Abstract
This article considers the theoretical and practical use of the systemic approach in music therapy. An overview of the basic elements of the systemic approach is given. The potential benefits the approach can bring to music therapy practice are outlined with reference to the author’s work with young people with social, emotional and behavioural difficulties and their families. The potential for the systemic approach to contribute to the ongoing development of music therapy theory and practice is also explored, with particular reference to community music therapy. Two case studies are used to illustrate the use of the approach in practice.
Keywords
Introduction
I have worked as a music therapist for 12 years with young people with social, emotional and behavioural difficulties (SEBD) and their families. This is a complex client group which presents with a multi-layered experience which can include the impact of past trauma and attachment difficulties, current family difficulties and wider societal factors such as poverty. As someone who initially trained in psychodynamically informed music therapy, I soon realised the limitations of that approach in explaining what my clients brought to music therapy but also in actually managing to engage them in music therapy in the first place. Working with young people and families often labelled as ‘hard to reach’ has challenged me to examine my practice thoroughly and to adapt it in order to respond as inclusively and helpfully as possible to the needs of my clients. From the start of my work, I have been aware of the need to at least consider and preferably work therapeutically with the relational contexts of their lives – family, neighbourhood, culture and society. Difficulties at home placed a limit on what could be achieved in therapy. I also felt powerless to work with wider issues like poverty, inequality and racism that could have crippling effects on my clients and their families. This frustration eventually led me to train as a family and systemic psychotherapist in an attempt to empower myself to work more effectively at those levels. I now integrate music therapy and psychotherapy as well as being informed by different theoretical approaches including psychodynamic and systemic in my work. I have been struck by how well the systemic approach fits with music therapy practice and particularly by the overlaps with one of the most significant recent developments in music therapy, community music therapy (CoMT).
Overview of the systemic approach
Systemic psychotherapy is a form of therapy that emphasises the relational contexts that people live in and sees difficulties as being generated in those contexts rather than residing inside people. It also tends to focus more on developing existing resources and strengths than thinking about problems. It is currently the main approach used by most family therapists in the United Kingdom (Flaskas, 2010) but can also be used in individual psychotherapeutic work and with organisations. As with other branches of psychotherapy (see, for example, Whitton (2003) with regard to humanistic psychotherapy), the seeds of its formation were born out of a growing unease about aspects of both psychoanalysis and psychiatry and frustrations at their limitations. The particular aspects that the pioneers of systemic therapy challenged were as follows:
Lack of attention paid to contextual factors in the present and too much attention paid to intrapsychic factors in the past (Hayes, 1991);
The inherent power of the professional and potential for abuses of that power (Kraemer, 1994; Pocock, 2006);
Problems of stigmatisation with diagnoses (Strong, 1993);
The location of problems inside people supporting political avoidance of tackling social problems like poverty and inequality (Minuchin, 1967);
The fallacy of the objective expert who could decide what was ‘wrong’ with a client without taking into account their own prejudices and cultural differences (Flaskas, 2010);
The potential for clients to get worse in psychoanalysis (Jackson, 1957);
The length of time, frequency and cost of psychoanalysis which made it inaccessible to most people (Haley, 1963).
I will not go into a detailed history of the systemic therapy profession, as this is outside the scope of this article, but for those interested, Dallos and Draper (2010) give a good account. I will instead outline some key concepts in current systemic therapy theory and practice.
Context and meaning
Systemic therapy sees people’s behaviours as arising largely out of the systems of relationships in which they are embedded (Campbell, 2003). An individual can be seen as interacting with different levels of context such as family, community, culture, society and world. In systemic therapy, these levels of context are explored in an attempt to understand (and change) behaviours, identify resources that can be used at different levels and explore what power people can realistically exert at different levels. Recently, the ideas of beliefs and meanings have become more significant (Flaskas, 2010), and their consideration is central to the therapeutic process. There may be different beliefs at different levels of context that contradict each other, and these tensions can also be useful to explore in order to provoke change. For example, a young person may be disengaged from school because the peers he associates with value street activity above education. However, there may be a strong family belief in the value of education that is causing tensions in his relationship with his mother. Exploring how his mother’s apparent disapproval may be an expression of her love for him and the value of that relationship to him may enable a re-evaluation of the beliefs holding that behaviour in place.
