Music therapy is special in its use of music to encourage communication and expression by playing an instrument, singing or listening, usually through improvised music. The therapist does not teach the client to play an instrument; the instruments offered can all be played intuitively.
Within the therapeutic relationship, there is a safe setting in which difficult or repressed feelings can be expressed and contained. Where words are inadequate (or even impossible), music can often make sense. In the restricted world of a seriously ill child, music therapy focuses on what s/he can do, gives choices and control, and raises self-esteem.
A music therapist at one children’s hospice talks about one session: “J suffers from Duchenne Muscular Dystrophy at quite an advanced stage, can no longer eat or drink by himself, and is totally dependent for all his care. During a recent session he played on drum and cymbal.
After ten minutes J said he had had enough, adding apologetically ‘My hand is weak, as is my arm, as am I.’ The music, however, had been vigorous, energetic and full of exciting accelerandi. No sign of weakness there. J had been involved in an experience which transcended his bodily limitations.”
At another hospice: “A small child had spent the morning distressed and crying, very tense and jerky physically. At first I held his hands or feet and sang back to him, responding to his rather chaotic sounds and movements and then introducing more order and rhythm. Leaving silences led to his increased awareness of his contact with me, and the realisation that he could initiate the music and movement.
This led to a vocal interaction, many times over, and he also played a hand-held wind chime positioned just where he could play it. He began to smile and became calm, relaxed and communicative by the end of the session.