Therapy in Music for Handicapped Children
Nordoff, Paul & Robbins, Clive (2004). Therapy in Music
for Handicapped Children (re-issue). Gilsum, NH: Barcelona
Publishers. I99 pages. ISBN 1-891278-19-3.
Reviewed by Rick Soshensky, M.A., CMT, NRMT.
Introduction
With the re-issue of Therapy in Music for Handicapped Children
by Paul Nordoff and Clive Robbins, we can rest assured
that this groundbreaking work will remain in the contemporary
sphere of influence appropriate to its timeless message
which
is, as Clive Robbins informs us in his acknowledgments
for this new edition: “the health and healing latent in
the livingness
of creative musicing” (p.12). If the poetic sweep of such
a statement is considerable, it is justified by the depth
of Nordoff-Robbins’ supporting theoretical constructs.
It is this integration of searching philosophy, reverence
for
music, and painstakingly conscientious clinical methodology
that has attracted a multitude of astute clinicians, inspired
countless students and made the Nordoff-Robbins approach
an indispensable contribution to the field of music therapy.
Therapy in Music for Handicapped Children, the first of
the major publications by Nordoff and Robbins (although
adapted
from an earlier, more limited edition) continues to be
as visionary today as it was when it was first issued in
1971.
Barbara Hesser, director of the music therapy degree programs
at New York University, noted in her introductory section:
At that time I did not find the music therapy
clinical work that I saw or read about to be what I envisioned
possible, and I was at a crossroads in my decision whether
to continue
in my pursuit of music therapy as a career. It was reading
this book that confirmed my belief that the artistic
and creative use of music was indeed a powerful tool
for work
with the mental physical and emotional problems of children
(p.7).
Encounters with Nordoff-Robbins Music Therapy
When I was first introduced to the book in the early
90's as a music therapy student at New York University,
I also
deeply resonated with its ideas. But I was a guitarist/singer
with stylistic roots primarily in rock, folk and blues
and, to me, Nordoff-Robbins was a pianist’s world.
The extraordinary
command, (both technically and clinically), in Paul
Nordoff’s classically influenced piano approach seemed
to have
established a legacy so formidable as to appear practically
impossible
for a primary therapist to play another instrument
and still call it Nordoff-Robbins music therapy. Although
I read a
considerable amount of Nordoff-Robbins literature and
adopted many of the concepts as my own, I couldn’t
foresee
any
further in-depth study of the approach beyond my New
York University
master’s degree.
That all changed in 2000 when, through a series
of events that seemed somehow miraculous to me, I became
the third
person to focus exclusively on guitar as a primary
instrument during my certification training as a
Nordoff-Robbins Music Therapist. To his credit as a progressive
thinker,
Clive
seemed only enthusiastic about my involvement as
a guitarist,
illustrating another shining feature as Hesser describes:
“One of the wonderful aspects of Nordoff-Robbins
work is that it is dynamic and does not stay static.
It
is always
evolving as each new generation of therapists add
their unique experience, understanding and talent” (p.7).
It was truly
a life and mind-expanding experience to study with
Clive and the staff at the New York Center. The reader
of this
review is forewarned that he or she will be obliged
to forgive my bias. In my opinion, the approach stands
at
the forefront
of the field in the profundity of its musical and
theoretical
foundations.
Therapy in Music
The wording of the book’s title immediately establishes
the Nordoff- Robbins position. It is therapy in
music; therapy
contained within, or intrinsic to musical engagement.
In other words, when a client is actively involved
in music,
therapy is occurring. Music therapy, in this sense,
functions as does all artistic creation; through
a process of discovery,
often unpremeditated and unforeseeable; taking
shape and unfolding moment-by-moment. We can have goals
or certain
preconceptions in mind, but if we are to stay true
to the artistic process, we must be receptive to
the manifestation
turning out differently from that which we originally
imagined.
This view is sharply differentiated from that which
would be implied by the reverse wording: music
in
therapy; or, applying music as a device toward
the purposes
of
some
disparate clinical conception which may be partly
or largely non-musical.
This precedent for all that was to become identified
as the Nordoff-Robbins approach is lucidly defined
on the
second
page of the authors’ introduction:
Music therefore becomes a sphere of experience,
a means of intercommunication and a basis for
activity in which
handicapped
children can find freedom, in varying degrees,
from
the malfunctions that restrict their lives. As
such, music
possesses inherent
capacities for effecting a uniquely significant
contact with handicapped children and for providing
an experiential
ground
for their engagement, their personality development,
their integration - both individually and socially.
To the extent
to which music achieves this it becomes music
therapy; in practice, the range of expression of music
as
an art, and
the structural constitution of music as an artistic
discipline, are directly involved (p.16).