Cybernetics and transitions
Families and other social systems are self-regulating in that a system of interwoven behaviours develops in order to maintain homeostasis (Bateson, 1972). Second-order cybernetics, developed from the theories of cognitive biologists Maturana and Varela (1980), stipulates that an observer of a system (such as a therapist) cannot observe without becoming a part of the system and thus forming a new system (Dell, 1982). The therapist thus has to be aware of what she brings to the system and how this impacts it. In other words, when a therapist observes a family, what she is actually observing is the family in relation to the therapist which may be different to how they function without the therapist. Problems in systems often arise during significant transitions such as immigration and life-cycle transitions like adolescence or a new relationship when the system’s usual repertoire of responses is not sufficient to successfully adapt to the transition (Burnham, 2002).
Social constructionism
Our perceptions of reality and the meanings that we ascribe to phenomena in our lives are socially constructed in relationships (Burr, 2003). That means that we create our realities through interaction with others (either directly or indirectly, for example, through the media). The recent trend in systemic therapy has been towards a soft social constructionism that acknowledges aspects of socially constructed reality interacting with more solid ‘out there’ aspects of reality. Pocock (2015) has linked this description of reality with the philosophy of critical realism, developed from the ideas of Bhaskar (1977). Social constructionism also links to the concept of identity in that significant aspects of our identities are seen as socially constructed and also constantly reconstructed from moment to moment (Gergen, 1991), which has potential significance for therapy. As an example related to my client group (young people with SEBD and their families), there is a social construction of people who have experienced domestic violence as victims which may cause additional problems on top of the immediate effects of that abuse. In systemic therapy, these constructions are explored and deconstructed collaboratively, so in this example someone may prefer to think of themselves as a survivor rather than a victim. The experience of therapy can be deconstructed too so that no assumptions are made about what therapy should be, and a therapy experience that suits the needs of particular clients is co-created with the therapist.
Narrative
According to White and Epston (1990), people make sense of their lives through the (social) construction of narratives. These narratives create roles for us that affect how we behave. For example, in relation to my client group, a boy whose father perpetrated domestic violence and left the family may be demonstrating aggressive, bullying behaviours in his family because he has a narrative that when his father left he had to become the man of the family and is also influenced by family narratives that men show strength by being physically aggressive. These narratives may also be influenced by cultural beliefs and societal narratives. For example, a young person may feel like a failure because their practical skills have not been allowed to flourish in school and the dominant narrative in society places most value on academic achievement. Because the dominant narratives in a society are often challenged in systemic therapy, this lends a political dimension to systemic therapy (Flaskas, 2011).
Circularity and power
Within systemic therapy, interactions between people are seen as circular rather than linear. This means that people’s behaviours influence each other in a mutual way rather that one person’s behaviour causing another person’s reactive behaviour (Watzlawick et al., 1967). Linear explanations tend to lead to blaming and descriptions of fixed character traits that can lead to entrenched and stuck positions. Circular descriptions emphasise mutual responsibility. For example, a father responds to his son’s challenging behaviour by criticising him personally. The son responds in a challenging way by showing him just how bad he can be. Both blame the other in a linear way so that the father is critical and the son is naughty. A circular view realises that neither behaviour is the start of the problem, rather they mutually maintain each other in a circular way.
Circularity was later critiqued in its simplest form for absolving any responsibility of those who abuse positions of power in relationships, for example, by suggesting that the domestic violence perpetrator was provoked to act violently by their partner’s behaviours. In contemporary systemic therapy, a more nuanced interpretation of circularity is used which acknowledges the impact of real power differentials (Jones, 1993). Both circularities and real power differentials can be usefully explored in therapy. Raising awareness of circularity reduces blaming explanations of behaviours and encourages accepting responsibility for self-change in order to improve a relationship (Israelstam, 1988). Bringing power differentials into the open allows their effect to be explored more honestly and for the beliefs holding those power differentials in place to be deconstructed. This includes acknowledging aspects of difference between therapist and clients that may affect how power is shared in the therapeutic relationship, for example, gender, race, sexuality and class (Jones, 1993).
