-centered one - the GIM client is expected to assimilate her emotional experience to the already established direction of the music. What GIM loses in the immediacy of accommodation, it gains in the challenging process of assimilation, and what is amazing is that, in practice, this challenge so often leads to transpersonal experiences. For example, in my dissertation research, I conducted one GIM session with four music therapists; even with a single session, the outcome of each was a transpersonal music experience. This was the essence of Helen Bonny’s work: that this kind of surrender (letting the music “take you where you need to go”) would ultimately stimulate peak experiences for psychological and spiritual transformation.
E: What would be the clinical reason to use a pre-designed program?
Lisa: A predesigned program challenges the client to surrender to the direction of the music. The intent of using a pre-designed program is to take you quickly through musical material. I can use an analogy from my experience as a scuba diver. Sometimes the ocean current is just going too fast, when there are great fish near a coral reef that I’m dying to see. If the current is too fast on that day, what am I going to do? I can willfully swim against the current to see what I want to see, or I can just let go, surrender, to the speed of the current and enjoy the thrill of whatever the ocean current has in store for me as I ride with it. This is an internal process of letting go. And that’s exactly what Helen intended with GIM. This kind of deferring to the music is a psychological and spiritual skill. It’s a beautiful metaphor about life because life doesn’t stop for you. GIM clients say, “oh, the music has something else in store for me; let me open and see what that is.” So the therapeutic value of a predesigned program is that it challenges healthy surrender to the unconscious, which then raises what are often uncomfortable and fearful experiences that need to be addressed.
E: What would you like to pass on to others about your recent doctoral work?
Lisa: I would say that my doctoral work has made me an advocate of music-centered GIM sessions - by that I mean GIM experiences that are not always mediated by imagery. My study examined two aspects of guiding: how to help clients to have the most direct music experience possible, and how to more directly link imagery experiences to the music. It gave me a deeper appreciation of the variety and the power of using music-centered interventions.
The other element I studied was the strategy of using repeated music in order to slow down the imagery process and to allow a more music-centered focus for the session. Music-centered guiding interventions and the use of repeated music are both now a vital part of my teaching in MI and GIM.
The doctoral research pointed out to me that there are ways to subtly adapt the Bonny Method to create other forms of GIM, and there are ways to significantly alter the Bonny Method into simplified music & imagery methods that lie outside the realm of GIM. I think music therapists need to study and more clearly define the differences among the Bonny Method of GIM and its many adaptations.
E: What percentage of your GIM sessions are spontaneously linked and which percentage would use a program? Or do you use programs at all anymore?
Lisa: I do - I would say 85-90% are spontaneously linked.
E: How is spontaneously linking music for a GIM session different?
Lisa: Programs that are linked spontaneously while the GIM client is imaging don’t have an already set shape or an already established direction. Spontaneously linked programs allow the shape of the program to be determined in a client-centered way - the therapist follows whatever direction the client is going in the moment. When I link GIM music spontaneously, my choices of music always reflect aspects of the client’s current state.
In an ocean analogy, you can say this: predesigned GIM programs are like an ocean dive with a strong directional current that helps the client to explore new territory. Spontaneously linked GIM programs are like an ocean dive where the current does not lead the direction; rather the diver gradually dives deeper and deeper, following his own pace. So, spontaneously linked programs are more contained and more clearly centered in the client’s current state, whereas predesigned programs only begin with the client’s current state and they move significantly beyond that territory.
E: What is your biggest contribution to music therapy?
Lisa: I think my biggest contribution to music therapy can be seen in the refueling of so many music therapists’ deep connections with music. Music therapists become burnt out because of the intensity of our clinical work. And unfortunately, for so many, music becomes relegated to a tool to use with clients. The professional connection to music predominates and the personal experiences with music, and our love of it, dries up. Yet this is the very nourishment that we need to counteract professional burn out: to keep having passionate, strong personal experiences with music through depth listening and active playing.
I still play horn in a community orchestra, and I use music and imagery on a weekly, sometimes daily, basis for my own personal growth. I can say that I don’t believe music therapists should practice music therapy without a connection with music that is central to their lives and this, for me, is a central part of teaching music therapy and GIM: that it is essential to keep having passionate, strong, personal experiences with music.
E: What do you feel passionately about as a music psychotherapist?
Lisa: Clients with depression, anxiety come to sessions with their life energy diminished - it's bound up inside them so they are preoccupied with issues. I love bringing my clients more fully into the here-and-now with music and imagery. When a client can begin to trust that their inner world has value, I love giving them a process by which they can open, listen to music and connect with a strong part of their inner world - maybe a feeling of anger, maybe a feeling of joy. It's a thrill to get past the client's defenses to see more of their true, inner feelings. To me, it feels like they are coming more strongly into themselves, to be more strongly alive. I love when they can feel their inner world through music and when they see their inner world as an image in a drawing. I love making people's inner worlds more accessible to them through music!
E: It seems that you have so much passion for this work. Can you imagine doing anything else?
Lisa: Well, I love diving so much that I could imagine becoming a scuba dive guide.
E: Thank you Lisa.