Improvisation: Our controversial discussions

Trends of differentiation and integration in UK music therapy and the spectrum of music-centredness

A long-standing trend to differentiate and even oppose psychodynamic and ecological approaches to practice can be identified in the UK music therapy literature. This is complicated by the way in which ecologically oriented thinking is associated with practice identified to be music-centred. While the trend to differentiate and separate approaches is most apparent in the literature, it is also evident that in practice, therapists have long integrated different perspectives and ways of working, this integral trend having its roots in the work of the UK music therapy pioneers. This article explores how the ecologically oriented thinking associated with the Community Music Therapy movement, and introduced soon after the turn of the 21st century, served in part to broaden the scope of UK practice in a progressive, integrally oriented way. However, the article also discusses the rejection of psychotherapeutically oriented thinking made by some ecologically oriented authors to make space for the new way of thinking. It is suggested that this rejection has been less helpful for the development of the profession as a whole, as the different ways of working in music therapy can be understood to address different types and levels of need. This means that psychodynamic, developmental, ecological, neurological and other perspectives are all potentially important. Case vignettes are used to illustrate this and an integral approach to working, with music-centredness discussed in a way that embraces the full spectrum of UK practice.

On improvisation as dreaming and the therapist’s authentic use of self in music therapy

This article discusses the Music Therapist’s authentic use of self in improvisation-based music therapy to involve the therapist’s ability to ‘dream in music’. The topic is explored with reference to the work of psychoanalyst Thomas Ogden and illustrated with clinical examples from work with an adolescent with autism. The author describes the music-based dreaming through which it was possible to establish a musical connection with the client for the first time that enabled the client’s music and process to evolve as it had not previously. The thinking presented has links with Winnicott’s ideas about play, creativity and psychotherapy; with Stern’s ideas about implicit relational knowing, intersubjectivity and affect attunement; and with theorising about transference and counter-transference in music therapy. The article develops a theory of dreaming in music that highlights the importance of the therapist’s ability to work with the creativity of the unconscious, trusting the music that emerges from within.

Two kinds of music therapy: Exploring ‘genre’ in the context of clinical practice

This article explores distinctions between different approaches to music therapy and how these distinctions might be relevant to clinical practice. The article adopts an exploratory subjective stance, with the author exploring the relevance of a perceived distinction between ‘music-centred’ and ‘psychodynamic’ music therapy, as described in the literature, to their own clinical practice. A series of clinical vignettes, taken from work with children and young people, are used to illustrate the influence of both psychodynamic and music-centred theories on clinical practice in context. An integrative client-centred approach is proposed, where psychodynamic thinking and music-centred ideas can be incorporated as needed, according to the individual needs of each client.