Solution-focused ideas
Ideas from solution-focused therapy (De Shazer et al., 1986) are linked with narrative ideas in the systemic approach. In therapy, subjugated narratives about strengths, success and resources can be developed and encouraged to flourish, and these new narratives can then drive new behaviours (Epston and Lobovits, 1997). This involves examining in detail exceptions, those moments when the problem is not so great, to see what resources are being used in those moments. The systemic use of the solution-focused approach also involves exploring resources at different contextual levels (e.g. someone’s faith community) and building on support outside of therapy. Such a resource-based approach can be powerful with clients who have problem-saturated lives and who have experienced repeated interventions by agencies that focus on those problems.
Therapist position
The therapist adopts a position of neutrality and curiosity towards clients and thinks and acts circularly (Cecchin, 1987). Maintaining curiosity helps to ensure that clients’ ideas are privileged above the therapist’s and attempts to limit the constraining effect of the therapist’s blind spots and prejudices. Paying attention to neutrality attempts to ensure that power in the therapy is democratised as much as possible. The therapist also acts self-reflexively, examining and acknowledging the impact of her own feelings, stories, beliefs and so on on the therapeutic relationship. She acknowledges that when with the family, she becomes part of a therapist-family system and cannot hope to observe the family objectively. The modernist idea of the therapist as expert is rejected in favour of post-modern therapist who acknowledges multiple truths and works collaboratively with the expertise of clients to co-construct a useful therapy experience (Flaskas, 2010). This does not mean she is non-directive. The therapist develops hypotheses (Cecchin, 1987) and uses these hypotheses to drive her interventions, but these hypotheses are constantly checked and adapted collaboratively with clients (Bertrando, 2007).
The systemic approach and music therapy
So how do these systemic ideas sit with current ideas about music therapy theory and practice? Some music therapists have written about work with families although none from a systemic perspective. Oldfield has written extensively about family music therapy and describes an interactive approach that makes use of musical communication between family members as informative enactments of behaviours and also in order to develop insight (Oldfield, 2006; Oldfield and Flower, 2008). Miller (1994) describes how musical interaction can have benefits in family therapy such as its potential to allow conflicted family members to communicate without the usual arguments caused by words. Like Oldfield, Miller describes how musical interaction can be used to assess the family’s strengths and difficulties and also highlights the motivational, emotional and cognitive benefits that music can bring to the therapeutic experience. Nicholson et al. (2008) describe the strategic and directive use of music therapy activities to promote positive interactions between parents and their children. Edwards (2011) also describes music therapy being used to support parent–child relationships, primarily from a psychodynamic perspective. There are a number of descriptions of music therapy being used effectively in family work in different contexts such as hospice care (Krout, 2003), paediatric trauma (McDonnell, 1984) and cancer care (Bailey, 1984). These authors emphasise the communicative potential of music in situations where talking may be difficult as well as the positive, healing qualities of musical interaction.
There are a few scant references to systemic ideas in the music therapy literature. Stige and Aarø (2011) quote Ruud’s (2004) description of CoMT as having a systemic perspective although there is no elaboration of that perspective. They also highlight the move towards systemic thinking in music therapy theory in the late 1980s, mentioning in particular the American music therapist Carolyn Kenny. Kenny (1985) does indeed refer to Bateson (1972), a systems theorist who was very influential in the initial development of the systemic approach and describes how music itself can be seen as a system (both physical and psychological). She ambitiously links this to the idea that there may be musical aspects to the very structure of the ultimate system, the universe itself. A significant development in recent years has been the evolution of the CoMT approach which has re-energised the debate about what approaches music therapy could use and has more fundamentally asked what is music therapy? A full description of CoMT is outside the scope of this article and has already been well documented (e.g. Ansdell, 2002; Pavlicevic and Ansdell, 2004; Stige et al., 2010; Wood, 2016), but key points include the following:
Music as a social participatory experience;
An emphasis on communal practice;
Questioning traditional ideas about place and time boundaries;
Context and culture as key elements, problems not located inside people;
Emphasis on positive, life-enhancing potential of music;
A self-reflexive and collaborative role for the therapist.
