Knowing as power, not knowing as empowerment

I've heard many times that knowledge is power. Power and empowerment is important to me - but there's times when power is abused and knowledge is misused.

When studying the social sciences, we are usually encouraged to lean into 'not knowing.' When I was first studying music therapy, it took me a little while to grasp the idea of 'not knowing' - but then I soon realised that it involved giving up power and control. Giving up power that I could read or control what might happen in the future and relieving the pressure that I should know everything.

What I discovered in the process was that there is a fine line to balance between not knowing and trusting what you do know. I also learned that not knowing could enable me to get to know a person beyond my own judgments and perspectives - and that not knowing meant I could allow myself to be grounded in the present...rather than caught in my past.

So here I am on the cusp of knowing and not knowing, where my intuition resides...and where connection is allowed. It's not always an easy place to be - as I'm only human...but I practice as much as I can because it is where things lift, move, change, evolve and happen.

Where's the science gone?

I love research. In my first year of music therapy masters I particularly fell in love with quantitative research and loved the idea of being able to conduct huge randomised controlled trials to show that music therapy is effective. In my second year, however, my love of research moved towards qualitative. So began this internal fight between numbers, logic, measurable findings - and - stories, emotion and individualised experiences of treatment. Both have a place in my world.

But - over the last few years, my experiences, conversations and reading have started me questioning the research that is thrusted into our lives whether we like it or not (yes - we are all effected by research even if we are not aware of it!).

During my music therapy life, I've been made aware by colleagues on the very experimental nature of psychiatric medications and that the trials are often funded by drug companies. At the 2012 Australian Music Therapy Association Conference in Sydney, I saw Dr Graham Martin reflect on his own experiences in challenging 'evidence-based practice' with 'practice-based evidence.' Then not long after, I came across this TED talk by Ben Goldacre: "What doctors don't know about the drugs they prescribe." For anyone passionate about mental health care, I strongly recommend you watch it.

This topic always makes me question why do we trust this research? Why is it that this poor quality research becomes the 'evidence base' of medicine and treatment? But then I also think. If I conducted a trial on music therapy and the results were negative - would I publish it? My initial thought was - of course not! Now, I feel like I would have an ethical need to do so. But I'm also aware now that other professions have studies that 'fail' - of course it's inevitable that all therapy and treatment trials will fail before they succeed. In failure there is a risk of being shunned and disconnected - so I worry that we are in a place where we try so hard to succeed, that we are missing the very point of research.

When I was at uni, we were told that scientific research should be empirical, sceptical, critical, tentative and open for the public. So my question is - where has the science gone?

The government tend to fund therapies and treatments that have a strong 'evidence-base.' Research is considered an ethical risk if an 'evidence-based' treatment was to be taken away from a participant. So what do we do? How can we prove ourselves, when the most trusted medical research has lost its scientific purpose? Do we keep trying to prove ourselves with quantitative research - and hope that they are positive and that we'll get noticed - or do we use the individualised stories of qualitative research because individuals respond differently to treatments anyway - with the chances that we don't get noticed?

For now - I'm just glad that I'm a clinician not a researcher. I will use the 'evidence base' to inform my 'practice-based' evidence in order to provide the treatment that I believe (and continue to observe) to be quality. Though I know I need to get my own knowledge out beyond the four walls of my own mind - so I will explore my research with the curious, scientific, sceptical and critical mind that research deserves.

The conformity box

As adults we so quickly fall into training babies and children to be adults. I think though that they have so much to teach us if we let them.

Conformity can begin from birth in our culture. There are many benefits. Conformity gives us rules and guidelines on how should dress, behave, speak and how not to dress, behave and speak. When it works well, conformity looks neat and tidy. So all in all conformity works right?

Maybe there is a home for it somewhere, but I haven't found it to be effective in my own existence as yet. If we don't fit into the neat tidy box of conformity (which we all experience at various points in our life if not every day!) we are considered to be weird, different, a loner, misbehaved, too quiet, too loud, mentally ill or essentially not good enough. If we do fit into the box, we spend every day putting all of our energy into keeping our place in the box. I have so many concerns on how this affects us through youth and adulthood.

