Music Therapy with Imogen
- Clara Browning
- Mar 19, 2020
- 4 min read
As with my previous post on Jack, I am pleased to be able to write about some work with another child I work with at a special school, with the kind permission of her parents and the school. The reason I want to share different pieces of music therapy work is to do my small part to help raise the profile of music therapy as an important psychological and developmental intervention, particularly for individuals with special needs who may process the world in a completely unique way and who may never have access to language.
This post is about a young girl called Imogen (not her real name), who has a complex diagnosis involving profound and multiple learning disabilities (PMLD). I started working with Imogen 2 years ago when I took over from another music therapist. I have worked with her on an ongoing basis since then as music is clearly the primary medium that she responds to; she becomes animated on hearing music, often moving her limbs in time to the music, smiling and moving her gaze towards the sound source. According to her parents, Imogen has always shown more interest in exploring sound than anything else. When sound or music are not involved, it is much harder to engage Imogen. I find that Imogen generally experiences the world through sound due to her complex diagnoses and impaired vision. Imogen has taught me more about the joy that sound can bring and it is a pleasure to interact with her through music and sound.
Here is an example of some recent work with Imogen, in which I respond to the sounds she was making on the keyboard by introducing a song: The Grand Old Duke of York. The sounds Imogen initiated reminded me of this song. A teaching assistant (TA) is present, and she has also kindly given permission for me to use this clip. Imogen is enjoying using her limbs to express herself and relate to both me and the TA through the sounds that she makes. I attempt to match Imogen’s style of playing in my musical accompaniment in order to validate her actions, interact and connect with her through the music. (You will see that I have edited this video several times, which I have done in order to remove any use of Imogen’s real name.)
As well as engaging Imogen in musical interaction, I am attempting to mirror the quality of her playing in my music, in order to affirm her expressive initiatives and thereby convey to her some sense that she is being listened to, heard and valued. Rooted in our need to be known and loved, being heard and valued are essential for us in our human experience, whether we are disabled or able-bodied. Music therapy theory, and general psychotherapy theory, looks at the idea of representing the patient’s expressions back to the patient in a way that is manageable and digestible. For example, if Imogen is having a difficult day, the music that I play might reflect these negative emotions. In this case, Imogen was enjoying the shared musical interaction and the music I/ we played was accordingly upbeat.
For Imogen, aims of music therapy are psychological, interpersonal and developmental. Psychological aims include facilitating self-expression, encouraging autonomy and building self-esteem. On an interpersonal level, joint music-making helps Imogen to interact and enjoy a shared musical experience. She has the opportunity to communicate her mood through the music she plays or does not play. I often offer her a choice of instrument by holding up two different instruments and waiting for her to fix her gaze on one of these, which provides another opportunity for communication. Developmental aims involve gross and fine motor movement, and sensory integration- helping Imogen to use her senses and to get an idea of where her body is in space.
To finish with, I would like to show another clip of Imogen and me taking turns to vocalise from nearer the start of our work together. Imogen is very engaged in this interaction, which feels almost like a ‘conversation’ in that we are listening to each other and enjoying each other’s contributions.
I was encouraged by this interaction as Imogen was really expressing herself and enjoying herself. She was enjoying the way that I responded to her as I was attempting to match her excitement and enthusiasm for the sounds we were making. She was enjoying the impact that she can have on the world around her. I feel that this is particularly significant for children like Imogen, who are unable to control the majority of their own experience – for example, they may be assisted to eat, with personal care, to stand or walk if applicable, to sit up, and so on. In this clip, Imogen was able to lead the interaction and be 'in charge'. I hope that through interactions like these Imogen’s self-esteem and self-confidence grows.
Thank you for reading. Please share with people you think might find this interesting.
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