Music-Centered Music Therapy
Aigen, Kenneth (2005). Music-Centered Music Therapy. Gilsum, NH: Barcelona, Publishers (322 pages). Reviewed by Rudy Garred, Sogn og Fjordane University College, Norway

At a convention for mathematicians a toast, reportedly, was proposed: "To pure mathematics, and may it never be of any use to anyone!" As we all know, mathematics has indeed been of much practical use, and shouldn’t mathematicians, of all people, be very pleased and proud about this? Still there is a sensibility revealed in this (jokingly, natually) proposed toast, of appreciating in some sense, the real, inherent value of mathematics, which ultimately would not necessarily be less if it were not useful for anything at all. And which could tend be "wiped out" of the picture, if the only reason for mathematics was its practical use. – Wherefore, presumably, the toast. Something of the same sensibility, of course, may readily be found with regards to music. "Pure music" is rather "useless" maybe, as commonly perceived (and in this respect probably less to worry about than "pure mathematics"). But music therapy is after all applied music. So how do you reconcile the appreciation of music as such with its therapeutic application? It might seem that this is the difficult task that a theory of music-centered music therapy needs to meet, and which Ken Aigen in his book Music-Centered Music Therapy makes some grand efforts at accomplishing.

Let me state at the outset that this book clearly must be regarded as a milestone in the literature on music-centered theory, both in the depth in which the issues are dealt with, and the in breadth of scope of theory that is presented. It is comprehensive in the coverage of music-centered thinking and practice, both historically, and in the inclusion of current frameworks and discussions. Furthermore it is original in presenting new contributions, developments and elaborations of theory.

Aigen first of all clears the way for his endeavours in the first chapter, by indicating his meta-theoretical position, on "The Nature of Theory," which is quite clarifying, but a rather "heavy" start. Aigen actually suggests that the first two chapters may be skipped if one is well acquainted with the matters. I would suggest that they might be read afterwards as well. In particular the second chapter, on "Theory in Music Therapy," which makes an advance on earlier discussions on the role of theory in music therapy, - his own and others’ writings as well. Aigen argues for music-centered theory as a platform for a general theory of music therapy, on account of the medium of music being central to all approaches and frameworks of music therapy. A music-centered theory could therefore serve as a unifying focus for a general theory, he proposes.

In chapter 3 Aigen traces origins of music-centered therapy, and clarifies foundations for a music-centered theory, considering the notions of medium, (Dewey) and of musicing (Elliot), and of the necessity of a theory of music as a basis for music-centered therapy. He writes:

This is a quite radical stance. One might question if music therapy is about music. Aigen nevertheless argues for the relevance of using notions of music from a non-clinical context as a basis for music therapy, taking Charles Keil’s notion or participatory discrepancies as an example here.

In chapter 4 Aigen explicates values central to musicing, as they apply to music-centered therapy. He sees music therapy in the context of an investigation of the nature and of the significance of music for human beings, in which a discussion of values becomes crucial. Some of the musical values he finds are: an understanding of silence, a requiring of listening, incorporating of the individual within the communal, involving surrender, cultivating a respect for craft, and creating connection. I think Aigen here does a great service to the field in bringing out and attempting to explicate musical values and their relevance for therapy. This is a basis that I believe has not been sufficiently recognized and that this chapter, both in the contents and in the attempt itself, points to in a significant way.

Chapter 5 is quite densely packed with "rationales, practices and implications of music-centered music therapy." Aigen makes some effort in establishing a rationale in which "music goals are clinical goals," based on a notion of a convergence of personal process and musical development. I do get a feeling here of this becoming somewhat one-sided, of making maybe rather too much of an equation of personal and musical development as such. Still Aigen does expand his view, taking into consideration intrinsic rewards of musical participation that may be found in creative dimensions, expressive process, aesthetic dimensions, communal dimensions, and transpersonal dimensions. He insists in music being an autonomous clinical force, and that the therapeutic relationship is a musical relationship. This is probably where some might raise objections as to the side of therapy in all this, and the role of the therapeutic relationship. But Aigen keeps an insistent focus on music, putting forth the view that the experience of the musical process is the therapy. Whether or not one agrees with the argument, in all it ramifications, it is very consistently developed, and from many different angles, which makes it well suited to bring out different aspects of the issue, to relate to.

