VII.

Worldkongress of Music Therapy

19.7.-23.7. 1993
Vitoria-Gasteiz / Spain
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 Worldkongress 1993 Index

I. Clinical Music Therapy 2.2.- Neurophysiological variations in the Music Therapy

* I.- Musicoterapia Clinica researches
* 2.2.- Variables neurofisiologicas en la investigacion
1.1.- Music Therapy in handicapped people musicoterapeutica
* 1.1.- Musicoterapia en Disminuidos
Conference Handouts
2.3.- Development of the musical function
1.2.- Music Therapy and Mental Health * 2.3.- Desarrollo de la funcion musical.
* 1.2.- Musicoterapia y Salud Mental
Conference Handouts
2.4.- Acoustic and sound perception
1.3.- Music Therapy in General Medicine . * 2.4.- Acusticay percepcion sonora
* 1.3.- Musicoterapia en Medicina General
Conference Handouts

II. Music Therapy and Experimental Research III. Music and Music Therapy
* II. Musica e Investigacion Experimental * III Musica y Musicoterapia

2.1.- Psychology and music 3.1.- Technical and Musical Aspects

* 2.1.- Psicologia y musica. * 3.1.- Aspectos tecnico-musicale
Conference Handouts
3.2.- Culture, music and music therapy * 4.4.- Perfilprofesional del musicoterapeuta
Conference Handouts
* 3.2.- Cultura, musica y musicoterapia
Conference Handouts
4.5.- Ethical code of the music therapist
3.3.- Music and musical development * 4.5.- Codigo etico del musicoterapeuta
* 3.3.- Musica y desarrollo musical

IV. Training and "role" of the music therapist

* IV. Formacion y "rol " del musicoterapeuta
Conference Handouts

4.1.- Schools, Methodology, Programming, Aims

* 4.1.- Escuelas. Metodologia, programacion, objetivos
Conference Handouts

4.2.- Training designs in every subject

* 4.2.- Disefios interdisciplinarios de formation
Conference Handouts

4.3.- The music therapist role in the institution

* 4.3.- El "rol " del musicoterapeuta en las instituciones

4.4.- Professional profile of the music therapist

3
 CORPOREAL RESONANCE AND SOUND DIALOGUE IN THE
TREATMENT OF INFANTILE AUTISM / LA RESONANCIA
I. CLINICAL MUSIC THERAPY CORPREA Y EL DILOGO DE SONIDOS EN EL
MUSICOTERAPIA CLINICA TRATAMIENTO DEL AUTISMO INFANTIL 37

1.1.- MUSIC THERAPY IN HANDICAPPED GIULIA CREMASCHI & MAURO SCARDOVELLI 37

PEOPLE / MUSICOTERAPIA EN DISMINUIDOS
(ABSTRACTS) 32
THE SPONTANEOUS GROWTH OF THE SPEECH IN THE
DEAF CHILD / EL DESARROLLO ESPONTNEO DE LA
MUSIC AND MOVEMENT - AN INTEGRATED VISION
PALABRA EN EL NIO CON SORDERA 39
MSICA Y MOVIMIENTO - UNA VISIN INTEGRADORA 3 2

LOLA BRIKMAN 32 GIULIA CREMASCHI 39

THE SIGNIFICANCE OF IMPROVISATIONAL MUSIC

THE APLLICATION OF MUSIC THERAPY ON DISABLED
THERAPY FOR CHILD PSYCHIATRY / LA IMPORTANCIA
TEENAGERS APLICACIONES DE LA MUSICOTERAPIA
DE LA TERAPIA MUSICAL IMPROVISADA (I.M.T.) EN
SOBRE ADOLESCENTES DISMINUIDOS 33
PSIQUIATRA INFANTIL 42
ALAIN CARR 33
JEAN EISLER 42
FACILITATED COMMUNICATION MOTIVATED BY
THE HYPACUSIAC CHILD: AN INTEGRATED PROJECT FOR
NORDOFF-ROBBINS STYLE CREATIVE MUSIC THERAPY /
AN OVERALL APPROACH TO THIS PROBLEM / EL NIO
COMUNICACIN FACILITADA, MOTIVADA POR LA
HIPOACSICO: UN PROYECTO INTEGRADO PARA UN
MUSICOTERAPIA CREATIVA DEL MTODO NORDOFF-
PLANTEAMIENTO GLOBAL DEL PROBLEMA 45
ROBBINS 35

GINGER CLARKSON 35 DIANA FACCHINI 45

4
THE MUSIC HELPS ME TO TELL ME MY STORY. MUSIC DISCAPACITADOS DEL DESARROLLO. UNA EXPERIENCIA
AND IMAGERY WITH BRAIN DAMAGED PERSON / LA ABIERTA A LA COMUNIDAD 52
MSICA ME AYUDA A CONTARME MI HISTORIA. MSICA E
IMGENES CON PERSONAS CON LESIN CEREBRAL 4 6 VICTORIA SHOCRON & MARTA MENDIA DE GONZLEZ 52

INGRID HAMMARLUND 46 WILLY, HIS MOTHER AND I / WILLY, SU MADRE Y YO 5 4

MUSIC THERAPY AND APHASIA / MUSICOTERAPIA Y M ROSA ALFONSIN DE SURMANI 54

AFASIA 47
MUSIC THERAPY AND CASES OF CHRONIC PSYCHIATRIC
BEP LAMEIJER- STERENBERG & C. ROMIJN 47 PATIENTS / MUSICOTERAPIA Y CASOS DE ENFERMOS
PSIQUITRICOS CRNICOS 55
MUSIC THERAPY IN THE TREATMENT OF A CHILD
SUFFERING FROM AUTISM / LA MUSICOTERAPIA EN EL YOLANDA VAICAITIS 55
TRATAMIENTO DE UN NIO AUTISTA 48
1.1 - MUSIC THERAPY IN HANDICAPPED
LETICIA MORAES LEITE PEREIRA 48 PEOPLE / MUSICOTERAPIA EN DISMINUIDOS
( CONFERENCE HANDOUTS) 57
INMEDIACY IN MUSIC THERAPY: POISED IN THE CREATIVE
ISOLATION AND THE MULTI-HANDICAPPED PATIENT: AN
NOW / INMEDIATEZ EN MUSICOTERAPIA: EQUILIBRIO EN
ANALYSIS OF THE MUSIC THERAPIST-PATIENT AFFECTS
EL AHORA CREATIVO 51
AND PROCESSES. 57
CLIVE E. ROBBINS 51
ANTHI AGROTOU 57
AN ART WORKSHOP: AN EXPERIENCE IN ART OPEN TO
MUSICOTERAPIA EN LA INTEGRACIN DEL NIO
THE COMMUNITY / TALLERES DE ARTE PARA
DEFICIENTE AUDITIVO 65

5
M FELICIANA ARGUEDA CARMONA 65 MUSICSPACE - THE CREATION OF COMMUNITY-BASED
CENTRES FOR MUSIC THERAPY, RESEARCH, TRAINING
DIFERENCIAS Y SIMILITUDES EN LA APLICACIN DE LA AND PERFORMANCE 140
MUSICOTERAPIA EN PACIENTES AUTISTAS Y EN COMA72
LESLIE BUNT 140
PROF. DR. ROLANDO O. BENENZON M.D. 72
"IN MOTION". A MUSIC-THERAPEUTICAL APPROACH IN
INTERACCIN MSICA-DANZATERAPIA EN CASO DE THE REHABILITATION OF PHYSICALLY HANDICAPPED
ATAXIA 84 CHILDREN. 150

MUSIC THERAPY, PHYSIOTHERAPY AND LOW VISION MADELEEN FLENTGE DE BRUIJN 150
TRAINING 106
BREAKING DOWN LEARNING BARRIERS WITH MUSIC 1 5 9
WALTER BINELLO - CHRISTIANE KLEIN 106
MAY GAERTNER 159
METODO ORAL-AURAL PARA LA ENSEANZA DEL NLO
CON HANDICAP AUDITIVO 119 LOS PERSONAJES INTERNOS EN MUSICOTERAPIA 169

MARCELA BOERIS 119 MARCELO GABRIEL GINDLIN 169

MUSIC-THERAPEUTIC TREATMENT ON A SELF-INJURIOUS LA POSIBLE METAMORFOSIS - MUSICOTERAPIA EN LA

SUBJECT WITH A DIAGNOSIS OF GENERAL DISTURBANCE GLOBALIDAD DE LOS LENGUAJES 178
OF DEVELOPMENT. 127
STEFANIA GUERRA LISI 178
ENRICO BRANCA 127
THOMAS`S MUSIC 211

6
PIXIE HOLLAND Y SARAH HALL 211 MUSICOTERAPIA EN EL NIO - ADOLESCENTE AUTISTA267

MUSIC, ANXIETY AND THE MENTALLY HANDICAPPED - A MONICA PETRUCH DE TANNY Y EDNA MISHORI 267
REVIEW 222
MUSIC THERAPY IN INFANTILE AUTISM 279
JEFF HOOPER 222
PROF. SERAFINA POCH, PHD,MT(NAMT) 279
QU NECESITA EL PACIENTE DE MI INSTITUCIN ? 2 3 0
FACILITATING BASIC EMOTIONAL COMMUNICATION IN
SILVIA BEATRIZ JENSEN 230 CREATIVE IMPROVISATIONAL MUSIC THERAPY WITH
STEVEN, A 4 YEAR OLD BOY WITH COMPLEX
MUSICOTERAPIA: ABORDAJE FUNDAMENTAL EN EL COMMUNICATION DIFFICULTIES (DIAGNOSED AUTISTIC)300
TRATAMIENTO DEL DISCAPACITADO AUDITIVO 244
JACQUELINE ZOE ROBARTS 300
LIA REJANE MENDES BARCELLOS 244
1.2. - MUSIC THERAPY AND MENTAL HEALTH /
MOVEMENT SOUND VOICE: FROM STEREOTYPING TO MUSICOTERAPIA Y SALUD MENTAL
CREATIVENESS IN A MUSICALTHERAPEUTICAL ( ABSTRACTS) 315
EXPERIENCE 257
LITERATURING WITH MUSIC / LITERATEAR CON MSICA
315
SILVANA NOSCHESE Y ELIGIA LEVITA 257

LA MSICA COMO INSTRUMENTO DE INSERCIN SOCIAL

LILIANA M D`ASERO 315
DEL DESCAPACITADO: UNA EXPERIENCIA CHILENA 2 6 0
MUSIC THERAPY IN DEMENTIA: A HOLISTIC APPROACH /
MUSICOTERAPIA CON LA DEMENCIA: UNA
BERTA PEREDO MANZO 260
APROXIMACIN HOLSTICA 318

7
RUTH BRIGHT 318 THE MUSIC THERAPIST AS GROUP LEADER - A
PROPOSAL FOR A PRACTICAL MODEL / EL
THE CORRELATION BETWEEN CONTENT OF PREFERED MUSICOTERAPEUTA COMO LIDER DEL GRUPO: UNA
MUSIC AND PSYCHIATRIC DIAGNOSIS OF CRIMINAL PROPUESTA DE MODELO PRCTICO 324
OFFENDERS AND EFFECTS OF THIS MUSIC ON OBSERVED
BEHAVIOR / CORRELACIN ENTRE EL CONTENIDO DE RACHEL DARNLEY-SMITH 324
LA MSICA PREFERIDA Y EL DIAGNSTICO
PSIQUITRICO DE VIOLADORES, Y LOS EFECTOS DE RESISTENCE IN MUSIC THERAPY / LA OPOSICIN EN LA
ESTA MSICA SOBRE SU CONDUCTA 320 MUSICOTERAPIA 326

MELISSA BROTONS 320 JANICE M. DVORKIN 326

MUSIC THERAPY A FORM OF NON VERBAL TREATMENT MUSIC THERAPY IN MENTAL HEALTH: HYPOTHESES FOR
IN ASSISTENCE TO PSYCHOTICS / EL TRABAJO DE LA A METHODOLOGY / MUSICOTERAPIA EN LA SALUD
MUSICOTERAPIA COMO FORMA DE TRATAMIENTO NO MENTAL: HIPTESIS PARA UNA METODOLOGA 326
VERBAL EN EL ATENDIMIENTO PARA LOS PSICTICOS322
GIANLUIGI DI FRANCO 326
ELIANA LOBO DO CARMO 322
ANXIETY AND PLAYING / ANGUSTIA Y JUEGO 328
MUSIC THERAPY AND CORPORAL EXPRESSION IN A
GROUP OF CHRONICAL HOSPITALIZED PATIENTS / REGINA HALMER-STEIN 328
MUSICOTERAPIA Y EXPRESIN CORPORAL CON UN
GRUPO DE PACIENTES CRNICOS HOSPITALIZADOS 3 2 3 ADDICTS AND MUSIC THERAPY - A CASE STUDY / EL
ADICTO EN MUSICOTERAPIA - PRESENTACIN DE UN
ALBERT CHAMORRO SALVAT & BLANCA TRREGA ESTELLER323 CASO 329

8
OFELIA HERRENDORF DE WAEN & DANIEL ALBERTO GARAY329 DIFICULTADES INTERPERSONALES DE LOS PACIENTES
PSIQUITRICOS 337
WORKING WITH AIDS AND DRUG ADDICTION /
TRABAJANDO CON SIDA Y DROGADICCIN 331 TERESA PAULA LEITE 337

OFELIA HERRENDORF DE WAEN 331 THE STORY SONG TECHNIQUE: A THERAPEUTIC TOOL
FOR THE YOUNG, EMOTIONALLY HANDICAPPED GROUP
MUSIC THERAPY IN PSYCHOTHERAPEUTIC TREATMENT / LA TCNICA DE LA CANCIN DEL CUENTO: UNA
OF SCHIZOPHRENIA / MUSICOTERAPIA EN EL HERRAMIENTA TERAPUTICA PARA UN GRUPO DE
TRATAMIENTO PSICOTERAPUTICO DE LA JVENES CON CONFLICTOS EMOCIONALES 339
ESQUIZOFRENIA 333
JOANNE LOEWY 339
HANNE-METTE KORTEGAARD 333
SCHIZOPHRENIA AND MUSIC: RESEARCH INTO
MUSIC THERAPY: A SUBJECT WELL WORTH NONVERBAL COMMUNICATION / ESQUIZOFRENIA Y
CONSIDERING / LA MUSICOTERAPIA: UN TEMA QUE MSICA, INVESTIGACIN DE COMUNICACIN NO-VERBAL
MERECE SER ESTUDIADO 335 341

BEP LAMEIJER- STERENBERG 335 GRETHE LUND 341

PLAYING MUSIC AND BEING WITH THE OTHERS. USING METHODOLOGICAL AND CLINICAL CONSIDERATIONS
MUSIC AS A METAPHORICAL EXPERIENCE TO ADDRESS ABOUT THE USE OF MUSIC THERAPY ON SUBJECTS
THE INTERPERSONAL DIFFICULTIES OF PSYCHIATRIC WITH SEVERE MENTAL DEFICIENCY AND PSYCHOTIC
PATIENTS / TOCANDO MSICA Y CONVIVIENDO CON DISTURBANCES / CONSIDERACIONES CLNICAS Y
LOS DEMS: USANDO LA MSICA COMO UNA METODOLGICAS SOBRE LA MUSICOTERAPIA PARA
EXPERIENCIA METAFRICA PARA TRATAR LAS DISCAPACITADOS MENTALES GRAVES CON DISTURBIOS
PSICTICOS DE LA CONDUCTA 342

9
 GERARDO MANAROLO, MARCO GILARDONE & FERRUCCIO GABRIELA G. PERILLI & SANTO RULLO 349
DEMAESTRI 342
EVOLUTION OF CLINICAL CASES THROUGH
THEORETICAL CONSTRUCTS TOWARDS THE USE OF MUSICOTHERAPY IN ADULT INSTITUCIONAL SETTINGS /
MUSIC FOR ATTUNEMENT IN PSYCHOTHERAPY / EVOLUCIN DE CASOS CLNICOS A TRAVS DE
CONSTRUCTOS TERICOS HACIA LA UTILIZACIN DE LA DIFERENTES TRATAMIENTOS DE MUSICOTERAPIA EN
MSICA EN LA PSICOTERAPIA 344 PSIQUIATRA PARA ADULTOS 350

CAROLE MARSHALL 344 SIMONE QUELIN, JOSETTE KUPPERSCHMITT, A. DEGIOVANNI &

J. DE VERBIZIER 350
FACUNDO`S LOST SCENE: THE CONTRIBUTIONS OF
MUSIC THERAPY TO A CLINICAL CASE / LA ESCENA ENVIRONMENTAL FACTORS AND REGRESSIVE
PERDIDA DE FACUNDO. APORTES DE LA CHARACTERISTICS OF THE NON-COMMUNICATIVE CHILD
MUSICOTERAPIA EN UN CASO CLNICO 346 IN MUSIC THERAPY / EL MUTISMO A TRAVS DE LA
MUSICOTERAPIA. FACTORES AMBIENTALES Y CARCTER
CLAUDIA INES MENDOZA 346 REGRESIVO DEL NIO 351

CURRENT ISSUES FOR MUSIC THERAPISTS WORKING IN M LUISA RIPOLLS CABRERA 351
PSYCHIATRY / CUESTIONES ACTUALES PARA LOS
MUSICOTERAPEUTAS QUE TRABAJAN EN PSIQUIATRA348 SOUND AND SYMBOL: THE INTERFACE OF MUSIC AND
PLAY IN MUSIC THERAPY WITH SEXUALLY ABUSED
HELEN ODELL-MILLER 348 CHILDREN / EL SONIDO Y EL SMBOLO: LA RELACIN
DE LA MSICA Y EL JUEGO EN LA TERAPIA MUSICAL
MUSIC THERAPY IN REHABILITATIVE PROGRAM / LA CON MENORES VCTIMAS DE ABUSO SEXUAL 352
MUSICOTERAPIA EN EL PROGRAMA DE REHABILITACIN349
JACQUELINE ZOE ROBARTS 352

10
THE USE OF MUSIC THERAPY WITH SEXUALLY ABUSED MUSIC THERAPY IN FORENSIC PSYCHIATRY / LA
CLIENTS. / LA UTILIZACIN DE LA MUSICOTERAPIA MUSICOTERAPIA EN LA PSIQUIATRA FORENSE 360
CON CLIENTES QUE SUFRIERON ABUSOS SEXUALES.354
KATIE SANTOS & HELEN LOTH 360
PENNY ROGERS 354
BODY IMAGE IN MUSIC THERAPY: A CASE IN INFANT
BEFORE THE EVIL CATCHES US .... / ANTES QUE EL PSYCHOSIS / LA IMAGEN CORPORAL EN
MAL NOS COJA ... 355 MUSICOTERAPIA: UN CASO DE PSICOSIS INFANTIL 3 6 1

FAUSTO RUSSO 355 SUSANA SATINOSKY 361

A STORY OF A FAMILY TOLD BY A DRUM / UNA POSSIBILITIES OF USING MUSIC THERAPY IN THE
HISTORIA DE FAMILIA CONTADA POR UN TAMBOR 357 HABILITATION TREATMENT OF CHILDREN IN THE AGE OF
DEVELOPMENT / POSIBILIDADES DE UTILIZACIN DE
FAUSTO RUSSO 357 LA MUSICOTERAPIA EN EL TRATAMIENTO DE
REHABILITACIN DE NIOS EN EDAD DE DESARROLLO363
MUSIC THERAPY AND ROCK MUSIC. INFLUENCES IN THE
TREATMENT OF DRUG ADDICTIONS / MUSICOTERAPIA ROSARIO SAVINO 363
Y ROCK. SU INFLUENCIA EN EL TOXICMANO 358
THE USE OF INDIVIDUAL MUSIC THERAPY IN THE
TXINTO SANCHEZ 358 TREATMENT OF PEOPLE WITH EATING DISORDERS / LA
UTILIZACIN DE LA MUSICOTERAPIA INDIVIDUAL EN EL
SHORT-TERM MUSIC THERAPY IN PSYCHOSOMATIC TRATAMIENTO DE PERSONAS CON TRASTORNOS EN LA
ILLNESS / MUSICOTERAPIA BREVE EN ENFERMEDAD ALIMENTACIN 363
PSICOSOMTICA 359
ANN SLOBODA 363
ELISABETH DOS SANTOS FELICIO 359

11
 LOREDANA VECCHI, ANNA FUSCO, PASQUALE
THE RELATIONSHIP BETWEEN EXCERPTS OF RECORDED
MASTANTUONO, BRUNO CAPUANO, GINA ROSELLI, GRAZIA
MUSIC AND VALUES IN
DE BIASE & CATERINA VOLPE 368
RECEPTIVE MUSIC THERAPY WITH DEPRESSIVE PATIENTS
/ LA RELACIN ENTRE FRAGMENTOS DE LA MUSICA 1.2. - MUSIC THERAPY AND MENTAL HEALTH /
GRABADA Y LOS VALORES DE LA MUSICOTERAPIA MUSICOTERAPIA Y SALUD MENTAL
RECEPTIVA EN PACIENTES DEPRESIVOS 365 (CONFERENCE HANDOUTS) 371

HENK SMEIJSTERS, BABY WIJZENBEEK & NIEK VAN GROUP MUSIC THERAPY IN THE PSYCHIATRIC
NIEUWENHUIJZEN 365 OUTPATIENT CLINIC OF THE HIGH MEDICAL INSTITUT -
SOFIA 371
CREATIVE PROCEDURES AND PROCESSES IN MUSIC
THERAPY: FUNDAMENTAL ASPECTS OF THE NORDOFF- GEORGE ANTONOV ANTONOV 371
ROBBINS APPROACH / PROCEDIMIENTOS CREATIVOS Y
PROCESOS EN MUSICOTERAPIA: FUNDAMENTOS DEL MUSICOTERAPIA EN PACIENTES PSICTICOS 379
ENFOQUE DE NORDOFF-ROBBINS 367
EULENICE BARBALHO DE ANDRADE 379
ALAN TURRY & CLIVE ROBBINS 367
ABORDAJE MUSICOTERAPEUTICO DE LAS ADICCIONES
MUSIC THERAPY: DESCRIPTION OF THE THERAPEUTICAL EN LA COMUNIDAD TERAPEUTICA 388
WAY OF A PATIENT BEING IN TREATMENT WITH AN
ACTIVE MUSIC THERAPY GROUP / MUSICOTERAPIA: MT. GABRIELA LAURA BELLO Y MT. SERGIO DANIEL FRIDMAN388
DESCRIPCIN DEL RECORRIDO TERAPUTICO DE UN
PACIENTE SOMETIDO A MUSICOTERAPIA ACTIVA DE DE LA ARMONA DEL ESCUCHA A LA MELODA DEL
GRUPO 368 INTERPRETAR BI-ESCUCHA / BI-INTERPRETACIN DEL
INSTRUMENTO PSICOANALTICO 404

12
 MARCELO BIANCHEDI Y ELIZABETH T. DE SUZANNE B. HANSER 433
BIANCHEDI 404
MIND, MUSIC AND HEALING: A TREATMENT APPROACH
SONORO-PLSTICO EN HOSPITAL PSIQUITRICO 416 IN WOMEN`S HEALTH CARE / MSICA, MENTE Y
CURACIN: UNA APROXIMACIN DE TRATAMIENTO
JARA DE JESUS BILEMJIAN (EDUCADORA DE ARTE Y PARA EL CUIDADO SANITARIO DE LAS MUJERES 435
HABILITADA EN MSICA) Y MARLCIA RODRIGUES
ADA MAE CROUSE 435
COUTINHO (EDUCADORA DE ARTE Y HABILITADA EN ARTES
THE NURSING COUPLE / LA PAREJA DE LACTANCIA437
PLSTICAS) 416

MUSIC THERAPY IN THE DEPARTMENT FOR CRISIS

ALISON LEVINGE 437
INTERVENTION IN MENTAL HEALTH CENTER IN
GUIDED IMAGERY AND MUSIC (GIM) AND
LJUBLJANA 428
PSYCHOANALYSIS / IMAGEN Y MSICA GUIADA (GIM) Y
PSICOANLISIS: COMPARACIN DE SESIONES,
VIDA CELAREC 428
PROCESOS Y TRANSFORMACIN PSQUICA. 438
1.3.- MUSIC THERAPY IN GENERAL MEDICINE
- MUSICOTERAPIA EN MEDICINA GENERAL BJRN WRANGSJ 438
(ABSTRACTS) 433
1.3. - MUSIC THERAPY IN GENERAL MEDICINE
MUSIC THERAPY RESEARCH IN PAIN AND STRESS - MUSICOTERAPIA EN MEDICINA GENERAL
REDUCTION. HOME AND HOSPITAL / LA (CONFERENCE HANDOUTS) 439
INVESTIGACIN DE LA REDUCCIN DEL DOLOR Y EL
MUSICOTERAPIA EN PACIENTES EN COMA EN TERAPIA
ESTRS EN MUSICOTERAPIA: EN EL HOSPITAL Y EN
INTENSIVA 439
CASA 433

13
 LILIANA M D`ASERO, A. FOLGUERAS, C.E. GOLDINI, R. DENISE ERDONMEZ, M.MUS RMT-BC 474
BENENZON, G. SCIFO, S. GUTIERREZ JIMENEZ, A. BONINO, H.
UEHARA, R. ZSCHOCKE, G. RODRIGUEZ DE GIL Y M. FUENTES439 MUSICOTERAPIA EN LA ETAPA PRENATAL 490

IMAGES OF THE SELF: COMMUNICATING WITH PART RUTH FRIDMAN 490

PERSONALITIES IN MUSIC THERAPY 441
"MUSICA Y POESIA EN PACIENTES COMATOSOS" 498
DIANE SNOW AUSTIN 441
MARCELO GABRIEL GINDLIN, SARA LEWKOWICZ Y PATRICIA
"LA REHABILITACION MOTORA CON REFUERZO RITMICO- KATZ 498
MUSICAL" 445
EXPLORING THE INNER LANDSCAPE - AN INTRODUCTION
FRANCISCO BLACO VERCHER 445 TO GUIDED IMAGERY AND MUSIC 501

MUSIC THERAPY AND CANCER CARE 459 FRANCES SMITH GOLDBERG, MA, RMT-BC, MFCC 501

LESLIE BUNT 459 MUSICOTERAPIA:UN ABORDAJE EN VINCULOS

TEMPRANOS 505
"THE EFFECTS OF MUSIC ON THE ANESTHESIA OF THE
HOSPITALIZED CHILD" 469 MARTA GROSMARK 505

PRF. ALAIN CARR 469 NATURALLY-OCCURING THERAPEUTIC USES OF MUSIC:

IMPLICATIONS FOR THE CLINICAL SETTING 523
GUIDED IMAGERY AND MUSIC, AND THE PROCESS OF
INDIVIDUATION IN TWO WOMEN AT MID-LIFE. 474 CONNIE ISENBERG-GRZEDA, MMT, MTA, RMT-BC 523

14
THE PROCESS OF MUSIC THERAPY WITH A BRAIN MUSICOTERAPIA EN CIRUGIA 583
INJURED PATIENT IN CONJUNCTION WITH MEDICATION
REDUCTION 533 SABINA PUPPO 583

DIANNE LANGAN 533 EL JUEGO EN LA CLNICA MUSICOTERAPEUTICA CON

NIOS Y ADOLESCENTES 592
POPMUSIC AS LEARNING THERAPY FOR MENTALLY
DISTURBED CRIMINAL OFFENDERS; EVALUATIONS ON GISELA BAROK, DESIREE FLORES, M PIA LATORRE, M
THIRTEEN YEARS OF PRACTICE 544 ANDREA LAHA, DANIELA MAMMALUCCO, , M GABRIELA
META, LIDIA ROMERO Y PAULA ZETTLER 592
MARCO F. NAARDEN: 544
MUSIC AND IMAGERY IN THE TREATMENT OF CHEMICAL
MUSIC THERAPY IN CANCER CARE WHEN THERE ARE NO ADDICTIONS 605
WORDS 560
RUTH SKAGGS, M.A., LPC, CET . 605
ANNE OLOFSSON 560
EFFECT OF VIBROACOUSTIC THERAPY ON BLOOD
ESTIMULACION MUSICAL PARA EMBARAZADAS 570 PRESSURE. SPECIFIC EFFECTS OF FREQUENCIES AND
CHOICE OF MUSIC 628
MARA ESTELA PIERINI 570
OLAV SKILLE 628
TRASTORNOS DE LA ALIMENTACION: ENFOQUE GRUPAL
MULTIDISCIPLINARIO 574 MUSIC IN MEDICINE: RESEARCH AND CLINICAL
APPLICATIONS 640
ESTELA PIERINI 574
JAYNE M. STANDLEY 640

