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Music-Centered Music Therapy

br2005_58Aigen, Kenneth (2005). Music-Centered Music Therapy. Gilsum, NH: Barcelona, Publishers (322 pages).

Reviewed by Rudy Garred, PhD, Sogn og Fjordane University College, Sandane, Norway.

At a convention for mathematicians a toast, reportedly, was proposed: “To pure mathematics, and may it never be of any use to anyone!” As we all know, mathematics has indeed been of much practical use, and shouldn’t mathematicians, of all people, be very pleased and proud about this? Still there is a sensibility revealed in this (jokingly, natually) proposed toast, of appreciating in some sense, the real, inherent value of mathematics, which ultimately would not necessarily be less if it were not useful for anything at all. And which could tend be “wiped out” of the picture, if the only reason for mathematics was its practical use. – Wherefore, presumably, the toast. Something of the same sensibility, of course, may readily be found with regards to music. “Pure music” is rather “useless” maybe, as commonly perceived (and in this respect probably less to worry about than “pure mathematics”). But music therapy is after all applied music. So how do you reconcile the appreciation of music as such with its therapeutic application? It might seem that this is the difficult task that a theory of music-centered music therapy needs to meet, and which Ken Aigen in his book Music-Centered Music Therapy makes some grand efforts at accomplishing.

Let me state at the outset that this book clearly must be regarded as a milestone in the literature on music-centered theory, both in the depth in which the issues are dealt with, and the in breadth of scope of theory that is presented. It is comprehensive in the coverage of music-centered thinking and practice, both historically, and in the inclusion of current frameworks and discussions. Furthermore it is original in presenting new contributions, developments and elaborations of theory.

Aigen first of all clears the way for his endeavours in the first chapter, by indicating his meta-theoretical position, on “The Nature of Theory,” which is quite clarifying, but a rather “heavy” start. Aigen actually suggests that the first two chapters may be skipped if one is well acquainted with the matters. I would suggest that they might be read afterwards as well. In particular the second chapter, on “Theory in Music Therapy,” which makes an advance on earlier discussions on the role of theory in music therapy, – his own and others’ writings as well. Aigen argues for music-centered theory as a platform for a general theory of music therapy, on account of the medium of music being central to all approaches and frameworks of music therapy. A music-centered theory could therefore serve as a unifying focus for a general theory, he proposes.

In chapter 3 Aigen traces origins of music-centered therapy, and clarifies foundations for a music-centered theory, considering the notions of medium, (Dewey) and of musicing (Elliot), and of the necessity of a theory of music as a basis for music-centered therapy. He writes:

A theory of music serves a music-centered therapy theory much as a theory of personality serves a psychotherapy theory (p. 68).

This is a quite radical stance. One might question if music therapy is about music. Aigen nevertheless argues for the relevance of using notions of music from a non-clinical context as a basis for music therapy, taking Charles Keil’s notion or participatory discrepancies as an example here.

In chapter 4 Aigen explicates values central to musicing, as they apply to music-centered therapy. He sees music therapy in the context of an investigation of the nature and of the significance of music for human beings, in which a discussion of values becomes crucial. Some of the musical values he finds are: an understanding of silence, a requiring of listening, incorporating of the individual within the communal, involving surrender, cultivating a respect for craft, and creating connection. I think Aigen here does a great service to the field in bringing out and attempting to explicate musical values and their relevance for therapy. This is a basis that I believe has not been sufficiently recognized and that this chapter, both in the contents and in the attempt itself, points to in a significant way.

Chapter 5 is quite densely packed with “rationales, practices and implications of music-centered music therapy.” Aigen makes some effort in establishing a rationale in which “music goals are clinical goals,” based on a notion of a convergence of personal process and musical development. I do get a feeling here of this becoming somewhat one-sided, of making maybe rather too much of an equation of personal and musical development as such. Still Aigen does expand his view, taking into consideration intrinsic rewards of musical participation that may be found in creative dimensions, expressive process, aesthetic dimensions, communal dimensions, and transpersonal dimensions. He insists in music being an autonomous clinical force, and that the therapeutic relationship is a musical relationship. This is probably where some might raise objections as to the side of therapy in all this, and the role of the therapeutic relationship. But Aigen keeps an insistent focus on music, putting forth the view that the experience of the musical process is the therapy. Whether or not one agrees with the argument, in all it ramifications, it is very consistently developed, and from many different angles, which makes it well suited to bring out different aspects of the issue, to relate to.