One can see that there is considerable overlap between the systemic approach and CoMT; however, there is very little reference to the systemic approach in the CoMT literature. Pavlicevic and Ansdell’s book Community Music Therapy does contain some links to systemic ideas by various authors. Ansdell (2004) describes music as a socio-cultural process and one that is essentially socially constructive. He also references the musicologist De Nora’s idea of musical affordances and appropriations – how people use music as a resource in their social lives which fits with the systemic idea of helping to develop people’s resources. Procter (2004) describes music therapy as a political act and highlights its potential to address issues of power with clients. Stewart (2004) does actually name the systemic approach, narrative ideas and social constructionism as significant influences and describes music’s ability to be re-constructive, not merely expressive. In terms of developing a theoretical basis to CoMT, though, the emphasis has been on drawing on ideas from musicology, music psychology, cultural psychology and sociology rather than drawing on ideas from the psychotherapy world. This may in part be due to the desire by some to distance CoMT from what Ansdell (2002) termed the consensus model with its association with conventional psychotherapeutic theory. This desire might in turn be linked to the domination of psychodynamics as the main psychotherapeutic model associated with UK music therapy and the fact that this model may indeed be difficult to reconcile with the perspectives and aims of CoMT. However, systemic psychotherapy has a very different orientation to psychodynamic psychotherapy, and its emphasis on context, culture, resources and collaboration could potentially make it a useful source of ideas for the developing theoretical basis of CoMT. It could also of course be a useful resource for those music therapists who do not feel particularly aligned to the CoMT movement.
In my own music therapy practice, I have found the systemic approach useful in a number of different ways which I shall summarise in Table 1. These will then be illustrated in the case studies.
Relationship between systemic concepts and music therapy.
Case studies
I will present two case studies to illustrate the use of systemic ideas in music therapy. Details have been changed to protect anonymity. Both case studies are from my work across two SEBD schools in London.
Group work – growing out of the chaos
This group contained three White British boys from working-class backgrounds who were all 15 at the time of referral. Alfie had been sexually abused by a family member when younger, would often find it hard to manage his emotions and was showing confusion about sex. Martin had been diagnosed with attention-deficit hyperactivity disorder (ADHD), had a quick temper and could also quickly become aggressive, usually when frustrated. Reece had also been diagnosed with ADHD, and his behaviours were chaotic and unpredictable. More positively, all three boys had a sharp sense of humour and an energy that I hoped could be channelled creatively. I enlisted the support of a teaching assistant, Samuel, in running the group as I felt I wouldn’t be able to manage them safely by myself. The sessions took place on a converted bus that had been adapted as a space for creative therapy.
The first sessions were very chaotic with the boys frequently provoking each other, myself and Samuel. My strategy involved balancing curiosity about the process and waiting for something useful to emerge, with the use of more directive interventions in order to nurture the possibility of this group as a different kind of community where the boys could experiment with different kinds of relationships. At times, Samuel and I needed to be explicit about boundaries of non-violence, but we also attempted to co-create a group culture with the boys collaboratively through being curious about their needs. This included being flexible about the boundaries of space, allowing the boys to use a grassed area around the bus at times if they needed to. These initial strategies were influenced by the systemic ideas of curiosity, sensitivity to power and the co-creation of a collaborative therapy construct.
