This paper is part of an ongoing case study covering seven years of individual music therapy sessions with an adolescent with severe multiple disabilities. In disclosing this article, consideration was given to the protection of personal information and privacy of the client, and consent was obtained from the client's family. In addition, this paper was written in such a way that individual participants in the dialogue could not be identified. In the early sessions, I wondered, “How can I make music with this client?” As I examined the clinical process in detail, I began to realize that my concern was connected to a more universal question: "What does it mean for a client and a therapist, each with different backgrounds and values, to make music together?” In retrospect, I intuitively felt that this question should not remain between the client and myself. This is because the relationship between client and therapist is not simply confined to a dyadic interaction, but is linked to various relationships and values held within the larger social structure. I wanted to share this question with people who were not directly involved in the case, so I organized a small-scale, dialogue event.

This paper will consider the significance of sharing questions generated from practice with people who are not directly involved in the case. The structure of this paper is as follows. In section 1, an outline of the case and how I came up with the question is given. In section 2, the style of dialogue used in this event, the Philosophy Cafe, is outlined. Section 3 comprises a detailed description of how the dialogue progressed during the event. Section 4 reflects on the findings of this attempt and considers their significance. Finally, I touch on how such a dialogue attempt could contribute to the music therapy field.

The client (Cl.) is an adolescent with visual impairment, and both intellectual and physical disabilities. When Cl. was five years old, the present co-therapist (Co.) began private music therapy sessions, and I took over as the main therapist when he was twelve years old. Since then, we have held music therapy sessions once every other week for seven years until he graduated from a special needs school. The sessions included singing and improvisation activities, and followed a client-centered and resource-oriented approach that encouraged Cl. to follow his own developmental path.

In the early days of the sessions, I asked myself, “How can I make music with him?” At that time, Cl. had a certain repertoire of songs for children at play and popular songs for young people, which he had developed over about seven years with his previous music therapist. He sang these songs each time, but he was quick to say, “No!” or “The end!” to any new activity or suggestion. I considered various possibilities, including nervousness about the change of music therapist, Cl. expressing that the new activity did not fit his cognitive or psychological situation and needs, or the process of Cl. developing autonomy, but I was not sure at the time of the reason for these behaviors. I merely understood his behaviors at surface level; I felt rejected by him and felt it difficult to expand our activities. In addition, when we sang his repertoire together, I often found it difficult to grasp how his paralyzed body felt and expressed the music, and felt that I could not get into the flow of the music. It felt as if I was simply trying to sing along with him, and it was difficult to feel that I was making music with him. In short, I had a challenge to "be together with the client in music."

Through trial and error, I became aware of the gap between Cl. and myself in our intentions and perceptions of "music" (Table 1). On the one hand, Cl. seems to be familiar with sounds/music of short durations with clear beginnings and endings. On the other hand, I wanted to develop his repertoire and expand Cl.'s preferred sound phrases and pop song motifs. The intention was to facilitate the musical development I wanted to see as a music therapist, but behind that was my personal anxiety that I would not know what to do if the music ended too soon, or that I would not be competent or skilled enough as a therapist to just repeat Cl’s. favorite songs/music. Thus, by focusing on the gaps in our “music,” I realized my desires as a therapist and the true feelings hidden behind them. In other words, I became aware of the biases in my senses and thoughts.

Table 1

The “Music” Gap between Client and Me

As I examined the clinical process in detail, I began to realize that my concern, “How can I make music with him?” was connected to a more universal question: "What does it mean for a client and a therapist, each with different backgrounds and values, to make music together?” I wanted to share this question with others and explore it further. More precisely, I felt a sense of urgency, as if I could not continue working without addressing this question. Usually, there are many ways to share questions and problems generated from a case, such as case study meetings (where problems and solutions to a particular case are discussed), and peer supervision (where music therapists support each other in order to grow as professionals in their practice). However, I had a vague feeling that I needed to explore my question in a different way than simply seeking ways to improve the session or to find a direction to take as a professional. In retrospect, I intuitively felt that the distance and discomfort sensed with Cl. should not be ignored between Cl. and myself. This is because the relationship between client and therapist is not simply confined to a dyadic interaction, but is linked to various relationships and values held within the larger social structure. I wanted to open up my question to people with different positions and perspectives who were not directly involved in the case. Thus, I organized a small dialogue event.

For the dialogue event, I adopted the Philosophy Cafe method. Philosophy Cafe is a place where people gather to talk, listen, and think on a single theme. The aim is to explore the theme together with one person facilitating the dialogue (Washida et al., 2014). It was initiated in 1992 by French philosopher Marc Sautet at the Café des Phares (Sautet, 1995), and its activities have since spread around the world. In Japan, it has been held in numerous places on various themes (see, for example, Washida et al., 2014, p. 323-339).

Characteristic of the dialogue in a Philosophy Cafe is that it aims for the discovery of questions and the renewal of questions, not at consensus building nor problem solving (Washida et al., 2014, p. iii). The questions formed here are not for the purpose of trying to find out what we do not know, but to re-question what we think we know by carefully exploring our preconceptions (Washida et al., 2014, p. 44). What is important is the process of inquiry itself, such as deepening our understanding of matters and each other, asking questions, exploring backgrounds and assumptions, and to do so collaboratively (Kajitani 2015, p. 102).

There is no standard or formulaic way to conduct a Philosophy Cafe. Basically, it is a one-time gathering of the people there. Participants do not need to introduce themselves and can come and go as they please. However, there are some basic rules participants are encouraged to follow in order to deepen their dialogue with others. According to Kajitani (2015), these rules are made to guarantee an atmosphere of intellectual safety and ensure respect for freedom of thought and speech (p. 102-106).

In a Philosophy Cafe, participants are expected to listen carefully to what others say on the theme, and to express the thoughts and feelings they have at that time, based on their own experiences. The narratives of the participants do not necessarily have to be coherent, nor do they have to be based on the narratives of the previous participants. It is acceptable to be interrupted, and it is acceptable to change one's mind or become unsure during the dialogue. In the Philosophy Cafe, such experiences that “shake up” what we take for granted are valued. In other words, it is important for each participant to become aware of their own accepted views, and to incorporate the viewpoints of others to see things from a new perspective. The facilitator acts as a kind of "traffic controller" who facilitates the dialogue by supporting the participants when they are speaking, asking the other participants if they are clear on what has been said, and creating links between the speaker’s views. Sometimes the facilitator gets lost along with the participants as the dialogue progresses.

The Philosophy Cafe event took place after several years of working with CI. There were about ten participants who had responded to a call for applications. They included music therapists, musicians, and people interested in dialogue. We sat in a circle on the floor of a room and talked; the whole event lasted about two hours. In the first half of the event, I talked about my own case and the process that led me to ask the question. In the second half, all the participants engaged in a dialogue hosted by the facilitator. I also joined the dialogue as a participant. The facilitator was not a music therapist, but a practitioner of Philosophy Cafe. Since this dialogue event was not originally planned as part of the case study research, permission to share the case was obtained from Cl.'s family. As the purpose of the event was not to examine the case itself, I minimized the information given about Cl. and concentrated on sharing my own experiences of the processes I had questioned.

The following section details the dialogue that took place at the event. The account is a reconstruction made from audio recordings of the participants' remarks. In addition, the account also makes reference to the comments of the facilitator who organized the participants' remarks. The account is based on the remarks of the participants and facilitator in the dialogue, without any later interpretation or summary by myself. However, my words as one of the participants are included in the account.