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Listening to Music in Psychotherapy

br2008_095Butterton, Mary (2008). Listening to Music in Psychotherapy. Oxford: Radcliffe Publishing.

Mary Butterton is a graduate of the Royal Scottish Academy of Music and Drama and a Senior Accredited Practitioner with the British Association for Counseling and Psychotherapy. She has a PhD in music, psychotherapy and theology. The author’s motivation in writing this book was apparently “to understand more of what might be happening in the psychotherapeutic process when music, chosen by the patient, was brought into the consulting room” (p. VII). Since she further wanted to understand the experience of listening to music in general, she explored areas such as philosophy, psychology, sociology of music and neuroscience.

The book consists of three parts. Part I – “Experiencing music” (Chapters 1-5) − presents conversations with four well-known public personalities: Mercedes Pavlicevic, Professor of Music Therapy in South Africa; Katie Melua, the popular British singer and song writer of Georgian descent; Baroness Julia Neuberger, Member of the House of Lords, Rabbi, and social reformer; and Benjamin Zephaniah, the British poet and social activist. In Chapter 5, “A gathering of musical experiences,” the author summarizes what she has learned from these conversations about the experience of listening to music. In Part II (Chapters 6- 9) − “How do we understand what we know?” − the author turns to disciplines such as philosophy, sociology, psychology and anthropology of music, music therapy and neuroscience – all in order to deepen the understanding of the experience of music. Part III (Chapters 10-14) deals with the experience of listening to music within psychotherapy via a case study of a client named Liz, who brought classical musical works to the sessions. It describes the music repertoire brought to the sessions, the reflection of both clients and therapists on the process, and a musical analysis of the client’s experience. The “Coda” introduces accounts of two psychotherapists about three clients who brought music into therapy.

As a music therapist, for whom the power of listening to music is at the core of my work with clients, I was looking forward to reading this book. I found the conversations in Chapters 1-4 rather engaging. The conversations with Baroness Julia Neuberger and Benjamin Zephaniah were particularly interesting with regard to the role of music in their lives. I was surprised, however, that these conversations were not focused on the experience of listening to music. Although the author explains that these familiar public figures agreed to be interviewed about their experience of music and what it meant to them, I wondered why she chose well- known public figures. How were they chosen? What is the connection of these conversations to the experience of listening to music in psychotherapy? Being a qualitative researcher, I could not help but asking myself why she asked specific questions repeatedly in all the interviews (“What if music was to be taken away from you, what would you imagine that would be like?” p.32), while others, rather important questions, were not. (“Has the experience of music changed for you over the years?” p.22; or “was a particular event in your life when music was especially important?” p. 39)

Chapter 5, which, supposedly, summarizes Chapters 1-4, is confusing. At the beginning of this chapter the author mentions and defines the term “communicative musicality,” and then discusses infant-mother communication. While it becomes clear that the author relies heavily on Malloch’s and Trevarthen’s theory of communicative musicality throughout the book, it remains unclear, however, why she introduces it here. Butterton then returns to her interest in finding out “what might we learn from these conversations about the experience of listening to music?” (p. 57). Yet, instead of writing about the experience of listening to music, the chapter is organized according to three different “ways” in which music can be understood: (1) what music is; (2) group experience;(3) everyday music and special music. It should be further noted that throughout the book the author treats the terms music and experiencing music as identical. It is unclear, then, whether she wants to understand what music is, or to understand the meaning of the experience of listening to music. In the third way – everyday music and special music − the author divides the musical experiences of the four interviewed persons into the ‘everyday’ and the ‘special’. “The everyday was the music they chose as background sound or other tasks and the ‘special’ seemed to have particular emotional significance for them” (p.59). She then talks about the idea that one particular musical piece might have more value than others, by introducing Ellen Dissanayake’s naturalistic aesthetics to support her view. Dissanayake’s theory is that the concept of beauty, quality, and routes to transcendence vary among people and cultures and need to be learned. She describes four successive criteria for “assigning aesthetic quality or ‘aesthetic success”’ to a musical event (p. 62): (1) accessibility coupled with strikingness (2) tangible relevance; (3) evocative resonance, and (4) satisfying fullness. The rest of Chapter 5 is organized according to the above four criteria, where a selected piece by each of the four interviewees is tested against Dissanayake’s criteria for aesthetic quality. Overall, I am puzzled by the process of the data analysis and decision making here. It is unclear to me how the author analyzes these interviews and how and why she came up using these particular topics and not others?

