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Psychiatric Music Therapy in the Community: The Legacy of Florence Tyson

br2005_044McGuire, Michael G. (Ed) (2004) Psychiatric Music Therapy in the Community: The Legacy of Florence Tyson. Gilsum, NH: Barcelona Publishers.

Psychiatric Music Therapy in the Community: The Legacy of Florence Tyson is an anthology (or reader) of published and unpublished writings, interviews, and conference presentations, by and about Florence Tyson. Tyson is a very significant early figure in music therapy in the USA, pioneering ideas in psychodynamic music therapy, community-based treatment, and qualitative research methodology in music therapy as early as in the 1950s.

Readers, such as this one edited by Michael McGuire, which bring together the major corpus of a single author’s works are relatively new in the music therapy literature. Others of a similar kind are Mary Priestley’s Essays in Analytical Music Therapy (1994), which was compiled by Priestley herself, and Music and Consciousness: The Evolution of Guided Imagery and Music, a compilation of published and unpublished writings by Helen Bonny, with biographical material included, which was edited by Lisa Summer (2002). To its credit, all three books have been published by Barcelona Publishers. Also noteworthy is that the three women who are the focus of these readers are all pioneers in psychodynamic music therapy. In my opinion, readers such as these are invaluable in that they provide us with the essential corpus of these writers over the course of their careers.

Michael McGuire is well-qualified to compile this collection of Tyson’s work. Not only did he know Tyson for 25 years as a friend and colleague, but as the founding editor of Music Therapy Perspectives (and editor for the first ten years) he prepared three of Tyson’s contributions for publication in 1982, 1984, and 1987. Following a foreword by Tyson’s long time companion, Saul Lishinsky, and a preface by music therapist, Christopher Bandini, McGuire organizes this book into seven parts, the first four being major themes about which Tyson wrote. After providing an introduction to each section, McGuire organizes Tyson’s writings within each theme chronologically. The seven parts are divided as follows: 1) The Music Therapy Relationship (theoretical foundations), 2) Case Studies (8 in all, one of which spans 3 chapters – and includes the patient’s perspective), 3) The Center (i.e., Creative Arts Rehabilitation Center), 4) Music for Healing (historical overviews), 5) Interviews, 6) Perspectives on Florence Tyson and Her Work (by McGuire and music therapist, Christine Stevens), and 7) Appendices (including Tyson’s CV and a bibliography of her works). The chapters hold together well within each theme. However, I suggest reading part 6 and the first chapter in part 3 first, as these chapters contain background information about Tyson and her community work which provides a helpful context before delving into her ideas and her clinical work.

The importance of this book cannot be separated from the importance of Florence Tyson as a historical figure in music therapy. Thus, instead of going through each of the seven parts and providing a short overview, I have decided to provide you with a glimpse of Tyson and her work by extracting examples from the writings that struck me as highly significant. Let me begin with some background information, which McGuire has largely presented in parts 6 and 3.

Tyson’s Background

Florence Tyson was born in 1918. She began learning the piano at the age of 6 and the significant impact of this experience on her is evidenced in her claim that “it was her soul.” She graduated high school in 1935. Although she began college, due to financial constraints she never completed a college degree. Given her love of music, when she heard that there was a job available as a development officer with the Musician’s Emergency Fund (MEF) she was determined to get it and she did. The MEF was a very early and strong advocate of music therapy in the US. By 1952, Tyson became the director of the Mental Health Division of MEF. Her job was to supervise music volunteers working in hospital settings. In this position, she recognized the need for outpatient services for patients, and in 1956 conducted a pilot program implementing a community-based rehabilitation program. In 1958, only 8 years after the Music Therapy Association was formed in the US, the MEF opened the Music Rehabilitation Center under the directorship of Tyson. The philosophy was to help people stay in the community longer and reduce time in inpatient treatment. By 1962, with the MEF no longer able to fund the center, Tyson, determined to keep the center running, founded the Creative Arts Rehabilitation Center (CARC) in New York City with a dedicated staff of 10 therapists who were willing to work on a voluntary basis for the first year until sufficient funding was raised.