In chapter 6 Aigen shows how music-centered aspects may be found to be present in the major models of music therapy, such as Analytic Music Therapy, Guided Imagery and Music and not least Nordoff-Robbins music therapy, which as it originated is regarded as the music-centered approach. In the following chapter music-centered perspectives is traced in contemporary music therapy frameworks, such as Aesthetic Music Therapy (Lee), Community Music Therapy (Ansdell), and Culture-Centered Music therapy (Stige). Aigen warns at the end of this chapter against a proliferation of conceptualizations if these are not also developed with a concern for consolidation as well as differentiation.

Part III, chapters 8, 9 an 10, constitute a core section of this book in that it presents an original contribution to music-centered theory, presenting and applying on the one side so-called Schema Theory, developed by Lakoff and Johnson, and on the other Zuckerkandl’s dynamic theory of tone, in an effort to outline a broad-based philosophy of music for music-centered music therapy.

Lakoff and Johnson have introduced a philosophical perspective on human cognition based on the notion of metaphor. The basis for metaphoric thinking, according to Lakoff and Johnson, may be found in image schemata, such as CONTAINER, UP-DOWN, CENTER-PERIPHERY, PART WHOLE, FRONT-BACK, LINK, FORCE, PATH. This perspective has been applied to many fields of inquiry, and also to music. Aigen extends the application that has been made of schema theory to music further to music therapy, in this way considering that the theory is music-centered, in that it builds on an application of theory that has originally been applied to music. Aigen makes a series of claims as to how schema theory can provide a philosophical grounding for music-centered therapy. He presents the notion that music may provide a compensatory experience of basic schemata, which are fundamental for all cognitive development. The basic idea seems to be that music may provide an avenue of experience that may provide development of basic schemata, that some people otherwise may not have had the opportunity of developing. Aigen explains:

This is a daring application of theory. I am not sure whether it actually is music-centered according to Aigen’s own criteria, or whether it actually moves beyond this. And I am not sure whether the claim holds, or even how it could be either validated or refuted. I think it would need to be substantiated more to be really convincing, empirically not the least, but also theoretically, because it seems that a strictly music-centered stance theoretically might become to narrow with regards to the therapeutic effects or outcomes that are indicated. Aigen however does provide an abundance of illustrations as to how different schemata may be applied to music therapy, such as verticality, part-whole, source-path goal, container, (with and inside, outside and boundary), time-as-space, force and motion in music, which are all highly suggestive and stimulating to consider.

Aigen gives a well informed presentation of Zuckerkandl’s theories of music, which have been much referred to in music therapy theory. His presentation is by far the most thorough in the literature, and he clearly brings out the relevance of Zuckerkandl’s for music centered theory. He also refers quite extensively to objections that could be made to these theories, and how they may be effectively met. But then a problem presents itself, how to reconcile these two theories, Zuckerkandl being mostly ontologically oriented, while Lakoff and Johnson present a constructivist epistemological view. Aigen devotes a chapter on trying to see how these may be brought together. And while he maybe does not achieve this completely, and also recognizes and acknowledges this, he finds nevertheless that it is possible to find a "reasonable accommodation" between the two. I find this chapter highly interesting, and intriguing, in that it opens a discussion that is really not settled, but which nevertheless is significant, on what musical experience is, from a realist versus a fictionalist view. This is actually a major quality of the book as a whole, I would suggest, that it brings out crucial issues that may well be discussed further, opening up the field of inquiry in the very attempt to bring the field together theoretically.