Gradually, things started to settle. The sessions would usually start with a conversation, often around a game of cards, that would then open up to include some musical improvisation, creating songs and raps and sometimes some spontaneous role-play. There was also much play-fighting which we encouraged the boys to manage themselves, intervening only when absolutely necessary. A clear hierarchy emerged with Reece as the alpha male, Martin his second-in-command and Alfie the underdog who was sometimes bullied by the other two, and this often played out in their music-making. I helped them think about the circularity of these interactions, how Alfie potentially had some power in influencing how he was treated and also how sequences of behaviours often resulted in an unhappy experience for Martin and Reece as well as Alfie. We linked how they interacted to wider contextual levels, for example, beliefs about how males are supposed to behave. We used solution-focused strategies; exceptions, both in therapy and outside, were noticed, praised and their development nurtured. This involved Samuel and I feeding back to the boys when we noticed any small difference such as Martin and Reece listening appreciatively to Alfie play some piano music he had previously learned. The idea here was to help develop more positive narratives with which the boys could identify themselves.
I explicitly demonstrated curiosity about what both therapy and music meant to them and tried to be self-reflexive about my own assumptions about these. Therapy was something they associated with ‘posh’ people and was also linked to celebrities and movies they’d seen. It seemed to have negative connotations but also positive aspirational associations. Alfie and Reece mentioned previous experiences of psychotherapy that they’d found unhelpful, and we explored what could make this therapy a better experience. Again, my initiation of this discussion was linked to systemic ideas of power and co-construction. In terms of what music meant to them, it seemed important. They liked playing music on their mobiles, and this acted as a useful way for them to show something about their musical culture. Interestingly, in contrast to many of the adolescents I work with, there was little use of the music software available on the bus. They tended to prefer live music-making, and I had the sense this was linked to the social possibilities this offered. There was some powerful group drumming which had a slightly dangerous energy to it and the tension between keeping to a common rhythm or descending into chaos felt exhilarating in itself but also seemed symbolic of the tensions in their behaviours and relationships. We talked about how this felt and how adolescents often seek intense and challenging experiences as part of growing up. My thinking here was linked to the systemic concept of transitions (Burnham, 2002), normalising some of their behaviours as expected life-cycle phenomena (hence potentially allowing for the questioning of some of their self-critical beliefs about their SEBD) and exploring how music could potentially be used as a safe-enough rite of passage.
Music also seemed to offer the potential for new narratives and meanings to emerge. The music often seemed related to their concept of maleness, and this was useful in terms of exploring beliefs about expectations of males. For example, Alfie’s piano-playing seemed to me like a really healthy and positive resource that also seemed linked to positive memories about his past. Initially, though, Reece and Martin ridiculed it as gay, and we discussed how piano-playing could be construed as gay or not. This led to useful discussions about sexuality that continued throughout the group. All three boys expressed at least a degree of uncertainty about their sexuality, often disguised in humour, or at other times, projected onto the other boys. Gradually, with persistent support from Samuel and me, the idea that being gay could be okay gained some credibility. These conversations felt useful in terms of exploring aspects of difference and how they affected the beliefs and narratives underlying some of their behaviours. Class was also explored, with the boys demonstrating a mixture of pride about being ‘ghetto’ or ‘street’ and shame at how they might be perceived by society generally because of their social position. They also linked this to tastes in music. Reece identified with traditional Cockney culture, and we celebrated this by singing some Cockney classics together as a group. Although this was performed with much hysterical laughter, the humour didn’t feel derisory and Reece seemed genuinely touched by the group doing this for him. Thinking about class felt important in terms of reconstructing some of their narratives about themselves through nurturing their pride in being from the ghetto and also thinking about their relationship to disempowering dominant narratives in society, when it made sense for them to conform and when it was more helpful to resist. Music was useful in aiding this.
New behaviours and narratives around tolerance, restraint, sharing and respect could be explored through music-making and supplemented through discussion. This involved Samuel and I contributing alternative stories, both verbally and musically. For example, I would often deliberately play gentle, reflective music, partly to help the boys regulate themselves but also as a way of modelling different ideas about maleness. The boys noticed this, for example, Martin saying that when I strummed a guitar gently while they talked, it felt ‘calm’ and said that it helped them manage their tempers.
