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Music Therapists Do It Differently: Verbal Interaction

In this series, we are exploring how music therapists do live music differently than other musicians, even though it may not be easy to see. This is part eight of a ten-part series. You can find an introduction and links to all ten posts here.

Music therapists talk a lot.

At least, we don’t spend ALL our time playing music, at least not usually. Verbal interaction is a crucial part of what happens in music therapy sessions. And, music therapists do verbal interaction differently from other professionals.

#8. Verbal Interaction

Consider two of our sister professions:

For performing musicians, the music is the point of their professional work. They may use speech as banter, as a bolster to the entertainment value of their show, but it’s probably considered to be ancillary to the music itself. This is especially clear in a classical concert, where you’ll hear very little speech. The conductor comes out, the orchestra plays, the conductor bows and everyone leaves. No jokes, no history lessons – just music.

"What are they talking about?"

“What are they talking about?”

On the flip side, for therapists who primarily work verbally – psychotherapists, social workers, counselors, and others – the verbal discussion is the point. They may use music as an added element in their sessions, but it is likely that the intention is to have that music start a meaningful discussion. Communicating through the music itself is not the intention.

For music therapists, though, music and verbal interaction are both integral parts of the therapeutic process. In fact, one of the major strengths of our medium of therapeutic interaction is that we can move back and forth between non-verbal (musical) communication and verbal communication as appropriate. And, as usual, these decisions are based on the needs and goals of the clients.

How do music therapists do verbal interaction differently?

Imagine a hospice music therapy session. The music therapist, Karen, is talking with Pat, a woman in her 80s who loves the gospel music of her rural Baptist church. In one session at Pat’s bedside, singing “How Great Thou Art” leads to a conversation about Pat singing in the church choir, which leads to her and Karen singing “Just A Closer Walk With Thee” and “Precious Lord, Take My Hand.” The session flows easily from music to conversation and back.

On another day, though, Pat is not chatty at all. Karen offers to sing “Precious Lord, Take My Hand,” and Pat agrees, but she doesn’t sing along, and her eyes glisten. At the end of the song, Karen pauses, waiting for Pat. After a few moments, Karen prompts Pat gently, saying, “what’s on your mind?” Pat responds that she’s just feeling tired today, that she’s “ready to be with Jesus.” Then, Pat closes her eyes and turns her head away.

What is Karen thinking about during these sessions?

1. Deciding When To Talk

Of course, the first decisions are whether to communicate verbally or musically, and whether to talk or to listen. In Karen’s first session with Pat, the conversation and music were feeding into each other easily. Here, the goals may have been assessment, establishing rapport, or facilitating reminiscence. Karen was likely mindful of gathering information about Pat that could be important in future sessions – her musical background and preferences, her spiritual background – as well as communicating an unconditional positive regard while engaging in music together.

Deciding whether to talk would have been trickier in the second session, when Pat was quieter and the session had more frequent silent moments. At the end of “Precious Lord, Take My Hand,” should Karen have started in on another song? What comes next – music? Silence? Talking? The end of the session? All of these are questions that the music therapist would have to consider in the moment, while thinking about the client’s needs and goals at that time.

2. Choosing What To Say

Beyond deciding whether to talk or not, the music therapist must consider the content of what she says carefully. For instance, after that silent moment with Pat, Karen could have said a number of things. She could have made a cheerful comment about how pretty the song was. She could have chided Pat for not singing that day. She could have suggested another gospel song, to get back into singing as quickly as possible. Or, as she did, she could have given Pat an opening for verbal interaction on another level.

The same choices applied after Pat made her statement about being ready to go to Jesus. Karen could have encouraged more verbal interaction. She could have let the silence stand longer. She could have chosen a song that validated Pat’s statements, to communicate empathy and acknowledge Pat’s spiritual beliefs, like “Peace in the Valley.” Or she might have jumped back into singing something to shift the mood, maybe something more upbeat.

What would have been the “correct” decision? It’s impossible to say, without being in that session at that time. In any case, Karen would decide what to say based on Pat’s needs in that moment.

3. Refining How We Say It

Deciding on verbal interaction vs. music vs. silence, then deciding what words to say – that’s tricky enough. But another level of nuance comes with how we say what we say. Doing music therapy can never be as simple as following a decision tree or a strict protocol, saying, “if Client says x, then MT sings y. Then MT says z with great empathy while patting Client’s left hand.” Rather, all of the music therapist’s experience and training and intuition come into play as he/she decides what to say or sing or do, and how to sing/say/do it.

This is frustratingly difficult to describe. So, here is where I find it especially helpful to think of music therapy sessions as being MUSICAL from start to finish, regardless of the level of silence or verbal interaction involved. As any musician knows, beautiful music is made of more than playing the correct notes and rhythms or singing the correct words. So it goes for music therapy sessions – the value of the whole music therapy session is more than the sum of the words we say and the songs we sing.

Verbal interaction is one important piece of the entire picture of the therapeutic relationship in music therapy.

That’s how music therapists do verbal interaction differently.

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