The full significance of this revolutionary
declaration has yet to be fully recognized. To begin with,
we must consider
the social context of the early 60's when Nordoff
and Robbins began developing their initial
ideas. Nordoff
and Robbins
embarked on their collaborative journey at
the Sunfield Children’s Homes for severely disabled
children in
England. The anthroposophical
philosophy of Sunfield, informed by the ideas
of Rudolf Steiner, seemed to be extremely progressive
for its
time. A wide range
of painting, music, movement, drama and craft
activities
were consistently employed. Still, in subsequent
writings, Clive Robbins described his extreme
frustration at
the seeming impossibility of penetrating the
communication barriers of
profound developmental disability and autism
in children during his initial position there
as a
special education
teacher. Sunfield Homes notwithstanding, I
would venture that expectations for severely disabled
children in
those
days were rather limited and that in most institutional
settings, creative endeavors, if any, were
of
the bead-stringing variety.
Most music therapy models at the time were
predisposed to behavioral and/or activity-oriented interventions
and remain
so in many contemporary schools of thought.
The
controversy over the degree to which music
therapy functions
predominantly according to the nature of art
and music, as opposed
to music taking a somewhat subordinate position
to psychoanalytic, behavioral, medical or recreational
principles, is as
relevant
today as it was in the 50's and 60's when the
field first began to establish itself as a
professional discipline.
The title of chapter III, “Outline of a New
Music Therapy,” seems to indicate that Nordoff
and
Robbins were well
aware of their essential voices as pioneers
and leaders in the
relatively nascent field. That music is a
universal language is virtually a platitude, and an empty
one at that, if
music therapists favor other “clinical strategies,”
and utilize
music in a relatively superficial manner.
As
Nordoff and Robbins pointed out, “What has
yet to be more
clearly recognized
is the range of expression that is possible
in this ‘language.’ The variety of human
expression that
can be communicated
through music is highly diversified and virtually
unlimited. Because of this, music becomes
vitally important as
therapy for exceptional [handicapped] children”
(p.49).
The Prototypical Nordoff-Robbins Methods
As the book’s title also indicates, the focus
during this early Nordoff-Robbins work
consisted exclusively
of work
with handicapped children. The period of
time covered, late 1959 through mid-1967,
follows
the inception
of the work
at Sunfield, a European tour of Steiner
Homes to widen the scope and first forays into
the United
States.
Structurally, the book takes something
of a textbook approach with
chapter titles such as “Individual Music
Therapy - Categories of
Response,” “Experimental Group Activity
- Working Report,” “Music Therapy and Personality
Change
in Autistic Children.”
Each chapter contains numerous sub-headings
indicating the
dominant themes in each section such as:
The effect of dissonant harmonies upon
children’s attention,
actions and singing
and, The development of songs to increase
awareness
and
social interaction. Integrated into each
section is case material
and the applicability of accompanying theory.
The book portrays the evolution and rationale
for the prototypical Nordoff-Robbins
methods for bringing
handicapped
children
into the experience of creative music,
many of which have endured to the present
day.
The origins
of the
“one-string” violin and cello and work
with drum-beating are examined.
The derivations of numerous “children’s
play-songs,” are
depicted including as the haunting, “Something
is Going to Happen” and countless others,
often improvised
directly
out
of the needs of the moment with titles
like the “Laughing Bird” song and “Faith’s
Hair
is Growing
Longer Every
Day.” Descriptions of the musical games
and stories that Nordoff
and Robbins developed such as “Pif-Paf-Poltrie,”
“The Three Bears,” and “The Children’s
Christmas Play” are
also provided.
Although these pieces addressed issues
inherently meaningful to the children,
none of them
are, in any way, condescending,
either musically or thematically. They
invoke a high degree of alertness, challenge
and
involvement. I
know, because
I participated in many of them as a student.
In
particular, the exquisitely intricate
“hist-whist,” stands out
in my mind. This full-length composition,
based on an e.e.
cummings
poem, encompasses specific orchestrations
for a group of children. I worked on
it with my
fellow students
for the
whole of a two-hour class and, personally,
never achieved anything one could honestly
describe
as
mastery (although
to be fair to myself, I seem to remember
trying to cover two parts). Nevertheless,
if this
was music
for handicapped
children, the clients must have intuitively
realized that, for once, someone (or
‘something’ inherent
in music) was
taking them seriously, offering them
an opportunity to rise to the occasion. Regarding
this,
it is noted:
The piece took three-and-a-half minutes
to perform, but eight sessions, each
an hour
and fifteen
minutes in length,
were
required to perfect it. This is where
the therapy lay. Once weekly the ‘sextet’
met
and worked
hard without
pause, learning
and practicing the piece, section by
section. The children accepted the
therapists’ single-minded
purposefulness in the same spirit;
they shared their enthusiasm
and
gave
themselves completely to the hard musical
work the piece demanded. Observers
of the sessions, who knew the children,
were incredulous
over their capacity to sustain this
kind of complete concentration for over an
hour (Appendix
II).