In chapter 6 Aigen shows how music-centered aspects may be found to be present in the major models of music therapy, such as Analytic Music Therapy, Guided Imagery and Music and not least Nordoff-Robbins music therapy, which as it originated is regarded as the music-centered approach. In the following chapter music-centered perspectives is traced in contemporary music therapy frameworks, such as Aesthetic Music Therapy (Lee), Community Music Therapy (Ansdell), and Culture-Centered Music therapy (Stige). Aigen warns at the end of this chapter against a proliferation of conceptualizations if these are not also developed with a concern for consolidation as well as differentiation.

Part III, chapters 8, 9 an 10, constitute a core section of this book in that it presents an original contribution to music-centered theory, presenting and applying on the one side so-called Schema Theory, developed by Lakoff and Johnson, and on the other Zuckerkandl’s dynamic theory of tone, in an effort to outline a broad-based philosophy of music for music-centered music therapy.

Lakoff and Johnson have introduced a philosophical perspective on human cognition based on the notion of metaphor. The basis for metaphoric thinking, according to Lakoff and Johnson, may be found in image schemata, such as CONTAINER, UP-DOWN, CENTER-PERIPHERY, PART WHOLE, FRONT-BACK, LINK, FORCE, PATH. This perspective has been applied to many fields of inquiry, and also to music. Aigen extends the application that has been made of schema theory to music further to music therapy, in this way considering that the theory is music-centered, in that it builds on an application of theory that has originally been applied to music. Aigen makes a series of claims as to how schema theory can provide a philosophical grounding for music-centered therapy. He presents the notion that music may provide a compensatory experience of basic schemata, which are fundamental for all cognitive development. The basic idea seems to be that music may provide an avenue of experience that may provide development of basic schemata, that some people otherwise may not have had the opportunity of developing. Aigen explains:

Through musical experiences of UP-DOWN, a person who is disoriented physically, emotionally, or socially can begin to achieve a better sense of personal orientation in these different spheres of human functioning. This is because the two experiences – that is, being grounded physically and being grounded psychologically – share common elements. Becoming oriented in tonal space can establish a template for becoming oriented in one’s psychological and social domain as well (p. 181).

This is a daring application of theory. I am not sure whether it actually is music-centered according to Aigen’s own criteria, or whether it actually moves beyond this. And I am not sure whether the claim holds, or even how it could be either validated or refuted. I think it would need to be substantiated more to be really convincing, empirically not the least, but also theoretically, because it seems that a strictly music-centered stance theoretically might become to narrow with regards to the therapeutic effects or outcomes that are indicated. Aigen however does provide an abundance of illustrations as to how different schemata may be applied to music therapy, such as verticality, part-whole, source-path goal, container, (with and inside, outside and boundary), time-as-space, force and motion in music, which are all highly suggestive and stimulating to consider.

Aigen gives a well informed presentation of Zuckerkandl’s theories of music, which have been much referred to in music therapy theory. His presentation is by far the most thorough in the literature, and he clearly brings out the relevance of Zuckerkandl’s for music centered theory. He also refers quite extensively to objections that could be made to these theories, and how they may be effectively met. But then a problem presents itself, how to reconcile these two theories, Zuckerkandl being mostly ontologically oriented, while Lakoff and Johnson present a constructivist epistemological view. Aigen devotes a chapter on trying to see how these may be brought together. And while he maybe does not achieve this completely, and also recognizes and acknowledges this, he finds nevertheless that it is possible to find a “reasonable accommodation” between the two. I find this chapter highly interesting, and intriguing, in that it opens a discussion that is really not settled, but which nevertheless is significant, on what musical experience is, from a realist versus a fictionalist view. This is actually a major quality of the book as a whole, I would suggest, that it brings out crucial issues that may well be discussed further, opening up the field of inquiry in the very attempt to bring the field together theoretically.

