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Music, Music Therapy and Trauma - International Perspectives

br2002_029Sutton, Julie P. (2002). Music, Music Therapy and Trauma – International Perspectives. London: Jessica Kingsley Publishers.

Reviewed by Toni Day

Music, Music Therapy and Trauma, edited by Julie Sutton emerged as a result of a Millennium Award that enabled the editor to make contact with other music therapists throughout the world who were working with people affected by traumatic events. The book is divided into four parts: “Trauma Perspectives;” “Culture, Society and Musical Perspectives;” “International Clinical Perspectives” and “The Support Perspective.” In my opinion, this book has much to offer any clinician working directly within the field of trauma along with various other fields, as in today’s world it is unlikely that our clients or ourselves will escape the impact of traumatic events at some level. Many of its chapters are not only stimulating but also challenge the reader to explore his/her own perceptions of trauma and how we react to our client’s experiences of trauma within a music therapy context.

Part One of this book is entitled “Trauma Perspectives” and includes two chapters – “Trauma in Context” (Sutton) and “The Brain – its Music and its Emotions: the Neurology of Trauma” (Swallow). As an Australian Music Therapist working with women and children who have experienced childhood abuse and/or domestic violence, I drew a great deal of information from Sutton’s overview of not only the immediate impact of a traumatic event but the psychological repercussions an individual faces which can manifest themselves in conditions such as PTSD (Post Traumatic Stress Disorder). Her discussion on contextualising definitions of trauma and multidisciplinary attitudes to trauma provide a solid introduction to the book and include a variety of perspectives. In Swallow’s chapter we are provided with a concise overview of the Neuro physical changes that occur when we take part in musical activity and the neurology of trauma from a neurologist who is also a practising musician. It is helpful in combining past and present brain research, and is relevant for any practicing therapist or student embarking on a career in music therapy.

Part Two of the book “Culture, Society and Musical Perspectives” provides an insight from researchers based in Northern Ireland. In Smyth’s chapter, “The Role of Creativity in Healing and Recovering One’s Power after Victimisation”, the reader is given an overview of ‘the Troubles’ of Northern Ireland using a statistical analysis. Smyth also discusses the role of creativity in the healing process. She writes “creativity is resistance to oppression: it is the refusal of victim hood and helplessness.”(p.76) This idea I believe is essential to reflect on in our work as music therapists with any individual who has experienced a loss of control over their lives as we endeavour to assist clients to recover their voices and their power. In Chapter 4, “The Politics of Silence: The Northern Ireland Composer and the Troubles,” Bracefield examines the impact of the Northern Ireland conflict, on the composers of the time.

Part Three of the book focuses on “International Clinical Perspectives” where therapists from different parts of the world describe their work. This main section of the book provides many sensitive accounts of clinical work undertaken in various countries, describing various approaches, along with, I believe, thorough theoretical discussions relating to the work and the cultural aspects that inform the authors’ work. Central to this section of the book are discussions on the effects of disruptions in early mother-child interactions on an individual’s experiences of trauma in later life, and the importance of silence in therapy. Whilst reading this section (Chapters 5-10), I was continually aware of the great care taken by authors’ in reflecting on their work with the most vulnerable of clients and of their obvious passion in ensuring a safe, containing, music space was created in which to begin to work through the trauma their clients had experienced.

The themes of violence in society and violence in childhood, and the concept of the ‘music child’ are addressed in Pavlicevic’s writings (Chapter 5) based on her work in South Africa. Chapter 6 (Dixon) explores the issues of music and violence and describes music making as a “touchstone for human rights” (p.131). In Stewart and Stewart’s account of the impact of early abandonment upon a child (Chapter 7), psychodynamic music therapy is examined along with Winnicott’s theory of play. Chapter 8 is co-authored by Lang and Mcinerney, and is a personal account of their experiences of working in a music therapy service in post-war Bosnia-Herzegovina. Tyler, in Chapter 9, provides the reader with a powerful account of working with a refugee child who had witnessed his father being tortured. The theme of early mother-child interactions is again addressed in Frank-Schwebel’s chapter (chapter 10) on developmental trauma and its relation to sound and music. The links made here between the idea of regression in therapy and the phenomenon of patients showing a preference for auditory and vocal experiences rather than playing music are fascinating. I have encountered this myself throughout my work with survivors of abuse; however, have found that it is not commonly addressed in music therapy literature.

The final part of this book, Part Four, examines the impact of working with traumatised clients on the therapist. Lang, McInerney, Monaghan and Sutton combine, in Chapter 11, to provide a detailed account of the supervision process of their work in Mostar. Whilst the client group is specific, it is thought that the themes discussed in this chapter are commonly found in many areas of clinical work and the importance of regular clinical supervision is suggested as being essential in keeping the therapeutic process safe for both client and therapist. Again, as an Australian music therapist working in this newly established field of trauma, I have often felt isolated by distance from other colleagues. It was interesting for me to read how this was overcome by this group of authors’ by using telephone supervision, although, this in itself I feel would take a great amount of skill to master. The final chapter of this book (Chapter 12) is written by Diane Austin and is entitled “The Voice of Trauma: A Wounded Healer’s Perspective”. Along with the theory that underpins Austin’s work, she discusses with a great deal of personal insight the impact of being a ‘wounded healer’ on work with clients who have been traumatised. It is refreshing to see terms such as vicarious traumatisation incorporated into the music therapy literature and the overall level of thinking in relation to our profession and our use of music within our profession.

In conclusion, this book has contributed largely to the limited body of literature available on music therapy with traumatised clients. It is extremely well edited by Julie Sutton, with a diverse range of issues covered and a phenomenal amount of theoretical, political and historical frames of reference to inform practice in this field. One of its greatest strengths, I feel, lies largely in the personal accounts and reflections from the authors on their work, which allow the reader to possibly reflect on a deeper level about their own work, with not only traumatised clients but all of the varied individuals we work with. This book is a thorough basis for further exploration in the field of music therapy and trauma and a ‘must-read’ for any clinician or student living in today’s society with the continual threat of violence impacting on the essence of humanity.

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