The Power of Therapeutic Relationships

The American Music Therapy Association’s description of our work is as follows: 

Music therapy is a clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program (www.musictherapy.org)

When I first began in the field 40 years ago, we had no evidence from research to inform our work. That would require 20+ years of waiting to truly begin. But we had client experience, versatile tools and intuition on our side. The set of tools and skills we developed allowed us to move forward with interventions that later would stand up to the trials of formal investigations. 

The import of therapeutic relationships has always been given great emphasis throughout the academic and clinical curriculum of music therapists and still is. We study, explore and experience how to observe and use our body language, how to prepare the patient emotionally for termination, how to encourage and motivate a person doing the hard work of recovery. We even train in the therapeutic relationships we have with ourselves so that we can continue to give by practicing self-care. 

The book ‘A general theory of love’ by Lewis, Amini and Lannon is the first resource I have seen to scientifically inform the experience of therapeutic relationships from a biological perspective. After 40 years of work in the field, it has provided me with insight to and affirmations of the clinical experiences that I have had. It not only informs the power of relationship but also the intuitive connections between people that advance therapy.

The authors speak of limbic resonance as “two mammals becoming attuned to each other’s state” (p. 63). It is the capacity of one individual to stabilize the neural functioning of another. When we meet with people who are anxious or in pain, emotional or physical pain, our calmness, our desire to serve as well as the familiarity and structure of music all work in their favor. There have been many sessions after which I felt exhausted or drained. Offering that type of stability to another can indeed be fatiguing. It is then that we as therapists must turn back to our resilience practices in order to be of service to the next person on our roster. We may each develop and have many different ways of doing that- breath work, meditation, meditation with music, movement, imaging, gestures, walks in nature. It doesn’t matter how we do it, it just matters that we do it. We need to continue to fill our emotional wells in order to do the beautiful work that we do. This makes perfect sense to me. What doesn’t make sense is why so many other professions don’t value these practices. Nurses, physicians and teachers come immediately to mind. Perhaps that is my message here- it matters that you give to others and it matters greatly that you create opportunities to work the inner peace circuitry of your brains to sustain these efforts in service of the common good. So what will your practices include?