Tears, Healing, and the ISO Principle...

A good friend shared some very deep and insightful thoughts on how she uses music when she's feeling down...and thus I have been inspired to write about the actual therapeutic use of music.

Early on in my work, a child was brought to the music therapy room by an educational aide for her music therapy session. A snapshot of this child (We'll call her "C"): C has Rett Syndrome (for info: www.rettsyndrome.org), resulting in very limited hand usage, no verbal communication, and other various and sundry issues. Suffice it to say, not a muscle in her body cooperates with her. So...look at it this way, C has no words, cannot use her hands purposefully, has balance and perception issues; and neurlogically, she is so overly sensitive that she often cannot process tactile, visual, and auditory stimuli, and that causes her to either 1) panic and start to cry, 2) completely shut down and withdraw.

On this day, C'd had a bad bus ride in--an aggressive older boy, lots of noise, a new bus monitor who hadn't been trained that yelling over a group of eight special needs children was probably not in their best interests. By the time she got to school, she was disturbed, by the time they got her coat off and backpack hung up, she was inconsolable. I could hear her crying as she and her assistant made their way up the stairs to the music therapy room. When they arrived, C immediately sat at the piano with me, and I began to improvise some music that matched the pitch and intensity of her vocalizations. Yes, she was still wailing, and still quite anxious. Our music was intense, but probably not what an outsider would call beautiful. Looking back on it, though...it was rich in emotion, and grist for the music therapy mill.

I wasn't paying attention to the assistant who was sitting behind us; so I was startled to hear her exclaim at one point, "Stop! Oh, my God...this music is SO SAD!!!"

Well, yeah. I was reflecting the sad and anxious vocalizations of a little girl who was sad and anxious. She had no words to express herself. No way of seeking validation because she could not verbally communicate her emotions (Can you say "TRAPPED?").

Long story long, we did not stop playing at the assistant's request...we continued until C finally stopped crying, and was more calm. When we finished, she was quiet; really, she was spent. Interestingly, the rest of her music therapy session was good-- and she had a better day after that. No--there was no magic in the music that took away her sadness and her fears; the music was simply a vehicle that allowed her to express it, work through it, come out on the other side.

After the session, the assistant confronted me again. "Why would you put her through all that? She was sobbing!"
I hadn't thought of this before, but apparently the assistant was a victim of a popular misconception. Music is spposed to make you happy. Right?

Yes. And no.

Have you ever been so depressed that all you wanted to do was listen to really bad breakup songs? Did they make you cry more? What teenager in the throes of adolescent sturm und drang hasn't holed up in her bedroom playing dark metal or other music until that boy finally called (or didn't)?

Conversely, what's a party without music? What's a road trip without a CD player full of whatever songs support that feeling of freedom and expectation? Are you with me?

Clinically, it's called the ISO Principle. ISO is Latin for "same," and what it entails in music therapy, is a "matching" of the client's feeling state. The theory behind this is simple; I could not MAKE C change her feelings. That would be disrespectful and futile. Look at it this way--have you ever been really down about something? Has some well-meaning friend completely dismissed your angst and implored you to "cheer up?" Gah. We've all done that, admit it. It comes from a longing to make things better, but also a fear of strong and unpleasant emotions. Some people are better than others at confronting those feelings, but it is never fun. However, it's a part of life. I explained this to the assistant, but she was having none of it at that time. Over time, she came to understand it better, and even reluctantly agreed that it was a good tool. A minor victory for Music Therapy!

That day, C was able, with the help of the music, to work through her feelings. BUT-- it didn't end there. When C looked like she was ready, I played music that was lighter in timbre and tonality. Therapeutically, you do not want to stay in that dark space. Gradually, I lightened the music according to her cues--body language, eye contact, vocalizations.

C had many more sessions in which the improvisations we did were sad, or angry--or JOYFUL!! YES! Joyful! She is a fully alive human being who just happens to be trapped in her own body by the Rett Monster. Music just happens to be the key to her soul, and I was humbled to have worked with her in this way. Like all of the children, she gave me more than I could ever give her. Special times, for sure.

So the next time you're feeling badly...be brave! Put on some music that matches how you're feeling. Remember, though, you need to be mindful that when you start feeling a bit better, you need to switch to some lighter music. Hopefully by the time you're done, your own dark clouds will have parted, even if only temporarily. I hope you can put this technique into your self-care toolbox for those stressful times.

Stay tuned!