15
"KINETIC MELODY" - MUSIC T'HERAPY AND PARKINSON'S II. MUSIC THERAPY AND EXPERIMENTAL
DISEASE (PD) ; 667 RESEARCH / MUSICA E INVESTIGACION
EXPERIMENTA 714
A JOINT PAPER BY JULIE SUTTON HEAD MUSIC THERAPIST)
DESIGNING, CONDUCTING AND PRESENTING THE
AND DR. MICHAEL SWALLOW (HONORARY CONSULTANT
FINDINGS OF QUALITATIVE STUDIES: A WORKSHOP FOR
NEUROLOGIST) 667 MUSIC THERAPY RESEARCHERS / DISEO, REALIZACIN
Y PRESENTACIN DE LOS RESULTADOS DE LOS
LA MUSICOTERAPIA EN EL TRATAMIENTO DE PACIENTES
ESTUDIOS CUALITATIVOS: UN TALLER PARA LOS
PORTADORES DEL VIRUS DE LA INMUNODEFICIENCIA
INVESTIGADORES 714
HUMANA (HIV O VIH ). 677
KENNETH AIGEN 714
HUGO UEHARA, SILVIA VILLAGRA, VIRGINIA
TOSTO 677 RESEARCH IN MUSIC THERAPY: QUANTITATIVE OR
QUALITATIVE? / INVESTIGACIN DE LA
PREPARATION FOR BIRTH: AN EXPERIMENTAL MUSICOTERAPIA: CUANTITATIVA O CUALITATIVA? 7 1 6
PROPOSAL. 685
DORIT AMIR 716
MARIA VIDESOTT 685
THE EFFECTS OF DICS MUSIC THERAPY / LOS
TECNICAS NEURO - SONORO - MUSICALES APLICADAS A RESULTADOS DEL SISTEMA DE INFORMACIN
PERTURBACIONES DEL SISTEMA NERVIOSO. 694 DOCUMENTAL Y COMUNICACIN DE MUSICOTERAPIA -
DICS 718
MT. GABRIELA WAGNER, DR. RICARDO ALLEGRI694
PIETER VAN DEN BERK 718

16
ANTI-ANXIETY MUSIC AND HEMISPHERICAL FROM MONODY TO POLYPHONY OR FROM SIGN TO
REPERCUSSION / MSICA ANSIOLTICA Y REPERCUSIN SENSE. LOUD-LOW: A SIGNIFICANT FUNCTION / DE LA
INTERHEMISFRICA 720 MONODIA A LA POLIFONA O DEL SIGNO AL SENTIDO.
FUERTE-SUAVE: UNA FUNCIN SIGNIFICANTE 726
TERESA FERNANDEZ, TRINIDAD VIRUES & PEDRO
FIGUEREDO 720 PATRICIA CLAUDIA PELLIZZARI 727

HOW TO ESTABLISH A MUSIC THERAPY RESEARCH PERSONALITY PROJECTIVE INTERVALS TEST / TEST
CLINIC. PROCESS DESCRIPTION / CMO ESTABLECER PROYECTIVO SONORO DE LA PERSONALIDAD 728
UNA CLNICA DE INVESTIGACIN MUSICOTERAPUTICA.
DESCRIPCIN DEL PROCESO 721 CARLA SAVIO 728

HANNE-METTE KORTEGAARD 721 2.1.- PSYCHOLOGY AND MUSIC - PSICOLOGIA

Y MUSICA. (ABSTRACTS) 730
THE DEVELOPMENT OF THE MUSICAL INTELLIGENCE: A
MUSICAL INDUCTION. CHANGES IN THE STATE OF SPIRIT
DIRECT-ACTIVE RESEARCH / EL DESARROLLO DE LA
AND COGNITIVE COMPLEXIZATION / INDUCCIN
INTELIGENCIA MUSICAL: UNA INVESTIGACIN DIRECTA Y
MUSICAL. CAMBIO EN EL ESTADO DE NIMO Y
ACTIVA 723
COMPLEJIZACIN COGNITIVA 730
SILVANA NOSCHESE, ANTONIO IANNACCONE & PINA BOGGI
JOS ANTONIO ADRIN TORRES 730
CAVALLO 723
DREAMS, PLAYING AND MUSIC / SUEOS, JUEGO Y
PSYCHOSOMATIC MUSIC THERAPY / MUSICOTERAPIA
MSICA 732
PSICOSOMTICA 725
JOS DE BACKER & JAN VAN CAMP 732
FRANCESCO PALMIROTTA & M ROSARIA TAGLIENTE 725

17
A SYSTEMS APPROACH TO THE INFLUENCE OF MUSIC EXPERIENCIA TERAPUTICA DE LA MSICA A LA LUZ DE
ON PEOPLE / UNA APROXIMACIN SISTMICA A LA LA PSICOLOGA DEL DESARROLLO HUMANO 740
INFLUENCIA DE LA MSICA SOBRE LA GENTE 734
KIMMO LEHTONEN 740
GERTINA J. BEZUIDENHOUT 734
MENTAL TEMPO, A CONTRIBUTION TO MUSIC THERAPY
THE INFLUENCE OF MUSIC ON COGNITIVE FUNCTIONING / TEMPO MENTAL, UNA CONTRIBUCIN A LA TERAPIA
IN STUDENTS ATTENDING PRACTICAL CLASSES IN MUSICAL 742
HUMAN ANATOMY / LA INFLUENCIA DE LA MSICA
SOBRE LA 736 YASUJI MURAI 742

FUNCIN COGNITIVA DE LOS ESTUDIANTES QUE IS MUSIC A LANGUAGE? THE VALUE OF MUSIC AS A
ASISTEN A CLASES PRCTICAS DE ANATOMIA HUMANA737 COMMUNICATION SYSTEM IN COMPARISON WITH
VERBAL LANGUAGE / ES LA MSICA UN LENGUAJE?
GERTINA J. BEZUIDENHOUT 737 EL VALOR DE LA MSICA COMO SISTEMA DE
COMPARACIN CON EL LENGUAJE VERBAL 744
ORGANISM, MUSIC AND MOVEMENT IN
ONTOPSICHOLOGICAL METHODOLOGY / ORGANISMO, TOMAS NORDLUND 744
MSICA Y MOVIMIENTO EN LA METODOGA
ONTOPSICOLGICA 739 PROCESS MUSIC: A TOOL FOR MUSIC THERAPISTS? /
MSICA PROCESADA: UNA HERRAMIENTA PARA EL
CLAUDIO FASSARI 739 MUSICOTERAPEUTA? 746

THE THERAPEUTIC EXPERIENCE OF MUSIC IN THE LIGHT MARTYN PARKER - EAMES 746
OF THE HUMAN DEVELOPMENT PSYCHOLOGY / LA
TEMPO IN DEPRESSIVE DISORDERS / EL TIEMPO EN
LOS TRASTORNOS DEPRESIVOS 748

18
GABRIELLA G. PERILLI & SANTO RULLO 748 MUSICA, IMAGEN Y EMOCION. UNA PERSPECTIVA
VYGOTSKYANA (TRANSMUTACION AFECTIVA Y
APPLICATION OF SOUND'S EVOLUTIONAL PSYCHOLOGY COGNITIVA A TRAVES DEL ARTE) 753
IN MUSIC THERAPY / APLICACIN EN MUSICOTERAPIA
DE LA PSICOLOGA EVOLUTIVA DEL SONIDO 749 ALVAREZ, J.; IGARTUA, J.; ADRIAN, J.A. Y PAEZ,
D. 753
SARA ROMANO, LYDIA BATTISTON & MADILDE DELLA CELLA749
THE PHENOMENOLOGICAL RECOVERY OF MUSIC AND
APPLICATION OF THE SEMANTIC DIFFERENTIAL FOR ONTOPSYCHOLOGICAL MUSIC THERAPY 774
INVESTIGATING THE INFLUENCE OF MUSIC /
APLICACIN DEL DIFERENCIAL SEMNTICO EN LA ARCO ARIANO 774
INVESTIGACIN DE LA INFLUENCIA DE LA MSICA 7 5 1
2.2.- NEUROPHYSIOLOGICAL VARIATIONS IN
IRINA SHLESINGER 751 THE MUSIC THERAPY RESEARCHES -
VARIABLES NEUROFISIOLOGICAS EN LA
MELODY: AN INTERNATIONAL MEDIUM FOR LANGUAGE INVESTIGACION MUSICOTERAPEUTICA
(ABSTRACTS) 776
ACQUISITION AND LEARNING / LA MELODA: UN
MEDIO INTERNACIONAL PARA ADQUIRIR Y APRENDER EL
A FRAMEWORK FOR QUALITATIVE RESEARCH IN MUSIC
LENGUAJE 752
THERAPY / UN MARCO PARA LA INVESTIGACIN
CUALITATIVA EN MUSICOTERAPIA 776
DAVID E. WOLFE & CANDICE HOM 752

2.1. - PSYCHOLOGY AND MUSIC - PSICOLOGIA KENNETH BRUSCIA 776

Y MUSICA (CONFERENCE HANDOUTS) 753
THE PHYSIOACOUSTIC METHOD / EL MTODO
FISIOACSTICO 778

19
PETRI LEHIKOINEN 778 CUANTIFICACIN DE LOS ASPECTOS CUALITATIVOS DE
LA MSICA UTILIZADOS EN LA TERAPIA VIBRO-
CLINICAL PRACTICE IN MUSIC THERAPY: A GLOBAL ACSTICA (VAT) 787
PERSPECTIVE / PRCTICA CLNICA EN MUSICOTERAPIA:
UNA PERSPECTIVA GLOBAL 780 OLAV SKILLE 787

CHERYL D. MARANTO 780 THE EFFECT OF MUSIC VS. MOTHER`S VOICE ON NBICU
INFANTS`OXYGEN SATURATION LEVELS AND
MUSIC THERAPY IN MEDICAL SETTINGS: THE CHALLENGE FRECUENCY OF BRADYCARDIA / APNEA EPISODES / EL
FOR MORE RIGOROUS RESEARCH, ESPECIALLY IN MUSIC EFECTO DE LA MSICA VS. LA VOZ DE LA MADRE EN
AND MUSIC VIBRATION APPLICATIONS / LA NIOS NBICU CON NIVELES DE SATURACIN DE
MUSICOTERAPIA EN ESCENARIOS MEDICINALES: EL OXGENO Y FRECUENCIA DE BRADICARDIA / EPISODIOS
PROBLEMA DE INVESTIGACIONES MS RIGUROSAS, DE APNEA 789
ESPECIALMENTE EN APLICACIONES MSICA Y
VIBRACIONES MUSICALES 783 JAYNE M. STANDLEY & RANDALL S. MOORE 789

DONALD E. MICHEL & KRIS CHESKY 783 OBSERVATIONAL RESEARCH-CASE STUDIES IN

VIBROACOUSTIC THERAPY / INVESTIGACIN
VIBROACOUSTIC THERAPY RESEARCH IN GENERAL OBSERVACIONAL-ESTUDIOS MODELO EN TERAPIA
MEDICINE / INVESTIGACIN DE LA TERAPIA VIBROACSTICA 791
VIBROACSTICA EN MEDICINA GENERAL 785
TONY WIGRAM 791
LAINE SIMSON & RIINA RAUDSIK 785
2.3.- DEVELOPMENT OF THE MUSICAL
QUANTIFICATION OF QUALITATIVE ASPECTS OF MUSIC FUNCTION / DESARROLLO DE LA FUNCION
USED IN VIBROACOUSTIC THERAPY (VAT) / MUSICAL . (ABSTRACTS) 793

20
SONOROUS-PLASTIC TEST / PRUEBA SONORO- SARAH LPEZ 801
PLSTICA 793
MUSIC AS A CATALYST FOR PERSONAL DEVELOPMENT:
JAIRA PERDIZ DE J. BILEMJIAN 793 THE EFFECTS OF THE BALINESE GAMELAN ON THE
MUSICAL AND COMMUNICATION SKILLS ON A GROUP
PROTO-RHYTHMS: BASIS FOR NON VERBAL TO VERBAL OF MILDLY AND MODERATELY MENTALLY HANDICAPPED
DEVELOPMENT / PROTO-RITMOS BASES PARA EL ADULTS / LA MSICA COMO CATALIZADOR PARA EL
DESARROLLO NO VERBAL AL VERBAL 795 DESARROLLO PERSONAL: LOS EFECTOS DEL GAMELAN
BALINESE EN EL TALENTO MUSICAL Y COMUNICATIVO
RUTH FRIDMAN 796 DE UN GRUPO DE ADULTOS LIGERA Y MODERADAMENTE
MINUSVLIDOS 802
SOUND CELLS / CLULAS SONORAS 797
RAYMOND A.R. MAC DONALD, PATRICK J. O` DONNELL &
JACQUES JOST & ESTER PINEDA 797 JANET WALLACE 803
FROM UTERUS ONWARD: TO COMMUNICATE BY SOUNDS ECHO REPETITION / LA VUELTA EN ECO 804
/ A PARTIR DEL TERO: COMUNICAR CON SONIDOS798
DOMINIQUE PERROUAULT 804
FRANCESCA LACCETTI 798
2.4.- ACOUSTIC AND SOUND PERCEPTION -
THE MUSICAL-EMOTIONAL NATURE OF LULLABIES AND ACUSTICAY PERCEPCION SONORA
PLAYSONGS AS REFLECTIVE RESONANCES OF THE ( ABSTRACTS) 805
PARENTAL COALITION / LA ESENCIA MUSICAL Y
EMOCIONAL DE LAS CANCIONES DE CUNA Y DE NIOS CUT THE NOISE / CORTA CON EL RUIDO 805
COMO RESONANCIA REFLECTORA DE LA COALICIN
PATERNAL 800 REN COUPAUD 805

21
PROPOSAL OF A PROJECTIVE SOUND TEST FOR THE HEIDI AHONEN 814
EVALUATION OF THE EXPRESSIVE POTENTIALITIES OF
THE INDIVIDUAL / PROPUESTA DE UN TEST MUSIC THERAPY FOR PEACE: A GLOBAL IMPERATIVE /
PROYECTIVO SONORO PARA LA EVOLUCIN DE LAS MUSICOTERAPIA PARA LA PAZ: UN IMPERATIVO
POTENCIALIDADES EXPRESIVAS DEL INDIVIDUO 807 GLOBAL 815

RENATO DE MICHELE 808 EDITH HILLMAN BOXILL & JOSEPH MORENO 815

THROUGH AUDITION TO LISTENING. THROUGH RECENT PUBLICATIONS, RESOURCES, DIRECTIONS AND

LISTENING TO COMMUNICATION / POR LA AUDICIN A NEW RESEARCH PROPOSALS IN THE INTERFACE OF
LA ESCUCHA. POR LA ESCUCHA A LA COMUNICACIN809 THERAPY, EDUCATION AND MEDICINE /
PUBLICACIONES, RECURSOS, INDICACIONES RECIENTES Y
M ISABEL SALINAS ALONSO & LORENZO CARBAJO ESTEBAN NUEVAS PROPUESTAS DE INVESTIGACIN EN LA
809 FRONTERA COMN DE LA TERAPIA, LA EDUCACIN Y LA
MEDICINA 817
SOUNDS, COLOURS AND PYRAMID AS DIFFERENT
ENERGETIC SOURCES TO HEAL / LOS SONIDOS, LOS NORMAN A. GOLDBERG 817
COLORES Y LA PIRMIDE COMO FUENTES ENERGTICAS
PARA CURAR 812 THE MUSICAL DICTATION OF TOTILA ALBERT AS A
WINDOW TOWARDS THE VIVENCIAL WORLD OF
FELICIANA SCURTULESCU 812 BRAHMS /
EL DICTADO MUSICAL
III. MUSIC AND MUSIC THERAPY - MUSICA DE TOTILA ALBERT COMO UNA VENTANA AL MUNDO
Y MUSICOTERAPI 814 VIVENCIAL DE BRAHMS 819

THE ROLE OF MUSIC IN MUSIC THERAPY / LA FUNCIN CLAUDIO NARANJO 819

DE LA MSICA EN MUSICOTERAPIA 814

22
HARMONIC THERAPY / TERAPIA ARMNICA 821 3.2.- CULTURE, MUSIC AND MUSIC THERAPY
- CULTURA, MUSICA Y MUSICOTERAPIA
WERNER SCHULZE 821 (ABSTRACTS) 858

3.1.- TECHNICAL AND MUSICAL ASPECTS - MUSIC AND TRAGEDY / MSICA Y TRAGEDIA 858
ASPECTOS TECNICO-MUSICALE
(CONFERENCE HANDOUTS) 823 DENIS ANDR CASAGRANDE 858

TECHNOLOGY IN THE SERVICE OF MUSIC THERAPY WITH ANALYSIS OF MOTION IN THE THERAPEUTIC NON-
PARTICULAR REFERENCE TO "MIDIGRID" 823 VERBAL COMMUNICATION PROCESS / ANLISIS DEL
MOVIMIENTO EN EL PROCESO DE COMUNICACIN
MARY E. ABBOTSON, RAYMOND ABBOTSON, ANDY HUNT Y TERAPUTICO NO-VERBAL 860
ROSS KIRK 823
ALICIA COPPO 860
INFORMATION TECHNOLOGY AND EXPRESSIVE THERAPY832
MUSIC THERAPY IN THE THIRD MILLENNIUM / LA
CLAUDIO CAVALLINI, BRIGITTE FLUCHER FEDERICO TUSBERTI, MUSICOTERAPIA EN EL TERCER MILENIO 862
FRANCO VECCHI Y DANIELE VESCOVINI - 832
ELISABETH DOS SANTOS FELICIO 862
MUSIC AND SOFTWARE 849
MASS MEDIA AND SOUND IDENTITY / MASS MEDIA E
ANDREW CLEATON, ROSS KIRK, ADELE DRAKE 849 IDENTIDAD SONORA 864

UNLOCKING MUSICALITY: USING SOUNDBEAM AS A NEW RENATO DE MICHELE 864

KEY TO ELOQUENCE. 853
TOWARDS A UNIVERSAL THEORY OF MUSIC THERAPY: A
TIM SWINGLER 853 MULTICULTURAL APPROACH / HACIA UNA TEORIA

23
UNIVERSAL DE TERAPIA MUSICAL: UN ACERCAMIENTO MARA PICCOLO 872
MULTICULTURAL 865
MUSIC THERAPY IN A CONTEXT OF POLY-EXPRESSION /
JOSEPH MORENO 866 MUSICOTERAPIA EN UN CONTEXTO POLI-EXPRESIVO874

THE SINGING THAT OPENS THE HEART: LIANNA POLYCHRONIADOU- PRINOU 874
TRANSPERSONAL SINGING / EL CANTO QUE ABRE EL
CORAZN: EL CANTO TRANSPERSONAL 867 3.2. CULTURE, MUSIC AND MUSIC THERAPY -
CULTURA, MUSICA Y MUSICOTERAPIA
SILVIA NAKKACH 867 (CONFERENCE HANDOUTS) 876

EXPRESSION AND IMPRESSION IN BAROQUE MUSIC / LA EXPRESION CORPORAL EN IA FORMACION DEL

EXPRESIN E IMPRESIN DE LA MSICA BARROCA 8 6 8 MUSICOTERAPEUTA 876

JOS LUIS PALACIOS GAROZ 868 GREGORIO TISERA 876

THE ONTOPSYCHOLOGICAL CONCEPT OF SONOROUS LA TRANSICION ESTETICA: INDICIOS DE UN PENSAR

IDENTITY: EXPRESSION OF THE INDIVIDUAL`S ORIGINAL ESTETICO EN MUSICOTERAPIA 892
INWARDNESS OR MUSICAL SEMANTICS / EL CONCEPTO
ONTOPSICOLGICO DE LA IDENTIDAD SONORA:
GUSTAVO RODRIGUEZ ESPADA 892
EXPRESIN DE LA INTERIORIZACIN ORIGINAL DEL
ARCHETYPICAL ASPECTS OF "POPULAR" MUSIC IN MUSIC
INDIVIDUO O SEMNTICA MUSICAL 870
THERAPY 908
MARA PICCOLO 870
ELENA DE ROSA Y DIANA FACCHINI 908
ONTOPSYCHOLOGIC MUSIC THERAPY /
MUSICOTERAPIA ONTOPSICOLGICA 872

24
UN MODELO PARA EL ANALISIS DEL DICURSO EN APROXIMACIN ARTSTICA MLTIPLE A LA
MUSICOTERAPIA 920 MUSICOTERAPIA: LA IMAGINACIN Y LA VIDA
COTIDIANA 972
PATRICIA LEONOR SABATELLA 920
HEIDI AHONEN 972
THE ORIGINS OF MUSIC TERAPY IN THE HEALING
RITUALS OF NON-LITERATE SOCIETIES 932 MAN AND MUSIC: ONTOPHILOGENETIC DEVELOPMENT /
EL HOMBRE Y LA MSICA: SU DESARROLLO
DR. CHAVA SEKELES (PHD, R.M.T., O.T.R.)* 932 ONTOFILOGENTICO 974

MUSIC THERAPY AS CULTURAL ENGAGEMENT - OR: LEONOR F. DE ALEMANN 974

HOW TO CHANGE THE WORLD - IF ONLY A BIT 951
VISUAL PLASTIC AND MUSIC / PLSTICA VISUAL Y
BRYNJULF STIGE 951 MSICA 976

IMPORTANCIA DE LA RELACION MEDICO PACIENTE Y EL ANA M BALLESTA & M ANGELES MARTI 976
RESCATE DE LOS VALORES PERSONALES MEDIANTE LA
MUSICOTERAPIA 965 RESONANCE LABORATORY: COORDINATED USE OF
VOICE, GESTURE, MOVEMENT AND POLYPHONIC
DRA. AGUSTINA ISABEL VERGES Y RUBEN ACUA 965 INSTRUMENTAL IMPROVISATION IN MUSIC THERAPY /

3.3.- MUSIC AND MUSICAL DEVELOPMENT - LABORATORIO DE RESONANCIAS: EL USO

MUSICA Y DESARROLLO MUSICAL COORDINADO DE LA
(ABSTRACTS) 972 VOZ, DEL GESTO, MOVIMIENTO Y DE LA IMPROVISACIN
MUSICAL POLIFNICA EN MUSICOTERAPIA 978
THE CROSS-ARTISTIC APPROACH TO MUSIC THERAPY:
THE IMAGINATION AND HERE-AND-NOW LIFE /
MICHAEL DWYER 978

25
VOICE AS A MEANS OF EXPRESSING EMOTIONS / LA TRANSFERENCE IN THE MUSIC THERAPY RELATIONSHIP
VOZ COMO MEDIO DE EXPRESAR LAS EMOCIONES 9 7 9 / TRANSFERENCIA EN LA RELACIN
MUSICOTERAPUTICA 986
GIANLUIGI DI FRANCO 979
LOUISE MONTELLO 986
THE MENTAL RETARDATION LABEL AND MUSIC
TEACHERS` AND PROSPECTIVE TEACHERS` ADVANCED MUSIC THERAPY SUPERVISIN WITH FOCUS
EXPECTATIONS FOR CHILDREN'S SOCIAL AND MUSIC ON ISSUES OF COUNTERTRANSFERENCE INSIDE AND
BEHAVIORS / EL TRMINO RETRASO MENTAL Y LAS OUTSIDE THE MUSIC / SUPERVISIN DE LA
EXPECTATIVAS DE PROFESORES Y FUTUROS MUSICOTERAPIA AVANZADA, DESTACANDO EL TEMA DE
PROFESORES DE MSICA PARA CON LOS LA CONTRATRANSFERENCIA DENTRO Y FUERA DE LA
COMPORTAMIENTOS SOCIALES Y MUSICALES DE LOS MSICA 987
NIOS 980
LOUISE MONTELLO 987
JUDITH A. JELLISON & ROBERT A. DUKE 980
I HAD IT, BUT I DID NOT REALIZE IT. MUSICAL
SONG SENSITATION: THE THERAPEUTIC USE OF SONG CREATIVITY WORKSHOP USING THE VOICE AND OTHER
AND ITS EFFECT UPON GROUP PROCESS / SONG MATERIALS / LO TENA Y NO LO SABA. TALLER DE
SENSITATION: LA UTILIZACIN TERAPUTICA DE LA CREATIVIDAD MUSICAL A PARTIR DE LA VOZ Y
CANCIN Y SUS EFECTOS SOBRE EL PROCESO GRUPAL982 DIVERSOS MATERIALES 988

JOANNE LOEWY 982 NLIDA HIROKO NAKAMURA 988

WORKSHOP ABOUT RYTHM / TALLER SOBRE RITMO985 MUSICAL PSYCHO-DRAMA / PSICODRAMA MUSICAL989

ATTILA RICHARD MISSURA 985 MONICA PETRUCH DE TANNY & ARIELA NIR 989

26
THE FREE IMPROVISATION GROUP: SOUNDS AND WHERE THERAPY AND EDUCATION MEET AND DIVIDE /
CEREMONIES OF KNOWLEDGE / GRUPO DE DONDE LA TERAPIA Y LA EDUCACIN SE ENCUENTRAN Y
IMPROVISACIN LIBRE: SONIDOS Y CEREMONIAS DEL SE SEPARAN 1000
CONOCIMIENTO 991
AURIEL WARWICK 1000
GUSTAVO RODRIGUEZ ESPADA 991
IV. TRAINING AND "ROLE" OF THE MUSIC
EVOLUTIONAL DEVELOPMENT / DESARROLLO THERAPIST - FORMACION Y "ROL " DEL
EVOLUTIVO 992 MUSICOTERAPEUTA 1000

MUSIC THERAPY: CREATIVE PROCESS, THERAPEUTIC

SARA ROMANO 992
PROCESS / MUSICOTERAPIA: PROCESO CREATIVO,
MUSIC THERAPY`EXPERIENCES IN ITALIAN SCHOOLS / PROCESO TERAPUTICO 1000
EXPERIENCIAS DE MUSICOTERAPIA EN LAS ESCUELAS
ITALIANAS 993
PATXI DEL CAMPO SAN VICENTE 1001

IV. CONFERENCE HANDOUTS 1002

LILIANA ROSSI PRITONI 993
TRAINING OF MUSIC THERAPEUTISTS BETWEEN MUSIC
MUSIC AND EDUCATION / MSICA Y EDUCACIN 995
AND THERAPY 1002
M LOURDES SEKEFF ZAMPRONHA 995 GIUSEPPA PISTORIO, G. GASTALDI Y G. SERAZZI-NICODANO1002

MUSIC-PSYCHOTHERAPEUTIC EXPERIENCIES /
SABER O NO SABER ACERCA DEL PROBLEMA DE LA
EXPERIENCIAS MUSICO-PSICOTERAPUTICAS 997
TEORIA EN MUSICOTERAPIA 1012
MARISTELA PIRES DA CRUZ SMITH 997 DIEGO SCHAPIRA 1012

27
4.1.- SCHOOLS, METHODOLOGY, METODOLOGA. UNA IMPORTANTE PARTE DEL
PROGRAMMING, AIMS - ESCUELAS. PROGRAMA DE LA CARRERA DE MUSICOTERAPIA EN LA
METODOLOGIA, PROGRAMACION, UNIVERSIDAD DE AALBORG. 1032
OBJETIVOS (ABSTRACTS) 1029
INGE NYGAARD PEDERSEN 1032
DIDACTIC MUSIC THERAPY / MUSICOTERAPIA
DIDCTICA 1029
STANDARDS, CURRICULAR STRUCTURES, AND
COMPETENCES FOR MUSIC THERAPY EDUCATION AND
ROLANDO O. BENENZON 1029
TRAINING / STANDARS, ESTRUCTURAS CURRICULARES
Y COMPETENCIAS PARA LA EDUCACIN
ACTIVITIES OF THE ITALIAN AXXOCIATION FOR THE
MUSICOTERAPUTICA Y SU FORMACIN 1034
STUDY OF MUSIC THERAPY: MUSIC THERAPY
REHABILITATION CENTRE AND THE SCHOOL OF
MARILYN I. SANDNESS 1034
PROFESSIONAL TRAINING FOR MUSIC THERAPISTS /
4.1. - SCHOOLS, METHODOLOGY,
PROGRAMMING, AIMS - ESCUELAS.
ACTIVIDADES DE A.I.S.MT.: CENTRO DE REHABILITACIN METODOLOGIA, PROGRAMACION,
DE MUSICOTERAPIA Y ESCUELA DE FORMACIN OBJETIVOS (CONFERENCE HANDOUTS) 1 0 3 6
PROFESIONAL PARA MUSICOTERAPEUTAS 1031
THE ESSENTIAL ROLE OF ONTOPSYCHOLOGICAL
GIOVANNA MUTTI & ALESSIA MARTINELLI 1031 PSYCHOTHERAPY AS PRESUPPOSITION FOR
MUSICTHERAPIC TRAINING 1036
"SELFEXPERIENCE FOR STUDENTS" AS A
METHODOLOGY. A COMPULSORY PART OF THE MUSIC MARCELLO BRUOGNOLO 1036
THERAPY PROGRAMM AT AALBORG UNIVERSITY. / "LA
PROPIA EXPERIENCIA DE LOS ALUMNOS DE LA CARRERA MUSIC THERAPY IN PORTUGAL 1042
DE MUSICOTERAPIA" COMO PARTE DE UNA