In the last part of the book Aigen completes the picture, in that he addresses other dimensions of music such as context, experience, and interactional processes. He elaborates on Ansdell’s notion of the “quickening” effect of music (from Oliver Sachs), animating the spirit, and, consequently, the body, relating this notion both to schema theory and to Zuckerkandl’s outlook. He also considers the notion of developing an I-Thou relationship to music, and change in the sense of self that may follow from this.

In chapter 12 Aigen presents, I find, a very clarifying discussion on music and emotion in music centered thought, applying both Susanne Langer’s and Peter Kivy’s aesthetic theories here. Kivy’s distinction between music expressing and being expressive of is highly relevant for music therapy. Aigen actually makes a distinction between four aspects: 1) music expressing a client’s emotion, or 2) being expressive of a (different) emotion, 3) evoking (some other) emotion in the therapist, or 4) creating a (new) emotion in the client. It is clearly necessary to keep these aspects apart in any discussion on music and emotion in therapy, which this chapter then is really helpful for.

In the following chapter Aigen presents the concept of life-force, as this may be found in the philosophy of music, and relates this to the issue of transformation. Although I find this relevant and significant, again it seems to me to be too simple to equate musical transformation and personal transformation, as reflected in statements such as: “As music unfolds it develops, and as we identify with it we experience ourselves as similarly developed.” (p. 269). But this is maybe just what a music-centered stance is about. I guess it will have to be up to each reader to decide how to relate to this kind of outlook. Aigen also refers to Carolyn Kenny’s notions of ritual and myth here, particularly the “Hero’s Journey,” which broadens the outlook somewhat, relating this further to Zuckerkansdl’s ideas about music.

In the last chapter 14 Aigen makes use of the schema of CONTAINER in an examination of musical themes or melodies as these may be related to self-identity. A case is referred to here, about Lloyd, who experienced the E dorian theme as a CONTAINER through identifying with this theme in improvisation with the therapist and co-therapist, and through which a variety of positive clinical experiences issued. This is one of very few clinical examples cited in Aigen’s book, to illustrate how the thinking he presents may be applied to illumine clinical practice. One could wish there was more such examples, which might have been clarifying. But then this is also something that might be a future prospect to provide, by the author, or by others finding this frame of understanding useful in bringing out qualities of music-centered clinical practice.

In the last part of this chapter Aigen draws a correspondence between musical transition and transitions in life, relating this to a discussion of Turners concepts of structure and anti-structure, which are linked with the notion of liminality, (which was introduced to music therapy writings by Even Ruud.) Then he elaborates somewhat more on CONTAINER as a metaphor for therapy and for life, seeing how there may be a series of transitions between musical themes and genres as containers within therapy, and further between therapy session to therapy itself being a container entered into and out of, through the course of life. Finally there is an emphasis on the spiritual aspect of music facilitating entering into and staying within a present moment: “To live in music is to experience how the goal is a means to achieve a path, not the reverse.” (p. 303).

In an after word Aigen considers the implications of this kind of outlook for the societal role of music therapy, seeing that practical concerns might indicate other kinds of thinking and legitimization, connected to other kinds of outcome that what a music-centered perspective will emphasize. But he nevertheless insists on a music-centered stance as more fundamental, and that he proposes should remain at the core of the work, for credibility in the long run.

There is a passion for music evident throughout the text of this book, and for the inherent benefit of musicing itself. Aigen takes a clear stance, and though not everyone could be expected to follow every single line of thread of thought, this is a work that deserves attention by any music therapist serious about the thought behind practice, and the potentials of the medium of music. This book is a veritable sourcebook of insights and at times provocative thoughts that I believe will prove hard to come by. Even if one might not regard oneself as belonging to the league of hard core music-centered practitioners it is quite clear that any music therapy will apply music in some way, and whatever the position one might take, it is valuable to have the music-centered stance formulated so uncompromisingly, and through such a variety of angles and approaches. Even in disagreeing on one or two points, or more, it is well worth considering, because it may prove challenging and stimulating to align the perspectives drawn here with one’s own outlook on music therapy practice, in any case. In that sense it does serve as a general theory. For anyone interested in keeping up with state of the art music therapy theory this book indeed is, and will remain for quite some time I believe, required reading.

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