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

Based on an interview with Oksana Zharinova

Daniel was my first child as a student: my first client ever. It was last year.

He was a six-year-old with cerebral palsy, learning difficulties, epilepsy and no speech. For the first session he came in a buggy and hardly moved. He wasn't really encouraged to move in his life, everything was done for him, everything was on his terms... I had a feeling that he could do things... although he was at a very low developmental level, under a year, probably. What I mean is, he would move his foot in the session, and we would put a tambourine in front of his foot, so that he could kick the tambourine and make e sound. He would stop immediately. Nothing was happening in the first three sessions. Either because I was a beginner - or else because nothing would happen. I felt bad, frustrated... first of all I was a student, he was my first child! We were supposed to do something, to develop, and I was so eager to apply my creativity and get something out of him! And after each supervision, I was told 'try playing less! Play less! Listen more, listen more!' And still it didn't help.

You are there in the room wanting to give everything you have, knowing that this child can do something... because he can.

His parents brought Daniel to music therapy because they thought that this would help him to understand simple developmental tasks through concrete and direct activities. And also the experience of hearing himself being played by music, making him more aware of himself... because that is the first stage of personal development, when the child becomes aware of themselves and the other person there....

ln the first few sessions he was emotionally detached, he didn't look at anyone, not at me, maybe he looked more at the co-therapist, my student-partner, because she was holding him. But she wasn't the musical source. Her role in the initial sessions was to hold him, although she did a lot more later on, encouraging him to use his hands, to play.

He was very passive, both in and out of the music therapy room....

After the first session we decided to take him out of the buggy and either put him on the co-therapist's lap, or else on the floor on the mat.

Also it was clear that it was difficult for him to respond to the piano, to make a connection with an unfamiliar sound coming from a 'big black box'; it was something very distant as well... I was sitting up at the piano and he was down in his buggy. By session four, I had abandoned the piano completely and worked on the floor with him. As he started to utter occasional short vocal sounds - it was his first and only active musical contribution at the time - I was also vocalizing with him. I was singing a song, quite a structured song, and in the middle of it he started to vocalize more, extending the duration of his sounds - my voice could match every aspect of his vocal sounds: pitch, intensity and timbre. At first I was matching him completely, and then I started to extend a little bit what he was doing, still keeping very close to what he was doing.. .and then he started! He was just all over the place with his voice! Up and down, quiet and strong - it was really playful! Very imaginative! It felt very much like what I was doing with him was half because of what I was told in the training and half was completely intuitive.... I was listening and I knew that in order to establish contact with him I had to catch him... but at the same time, I don't know how to explain the timing of it, everything, it was complete intuition.... I knew that I had to match him, his voice, and at that particular moment, my voice could match his pitch and intensity and timbre.

While it was happening, I was amazed... first of all because it was the first time that I was completely with him. . . when I could experience him the way he was. It was very powerful - maybe because, well, if I'd had my own children, I probably would have experienced this quite differently - but I never had that experience. I was watching his breathing a lot... no he wasn't watching me at all... usually he sat with his eyes looking up at the ceiling. We didn't have any eye contact until session ten.

I had no sense that something like this was going to happen.... He had vocalised little bits in previous sessions, but it was two sounds here and two there. . . but here it was a continuous ten minutes. . .And not  just vocalizing by himself in some way that was closed. It was a really open vocalization, related to what I was doing and very communicative... something big; sounds of incredible intensity and range. The more I did, the more he did... the vocalization fluctuated... it would come to something big and then go back, then come again. . ..

It was coming from him - from the inside - from the whole of him - at that moment I had no question about this is him doing what he wants to do - it was very authentic - that is why it was so powerful and meaningful. His voice was really.. . something. .. and this was not a developmental thing. . ..what we were doing with his body in music therapy was trying to make him more aware of it.

He always sat in a closed posture, with his hands bent at his chest. And although we were working with him as a whole, it still felt that when the voice came that here was something very very special.... it was like a vision... he revealed that he can do something - OK, I knew it, but it had stayed at the level of my 'knowing' and 'believing', not more than that... and finally here was the music child, which is ready to blossom! He showed that he's got that within him, which can sound and which is ready to communicate, given the right circumstances…………..

Then a lot of things happened in our work together. He got much more active... he vocalized a lot afterwards,' but never with such concentration of expression in terms of time and intensity. Also I could start to be more relaxed! I took that vocalization so seriously! And then, three or four sessions later, I realized that he needed something playful, and we did lots of shaker, tambourine and piano sound anticipation - like peek-a-boo games. Mother-baby type interactions, captivating musical activities, lots of contrast in the music to get his attention, lots of lively sounds and facial expressions from me and the co-therapist – to keep his attention going - and there were moments of musical connection here and there. When I took him in my arms, he would move and I would sing with his movements. He was very aware and then he began to look at me properly.

At the end he was much more independent and he knew …. what was happening, he was much more aware.