28
 GRACIELA CINTRA GOMES, JACQUELINE VERDEAU-PAILLES, GREGORIO TISERA 1101
ELEUTERIO GOMES DE AQUILAR Y TERESA PAULA LEITE 1042
LA ACTIVIDAD DE MUSICOTERAPIA EN CREI-SANTS: UN
MUSIC THERAPIE : ART-THERAPIE OU PSYCHOTHERAPIE1049 MODELO DE FORMACION E INTERVENCION 1118

R. FORESTIER 1049 FELICIANO CASTILLO ANDRS Y M. DOLORES TORRES JORDI1118

IN SEARCH OF THE GOOD EAR : SOME THOUGHTS ON 4.2.- TRAINING DESIGNS IN EVERY SUBJECT -
POST-GRADUATE MUSIC THERAPY TRAINING 1058 DISEFIOS INTERDISCIPLINARIOS DE
FORMATION (ABSTRACTS) 1134
SARAH HOSKYNS 1058
CREATING THE ROLE OF THE MUSIC THERAPIST ON THE
BASIS OF THEORETICAL-PRACTICAL-LEARNING IN THE
LA MUSICOTERAPIA DENTRO DE UN CURSO DE
INTERACTION BETWEEN OBSERVATION-SUPERVISION-
FORMACIN PERMANENTE DEL PROFESORADO, Y COMO
APPLICATION IN MENTAL DISABILITY / FORMACIN
ASIGNATURA EN EL NUEVO PLAN DE ESTUDIOS DE
DEL MUSICOTERAPEUTA A PARTIR DEL PROCESO DE
PSICOPEDAGOGA, CON METODOLOGA A DISTANCIA1068 APRENDIZAJE TERICO-PRCTICO EN LA INTERACCIN-
OBSERVACIN-SUPERVISIN. APLICACIN EN LA
PILAR LAGO CASTRO 1068 DISCAPACIDAD MENTAL
1135
PROFESSIONAL PROFILE OF THE MUSIC THERAPIST IN
ITALY: THOUGHTS AND PROPOSALS 1087
IRIS MARIANA COCHIA & RICARDO RODRIGUEZ 1135
PIER LUIGI POSTACHINI Y MARZIA MANCINI 1087
PSYCHODYNAMIC, INTEGRATIVE WORK WITH THE
PHENOMENON OF THE INNER CHILD EXPRESSED AND
LA EXPRESION CORPORAL EN IA FORMACION DEL
REFLECTED THROUGH BODY, VOICE AND MUSIC
MUSICOTERAPEUTA 1101
INSTRUMENTS / TRABAJO PSICODINMICO E

29
INTEGRATIVO DEL FENMENO DEL NIO INTERNO ATENCIN FLUCTUANTE MUSICAL: UNA REFLEXIN
EXPRESADO Y REFLEJADO A TRAVS DEL CUERPO, LA RESPECTO AL PAPEL DEL MUSICOTERAPEUTA 1166
VOZ E INSTRUMENTOS MUSICALES 1136
MARCIA MARIA DE SILVA CIRIGLIANO 1166
INGE NYGAARD PEDERSEN 1136
ENCUADRE: LIMITANTE O PERMISOR? 1175
4.2. - TRAINING DESIGNS IN EVERY SUBJECT
- DISEFIOS INTERDISCIPLINARIOS DE DIEGO SCHAPIRA 1175
FORMATION (CONFERENCE HANDOUTS)1 1 3 7
LAS PRINCIPALES IDEAS QUE SUSTENTAN EL EJERCICIO
UN MODELO DE MUSICOTERAPIA PARA LA SALUD. UN PROFESIONAL DEL MUSICOTERAPEUTA EN LA
ESPACIO DIFERENTE PARA PENSAR LA REALIDAD 1 1 3 7 ARGENTINA. 1186
AIZENWASER, MARCELO BIANCHEDI, JULIO FAINGUERSCH Y GABRIELA WAGNER Y M CELIA PREZ 1186
ROBERTO SEVILLA 1137
4.4.- PROFESSIONAL PROFILE OF THE MUSIC
SELF EXPERIENCE FOR STUDENTS AS A METODOLOGY - THERAPIST - PERFILPROFESIONAL DEL
A COMPULSORY PART OF THE MUSIC THERAPY MUSICOTERAPEUTA (ABSTRACTS) 1238
PROGRAM AT AALBORG UNIVERSITY. 1146
MUSIC THERAPY IN BELGIUM / LA MUSICOTERAPIA EN
INGE NYGAARD PEDERSEN 1146 BLGICA 1238

4.3.- THE MUSIC THERAPIST ROLE IN THE JOS DE BACKER 1238

INSTITUTION - EL "ROL " DEL
MUSICOTERAPEUTA EN LAS INSTITUCIONES 4.4. - PROFESSIONAL PROFILE OF THE MUSIC
(CONFERENCE HANDOUTS) 1165 THERAPIST - PERFILPROFESIONAL DEL

30
MUSICOTERAPEUTA (CONFERENCE CLAUDIA MENDOZA 1277
HANDOUTS) 1239

THE RESPONSIBILITIES OF THE MUSIC THERAPIST 1 2 3 9

RUTH BRIGHT. 1239

THE USE OF VIDEO BY THE MUSIC THERAPIST -

TOWARDS A CLEARER PROFESSIONAL IDENTITY. 1254

AMELIA OLDFIELD, M.PHIL. RMTH 1254

PROFESSIONALISATION OF MUSIC THERAPY 1268

MARTYN PARKER-EAMES 1268

4.5.- ETHICAL CODE OF THE MUSIC

THERAPIST / CODIGO ETICO DEL
MUSICOTERAPEUTA (ABSTRACTS) 1276

ROUND TABLE ON ETHICS / MESA REDONDA SOBRE

TICA 1276

CHERYL D. MARANTO 1276

MUSIC THERAPY IN LATIN AMERICA / LA

MUSICOTERAPIA EN AMRICA LATINA 1277

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 Brikman, and under an agreement with the
Occupational Therapy service of the Argentinean
I. CLINICAL MUSIC THERAPY / Jewish Women's Council, with the objective of
MUSICOTERAPIA CLINICA
implementing movement stimulation by means of sound
and vice-versa, under the responsibility of the Music
Therapist Marcelo Gindlin and supervised by Professor
Lola Brikman.
1.1.- MUSIC THERAPY IN HANDICAPPED
PEOPLE / MUSICOTERAPIA EN DISMINUIDOS This service has 20 adult mentally disabled patients,
(ABSTRACTS)
who meet to carry out different activities such as
lectowriting, physical education, handicraft, gardening
and music therapy. Such meetings last two and a half
M U SI C AN D M O VEM EN T - AN I N T EG R AT ED hours a week per activity.
VI SI O N M SI C A Y M O VI M I EN T O - U N A VI SI N
I N T EG R AD O R A
Este trabajo fue realizado con el auspicio y
L OLA B RIKMAN asesoramiento de la Funcin Arte y Movimiento Lola
Brikman, en convenio con el Servicio de Terapia
Ocupacional del Consejo Argentino de Mujeres
This work was carried out under the auspices and
Israelitas, con el objetivo de implementar la
advice of the Art and movement Foundation Lola

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estimulacin del movimiento a travs del sonido y Music, as a discipline of sensitivity, is directed to all
viceversa, bajo la responsabilidad del Musicoterapeuta parts of the individual: his body, his psyche, his
Marcelo Gindlin y la supervisin de la Prof. Lola emotivity, his thoughts ...
Brikman.
The musical act exercises multi-ensorily:
Este servicio cuenta con 20 pacientes adultos con
- Tactile sensitivity, one could even say vibrotactile,
deficiencias mentales, que se renen para realizar
as we are referring to sensitivity to musical sounds.
diferentes actividades tales como lectura y escritura,
- Hearing, concretely in the perceptive phase,
educacin fsica, manualidades, jardinera y
which can lead the individual to listening.
musicoterapia. Los encuentros tienen una duracin de
dos horas y media semanales por cada actividad. - Sight, which allows us to prepare a musical
gesture and appreciate the reactions of others to what
has been broadcast or heard.
T H E APL L I C AT I O N O F M U SI C T H ER APY O N
- Taste and smell, which add valuable information
D I SABL ED T EEN AG ER S APL I C AC I O N ES D E
on the sound material, the instrument...
L A M U SI C O T ER API A SO BR E AD O L ESC EN T ES
In case of multiple disability, music therapy offers a
D I SM I N U I D O S
really therapeutic activity for the teenager,
A LAIN C ARR
- it supplies a possibility of sensorial stimuli,

33
- it favours his/her social life (collective practice), - el gusto y el olfato que aportan valiossimas
informaciones adicionales acerca del material sonoro,
- it constitutes not only a means of expression, but
el instrumento...
also a means of communication.
En caso de disminucin mltiple, la musicoterapia
ofrece una actividad verdaderamente teraputica para
La msica, como disciplina de lo sensible, se dirige a el adolescente.
todas las partes del individuo: su cuerpo, su psiquismo,
- le proporciona la posibilidad de estmulos
su emotividad, su pensamiento...
sensoriales
El acto musical ejercita la polisensorialidad:
- favorece su vida social (prcticas colectivas)
- la sensibilidad tctil, se podra incluso decir
- constituye un medio de expresin pero tambin
vibrotctil ya que se trata de la sensibilidad a los
de comunicacin.
sonidos musicales.

- el odo, en particular en la fase perceptiva que

puede llevar el individuo a Escuchar.

- la vista que permite preparar el gesto musical y

apreciar las reacciones de los dems ante lo que se ha
emitido u odo.

34
 (The controversy was examined on January 23, 1992,
F AC I L I T AT ED C O M M U N I C AT I O N M O T I VAT ED
when the American television program "Prime Time"
BY N O R D O F F - R O BBI N S ST YL E C R EAT I VE
featured an interview with F.C. pioneer Dr. Douglas
M U SI C T H ER APY / C O M U N I C AC I N
Bicklen of Syracuse University.)
F AC I L I T AD A, M O T I VAD A PO R L A
M U SI C O T ER API A C R EAT I VA D EL M T O D O In his comprehensive book "Improvisational Models of
N O R D O F F - R O BBI N S Music Therapy," Dr. Kenneth Bruscia of Temple
University describes "creative music therapy" as an
G INGER C LARKSON improvisational approach individual and group therapy
developed by Paul Nordoff, an American composer-
pianist and Clive Robbins, a British-trained special
Facilitated Communication (F.C.) was developed fifteen
educator. Nordoff and Robbins collaborated from 1959 -
years ago by an Australia special educator, Rosemary
1976, working internationally as cotherapists with
Crossley. It is a training method to facilitate written
mentally, emotionally and physically handicapped
expression of people who have had little or no
children.
meaningful communication. A facilitator supports the
hand, wrist, or elbow of an individual who selects letters The Nordoff-Robbins approach is called "creative"
and forms words on an alphabet board, electric because the music therapist uses musical
typewriter, or computer keyboard. The technique has improvisations creatively within each session to seek,
generated great controversy internationally among gain and maintain contact with the client from moment
autism researchers and is revolutionizing their field. to moment. The therapist also creates a progression of

35
therapeutic musical experiences from session to est revolucionando este campo. (La controversia se
session, supporting stages in each client's manifest el 23 de enero de 1992, cuando en el curso
development. The primary purpose of the therapist's del programa "Prime Time", se emiti una entrevista al
improvisations is to involve clients actively in music- Dr. Douglas Bicklen de la Syracuse University, pionero
making, which is accessible to exploration and de la comunicacin facilitada).
transformation. Nordoff and Robbins modeled how
En su libro "Improvisational Models of Music Therapy",
music can be a primary means of motivating and
el Dr. Kenneth Bruscia de la Temple University describe
effecting clients' therapeutic growth.
la "musicoterapia creativa" como mtodo de
improvisacin para la terapia individual y de grupo
desarrollado por Paul Nordoff, un compositor-pianista
La Comunicacin Facilitada (CF) fue desarrollada hace
estadounidense, y Clive Robbins, un educador especial
quince aos por una educadora australiana, Rosemary
ingls. Nordoff y Robbins colaboraron desde 1959 a
Crossley. Es un mtodo de formacin para facilitar la
1976 trabajando a nivel internacional como co-
expresin escrita de las personas que tienen escasa o
terapeutas con nios disminuidos a nivel mental,
ninguna comunicacin inteligible. Un "facilitador" sujeta
emocional y fsico.
la mano, el pulso o el codo del paciente que elige las
letras y forma palabras en un tablero alfabtico, una El mtodo Nordoff-Robbins se denomina "creativo"
mquina de escribir elctrica o un teclado de porque el musicoterapeuta utiliza creativamente las
ordenador. Esta tcnica dio origen a una controversia improvisaciones musicales en cada sesin para buscar,
internacional entre los investigadores del autismo y ganar y mantener el contacto con el paciente. El

36
terapeuta tambin crea una progresin de experiencias In this report we refer the case of a seven year-old
musicales, sesin tras sesin, apoyando las fases de young girl, born dumb, under psychotherapy treatment
desarrollo de cada paciente. El objetivo primario de las since the age of two. The diagnosis is symbiotic
improvisaciones del musicoterapeuta es implicar psychosis, with autistic traits.
activamente a los pacientes en la creacin musical, que
We underline a new modality of intervention, that comes
est abierta a la exploracin y transformacin. Nordoff y
from twenty years activity with deaf and mental retarded
Robbins modelaron la manera en que la msica puede
children. This method is producing good results also in
ser un medio primordial para motivar y realizar el
the treatment of psychotic children. The main points are:
crecimiento teraputico del paciente.
- the child is sitting on top of a square piano;

- a psychomotorial therapist is sitting on the piano, near

C O R PO R EAL R ESO N AN C E AN D SO U N D the child;
D I AL O G U E I N T H E T R EAT M EN T O F I N F AN T I L E
- one or both parents are also present, beside the piano;
AU T I SM / L A R ESO N AN C I A C O R P R EA Y EL
- the musictherapist plays the piano, observing the
D I L O G O D E SO N I D O S EN EL T R AT AM I EN T O
child, matching his tempo, his energetic level, his tone
D EL AU T I SM O I N F AN T I L
variations, his movements. Reading the minimal
G IULIA C REMASCHI & MAURO S CARDOVELLI posture and body cues of the child like a living score, he
reaches a deep empathy state with the child;

37
- the psychomotorial therapist intevenes with massage chances to intact inside the family.
and tonic dialogue, matching the child postural and
tonic variations and the rythm and energy of piano
music production.
En esta ponencia referiremos el caso de una nia de
siete aos, nacida con sordera y bajo tratamiento
In fact, the matching is the most powerful way of deep
psicoterpico desde la edad de dos aos. El diagnstico
acknowledgement and acceptance (Bandler, Grinder,
es psicosis simbitica con rasgos autistas.
1975; Scardovelli, 1992) fit to build a safe base (Bowlby,
1988), from which start and explore the world and begin
Destacamos una nueva modalidad de intervencin que

to grow again.
surge de veinte aos de actividad con nios sordos y
retrasados mentales. Este mtodo est produciendo
Thanks to the contact with the cover of the piano, the
buenos resultados tambin en el tratamiento de los
child receives directly in the body the sound vibrations,
nios psicticos. Los puntos principales son:
that, being syntonic with her emotional state, induce
and facilitate the body internal resonance and,
- la nia est sentada sobre un piano;

therefore, increase the wish to open and facilitate the - un terapeuta psicomotor est sentado sobre el piano,
relationship with the external world (Cremaschi, 1987). cerca del nio;

Usually, we can see changes in physiology, tono, visual - tambin estn presentes uno o ambos padres, al
orientation. In fact, parents begin to change their static lado del piano;
vision of the child and start to see more productive
- el musicoterapeuta toca el piano, observando a la

38
nia, ajustando su tiempo, su nivel energtico, sus y posibilitan la resonancia corprea interior y, por lo
variaciones de tono, sus movimientos a los de la nia. Al tanto, aumentan el deseo de abrirse y facilitan la
leer las ms mnimas indicaciones en la postura y el relacin con el mundo exterior (Cremaschi, 1987).
cuerpo de la nia, el musicoterapeuta alcanza un
Generalmente, podemos observar cambios en la
estado de profunda empata con la nia;
fisiologa, el tono, la orientacin visual. La implicacin
- el terapeuta psicomotor interviene con el masaje y el de los padres es muy importante en el desarrollo del
dilogo tnico, acoplndose a las variaciones tnicas y proceso teraputico. En efecto, los padres empiezan
de postura de la nia y al ritmo y la energa de la msica a modificar su visin
del piano.
esttica del nio y a ver oportunidades ms
En efecto, el acoplamiento, es la forma ms poderosa provechosas de interaccin dentro de la familia
de conocimiento y aceptacin profunda (Bandler,
Grinder, 1975; Scardovelli, 1992), adecuada para
construir una base slida (Bowbly, 1988), para T H E SPO N T AN EO U S G R O WT H O F T H E
empezar a explorar el mundo y empezar a crecer de SPEEC H I N T H E D EAF C H I L D / EL
nuevo. D ESAR R O L L O ESPO N T N EO D E L A PAL ABR A
EN EL N I O C O N SO R D ER A
Gracias al contacto con la tapa del piano, la nia recibe
directamente en su cuerpo las vibraciones del sonido G IULIA C REMASCHI
que, al ser sintnicas con su estado emocional, inducen

39
A Scientific Research is being carried on in order to test e) The sound, besides being relation in itself,
the results in Music Therapy obtained on deep-deaf and because its components are never separable (Timbre,
deaf children with associated disorders, diagnosed and Length, Instensity and Duration), it is relationship in the
prothesied within the first 18 months of life. widest meaning.

Methodological criteria or my way of proceeding in 2) The Resonance phenomenon is the way by which
music therapy: any perception is possible.

1) Knowledge of the physical phenomena 3) The Resonance phenomenon is considered in

concerning the perception of the sound-waves in the relation with the bodily perception, the hearing
human being. perception and the use of hearing-aid.

a) Sound is relationship. 4) The deaf child perceives the sound (fundamental

tones and overtones) in a very natural way, thus tuning
b) Sound is a complex phenomenon as a result of
his voice and opening himself to the verbal
fundamental pitch and other vibrations called
communication.
overtones.
5) The Musical Improvisation is the best way to
c) Sound includes Timbre, Length, Intensity and
understand every little communicating hint coming from
Duration.
the child.
d) The duration of the sound must be considered by
6) The Method can be expressed by the word
the relationship beteen Silence-Sound-Silence.
"Eurythmy", meant as the relationship between music-

40
therapist/child, both involved in the whole cycle: Sound- musicoterapia:
Rhytm-Movement.
1) Conocimiento de los fenmenos fsicos
7) We only consider the spontaneous responses of relacionados con la percepcin de las ondas sonoras
the child. en el ser humano;

8) The Music Therapy classes usually take place in a) El sonido es relacin.

the presence of one or both parents.
b) El sonido es un fenmeno complejo,
9) The music-therapist uses the grand piano, consecuencia de un tono fundamental y otras
idiophonic instruments (harp, guitar and so on...), wind vibraciones llamadas sobretonos.
instruments (flutes, horns...), so that he may always
c) El sonido incluye timbre, longitud, inten-sidad y
keep the child's interest alive.
duracin.

d) La duracin del sonido se debe considerar por la

Se est llevando a cabo una investigacin cientfica relacin entre silencio-sonido-silencio.
para comprobar los resultados de la musicoterapia
e) El sonido, adems de ser relacin en s mismo,
aplicada a nios que sufren sordera profunda o sordera
puesto que sus componentes no se pueden separar
con trastornos asociados, diagnosticados y con
nunca (timbre, longitud, intensidad y duracin) significa
prtesis desde los primeros 18 meses de vida.
tambin relacin en el sentido ms amplio.
Criterios metodolgicos de mi forma de proceder en la
2) El fenmeno de la resonancia es la forma en que

41
es posible cualquier percepcin. 8) Las clases de musicoterapia normalmente tienen
lugar en presencia de uno o ambos padres.
3) El fenmeno de la resonancia se estudia en
relacin con la percepcin corporal, auditiva y la 9) El musicoterapeuta utiliza el piano, instrumentos
utilizacin de las prtesis auditivas. de cuerda (arpa, guitarra, etc.), instrumentos de viento
(flautas, cuernos, etc.),
4) El nio que sufre sordera percibe el sonido (tonos
y sobretonos fundamentales) de forma muy natural, para mantener siempre vivo el inters del nio.
afinando as su voz y abrindose a la comunicacin
verbal.
T H E SI G N I F I C AN C E O F I M PR O VI SAT I O N AL
5) La improvisacin musical es la mejor forma de
M U SI C T H ER APY F O R C H I L D PSYC H I AT R Y /
comprender cualquier indicio de comunicacin
L A I M PO R T AN C I A D E L A T ER API A M U SI C AL
procedente del nio.
I M P R O V I S A D A ( I .M .T .) E N P S I Q U I A T R A
6) El mtodo se puede resumir con la palabra I N F AN T I L
"Euritmia", considerada como la relacin entre el
J EAN E ISLER
musicoterapeuta y el nio, ambos comprometidos en la
totalidad del ciclo: Sonido-Ritmo-Movimiento.

7) Slo se tienen en consideracin las respuestas This paper looks at the Role Music Therapy can and
espontneas del nio. should play within the multi-disciplinary team wording
with emotionally and behaviourally-disturbed, often

42
rejected and abused children, including 3 - 6 year-olds relationship is built on what the child offers in sounds -
showing poor language and emotional problems who vocal and instrumental body- language and activities.
are failing to cope with early trauma, with consequent Being engaged musically, the child is making music at
developmental delay. the level where s/he functions spontaneously and
unstressfully.
The dynamic strength of clinically-directed
improvisational music therapy still meets with Children otherwise difficult to engage in treatment
scepticism and underestimation, lack of awareness and usually respond readily in improvisatory music therapy.
understanding among medical, multi-disciplinary and Its predominantly non-verbal, self-expressive,
educational colleagues. sometimes symbolic forms being less threatening to the
withdrawn or disturbed child than more verbal forms,
We have to remedy this by making its contribution better
yet proving sufficuently trustworthy for painful feelings
known.
to surface and be faced within the musical ambience.
Music can reflect and resonate with the whole spectrum
The child senses that s/he is being heard, listened to,
of the human condition. When improvising freely, we
being taken seriously there is echoing, understanding
present telling pictures of who we are, how we are
and mirroring and communication that encourages
functioning and feeling. Music therapists use this self-
spontaneous interaction and self-expression, in
expressive immediacy to build strong musical
whatever form it may come. With it comes a good sense
relationships with clients.
of self, self-confidence and achievement.
Often likened to "good" mother/infant interaction, the

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 percibimos. Los musicoterapeutas utilizan su propia
inmediatez expresiva para construir una fuerte relacin
La ponencia estudia el papel que la musicoterapia de
musical con sus clientes.
improvisacin puede y debe desempear dentro de
equipos multi-disciplinarios que trabajan con nios con Esta relacin, que a menudo es considerada como una
trastornos emocionales y de comportamiento, a buena interaccin madre/hijo, se construye a partir de
menudo rechazados y maltratados, incluidos nios de 3 lo que el nio ofrece con los sonidos -vocales e
a 6 aos que presentan un lenguaje pobre y problemas instrumentales-, el cuerpo, el lenguaje y sus
emocionales y que no consiguen resolver su trauma, actividades. Cuando est comprometido musicalmente,
con el consiguiente retraso en el desarrollo. el nio est haciendo msica a un nivel en el que l
funciona espontneamente y sin stress.
La fuerza dinmica de la musicoterapia de
improvisacin clnicamente dirigida an se encuentra Nios que de otra manera difcilmente responderan a
con el escepticismo y la subestima, la falta de un tratamiento, suelen responder rpidamente a la
conocimiento y comprensin entre los colegas del musicoterapia de improvisacin. Sus formas
ambiente mdico de otras disciplinas y del mundo de la prevalentemente no-verbales, auto-expresivas y, a
enseanza. Es necesario remediarlo dando a conocer veces, simblicas resultan menos amenazadoras para
su contribucin. La msica puede reflejar y hacer de un nio retrado o con trastornos, con respecto a
resonancia a todo el abanico de la condicin humana. formas ms verbales, proporcionando sin embargo
Al improvisar libremente, presentamos una imagen suficiente confianza para enfrentarse a sentimientos
viviente de quines somos, cmo funcionamos y dolorosos, dentro del entorno musical. El nio percibe

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que se le oye, se le escucha, se le habla seriamente; Naples (director: Doctor G. Motta) using an integrated
existen comprensin, resonancia y comunicacin que approach (music therapy, speech therapy,
alientan la interaccin y la expresin espontneas, de psychomotricity) to face the communication problem of
cualquier forma pueda producirse. Junto con esto the hypacusiac child with an holistic conception.
aparece un sentido positivo de confianza en s mismo y
We shall give data and evaluation relating to this clinic
realizacin.
material in adittion to a filmed documentation. This work
has been carried on taking into account two groups of
children of different ages: the former was the group of
T H E H YPAC U SI AC C H I L D : AN I N T EG R AT ED
"little children", about two or three years old and the
P R O JE C T F O R A N O V E R A L L A P P R O A C H T O
latter was the one of "old children", about five years old.
T H I S PR O BL EM / EL N I O H I PO AC SI C O : U N
The pecularity of this intervention has to be stressed
PR O YEC T O I N T EG R AD O PAR A U N
because of the use of music therapy as a discipline
PL AN T EAM I EN T O G L O BAL D EL PR O BL EM A
which operates within a "pre-logic" context together with
D IANA F ACCHINI another discipline as speech therapy which operates on
a verbal level.

In this report we discuss the results of a three years

work carried on at the Institute of Phoniatrics of the En este informe queremos resear, tambin a travs de
Otorhinolaryngology of the Second General Hospital of una documentacin filmada, el resultado de tres aos

45
de tratamiento integrado con musicoterapia, logopedia D AM AG ED PER SO N / L A M SI C A M E AYU D A A
y psicomotricidad, en el Instituto de Foniotra del C O N T AR M E M I H I ST O R I A. M SI C A E
Departamento de Otorrinolaringologa del II Policlnico I M G EN ES C O N PER SO N AS C O N L ESI N
de Npoles (dirigido por el prof. G. Motta), para encarar C ER EBR AL
el problema de la comunicacin en el nio hipoacsico
INGRID H AMMARLUND
con una acepcin holstica.

Sern facilitados datos y evaluaciones relativas a este

material clnico para el cual se ha tenido en cuenta un In this paper I will approach the use of Guided Imagery
trabajo obrado sobre dos grupos de nios de diversas and Music in musictherapy work with persons with
edades: el primero formado por "pequeos" de dos a different kinds of brain damages, especially with a
tres aos y el otro por "grandes", entorno a cinco aos. young woman, suffering from specific memoryloss and
vizualisingdisabilities after enchepahlitis.
Es a subrayar la especialidad del tratamiento debida a
haber juntado la musicoterapia como disciplina que I work as Musictherapist in a special rehabilitation
interviene en un mbito "prelgico", con una disciplina project in a hospital in Stockholm.
como la logopedia que interviene a nivel de palabra.

