Sunday, June 29, 2014

Patricia Skar - Weaving Analytic Therapy and Music Therapy

"D. W. Winnicott (1971) pioneered the idea in psychoanalysis that play is important in the emotional development of the person, and that the psychotherapy process can also be seen as a playground in which to experience, in the present, that which was lost or missed out in the past. For this patient, and for others who have used the instruments in this way, the improvisations opened out the dimension of play in the analytic space in a real, physical way. Playing the instruments, like active imagination in general, could also be seen as a ‘waking dream’. The music produces the emotional dynamic stimulus that helps to unfold the situation which the unconscious wishes to reveal to the conscious mind. This frees the energy formerly bound up in the unconscious symbols and makes it available for conscious use. The process begins with the inner realization of the symbol and then is given the musical expression. After the feelings and physical sensations have been experienced through the music, words are often more readily accessible. I have found the instruments also quite useful in acting out situations from a dream, especially when the patient is split off from the emotional content, or from parts of the psyche inherent in the dream characters. Because emotions can be expressed directly through music without words, the analysand is freed from the guilt often associated with the use of words in, for example, expressing anger.

In looking at the difference between communicating in words and through music, we see that one of the main distinctions is that when we talk, we must take turns speaking. In music, there can be a more fluid, overlapping connection; we can hold or contain each other in the greater sound matrix. Words can conceal feelings and may also feel too explicit, pinning down an emotion into a narrow band of meaning. In music it is safe to let one's real feelings out; no specific content need be assigned to sound, and no one will be injured by the expression of an intense emotion. Finally, there is silence, before and after shared music, that is unlike the silence that surrounds a verbal interchange. The initial silence contains unconscious intuitions of the music to come and also holds the risk that both people feel of letting themselves go into spontaneous sound expression. When the musical dialogue is over, both again arrive at the silence of the beginning, but this time they have shared the ‘third thing’ - the archetypal dimension of the music. This shared bond is fruitful ground which gives much food for the work, and in my experience has also led to a deepening of trust between analyst and analysand.

An important point to mention here is that the analyst should have no goal or aim in the improvisational experience with a patient. This, of course, is crucial to the analytic process which Jung advocated:

Any interference on the part of the analyst, with the object of forcing the analysis to follow a systematic course, is a gross mistake in technique. (Jung 1916/1985, para. 625)

If I did not already know it from playing music myself, these experiences with my analysands have taught me the power of music to access the unconscious and put into accessible form, deep life experiences. (For more case examples, see Skar 1997.) The question remains whether the technique of using music within analysis is something which could be incorporated into analytic trainings, much like the use of sandplay and spontaneous drawing is currently taught in some courses. Would it be necessary for trainee analysts to have a musical background to consider adding this component to their analytic practice? My own feeling is that a musical background would be helpful, but not absolutely necessary, just as a background in art is not usually considered a requirement before using spontaneous drawing in one's work. The important thing in training would be the opportunity to experience the improvisational work oneself over a period of time with a trained music therapist, to evaluate whether one feels suited to the work or not. Here I would like to emphasize that the use of music within the analytic situation should never be seen as competing with a full music therapy experience, just as spontaneous drawing within analysis cannot be compared with art therapy. Each of these separate expressive therapies has its own parameters and is potentially just as facilitating - on its own - of the individuation process.

There is much need for discussion of this issue, and because of the power of music and sound, there will be controversy about the release of this dimension within the analytic container, just as there is controversy about the use of expressive therapy at all within the analytic experience. Ultimately, this controversy centres around the question: Should analysis remain exclusively a ‘talking cure’? This is one of the issues that has separated Jungian analysis from the psychoanalytic tradition, and is an ongoing problem in defining what it means to be Jungian. My opinion is that expressive therapy does have a place within analysis, but requires the analyst to have a firm grounding in adequate training and the sensitive application of its use. Expressive therapy, including improvisation with simple instruments as I have described, is definitely not for all patients and needs always to be understood within the ongoing and symbolic relationship (i.e., the transference and countertransference) between analyst and analysand. But when it is used appropriately, it can be a powerful form of communication, deepening the relationship between analyst and analysand and opening new pathways for the process of individuation within the analytic container." (pp. 635-636)
Patricia Skar (2002). The Goal as Process: Music and the Search for the Self. Journal of Analytical Psychology, Vol. 47:629-638.

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