There was a lot of comedy in the group, and this was also expressed in the music. Alfie would often sing improvised darkly comic songs about paedophiles. The comedy, as is often the case generally, seemed like a safe way of exploring disturbing themes, and I would occasionally gently open this up to ask them what they thought about these themes. This led to useful discussions about sexual, physical and emotional boundaries in relationships and different interpretations about what abuse meant. Sometimes the performances would stray into actual stand-up comedy with Reece and Martin taking turns to do routines with Alfie providing comic musical flourishes.
The school community was a contextual level that was important to the boys and could harbour both resources and constraints. There was shame at having SEBD and confusion about what that meant. I tried to explain what I understood it to mean in a way that hopefully offered them a more positive narrative but also expressed curiosity about what it meant for them. The boys gave each other tips on how to manage their behaviour. I was really aware of how this group was becoming a little community for the boys that enabled them to act differently. I tried to facilitate the extension of this difference into their wider lives, not only through the conversations we had together but also more directly, through meeting the boys separately with their families and supporting their interactions with the wider school and professional networks. Samuel and I also encouraged the development of the creative talents they were demonstrating in therapy. With our support, the boys did a musical comedy performance at a school assembly. This was a huge achievement for them, and the genuine appreciation of the audience was a transformative experience for them. I was also struck by how it seemed to be a rite of passage, helping them negotiate the tricky path on the road to adulthood.
By the end of the group, all three boys had much improved levels of SEBD (measured using Strengths and Difficulties Questionnaires (Goodman, 1997)), were involved in less behavioural incidents and were engaged in applying for college courses. Reece had also managed to hold on to his school placement which had been under threat.
Family work – striving for peace
Jovaine was 8 at the time of referral, and I supplemented his individual sessions with family sessions roughly once a month. He had experienced physical abuse by his father and neglect by his mother, Donna. He had passed through a number of foster carers and was now cared for permanently by his maternal grandmother, Lynn. He saw his mother regularly. He had mixed Trinidadian, Jamaican and Irish heritage. He was very anxious about attachments to adults, had been diagnosed with ADHD and could become aggressive, often around transitions. He also sometimes soiled himself and often seemed to dissociate. The individual work felt important as a private space for him to process his trauma, but the family work also felt necessary as much of his difficulties seemed connected to family dynamics in the present.
In the family sessions, I initially worked with Lynn and Jovaine as a dyad, and then later we also collaboratively decided to involve Donna. Music was a central part of the sessions. Jovaine loved playing music in his individual sessions and was keen to play in the family sessions too. We improvised together and also performed renditions of songs that were familiar to the family. The music-making felt useful on a number of levels. First, it acted as a general interactive activity that demonstrated some of the relational difficulties in the family. Second, it had the potential as a healthy social activity in which positives could be developed. Third, it acted as a conduit for celebration of the family’s culture.
A number of patterns emerged both in the music and in conversation. Jovaine felt neglected by Lynn and would provoke her with what she described as ‘attention-seeking’ behaviours. Eventually, Lynn would either lose her temper or she might actually reach out to attend to him. If she tried the latter, Jovaine would often reject her attempt to meet his needs and she would then retreat into a resentful, neglectful mode again. This was seen clearly in the music-making, for example, Jovaine complaining that Lynn wasn’t listening to his music or rejecting her when she gave him an instrument to play. I highlighted the circularity of the pattern, even drawing a simple diagram to show them what I thought was happening. I aimed to reduce the linear blaming explanations that were taking place, with Jovaine being labelled as naughty and Lynn as neglectful, and to show that they both needed to cooperate if they wanted things to be different. I helped them write and perform two songs, one describing their vision for a preferred future for the family and the other describing what they both loved about each other. The idea here was to work in a narrative way, to help them think about more positive narratives about each other and themselves and also to inspire hope that things could change by imagining a different future, often a key aspect of solution-focused work. The idea of peace emerged with Lynn using the refrain ‘give peace a chance’ from the popular 1960s song by the Plastic Ono Band, and they both felt they wanted more peace in the family. Jovaine loved the song, naming it the Peace Song, and it became a regular feature of the sessions. We performed both songs with me providing a composed chord arrangement and Lynn and Jovaine using microphones to sing and improvising on the instruments as well. In the other song, they were able to celebrate positives about each other, including Jovaine’s affection and Lynn’s cooking. Of course, these ideas around circularity and narrative could have been worked on just verbally, but the songwriting seemed to help because it was hard for them to talk about their relationship without arguing, and the creative task seemed to act as a useful difference that brought them together and enabled their relationship to be explored more safely. We explored what was blocking the development of more peace. Jovaine thought that Lynn was jealous of him which I thought was a remarkable insight for an 8-year old. I explored this gently with Lynn and she conceded that she wished she’d had all the support that Jovaine was getting when she was a child. She too had had an abusive childhood and didn’t feel she had her needs met. We thought about how Lynn could have her needs met now, and this eventually led to her enrolling on an adult education course and considering finding a partner. She worried about the impact of the latter on Jovaine, but he was able to give her permission and liked the idea of having a new dad figure, particularly as someone who could help him with his football. This new conversation felt useful as it was helping them see the meaning of each other’s behaviours differently. There was potential to change their responses to each other as a result, and it was a conversation partly made possible by music.
