An Interview with Denise Grocke: Discussing GIM and its Adaptations

Co-edited by Erin Montgomery & Denise Grocke

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Emeritus Professor Denise Grocke PhD, RMT, RGIMT, FAMI founded the music therapy course at the University of Melbourne in 1978, and retired from that position in 2012. She continues to lead Guided Imagery and Music (GIM) training at the University of Melbourne, and co-ordinates the International Consortium of Music Therapy Research Universities. She is co-author of Receptive Methods in Music Therapy (2007), co-editor of Guided Imagery and Music: The Bonny Method and Beyond (2002), and co-editor of recently published Guided Imagery & Music and Music Imagery Methods for Individuals and Groups (2015).

Erin: What brought you to the profession of music therapy?

Denise: It was during the third year of my Bachelor of Music degree at the University of Melbourne that I developed an interest in music therapy as a career after reading an article on music for Deaf children in the Journal of Music Therapy. I travelled to the US in 1968 and enrolled in an "equivalency" program at Michigan State University. After completing my two years of course-work, I completed my supervised clinical training in music therapy at Northville State Hospital in Detroit, which led to Registration with the then National Association for Music Therapy (NAMT).

In 1970, when I returned to Melbourne, a psychiatrist Dr. Daniel Kahans established a music therapy position for me at Larundel Psychiatric Hospital in Melbourne, which was the first in Victoria, and Australia. The total patient population at Larundel was 550 patients, and initially I tried to provide music therapy for everyone, but soon realised that it was like “conveyor-belt” therapy. Trying to reach all patients led to superficial work. Subsequently I restricted my program to a few wards. This enabled me to provide music therapy at a more intense level. At that time patients with Huntington’s disease were hospitalised in psychiatric hospitals, and I conducted a small research project with these patients in 1976.

Erin: What brought you to study GIM?

Denise: At Larundel Hospital I was running relaxation sessions with patients in the acute wards. Periodically I received advertising material from the US, and one day there was a flyer announcing Music and Your Mind: Listening with a New Consciousness by Helen Bonny and Lou Savary. I was excited by the description of this book and ordered it. I started to use Helen’s relaxation inductions from that book, and Helen’s music suggestions. It was a learning experience for me, as classical music was often not preferred by patients. They reported imagery of funerals and other sad events when I used the slow movements of Mozart concertos, for example. I found impressionistic music more amenable: Debussy’s Afternoon of the Faun, and Butterworth’s On Banks of Green Willows.

I established the music therapy course at the University of Melbourne in 1978. One of the first students of that course was Alison Kuehne (now Alison Short). Alison went to NYU to do her Masters, and she chose the GIM option. In 1987, when Alison came back to Australia she gave me my first GIM session. I was then intent on doing the training myself. Through AMTA (Australia) we received grants to bring Linda Keiser and Alison Short to run a Level I, then Mady Ventre and Alison Short to conduct a Level II. Then Florence Holligan and I went into a mentor program with Mady to complete level III. Mady was teaching level III at NYU and recorded her lectures on cassette tapes, and sent them by mail to us in Melbourne Australia. That’s how we learned the theoretical information. At the time, Jessica Fleming was practicing as a GIM therapist in New Zealand, and we would bring her across to do the required personal GIM sessions and supervisions. Then in 1994, we set up the Music and Imagery Association of Australia (MIAA). Helen Bonny was visiting New Zealand at the time, and we asked her to come on to Australia. She was present when MIAA was established. We were looking for the name of the association. We knew it would have “music” “imagery” and “Australia” in the title, and when we discussed what order these words would be in, Helen’s voice said clearly “put the music first.” So we did.

Erin: Can you discuss the landscape of GIM in Australia, and the evolution of the MIAA training program?

Denise: In 1994, we set up the typical three-tier training in GIM. Through MIAA we ran five-day Level I, and seven-day Level II programs. I set up advanced training (Level III) at the University of Melbourne as a Graduate Diploma in GIM, and the first intake was in 1995. Alison Short was a Primary Trainer, and we brought her down to Melbourne to teach the first group, while Florence and I had our training shoes on for becoming primary trainers. Then, in 1996 Florence and I became the trainers. We have taught a group of advanced trainees every year since, although the numbers have often been very small. We are fortunate, in a way, that there has only been one training course for the country.

The Graduate Diploma in GIM at the University of Melbourne runs over two years, and in order to fit into a university structure there are four long-weekend seminars for each year, that is, eight seminars altogether. This meant we could study three to four music programs at each seminar, and trainees then know about 26 music programs by the end of the course. This includes the 18 that Helen Bonny put together, five Linda Keiser Mardis programs, several of Ken Bruscia’s programs, (e.g. Gaia, Faith, Warrior/King), and others developed in Europe (e.g. Ellen Thomasen’s Present Moments).