En este trabajo abordar el uso de la creacin de

Imgenes Guiadas en el trabajo de musicoterapia en
T H E M U SI C H EL PS M E T O T EL L M E M Y
personas con diferentes tipos de lesiones cerebrales,
ST O R Y. M U SI C AN D I M AG ER Y WI T H BR AI N

46
especialmente con una joven que sufra prdidas de been treated. These findings came forward as a result
memoria y tena dificultades para visualizar despus de of interviews with a representative sample of music
padecer una encefalitis. Mi trabajo como therapists working in rehabilitation-centers in the
musicoterapeuta se ha desarrollado en un proyecto Netherlands. The therapist were asked to describe in
especial de rehabilitacin en un hospital de Estocolmo. detail how for up to five patients their treatment
progressed. It appeared that of the 29 cases that were
related in this way, in no less than five cases,
M U SI C T H ER APY AN D APH ASI A / sometimes considerable, progress had been made in
M U SI C O T ER API A Y AF ASI A restoring speech-functions in patients.

B EP L AMEIJER- STERENBERG & C. ROMIJN

En nuestra ponencia presentamos un mtodo
especfico de Musicoterapia que se est actualmente
In our paper a specific method of Music therapy will be
desarrollando en Holanda. A juzgar por los resultados
discussed that is being developed in the Netherlands at
preliminares de nuestro proyecto, la Musicoterapia, as
this moment. Judging from preliminary results of our
como es utilizada por los musicoterapeutas
project, Music therapy, as it is used by Dutch music
holandeses, parece no slo tener una funcin de
therapists, seems to not only have a speech-replacing
sustitucin del habla, sino tambin una funcin de
function but also a speech-restoring function for a
restauracin del habla en un nmero relativamente
relatively high number of aphasic patients that have
elevado de pacientes afsicos que fueron tratados.

47
Estos descubrimientos fueron el resultado de Age: 7 at the beginning of the treatment.
entrevistas con una muestra representativa de
Motive for treatment: schooling inadaptation problems,
musicoterapeutas que trabajan en los centros de
lack of a sense of reality, frequent "attacks of fury".
rehabilitacin de Holanda. Se pidi al terapeuta que
He is obsessed and has a fixation on hero-magazines.
describiese detalladamente el progreso experimentado
He always plays the role of the hero in the stories,
por hasta cinco de sus pacientes. Sobre 29 casos
whatever magazine he may have in his hands.
descritos de esta manera, en al menos cinco de ellos se
haba conseguido un progreso - a veces considerable - His behaviour at school is quite inadequate. He would
en la restauracin de la funcin del habla en los speak loudly, shout, gesticulate, hit away at thin air until
pacientes. he reached total uncontrolled fury in any situations he
did not feel sure in. Once he felt relieved, he would go to
one side of the room, lie under the desks and eat
M U SI C T H ER APY I N T H E T R EAT M EN T O F A anything he would find on the floor.
C H I L D SU F F ER I N G F R O M AU T I SM / L A
His referral to a children's psychiatric institution
M U SI C O T ER API A EN EL T R AT AM I EN T O D E U N
depended solely on the school's technical team.
N I O AU T I ST A
Among the many cases of Autism I had worked on, this
L ETICIA M ORAES L EITE P EREIRA one seemed particularly interesting for the following
reasons:

48
- The sound of instruments helped me open the first and a half years.
channel of communication with the outside world.
He became literate, and studied 1st and 2nd grades in
- He evolved by letting each student represent a hero government schools.
and by recognizing it as such.
His social behaviour slowly progressed towards
Once such relationships had been established, it was normality.
easier to analyze his conflicts, fears, dreads, and ghosts
When he became 15 years old he was solidly immersed
through their musical representation.
in his social context. The last time I spoke to him, he told
It was only then that he perceived the music therapist me he was considering joining the Brazilian Navy.
and allowed her to get between him and his heroes by
means of the music she played and improvised.
Edad: 7 aos en el inicio del tratamiento.
I saw that it was only after having established such
connections that he began to progress towards his
Motivo del ingreso: Inadaptacin escolar, falta de

healing.
realidad con frecuentes "ataques de furia".

The heroes slowly left, liberating the instruments and

Tena obsesin y fijacin por revistas de hroes.

losing their identities, leaving the patient alone as a

Asuma siempre la personalidad del hroe de las

unique and singular psychic entity.

historias, dependiendo de qu revista tuviera en las
manos.
The patient's music therapy treatment lasted over two

49
Su comportamiento en la escuela era completamente Despus de establecidas esas relaciones, le pareci
inadecuado. En cualquier situacin que se le dejase se ms fcil la elaboracin de sus conflictos, miedos,
senta inseguro, hablaba alto, gritaba, gesticulaba, congojas, fantasmas a travs de sus hroes con
daba golpes en el aire hasta conseguir una furia vestuario instrumental.
descontrolada. Aliviado iba hacia un lado de la sala,
Slo entonces percibi a la musicoterapeuta y le
tumbndose debajo de las mesas. Coma todo lo que
permiti introducirse entre l y sus hroes, a travs de
hallase en el suelo.
las melodas improvisadas.
Su ingreso en un Hospital Psiquitrico Infantil slo
Percib que slo entonces, despus de establecidos
dependa de la opinin del Equipo Tcnico de la
esos vnculos se encamina en direccin a la cura.
Escuela.
Los personajes se fueron vaciando y libertado de los
Entre los muchos casos de autismo que estuve
instrumentos, perdiendo sus identidades para dar lugar
trabajando, se me pareci interesante por varios
a l, como una entidad psquica nica y singular.
motivos:
Permaneci an por ms de dos aos y medio su
- Fue el sonido de los instrumentos el que le ayud y
tratamiento musicoteraputico.
permiti la apertura del primer canal de comunicacin
con el mundo exterior. Consigui el 1 y 2 grados en Escuelas del Gobierno.

- Evolucion permitiendo que cada instrumento Su comportamiento social se fue padronizando hasta la

representase un hroe y lo reconoci como tal. normalidad.

50
Ya a los 15 aos estaba bien integrado en su contexto qualities and music freely created yet clinically applied.
social. In such a process, the content and evolution of
interactivity is unpredictable, yet in retrospect there is
En mi ltimo contacto con l, me coment que se
an inevitability in the sequence of its events and
estaba preparando para realizar el curso de la Marina
development: each creative step begets or supports a
Brasilea.
response; each response calls forth the next creative
step. In clinical musicianship, there is no dichotomy
between creative freedom and controlled intention,
I N M ED I AC Y I N M U SI C T H ER APY: PO I SED I N
between intuition and clinical responsibility, between
T H E C R EAT I VE N O W / I N M ED I AT EZ EN
methodical musical construction and spontaneous
M U SI C O T ER API A: EQ U I L I BR I O EN EL AH O R A
expression. The presentation will demonstrate how a
C R EAT I VO
client, in the ongoing immediacy of the clinical situation,
C LIVE E. ROBBINS inspires musical ideas from the therapist, musical ideas
which, in turn, release developmental potential in the
client.
By means of a recorded example of the work of the late
Dr. Paul Nordoff, the presentation will ilustrate and
consider related factors in the creative clinical process. Por medio de la grabacin de un trabajo de la ltima
Improvisational communication in music therapy is etapa del Dr. Paul Nordoff, la presentacin ilustrar y
realized through the living synthesis of individual human considerar factores relacionados con el proceso

51
creativo clnico. La comunicacin improvisada en AN AR T WO R KSH O P: AN EXPER I EN C E I N AR T
musicoterapia es realizada a travs de la sntesis viva O PEN T O T H E C O M M U N I T Y / T AL L ER ES D E
de cualidades humanas individuales y msica creada AR T E PAR A D I SC APAC I T AD O S D EL
libremente aunque aplicada clnicamente. En este D ESAR R O L L O . U N A EXPER I EN C I A ABI ER T A A
proceso, el contenido y la evolucin de la interactividad L A C O M U N I D AD
es impredecible, aunque retrospectivamente hay una
V ICTORIA S HOCRON & MARTA M ENDIA D E G ONZLEZ
inevitabilidad en la secuencia de sus acontecimientos y
desarrollo: cada paso creativo origina o apoya una
respuesta. Cada respuesta requiere un nuevo paso "This project developed out of my personal experience
creativo. En la comunidad musical clnica no hay una with art having moved through dance classes to theatre
dicotoma entre libertad creativa e intencin controlada, and song. It also arose out of a realization of how
entre intuicin y responsabilidad clnica, entre una difficult it must be for disadvantaged people to access
construccin musical metdica y la expresin these forms of communication. It would be particularly
espontnea. La presentacin demostrar cmo un difficult for them to afford the cost of private or individual
cliente, con la continuidad de la situacin clnica, tuition.
obtiene ideas musicales del terapeuta, ideas musicales
The object of these workshops is to work with the
que a su vez liberan un desarrollo potencial en el
abilities rather than the disabilities of the participants.
cliente.
Using mutual love and respect as a base to the
marvellous world of Art".

52
The aims of this poster are: El objetivo principal de estos talleres es el trabajar con
las capacidades de cada alumno y no con sus
* to show the activities of the workshops via video
discapacidades. A partir de all y basndonos en el
and photographs.
RESPETO Y AMOR que nos debemos entre todos, es
* to show the objectives, fundamental theories and
que comenzamos con la tarea tan gratificante de
results underlying the workshops. The evaluation of the
acercar a las personas con diferentes discapacidades
project is done by the parents and the students.
mentales al inmenso y maravilloso mundo del ARTE."
* to show the work of the parents who form work
Este poster tiene como objetivo:
groups for creative self-expression in sculpture and
* Presentar e ilustrar las actividades de los talleres
folkloric dance classes.
incluyendo: fotografas y vdeo

* Presentar los objetivos y los fundamentos tericos

"Este proyecto nace a partir de mi experiencia personal de los mismos as como los resultados obtenidos. La
en el arte, transitando clases de Danzas, de Teatro, de evaluacin se hace desde los comentarios de los
Canto, y, a modo de toma de conciencia de la alumnos y de los padres.
necesidad de abrir caminos de comunicacin para las
* Presentacin e ilustracin del trabajo del equipo
personas con diferentes discapacidades para quienes
de profesionales.
es ms difcil an costearse dichas clases en forma
privada e individual. * Presentacin e ilustracin del trabajo de los
padres quienes formaron grupos de trabajo

53
creativo autogestivo en clases de plstica y de danzas other materials such as: rings, balls, springs, sticks,
folklricas. ribbons, etc..

Unable to communicate verbally, Willy has acquired,

and continues to acquire, a code of highly significant
WI L L Y, H I S M O T H ER AN D I / WI L L Y, SU
communication which includes gestures through to
M AD R E Y YO sounds.

M R OSA A LFONSIN D E S URMANI At present the patient is 42 years old and has achieved
a degree of self-worth within his family setting and his
environment. He can ask when in need, and can accept
This paper will present the case of an adult patient, his
a "no" by the methods described.
history, the music therapy treatment and the
importance of his mother's involvement.

According to Dr. Ricardo Allegri the patient has cerebral En esta comunicacin se presentar el caso de un
palsy. paciente adulto, su historia, su tratamiento
musicoteraputico y la importancia de la interaccin de
The above-mentioned treatment began 10 years ago,
su madre en el mismo.
and continues at present with three weekly sessions.
We work on body dialogue with simultaneous listening El diagnstico del paciente dado por el neuropsiclogo
to melodies. The objects used as "intermediary objects" Dr. Ricardo Allegri, es parlisis cerebral.
are: the piano, the flute, percussion instruments, and

54
Dicho tratamiento se inici hace 10 aos, continuando M U SI C T H ER APY AN D C ASES O F C H R O N I C
en la actualidad con tres sesiones semanales en forma PSYC H I AT R I C PAT I EN T S / M U SI C O T ER API A Y
ambulatoria e individual. Se trabaj el dilogo corporal C ASO S D E EN F ER M O S PSI Q U I T R I C O S
con audicin simultnea de melodas. Los instrumentos CRNICOS
utilizados como objeto intermediario son: piano, flauta,
Y OLANDA V AICAITIS
meldica, instrumentos de percusin y otros materiales
como: aros, pelotas, resortes, bastones, cintas, etc.

Ante la falta de lengua verbal Willy adquiri y, Eight years of experience at the Esquirol (Charenton)
actualmente contina haciendo, un cdigo de psychiatric hospital near Paris, France, have provided
comunicacin altamente significativo, desde lo gestual me with the opportunity of applying music therapy in the
a lo sonoro. treatment of profound mental and physical defects. Six
months to one year of music therapy were sufficient to
El paciente que en la actualidad tiene 42 aos, ha
completely alter these patients' view of the world as well
alcanzado un grado de autovalimiento dentro del grupo
as the world's view of them.
familiar y su entorno.
Among the most striking examples is a 55 years old
Puede demandar ante la necesidad: acceder a la
mental invalid who after 20 years of psychoanalysis,
incorporacin de un "no" con las caractersticas
dream-therapy, psycho-drama, theatre therapy and a
anteriormente citadas.
myriad of various attempts at treating his total
incapacity to live a normal life, found the courage to

55
"abreact", that is, to re-live and to recount a moving de 20 aos de psicoanlisis, terapia de sueo,
traumatic experience which had been buried deeply in psicodrama y una infinidad de intentos para tratar de
his subconcious since the age of 14. This dramatic tener una vida normal, encontr el valor para revivir y
catharsis, followed by a complete metamorphosis of the contar una experiencia traumtica que haba enterrado
patient's personality were made possible by one profundamente en su subconsciente desde los 14 aos.
specific piece of music, which the congress participants Esta catarsis dramtica seguida de una completa
will have the pleasure of hearing. metamorfosis de la personalidad del enfermo fueron
posibles gracias a una composicin especfica de
msica que los participantes al congreso tendrn el
Ocho aos de experiencia en el Hospital Psiquitrico placer de escuchar.
Esquirol (Charenton) me han otorgado oportunidades
de utilizar musicoterapia para el tratamiento de los
enfermos con profundas deficiencias mentales y
defectos fsicos. De seis meses a un ao de
musicoterapia fueron suficientes para cambiar
totalmente la visin del mundo que tenan los enfermos
y la visin que el mundo tena sobre ellos.

Entre los ms impresionantes ejemplos es el caso de

un enfermo mental de 55 aos de edad quien despus

56
 spastic hemiplegia of his left side and severe mental
1.1 - MUSIC THERAPY IN HANDICAPPED
PEOPLE / MUSICOTERAPIA EN DISMINUIDOS retardation; that he had serious hearing impairment,
(CONFERENCE HANDOUTS) though the degree of his deafness, whether it was
partial or total, remained officially unanswered.

I SO L AT I O N AN D T H E M U L T I - H AN D I C APPED Due to family difficulties, Emilio was admitted at the age

PAT I EN T : AN AN AL YSI S O F T H E M U SI C of five into the institution where he has been living ever
T H ER API ST - PAT I EN T AF F EC T S AN D since.
PR O C ESSES.

A NTHI A GROTOU From his early years he was characterized as a child

with no interest in objects or in his environment, with an
aggressive or self-destructive behaviour, often
-- Video excerpt as introduction --
accompanied by wailing or crying.

Emilio had a normal birth in 1972. On the third day of his

The official assessment of his condition, carried out in
life he contracted meningitis. The diagnoses given
88, described that, due to multiple damage, his brain
during the first five years were that, as a result of
cannot receive and work out stimuli other than tactile
meningitis, Emilio was blind, could not speak, had

57
and motorsensory ones; that his seclusion is objectively The fact that one can feel music through one's body and
caused and his behavioural problems a natural result, that Emilio appeared to have had a special body
while the possibilities of change are non-existent, connection with the environment, was one of the
particularly in the context of institutionalized life. reasons that I chose to work with him. Also, because his
countenance did not look, in my opinion, so laden with
handicaps as the diagnoses described, but maintained
When I met Emilio at the age of seventeen, his isolation
aspects of brightness and clarity. Such a face, placed
was indeed impressive: for days on end he would sit
within its total isolation, intensified the tragic elements of
alone with his body bent, or would lie on the floor; and
his personality - a personality to which I felt that I had
the only elements with which he appeared to be
something to say.
interrelated were the rays of the sun upon his naked
body.
To begin with, I tried to create vibrations in response to
the scanty motives of his repertoire, which often only
We started weekly music therapy sessions in October
consisted of breathing in and breathing out. We can see
1989. This was not the result of a referal on behalf of
here, in this extract from session 2 in October 1989, a
the institution, as the collective belief was that Emilio
typical example of that initial period.
was deaf, or almost so.

-- Video excerpts from session 2 on 10 October 1989

58
 something that was totally and fundamentally absent
from his entire life.
Remarks during playback:
Within one month, the issues were no longer so simple
Breathing in and out, his basic theme, gets reflected by
and square. His self-stimulations turn into painful
me in the drum and cymbal, instruments with loud and
beating and whipping onto his own body, his
multiple vibrations.
vocalizations into intense cries of indignation and
Or, here, another response to his scarce vocalizations
desperation.
with the gong.

-- Video excerpt from the session of 7 November 1989 -

***************************

*****************************
An experience of receiving vibrations within his body
could, in my thinking, gradually call forth a pleasure
together with a bodily embrace, as I was suspecting he For the months that followed, things were utterly
sensed through the hot rays of the sun. And if these unpredictable. Emilio was either withdrawn into his
vibrations were to follow the rhythm of his movements ritualistic movements, or in desperation through
or vocalizations, he might, perhaps, experience this primitive cries, beating and wailing.
holding embrace in relation to a human presence,

59
 people, who unavoidably hit on him, and where his
blindness and hemiplegia make him totally incapable of
Perhaps the vibrations, just as the surrounding objects,
foreseeing and defending himself from such attacks.
were often perceived to be threatening, like beings that
were invading him from inside and against his very
existence. It was as if his body was not held together
As a consolation, with his own arms he would embrace
through a compact skin, but was open and exposed to
himself, in particular, his head, the source of one's
wounds.
feelings and problems; or, he would stimulate it, often as
For this reason, whatever object he would encounter he a way of being reassured that he is still in existence.
would push away, as if it was this object that was
speeding against him in order to crush him. People were
also, apparently, equally threatening object. As from February '90, five months after our first
meeting, a period of exploring the room had begun, a
Frequently, he would place his hands above his head,
phenomenon that reappears frequently ever since. lt
like a shield of protection from all these threatening
falls within the time when I left the percussion
beings that existed outside, but also existed within his
instruments for good and would use almost exclusively
fragile inner space.
the piano, mainly in order to translate on it the dramatic
aspects of his condition.

All these, I believe, were worsened by the fact that

Emilio lives in a room with hyperactive or aggressive

60
Still thinking about his hearing problems, though, I condition.
would play loudly, at the same time being aware that the
piano's vibrations are less numerous than those of the
percussion instruments. In October '91, two years after our first meeting, the
sessions were increased to twice a week. The beatings
These minimal strikes on the ground with his hand
on the floor still remain the most fundamental
make their appearance now and form the most
indications of his co-existence.
fundamental indications of a possible mutuality for the
months that follow.

Apart from these strikes, the following year brought The movements through his body assume now a

nothing essentially new. Sometimes he was in turmoil different form. They appear concentrated within a

and anxiety, but never in such dramatic desperation as concise intensity. It seems to me that he is forming a

in the first five months. Most of the time he was bodylanguage repertoire. To this I respond, phrase by

withdrawn. phrase, both in its affective and in its descriptive

content.

As from February '91, I decided to respond to Emilio as

to a normal-hearing person. Ever since, the music For example, in the following extract, taken from the

created has been channelled into an attempt to reflect session of 8 January '92, Emilio begins with a thrust of

the colours, shades and complexity of his affective his body forwards and a movement of his hand forwards

61
and then slightly backwards. These are responded to followed, so that the uncertainty concerning his hearing
note by note, both interpretatively and descriptively. would remain pending between us. Alternatively, the
The same occurs in what follows, i.e. the embrace of his clearest ever vocal exchange would stir up bouts of self-
face, the intensity in the stretching of his hand beating and anxiety. It is 28 February '92 and his
backwards, his vocalizations, the beatings of his hand: vocalizations are formed exactly within the pitch of my
all are responded to almost note by note. voice and in the duration of my pauses.

-- Video-excerpt from the session of 8 January '92 -- -- Video-excerpt from the session of 28 February '92

************************* ****************************

Perhaps on account of its cost in psychic pain, a vocal

His vocalizations gradually appear in increased doses,
communication of such duration was not repeated
but they seem to be created for himself. If ever a vocal
again for a number of months. Yet it was now evident to
phrase of his was heard in direct correlation to mine, it
me that Emilio's isolation was not the simple result of
was so low in volume and of such brief duration, that I
multiple brain injuries, nor of deafness severe or partial;
was never sure I had heard correctly. And when I was
rather, it was that life was so much filled with mistrust
sure, his voice would disappear for the sessions that

62
that he chose to create a shell of protection that would By the late summer and fall of '92, I was experiencing
ward him from everything and everyone. Inside this the bond that Emilio was gradually creating with me and
shell, though, there was horror, anxiety and pain. the music therapy setting. In this, I believe that the
"bonding" music of those months, with its repeated
themes in F major - D minor, played a major part.
Now that this shell was beginning to open, with such
hesitation, ambivalence and fear, yet with courage, I felt
that I should be particularly soft and holding, inviting his *************************
trust and strength as gently and inexhaustibly as I could.
On the tonality of F major or its related D minor, keys
that contained his natural sounds of D, E, F and B flat, I So by November '92, the reassurance of his existence

would play soothing music in concordant harmonies, by stimulating his own face or body is not so necessary

while incorporating themes based on the motives of his any more nor are the self-inflicted injuries. The

own vocalizations. quietness that Emilio brings into the sessions now has
another quality. lt is a quietness that finds its roots in the
security of a human relationship and that leaves him
Then tonality and themes would reoccur, so that I could free now to take pleasure in his hearing.
function like his memory, so that he could experience a
continuity, a history of hearing memories between us.
-- Video-excerpt from the session of 20 November '92

63
containing some of our "bonding" music -- immense anxiety that any human contact caused him.
Moments of clarity as to his hearing abilities were
speedily covered up and would not reappear for weeks
Remarks during playback:
or months.
The music stops, the pleasure stop.

The music begins, the pleasure begins.

Without ever having left the dramatic element, or our
moments of uncertainty and doubt, we are now going
through a period of revelation and bliss. Having
***************************
discovered and internalized a good object, and trusting
that there would be no injury, Emilio now chooses to sit
An inability to work out stimuli is definitely not in Emilio's on the piano for his first but scattered sounds.
predicament. lt is, indeed, an aspect of tragedy that
Emilio chose to close his ears for so many years of his
-- Video-excerpt from the session of 25 June '93 --
life. To have kept his ears shut meant the blocking of his
soul and mind from all the drama of his life.

****************************

During the three years and nine months that I have What the future will be, I do not know. I simply know that
been working with him, I have lived step by step the Emilio can hear, can invite and create the human

64
relationship from a position of stillness, of rest. I am 5.- Actividades.
ending with his newest sounds within a farewell piece.
6.- Conclusiones.

-- Video-excerpt from the session of 11 June '93 --

1.- INTRODUCCIN.

Durante casi toda la historia del hombre, la Msica y la

Terapia han estado estrechamente unidas.
M U SI C O T ER API A EN L A I N T EG R AC I N D EL
N I O D EF I C I EN T E AU D I T I VO

M FELICIANA A RGUEDA C ARMONA Segn Platn : "La Msica es la parte principal de la

educacin, porque se introduce desde el primer
momento en el alma del nio y le familiariza con la
NDICE. belleza y la virtud".
1.- Introduccin.

2.- Deficientes Auditivos. El valor terapetico de la Msica capacidad de

3.- Objetivos Especficos. sensibilizar al ser humano aspecto fsico como
psquico; debido a los dos componentes bsicos de la
4.- Tcnicas Utilizadas.
misma : Ritmo y meloda a su vez fundamentales para
la terapia del nio sordo.

65
 Educacin Especial "Ponce de Len" de Crdoba. Se
ha experimentado con un grupo mixto de nueve
Educar al deficiente auditivo, a travs de la Msica es
nios/as sordos/as, cuyas edades oscilan entre los seis
ponerlo en contacto con el mundo sonoro, para
y ocho aos, durante dos sesiones semanales de una
despertar su apetencia por los sonidos. Con ello se
hora; teniendo en cuenta los restos auditivos de cada
ejercita la percepcin sensorial y se tiende a la
alumno, su edad mental y cronolgica, temperamento
emotividad, desarrollando la atencin, imaginacin
grado de escolaridad y condiciones de lenguaje.
concentracin razonamiento, memoria y disciplinando
su voluntad.

El primer acercamiento hacia estos nios, ha sido por

medio del Principio de ISO, aplicado a las percusiones
A partir de aqu, la Msica puede ofrecer a estos nios,
corporales e instrumentales, para quitarles sus
numerosas formas de integracin, y puede adaptarse
inhibiciones iniciales y procurarles un medio de
tambin a la etapa de desarrollo en que se encuentran.
comunicacin no verbal.
Es de resaltar que con frecuencia responden mucho
ms pronto a una actividad musical que a cualquiera de
otro tipo.
2.- DEFICIENTES AUDITIVOS.

Resulta extrao hablar de Msica en la educacin del

Estos conceptos, los hemos observado e investigado nio sordo. Pero profundizando en este tema, hemos
durante dos Cursos ( 89-90 y 90-91) en el Centro de visto que el mundo musical no les est del todo vedado.

66
 palabras, con la acentuacin en la Msica, le agudiza la
observacin y la creatividad
A pesar de que carecen de la audicin, para la
percepcin musical, logran advertir determinados
elementos de la Msica: Ritmo, tiempo, acento,
Incluso en el terreno fonoaudiolgico, es muy valiosa la
intensidad, movimiento, carcter, y sobre todo las
prctica musica. ya que puede facilitar la produccin de
excitaciones vibratorias. Esas impresiones vibratorias
"articulaciones imposibles" en el habla que por otro
desempean para los sordos, un papel de gran
camino, hubiera sido difcil de lograr, objetivo este del
importancia, pues la enseanza que se les imparte para
Ritmo Musical, dentro de la Metodologa Verbo-tonal.
que aprendan a articular sonidos y palabras consiste,
en la percepcin de la vibracin de los fonemas en el
rostro, garganta, trax etc. del profesor. Con respecto a su intelecto, los conceptos son
diferentes segn las escuelas que los enuncian. Desde
la antigedad (en que se les negaba inteligencia),hasta
Mediante el tacto, que est distribuido por todo el
nuestros das, las opiniones han variado de forma
cuerpo, los deficientes auditivos reaccionan ante todas
notable.
las excitaciones de tonos y ruidos.

Hoy se considera que el sordo es potencialmente un

Desarrollar el sentido del ritmo ayuda enormemente al
individuo de inteligencia normal, pero sus fuentes de
nio sordo. Puede relacionar la acentuacin de las

67
informacin estn disminuidas y por lo tanto eso
repercute en su rendimiento.
- Mejorar su coordinacin corporal.

- Desarrollar su lenguaje, mediante la

El sordo se encuentra en desventaja con respecto al recuperacin, por medio de la Msica, de su ritmo
pensamiento abstracto, no as, en cuanto a lo concreto. verbal y acento correcto.

- Proporcionarle la oportunidad de descubrir el

sentido del ritmo propio.
Los nios con deficiencias auditivas quedan, en
muchos casos, fascinados por la Msica y, si bien las - Fomentar la comunicacin con los dems, por
repeticiones verbales de una reeducacin clsica le medios no verbales.
cansa, las musicales, en cambio les ayudan y,
- Elevar su nivel de autoestima.
mediante ecos, preguntas y respuestas, etc., estas
- Posibilitar su maduracin psicofsica, en la
mismas repeticiones adquieren un sentido placentero.
medida de sus posibilidades para evitar su aislamiento.

3.- OBJETIVOS ESPECFICOS.

4.- TECNICAS UTILIZADAS.
En nuestra experiencia con este tipo de nios, hemos
Las tcnicas que hemos utilizado incluyen: Movimiento
pretendido alcanzar los siguientes objetivos:
rtmico, canto, psicomotricidad, discriminacin auditiva,

68
juegos musicales, prctica de instrumentos de sonido
determinado e indeterminado, audiciones,
Las canciones que hemos utilizado para desarrollar su
escenificaciones y creatividad. El proceso ha sido lento
lenguaje y ritmo verbal, han sido de frases musicales o
pero eficaz.
verbales breves, y con palabras concretas, ya que lo
abstracto les resulta incomprensible.

Hemos procurado siempre hacer creer al nio que su

accin es valiosa y aceptada. Cada concepto
Tambin la Msica les ha ofrecido el medio para
aprendido, no importa lo pequeo que haya sido, ha
expresarse alegremente a travs del movimiento.
constituido un progreso importante para el alumno, lo
cual ha servido de gran ayuda para elevar su
autoestima. 5.- ACTIVIDADES.