We explored resources that could help them move forward, and their Christian faith emerged as important. Jovaine encouraged his grandmother to sing a song from church. She was reluctant but eventually agreed. She performed eloquently and emotionally, and I was close to tears throughout the whole performance. I accompanied on piano, improvising gospel-style chords to follow her melody, and Jovaine played the drums with chaotic exuberance. Musically, there was something both funny and moving about the combination of Lynn’s poised, graceful performance (vocally and bodily) and Jovaine’s hyperactive drumming which didn’t quite gel in a traditional musical sense but which absolutely made sense aesthetically and seemed to symbolise something quite beautiful about their relationship. I reflected on this with them hoping to highlight how their differences could potentially be a strength in their relationship. It also seemed like a real celebration of their culture, and I felt privileged to be a part of it.
I was aware of my cultural difference and expressed curiosity about this with them, asking whether there were any differences between their family culture and my White British culture that they felt were important. This led to Lynn admitting that she was worried that I would judge her use of physical discipline which she felt was acceptable in her culture. I asked Jovaine what he thought of smacking, and he said that he wished she didn’t smack him. We explored other attitudes to discipline in the family, and this led to Lynn questioning her own parents’ methods and a wish to be different to them. We touched on the abuse of Jovaine by his father, and I suggested that maybe smacking might have a particular meaning for him because of that trauma. This was a risk, as I was aware that she might see this as confirming her worries about me, but I also felt an ethical obligation to voice something on behalf of Jovaine that he would struggle to articulate himself. This made Lynn cry, and she admitted that she didn’t want to smack him but sometimes felt unable to stop herself. Jovaine went over to his grandmother and hugged her, and I acknowledged how sensitive and caring he was, just as Lynn had written about him in her lyrics.
We explored other disciplining methods, but I acknowledged this was really outside my expertise. Lynn gave me permission, though, to refer her for some parenting support. This systemic use of self-reflexivity and openness about racial and cultural difference felt important in terms of exploring any covert beliefs linked to such difference and encouraging potentially useful conversations. The acknowledgement of our difference could also potentially allow for any tensions that might arise from my possible association with White privilege to be explored in a way that might give the family more power in their therapy experience. McIntosh (1990) asserts that naming such differences in power by association is the first step in attempting to redress them.
Later sessions included Jovaine’s mum, Donna. These were often tense sessions. A theme of shame emerged, with Donna feeling like a failed mother and Jovaine feeling embarrassed because he didn’t live with his mother. We thought about the social construction of the ideal of mother–child relationships and then deconstructed some of those ideas with reference to different cultural beliefs. We also explored Donna’s strengths as a mother as well as the real limitations and what both meant for Jovaine. We also thought about the reasons why Donna was unable to be Jovaine’s main carer, and this included acknowledging her mental health difficulties and drug use, which Jovaine was aware of but didn’t fully understand. We placed these difficulties in the context of systemic factors like poverty, the lack of support available and community problems. This enabled him to construct a different narrative about his mother and about his journey through life. Jovaine suggested that Donna add some lyrics to their song about each other and so she wrote some lyrics about both Lynn and Jovaine, and then Lynn and Jovaine co-wrote another verse celebrating Donna’s positive qualities. Lynn and Jovaine also helped Donna join in some improvisations, and there was a moving sense of this co-created music symbolising her important place in the family, despite the separation involved. Jovaine would often move physically between Lynn and Donna during the music before settling in a place that felt right for him, and his position varied in different sessions. Often in systemic therapy, the idea of spectra or polarities is explored (Jordan, 1985) with the idea that people can be more fluid about where they want to position themselves, and this enactment seemed related to that idea.