In 2000, we converted the Level I and II intensives to a Certificate course in Music Imagery Methods, and spread the content across four weekends (four seminars) of the year. In the new structure we teach group Music Imagery first, and trainees run a series of four group sessions between the first and second seminars. Then, at the second seminar we introduce the individual form of the Bonny Method, and give the trainees one music program to use with five different people. We then give them a second music program to use five times with another five people. Then they enter advanced training through the Graduate Diploma for level III. This training framework suits the Australian situation well.

In 2014, MIAA celebrated its 20th anniversary, and brought Lisa Summer to Australia as Keynote for the conference. We were interested in her Music Imagery (MI) framework, and she presented several lectures on her three-phase MI structure: supportive (resource-oriented) MI, re-educative MI, and re-constructive MI. She also lectured on her concept of “repeated music” in GIM, drawing on the findings from her PhD.

Erin: How did your collaboration with Torben Moe on the new text Guided Imagery & Music and Music Imagery Methods for Individual and Group Therapy come about?

Denise: Torben and I met in Denmark in about 1995. We were both in the throes of doing our PhDs and we both had clinical experience working with people who have mental illnesses. Torben’s PhD was based on restitutional factors in GIM for people with serious mental illness. Sometime after 2000, I was telling him about the way we re-structured Level I and II training, and he liked that idea. So we had similar clinical experience, and similar views about teaching GIM from more of a pedagogical perspective; that is, introducing the elements of the Bonny Method in an incremental way. Then trainees can incorporate techniques into practice, rather than the traditional Level I, where trainees cannot use any of the skills and experiences from the 5-day intensive in practice.

The idea for a book on adaptations and modifications came from our view that there is a spectrum of approaches from MI to GIM and we wanted to capture the range of approaches from MI with young children through to palliative care, and group work.

Erin: Can you discuss the process of editing this new GIM textbook?

Denise: Over the last decade there have been several surveys and conference presentations on adaptations and modifications. First of all, Torben and I made a list of presentations we had heard, and responses to surveys, and we set out to include MI and GIM with individual and groups across a wide spectrum of ages and needs. We also wanted to include new music programs, and a section on training. There are 32 chapters and all authors are Fellows of GIM. The age range of the clients is from 10 years through to those in palliative care. There are chapters on MI in hospitals and schools, as well as in private practice. The music programs comprise new culturally-specific programs, and new genres, such as a jazz program. The chapters are also illustrated with mandalas, which I am pleased are reproduced in colour in the book.

The book was conceived in June 2013, so it has taken 2 years to come to fruition. In that time there has been continuing dialogue about adaptations and modifications that GIM practitioners can make in the moment, for the client’s needs. There are also new methods evolving that require further training. A Swedish GIM therapist Margareta Wärja, is completing her PhD using KMR (Korta musikresor, or “Short Music Journeys”). But a qualified GIM therapist is not really able to use Margareta’s method without some further training. Similarly Dag Körlin’s model of Music Breathing also needs some additional training, (e.g., as Continuing Education) as it focuses very closely on breathing techniques to help traumatised clients regain control in situations that are over-whelming.

In retrospect we might have included a few chapters illustrating the full Bonny Method in this book, to make it more comprehensive. But there are 32 chapters already, and it is quite a large book in comparison to others. In addition Ken Bruscia has published his Case Examples in GIM through Barcelona, and we direct readers to that book for more information on the Bonny Method.

I have a strong sense that GIM is going through a period of development not unlike MT in the 1980’s and 1990’s, where we had the five music therapy models (celebrated at the World Congress in Washington, 1999), but where each was also evolving into something new. This has occurred for example in Nordoff-Robbins Music Therapy, where traditionally there was a pianist and a second therapist who facilitated. The songs were Nordoff-Robbins songs. These days other instrumentalists, such as guitarists, can train and practice Nordoff-Robbins music therapy, and a wide range of songs are used. I see GIM as being poised on a similar path of growth and expansion.

Erin: Can you speak about the Bonny Method of GIM, GIM, adaptations, Music Imagery, etc.? Do you have an idea of what each of these is and is not?

Denise: I view all these on a spectrum! Music imagery is a brief discussion, then the therapist chooses a short piece of music. The client may have a focus image or imagery journey, but the music is listened to silently – there are no interventions. In group Music Imagery there is a discussion where the group members come to a focus for the music journey. The therapist chooses the music, and the group members image silently. Then there is a discussion of their experience, often after drawing a mandala.

In group GIM there is guiding within the group. Either the therapist suggests a journey that group members follow, which is broad enough for each person to have an individual experience, or the group members themselves generate the imagery that is described out loud.

Then there are short Bonny Method sessions, where all the elements of a full session are there, except it is shortened, and finally the full Bonny Method session with a full program of 30-45 minutes in length.