I'm not gonna lie. I step into conformity myself. Sometimes I wish people would be just like me, I wish people or children would do what I tell them to and then other times I try to squeeze myself into the right type of clothes, the right groups of people and try to be the cool, calm, outgoing, in control person. These are the days I feel powerless and small no matter how successful I am at getting myself or others into that box. I believe that conformity breeds anxiety, stress, anger, depression, fear, self-hate, shame and possibly much more.

The days that I feel my best are the days that I let myself learn from the people and events in my life and surrender myself to not knowing (turns out I can't read minds or the future), creativity, play, curiosity and the gap in life. I didn't learn that from my family or my school education...I first learnt it through music, art and dance...and try to practice it in the way I play, rest and work :)

Where does conformity fit for you?

Life has a gap in it...

Life has a gap in it. I can't offer any scientific evidence for that...just my own life experience and observations. I also stole the quote from a character from the film "Take This Waltz" who happened to be recovering from an alcohol addiction.

So what do we do with this gap or hole? Most of us try to fill it up in some way. Some of us use alcohol as our weapon of choice, while others use drugs, perfectionism, food, work, image, sex, violence, self-hate, hate, isolation, anger, anxiety, control, stress, Facebook, technology, exercise, religion...and I'm sure there are many other options available. My personal choice can be food, work or perfectionism depending on how resilient I'm feeling.

There is such a stigma for those recovering or managing addictions with alcohol or drugs...but often our culture almost applauds those who overwork, overexercise or those who chase perfectionism. But these things may be just as detrimental to our mental and physical health as the well known stigma driven drug and alcohol addictions. Often addictions help us to function in everyday life, but they can also drive us back into the very hole we were running away from.

What is the hole?

I think it's many things. It's vulnerability, purpose, meaning, presence, mindfulness, love, soul, life, laughter, awareness, creativity, spirit and possibly a number of 'wishy washy' words that are avoided in everyday conversations. So we have 2 options now. Try to fill the never ending gap or accept and cultivate the very reason it's there :)

"Life has a gap in it, it just does. You don't go crazy trying to fill it." - Geraldine, Take This Waltz

What is mental illness?

Ok mental illness is out in the media again...and now the DSM-V has psychiatrists split 3 ways about what mental illness actually is. Is this a turning point in mental health care?

I write this post with somewhat hesitance. On part, because there's a part of me that feels I need to serve  my standing in the hierarchy of mental health care and watch the 'experts' make a decision - and then my personal need to be respected by medical professionals. So I'm going to put my 'professionalism' on the line and chat about what mental illness means to me.

I can see how diagnoses came to be important as psychiatry developed in the 1900s - and I do believe that they serve a purpose to an extent. I often see how it can be helpful for people to receive a diagnosis - but I also see the other side - when it is really unhelpful...and where a diagnosis begins to define who a person is - resulting in a lesser capacity to make a recovery. Here I'd like to share why I personally do not refer to diagnosis directly - but prefer to work with the whole person.

I truly believe we are all on the spectrum of 'mental illness' or rather mental health. The book, "We are all weird" by Seth Godin - while I have not read it yet - I think will sum it up when I get around to it (see below)!

While we are all on the spectrum of mental health - at varying times we have more resilience and protective factors keeping us going...and sometimes our risk factors are holding us back from living a full life. There are some people with numbers of risk factors - but yet seem to bounce back with no troubles - then there are some with a few risk factors that have difficulty engaging with life. Then there are some with so many risk factors who have never had the opportunity to build on their resilience. What would happen if we looked at building resilience to improve a person's capacity to bounce back from adversity? Did I lose you at risk and protective factors? I can't find any good simplified links that explain the concepts - but will keep looking...or I might just have to write another blog post :)! 

Ultimately, I believe this is what the recovery model is about - and I am really excited that psychiatry is starting to take these elements into practice....and so begins a culture change in the world of mental health...

Maybe it will fit into the Press Play vision?
"A world where creativity, music, culture and collaboration are valued factors in mental health prevention and intervention."

Music therapy, medications or talking therapy?

Throughout my time practising as a music therapist, I have worked closely with the 'talking therapies.' People often wonder what added benefit there is from music therapy - especially when talking therapies, (specifically Cognitive Behavioural Therapy) and medications are the 'evidence-based' therapies at present. What do you get in music therapy that you may not get in talking therapies alone?