Assessment
Therapy in Music for Handicapped Children
also introduces the first of the
Nordoff-Robbins assessment scales:
“Categories of Response,” which outlines
thirteen
categories (with
various sub-categories) for evaluating
a child’s manner of participating
in music (i.e., - Complete Rhythmic
Freedom, Compulsive Beating, Evasive
Beating,
Responses by Singing,
Responses to Specific
Musical Idioms). Further rating scales
were to come in subsequent publications.
Although
a review
of
contemporary music therapy
literature reflects a diversity of
assessment scales designed for work
with children,
most of them evaluate
behavioral
tasks that are seemingly unrelated
to the dynamic musical relationship
that
naturally
occurs
between client and
therapist. To this day, the Nordoff-Robbins
Scales remain
in the minority
of music-centered assessment instruments
utilized in the field.
Nordoff, the Composer
In understanding the origins of such
a profound focus on music, we cannot
underestimate
the
significance of Nordoff’s
background as a serious composer,
university professor and virtuoso
pianist. This
was not a man to play
some insipid version of a children’s
song and leave it at
that. In the
depth of Nordoff’s commitment to
put his former career
aside
to investigate the possibilities
of music therapy coupled with Robbins’
emancipation
from the
limitations of
special education, the sense of
possibility and rejuvenation they feel is palpable
on every page,
as illustrated
by
passages
such as this one:
The therapist feels reborn in his
new musical-therapeutic experiences
and
realizes the art of music
as therapy will never cease to
challenge him,
never cease
to require all
his musical resources. As mediator
of therapeutic music he assumes
new, uplifting
responsibilities.
Out of
his love
for music he approaches handicapped
children musically, feels them
musically. Through
his practical ability
as a musician
he works with them clinically.
With his musical perceptiveness
and musical
intelligence
he
understands their responses
artistically and humanly recognizes
what they express (p.142).
From the very first project,
at Herbert Geuter’s (Sunfield’s
treatment
team
director) suggestion,
Nordoff and Robbins
plunged in with a sense of
passion and discovery. In collaborating
on developing
a musical
game for children
based on the
Grimm’s Fairy Tale, “Pif-Paf-Poltrie,”
they noted: “The deliberate,
judicious use of dissonance
had a liberating effect on the children”
(p.22). A bit
further on in the
book, this
finding
is stated even more definitively:
One fact, however, emerged:
dynamic, dissonant music
does not necessarily
excite or disturb
psychotic children...As I
aimed to express the turbulence
of
their emotional
lives
in the music I improvised,
it was often wild and dissonant.
This
experience appeared to
be more
significant than
quiet, soothing music which
might
have
been considered more suitable
(p.41).
The courage involved in resisting
the dominant sentiment
of the time cannot
be overstated
and is no less germane
an issue today. However,
at least when contemporary
music
therapists
engage in methodological
debates with
other professionals or
administrators, they have
Nordoff-Robbins
and those who followed
in their path to substantiate
the work.
Nordoff and Robbins had
only their own convictions, as
they recounted:
The visits to Sonnenhof,
Switzerland and Bingenheim,
Germany were
important because
of the clarification
of concepts
our experiences there
demanded. Both institutions placed
great value on music
in the lives
of their children and
in the discussions
that
took place
we were seriously
challenged
to justify our use of
music. Many workers found much
of it too loud, too dissonant
and too rhythmic. They
were
of the
opinion that music for
handicapped children
should be soothing,
rather soft, conventionally
harmonious,
and,
if active,
not stimulating (p.44).
They go on to characterize
such soporific musical
participation to be
“...more a mild form of
entertainment than
a music therapy, and could
be a
subduing, conditioning
factor
in a child’s life.
Music, we fervently
believe, could be more
than this” (p.45) [bold
italics mine].
In another early example,
work with a hypertonic,
epileptic boy at
Sunfield is discussed.
This boy could only
take small, awkward
steps
and was
unable to
raise his arms above
his shoulders. Dr.
Geuter prescribed
a specific movement
- to take a big stride
and at
the same time thrust
his arms
outwards,
spreading them above
his head:
He was to attempt
to make this large
free
movement
by his
own efforts
to a rhythm,
one often found
in Spanish
music...After
seven months, having
worked thrice weekly,
he was able
to perform
it successfully.
As a result all
his movements
became
freer and the tensions
that had hindered
his mixing with
others
began to ease.
His speech
became less
strained and gained
in fluency. The
strongly accented accompaniment
in the Spanish
idiom I used was an essential
part
of
the treatment
(p.27).