In the last part of the book Aigen completes the picture, in that he addresses other dimensions of music such as context, experience, and interactional processes. He elaborates on Ansdell’s notion of the "quickening" effect of music (from Oliver Sachs), animating the spirit, and, consequently, the body, relating this notion both to schema theory and to Zuckerkandl’s outlook. He also considers the notion of developing an I-Thou relationship to music, and change in the sense of self that may follow from this.

In chapter 12 Aigen presents, I find, a very clarifying discussion on music and emotion in music centered thought, applying both Susanne Langer’s and Peter Kivy’s aesthetic theories here. Kivy’s distinction between music expressing and being expressive of is highly relevant for music therapy. Aigen actually makes a distinction between four aspects: 1) music expressing a client’s emotion, or 2) being expressive of a (different) emotion, 3) evoking (some other) emotion in the therapist, or 4) creating a (new) emotion in the client. It is clearly necessary to keep these aspects apart in any discussion on music and emotion in therapy, which this chapter then is really helpful for.

In the following chapter Aigen presents the concept of life-force, as this may be found in the philosophy of music, and relates this to the issue of transformation. Although I find this relevant and significant, again it seems to me to be too simple to equate musical transformation and personal transformation, as reflected in statements such as: "As music unfolds it develops, and as we identify with it we experience ourselves as similarly developed." (p. 269). But this is maybe just what a music-centered stance is about. I guess it will have to be up to each reader to decide how to relate to this kind of outlook. Aigen also refers to Carolyn Kenny’s notions of ritual and myth here, particularly the "Hero’s Journey," which broadens the outlook somewhat, relating this further to Zuckerkansdl’s ideas about music.

In the last chapter 14 Aigen makes use of the schema of CONTAINER in an examination of musical themes or melodies as these may be related to self-identity. A case is referred to here, about Lloyd, who experienced the E dorian theme as a CONTAINER through identifying with this theme in improvisation with the therapist and co-therapist, and through which a variety of positive clinical experiences issued. This is one of very few clinical examples cited in Aigen’s book, to illustrate how the thinking he presents may be applied to illumine clinical practice. One could wish there was more such examples, which might have been clarifying. But then this is also something that might be a future prospect to provide, by the author, or by others finding this frame of understanding useful in bringing out qualities of music-centered clinical practice.

In the last part of this chapter Aigen draws a correspondence between musical transition and transitions in life, relating this to a discussion of Turners concepts of structure and anti-structure, which are linked with the notion of liminality, (which was introduced to music therapy writings by Even Ruud.) Then he elaborates somewhat more on CONTAINER as a metaphor for therapy and for life, seeing how there may be a series of transitions between musical themes and genres as containers within therapy, and further between therapy session to therapy itself being a container entered into and out of, through the course of life. Finally there is an emphasis on the spiritual aspect of music facilitating entering into and staying within a present moment: "To live in music is to experience how the goal is a means to achieve a path, not the reverse." (p. 303).

In an after word Aigen considers the implications of this kind of outlook for the societal role of music therapy, seeing that practical concerns might indicate other kinds of thinking and legitimization, connected to other kinds of outcome that what a music-centered perspective will emphasize. But he nevertheless insists on a music-centered stance as more fundamental, and that he proposes should remain at the core of the work, for credibility in the long run.

There is a passion for music evident throughout the text of this book, and for the inherent benefit of musicing itself. Aigen takes a clear stance, and though not everyone could be expected to follow every single line of thread of thought, this is a work that deserves attention by any music therapist serious about the thought behind practice, and the potentials of the medium of music. This book is a veritable sourcebook of insights and at times provocative thoughts that I believe will prove hard to come by. Even if one might not regard oneself as belonging to the league of hard core music-centered practitioners it is quite clear that any music therapy will apply music in some way, and whatever the position one might take, it is valuable to have the music-centered stance formulated so uncompromisingly, and through such a variety of angles and approaches. Even in disagreeing on one or two points, or more, it is well worth considering, because it may prove challenging and stimulating to align the perspectives drawn here with one’s own outlook on music therapy practice, in any case. In that sense it does serve as a general theory. For anyone interested in keeping up with state of the art music therapy theory this book indeed is, and will remain for quite some time I believe, required reading.