This chapter also introduces some surprising comments regarding the choice of musical repertoire. For example: when the author writes about Mercedes Pavlicevic’s choice of musical works she refers to the playing of Bach by Yo Yo Ma and the music of the famous Chilian folklore singers of Inti-Illimani.. Her comment on these two particular choices is: “One of the reasons these pieces are accessible is because she [Pavlicevic] is highly trained in music” (p. 62). It should be remembered, however, that musical choice and musical taste are, to a great extent, very personal and that these particular pieces can obviously be known and loved by music lovers who are not necessarily highly trained musicians.

In Part II – “How do we understand what we know” − the author explains that “we turn to the music itself.” This is an unclear title: does she mean: how do we understand music? how do we understand the meaning of music? how do we understand the meaning of musical experience? Sometimes music is treated as an object, yet the author’s main point in this book is to convince us that music is a shared experience, “right brain to right brain”. She subsequently turns to philosophy, sociology, psychology, anthropology, neuroscience and music therapy in order to support her perspective and deepen the understanding of the experience of music. However, despite her close familiarity with theorists in these diverse fields, a clear connection between their ideas and the main theme of this book remains unclear.

Chapter 6, the first chapter in Part II, serves as an example of a lack of perspective with regard to the musical experience within the context of the disciplines discussed in the book. At the opening of the chapter we find the following statement: “At this point of writing there does not seem to be a philosophy that underpins adequately the experience of music within psychotherapy. This may be because, incredibly as it may appear, until very recently (my emphasis) music has been considered as a separate discipline in its own right and not considered as intrinsically part of what it is to be human” ( p. 69). She further contends that “what it is to be a human being, experiencing all kinds of music, is now being addressed in the 21st century through many disciplines” (p. 69). This is far from being accurate. The author herself describes ideas taken from Zuckerkandl’s book Sound and Symbol which was written in 1956! She might be unaware, additionally, that ethnomusicology has been approached as a social, anthropological, and psychological phenomenon at least since the early 20th century. Certainly since the 1960s the so-called “New Musicology” (in counteracting historical positivism) has treated Western music as integrative component within Western cultural history. (Carl Dahlhaus, Theodor Adorno, Joseph Kerman, Leonard Meyer, to mention some of the prominent names, were among the principal musicologists who consolidated this orientation, followed by the majority of the leading musicologists to the present.

Although Butterton presents in Part II (as well elsewhere throughout the book) theories and practices in the field of music therapy, especially those dealing with listening to music techniques, she does not explore the field sufficiently as one would expect. For example, although she describes the The Bonny Method of Guided Imagery through Music (known among music therapists as BMGIM), she claims that she cannot take anything from it, because in this method the therapist, rather than the client, is the one who chooses the music. Also, according to this approach the focus is on the music, rather and not on the relationships between the therapist and client. However, elsewhere in her book (p. 95) Butterton explains that aspects of psychotherapy such as transference and counter-transference have been explored in the BMGIM process. If this is so, there might be something to learn from it. Additional ideas from Grocke’s & Wigram’s Receptive methods in music therapy (2007) could have been of help here as well. There have been certainly numerous scholarly studies in music therapy in the past 60 years or so, which deal with Butterton’s question “what it is to be a human being experiencing all kinds of music” (p. 69) that could have strengthened the argument here. Let me also underscore David Elliott’s Music Matters: A New Philosophy of Music Education (1995), which introduces the concept of “musicing” as a form of musical knowledge that helps to develop both the self and society. His chapter on listening to music could have served as a valuable addition to the discussion of listening to music in Part II

In Part III Butterton addresses the experience of listening to music within psychotherapy in conformity with the title of her book. Chapter 10, the first chapter in this part, is a clinical example of listening to music chosen by a patient, named “Liz”, in word-based psychotherapy, described and analyzed by both therapist and client. It is called a “two-part invention.” When Liz first came to therapy with Butterton, they did active musical improvisation as part of her therapy. When she returned after a six-month break, the therapist offered her the possibility of listening to music of her choice, in order to address now “what might have been non-verbal and not ready to be engaged with earlier in therapy” (p.122). Liz chose pieces such as Elgar’s The Dream of Gerontius, Tolga Kashif’s The Queen Symphony, and the first movement of Dvorak’s Second Symphony. I enjoyed reading Liz’s reflections on her therapy and especially on the musical pieces she brought to therapy. She is obviously a creative woman.