Para conseguir los objetivos antes mencionados,

Estos nios sienten y gozan con la Msica, cuya funcin hemos realizado diversas actividades, de las que

teraputica contribuye al desarrollo integral de las reseamos las siguientes:

facultades fsicas y psquicas, y se les acerca al mundo

del
a) Ejercicios de ritmo con lenguaje, en el que cada
oyente. nio dice su nombre acompandose con una palmada
para cada slaba, y mas tarde entonndolo con dos

69
sonidos. sus emociones.

b) Esquemas rtmicos y meldicos, acompandolos

de gestos y fonemas.
6.- CONCLUSIONES.
c) Ejercicios de psicomotricidad con ritmo musical.
Durante estas experiencias, hemos observado que la
d) Juegos musicales viso-motores, en los que tratan Msica, es un medio que permite al nio sordo
de coordinar la vista con los movimientos de su cuerpo expresarse cuando est con otros y romper con su
y el ritmo de la Msica. aislamiento.

e) Discriminacin auditiva, por medio del tacto y el

timbre de los instrumentos.
Resaltamos que durante las primeras sesiones haba
f) Ejercicios de logopedia con ritmo, por medio de cierta competencia entre los componentes del grupo;
canciones muy cortas y fciles, para desarrollar su todos queran destacar a la hora de tocar los
lenguaje. instrumentos. Poco a poco se han ido agrupando con la
consiguiente alegra y satisfaccin de poder
g) Instrumentacin de canciones elementales.
comunicarse entre s y compartir ese sentimiento.
h) Audiciones de Msica, con efectos sonoros, por
medio de la expresin plstica.
En algunos momentos, la figura de la profesora pas a
i) Danza-Terapia, con la que los deficientes
un segundo papel, ya que ellos iban saliendo
auditivos hayan nuevas posibilidades para exteriorizar

70
voluntariamente, queriendo ocupar mi puesto, e - Los integra en el grupo, como etapa previa a la
indicndome que yo me sentara para ellos dirigir el mejora de su reinsercin en la sociedad.
grupo.
- Desarrolla su atencin.

- Fortalece su personalidad.
La prctica de los instrumentos ha enriquecido a dicho
- La Msica les hace sentir satisfaccin y bienestar.
grupo con hallazgos rtmicos y meldicos, lo cual les ha
- Mediante las canciones acompaadas de
favorecido en su resocializacin.
instrumentos se les desarrolla el sentimiento de
autoestima.
De entre todos los logros conseguidos, destacamos las
siguientes conclusiones:
Finalmente consideramos, que la sensibilidad
- La Msica les ayuda a perder la timidez.
emocional tambin ha de formar parte de la educacin
- Les desarrolla la imaginacin. integral de estos nios, y creemos que deben salir de la
escuela capacitados no solamente para vivir una vida
- En general todos han avanzado en cuanto al
normal, sino tambin para vivirla con cierta emocin.
lenguaje.

- Palabras que antes no comprendan, mediante el

aprendizaje de canciones, las fueron introduciendo en Esta Ponencia va acompaada de un video sobre la
su vocabulario. experiencia realizada.

71
BIBLIOGRAFA nio sordo". Edit. CEPE. Madrid.

AIMAR, Paule y otros. (1989). "El nio sordo". Edit

Narcea. Madrid
D I F ER EN C I AS Y SI M I L I T U D ES EN L A
ALAIN, Morgon y otros. (1978). "Educacin precoz del
APL I C AC I N D E L A M U SI C O T ER API A EN
nio sordo". Edit Toray-Masson, Barcelona.
PAC I EN T ES AU T I ST AS Y EN C O M A
ARGUEDA CARMONA, M Feliciana. (1985).
PROF. DR. ROLANDO O. BENENZON M.D.
"Musicoterapia aplicada al nio deficiente".
Experiencias. Servicio de Publicaciones de la Excma
Diputacin Provincial de Crdoba. La Musicoterapia es la primera tcnica de
ARGUEDA CARMONA, M Feliciana. (1989). acercamiento al ser humano, tal el caso de los autista; y
"Musicoterapia y el nio sordo". Publicado con la es tambin la ltima en acompaarlo, tal el caso de los
colaboracin de la Junta de Andaluca y la Excma pacientes en coma.
Diputacin Provincial de Crdoba. La Musicoterapia es un proceso histrico vincular,
DI MARCO, Carmen E. (1980). "Ritmo, Msica y dentro de un contexto no-verbal, entre el terapeuta y su
deficientes auditivos", Editorial Universitaria de Buenos paciente.
Aires. Segn el concepto antedicho describir las diferencias
RAMIREZ CAMACHO, RAFAEL A. (1982). "Conocer el y similitudes en la aplicacin de la Musicoterapia en
pacientes autistas y en coma.

72
 todos los fenmenos que tienen por base el
movimiento).
a) El paciente: Ambos pacientes tienen en comn la
falta de comunicacin total o parcial, en forma La respuesta es a travs del sistema de feed-back
aparente. Digo que esto es en apariencia, pues el monitorizado; Frecuencia cardaca y respiratoria,
autista, percibe los fenmenos sonoros-vibracionales tensin del tono muscular, gesticulacin, movimiento
en un forma particularizada y sus respuestas se basan del globo ocular, sudoracin, sollozos, prehensin u
en formas expresivas no esperadas. otras.

La respuesta puede ocurrir al minuto, o dentro de una El autista tiene su cuerpo libre, se puede mover y
hora, o en otro momento cualquiera, segn su tiempo desplazarse a voluntad.
biolgico, y la expresin puede ser un grito, un llanto,
El comatoso tiene su cuerpo inmvil, rodeado de
un salto, un golpe, un apartarse del lugar, u otras.
aparatos e invadido en su interior por tubos, fijado a la
El paciente en coma tambin percibe los fenmenos cama, imposibilitado de desplazarse.
sonoros-vibracionales, con un sistema perceptivo
En ambos prevalecen los impulsos inconscientes, no
globalizador que integra lo auditivo, tctil, cenestsico y
existiendo mecanismos de defensa psquicos que los
kinestsico - (cenestesia: (del griego Koins: comn, y
repriman o los modifiquen.
aisthsis: sensacin) o sea sensacin general de la
Los impulsos inconscientes se manifiestan por
existencia del propio cuerpo independiente de los
expresiones corporales que pueden observarse desde
sentidos); (cintica: del griego Kinetikos, aplicase a
el descontrol esfinteriano a movimientos

73
estereotipados. Por lo tanto, como hiptesis, dir, que ideas mesinicas, filantrpicas, msticas y
las identidades sonoras que prevalecen pertenecen al omnipotentes.
ISO Guestltico y al ISO universal.
Cada una de estas palabras merece una reflexin
profunda que son motivos de otros artculos.

INSERTAR GRAFICO 1 Si el musicoterapeuta no logra elaborar lo antedicho,

tarde o temprano, padecer de estados de tensin, que
desencadenan estados depresivos, que provocan por
INSERTAR GRAFICO 2
un lado sntomas perversos sutiles, sntomas
psicosomticos, y produccin de mensajes bizarros y
guistes de comunicacin.
b) El musicoterapeuta: Para trabajar con ambos
pacientes debe prepararse en forma especial, Ambos pacientes producen en el musicoterapeuta
informarse y formarse para aplicar su tcnica en estos estados contratransferenciales como los anteriormente
pacientes. descritos.

El concepto de formarse, significa "reconocerse". El En general el musicoterapeuta que se dedica a trabajar

musicoterapeuta debe reconocer en si mismo sus con estos pacientes, comienza con expectativas
propias identidades sonoras y por otra parte sus nutridas, con ideas omnipotentes. "Todo lo que el ser
propias conflictivas con la muerte, con la intolerancia a capaz de modificar y de dar y recibir". Al cabo de un
las frustraciones, con su propio narcisismo y con sus tiempo no solo el paciente no evoluciona, sino que a

74
veces involuciona y otras muere. mdicos, o elevar el tono de voz, o dar tonalidades
como si fuese un beb y hasta llegar a realizar frases
El autista parecera que estuviera muerto y el paciente
en tercera persona: identificacin con la psicosis. Y/O
en coma, muere realmente.
crear guistes de comunicacin, que son formas de
La herida narcisstica es importante, la intolerancia a la
mensajes estereotipados y repetitivos que se suceden
frustracin constituyen estados crnicos de
a lo largo de las sesiones sin que el musicoterapeuta
insatisfaccin, aparece el estado de depresin y se
sea consciente de los mismos.
produce el acting perverso = llegar tarde, faltar,
Por lo tanto el musicoterapeuta debe realizar una o
abandonar con excusas varias, hablar mal o criticar al
varias experiencias de Musicoterapia Didctica,
servicio, a los otros colegas, a la institucin, transgredir
extensas e intensas. El hecho de someterse a los
las reglas normativas de la institucin y de la
mismos elementos con los cuales someter al paciente,
metodologa y de la tcnica. O la aparicin en el cuerpo
a percibir y sentir los diferentes estados regresivos le
del musicoterapeuta de alteraciones psicosomticas =
permitir un fortalecimiento interno que provocar un
estados alrgicos, cefleas, lceras, hemorroides,
continente estable para el paciente.
estados febriles, gripe, etc. Y/O la identificacin con
aspectos del paciente, similares a los sntomas Realizar un tratamiento psicoterpico propio. Bsqueda
observables en el grupo familiar, ejemplos: comenzar a de supervisin constantes y y grupos de reflexin de la
hablarle algunas palabras que le dicen algunos ntimos, tarea.
o dejar de decirle palabras que antes le decamos;
Crear y aceptar normas de tica que salvaguarden su
enmudecen como le sucede a algunas enfermeras o

75
salud mental y la integridad del vnculo con el paciente. c) El contexto no-verbal: Las fuentes nutritivas
Por ejemplo, limitar el nmero de horas de trabajo con corporo-sonoro-musicales del contexto no-verbal con
este tipo de pacientes. No se puede trabajar con ms un paciente autista son: 1. la voz del Mt, usada
de dos pacientes en coma por da. Lo mismo ocurre verbalmente para presentarse y explicar su tarea; o en
respecto a los pacientes autistas. forma no-verbal, a travs de emisin de sonidos o el
canto. 2. El cuerpo del musicoterapeuta, palmeando,
Ambos pacientes impactan el cuerpo del
taconeando, frotando, etc. movindose, pero con
musicoterapeuta El autista, con sus movimientos
grandes dificultades para tocar, acariciar, presionar,
respectivos, sus golpes indiscriminados, sus gritos, sus
etc. 3. Los objetos intermediarios, diversos. En estas
aullidos, sus olores, sus excreciones y sus secreciones,
tres fuentes se intentar introducir elementos
su no respuesta, su mutismo, su abandono, su huida,
caractersticos de las primeras etapas evolutivas.
su desaparecer, su rechazo.
Ritmos binarios, latido cardaco, agua, canciones de
El comatoso, sus olores, sus excreciones y
cuna u otras. Aspectos referenciales de la historia
secreciones, sus sonidos respiratorios o los sonidos de
sonoro-musical, tomando a los padres u otros
los aparatos que lo rodean, su no respuesta, su
miembros del grupo familiar. 4. De tanto en tanto las
mutismo, su parlisis.
voces y los cuerpos y los objetos intermediarios del
Todos estos aspectos obligan a un constante desgaste grupo familiar. 5. Las sonoridades propias y
energtico, que se necesita reparar. caractersticas de la institucin y/o el espacio en donde
se desarrolle la actividad vincular con la Musicoterapia.

76
Las fuentes sonoro-musicales en un paciente cadas de elementos, tensimetros. Cercano al odo del
comatoso son: 1. Las mismas con respecto a la voz y el paciente lo destacable son los sonidos cclicos del
cuerpo del musicoterapeuta. 2. En un primer momento respirador y monitor quedando como figura y pasando
suele trabajarse con canciones, fenmenos sonoro- a quedar como fondo el resto de los sonidos entre los
musicales de los ltimos momentos anteriores al coma, que se encuentra las voces. Recordemos que el
cuyo relato se obtiene de familiares y amigos. 3. Hay paciente en coma est en dependencia del Equipo de
tendencia a introducir msica grabada, pero esto se Salud y de los aparatos, por momentos la falta de los
observ como un mecanismo de defensa del sonidos puede significar la ausencia de teraputica o
musicoterapeuta frente a su angustia de soledad y de la vida real.
muerte. El fenmeno musical continuo creaba una
Este significado puede tambin existir en el
atmsfera en el contexto no-verbal tranquilizadora en el
inconsciente del autista, frente a la vivencia regresiva
transcurrir del tiempo. 4. El grupo familiar interviene
del estado fetal, donde la modificacin de los ritmos
ms asiduamente. 5. El ambiente sonoro en la sala de
binarios del latido cardaco de la madre provocaban
terapia intensiva es ajeno al habitual de los pacientes.
sensaciones vitales de respiracin, nutricin,
Los sonidos propios de este tipo de salas, se
termorregulacin.
caracterizan por el contraste de alturas, intensidades,
timbres, periodicidad, derivados de los equipos:
respiradores, monitores, alarmas, trnsito de carros d) Los objetos intermediarios: En el autista, el objeto
diversos, instrumental, prdidas de gases medicinales, intermediario, en un primer momento, es anulado como

77
tal. El autista lo convierte en un objeto enquistado. Lo distensin muscular, movimientos de flexin o rotacin
transforma como una parte de si mismo y lo usa a su de los miembros, con aumento de la sudoracin. El
antojo con gran habilidad. Muchas veces rechaza musicoterapeuta tiene tendencia a traer pocos o ningn
activamente el instrumento, debiendo el Mt recurrir a objeto intermediario, que , por otra parte, difcilmente el
otros elementos no propios de la Musicoterapia. paciente pueda activar, salvo en algunas excepciones y
con adaptaciones especiales. Suele traer el aparato
El objeto intermediario corporal, tambin es rechazado
reproductor de sonidos para hacer escuchar
como tal, impidiendo el acercamiento a su entorno
pasivamente elementos musicales. Suele utilizar
corporal.
algunos de los elementos que rodean al paciente para
El Mt tiende a multiplicar la presencia y la
producir sonoridades varias, como ser, los bordes de la
heterogeneidad de los objetos, enfrentando la
cama, o de algn aparato o instrumental. En ambos
frustracin de los rechazos. Los instrumentos suelen
pacientes suele intentarse grabar la voz y el canto de
romperse y usados como elementos agresivos,
los progenitores o de algn familiar afectivamente
esparcindolos por el espacio.
ligado.
En el coma, tiene relevancia el objeto intermediario
corporal tanto del musicoterapeuta, como del paciente.
e) El tiempo: En ambos pacientes se trabaja con la
El musicoterapeuta, toca el cuerpo del paciente, lo
percepcin del tiempo biolgico. Es el tiempo que
presiona, lo distiende, lo acaricia, lo muere y por esta
caracteriza su propia homeostasis psico-corporal. El
misma va, el paciente responde con tensin o
paciente en coma tiene camuflado su tiempo biolgico,

78
por el tiempo determinante de los aparatos que lo f) Espacio: Los espacios donde se trabaja y se
rodean. aplica la Musicoterapia difiere del paciente autista y del
coma.
El autista manifiesta su tiempo biolgico con total
esplendor. Los tiempos de elaboracin de respuesta En el autista existen tres espacios posibles: 1. El
ante demandas o instrucciones variarn de un caso a gabinete de Musicoterapia especialmente diseado,
otro. La periodicidad de las sesiones de con aislamiento acstico de dentro para afuera y de
musicoterapeuta, en el paciente en coma ser de dos a afuera para adentro, con pisos y paredes de madera,
tres sesiones diarias. En el paciente autista depender con proteccin de los vidrios de luz o ventanales, etc. 2.
de la institucin o comunidad en que se encuentre, El agua, en piletas de natacin, a temperatura corporal
siendo aconsejable, una sesin al da por medio. (el espacio ideal) o 3. la naturaleza, con sus lmites
propios y sus objetos intermediarios.
La duracin de las sesiones depender de los tiempos
biolgicos del paciente y del musicoterapeuta, en cada En el coma, su nica posibilidad es la cama fija en la
circunstancia, dando como resultante un tiempo sala de terapia intensiva. Sin embargo he supervisado
teraputico que caracteriza ese vnculo y ningn otro. un caso en que la familia mont un dormitorio del hogar
del paciente una especie de sala de terapia intensiva,
Esta periodicidad constante es parte del desgaste
con lo cual modificaba de esta manera, parmetros
energtico del musicoterapeuta y su fatiga
sonoros, propios del hogar donde habitualmente viva
concomitante.
el paciente y posibilidades de contacto afectivo con los
miembros de la familia en forma constante a todas

79
horas de la cotidianeidad. musicoterapeuta el espacio adecuado para trabajar,
respetar los parmetros sonoros del entorno de ese
espacio, como as tambin, aceptar los sonidos
g) La institucin: En el autista se trabaja en un
bizarros, (gritos, aullidos, golpes, estridencias) que
hospital de da, o comunidad ambulatoria, o comunidad
surgirn del interior de ese espacio. Respetar los
de vida permanente, en el coma o en la institucin
distintos tiempos de duracin de las sesiones y evitar
hospitalaria donde se encuentra el servicio de terapia
la invasin o intromisin en el encuadre
intensiva.
musicoteraputico. El musicoterapeuta no ser
Todas estas instituciones deben respetar las normas cmplice de la perversin institucional.
ticas que exige la aplicacin de la Musicoterapia. Para
La institucin en el caso del coma, respetar el
lo cual todo musicoterapeuta tiene que hacer saber a
momento oportuno y adecuado para que el
las autoridades y a los equipos de salud el desarrollo de
musicoterapeuta se acerque al paciente. Por ejemplo
la Metodologa y la tcnica en Musicoterapia. Es til
es oportuno que el musicoterapeuta aplique la
para estos casos realizar laboratorios de trabajos
Musicoterapia antes que los enfermeros cambien o
Musicoteraputicos de cuatro sesiones con el equipo
baen al paciente, pues se ha observado que luego de
de salud (mdicos, paramdicos, enfermeras,
limpiarlo y el paciente se fatiga en demasa y no est en
mucomas), a los efectos de una mejor comprensin del
condiciones de establecer vnculo alguno. La institucin
contexto no-verbal y sus virtudes. De esta manera la
respetar la duracin de la sesin evitando todo tipo de
institucin en el caso del autista, le dar al
intromisin. Evitar los sonidos agregados haciendo el

80
esfuerzo de que el personal hable en voz baja, evite cmara de gesell. La supervisin la realiza un
abrir y cerrar puertas en forma estrepitosa, evite profesional con idoncidad en la materia y con aos de
circular con carros por el lugar y otras manifestaciones experiencia.
que aumentan la interferencia del vnculo en el contexto
En estos casos tan complejos del autismo y del coma,
no-verbal.
sugiero una supervisin doble, no comprometida, o sea
As, el musicoterapeuta no sera cmplice de la que no tenga ninguna vinculacin con la institucin. La
perversin en terapia intensiva. supervisin comprometida permite modificar detalles
tcnicos que protegen el cuerpo del musicoterapeuta y
el del paciente, aportando nuevos objetivos
h) La supervisin: La aplicacin de la musicoterapeuta
intermediarios modificando otros, posturas corporales
en pacientes enfrentados a la muerte o a la extrema
diversas, formas de acercamientos etc. La supervisin
incomunicacin requiere por parte del musicoterapeuta
no comprometida permite elaborar las fantasas del
de una constante supervisin. La supervisin consiste
Mr., aliviando los conflictos inconscientes movilizados
en informar sobre el desarrollo de las sesiones y sobre
en el vnculo con el paciente. Protege la relacin
las sensaciones contratransferenciales que la relacin
vincular para que no se convierta ni en promiscua, ni en
vincular produce en el musicoterapeuta. La informacin
perversa. El primer supervisor trabaja sobre el
puede realizarse, relatando los hechos en forma oral "o"
contenido manifiesto, comprende y refuerza el yo del
escrita, dramatizndolos, aportando material grabado
musicoterapeuta, el segundo supervisor analiza,
en vdeo o en cassettes o mediante observacin en
elabora el contenido latente y alivia al musicoterapeuta.

81
 En el autista se debe contar con dos musicoterapeutas
de la institucin. En ambos se requiere protocolizar una
i) Metodologa y Tcnica: En el autista, trabaja un
ficha Musicoteraputica que contenga todos los datos
musicoterapeuta con el paciente, para producir un
de su historia corporo-sonoro-musical, desde la
vnculo definido entre ambos. En el coma, se trabaja en
concepcin, hasta el momento actual. En ambos
pareja teraputica, o sea, son dos musicoterapeutas. El
pacientes estos datos deben ser requeridos a los
trabajos en pareja teraputica, permite aliviar el
progenitores o familiares ms directos. Con estos
impacto producido por el desarrollo de la enfermedad y
datos, ms la referencia significativa de la vivencia
el desenlace. Permite una mutua reflexin de la tarea,
contratransferencial que otorga los primeros contactos
gracias a una observacin ms libre y profunda.
con el paciente se estructura una situacin vincular que
Refuerza el instinto de vida de las Mrs., y se convierten
marcar el camino por donde transitar la teraputica.
as, en un continente ms firme para el paciente y ellos
mismos. Paralelamente se trabaja en ambos pacientes con el
grupo familiar a los efectos de aliviar las angustias,
En ambos pacientes el musicoterapeuta debe luchar
ansiedades, bloqueos y temores, que dificultan el
contra la identificacin de los sntomas de: aislamiento,
normal acercamiento de ellos con el familiar enfermo.
regresin (dimensin fetal), melancola y paranoia. En
Tambin se trabaja en ambos pacientes con el equipo
el paciente en coma se requiere un equipo de no
de salud a los efectos de modificar en ellos cdigos de
menos de cuatro parejas de musicoterapeutas
comunicacin, rompiendo y reestructurando guistes de
preparados para trabajar en el momento del ingreso de
comunicacin, y/o formas mecanicistas de
un paciente en coma o al coma.

82
acercamiento. A partir de esa primera sesin se van estructurando la
trama vincular en el contexto no-verbal que
En ambos pacientes el musicoterapeuta se presenta al
caracterizar a ese vnculo y a ningn otro.
paciente entonando una meloda a modo de saludo,
presentando el nombre del paciente y el del El fin del tratamiento, si es que este existe, debe ser
musicoterapeuta. Esta meloda surge de una mezcla cuidadosamente planeado por el musicoterapeuta, el
del conocimiento que el musicoterapeuta tiene de la supervisor y el equipo de salud, mucha ms an los
historia sonoro-musical del paciente y del impacto perodos de abandono por vacaciones u otras razones.
contratransferenical que le produjo en ese momento. La situacin vincular con estos pacientes es tan
Todo esto debe ser cuidadosamente elaborado en delicada que incluso se pueden percibir sensaciones de
supervisin. De esta manera del Mr. va normatizando el abandono en plena presencia.
modo de presentarse por medio de la msica que lo
En conclusin a travs de lo sintctico de esta
representa, respetando al mximo el contexto no-
conferencia he querido expresar que las diferencias y
verbal.
similitudes del trabajo Musicoteraputico en pacientes
En el caso del coma, simultneamente mantiene un autistas y en coma, son muy sutiles y delicados,
contacto corporal con el cuerpo del paciente, debiendo reflexionarse en el marco vincular que
generalmente en manos y brazos libres de intubacin. caracteriza cada paciente y su circunstancia, y en un
En cambio en el autismo el musicoterapeuta debe entorno tico comunitario.
esperar varias sesiones y ser muy cuidadoso antes de
pretender establecer un contacto corporal.

83
 I N T ER AC C I N M SI C A- D AN Z AT ER API A EN individual, la realizacin de Programas individuales
C ASO D E AT AXI A adaptados a las caractersticas del nio con diferentes
deficiencias o disfunciones y el desarrollo de
M ANGELES BERMELL CORRAL
metodologa especializadas as como la utilizacin de
recursos apropiados, todo ello hace reflexionar antes
El elemento sonoro/musical junto con la estimulacin de llevar a cabo una investigacin.
que provoca el movimiento, encierra un abanico de
posibilidades que permiten interactuar de manera
profunda en el ser humano. Tal situacin nos lleva a El desarrollo de la fundamentacin cientfica se ha

manifestar cierto rigor ante la docencia del profesorado llevado a cabo a travs de las nuevas corrientes

especialista y de sus futuros alumnos. cognitivas, de las directrices de la Neuropsicologa

(Vigosky y Luria) con la formacin teorico-prctica de
las tcnicas rehabilitadoras y de enseanza-
La integracin hoy quiere ser una realidad, pero en aprendizaje haciendo un paralelismo con los sistemas
cambio, la especialidad del profesorado de E.G.B. en metodolgicos musicales y la tcnica de la danza mas
Msica o Musicoterapia no ha tomado suficiente auge idneos para el caso a tratar y as nos encontramos:
en todo el pas para impartir una calidad de enseanza.
Si aadimos que recuperar, rehabilitar y modificar la
conducta adquiere un significado propio y distinto a la 1.- Modelo neoconductista se eligi el aprendizaje

educacin ordinaria, como el partir de un diagnostico vicario ya que tiene en cuenta la observacin e

84
imitacin de acciones de un modelo, sea el profesor, cognitivo al programa nos supone:
padre, compaero al que implicamos en acciones para
que por parte del sujeto pueda establecer una continua
observacin, imprescindible para la accin del a) Que los resultados que queremos conseguir

movimiento del cuerpo, su desarrollo de orientacin y con el proceso de enseanza aprendizaje (objetivos) se

equilibrio. expresan no en verbos de comportamiento sino en

destrezas cognitivas, donde los objetivos de la msica y
la danza vienen todos referidos tambin en destrezas
2.- La aplicacin del modelo cognitivo al campo de la congestivas (ed. rtmica, ed. vocal. etc.)
investigacin educativa y su intervencin didctica en el
aula supone el anlisis de los procesos internos del
alumno al mismo tiempo que la toma de decisiones del b) La tcnica que se utiliza para la

profesor y donde la msica junto - con el movimiento secuenciacin de los objetivos el -"anlisis de tareas"

adquiere un papel importantisimo debido al poder de desde el punto de vista cognitivo Este anlisis de tareas

anlisis y sentido globalizador que poseen de manera intenta descubrir y explicar como operan las personas

que permite al especialista observar mencionados (procesos ) con los datos que poseen (informacin)

procesos al mismo tiempo que conjugar el papel para resolver una tarea (ejecucin).

didctico en el aprendizaje rehabilitador porque se

estimula y potencia el desarrollo del cerebro de manera
Esta es una tcnica que se encuentra todava en un
diferente a otras materias. La aplicacin del modelo

85
estadio incipiente de desarrollo, ahora bien, desde mi *i *a

*t *r
experiencia opino modestamente que nosotros lo
(procesos) *m *u (informacin)
venimos haciendo ya que el aprendizaje rehabilitador
*O *g
de estas materias plantea una serie de tareas, como la
* *i
introduccin de la rtmica que va detectando como lo * *f
resuelve la persona (procesos) y las posibles MEDIR-MOVTO

anomalas, el asumir el valor de las figuras, comps

etc.(informacin) para que pueda resolver la tarea
3.- Teora de Procesamiento de informacin. Dado
(ejecucin) de moverse rtmicamente.
un estmulo-imput. y la respuesta del individuo -ouput-
se desencadena una serie de procesos que el individuo
Secuenciacin objetivos --------------------->Anlisis de tareas realiza pasando por la percepcin en un primer lugar, el
S*e*e*n
lenguaje y el razonamiento y en todos ellos existe una
*C 0*
constante que es la atencin.
*O p*

(procesos) *m e* (informacin)

*O u*
INSERTAR GRAFICO 1
* q*

*operan datos

EJECUCIN

Secuenciacin objetivos -------------> Apren. Msica y Danza.