This bookreview was released December 12, 2005. ©2005 Nordic Journal of Music Therapy

Music-Centred Music Therapy

by Kenneth Aigen
Barcelona Publishers (2005)
322pp. Pbk $46. Available from the BSMT price £30
ISBN 1 891278 25 8

Reviewed by Leslie Bunt

The music therapy community has been waiting for this kind of text for some time and Kenneth Aigen is well positioned to be the colleague to bring together and evolve, within one carefully-structured volume, thoughts and ideas that have been fundamental to his clinical practice, research and writings for many years. He is not presenting a further music therapy model or approach here since, as stated at the outset, he has ‘conceived music-centred thought as an attitude towards music and music therapy possessed in relative degrees among clinicians and theorists from a variety of orientations and working within a variety of clinical models and treatment milieus’ (Preface, xvi). Working in a music-centred way is clearly part of Aigen’s identity as a clinician, yet he is open and mature enough to acknowledge that for other colleagues it may only be aspects of this term that relate to their work. He is also clear that he is not proposing that all features of this kind of thinking are applicable in all contexts and for the needs of all clients/patients. Consequently there is a great deal of material within this text that will be of interest to music therapists from different theoretical and philosophical perspectives. I strongly recommend that it becomes essential reading not only for music therapists in training but also for colleagues curious to explore the musical roots of their practice.

This text takes us to a new watershed in the continuing debate between the need to look to external references to validate our work and the internal search using music and the musical processes inherent in music therapy as a unique and more indigenous mode of inquiry and validity, namely music being used to explore music therapy. I can certainly see this text becoming pivotal in a dialectical process that is very much part of our on-going development as an academic discipline, even if at times it is not given the space and attention it deserves. With the profession of music therapy reaching the grand old age of sixty in the US and nearly fifty in the UK we appear to have the necessary confidence and assurance to bring the music-centred themes within this text well into the open. Only seven years ago Elaine Streeter wrote an honest and thought-provoking paper in this journal (Streeter 1999) that proposed finding a balance between musical awareness and psychological thinking in order to understand the music therapy relationship. She used one psychological perspective, namely a view from psychoanalysis, in order to demonstrate how such external views could enhance our understanding of the musical process and protect therapeutic boundaries. Streeter’s piece was provocative and Aigen was one of four respondents to Streeter’s challenge in the Dialogue section of the next issue of the journal (Aigen 1999). Here in this new text Aigen has found the opportunity to reflect and expand on many of the ideas that were spotlighted in that response.

The book is divided into four parts: the first providing the context for a Music-Centred Music Therapy Theory (capital initials being used in the rest of this review); the second explaining its origins and exploring some current applications; the third returning to a more philosophical foundation for MCMT based within some theories of music with the final part presenting the basis of a general MCMTT that I hope will become the basis of further exploration and research. In his Preface Aigen provides a useful road-map for readers who may be familiar with certain theoretical aspects and who may wish to start their reading of the text at different junctions.

At the start of Part I is a discussion of the nature of theory and I agree with Aigen that the timing is right for a book of this kind given that we have been building up observations of music therapy practice in a variety of contexts and that we can now move into a period of reflective theory building. As in most of the more theoretical sections of the text, Aigen is careful not to immerse the reader in too much complex theoretical discourse. He introduces examples, here a consideration of the work of Freud and Darwin, to enliven and lighten the text. In many ways Freud is a good exemplar having built his theoretical constructs from extensive and detailed clinical observations from his own practice. He told his stories and evolved his constructs from them. Music therapists still have many stories to tell, out of which we can begin to build theoretical constructs in the way that Aigen has begun to do in this text.