Chapters 11 and 12 rely heavily on Malloch’s and Trevarten’s “Communicative Musicality.” In Chapter 11 the author presents her reflections from a therapeutic perspective and performs a psychological analysis of the experience of listening to music. She focuses on Liz’s capacity for communicative musicality in her early childhood as well as on other important events in her life (such as the death of her father). In Chapter 12 the author describes and analyzes psychologically the client’s musical choices within the context of enhanced communicative musicality. She explains that, according to Malloch & Trevarten, communicative musicality “exists in the dynamic space between musical sounds and persons” (p. 106) and that its main elements are pulse, quality and narrative. She then applies these three elements to the musical pieces selected by Liz as well as to the therapeutic engagement. Curiously, however, we still do not know much about Liz. Although her childhood is referred to in the book (p. 148), we do not have relevant information about her such as her age, occupation, and family situation.

In addition, even though we get the impression that the main point of listening to music in psychotherapy is the meeting between patient and therapist, and it is stated explicitly that “we are not studying the experience of one person only, there are two people involved” (p. 93), this is not reflected in her analysis. When describing and reflecting on Liz’s musical choices, the author writes only about Liz, the client. The reader does not know how the author, the therapist, was influenced by the music or what feelings did she have while listening to the music. How did these feelings influence her countertransference?

Chapter 13 − “Where are we now?” − is kind of an integration of the central ideas presented in the book. The author re-visits the conversations with the four persons in Part I, the various theories posited throughout the book, and the meetings with Liz, in order to set up the base for a future integrative therapeutic theory of music in psychotherapy.

As the pivotal stage of the book, Part III certainly should introduce more than one case study. I also expected to read ideas and discussion concerning issues, such as the place and the goal of listening to music in psychotherapy, the reasons for suggesting it, and the appropriate conditions for doing it. Do therapists in general need to have a sufficient musical training and/or familiarity with the particular musical works brought by client to the session(s)? Does the client need to have musical training in order to benefit from listening to music in psychotherapy? (It is obvious that Liz, for example, has a vast musical knowledge as deduced from her written reflections on her therapy.) What about clients who do not have any educational background in musical or a limited musical education, or higher levels of music education? Would the therapist’s interaction with the client and his understanding of the client be different depending on his familiarity or unfamiliarity with the musical piece brought to the session by the client? Can any psychotherapist, even the one who is unfamiliar with classical music or other types of music, offer this technique? Is every patient suitable for this technique? When does the therapist ask the patient to bring in music?

In conclusion, I found the conversations with the four individuals in chapters 1-4 and Liz’s reflections on her therapeutic process in chapter 10 to be engaging. However, the book often lacks organizational cohesiveness and contains many inaccuracies.

The most noticeable examples are: (1) An excessive use of “this will be discussed more fully later,” which does not provide a useful overview of what is to come. (2) A selective choice of references in support of an argument. For example, when discussing consciousness and the unconscious realm, she draws heavily on Jung and ignores others who write about this topic. A rationale for bringing only Jung would have strengthened the choice. (3) On too many occasions she treats basic terms as music and experiencing music as if they were identical. It is not clear, therefore, whether she intends to convey what music is, or what the meaning of the experience of music may be. (4) The author turns to philosophy, sociology, psychology, anthropology, neuroscience and music therapy in order to support her perspective and deepen the understanding of music/the experience of music. However, despite her close familiarity with theorists in these diverse fields, a clear connection between their ideas and the main theme of this book is vague and unsatisfactory. (5) Specific terms that carry multiple or ambiguous connotations, such as “habitus,” need to be clarified. (6) Misspellings of author’s name (“Rudd” instead of “Ruud”) and inconsistencies of terms (referring to the Bonny Method of Guided Imagery and Music as GIM in some places and as BMGIM in other places).

Listening to music in psychotherapy by Mary Butterton introduces a novel and fascinating musical aspect within psychotherapy. When a thorough and systematic interdisciplinary research is further pursued in this area, it might have interesting ramifications not only in psychotherapy, but also in music education and music therapy.



Elliott, David (1995). Music matters: A new philosophy of music education. New York: Oxford University Press.

Grocke, D. & Wigram, T. (2007). Receptive methods in music therapy. London: Jessica Kingsley Publishers.

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