Although not formally trained in music therapy or psychotherapy, Tyson emphasized high standards of clinical practice. As early as 1963, she made sure that the music therapists working at the center were registered with NAMT (most of whom were registered based on experiential equivalency as was Tyson herself); she expected music therapists working in outpatient music therapy to undergo or to have undergone at least three years of psychoanalysis themselves (I am assuming Tyson underwent this herself, although this is not indicated in any of the writings); the staff at the center had regular supervision with a consultant psychiatrist; clients (or patient-members as they are referred to) at the center had to be referred by a mental health professional and remain in treatment with a mental health professional while attending CARC; and, regular communication was maintained between CARC and the referring agency/person.

As I read this book, I found myself continually inspired by Tyson’s vision and dedication. In the early 1960s, Tyson was on the cutting edge not only in the music therapy profession, but also in community mental health. As Christine Stevens states, when Tyson created CARC in 1963, she “showed tremendous foresight in identifying a need for a continuum of services” (p. 362). This is even more significant when one considers that the idea for this originated in 1956 and it was not until 1963 that the US “Congress enacted PL88164, which appropriated funds for the construction of community mental health centers” (p. 362). Furthermore, as late as 1988, the center was described as the first and only mental health agency in the US devoted solely to creative arts therapies. In her Eulogy (2001), Ken Aigen described Tyson’s thinking in terms of community-based treatment as being decades ahead of most (p.205). And, McGuire states that the guidelines for music therapy services in the community, although written in 1958, could serve as the basis for a programmatic proposal today (p.205). In it, she offers very helpful advice for music therapists working in private practice.

Although her vision and dedication in terms of creating and running CARC is impressive, Tyson’s historical significance in terms of utilizing a psychodynamic orientation to music therapy is unprecedented. She is the first music therapist, who I know of, to have written about a psychodynamic approach to music therapy (Hadley, 2003). McGuire describes her approach as eclectic (sometimes utilizing psychoanalytic, person-centered, behavioral, cognitive, gestalt, etc., concepts), although predominantly psychodynamic in orientation. The main influences on her work come from Balint, Freud, Erickson, Hartmann, Mahler, Langer, and Arieti. She wrote about transference and counter-transference in the therapeutic relationship. Furthermore, Tyson viewed the role of the music therapist in terms of object relations. She felt that regression was necessary before proceeding to higher achievements, based on Balint’s basic fault theory. Tyson believed that music is a symbolic language through its forms, not its contents. She wrote early on about the symbolic significance of music and of musical instruments. She posited a relationship between musical growth/arrestment and psychological growth/arrestment. She believed that music was the bridge between inner and outer worlds and that achievement of outflow was blocked by guilt, anxiety or self-destructiveness. Therefore, she encouraged “patient-members” to participate in music to encourage outflow of expressiveness. Yet, while she believed that unconscious processes shape behavior, she warned music therapists about imposing a single technique of a one-sided theoretical system as sometimes the cause of illness may be organic.

Telling Stories

Also noteworthy, and much in evidence in this reader, is Tyson’s qualitative approach to research at a time when experimental research was predominant in the US. Tyson utilized case studies to delineate her work. She felt that by telling stories that the message and meaning of the work could be considered. She was quick to point out in her conference presentations that she was not going to present techniques for general application. In fact, when one reads through this collection of her writings, there is a notable lack of description of musical techniques. Her approach was to provide “music instruction” (in a wide range of instruments, voice, and theoretical subjects), which functioned as the basis for the therapeutic relationship. However, the therapeutic intention always took precedence over music-learning considerations. This, for me, was a notable difference from the approach Mary Priestley developed. While Tyson and Priestley based their work on very similar constructs, Tyson places far less emphasis on the music or music techniques. What I also found interesting in my reading was that while both Tyson and Priestley were working with similar constructs at around the same time, neither make reference to the other’s work.