Con el aprendizaje de la msica es estimulo propio
*r *s musical que nos sirve como puente de comunicacin

86
para potenciar la percepcin auditiva que se traducira desenvolver ms tarde y en definitiva conseguir la
en el "lenguaje musical", archivndose en la memoria organizacin de percepciones intelectuales superiores.
para llegar a la interpretacin de los sonidos musicales
-razonamiento- transmitiendo una expresin musical
que sera la "respuesta". A partir de los dos aos de edad, los significados y
conocimientos que el nio construye se transforman en
smbolos, incluyendo las palabras y fantasas en la
INSERTAR GRAFICO 2 medida que va surgiendo en el desarrollo normal, la
capacidad para simbolizar. Una vez que estos primeros
significados sensoriomotores no verbales, se traducen
Sabemos que el movimiento rtmico es la primera
a una modalidad simblica, estn disponibles para que
respuesta del individuo a los estmulos del medio. Ya
el nio pueda repetirlos en los juegos y cuentos. De
desde el seno de la madre existe una comunicacin
manera que en la misma medida que los significados
rtmica y en los primeros momentos de la vida, el
simblicos se van repitiendo en los rituales del juego,
lactante vive como fundido en el mundo que le rodea y
stos se irn revisando y transformando en
no tiene conciencia clara de sus limites de su yo
representaciones de experiencias cada vez ms
corporal. Este proceso se ir desarrollando muy
detallados, dando un significado ms complejo a la
lentamente hasta alcanzar la total interiorizacin del
interaccin del yo del nio con los dems personas y
conocimiento de su cuerpo que le servir de referencia
con los objetos. De esta forma, estos significados y
para establecer relaciones con el medio en que se
representaciones pasan por una continua revisin y

87
transformacin, asimilando y adaptndose a las
expectativas y oportunidades del hogar, colegio
Royce define la personalidad como una unidad
etc.(Santostefano 1.990).
psicolgica total, un sistema organizado de procesos
multidimensionales por medio del cul un organismo
manifiesta no slo fenmenos conductuales sino
Por lo tanto la prctica de la msica y el movimiento se
tambin fenmenos mentales.
puede valorar y considerar de modo semejante a como
se juzgan los aspectos cognitivos de otras reas,
porque es expresin/comunicacin no verbal que
As podramos definir la msica desde el punto de vista
ayuda a fusionar el conocimiento del Yo junto con las
psicolgico, como un medio de
emociones a travs de smbolos, dirigindolo hacia un
expresin/comunicacin no verbal organizado por
mejor equilibrio emocional.
procesos vanos donde se hace intervenir tanto el
aspecto cognitivo como el conductual comprometiendo
la personalidad del que lo aprende y del que la instruye.
4.- Teora de Royce. Teniendo en cuenta el modelo
Psicometrico, se eligi la Teora de Royce por su
sntesis recogida de una metodologa multivariada
Royce sigue diciendo que la personalidad es un
como la Teora General de Sistemas y la Teora del
suprasistema que est compuesto de seis sistemas
Procesamiento de la Informacin antes mencionada.
que interactuan: Sensorial, Motor, Cognitivo, Afectivo,
Estilos y Valores.

88
 interaccin de estas materias, determinan un estilo
peculiar de llevar a cabo el aprendizaje rehabilitador,
Los sistemas "cognitivos y afectivos" son unidades
valorando su proceso de maduracin que constituir la
de procesamiento que transforman la personalidad. La
base sobre la que se asientan los procesos
danza y la msica a travs de sus elementos: ritmo,
intelectuales superiores, ayudando a integrar la
meloda y armona aumentar el nivel expresivo-
personalidad. Es decir, una persona puede desarrollar
comunicativo del alumno de E.E. con un doble concepto
experiencias musicales segn el estilo cognitivo que
intelectual y afectivo, por lo tanto transformar la
tenga para luego conducirse por medio de unos valores
personalidad del alumno. Las emociones y las
que formaran en definitiva una linea a seguir en su vida
acciones influyen en la actividad cognitiva.
por lo tanto, evolucionar.

Los sistemas "estilos y valores" son unidades de

Y por ltimo "sensorial y motor" que son los
procesamiento que integran la personalidad. El estilo
traductores de Input y ouput, reciben y dan la
viene refrendado por la forma de aprender de una
respuesta. El estimulo sonoro provoca una respuesta
determinada manera mientras los valores es aquello
inmediata donde queda expresada por el cuerpo es
que motiva y orienta la conducta de una persona, por lo
decir, el aspecto sensorial y motor son los traductores
tanto los valores son de origen cultural o social en
de la informacin y de la respuesta, la vida sensorial es
definitiva son aprendidos. Las experiencias sensorio-
la que se estimula, es la que potencia la sensibilidad
motriz que se desarrollan a travs del aprendizaje de la
para dar calidad de vida o a la interpretacin y el

89
aspecto motrico es una funcin psquica compleja Consiste en el estudio de los complejos sistemas
dentro de esa sensibilidad que se ofrece como funcionales del cerebro, de como estn distribuidos y el
respuesta, es la comunicacin/expresin del mensaje papel que desempea cada rea del cerebro en los
musical. mismos.

Todos sabemos que es muy frecuente la aparicin de Sabemos que el cerebro se modifica con el ejercicio,
alteraciones y trastornos mas o menos graves en el con la estimulacin y con el aprendizaje, que supone
desarrollo psicomotor, por ello es prioritario e ineludible una determinada organizacin cerebral. Por lo tanto los
educar o rehabilitar al nio en la accin, con el ritmo y instrumentos de diagnostico neuropsicolgico nos
con el movimiento etc. sea cul fuere su tipo de grado miden el grado de organizacin que ha alcanzado el
de dificultad. Con estas tcnicas de expresin se pone cerebro. Esta organizacin puede estar disminuida
a disposicin del futuro profesor-alumno, un nuevo tanto por una lesin o disfuncin cerebral como por
vehculo de expresin/comunicacin poco utilizado, falta de estimulacin y aprendizaje adecuados
potencindole el proceso madurativo y el (Monedero 1.984.). as pues el origen de las dificultades
descubrimiento de otras facetas poco conocidas por l del aprendizaje no son exclusivamente alteraciones
mismo. neurolgicas y de entidad patgena, sino que pueden
ser de carcter ambiental aunque esto ltimo no es
nuestro caso.
5.- Teora Neuropsicologica (Vigosky y Luria).

90
 mtodos precisos, en realidad no existe tcnica
psicoteraputica moderna que en su evolucin, no
El enfoque de la escuela rusa parte de las funciones
haya optado por incidir en una cierta perspectiva de
psquicas que se apoyan en un sistema funcional
trabajo corporal.
complejo en que participan varias reas del cerebro
conjuntamente y que cada rea contribuye a la
consecucin de esta actividad compleja. Estas
Por otra parte no cabe duda, que a nivel de
funciones pueden ser rehabilitadas sustituyendo las
observacin, deteccin, diagnostico y evaluacin, la
reas daadas por otras y procurando la
fidelidad del conocimiento depende en gran manera de
reestructuracin de todo el sistema funcional sobre
saber encontrar y reconocer datos corporales, siempre
bases nuevas.
que sepamos aislar los mismos de los estereotipos
comunes y de los rasgos culturales que fuerzan de
alguna manera la forma de expresin a veces oscura.
Por lo tanto debe someterse a un aprendizaje
rehabilitador sistemtico y cientficamente fundado y
ste sera el objetivo de la "Enseanza rehabilitadora",
As, la danza, se concibe en este contexto no solo como
la reconstruccin de las funciones alteradas, utilizando
finalidad de la misma, sino como vehculo que potencia
las zonas intactas. Comentar que no existen fuera de
la atencin, que ofrece una respuesta rpida y
experiencias teraputicas de psicomotricidad muy
observable y con ello ayuda a la discriminacin auditiva
concretas, demasiadas lineas de actuacin con
y formacin rtmica de base que cumplir con los fines

91
establecidos de la enseanza rehabilitadora. mentales que se desarrollarn de manera gradual. La
actividad del hemisferio derecho y la del hemisferio
izquierdo deben ser conocidas, sino, se producir una
Jean Paul Despins en su libro "La msica y el cerebro"
especie de "difrenia" que se manifiesta con tics,
nos habla del lugar que ocupa la Msica y que si bien el
bloqueos, posiciones etc.
hemisferio derecho es que regula ciertas funciones
musicales(Wagner y Harron 1.981) tales como la
tonalidad meldica, el timbre, la tonalidad vocal En base a lo comentado hasta ahora se incluy en el
cantada y el sentido de la emocin y de la expresin programa musicoteraputico el aprendizaje del
musical, el hemisferio izquierdo en especial gobierna el lenguaje musical junto con el movimiento rtmico y
sentido del ritmo (sobre todo si es complejo), regula los danza porque podemos detectar rpidamente los
mecanismos de la ejecucin musical y persiste que. en problemas, alteraciones y trastornos psicomotores que
un ser humano perfectamente equilibrado es el que forman un comn denominador en la E.E., por lo tanto
hace funcionar de manera alternada o simultnea es ineludible para mi -educar o rehabilitar al nio en la
ambos hemisferios. Y que no se llegar a la "plenitud accin-.
del desarrollo de la inteligencia humana" si las
capacidades cerebrales especificas de cada hemisferio
no estn sujetas a una interaccin capaz de En cuanto a los sistemas metodolgicos musicales a

complementarias. Una diversificacin demasiado emplear, se eligi no el patrn totalitario de cada uno de

grande de sus actividades puede llevar a trastornos ellos, sino una linea metodolgica propia basada en

92
estos sistemas para una adecuada aplicacin del caso necesidad ms imperiosa que tienen los futuros
que nos ocupa. Es decir, en cada sistema eleg un profesores de sentir y crear con la msica y la danza
aspecto ya experimentado y como consecuencia adecuaciones curriculares para que a su vez puedan
relevante para mi dentro de la didctica musical para su transferir a sus alumnos el modelo adecuado y su
aplicacin. Por otra parte las ltimas investigaciones puesta en el aula.
realizadas sobre el aprendizaje musical y sus
reacciones en el cerebro, nos demuestran que aquellas
tcnicas que hacen demasiado hincapi en una De esta manera, del mtodo DALCROZE se eligi su

analtica rtmica que se ubicara en el hemisferio rtmica por el sentido pedaggico que desarrolla la

izquierdo, vendra en detrimento del hemisferio actividad muscular a travs de la disociacin y por

derecho y que de alguna manera obstaculizara el medio del ritmo y el movimiento que llev a acciones

efecto de improvisacin, llegando a un desequilibrio ms conscientes para la enseanza rehabilitadora.

entre dos modos generales de funcionamiento

cognitivo que en este caso sera, hipertrofia de la lgica
De KODALY su desarrollo de la fononimia que potenci
analtica e hipertrofia de la lgica global.
la educacin auditiva y la improvisacin.

Llevado esto a la prctica quiere decir que si damos

Con ORFF, la palabra analizndola rtmicamente y con
importancia desmesurada a la adquisicin de la teora
el cuerpo para dar paso a la improvisacin y a los
musical, corremos el riesgo de no potenciar la

93
instrumentos de percusin por su poder de Tambin es imprescindible una revisin continua,
acompaamiento y sencillez. que vendra dada por el seguimiento del sujeto en clase
despus de cada aplicacin que es lo que nos va a dar
un valor verdadero de conocimiento de la persona.
Y de WILLEMS su filosofa sobre las bases psicolgicas
de la msica y esa sensibilidad que caracteriza el
mtodo a mi manera de ver. Referente a los dems En cuanto a investigaciones ya realizadas se ha
sistemas y si bien se detectaron aspectos notables no elegido las siguientes:
se pudieron aplicar en las circunstancias de este caso y
por ahora no se ha encontrado posibles vas.
El esquema bsico neurofisiolgico del "estimulo-
respuesta" que se produce a travs de un estimulo
Otro factor que se sigue observando es como nos musical que recorre unas vas aferentes,
seala la Psicologa evolutiva "el ritmo de desarrollo y proporcionando una respuesta va eferente a partir de
aprendizaje que posee cada sujeto", pues no se puede las motoneuronas. Se ha propuesto una terapia
dar un proceso de enseanza-aprendizaje-teraputico basada en el estimulo de un telerreceptor EL OIDO a
sino nos situamos en las conductas llamadas normales travs de la msica y la danza.
que marcan las directrices de la evaluacin del hombre.

Y as nos encontramos con la INTERRELACION

94
CEREBOCEREBELOSA: actuara por coordinacin sobre el otro, que es lo que
se pretende en casos patolgicos donde alguno de
ellos esta lesionado. Los movimientos musculares
Existe una relacin cerebro-cerebelosa patente
reflejos estn condicionados e interaccionados por la
demostrada por Rossi 1.912 donde la estimulacin del
actividad del resto del sistema nervioso. Y esta
cerebro aumenta la excitabilidad de la corteza motora
interaccin se debe a la existencia de conexiones
cerebral. Y por Adrin 1.943, existen diferentes reas
sinpticas entre todas las vas y as en condiciones
de la corteza motora cerebral que se proyectan en
normales todo el sistema nervioso funciona como una
diferentes zonas de la corteza cerebelosa. Es decir, el
unidad integrada.
cerebro recibe informaciones propioceptivas, tctiles,
visuales, auditivas, neurovegetativas y de la corteza
cerebral; estas informaciones se utilizan para regular Rosignol y Jones (1.976) dirigieron una serie de
los movimientos, funcin para la cual este rgano est experimentos mostrando que los sonidos agudos, no lo
muy capacitado por sus conexiones con las neuronas bastante intensos para producir sobresalto, facifitan un
motoras de la corteza cerebral y de la medula espinal, incremento de la excitabilidad de las neuronas motrices
actuando como servomecanismo con respecto a una de la mdula.
orden dada para ejecutar un movimiento.

Gallahue(1,982) seala el ritmo como un

El estmulo de uno o de otro (cerebro o cerebelo) componente bsico en todos los movimientos

95
coordinados y nos dice que las actividades rtmicas consiguiente a su proceso y a la reseccin de dicha
deberan ser utilizadas para: tumoracin infiltrada claramente suelo del 4 ventrculo
y los pednculos cerebelosos. Como consecuencia
1.- Realzar las capacidades locomotoras y no
presentaba:
locomotoras fundamentales en los nios.

2.- Potenciar la capacidad del nio para responder a

las variaciones en el tiempo, intensidad, acento y -Parlisis facial derecha
modelo rtmico.
-Parlisis del lbulo ocular derecho.
3.- Desarrollar la capacidad del nio para imitar e
-Gran ataxia de tronco.
interpretar a travs del movimiento rtmico y creativo.
-Hipotona.
4.- Desarrollar y perfeccionar la capacidad rtmica
-Hidrocefalia.
auditiva a travs de la participacin en juegos con los
dedos, poemas, canciones infantiles etc.

B.-EXPLICACION DE LOS TRASTORNOS QUE

CONLLEVA ESA PATOLOGA.
A.-EXPOSICIN DE LA PATOLOGA.
Estos pacientes generalmente nios, no pueden
El trabajo efectuado sobre la persona portadora de
mantener el equilibrio y aumentan la base de
tumor en fosa posterior: meduloblastoma, ha sido
sustentacin es decir separan mucho los pies y su
enfocado para paliar en lo posible el dficit funcional

96
marcha es titubeante por lo tanto "no hay un ritmo trastornos en el equilibrio." Algunos nios con ataxia
sincronizado". Esto se debe a la ausencia de la demuestran variaciones en su conducta motora
inhibicin cerebelosa sobre los reflejos labernticos ya haciendo necesario un programa individual.
que las reacciones vestibulares carecen de medida y
determinan la perdida del equilibrio. Segn Connor,
Williamson, Antiepp (1.978), los nios tienen dificultad Por su parte Goellnitz (1.976) nos dice que aparte del

para "mantener una postura de una manera coordinada goce general de las actividades musicales rtmicas, las

y a menudo tropiezan y caen". Esta postura inestable deficiencias en la realizacin motriz y socio-emocional

puede hacer que tomen demasiadas precauciones y pueden ser positivamente influenciada a travs de

rigidicen el tronco para aumentar su estabilidad. terapia musical rtmica y psicomotriz.

Cuando estn caminando, pueden fijar visualmente en

un objeto con esfuerzo y mantener as una postura
Por ello la Metodologa a emplear teniendo en cuenta la
controlada.
Ataxia en la que "prima la falta de coordinacin motriz"
por dismetra en el calculo de la distancia, se realizaron

Segn Walsch (1.963) cuando intentan proponerse una actividades rtmicas acompaadas en todo momento

lectura, a menudo se pasan de linea debido al temblor del movimiento para la reeducacin propioceptiva y

distal y ondulante. El Nistamus es muy frecuente y coordinacin cerebelosa.

segn Brown (1.973) los nios que tienen por diagnosis

primario ataxia, "escriben dificultosamente y tienen

97
C.- APLICACIN DE LA MSICA Y LA DANZA A LOS de los miembros superiores y la incidencia de este
TRASTORNOS MOTRICOS. movimiento para el aislamiento del tronco y de la
tensin que sufra en la mano izquierda, a partir de
1.- ATAXIA.- es una perdida de la coordinacin de los
estos movimientos se empez a controlar la
movimientos debido a las lesiones de centros
independencia de las manos.
nerviosos, es decir, el sujeto no poda seguir una
direccin recta, tampoco poda mantener o acelerar
una velocidad era ms bien lenta y no tena sentido del
2.- DISMETRIA.- Se present como una dificultad de
amplitud. Cuando meda el espacio al hacer un
control de la "amplitud de un movimiento", es decir, no
movimiento o paso de danza, haba una perdida de
tena control en la extensin del movimiento a realizar y
direccionalidad y equilibrio. Tomando como eje
por eso el miembro/s iba ms all de su objetivo o era
principal el ritmo y la meloda se pudo fijar unos puntos
insuficiente. Se realizaron esquemas rtmicos sencillos
en el espacio que le sirvieron de punto de apoyo,
por medio de las palmas orientndose hacia el
controlando as un espacio determinado y llevndole
alrededor del cuerpo, ya que es una manera de
primero a una direccin ms tarde a otras
acaparar la atencin con las manos y potenciar
consecutivamente. Al principio nos expresbamos con
movimientos simtricos porque las manos tienen que
las manos (por la perdida del equilibrio) realizando una
juntarse a la vez, ayudando a reforzar la atencin
danza individualmente y luego conjuntamente despus
rtmica. Los movimientos de brazos junto con los mos
se fueron incluyendo otras partes del cuerpo. El objetivo
e intentando imitar el desplazamiento de algunos
que se pretendi fue la situacin rtmica-motriz a travs
animales le sirvi de mucha ayuda y empez a

98
relajarlos. Seguidamente pasmos a realizar impulsos desarrollar movimientos rtmicos voluntarios
con los dedos pasando todos por el pulgar, con una comprometiendo a la parte del cortex. Los movimientos
mano y luego ambas a la vez. Segn Lucretia Rogers corporales que imitan las mquinas producen un
en "Msica para nios invlidos en un hospital" la esfuerzo de atencin y control del cuerpo con
prctica teraputica sobre el piano bien estructurada, acompaamiento de sonidos producidos por el propio
puede proporcionar la cantidad exacta de resistencia y alumno y adecundolo segn su ritmo biolgico. En
amplitud del movimiento flexin y extensin digital y este apartado se comenz el desplazamiento de los
dorsoflexin de los pies. miembros inferiores muy lentamente y ejerciendo una
fuerza para no flexionar las piernas, se sostuvo la frase
de que sus piernas eran pesadas como grandes
3.- APRAXIA.- Es cuando existe una imposibilidad de
piedras.
efectuar movimientos voluntarios. Son las diferentes
fases de un movimiento que se ejecutan
separadamente y sin una secuencia armnica, es una 4.- HIPOTONIA.- La hipotona es una discriminacin
descomposicin de los movimientos. El ritmo al ser del tono muscular, est demostrado que el ejercicio
productor de energa estimula por medio de la msica fsico va recuperando una estabilidad del musculo.
(va auditiva) invitndole a la imitacin de movimientos Pues bien si aplicamos msica con mucho carcter
que al principio eran muy lentos, ubicndolos en unos pero ritmo lento o pausado y solemne facilitar la
momentos determinados de la msica que previamente excitabilidad del musculo cuando se dance. Al principio
se haba analizado para el sujeto, llegando a se trabaj con posturas de piernas abiertas y sin

99
movilizarlas solamente flexionando cuando se daba la se necesita la contraccin alternada de los extensores y
orden y segn los movimientos de los brazos que flexores de manera sincrnica con la adaptacin del
tenan un carcter de amplitud formando figuras miembro a movilizar, llegando a unas conclusiones:.
geomtricas en el espacio, ms tarde se introdujo
posturas que representasen estados de nimo y donde
segn miembro a trabajar se produca una 1.- Opino que es muy importante que el movimiento

concentracin de fuerza acompaado por ciertos corporal tenga una msica ritmo de base porque

acordes de la obra musical; el tronco slo se flexionaba potencia las estructuras musculares voluntariamente al

hacia delante y hacia atrs . Los diferentes comprometer una serie de pasos. Y tal contraccin

instrumentos de percusin elegidos por el sujeto y para debe ser adems somtrica con un aumento de

acompaarme intervinieron siempre teniendo en tensin que sea paralelo a la fuerza aplicada al musculo

cuenta el conjunto de movimientos dirigidos de una (el que se quiera movilizar).

manera adecuada para facilitarle el desplazamiento de

sus brazos y cuerpo.
2.- El ritmo corporal del sujeto debe ser analizado
previamente y adaptarle el ritmo musical porque, esta

Por lo tanto y teniendo en cuenta desde el punto de situacin necesita la integridad de la inervacin

vista de la danzaterapia la Ataxia se explica por la reciproca con un reclutamiento en el tiempo y 'en el

perturbacin de la "estabilizacin rtmica" de las espacio de todas las unidades motoras implicadas.

articulaciones y para que una articulacin se estabilice

100
3.- Al danzar y escuchar msica al mismo tiempo hay
una integracin y coordinacin del cuerpo, estimulando
La primaca del orden se refiere aqu slo con la
as la parte afectada y potenciando la percepcin y el
toma de conciencia, con el acto cerebral, En cambio, el
campo de la sensibilidad. Por lo tanto y en este caso
sentido del movimiento precede al del orden as como
concreto debido a que la recuperacin funcional por
la vida precede a la conciencia.
medio de ejercicios teraputicos es un proceso
relativamente lento, es aconsejable inducir la mayor
actividad posible en las zonas afectadas con esfuerzos Otro hecho que habla en favor de la supremaca del
voluntarios con objeto de acelerar la recuperacin , por movimiento rtmico es que es ms fcil imaginar un
eso se propuso un programa ms danzateraputico. movimiento que produce un ordenamiento (marcha,
empujar un columpio etc.) que un ordenamiento
provocando un movimiento. Este es en general la
Todos sabemos que Piaget establece que la nocin
causa, el otro el efecto, si en el arte la forma ordenada
de orden precede a la del movimiento es decir, el nio
es importante, el poder que ordena y produce formas
realiza:
es primordial. Por lo tanto el movimiento se consigue
a.- Operaciones de ubicacin que conducen a la nocin con un umbral de excitacin mayor con la ayuda del
de orden. ritmo pero ese movimiento debe estar bajo las reglas
de la tcnica de la danza. Por ejemplo: el caminar por la
b.- Operaciones de desplazamiento que nace la idea
clase haciendo coincidir el paso con palmadas en un
del movimiento.

101
principio y teniendo en cuenta la acentuacin fuerte que a) Crecimiento orgnico y maduracin de los
debe recaer en el pie izquierdo y ms tarde entonando sistemas nervioso y endocrino.
una cancin, es una manera de comprometer al cortex
b) Dado el ejercicio y la experiencia adquirida,
ya que el cerebelo es la parte daada en este caso.
llevarla a la accin sobre los objetos.

c) Las interacciones y transmisiones sociales.

4.- Es lgico pensar que cuantos ms estmulos
d) Y de la autorregulacin del sujeto resultando de
reciba el alumno mayor vas se excitan hacia el cerebro
una construccin ininterrumpida.
por lo tanto menos respuestas excluidas quedan.

Teniendo en cuenta estos cuatro factores, el ritmo

5.- Otros aspectos a tener en cuenta frente a la
adquirido potenciar la energa del cuerpo y beneficiar
msica sera, que sonidos pueden ayudar ms a la
los movimientos dinmicos para alcanzar mayor
recuperacin del individuo.
desplazamiento en un tiempo determinado

6.- Para alcanzar la educacin del movimiento o la

D.- EVALUACIN.
recuperacin del mismo, es imprescindible el dominio
del espacio que depende de cuatro factores que Debido a la carencia de instrumentos para medir a

influyen en la organizacin espacio-temporal: travs de la msica y el movimiento para detectar las

situaciones anmalas y aplicar una terapia musical y de

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danza, se establecieron unas secuencias de sesiones c) Y el desarrollo de ejercicios ritmicos-motrices con
de ejercicios sistematizados por el mtodo de una secuenciacin progresiva teniendo en cuenta la
observacin. dificultad personal tanto en la msica como en el
movimiento.

d) Su capacidad de aprendizaje musical elemental y

Por cada ejercicio que desarrollbamos, iba anotando
sus respuestas motoras, cognitivas y fisiolgicas.
como ocurra el procesamiento de informacin al recibir
una orden previa. Cmo llegaba el estimulo auditivo-
motriz (input), que pasos determinaba su colaboracin
As llegu a ciertas conclusiones deficitarias partiendo
y su respuesta (ouput), si era correcta y el tiempo global
del diagnstico previamente establecido:
que necesit desde que recibi la informacin hasta la
respuesta.
Deficiencias rtmicas:

En cada ejercicio se estableci: - No poda asimilar un esquema rtmico sencillo, no

lo interiorizaba por tanto su respuesta era equivoca
porque no conceptualizaba abstra. -Al percutir con
a) Lo que hacia sus manos no guardaba una simetra de movimiento
del ritmo.
b) Aquello que no poda realizar

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Deficiencias meldicas: Teniendo en cuenta sus enfermedades patolgicas y
despus de analizar las situaciones ritmico-motrices,
- No poda repetir una imitacin meldica sencilla,
pensamos que existe una deficiencia de estructuracin
deficiencia en el pensamiento lgico, aunque si poda
en el pensamiento lgico, aunque el sujeto es
reproducir canciones ya trabajada anteriormente, con
inteligente y con gran capacidad de trabajo.
cierta interpretacin errnea en algn momento en el
ritmo, altura de sonido y duracin.

Por lo tanto este proceso del aprendizaje-rehabilitador

a travs de la msica y junto con la danza cumple las
Deficiencias motricas:
necesidades del nio porque:
- Perda el equilibrio al andar pausadamente y no
exista un ritmo constante.
a) El nio toma conciencia y puede experimentar las
- No flexionaba las piernas a ritmo a no ser que
resistencias de su cuerpo.
levantase mas de lo normal el pie, antes tena un cierto
temor a las escaleras, hoy puede subir una montaa si b) Desarrolla y afina la percepcin.
se lo propone.
c) Analiza las posibilidades que tiene de moverse
- No poda saltar continuamente ni estaba relajada, libremente.
hoy danza.
d) Coordina sus movimientos y armoniza su
actividad musical con la de los dems.

104
 formativa y como instrumentos pedaggicos, ya que el
aprendizaje-rehabilitador que se quiere alcanzar nos va
Y este potencial instrumental le llevar a un despertar,
a medir, los procedimientos, valores, normas y
unas veces por s solo, otras debern ser motivadas
actitudes. No se pretende pues una evaluacin
por el adulto para que se pueda:
cuantitativa sino cualitativa y observable, de manera
que nos lleve al procedimiento de retroalimentacin si
a.- Observar la actitud estable o variable. se diera el caso.

b.- La seleccin de control ante actividad rtmica

acomodada a cada uno.
Por lo tanto los procesos de aprendizaje significativo de
c.- Potenciar su atencin y percepcin, llevndole al la msica junto con el movimiento son explicables a
campo de los estmulos, donde procesar la travs de las teoras cognitivas comentadas; as
informacin y con ello comenzar el aprendizaje que le mediante una estimulacin sensorial proporcionada por
llevar a un cambio del comportamiento. el profesor y adecuada al nivel de conocimientos
previos conseguidos por el alumno y cuyo objetivo es la
rehabilitacin de los procesos alterados compensando
En cuanto al proceso de evaluacin en un caso a las funciones de las zonas cerebrales daadas por las
rehabilitar, opino que debe servimos para una continua otras intactas, el alumno procesa la informacin en sus
valoracin del aprendizaje significativo y funcional es tres aspectos: conceptuales, procedimentales y
decir, hemos de partir de una evolucin inicial, actitudinales, uniendo los conocimientos con los

105
afectos y produciendo una respuesta que a su vez, es Their conditions are caused by:
punto de partida de la nueva estimulacin y de los
- subatrophy or atrophy of the optic nerve - 31.6%
ejercicios propuestos por el profesor.
- ROP (retinopathy of prematurity) - 28.7%

- congenital malformations - 16.9%

M U SI C T H ER APY, PH YSI O T H ER APY AN D L O W
VI SI O N T R AI N I N G - cataract - 11%

- toxoplasmosis - 3.7%
W ALTER BINELLO - CHRISTIANE KLEIN
- anophthalmia - 3.7%

The "Fondazione Robert Hollman" was established - various other pathologies - 3.7%

in 1979. - congenital glaucoma - 0.7%.