Holistic treatment
Often talking therapies are based at a very 'cognitive' level. This works really well for some people, but in some cases a person may not be in the right headspace to rationalise or process cognitively; and in some cases talking therapies can be a welcome opportunity to intellectualise our thinking or doing - which can impede on our capacity to make active change in our lives.

Pharmaceutical therapies, while very effective to stabilise mood and chemicals in the brain are known not to be effective without additional therapeutic support. Medications may assist to kick-start therapy, however, I work from the understanding that particular experiences produce long lasting changes in the brain and body.

Through music therapy, I work with an individual from many different angles. I am aware that many of us (including myself!) cannot work at a cognitive level until the rest of our system is more 'in sync.' Therefore, I may focus more on physical or physiological functioning, state of arousal, sensory systems, motivation, meaning and/or emotions through music based experiences to better prepare our brains for processing and understanding challenges, traumas or memories - to then move towards empowering individuals to 'press play' or 'author' their future.

Individualised treatment
I'm aware that many therapists and therapies aim to cater directly to the individual - but I'd like to share how I may be customise therapy according to who I'm working with.

• Every session in music therapy is different - while I do work from specific structures and frameworks - everyone has a different brain and body - therefore, I adapt everything according to the unique needs and dreams of every person I work with.
• I work with whatever is brought into therapy. Regardless what may have happened in a previous session, I find it really important to check in with what a person brings into the room with them - before moving on to their long term goals
• Whatever is important to you is important to me (sorry for being a little cliched!). I don't write goals for you - we work together to find out what you'd like to get out of therapy - I will make some suggestions based on your personal values, but your motivation to be in therapy and life is what will take you to those goals and your purpose.
• What music works for you? What music doesn't work for you? What does music mean to you? What is meaningful to you? We'll use music in a way that addresses your needs.
• The communities, cultures, and people we are surrounded by also play an important role in our identity. For this reason I also consider the way a person fits into the map of their communities or families and how this may need to be changed for a person to recover from their immediate challenges.

Music

We use music as a tool to make chemical changes in our brains and bodies or to establish or strengthen pathways in the brain. We use music to help us feel, connect, communicate, express ourselves, think or do. We use music as a health resource - for you to take and use in your every day life. Music is powerful. Relationships are powerful. Combine the two and you get music therapy.

So music therapy, medications or talking therapy...which one?

It depends on what works for you :)

I firmly believe (and research supports this) that the therapeutic relationship is imperative to recovery. Some people don't respond to music therapy and others will only respond to music therapy.

Regardless, each person needs to find what works for them.

Introducing....Drumroll....

The Press Play Music Therapy Rebate.

Ok. I am 30% excited, 30% curious and 40% scared out of my brain about my new Pozible campaign to establish funding for a music therapy rebate.

However, the passion behind this project is what drove me to set it up. The majority of people who would like or need to access music therapy cannot afford to pay full fees. However, music therapy is not yet supported by medicare or health fund rebates. My professional association (Australian Music Therapy Association) is working closely with the government to make these changes - however it can take many years before change is actioned. So...instead of waiting for the government to catch up with current research and practice, I'm taking my own action to establish an alternative.

Some of you may be familiar with the concept of crowdfunding, but for those of you who aren't - crowdfunding is a platform to source small amounts of funding from a large group of individuals as opposed to a large sum of funds from fewer investors. I've chosen this platform as a) it allows me to know how viable my project is (ie. it won't go ahead if I don't have enough financial support); b) it is a sustainable way for me access funds without going into debt and c) I can give financial supporters a reward in return.

Please join me with this campaign. It just takes 3 steps.
1. Share the video/link with your friends and contacts
2.  Pledge how much you feel my project is worth (or how much you can afford) from $1
3. Collect your reward (once the project is successful you will receive your reward)

Please note that credit cards will not be charged until the project has reached my target goal of $3000.

See www.pozible.com/pressplaymt for more information about the project, awards and to make your pledge.

Thank you thank you thank you!!!!

Playing with boundaries

2013 has brought many changes for me. Over the last 3 year's I've set value based New years resolutions. 2010 was simplicity, 2011 was freedom, 2012 was truth, but this year it was mindfulness. I talk about mindfulness every day, but I decided that this year I had to make action and physically make it a part of my life. You know the whole 'practice what you preach' kind of thing. The more I've been experimenting with mindfulness (I say experiment because practice sounds like it needs to be 'perfect'), the more I've realised that boundaries are a core part of it.

