The author present his book as a “guide to the early work of Paul Nordoff and Clive Robbins: to their motivation, their thinking, and their attempts to articulate the essence of their approach” (p. xvii). He wants it to be a bridge of understanding for therapists with limited familiarity of the approach and a source of deeper inspiration for those more familiar with it. I belong to the first group of readers, and I certainly think the author is successful in reaching his goal. This is a rich book; a solid piece of qualitative research and also a moving encounter with two pioneers and some of their clients.
.....Right from the beginning Nordoff and Robbins made tape recordings of their music therapy sessions, and these recordings – including the complete courses of therapy for the 223 children and adults seen by the therapists from 1960-1974 – make the N-R Archives (now at New York University) a goldmine for clinicians and researchers even today. This book is the result of 4 years of studying material from the founding years of the approach.
.....Ken Aigen has chosen 8 clients from the first years of Nordoff and Robbins’ clinical work in the USA (1961 and 1962). Some of these clients – children aged 3-16 – are well known to readers of the N-R literature, others have never been described in external publications before. They represent a wide spectrum of physiological and psychological problems and disabilities, and the clinical work reflects the differences between them in a most stunning way.
.....Section II, which comprises two thirds of the book, deals with the analysis of these individual clients, focusing on specific aspects of their clinical processes and the therapists’ explicit or implicit considerations. Research materials are the tape recordings; the original session summaries and indexes, publications and unpublished material from the archives plus the researcher’s logs and memos. Finally Aigen has interviewed Clive Robbins, who looks back and gives his detailed comments on selected aspects of the case studies and his work with Paul Nordoff.
.....The research process and the design of the study is outline in the short, but precise Section I, and in Section III Aigen makes a comparative analysis in four parts: the form and structure of the sessions and the use of music is analyzed in details; this leads to a discussion of the underlying (not always explicit) philosophy and rationale of the model; and finally the question of the N-R approach as music psychotherapy is discussed, based on the examination of the therapeutic relationship as it unfolds in the case studies.
.....I admit, that my own biased expectations were that the cases and the case studies would be much more ‘uniform’, than they in fact are. An important part of the explanation is of course that we are dealing with individual work (group work is only mentioned when or if relevant for the case), and that there was really no N-R ‘model’ developed yet round 1961. I think one of the most interesting aspects of the book is that it shows how the model was shaped: through experimental clinical work designed specifically for each of the clients, and through careful clinical documentation, analysis and discussion of each single session.
.....The professional level of the exploratory work is very high. It is also clear that the founders had difficulties when trying to apply their anthroposophical background to psychological traditions of the institutions they worked in, and that they did not receive any formal training as psychotherapists, which gives their work a certain psychological naïveté (simplicity) concerning the relationship between client and therapists. It strikes me how strong and dramatic the music often is – and how challenging it can be for the client. When you listen to tracks like Terry, Excerpt 2 or 7 (CD I, track 21+26) or Indu, Excerpt 1 (CD II, track 5) you understand, why this clinical work was often met with a massive lack of understanding by the colleagues at the institutions. They often thought that music for these clients should only be gentle and supportive, not “crude” and challenging. But sedation and entertainment was far from the ideas of Nordoff and Robbins. Aigen makes it clear, that they had to move from Pennsylvania (the Devereux residential school for handicapped children and the University of Pennsylvania day-care clinic for psychotic-autistic children) to Kansas (the Institute of Logopedics), because the needed more freedom and professional acceptance from their surroundings to develop their ideas.
.....As a research document I find the book impressive and convincing. Aigen belongs to the ‘radical’ wing of qualitative research (se the discussion in Henk Smeijster’s Multiple Perspectives, 1997, p. 193ff), underlining the inevitability and importance of the researcher’s personal interaction with data/the world, denying any ‘old paradigm’ idea about ‘objectivity’. The ‘trustworthiness’ of the research thus demands not only extensive documentation, but also a thorough explication of the ‘selective function’ of the researcher, and reports on his own process and struggle with the material. This is what Aigen does: the more complex, controversial or ambiguous the material is, the more he explicates and reviews his own thoughts about it. Thus you may disagree in analytical details, or in some of Aigen’s interpretations and theoretical speculations, but you are always well informed about how the author came to his conclusion. He also realizes that the inclusion of material like the CDs makes it possible for the reader to make his own interpretations. Some readers may find this ‘trialogue’ between research material, researcher and reader unusual and maybe too personal; I like it. I find the use of personal comments appropriate in the context – to give just one example: In order to understand why and how the focus of the research changed significantly from “Patterns of development” to “Paths…” (i.e. “From commonalities to uniqueness”) it is important to know how the researcher gradually opened his ears and mind to the admirable – and quite surprising – individualization of the clinical work presented here. I think the personal voice of the researcher makes the book not only trustworthy, but also more varied and interesting to read.