The current program since 1988 involves early In addition, 50.73% of the children present other
therapeutic intervention with regard to new born to four- handicaps such as motor/psychomotor deficiencies,
year-old blind or severely visually impaired children who cognitive retardation, or problems concerning social
may or may not have additional handicaps. and emotional relationship which are not simply a

All the children served have severe visual impairment or consequence of the visual handicap.

are blind. Of the children we serve, 49.27% do not have other

problems apart from their visual impairment or certain

106
kinds of retardation which generally are considered We give special importance to the parents' needs,
normal in such cases. offering them psychological support and advice to help
them in day to day living with their child.
A high percentage of the children (39%) were born
prematurely (between 23 and 34 weeks gestation). We base our program on the convinction that in every
child, notwithstanding the presence of a serious
As a consequence of the long periods of hospitalization
handicap, there are numerous possibilities for
often experienced by them, most of the children have
development. It is therefore a matter discovering this
suffered psychologically. Almost all the children show a
potential by means of differentiated methods of
marked difference between their chronological and their
evalutation and by devising a program of rehabilitation
developmental age. Psychological distress and
tailored to the needs of the child.
disturbances of the sleeping-waking rhythm are very
typical in these children. It is well-known that when babies are born their visual
functions are still incomplete and reach their full
development only through the visual stimuli received
Our therapeutic program.
spontaneously from the environment during the first
A fundamental aim of our work is therapeutic year of life. The visually impaired child is unable to
intervention with regard to visually impaired or blind receive these stimuli unless they are presented to him
children during their early childhood (between birth and at times and under conditions which are particularly
four years), including those cases in which the child favourable.
presents multiple handicaps.

107
A feature of our Center is that the children's periods of handicap and/or other problems.
residence are not rigidly organized. The following
- Music therapy based on the analysis of the
details are therefore purely indicative and may be
man-sound relationship and on body resonance. The
modified at any time to suit the needs of individual
child, lying or sitting on the grand piano, plays with the
children and their families.
therapist and an improvised sound dialogue develops
The first stay at the "Fondazione Robert Hollman" between him and the child.
lasts four weeks, followed after about a six-month
- Orofacial therapy indispensable in the
interval by further stays of two weeks, according to
treatment of disorders of sucking, chewing, swallowing
individual needs.
and language in children with sensorimotor problems in
The cost of the mother's and child's stay at the the face, in the month and throat areas.
"Fondazione", including all treatment, is borne by the
- Psychomotor therapy, helpful in attaining full
"Fondazione", and is completely free of charge to the
consciousness of one's body, in relation with the
family.
environment.
The activities are devised as follow:
- Hydrotherapy, as a means of getting to know the
- Visual Stimulation (Low Vision Training), in element "water" and to stimulate psychomotor abilities.
order to maintain and develop the use of residual vision.
- Play therapy, aimed at the child's global
- Physiotherapy, which helps to prevent and development through multisensorial stimulation.
modify the effects of retarded mobility due to the visual

108
- Baby-massage, which has the primary aim of interact with the world around him, and through
facilitating and strengthening the affective contact movement learns simples activities before going on to
between parents and child, to improve the child's overall develop those which are more complex.
perception of his body.
The first movements are the basis of his future
- Practical activities with mothers or fathers, development, which is the postnatal continuation of the
with the purpose of inventing and constructing play maturation of the sensorimotor process which was first
material for the child. begun during the child's intrauterine life.

- Psychological counselling, to provide the Every child with problems (disorder of neurological,
families with necessary support, paying particular sensory and psychological development, prematurity,
attention to the relationship between parents and child. hypotonia, and so on) is a human being with his own
special individuality. It is of vital importance to recognise
We also have at the family's disposal an
the major problem of the child and his family and on this
ophthalmologist, a neuropsychiatrist, a low vision
basis to establish a therapeutic program which will
trainer, a speech therapist, a music therapist and an
continually take into account the child's particular
optometrist, as specialized advisers.
needs.

What is the child able to do? How does he do it? What

Physiotherapy in early intervention.
can he not do? and for what reason? How does he
Already in the first month of life, the child begins to move in space? How does he get his food? How should

109
one behave towards him, and why? How can we applied according to the concepts of BOBATH,
decrease his limitations in motor and sensory CASTILLO MORALES, and JEAN AYRES. Generally, in
perception? and how can we stimulate his capacity for informing the family, we lay no particular emphasis on
rehabilitation? the specific method which is being used: we prefer
rather to stress the kind of techniques employed for the
In the course of our work, the first time we meet the child
overall development of each individual child.
and his family we devote the encounter to looking for
answers to these questions. We also pay particular Our experience ha taught us the great importance of
attention to the harmony of the child's movements, as orofacial therapy, indispensable in the treatment of
evidenced in the intermediate passage from one disorders of sucking, chewing, swalloing and language
position to another, and how the child uses the flexion - in children with sensorimotor problems in the face,
extension-rotation mechanism in relation to the median mouth and throat areas. But it is very difficult for many of
line of his body. our children to keep still in one position ("calma
motoria") and to accept being touched in the mouth
The child's refusal to use some positions (lying face
area (many of them were intubated and still present
towards and supine) motivates us to look for an ideal
pathological reflex movements, etc.).
situation in which the child can accept this position, to
allow him to armonise his movements better. Also in this case, in looking for an ideal situation for the
child, after we have established a good relationship with
In the Fondazione Robert Hollman of Cannero
him and the parents, we noticed that through
Riviera, physiotherapy methods in early intervention are
proprioceptive stimulation, as on the swing, the child is

110
more willing to accept orofacial and other stimulations. sound relationship, and on principles borrowed from
acoustic physics, which explain the interrelational
Another important technique we use is vibration, which
nature of the phenomenon of sound. The paradigm at
can produce higher muscle tone (short intermittence
the basis of music therapy is sound-rhythm-movement,
vibration) or relaxation (long intermittence vibration).
which we understand as something that accompanies
As proprioceptive stimulation and vibration form the
man from the moment of his conception, during his life
basis of the music therapy practised in our Centre, we
in the womb, at his birth, and throughout his whole
began to combine physiotherapy and music therapy in a
existence.
situation which is enjoyable for the child and which
The method, based on communication, has its origin in
creates a more intensely emotional experience.
recent Neuro Linguistic Programming (NLP) studies,
Since using this joint method, we have had more
and may be expressed by the terms matching, pacing,
involved participation both by the children and their
and leading. On a cultural level, the approach is an
parents, and the results achieved have in a short time
inquiry into the nature of sound in its relationship with
exceeded our expectation.
man: it may therefore be described as maieutic with
regard to the musicality inherent in each person, and
may summed up in the terms syncresis, analysis,
Music Therapy.
synthesis.
Music Therapy is based on theoretically both on
phenomenology, as regards the analysis of the man-

111
The theoretical reference model. Resonance is the faculty of an elastic body for
spontaneous convibration when excited by external
The two branches of knowledge of phenomenology and
vibrations whose frequency coincides with the natural
acoustic physics serve as references in formulating our
duration of its vibration.
theoretical model.
In our view, the nature of sound is a relationship: firstly,
Phenomenology provides a starting-point for analysing
due to the resonance cavities in our bodies, between
the philogenesis and ontogenesis of the man-sound
the acustic vibrations generated by a motive power and
relationship, with particular reference to man's ability to
the auditive sensation produced when the sound wave
learn the function of listening and exploratory kinds of
reaches us, forging a union between body and psyche.
behaviour which allow him to make contact with his
Secondly, there can be a sound relationship between
environment.
two people (ex. therapist and child) who are in a
Acoustic physics supplies the analysis of sound
dynamic rapport, created by the medium of sound. We
parameters (intensity, duration, loudness, timbre) with
use the term "covibration" to describe this relationship.
particular reference to the phenomena of harmonic
Vibration itself is an undulating movement, like that of a
tones and resonance.
pendulum or a swing. Sound vibration derives from very
The theory of harmonic tones explains the relation
fast movement of the sound body around its balance
which exists between the basic frequency of a tone and
position. The sound body is an elastic body which tends
the multiple frequencies which expand in proportion to
to return to its original shape when the distorting force
it.
stops. This is what also happens through the

112
proprioceptive stimulation of the swing, in which there is listener and sympathetic interlocutor.
a vibrating movement which promotes the
On a cultural level, the approach is an inquiry into the
establishment of rapport.
nature of sound in its relationship with man: it may
At this point we can talk about covibration not only as a therefore be described as a maieutic with regard to the
physical phenomenon elicited by sound through the musicality inherent in each person, and may be
presence in our bodies of resonance cavities, but also summed up in the terms syncresis, analysis, synthesis.
as a positive dynamic relationship between two people
(e.g. therapist and child).
The technique.

In practice, the technique consists in putting the child in

The method.
a condition of bodily resonance, by exploiting the
The method, based on communication, has its origin in frequencies which may be perceived through the case
the latest Neuro Linguistic Programming (NLP) studies of a grand piano. From this starting point there develops
and may be expressed by the terms matching, pacing a series of improvised games in sound (sound
and leading. dialogue), through which the child can experiment with
spontaneous movement and with his voice, and may
Matching and pacing are the foundations on which the
also improve his posture and body tone.
rapport (sensu Rogers) is built and maintained, while
leading indicates the contribution of novelty introduced Lying or sitting on the grand piano, the child relaxes and
by the therapist as a creative personality, empathic his capacity for listening and his exploratory behaviour

113
come into action. At this point, with the child attentive stimulate him in a half-dark room or in a natural light,
and ready to explore his surrondings, we can perform placing the objects at a distance of 20 to 40-50 cm. from
an intervention based on perception by the child of his him so as not to lose his attention. He is not able to take
own body and of movement, in accordance with the hold of anything, but he tries to move his arm in the
median line of his body. direction of the light. His motor diagnosis is a dystonic
tetraparesis, more hypertonic in activity; when he is
Visual training, on the other hand, consists of activities
inactive his hypotone is more evident. This lovely child
aimed at detecting the existence of residual vision in the
cannot change position autonomously but depends
child, with the objective of stimulating his impulse to
entirely on other people. He is fed mainly by his mother
look. In this case too, music, use as described above,
and we show her how to perform orofacial therapy
can foster an attentiveness in listening, which is an
before feeding him. He cannot sit alone without help, but
essential prelude to low vision training.
we think the sitting position is important for him, also so
that he can be in a suitable position for communication
The case of P.**) and so as not to be always lying on the floor. It is
therefore important to stimulate and motivate him to sit
This little boy, now three years old, was born in the 36th
with better symmetrical control of his back and head.
week of pregnancy; there was a twin, who died. He
suffered asphyxia of the new born and cerebropathy, In october 1992, P. stayed at the Fondazione Robert
which damaged the optic nerve. His papilla is pale and Hollman with his mother for two weeks, during which
there is nystagmus. The low vision trainer is able to he took part in two music therapy sessions.

114
The work presented on the video shows only one of balance muscle tone until playing with a inflatable toy
these sessions. rubber horse to reinforce his plantar support and
diaphrammatic push, he managed to stay sitting with his
Lying on the piano, with his mother nearby, P. played
back straight for really quite a considerable time.
with the physiotherapist, listened, responded to the
sound stimuli which were gradually absorbed into his
body. Thanks to the great motivation provided by the
The case of E.
music the child relaxed and took on a more balance
muscle tone. Then, with the help of the physiotherapist, This little girl was one year and two months old when

he settled his body symmetrically and and finally sat up, she and her mother come to stay with us at the

managing to stay in this position for some time. Once in Fondazione Robert Hollman for four weeks. She

a sitting position, he was able to play and manipulate was born in the 38th week of pregnancy with a weight of

the sound material offered to him, showing especial only 1,860 kg because she had stopped growing. After

interest in the bells. birth she was in an incubator for two months; her
parents could not visit her until one month later, and
P.'s excellent listenig attention was confirmed by the
only for one hour a day. Her diagnosis is infection by a
appearance of a smile and vocalization every time the
citomegalovirus; her problems are explained by visual
music changed.
agnosis, a very small hypoacusia on the right ear, and a
As the sound wave gradually filled the child's legs and slight hemisyndrome on the right side of her body.
body we observed P. acquiring a more and more
But what did this mean in terms of her real problems in

115
daily life? later to harmonize the coordination of her movements
so that she might be more willing and more motivated to
She had difficulty in keeping her attention on luminous,
be attentive; and also to improve the relationship
contrasted stimulation; she was not interested in
between mother and child as well as the child and the
objects, and did not look at people, not even her mother.
world around her.
While sitting she rocked herself continually as a
stereotypie: left to herself she would not take up another We put these ideas into practice during therapy on the
position. Lying on the floor, she was continually in swing and, mainly, during music therapy, when the child
movement, knocking her arms and legs on the ground lay on the grand piano.
without coordination. Up to now she was never
The results achieved by the child and her mother were
accepted staying in a prone position, not even on her
extremely satisfactory and, four months after leaving
mother's body. When we saw this child, so lacking in
the Fondazione Robert Hollman, the mother has
concentration, and her mother, who talked and sang to
told us that her daughter looks attentive when people
her continually to try and attract her attention, we felt
are talking, and tries to look them in the face, she takes
that we were not prepared to be restricted by the
up other positions, she is calm and happy.
diagnosis she had been given; we wanted to get to know
her independently of her pathology. So we decided to The latest news is that the little girl is now moving

use her four-week stay at the Fondazione Robert around on her feet, holding on to the forniture. It was a

Hollman to help the little girl to feel the pleasure of very emotional moment for us, to hear this mother say

keeping still in the prone position (calma motoria), and that her daughter E. learned to like life during her stay in

116
Cannero. This very important development appeared along with a
daily growth in the child's listening attention, and with
In february 1993, E. came for a therapeutic stay of four
her acquiring a sort of "calma motoria" which
weeks with her mother and sometimes her father.
subsequently made it possible for us to work on her
One of the little girl's handicaps was that she had a
visual attention too.
decided aversion to the prone position and continually
Towards the end of her stay, music therapy was
sought back stimulation, through a backward
integrated with therapy of visual stimulation. This
movement; she often toppled over, losing her balance.
fostered a marked improvement in the child's visual
One of our objectives, therefore - not only in music
functioning.
therapy but in all the therapy performed with E. - was to
encourage her to accept the prone position, an
important stage in a child's psychomotor development.
Conclusion.
From the very first session of music therapy, thanks to
In conclusion, it is our conviction that the role of the
the vibratory stimulus of the sound and to the motivation
music therapist, through the use of body, voice and
generated by the music, the child managed to lie prone,
improvised music, is to be in tune with the variations of
remaining in the position for a long time and in the end
rhythm, energy, movement and sound which may be
actually falling asleep. During this time we were able to
observed in the client's behaviour, and to calibrate
observe some impulses to movement starting from the
himself on these expressive signals from the other
legs, as well as lifting and rotation of the head.
person. In this way a genuine sound dialogue takes

117
shape during which the clients becomes in a sense a movement, NLP, matching, pacing, leading, bodily
living score. The more accurately and creatively resonance, covibration, sound dialogue,
(matching and pacing) the music therapist, through improvvisation, creativity.
careful calibration, manages to read the music, the
more the living score will be disposed to change and
grow through the interaction. Of course, the reading by
the therapist will be more effective (in the sense of BIBLIOGRAPHY
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119
humana. capacidad auditiva e intelectual, hasta podr beneficiar
la inteligibilidad de la palabra y la construccin de su
Creemos que la variedad de estimulos otorgados a un
lenguaje.
nio amplia el campo referencial y los resultados en el
manejo de ese campo. Es por eso que el nio se ver Uno de los grandes desafios que debemos enfrentar
enfrentado al lenguaje grfico y escrito, a la lectura los educadores oralistas es lograr una buena voz y
labial y a la estimulacin del canal que tiene afectado: el articulacin en el discapacitado auditivo, que le
auditivo. La estimulacin auditiva, muchas veces permitan al interlocutor decodificar el mensaje que se
dejada de lado, ocupa un lugar importantisimo en transmite y conocer a travs del mismo, el nivel de
nuestro sistema educativo. En primer lugar, porque es lenguaje alcanzado.
posible darla, ya que toda persona con prdida
Por ello, hemos llegado a la conclusin de que resulta
auditiva, cualquiera sea su grado, posee un haber
prioritario apuntar a la correccin de los aspectos
auditivo que si se valora y se estimula adecuadamente
suprasegmentales del habla: ritmo, entonacin,
lo ms temprano posible, permitira aumentar las
acentuacin, duracin, pausa y tiempo.
posibilidades de desarrollo.
Los mismos, junto con la connotacin afectiva,
Y fundamentalmente ofrecer esta estimulacin es
preceden y acompaan el aprendizaje articulatorio. El
necesario, porque por medio de ella el nio podr tomar
ritmo y la entonacin, a los que siempre se les ha
contacto con el entorno acstico que lo rodea y usar
reconocido una peculiar trascendencia en la
ese material como otro medio de informacin que le
transmisin de los matices emocionales de la palabra,
ayudar en su manejo cotidiano y, de acuerdo con su

120
actan tambin en muchos casos, como verdaderos otorgndoles significado.
elementos gramaticales.
Este es un proceso lento en el cual se deben respetar
El logro de estos objetivos se alcanzar firmemente las diferencias individuales, ya que los
fundamentalmente a travs de un intenso plan de logros dependern de diversos factores como el grado
trabajo de estimulacin auditiva. Para el desarrollo de de prdida auditiva, la capacidad intelectual, los
este programa es requisito fundamental que nuestros aspectos emocionales y afectivos del nio.
nios estn equipados con un sistema de amplificacin
Es un proceso adems, que no puede olvidarse en
adecuado que optimizar los resultados.
ningn momento ni en ninguna actividad del nio. Es
Deben ser objetos de una intervencin profesional el imprecindible hacerle tomar contacto con toda situacin
proceso de sensacin auditiva y el proceso de acstica que se presenta, tanto en la escuela como
percepcin auditiva. E1 proceso de sensacin auditiva fuera de sta.
ya que la capacidad sensorial est reducida y por ende,
Dentro de la escuela el trabajo no se limita al realizado
el aparato de la audicin responde a un nmero menor
en el Gabinete de Estimulacin auditiva, sino que los
de estimulos acsticos. Y el proceso de percepcin
docentes de las distintas reas (Educacin Fisica, Arte
auditiva, debido a que el nmero restringido de
y, por supuesto, el rea pedaggica propiamente
estimulos sonoros recibidos no llegan a adquirir
dicha), aprovechan todas las ocasiones que se
significacin en forma espontnea, es decir que deber
presentan, ya sean provocadas o espontneas, para
tratarse de desarrollar la capacidad de reaccionar
poner en contacto a los nios con ese mundo sonoro.
selectivamente ante los estimulos sonoros

121
Pero tambin creemos necesario para el cumplimiento tener frente a l, la representacin resultante de su
de nuestra propuesta, apoyarnos en otros canales produccin vocal.
adems del que tiene afectado. El tacto le facilitar al
Para realizar esta experiencia contamos con un
nio la captacin de los fonemas que resultan ms
Visualizador Fontico (Speech Viewer) que funciona en
dificiles de visualizar y diferenciar, sintiendo las
una computadora. El nio tiene la posibilidad de
impresiones vibratorias en su cara y cuello.
acceder a la graficacin de lo emitido a travs del
El sentido de la vista ser muy valioso para que el nio monitor de la computadora, pudiendo corregir sus
pueda, a travs de la lectura labial, corresponder la errores tantas veces como sea necesario. Tambin
expresin hablada a los movimientos de los rganos podemos grabar las ejercitaciones (incluida la voz) para
articulatorios ms visibles e imitarlos, en una realizar un muestreo comparativo de las distintas
adquisicin de puntos articulatorios ms espontanea. instancias del aprendizaje y el anlisis estadstico
Tambin por el canal visual, el nio podra autocorregir correspondiente.
las posiciones de sus rganos fonoarticulatorios
El criterio de trabajo es el interactivo, logrando un clima
observando las mismas en su profesora y
ms distendido y placentero con un continuo feed-back
observandose a si mismo en el espejo.
visual y auditivo.
Adems, el sentido de la vista se convertira en un gran
A partir de la aplicacin de estas tcnicas
aliado, debido a que en la actualidad contamos con
computarizadas, que permiten objetivar la produccin
tecnologia de punta que permiten objetivar la funcin
del mensaie hablado, creemos que los pequenos
vocal, brindandole al hipoacsico, la posibilidad de

122
tendrn frente a sus ojos mas elementos de apoyo y Edad de comienzo de trabajo sistemtico: 1 ao y 2
lograran una mayor fluidez y mejor entonacin que las meses
generaciones pasadas, haciendo que se acerquen a
Escolaridad actual: Preescolar Colegio "Federico
patrones mas adecuados de voz y articulacin.
Dominick"
Tambien los reeducadores dispondremos de datos,
que hasta hace un tiempo resultaba impensado contar,
facilitando nuestra tarea de control y seguimiento. Es Alumno:Mariano Casares
nuestro deseo poder mostrar nuestra experiencia
Edad: 6 aos
ulica que permitir apreciar los logros de los nios.
Causa de la sordera:Meningitis a los 3 aos

Edad en la que fue equipado: 3 aos y medio

GRUPO TESTIGO
Edad de comienzo de trabajo sistemtico: 4 aos

Escolaridad actual: Preescolar Colegio "Federico

Alumno: Matias Javier Zacchi
Dominick"
Edad: 5 anos

Causa de la sordera: Rubeola durante el 4 to. mes de

Alumna: Martina Martinez
embarazo
Edad: 5 aos
Edad en que fue equipado: 6 meses

123
Causa de la sordera: Meningitis al ao y medio

Edad en la que fue equipada: Se mostrar en video una actividad realizada por este
grupo dentro del aula. La misma es una noticia llevada
Edad de comienzo de trabajo sistematico: 3 aos
por uno de los nios a la clase donde es recreada.
Escolaridad actual: Preescolar Colegio "Federico
Dominick"
Texto:

Alumno: Julian Gonzalo Marcigliano

La noticia de Matias
Edad: 5 aos

Causa de la sordera: Indeterminada

Matias, Florencia y su mam hicieron licuado de
Edad en que fue equipado: 2 aos
banana.
Edad de comienzo de trabajo sistematizado: 3 aos
Nosotros tomamaos mucho licuado.
Escolaridad actual: Preescolar Colegio "Federico
El licuado de banana estaba rico.
Dominickw"

Trabajos relacionados
Plan de trabajo:

124
 - Discriminacin de oraciones con omisin de
palabras para que el nio pueda completar.
En el Gabinete de Articulacin:
- Discriminacin de oraciones semejantes.
- Lectura de la noticia con marcacin de pausas y
correccin articulatoria. - Extraccin de una sustantivo o verbo y utilizacin
del mismo en diferentes oraciones.
- Evocacin de la noticia memorizada y
observacin de cuidado articulatorio y ritmico. - Reconocimiento de otros elementos
perteneciente a la categoria frutas.
- Ubicacin de "x" fonema en diferentes palabras
para trabajarlo especficamente. - Trabajos de secuencia y memoria auditiva.

- Trabajo de preguntas y respuestas para evaluar Con el trabajo en computadora:

habla sin lectura.
- Control de intensidad
- Trabajo especficos de respiracin para lograr
- Ataque- cuerpo- filatura.
una mayor coordinacin fono-respiratoria.
- Fluencia
En el gabinete de Estimulacion Auditiva:
- Barrido fonemtico
- Discriminacin de oraciones, unidades de sentido
- Ejercitacin especifica de oraciones y palabras
y palabras.
con espectogramas y ondas, analizando los
- Trabajo con estructura ritmica.
componentes del mensaje.

125
 * Habla montona

Trabajos de extensin: * Tono fundamental adquirido con dificultad

- Lectura referida a la fruteria. * Imprecisin del volumen de voz emitido.

- Adivinanzas de las frutas. * Ataque brusco o soplado, cuerpo acortado, filatura

trunca.
- Actividad esttico plstica.
* Ritmo de la frase inadecuado.
- Cancin de las frutas en Musicoterapia.
* Incoordinacin fono-respiratoria.

* Entonacin sin ajustarse a reglas.

Es nuestro propsito mancomunar esfuerzos, para
alcanzar, gracias a una planificacin en base a centros * Alteracin del tiempo de produccin de cada fonema.
de inters, abordados por distintos canales, pero
* Exceso de tensin.
siempre relacionados entre si, impactar al nio sordo,
propendiendo al logro de un buen nivel de lenguaje y al
mismo tiempo, a la correccin de los elementos La combinacin de todos o algunos de estos
prosdicos, que como dijimos con anterioridad se elementos, conspira contra la inteligibilidad del habla,
encuentran alterados, provocando en muchos casos: impidiendo el buen desenvolvimiento de la cadena
comunicacional.

126
No le neguemos al discapacitado auditivo el don de la He had a normal physical development, I was struck by
palabra; brindmosle la oportunidad de conocer el the stif fness of his body and especially of his arms: he
cdigo que maneja la mayor parte de la gente. was sitting in a yoga position, his forearms were rested
on his legs and he was continuously swinging, He had
been wearing two pipes of stiff plastic on his arms for
"Abramos nuestra mente a la posibilidad de oralizacin about three years: the institute he came from had
del nio sordo ya que el aprendizaje abrira sus oidos". decided to make use of these pipes in order to stop his
slapping (however the institute came to this decision
with his parents's agreement). As a matter of fact the
M U SI C - T H ER APEU T I C T R EAT M EN T O N A peculiarity of this case is selfinjuring: when the subiect is
S E L F - I N JU R I O U S S U B JE C T W I T H A left free, he begins slapping himself violently and
D I AG N O SI S O F G EN ER AL D I ST U R BAN C E O F continuously.
D EVEL O PM EN T .
But the pipes were not a good solution: the doctors
E NRICO B RANCA agreed that G. was loosing the articulation of his arms;
so the sanitary director of the institute decided to
remove the pipes, The institute organized day and night
THE SITUATION BEFORE THE TREATMENT
shifts for all the operators in order to help G. to control
The first time I saw Giuseppe was on february 1990; he his aggressiveness. During this period I saw G. for
was sixteen years old, with black eyes and black hair. three meeting of music-therapy.

127
 mother's help he get used to this new situation and he
began even to sillabicate mama and papa. After that he
HISTORY OF THE CASE
did not talk any more.
G, is a son of an unmarried woman. His adoptiye
The adoptive mother also told us that after the adoption
parents told us that his mother was very violent: as a
G, showed a self-injurious attitude towards adversities:
matter of fact, when he was newborn he ended in
he used to knock his head on the wall, and he used to
hospital many times because of his mother's beatings.
bite his hands.
Then he was left in a home for abandoned children, His
father suffered from mental As far as music concerns, he seemed to be interested in
music instrumets; he even mimed the way of playing the
diseases, When G, was three years old he was adopted
instruments , His father was the one who toned some
after a period of trial, Even if his new parents knew the
motifs, that G, showed to appreciate, G, repeated some
baby had some problems and perhaps he was not
melodies uttering sounds with the mouth closed. He
normal, they decided to take care of him, We do not
recognised the sounds of surroundings ( for example
have any other news relative to the period before his
the roar of his father's motorbike); he was frightened by
adoption, When G. went to live with the new family he
some other noises such as that of mixer).
was not able to do anything; his mother describes him
as a little animal: he could not wald, he could not eat G, was cuddled very much; once his adoptive father
solid food, he could not talk; he seemed very frightened bought him a bunch of baloons G. had expressed the
and needing reassurance, Thank to his adoptive desire to have one.