These examples
trace the roots
of Nordoff-Robbins’
music-centered
convictions,
wherein
a specific idiom,
harmony or any
other
musical
form
is,
in and of
itself, an intervention.
This requires
a substantial musician.
Right from the
start,
Nordoff and Robbins
held us all
up to
the highest
standard of clinical
music and I think
many music therapists
might
be intimidated,
justifiably
so. As a guitarist
beginning
my training,
I was certainly
unnerved. It
simply would not
be an option
for
my musical resources
to be confined
to the rhythmic
strumming with
full, consonant
chords
and predictable
tonal resolution
to which many
guitarists are habituated.
I
needed to cultivate
a more highly
developed sense
of
clinical presence
and
musical dexterity
as I
experimented
with techniques that
generated
the tensions,
dissonances, modal influences,
use of intervals,
diverse
harmonies,
idioms and flexible
rhythms
that seemed
true to the criterion
set by
Nordoff and Robbins,
as in this
description:
All the compositional
styles of the
last seven
centuries, all the
folk
music,
the idioms,
the elements
of
music, the
very notes themselves
- even the
smallest expressive and
structural
components - become significant
in countless,
undreamed-of
ways.
The world of
music opens
anew, now disclosing
an
inner musical
life of therapeutic
potential (p.142).
The Music
Music in modern times has, to a great extent, been trivialized,
marginalized and characterized primarily as entertainment
or background. Pop music is a billion-dollar industry,
classical concerts fill halls, jazz aficionados gather
in dark clubs,
folkies travel to festivals, wedding bands play endless
parties. Music is used to create a desired atmosphere in
films, television
commercials, and shopping malls. Entire careers are devoted
to criticizing it, analyzing it and merchandizing it. Our
lives are saturated with music yet somehow it all seems
so frivolous. Legions of musicians continue to nurture
the dream
of becoming rich and famous. Nordoff, himself, was on sabbatical
from his university to further his composing career in
Europe when he was first introduced to the idea of music
as therapy.
Had his original intent worked out more to his satisfaction,
perhaps the Nordoff-Robbins partnership would never have
happened. It was frustration - Nordoff’s with the music
profession and Robbins’ with the special education system
that led to
the need to look beyond the way things were and create
something different.
Perhaps it is a cliche or a generalization
to say that the most potent music arises out of a mood of
social
or personal
oppression, but I still think it is basically true. Music
may be promoted as an entertainment and star-making business
to serve the purposes of a capitalist culture but this
is not its reality. In music, we are able to transcend
the loneliness,
fear and constraint inherent in the experience of being
human. As Nordoff and Robbins noted, within handicapped
children
live some of the deepest needs of humanity and this is
why music can become so important in their lives. But
as music
therapists, we are not simply providers. In participating
in music that has been restored to a context more worthy
of its essence, we are all renewed. This intensely humanistic,
even spiritual perspective lives at the heart of the Nordoff-Robbins
approach:
As [the therapist] leads and follows the child
into new regions of self-expression, into new discoveries
of freedom,
his
joy is the child’s joy, his fulfilment is the child’s fulfilment.
The relationship he has to the child’s self-creating self
through the creative effort of his music-making, gives
his own musical nature - and with it the art of music
- a new
moral reality in the world (p.144).
The Therapist
We have a profound responsibility toward clinical and professional
standards if we are to refer to ourselves as therapists.
Our encounters with our clients may affect us in untold
ways but this is not our focus. We enter a session in service
to our clients. At the same time, in music we are united.
Two or more people playing together generate one sound;
one
creation. The purpose of music therapy is to offer an opportunity
to step outside of the restrictive boundaries imposed by
society, pathology and ego-isolation. As therapists, we
cannot stand back dispassionately and apply music like
some sort
of quasi-medical treatment and expect to facilitate a creative
environment that has any heart. Our objective is to visit
the world of music with our clients and help them to return
with something new; maybe something they can use.
Conclusion
I have come to this view of music therapy and feel empowered
to write like this largely through the example of Nordoff
and Robbins. This is certainly not to suggest that my
opinions represent a consensus among Nordoff-Robbins
therapists,
or that there even is one. It is, in fact, its diversity,
encouraging
dialogue and debate that makes the Nordoff-Robbins approach
so vital 35 years after the initial publication of Therapy
in Music for Handicapped Children. Since then, many additional
brilliant insights, elucidations, and interpretations
have been set to paper by Nordoff and Robbins, Clive
and Carol
Robbins, Clive by himself, the many notable Nordoff-Robbins
trained clinicians, and other kindred spirits. But with
this book, Nordoff and Robbins created the paradigm that,
like
any great work of art, responded to the needs of its
time as much as it illuminated the future.
This
book review was released March 4, 2005. ©2005
Nordic Journal of Music Therapy