Before moving to detailed elaboration of MCMT Aigen provides a thorough contextual analysis of music therapy within different categories of inquiry. Here he refers to the important work carried out over recent years by Brynjulf Stige and Kenneth Bruscia in helping us understand the complexities and overlaps of the various reference points within music, health, therapy, education, philosophy and so on. This material will be familiar to many readers but it is useful to have it reviewed in such a systematic manner. There have been previous attempts to build a kind of foundational theory in music therapy and traditions rooted in behaviour therapy and psychoanalysis are highlighted here, although of course it has not been possible to apply any one theory to all contexts. The musical intelligence demonstrated by participants in a music therapy process is a further kind of valid inquiry and one that appears to evolve internally and from the bottom up. In exploring notions of a general theory (and Aigen prefers this term) he refers to the writings of Carolyn Kenny, particularly her emphasis on respecting the tension between what is both unique and general in music therapy.

Part II of the text begins with a discussion of the origins and foundations of MCMT. Links are made with Bruscia’s formulation of music as therapy and roots located within two current music therapy approaches: on the one hand, Creative Music Therapy and the writings of Paul Nordoff and Clive Robbins and those researcher clinicians trained in that approach, for example Gary Ansdell (particularly his contribution of the nature of quickening in music), Colin Lee (particularly his work on aesthetic music therapy) and Aigen himself; and, on the other hand, Guided Imagery and Music (GIM) and the writings of Helen Bonny and her colleagues such as Barbara Hesser and Carolyn Kenny. I find the links drawn between these two approaches totally absorbing although, as a GIM practitioner, I must acknowledge a certain bias towards respecting the central place music holds within GIM, with our prime responsibility as GIM therapists to facilitate as deep a relationship to the music for our clients as possible. What is intriguing is that Aigen’s assertion that ‘the mechanisms of music therapy processes are located in the forces, experiences, processes, and structure of music’ (p.51) is relevant both to the active improvisational processes within the Nordoff-Robbins approach and the receptive processes in GIM. The discussion integrates the common elements, drawing more parallels than differences, highlighting the way that a music-centred position is not driven by any one approach or specific to a particular model.

I think it is fair to say that many music therapists, perhaps even the majority, would consider that music is used in music therapy to achieve so-called non-musical goals or outcomes, in accordance with the old adage that music is being used as a means to an end and not as an end in itself. In contrast ‘the goal of music-centred work is the achievement of experiences and expression specific and unique to music. In this view, the clinical and the musical are not separable. What is achieved through the music cannot be approached in any other way because musical experience and expression are the goals of therapy.’ (p.56) In spite of this central focus, Aigen points out time and time again that music-centred work can lead to benefits that are of a so-called non-musical nature, but that these are not the sole reason for undertaking the activity. Our patients/clients make music or listen to music with us as their attendant therapists and this is the motivating factor. In this second section of the text, Aigen begins to explore theoretical concepts that support this thesis and I encourage readers to be open as they can to make the journey with him, even if at times his views may be in complete antithesis to an individual’s personal orientation as a therapist.

Many music therapists will need convincing by the topics Aigen chooses to support his thesis and I can only begin to highlight some of the themes he brings together. Chapter 4 touches on the idea of musical values, particularly those integral to the concept of musicing: understanding of silence; deep listening; the incorporation of the individual within the communal; a respect for craft; the need for surrender and the primacy of making connections. There are further rationales in the following chapter with more discussion of the primacy of the music as the key experience for clients with musical goals resonating with the clinical goals, processes of personal transformation and growth converging in detailed congruence and symmetry with the way in which music unfolds and works. Aigen has always had an interest in the philosophy of music and I found his introduction to the work of Peter Kivy in this chapter illuminating. Traditionally within expression theory there is a split between the music itself and the experience transmitted from the improviser/composer to the listener with the primary role of the music to be expressive or to symbolise emotion. Aigen draws on Kivy’s distinction between “to express” and “to be expressive of”, noting how music and MCMT can do both and referring to Nordoff’s maxim that ‘we use very little expression in music. We use expressive components in music clinically’ (p.99).