.....The 8 case studies are for example written with a specific, clear focus to each of them: Work, Myth and Singing in Self-Actualization; Musical Skills and the Development of the Self; A Process Model; Overcoming the Fear of Failure; Restructuring the Self through Music; The Aesthetic From of the Session; From Sensory Stimulation to Musical Experience; Mutuality in the Therapy Process. Every headline is also a ‘construct’, identified by the research as a core issue of the case. The case of Mike may be very close to a more traditional N-R study, while the case of Loren, in which Aigen discusses its relevance to contemporary concepts of music psychotherapy, is quite far from that tradition. The disposition is chronological in most of the cases, but the study can also be systematic, as in the case of Indu, which focuses on “Five Stages of the Session”, identified by the researcher: Opening, Transition, Working, Transition, Closure. This model is not generalized, and the same goes for the “Four Stage Model of Therapy” identified in Terry’s case: Exploration; Conflict-Crisis-Breakthrough; Consolidation; Closure. The filed of interpretation stays open.
.....The descriptions of the clinical work, the music, the process and the musical relationship are generally clear and easy to follow, and the illustrative CD excerpts seem very carefully selected. The verbal descriptions of the excerpts are not always very detailed or quite as easy to follow, and I would have liked time references to the CDs – also because some of the excerpts are very long (short excerpts are round 1 minute, the longest – Indu Excerpt 9 – is 7:17. The Index does not specify the length of excerpts).
An example of how it could have been done easily (The end of the excerpt mentioned, p. 188): The music is calming and extremely delicate (CD 1 cut 14, 5:17-6:24)./ It changes to an improvisation in E flat major (6:24-7:04)./ Indu beats and Paul does not respond directly to it (7:04-7:13)./ Paul brings out the chords that were underlying the previous music to the end of the improvisation (7:13-7:17)
.....I find it extremely interesting to read Section III, where Aigen examines the “constructs and concepts arising” from the case studies. Among the concepts discussed is the question of Music’s universal properties or “The objectivity of Music” (p. 255; Paul Nordoff wrote about ‘Musical Archetypes’). Aigen has based his discussion on Peter Kivy’s distinction between ‘music expressing an emotion and music being expressive of an emotion’, a way of avoiding the pitfall of traditional ‘expression theory’. What Aigen comes up with is sort of a compromise between an ‘absolutist’ and a ‘relativist/constructivist’ notion of musical meaning: “A possible solution is to accept the possibility of musical objectivity, without granting the objective qualities the status of universality” (p. 257).
.....I do not find this compromise quite convincing theoretically, but clinically Aigen makes it clear that Paul Nordoff would never use music in a prescriptive way. I find it very important to continue the discussion of this core concept of N/R theory and how it relates to modern theories of meaning in clinical music. In the music chapter Aigen presents many important points and observations; on the importance of singing in N-R therapy; and of course on “Establishing a musical world”: it becomes very clear how therapist(s) and client(s) can create a new and different world in music, where the client can act creatively and experience herself communicating in a potentially transforming interaction process. Development can be initiated and stimulated in several ways: by musical explorations of opposites, by expressing paradoxical emotions, by establishing new relationships and by transforming resistiveness into participation – just to mention some of the most important contributions of N-R theory for music therapy.
.....Another very important discussion addresses the question whether N-R is music psychotherapy or not. There are different standpoints within the ‘Creative Music Therapy Camp’ itself, with Gary Ansdell as an example of therapist and researcher who advocates the ‘classical N-R idea’ of music being the primary, if not the only agent of change in the clinical work. Aigen demonstrates in the case studies (supported by the statements of Clive Robbins) how the relationship is an important agent of change in at least 3 of them. The therapists’ lack of formal psychotherapeutic training seems to be the most important reason for the minor role the therapeutic relationship plays in early N-R theory and practice. Nonetheless it is clear, that the pioneers used music as well as the therapeutic relationship as vehicles for deep work – when appropriate. In a fine passage Aigen argues that a psychotherapeutic framework may not be necessary for understanding N-R therapy even today, but that it may be helpful, productive and relevant with many disabled clients – as it would have been in two or three of the cases in the book.
.....The chapter discussing the Clinical Process is a valuable contribution to the discussion of epistemological and ontological aspects of the N-R approach. Aigen show how the concept of Work plays a major role in all the cases – But in many different ways. To Nordoff and Robbins therapy meant work – for themselves as well as for the clients. Most of all because “the ability to engage in meaningful work is a necessary component of psychological health because it gives meaning to life” (p. 284). Also the concept of will (willful action) and its theoretical implication is discussed. Aigen connects the N-R understanding of the will to the philosophy of Kant and Schopenhauer and makes also a connection to “the Forces in Music” via Susanne Langer and Victor Zukerkandl. The combining metaphor is “striving toward a goal” as found in tonal music as well as in human life. This looks like the first draft of a very interesting theory that needs elaboration.
.....Towards the end of the century/millennium we are still able to learn more about the shaping of one of the most important and influential models of music therapy. Paul Nordoff’s London lectures from 1974 are available now, some of the important music plays have been made available to practitioners, a new edition of Creative Music Therapy (2nd edition, revised) will appear later this year. Together with this book they make a perhaps late, but nevertheless fundamental contribution to our understanding of the Nordoff-Robbins approach. The material is clinically rich, theoretically challenging, often very beautiful and always inspiring.