We all have boundaries. Some stay close to us while others blur into someone/something else, but ultimately boundaries define who we are and who we are not... they're not easy to set because they take a whole lot of self-respect and self-compassion (which kinda goes against the grain of the western world).

My online presence. I've recently set up a website, blog and business facebook and Twitter account about something that I'm very passionate. I'm exposing my self in a new way to the world. I wouldn't be able to do this effectively without checking in with myself and acknowledging when I do overstep my limits.

Work. I recently restructured my work so I'm working more inline with my own values and giving myself time to be more mindful of my actions. But this also means that I have to remember to clock off even if I'm in the middle of something I'm deeply passionate about/or something that is sucking my precious energy dry.

Play. I'm focusing on making play and creativity my priority. This admittedly doesn't come naturally and it means I HAVE to set aside time where I consume myself 100% with my own immediate needs and the important people in my life.

So here is where my boundaries lie.

Somewhere between myself and my computer (I know I lose sense of who I am and my social skills/capacity when I've spent all day at a computer screen).

Somewhere between myself and my work. My work is only a part of me - but the more time I invest in it, the more it becomes me or just the same, I become my work.

Somewhere between myself and the people in my life. I need people in my life but I cannot please every one - therefore I need to look after myself as well so I can be present with both my own and other's needs. There's a line somewhere between me becoming someone else (and losing my voice) or others becoming me (and losing their voice).

And...

Somewhere between myself and creativity...this one is blurred for me at the moment - as I believe that when I'm in a state of creativity and play - I'm being authentically me (though I can imagine that if I was in the public eye for my creativity I could run the risk of my products defining who I am as a person rather than a representation of a certain experience).

Boundaries will be stretched, dented and squeezed...but I and we are only human. If we don't play with boundaries, how do we know who we are - and who we are not?

It's all part of the dance...

When the stop button can't be close enough...

Sometimes when music is on, the stop button can't be close enough. Often, people talk about music being something that helps them to feel better, but this isn't always the case. I can't give any 'diagnoses' or specific reasons for why this happens...but I thought I might open space for the conversation.

Some people have never been able to listen to music. It's just noise. For others, there was a time when music was a large part of their life, but for known or unknown reasons, they can't listen to it anymore. Then of course there's the times that listening to music just makes us feel worse (this is probably a whole other blog post!). I'd like to share how my mind understands these experiences.

Music and emotion
Music can be an expression of emotion. Often when we've experienced certain life events (or ongoing/prolonged life events) - such as a trauma or loss, our body and brain step into protection mode to reduce the pain. However, when this happens, we lose sense of not only the pain, but all emotions - leaving behind numbness, anxiety or anger. If our body isn't ready to feel, I sense that turning music off, could be our body's way of protecting itself from pain and connection.

Music and memories
Music has this amazing capacity to take our minds back to a certain event - whether it's a party, funeral, or a song that reminds us of a particular person or relationship. This can be great when it's a good memory at the right time, but it can also trigger memories, moods and physical reactions that we'd prefer to leave back in January 1983 or August 2004. This then may lead to the response that I mentioned above on music and emotion.

But...we cannot escape music (it's everywhere now!) - and sometimes we'd just like to be able to enjoy music (or life) again.

As I mentioned above, I'm a big believer that we chose not to listen to music because we are protecting ourselves - it's a way of coping and managing the feelings that are too big for our body to contain right now. It can get to a point though, where this self-protection actually hinders us from moving forward.

I facilitate in-patient music therapy groups for people who've experienced complex trauma. Some have said they cannot listen to music due to their life experiences. Some won't attend music therapy initially (I think even not knowing what music therapy is can be frightening in itself). During the first few sessions some people will stay in the room for 5-10 minutes before leaving. By the 3rd or 4th session the same people will remain in the room for the whole session. By the 5th or 6th (or later)* session, the same people will remain in the session and experience moments of 'feeling' whether it's through crying, laughter, experiencing a moment of peace, contentment or expressing grief and anger (or sometimes all of the above). Some 'feel' for the first time in music therapy and others express themselves for the first time. I feel really fortunate and honoured to be apart of these vulnerable moments.