I don’t particularly like the way we distinguish between the Bonny Method and the “not the Bonny Method” way of thinking. I prefer to think of what we do as being on a spectrum. In a GIM session if a client has engaged very closely with a piece of music, for example, Gorecki’s Symphony of Sorrowful Songs, second movement, then I will repeat it. I don’t consider this an “adaptation” because Helen Bonny herself repeated music, and she changed the music too if it wasn’t suitable. Similarly, if a client wants to talk about his/her life for longer than usual, then I will suggest a short piece of music to consolidate what we’ve discussed. Again I don’t think of that as an adaptation – to me it is all part of GIM practice. Lisa Summer’s Music Imagery Model however is different from the Bonny Method, and Lisa herself makes that clear.

Erin: Please tell me about your interviews with Helen Bonny.

Denise: My PhD study on pivotal moments in GIM was conducted over several years. First, I interviewed clients about GIM sessions that stood out in their memory as being pivotal. Second, I interviewed the therapists who guided the session that was pivotal to seek descriptions of their experience of the client’s pivotal moment. I had analysed these interviews and interesting themes were emerging, but it did not seem complete. A dream came to me; I was in an airport arrivals hall standing at a carousel waiting for my luggage, then I saw it passing through a hole in a wall over which were written the words Port Townsend. I took this dream to my Jungian therapist and we worked with it. Port Townsend was where Helen Bonny went after her heart surgery to recuperate. At the end of the session my Jungian therapist made the comment “perhaps it has something to do with the dissertation.” I realized that what was missing was a study of the music. In those days, not a lot was written about Helen’s music programs, and so I communicated with her about going to Salina to record her talking about the music programs she created. I made three trips to Salina and for each program we began with the discussion points: why did Helen create it? How did she compile the selections? Then we listened to the music program while Helen did a “voice-over,” a phenomenological description of the music as she heard it. These recordings informed my PhD study, and gave me wonderful quotes to use in the overview of the music programs (chapter six of Guided Imagery and Music: The Bonny Method and Beyond, co-edited by Ken Bruscia and me).

Erin: What are your ideas about directions for research in GIM?

Denise: I go back to the adaptations and modifications with regard to direction for research. Some excellent studies are coming out of Aalborg University in Denmark, supervised by Lars Ole Bonde and Cathy McKinney. Carola Maack’s study of complex PTSD was a randomized controlled trial (RCT) demonstrating that adapted GIM was more effective than another standard treatment for this condition. Similarly Bolette Beck’s study of people on stress leave from work, which was also an RCT, demonstrated significant effect for those who received adapted GIM sessions. There are other studies underway too, but all use an adapted form of GIM, which supports the view that the Bonny Method is evolving into more discrete forms of therapy practice, and this is evidenced too in research.

Erin: What do you feel has been your biggest contribution, or legacy, to the field of music therapy?

Denise: My biggest contribution to MT in Australia, was to establish the course at the University of Melbourne in 1978, and co-create the Australian Music Therapy Association in 1975 with my colleague Dr. Ruth Bright. I also established a National Music Therapy Research Unit (NaMTRU) in 1998 which has served as a supportive environment for music therapists to conduct research at Master’s and PhD level. Another initiative was to establish collaborations with international researchers in music therapy, initially with Aalborg University in Denmark, and Witten/Herdecke in Germany, and then with Temple University in the US, the Grieg Academy at the University of Bergen, the Norwegian Music Academy in Oslo, the University of Jyväskylä in Finland, Lemmensinstitut in Belgium, and Anglia Ruskin University in the UK. This Consortium of research universities has been active since 2005 in promoting international multi-site trials in many aspects of music therapy practice, and it continues to meet.

Erin: What do you feel most passionately about as a music psychotherapist?

Denise: Music has played a very important part in my life, from listening to my grandfather’s a capella choir rehearsing in the living room of our house, as I went to sleep, fabulous experiences at high school singing Handel’s Messiah with a choir from the near-by boys school, and at university playing Mendelssohn’s 1st piano concerto with orchestra.

When I stayed with Helen Bonny in Salina, she shared many resources most generously, including her notes on the music, her lecture notes, and other writings. A quote of Ralph Waldo Emerson (a poet who led the Transcendentalist movement in the mid-1800’s), was written beautifully on a framed large card:

“Do not follow where the path may lead; go instead where there is no path and leave a trail.”

The words aptly reflect Helen Bonny’s life, and I think I have lived by that dictum to a certain degree too. Mostly it felt like living life day by day, but looking back over 40 plus years in music therapy, and almost 30 years in GIM, I can see these two paths as fantastic journeys, full of struggle and angst, but also wonderful moments. I don’t think I would have changed anything actually. On reflection it seems that everything went the way it should – studying music first, then music therapy, then Guided Imagery and Music. It seems a logical sequence. I’ve travelled to fascinating parts of the world as part of my teaching and training. I co-taught the first GIM training in Spain (with Ginger Clarkson), and I am co-teaching GIM in Singapore with my colleague Carolyn Van Dort. And the connections with Denmark continue to be strong. I feel very fortunate actually. I think we just have to let life lead us where we are meant to go – just like a GIM session.

Erin: Thank you Denise.