Aigen looks to music theorists to help us further our understanding of MCMT. I am particularly grateful to Aigen for elaborating on schema theory as a means of musical analysis. This metaphorical elaboration of the many ways that we think and act both inside and outside the music therapy room will be of great interest to colleagues of all persuasions. Schema theory is holistic in nature, linking body and mind, emotion and cognition and meaning of actions. Elaborating from the pioneering work of Lakoff and Johnson, with which many colleagues will be familiar, Aigen provides examples of schema that appear in music therapy, for example: CONTAINER, UP-DOWN, PART-WHOLE, FORCE, SOURCE-PATH-GOAL, LINK and the musical metaphors of MUSIC IS MOTION and MUSIC IS PURPOSEFUL. As before, the theoretical exposition is broken up with practical illustrations from music, music therapy and everyday life. I found the discussion on MUSIC IS MOTION particularly inspiring, with connections drawn between a very disabled person being able to feel and be part of a wide range of motion within the musical forms/schema, even if unable to experience such a range of physical activity outside of the music. Links are also made between the means with which the various schemata can help people with emotional and behavioural problems. I would imagine even the most psychodynamically-informed music therapist would discover interesting connections, for example between the discussion on the metaphor of CONTAINER and Bion’s use of container/contained. Within the GIM community, for example, there is a great deal of discussion of the use of large or small containers when selecting the appropriate music for different contexts.

The other main theoretical point of music-centred reference is to the writings of Victor Zuckerkandl. Whereas many music therapists have been drawn to theoretical discussions of the energising and organisational properties of pulse and rhythm, Zuckerkandl’s major contribution to music theory is his elaboration of the dynamic qualities of tone and melody (particularly as they reflect states of tension and balance) and it is in these areas that Aigen makes the connections with MCMT. Again he finds that both Helen Bonny and Paul Nordoff drew inspiration from Zuckerkandl and his emphasis that, the more we learn about music, the more we understand what it is to be human and our relationship to others and the world around us. He believed in the notion of homo musicus. ‘Therefore, a relationship with music, in some way, is required for people to be fully human. If true, this is a powerful rationale for music therapy of any kind, but particularly for music-centred forms of practice. Because the relationship to music is considered an essential aspect of an individual’s humanity, no non-musical rationale is required to explain the benefits of music therapy treatment.’ (p.210) I can imagine a sentence from this quote being used as a topic for many a postgraduate essay on the benefits of music therapy. Yet again Aigen is not averse to using other metaphors and images to support his argument and here he links Zuckerkandl’s notion of tonal movement as being both ‘a departure from and an advance toward’ (p.213) with the archetypal theme of the ‘Hero’s Journey’ and the myth of ‘eternal return’, thus making connections to Jung and other writers on personal and collective archetypes.

As we move towards the closing section of the text, Aigen begins to reconcile themes from Schema Theory and Zuckerkandl and their practical application in MCMTT. The earlier discussion of motion in music is elaborated in Chapter 10, alongside that of musical force and space. I hope more music therapists begin to explore how these constructs can be applied to their work and we begin to have descriptions of clinical work that are framed using some of the constructs introduced by Aigen. It is only then that we will begin to see whether his theoretical building can have a more general use. Clearly it has been fundamental in the underpinning of his clinical practice and the text is illustrated by reference to his publications of case material, including the work with Lloyd with which many readers will be familiar (Aigen 2002). A refreshing feature of this text is that there are many references to non-classical traditions, Aigen and his co-therapist being fluent in jazz and other popular styles. Given the musical tastes of many of our music therapy clients, it is stimulating to have an analysis of the music of The Grateful Dead, for example, in a music therapy text. I was reminded of a case study by Oliver Sacks - The Last Hippie - and how a blind, neurologically very disabled young man became transformed whilst relating his memories of attending a concert of this group. As Sacks questioned him about the concert he lost all disconnectedness, speaking enthusiastically about the event, singing his favourite number ‘with great feeling and conviction - a depth of feeling of which, hitherto, he had not shown the least sign. He seemed transformed, a different person, a whole person, as he sang.’ (Sacks 1995: 44).