*Please note that these sessions usually occur over 1-2 years due to the nature of the program.

So how does this process eventuate? I don't think I can do justice to the amount of strength, courage, vulnerability and determination it takes for people to move through this process. In fact, I don't know exactly how it happens (one day I'll do research on it!), but my thoughts are that it stems from building resilience. I think that resilience is different for everyone - but I particularly identify with Brene Brown's model of shame resilience (see this post for more). As well as resilience, it involves a lot of grounding to the present moment (we often refer to breathing, taking note of items in the room or holding items in hands). Some people are able to build their resilience through their existing relationships. Others, however, may not have access to the empathy or compassion they need, so may turn to building their resilience through the help of a therapeutic relationship. Ultimately, however, it is through this connection that we can hopefully access the resources we need to feel and move through pain so we can experience the full platter of emotions that enable us to enjoy, appreciate, grieve, cry, laugh or just be.

...

This is just the beginning of a conversation. A conversation that might give you food for thought - or one that you can contribute to yourself.

Ordered chaos

At times I think about how I'm going to order this blog.  But then I realise that the reason we have creativity and play is because life is undeniably messy and some things just aren't meant to be tidied up. So there you have it. This blog may have no order at times, but will just represent what is important to me at various points in my days or weeks.

Welcome to my organised chaotic paradise.

Creativity - a missing link in mental health?

One thing that I always notice in my work - is that adults are often afraid to make music or sometimes engage in music therapy because they might get it wrong. Why? I mean as children we're always trying something new - making up our own games - unafraid. But something happens and we lose that courage to just have a go. Our education system is set up for us to get jobs and that there is a right way and a wrong way. So you either keep trying till you get it right or you get it wrong and then give up - or not try at all - cos if you don't try at least you don't have the chance for failure.

So who decides what's right and what's wrong? When we come into adulthood and discover that there are no rules for sustaining or forming relationships - there's no rules on creating the lives that we want - no guidelines on being human - no rules on expressing our authentic selves - we start to get a little lost...possibly because we have not been taught to create without borders.

I believe that creativity in education is essential - and it is missing in the way the learn as children, young people and adults. Without creativity we become afraid of what could go wrong instead of thinking of the wrongs as being part of the process. I also wonder whether there is a link between the way we educate - and the cognitive distortions we take on?

I also believe that creativity in mental health recovery is essential. Creativity develops many life skills:

• The ability to see one situation from many perspectives
• The ability to feel emotions and express oneself authentically
• The ability to make connections
• The ability to engage in the present moment or understand the past
• The desire to make change and try something new
• The ability to withhold judgment (from the self and others)
• and I'm sure many more...

Need any more excuses to get your creative on?

Inspiration from YouTube

Thanks to the world of social media, I was introduced to this video approximately 18 months ago - which inspired my interest in 'shame resilience.' I was always interested in vulnerability and connection - and Brene Brown put it into the language I was searching for!

You can learn more about her at www.brenebrown.com.

Enjoy...
 

Why Press Play?

So why the name Press Play? For me, it means so many things, so I thought I might take some time to share...

Press Play (music)

Press play on your iPod, MP3 player, Record player, Cassette player, Discman, Walkman, CD player, radio...it could make a difference to the way you experience the moment.

Press Play (as opposed to rewind, fast forward, pause or stop)

Sometimes our heads live on rewind (shame and anxiety about the past) or fast forward (fear and worry about the future). For myself (and the research also suggests), I work better when I'm living in the present moment. So through my work in music therapy, I hope to help people move from rewind/fast forward to stop or pause, so they can press play on their lives.

Press Play (on your own life)

Sometimes it feels like someone else has control of the remote of our lives...whether it's a person in our lives, our career, an illness or our past...being able to set your own values, beliefs, goals and to take action can be the most empowering thing that can happen.

Press Play (and rest and create)

Traditionally adults don't play. I'd like to put a change to that - because when we don't give ourselves a chance to play, we don't give ourselves the chance to live fully. Play outdoors, dance, play music, play with your family. And...while we're at it let's also rest and create - because without those things we have a tendency to lose sense of who we truly are.

so to cut a long story short... please take some time to Press Play in your own way :)

feel free to contact me at info@pressplaymt.com for more information.