After 14 sessions, we agreed to end, and this coincided with the end of Jovaine’s individual therapy. Things had improved significantly at home. There was no more smacking, the soiling had ceased and the family were responding to each other more positively. School staff also reported a reduction in Jovaine’s anxiety and tendency to dissociate. The space had been valuable for the family, but it also felt important to enable them to move forward without needing its support and they agreed they felt ready for that step.
Discussion
The systemic approach acted as a useful framework within which both the musical and non-musical elements of the work could be thought about with these clients. The music was an important part of the systemic work in a number of ways, but in particular as a social interaction that could act as a source of difference, resource and ritual and could offer a way of inhabiting what the family therapist Barry Mason (1993) describes as safe uncertainty. Difference is a key concept in systemic therapy, both in terms of exploring aspects of difference in people and also the idea of new information acting as a difference that can precipitate change (Bateson, 1972). Such information could be in the form of verbal language, and I would suggest that it can also come in a musical or more broadly experiential form.
Music can act as a rich resource in people’s lives, particularly with regard to young people. It can help regulate emotions, act as a celebration of culture and conduit for social interaction and aid in the development of personal identity. It can also act as a link between different systemic levels of context from the intrapsychic through different levels of relationship right up to the cosmic and transpersonal. Music can help clients reflect on their inner space as well as their connections to each other, their culture and their beliefs about the wider cosmos and their place in it. The latter transpersonal element of the music felt significant in both case studies, the religious music in the family sessions and the powerful repetitive drumming of the group. On a systemic level, music therapy has the powerful potential to access both the universal and the personal and all areas in between.
The ritual use of music is perhaps another specific way in which music can be employed as a resource. Ritual has also been used prescriptively in systemic therapy with families (Palazzoli et al., 1978). Rituals can act as a contextual container in which something meaningful and transformative can occur. With regard to adolescents, Frankel (2014) describes how initiation rites have largely disappeared from modern Western society and how adolescents may create their own rites through behaviours that may seem dysfunctional such as gang activity or self-harming. This links to the systemic concept of life-cycle transitions and how they can trigger problems. Music has the potential to act as a ritual to help people navigate life-cycle transitions. The boys in the group case study seemed to instinctively use music in a ritual way at times, and this felt appropriate to their developmental needs. In a different way, music was perhaps used as a ritual in the family case study as a way of holding a safe space for the rearrangement of family relationships. Finally, joint music-making can enable clients to interact with each other more reflectively in a way where old certainties are temporarily suspended, and there is an openness to new ways of being with each other. Mason (1993) describes safe uncertainty as the ideal state for clients in therapy where risk is balanced with security so that change can happen. If therapy is too safe, it will be unlikely to lead to anything new, and if it feels too dangerous, clients will be unlikely to take therapeutic risks. I would suggest that joint music-making, through its containing properties, can be a powerful way of creating the safety necessary for the uncertainty to be tolerated.
To summarise, I feel that the systemic approach is a potentially rich source of useful ideas for music therapy, particularly when facing some of the challenges inherent in contemporary multicultural work in settings where contextual factors like poverty and inequality are relevant. I hope that this article may contribute to the ongoing debate in our profession about what music therapy can be. To use systemic language, music therapy, like any discipline, is a social construct and as such has the potential to be constantly reconstructed in new ways to the benefit of our clients. I believe the systemic approach has a valid place as a potential influence in that reconstruction.