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From Music Therapy – Intimate Notes – case studies compiled by Mercedes Pavlicevic

Based on an interview with Nigel Hartley who works at the Nordoff-Robbins Music Therapy Centre in London and Sir Michael Sobell House in Oxford.

Steve was my first adult client, my first ever 'dying' client. Our work together lasted two years. He was HIV positive. I was absolutely terrified: he'd had music therapy before so he'd have some expectations . .. and I didn't know whether I could be the music therapist he wanted me to be. I didn't know what to say when he first came, how to be with him, what do I do here, should I be in some kind of pseudo counselling mode? As soon as we started playing together, I felt a huge relief, like this was where we should be, this is it. That was my first experience of really feeling 'I am a music therapist!' - after two years of working with learning-disabled children and adults, and also with children and adolescents in psychiatry.

Enormous music started to happen with Steve, and I started thinking that this was because he'd had music therapy before. He would come, we would improvise together for an hour and he would go, and there would be no reflection on it. He was not interested in reflecting, so I was left alone with this enormous music. I then asked myself what this music was about for him, why was it important for Steve to have an experience of himself in music.

Of course he would let his feelings out, that was part of it, but then, he could have done that alone. No, I think there was something about my involvement in the music with him.. . this is why it was so important:  for him to have this experience of himself in music - with me. My responsibility was to be as open, flexible, and as accepting of him as possible when we played music. So the question became, 'what kind of musician does Steve need me to be in order for him to experience himself in music?' As a music therapist, I have this enormous wealth of musical experience and have this responsibility to provide, depending on the person's needs, and what they are asking from me.

It was in my work with Steve that I began to understand that this was my task: to be in music with clients and to give them the experience of themselves in music.

He taught me a lot about the work. He demanded such a wide range of musical styles and responses: he would come and drum, and his drumming was like nothing I had every experienced in my life. . . I don't like using the word chaotic, but there was nothing repeated! He drummed all the time, with no space for me to be heard, and every time I tried to catch or to meet what he was playing, he would take off somewhere else! His playing was more like a collection of noises and sounds than anything cohesive or what we would think of as being music. He was completely hard work! Then, out of the blue, he'd let me hang on to something in the music with him, and there would be no rhyme or reason why he would do it at that point... our pulse would coincide, or my harmonies would 'fit' his drumming. .. but this was fleeting. Over two years, that drumming never changed: it never became more cohesive, more pulsed, more in the metre. Within it, though, were bits that he gradually allowed me to share with him. He would alter his playing and we would move towards each other... it was almost like flying through the air with someone, suddenly we would land... on this planet, experience music together and then go off again,  Iand on another one - and none of these planets would be the same, musically. And yet it was just so intimate. .. the meeting was beyond anything I had ever experienced before. . . it was exhilarating.

Then I began to realize that he was making a conscious decision to play the drums like that. The drumming was not necessarily reflecting his inner life. What happened was that in one session after a few months of working with him, I was playing with him and getting really frustrated: I couldn't meet him musically, couldn't reach him, we seemed to be in different worlds except for those fleeting meetings! In this session, I was trying all kinds of things in the music to get him to play a pulse, be with me in that, and allow something to happen... and he'd been hitting the marimba with a drumstick, it was really percussive.

There was no sense of melody at all, he was using it as another drum. I got so frustrated that I stood up, picked up a stick and whacked the marimba, straight across what he was doing.... He stopped playing and looked at me. He was really angry. He said 'is that a therapeutic technique?' I dug around in my mind for my best therapeutic technique and said 'well, are you upset because I invaded your space...?' He said, 'no, I'm upset because what you did had nothing to do with what I was playing'. I thought, what does he mean... and it turns out that he was a freak listener, he would go home and listen to people like Eddie Prevost, a group called AMM - a group of improvisers who would create a wash of sound together... and he just loved it and he was trying to recreate this music. He was making decisions of what he wanted, and he wasn't being what I wanted him to be....

As soon as I realized that I had gotten myself totally stuck on what I wanted him to be, I don't know whether what we actually did changed, but certainly my perception changed. Our playing became music as opposed to just noise... and although the 'landings-on-planets' music didn't change, the times in-between felt a lot more significant as opposed to thinking, 'oh god, we are just going through this in order to get there'. The bits in-between began to feel important.  We both let go and were able to just be in the music - as opposed to trying to make it into something else - therapeutic improvisation, maybe! I was with him a lot more than I had been, in his trying to recreate something... which was what he wanted.

The most moving thing about working with him was that he died very quickly and unexpectedly. He had got ill a couple of times... and I got to thinking he's never going to die because he's been ill so many times. We had our last session on the Monday evening and he died the following Sunday morning... and I didn't know.   I was expecting to see him the next week, and what had happened was that the virus very quickly got into his brain and he deteriorated rapidly. It was a dreadful shock………………………..

In our final session - we didn't know it was going to be the final one - there was a lot of drumming, it was busy, rhythmic, and it got to the last two minutes and we swapped over, with him playing the piano and me the drums. Suddenly the whole thing changed. It is as though, in the music, a stillness opens. . .. I hear it in his touch on the piano. .. this is the end of two years of enormous work with someone. . .. I want to play you the recording of the last one-and-a-half minutes....

You can hear Steve's touch change at the piano... at the beginning, the excerpt is very busy and full of sound, and then suddenly Steve plays three notes only. Nigel is on the drums, and fades to almost nothing.  Only three notes repeated, with held pedal, both insistent and strong, and open at the same time... the rhythm expands, slightly and then more, Steve brings in bass notes of the piano, very deep and strong, open music... and then a long, held note, alone... and silence.

There is something almost infinite about it, the repetition, the simplicity it is just so unlike him. . . and the fact that I could just disappear be there very quietly underneath his playing. At the time, I didn't register that it was different. I hadn't remembered the session.

When I listened back to the tape, I could hear that there was something significant, even though part of me thought, well am I just looking for something because I need an end to this work. But when I listen to it I feel quite accepting of what happened, of his dying so suddenly.