With my own interests in narrative therapy and feminist thought, I was fascinated by two other aspects that I noticed in Tyson’s work in the 1970s. Not only did Tyson “tell stories” about her work, but she often explored with her patient-members that they were trapped in someone else’s script of them and that they needed to re-write their own script, that is, to engage in the process of re-authoring their lives. Also, in terms of empowering patient-members, there are several examples, but what struck me was that she co-presented a case study with one of her patient-members (at two different periods of this patient-member’s treatment) at several music therapy conferences. This allowed the patient-member to have her voice heard and to further grow from the actual experience of presenting. From the words of this patient-member it would seem that there was some resistance from the music therapy community to the type of work that Tyson was doing. She said that there was tremendous hostility from the audience and a tidal wave of shock or anger. This gives a glimpse of how Tyson was received by many music therapists in NAMT in the 1970s.

Professional Hardship

Although Tyson had strained relations with some of the music therapy community, she maintained a good working relationship with music therapists from New York University, supervising many of NYU’s music therapy students. She also maintained strong ties with the MEF leaders and the New York community of psychiatrists. Furthermore, she had strong financial support from influential people, including famous people involved in the Arts. Also noteworthy is that Dr. Oliver Sacks served as a medical advisor to CARC from 1988 on.

Due to financial difficulties, CARC closed in the mid 1990s. It appears that with the closing of the center and the consequent reduction of responsibilities, Tyson’s health declined and she died in 2001. As a testament to her work, in 2002 a small group of creative arts therapists who had worked for Tyson opened the Creative Arts Therapy Space for private treatment in order to continue Tyson’s legacy.


While reading this book, I was struck by the descriptions of Florence Tyson. Integrity was a word that was used several times: the integrity of Florence the person, who was described as honest, direct, and someone you could believe in both as a person and as a therapist; the creation of CARC was also seen in terms of her integrity in that it was an emergency response to the needs of mental health patients at that time; and, the integrity of the staff was another indication of the integrity of Tyson. They believed in her vision, in what they were doing, and they did it with integrity.

Also included in the book is a description of the development of the music therapy profession in the US, the first part of which was written by McGuire and the second part by Tyson. This is a helpful resource and interesting from a historical perspective. While the material in this chapter was informative, it was not essential in the understanding of Tyson’s legacy.

Much of the material in this book can be found in the Florence Tyson Archive at Temple University, Philadelphia. Archives of music therapists are a relatively new phenomenon. However, Temple University houses the Mary Priestley Archive, the Helen Bonny Archive and the Florence Tyson Archive. These archives are of tremendous historical significance for the profession, as are the anthologies/readers of the work of these three psychodynamic music therapy pioneers. What the music therapy literature needs now is to have critical readers on the work of significant contributors to music therapy in which a cadre of scholars critically reflect on the primary works of these and other pioneers.

The most interesting parts of the book for me were the case studies and the perspectives on Tyson and her work. The part of the book on the center, while essential to the understanding of the legacy of Tyson, had several chapters which were very similar in content. While this is a compilation of Tyson’s work, there are instances in this part (part 3) where the material is replicated several times. It would not have taken away from the integrity of the book were some of these chapters omitted.

Psychiatric Music Therapy in the Community: The Legacy of Florence Tyson is a solid contribution to the music therapy literature. Given that the writings span from the late 1950s to the early 1990s, there may be claims that can be contested, terminology that may be out of date, and practices that may be questioned on ethical grounds. However, what is fascinating about Tyson’s work is its relevance in terms of current issues being grappled with in music therapy. The book is engaging and informative. Today’s music therapists will gain much from engaging with the early groundbreaking work of Florence Tyson.


Hadley, S. (Ed.) (2003). Psychodynamic Music Therapy: Case Studies. Gilsum, NH: Barcelona Publishers.

Priestley, M. (1994) Essays in Analytical Music Therapy. Gilsum, NH: Barcelona Publishers.

Summer, L. (Ed.) (2002) Music and consciousness: The Evolution of Guided Imagery and Music – Helen Bonny. Gilsum, NH: Barcelona Publishers.

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