The final part introduces more clinical examples of the theoretical constructs, for example the way that music can animate the body and facilitate personal agency, motion and controlled action in the world. There is further discussion of Ansdell’s concept of quickening and the schemas SOURCE-PATH-GOAL and FORCE in relation to MCMT. Here I would have welcomed a discussion of intent as this seems to be an area that helps to differentiate between musicians meeting together in order to rehearse for a particular musical outcome and musicians meeting together as part of an on-going therapeutic relationship. I recall John Sloboda challenging colleagues at a music therapy conference to account for the difference between these two contexts, the music possibly sounding similar in both. However, I do appreciate Aigen’s discussion in the Afterword of the way a music-centred approach can create a ‘dialogue of equals’ (p.307) which echoes a phrase often repeated by Juliette Alvin that in music we can be in equal partnership with our clients/patients.

We return to musical descriptors for the final chapters with discussion of musical form and the development and transformation of musical ideas as mirrored in a client’s journey through therapy and life. (It is interesting to note how often Aigen uses intriguing metaphors of travel and movement such as climbing, hiking, the flow of a river etc. throughout the text). These vital life forces are witnessed in both GIM and Creative Music Therapy and are part of myth and the world’s natural wisdom. In GIM such myths as death-rebirth and the ‘Hero’s Journey’ are crucial: one of Bonny’s original GIM programmes, for example, is entitled ‘Death-Rebirth’, and Marilyn Clark has constructed one on the ‘Hero’s Journey.’ The final chapter continues to explore melody, container and the concept of transition. Crucial in music of all kinds, Aigen here discusses transition sections in popular song. Transitions in therapeutic process are also highly complex to manage, be they in improvised active music-making or in moving smoothly from one part of a GIM session to the next.

In the short Afterword, Aigen encourages us to explore making more connections with disciplines such as ethnomusicology and the philosophy of music to help us understand more about the musical processes and structures within music therapy. He is not naïve, recognising the pressure to provide evidence for our interventions and to convince service providers of the benefits of our discipline, but he challenges the music therapy community to think more of ‘music therapy as a specialized application of music rather than a specialized medium of therapy’ (p.307). Having just transferred the Bristol-based music therapy training from one university’s Faculty of Music to another’s Faculty of Health and Social Care this challenge is highly topical for me. It also feeds into contemporary debates on the role of music in health with current moves, at least in the UK, to employ generic arts or music workers in certain health and social care settings in preference to music therapists. Where do we all stand on the continuum: music in health, community music, community music therapy, music as therapy etc.? Whilst personally my music therapy practice shall continue to be informed by humanistic philosophy and increasingly by psychoanalysis, in particular the elaboration of metaphor in psychotherapy (including on-going supervision with a Jungian analyst), this text has helped me to re-confirm the musical roots to all I do as a musician, be it as therapist, trainer, researcher or conductor. And for that I am grateful to Kenneth Aigen and recommend that you likewise let him take you on a journey of discovery.

References
Aigen, K. (1999) ‘The true nature of music-centred music therapy theory’. British Journal of Music Therapy 13(2): 77-82

Aigen, K. (2002) Playin’ in the band. A qualitative study of popular musical styles as clinical improvisation. New York: Nordoff-Robbins Center for Music Therapy, New York University

Sacks, O. (1995) An Anthropologist on Mars. London: Picador

Streeter, E. (1999) ‘Finding a balance between psychological thinking and musical awareness in music therapy theory: a psychoanalytic perspective’. British Journal of Music Therapy 13(1): 5-20

Leslie Bunt is Professor in Music Therapy at the University of the West of England, Bristol, UK.