128
However G, grew up and his adoptive mother was not When he was about sixteen he was discharged from the
anymore able to direct the situatio; so his adoptive first institute because he had exceeded the age limit;
parents decided to institutionalize him, but they took him then he was admitted as a boarder in the institute
back home every week-end and during summer "I,M,P,P, Maria Santissima del Carmelo" of the D,D,A, of
holidays. Catania (an assistance institute for psycho-physical
handicapped people).
When G. was about thirteen years old something new
happened: the little family was on the beach and it was
very hot; GG.'s father insisted that the boy had to talk: he
PHYSICAL SCHEME AND ANALYSIS OF
told his so that he was the strongest and therefore G.
MOVEMENTS
had to obey him, As a consequence to this frustration,
G, began slapping violently his face, without any G, shows a generalized hypotonia with moments

possibility of stopping, After this event it became very of tension together with psychomotor rigidity. Hands

difficoult to manage with G, at home, and in the institute; are used only for slapping himself; there is always an

so it became necessary to reach any result, make use adult who replaces him in all manual activities. Fine

of helmet in order to protect his face, but G. always took motility is lacking, When the subiect walks his feet are

it off, So the director of the institute decided to use pipes wide apart and they seem to sink in the floor, The

to keep G,'s arms still; the pipes would have been more movement is not aimed; it is without any destination.

and more short in order to be able to get rid of them at, When he sits down he takes a so called "lotus position";

last, However, as we know, this strategy did not. when he lies down on his back he crosses his legs and

129
he takes them up on his chest, He has reached sexual He does not use either verbal nor sign language.
maturity (however masturbation is absent, perhaps also
lt is not possible to give any communicative value to his
because of the, pipes, which do not allow any
stereotypes.
articulation),

He succeeds in staying a whole day without urinating

and when he decides to go to the bathroom he sits CHOICE OF INTERVENTION

down on the toilet. During the first meeting with the equipe and all the

He is not interested in his surroundings; he keeps operators who worked with G. when his pipes were

on rocking himself (both when he stands up and when taken off, it emerged that the boy reacted exclusively to

he sits down). He has many stereotypes concerning his sonorous stimulus-reactions. Therefore the sanitary

fingers: he points his forefinger, he extends his thumb director decided to begin a music-therapeutic treatment

and his little finger, while he lets down or crosses the (he took this decision after he had heard my favourable

other fingers. advice).

He always follows all these movements with the eyes.

The mouth is half-opened. PURPOSES

On the whole I have the impression of seeing the parts Short-term purposes 2 months):
of his body detached one from another.
general; observation for knowledge;

130
specific: find out the sounds he prefers, After about three months of work these meetings were
interrupted because of the transfers of the psychologist
and the psychiatrist, Verifications are carried out only by
Medium-term purposes (6 months):
the music-therapist who writes a protocol at the end of
general: try to establish a significant relation following every session.
the stimulations of the patient; OBSERVATION
specific; a study of the material that can be used
After the first cycle of meetings of observation, it is
refering to the stimulations of the patient, not possible to give an exact estimate of G.'s abilities
and deficits, because of his total closing towards reality.

Long-term purposes ( 12 months);

general: reduce self-injurious; TAKING IN CHARGE

specific: make the sounds become a way of As there are not sufficient elements concerning G.'s
communicating, cognitive, communicative, expressive, relational,
affective, emotive, psychomotor processes, the taking
in charge becomes a support and a reinforcement of
VERIFICATIONS the Ego and as a help tp improve life's quality.
Some weekly verification-meetings were organizad with
the music-therapist, a psychologist and a psychiatrist.

131
SETTING resonance box taken on by oral, nasal and auricular
cavities.
The treatment began on April l8th 1990, lt has a
frequency of five days per week and a length of about
60-90 minutes lt is held in a room equipped with an
undirectional mirror, This mirror is for video-film and
observations, This room ( usually used for EVOLUTION OF THE CASE

physiotherapy) is prepared with the necessary musical 1. Initial phase

instruments, The instrumentation chosen for the initial
I soon realized that G, stimulated all his sensorial
treatment was selected in connection with G.'s self-
channels with his slap: sight - a particular visual
injuring attitude, There are percussion instruments such
attention for his fingers skiming his face preceded slaps;
as little bongoes, drums, xilophone, cymbals, plates
taste and sense of smell - first of all the slap strickes the
(the gesture necessary for playing these instruments
ear, then it slips on his cheek, until it strikes the nose
recalls to our mind G,'s hand movement of slapping his
and the mouth (as it caused internal and external lesion
face), The sonorities produced by these instruments
G. tasted undoubtely of blood; blood mixed with saliva
could recall those of G, 's slaps, The beginning and the
and a particular smell of his skin provoked an olfactory
fall of the sound produced by a drumstick that beats the
sensation that reached his nose thank to his hand);
skin of the drum are relatively similar to those produced
hearing - slap produces an acoustic sensation; touch -
by a hand that beats the skin of the face, The resonance
slap represents a tatctile and pressure stimulus
box of a drum could be compared to the function of
concerning ear, cheek, lips, nose and hand. Thank to a

132
single gesture, G. succeeded in starting a global an inexact use of some mental functions and it provides
perceptive process concerning the five senses. a substitute to the function of container of the skin.

I had the impression to see G 's act of slapping himself I thought it was necessary to come out from the circle
as a way to perceive his body joined together ( as if he that was built around G,: slap, an impediment to the
were scared to break into pieces). slap, reproach, slap, In this situation G, was of course
the strongest, and everybody else could not experiment
According to E, Bick's theory, in a non-integrated state
anything else but impotence, So, I tried to consider a
of a very young child, the need of a containing object
slap as a sonorous message, in order first of all to
seems to produce a frantic search of an object (a light,
organize the intervention, and then to communicate my
a voice or other sensory stimulus) which is able to
presence, By means of the technique of reflecting I
attract his attention and, therefore, it can be
transfered G's video aggressiveness on the cymbal and
experimented as a way of keeping all the parts of the
on the drums: every time G. slapped his face I answered
child, of his personality, together. The best object is the
playing instruments with the same intenseness G. had
nipple, together with the holding, the talking and the
used on his fave. As a result the situation turned over:
smell of a mother. Therefore the infant experiments this
as soon as G, gave vent to his anger on his face, and I
containing object as a 'skin' When this primary function
vented my anger on the instruments to reflect him, G's
is umbalanced the infant can develop the idea of a
reaction was to take the drumsticks off me, to throw the
'second skin', which has the function of replacing the
drums on the floor and to hold my hands; with me he
dependence from the object with a fictitious
behaved like all the people behaved with him when he
independence. This 'fictious independence' consists in

133
slapped himself. Gradually I tried to substitute the mechanic containment
he searched for (tubes, other objects), with an
emotional one. Moreover 1 tried to establish a
After these events, I realized that he was not struck so
communication on an empathic level.
much by the timbre of the instruments I used, but mainly
by the way I made use of these instruments, and by the
symbolic meaning they had acquired for him, I became INTERMEDIATE PHASE
certain of al this one day when he came in the room
G, tried always to produce sonorities with all kinds of
where I kept all the instruments and he began to play
objects, Sometimes he rolled the plate and he beat it on
them without beeing frightened.
the f loor, producing very strong sounds,I thought he
After about one month (20 sessions), he accepted to lie combined these sonorities with those produced by slaps
down on the mattress. As soon as he put his head ( the difference could consist in the tactile aspect).
between my legs the frequency and the intensity of
I considered these sonorous elements as G,'s language
slaps diminished; in the meanwhile I tried to get in touch
receiving my answers, At the beginning these answers
with him by reflecting his muscular tonus, the rhythm
provoked G.'s annoyance, but later on they became the
and the intsisity of his breath.
context of our dialogue. In the meanwhile I worried
about the other aspect of the slap, the tactile one,
thanks to massages, caresses, physical contact and
This was the only moment in which he succeeded in
stimulations with some cloths, I began to make use of
relaxin himself.

134
little monodies in connection with some G.'s attitudes ( disappeared.
such as his rocking); this gave the opportunity to
transform G,'s moments of enormous closing in a
shared experience. THIRD PHASE

During this period G, liked to, use as instruments some According to Winnicot, a baby knows his object of love

little pieces of wood; he bounced them on the floor by means of the stimulations, coming from the

producing sonorities, It was just with these pieces of 'environment mother'. The most important stimulations

wood that a relational phase began; it was a sort of are the sonorous ones (such as mother's voice, the

exchange of sounds, of objects, of imposition, of trust. recognition of the heartbeat), and the tactile -
cutaneous ones ( such as holding during the breast --
One day, after a moment of extreme violence, G. took
feeding, caresses and massages during the bath and
the drums and the plate and took them in the auditorium
the dressing).
and he put them down with the other instruments, Since
that day our sessions have been more peacefull; the We know too little about the first period of G.'s life;

frequency and the Therefore, as there had been a however there are no doubts about the fact that his

partial reachirig of purposes, the sanitary director mother beat him; the sensations connected with slaps

decided to reduce the number of lisits with G. from might represent a sort of reminder that connects G. with

five to three per week, intensity of his slaps have his mother; he might have persuaded himself that the

reduced. At the beginning of July, after three months sonorous contact is the only way of getting in touch with

from the beginning of the treatment, the slaps almost the body; the caress would, therefore, become a caress

135
producing sound (the slap), and the sound would
assume the painful characteristics of a slap. All this
At the beginning of the second year of treatment I told
might explain the reason why G. refuses to utter
G, about a baby who had felt a great pain because
phonemes; indeed when his father insisted in him to tald
somebody had beat him, The baby was very frightened;
he answered with the only sound he knew: the painful
but now he must not worry any more, because he has
one.
found a friend who loves him, who hugs him in his arms
My role as a music-therapist consisted in promoting and who gives him many kisses, As soon as I told him all
moments of integration, trying to be a sort of maternal this he began to cry, It was the first time he cried with
object which, on one hand, is able to accept tears, and he had an expression of great pain, I called
aggressiveness, and, on the other, it supports the him 'my little baby' , and I told him that perhaps he
strengthening of libido. When G. slaps himself I usually needed good caresses, the ones that do not hurt; but he
do not reproach him, I caress him and I lead his hand on also needed to feel a lot of sound and we can produce
my face in order to be caressed: I try to combine a that with the musical instruments.
"good caress" with a painful contact, that perhaps is the
About a month later, while we were sitting on the
only possible for him. The use of flour kneaded with
mattress, and I was singing a lullaby, he came in my
water helped me to point out perceptive differences
arms and 1 started cradling him as a baby; while I sang
concerning changes in frequency, loudness, timbre and
to him, I lightly touched his face with mine, in order to
affectivity of a body-skin played in a violent way
make him perceive sounds even through skin, In the
compared with a caressed body-skin.
following sessions I used to ask him: "Do you want to

136
come in my arms and I shall sing you a lullaby?". He In the meanwhile there were changes in the sexual
used to answer with a smile and he used to come in my sphere: he had already began to touch himself the penis
arms; he half-closed his eyes with a blissful expression and to masturbate, He accepted to go to the bathroom
and he threw his arms round my neck. to piddle or to defecate; he used to sit down on the toilet
and he wanted me to hold his hands. I used to tell him
He started to use his legs always better: he began
not to be scared to loose something that belonged to
running, jumping, kicking the ball, riding a ciclette, He
him because later on he would have drunk and eaten
proved to understand better verbal language; he carried
and his tummy would have been filled up again, He
out complicated orders (but he wanted me to stay near
used to look at me and smile, Once he began to jump
him), He had aquired a great dependence from me; as I
and smile while he was sitting on the toilet: he seemed
was more and ai-id more important for him, he even
to be happy to defecate 'without danger (Kelin 1975).
liked me more than his parents, This fact would have
He also proved his fear of loosing something when he
given me the opportunity (after having strengthened
vomitad or he salivated too much: in fact he had the
this phase) to incite G. to have new experiences with the
habit to pass his hand over what he had lost, as it he
certainty of my disposability. Little by little he accepted
wanted to get it back again.
to carry out orders which made him go away physically
(even if he was very unwilling to do this); however, he Because of these good results, I planned an
used to come back as soon as possible as if he needed intervention in order to favour his socialization: I made
an affective supplying (Mahler 1978). him watch the rehearzal of the "concert" (it is a practical
activity I educational- rehabilitative level), G, stayed on

137
the stage box in order to hear the group playing. He situations), G, proves to understand better and better
recognized some of the pieces and he even smiled and verbal language, and to communicate needs and
showed to like some of them, During these desires by the use of mimic-gestualsonorous requests,
circumstances, G, did not slap himself; moreover, as This growing contact with reality gives the opportunity of
time passed, he accepted to clap his hands and to play trying some directional changes in the intervention: from
little bongoes with the other boys. He began to accept a specifically therapeutic context we have moved in a
the game. Then, I included some coloured baloons in rehabilitative-educational context, Of course all this
the material of the setting and I used them in order to allows an extension of the purposes which aim to reach
make him move in the space towards something that a greater confidence in one's capabilitiespossibilities,
files away, but can be caught again. G. reacted very and a greater level of independence and integration.
well; his movements (at first indirect) had finally and aim;
Even the instrumentation and the way I used it changed:
the achivement of a project the usual posture had
it now includes also a piano and some synthesizers.
straightening; his eyes were more awake.
A progress in G,'s personality consists in the
acceptance of piddling while he is standing up;
PRESENT TIME moreover, while before he repelled his parents , now he
asks to go back home, Besides, he recognizes his act of
Three years have passed since the beginning of the
slapping as an attitude n accepted by his surroundings,
treatment of G,, Even if there have been alternate
an attitude which coul involve his parents's refusal or
phases (probably because of particular surrounding
the punishment of not letting him go home.

138
 takes initiatives, he makes requests, he communicates
his desires.
FINAL CONSIDERATIONS
As far as his relationship with me concerns, I can say
lf we consider G.'s behaviour before the beginning of
that, after a phase of 'maximum dependence', thanks to
the music-therapeutic treatment and we compare it to
the use of objects that can be defined as 'transitional',
the present situation, we can surely assert that there
G. is now going towards the 'separation-identification'
have been important changes; from a total dependence
phase (Mahler).
from. pipes, from the lack of interest in everything
around him, from the absence of reaction towards
external stimulus, from the refusal of every kind of
BIBLIOGRAPHY
relationship, from the absolute non -cormunication,
from the constant activity of compulsive self - injuring, V,v, "La relazione aggressiva", Borla, Roma, 1988.

today (even if with alternate phases) we can say that the Guerralisi S, "comunicazione ed espressione nella
boy directs his life without pipes, he begins to show globalit dei linguaggi", Il Ventaglio, Roma, 1983.
interest for the surroundings, he receipts and he
Klein M, "La psicoanalisi dei bambini", Martinelli,
answers to external stimulus making a correct use of
Firenze, 1988.
analyzers, he has established a good relationship not
only with me, but also with some other operators, he Lorenzetti L. M, "Apprendimento, riabilitazione,

makes use of a mimic-gestual-sonorous language, he musicoterapia", P.C.C., Assisi, 1984.

succeeds in controlling self-aggressive impulses, he

139
Lorenzetti L.M. La ragione dei sentimenti, Angeli,
Milano, 1990.
The MusicSpace Trust has evolved in response to
Lorenzetti L.M. "Suono e comunicazione", Unicopli, current British moves towards of 'Care in the
Milano, 1987. Community' for people with wideranging physical and
mental health care needs. The main objective of
Mahler M. "La nascita psicologica del bambino",
MusicSpace is to set up a network of centres
Boringheri, Torino, 1978.
nationwide.
Winnicott D.W. "Dalla pediatria alla psicoanalisi",
These centres will be based in localities where people
Marinelli,Firenze, 1975.
live, outside of the more traditional hospital and school
settings. Music therapy will therefore be at the hub of a
local service.
M U SI C SPAC E - T H E C R EAT I O N O F
C O M M U N I T Y- BASED C EN T R ES F O R M U SI C
T H ER APY, R ESEAR C H , T R AI N I N G AN D
MusicSpace was the practical outcome of a two year
PER F O R M AN C E
project that explored how a community music therapy

L ESLIE B UNT service might develop within the County of Avon.

What is MusicSpace?

140
MusicSpace acts as a centre for:

* Music-making - offering the rehearsal and

performance space for a wide a range of music-making
* Music therapy - providing individual and group
as possible. MusicSpace also initiates musical events as
music therapy service for children and adults and
part of its fundraising policy.
outreach sessions for those unable to attend a centre.

THE MUSICSPACE TRUST

* Training - for parents, carers, teachers and other
professionals: workshops and short courses on aspects
of music therapy; the training of music therapy students.
WHAT DOES MUSICSPACE AIM TO PROVIDE?

* Research - initiating specific projects to examine

COMMUNITY-BASED MUSIC CENTRES FOR:
the effects and processes of music therapy.

* MUSIC THERAPY - individual and group

* Resources - providing a library of relevant
sessions for children and adults
literature and music equipment for students and
practitioners.

141
* TRAINING - short courses and The first MusicSpace centre was officially opened in
workshops for parents, carers, teachers and other Bristol in November 1991.
professionals - training courses for music therapists

Music Therapy
* RESEARCH - examining the effects and
processes of music therapy
The music therapists at the Bristol centre are currently
seeing over two hundred and fifty children and adults
* RESOURCES - library of literature and per week either at the centre or as part of a busy
musical instruments and equipment outreach programme. Three full-time, one part-time
and one sessional therapist are employed by the trust.

* PERFORMANCE - rehearsal and

performance space for wide range of music-making The Bristol team see:

- initiating musical events

individual children with learning disabilities

BRISTOL MUSICSPACE pre-school children with special needs and their

parents at local centres

142
 children with physical disabilities either at referrals from a project for single homeless
MusicSpace or at school women

children with autistic features

adults with wide-ranging learning difficulties Future music therapy projects include:

adults with physical disabilities

adults with mental health problems work at residential homes for the elderly

mothers and babies in a hospital's unit for mothers work at local psychiatric day hospitals
with severe post-natal depression/mental health
work at a nursery for children with language delay
problems
work at a day centre for adults with drug and
adults in a prison's hospital wing on remand or
alcohol problems
begnning/ending long prison sentences
work at an inner-city project for the homeless
adults living with HIV/AIDS

adults living with terminal cancer

BRISTOL MUSICSPACE
adults referred with a history of sexual abuse

adults referred through the local drug and alcohol

service The Bristol team of music therapists see:

143
 adults living with HIV/AIDS

individual children with learning disabilities adults living with terminal cancer

pre-school children with special needs and their adults referred with a history of sexual abuse
parents at
adults referred through the local drug and alcohol
local centres service

children with physical disabilities at MusicSpace or referrals from a project for single homeless
at local schools women

children with autistic features

adults with wide-ranging learning difficulties Future music therapy projects include:

adults with physical disabilities

adults with mental health problems work at residential homes for the elderly

mothers and babies in a hospital's unit for mothers work at local psychiatric day hospitals
with severe post-natal depression/ mental health
work at a nursery for children with language delay
problems
work at a day centre for adults with drug and
adults in a prison's hospital wing on remand or
alcohol problems
beginning/ending long prison sentences

144
 work at an inner-city project for the homeless During the first period of operations Bristol MusicSpace
ran training and music workshop days for staff and
parents working with adults with learning difficulties;
Training adults with mental health problems; the elderly; pre-
school children and children with learning difficulties.
There are plans to develop more workshops including
In conjunction with Bristol University, MusicSpace set up
sessions for adults with hearing impairments.
the first British part-time post-graduate diploma course
in music therapy and the first group of 15 students
began their studies in January 1992. The course offers
MusicSpace also runs workshops internationally with
an alternative to the present full-time courses and can
regular work overseas particularly in Italy including
be viewed as a model for the development of other part-
Assisi, Bologna, and Genoa.
time courses. The present economic climate makes
part-time training a very practical option for mature
musicians. Research

Over 100 applications have been received for the next MusicSpace was commissioned by the Wessex
course starting in January 1993. Regional Health Authority to carry out an investigation
into the effects of music therapy with elderly mentally ill

145
residents at one of the region's hospitals. The project - a children's opera group
was set up in collaboration with the hospital's senior
- Bristol Opera Company
clinical psychologist and three blocks of fifteen sessions
- Amici, a local chamber group
have been carefully monitored and evaluated.

MusicSpace is setting-up a musician-in-residence

Other research proposals currently include:
scheme, with funds from the Ralph Vaughan Williams
- a detailed study of the behaviour of two autistic
Trust.
children n a period of music therapy

- a nationwide survey of music therapy and children

with cerebral palsy, a joint study also involving the MusicSpace has already promoted a wide range of

Institute of Child Health, University of Bristol and the musical performances which not only helps secure

Department of Psychology, University of Leicester more funding for the various projects but also brings
more people in touch with different kinds of music.
Several of the charity's Patrons have been involved in
Performance these performances.

National Development Plan

Several groups are affiliated to Bristol MusicSpace and

use rehearsal space at the centre:

146
MusicSpace is setting-up a national development MusicSpace is managed by its Council which includes
strategy with a firm intention to create other centres leading figures from the musical, academic, educational
nationwide. Each new centre will reflect the need of the and business communities. Hard-working groups of
particular community. Therapists and colleagues from volunteers support some of the administrative work and
many cities and also from more rural settings have fund-raising activities. The growing list of well-known
expressed serious interest in establishing such centres Patrons adds support to the development of the trust.
in their own communities.

Funding for the activities of MusicSpace comes from a

Nottingham MusicSpace will be starting operations in mixture of sources: statutory bodies such as the
September 1993. Departments of Health, Education and Social Services;
other charities and trusts, company giving and private
donations.
There are current discussions with colleagues in
Summary
London, Edinburgh and Belfast with a view to potential
links.

All is all MusicSpace aims for able-bodied and dis-abled

people alike to come together through active
Management and Sources of Funding
participation in music. This is a core philosophy of
MusicSpace, the trust recognising that music has the

147
potential to be a very powerful social equaliser. the elderly

TRAINING - International work particularly in Italy

- Bristol University Diploma in Music Therapy RESEARCH

2-year part-time diploma

15 current students - music therapy for the elderly mentally ill,

new intake in January 1994 commissioned by the Wessex Regional Health

Authority

Future proposals include:

- Workshops focusing on such areas as:

adults with learning difficulties

- detailed analysis of music therapy sessions for
adults with mental health problems
two children with autistic features
pre-school children with communication problems

children with learning difficulties

- nationwide survey:

148
 music therapy and children with cerebral palsy - a concert by the English Chamber Orchestra
conducted by Jeffrey Tate (President)
+ Institute of Child Health, University of Bristol
- A Noel Coward evening hosted by Sheridan
Department of Psychology, University of Leicester
Morley

- Performances of opera in aid of MusicSpace

PERFORMANCE
- A dinner hosted by John Mortimer with music from
Jacques Loussier
Various local groups are affiliated to Bristol MusicSpace
and use the spaces for rehearsals.
MusicSpace is setting-up a musician in residence
scheme,
MusicSpace initiates wide-ranging musical events as
with funding from the Ralph Vaughan Williams Trust.
fundraising projects:

NATIONAL DEVELOPMENT PLAN

- an evening with the entertainer Richard Stilgoe
(Patron)
Nottingham MusicSpace is planning to begin work in
- a concert given by leading saxophonist Andy
September 1993.
Sheppard (Patron)

149
 A physically handicapped child has disorders in
movement, caused either by a hereditary disease, by
We are presently having discussions with other music
an affection before or during birth, by an accident or by
therapists throughout the country.
illness. The most important are:

Encephalopathia infantilis, an affection of the brain,

"I N M O T I O N ". A M U S I C - T H E R A P E U T I C A L disturbing the development of the brain. We distinguish
APPR O AC H I N T H E R EH ABI L I T AT I O N O F cerebral palsy, ataxia, athetosia.
PH YSI C AL L Y H AN D I C APPED C H I L D R EN .
Transverse lesion, an affection or the spinal cord,

M ADELEEN F LENTGE DE B RUIJN through which the conductiong of the stimulus is

interrupted.

Muscular Dystrophy, different diseases of the muscles,

Good afternoon. I`m going to tell you something about
leading to grafe disability.
the use of musictherapy in the treatment of physically
handicapped children from 2-20 years admitted to a Brain damage, caused by an accident, characterised f.i.
rehabilitationcentre in The Netherlands. by a long coma, paralysis, aphasia, loss of memory,
behaviourproblems, etc.

For the clearness of my paper I`ll give you some general

information. The treatment consists of an intensive cooperation

150
between the various departments: the medical, the connection, however, much more is meant than just
paramedical, the psychosocial department, the muscular movement, namely social and emotional
departmet who looks after the care of the children, the movement. By social movement we mean the
technical department and the school. movement which takes place between the different
individuals, based on attention and reaction, contact
Musictherapy belongs to the psycho-social department.
and communication. Emotional movement is the
In 12 of the 27 rehabilitationcentres in The Nederlands
movement of inner emotions which can be brought out,
music-therapy is part of the treatment. The
where by the expression and release of feelings is the
musictherapist has a parttime appointment usually 50-
main concern.
70 per cent.
These various forms of movement are all of importance
in the development of children in general and of
INTRODUCTION
physically handicapped children in particular. This
In music-therapy in The Netherlands, it is not the applies as much to physical as to social and emotional
limitations but the abilities of a child which form the core development. Being in motion means development and
for treatment. This appears to contradict the title "In growth in other words: life.
motion". A music-therapeutical approach in the
Although these aspects of development are interwoven
rehabilitation of physically handicapped children. The
as they are continually influencing eachother - both in a
abilities of these children to move are, after all, often
positive as well as in a negative sense - a distinction
extremely limited or lacking altogether. In this
between them is often made in the rehabilitation of

151
physically handicapped children. Quite logically, the
various consultants - physician, physicotherapist,
What is meant exactly by music-therapy in a
occupational tjerapist, speech therapist, psychologist
rehabilitation-programme: is musictherapy used to
and pedagogue - all concern themselves with their own
improve movement is it behaviour-therapy or
particular field in the development of the child. This
psychotherapy?
singling - out can also be observed in music-therapy,
whereby the question immediately arises as to which When reference is made to literature on this subject it is

aspect should have priority: the physical, the social or found that right up until the present day opinions differ.

the emotional development. Waves of movement for and against can be seen waves

Is the physical development the most important of action and reaction. At times for example, music-

development where the physical handicapped child is therapy can be used to blowing, muscle tension can be

concerned? Do emotional and social problems deliberately reduced by "low frecuency sound" and a

automatically disappear when physical movement half-paralysed hand can be exercised by drumming.

improves? And what happens when physical movement Sometimes however nothing good can be said about

only deteriorates, as in the case of children with a this approach and music-therapy is only regarded as

muscular disease? Wouldn't it be better for the music- therapy when it concerns itself with the emotional

therapist to leave the physical aspects to the other problems which - undoubtedly - physically handicapped

consultants and to concentrate on the social and people have to learn to cope with.

emotional side of the child's development? In my opinion, in music-therapy there can be no

152
question of hierarchy in the various forms of
development, because - as mentioned before - each
ASPECTS
form influences the others and together they form a
whole. A. Physical development.

In my vieuw, the aim of music-therapy must be to In this way the physical development is linked to the

distinguish between the obstructions present at movement abilities of the child: we go along with his

different levels in order to - where possible - reduce or pattern of movement and try to induce relaxation with

erase at different levels in order to develop freely to the the help of music with peaceful rhytms, low tempi,

best of his or her ability. flowing melodies and using low-pitch instruments.

In The Netherlands this optimal development of all the

different aspects forms the centre of music-therapy Movement becomes easier, children experiences it as
treatment in the rehabilitation of physically handicapped more pleasant and more ways of self-expression are
children. created.

The starting-point is not a child's restrictions, but his or After this relaxation activity can follow. We stimulate the
her capabilities. This positive approach encourages a child to do more for himself and assist him with the help
child and gives atmosphere the child feels free to open of more definite rhythms, sharper melodies and faster
itself up to the music, thus allowing music-therapy to be tempi.
of influence in its development.
By playing different instruments, active moment is

153
provoked and stimulated and movement itself is more large range of acoustic and electronic instruments at
varied. Repetition leads to move control and the mere our disposal. Instruments can also be adapted to fit the
fact that one is capable of playing a musical instrument requirements of a specific child. Positive experiences
gives pleasure and a feeling of self-respect. (video- give a child more self-confidence and broaden his
ilustration)(1). outlook and his world.

B. Social development. When working with very young children (2-3 years) we
involve the parents. Problems often arise for them in the
handling of their physically handicapped child. The child
In order to stimulate social development, much work is
often reacts in a way different from that which was
done in groups and use is made of the possibilities
expected. All sorts of everyday things (like washing,
which playing together provides. While making music
dressing, eating, etc.) have to be done in a particular
together the children have to pay continuous attention
way. It seems as if nothing runs smoothly and this
to the whole, to the consonance, to the singing and
makes parents often insecure and tense.
playing of the others. Each child belongs and its
When making music, emphasis is put on what the child
contribution can't be missed. At the same time each
is capable of achieving. Pleasure can be gained by
child can participate in his or her own way, because
singing, playing and moving spontaneously together
music has much to ofter where variation is concerned;
and ways are created for parents and children to get
singing, moving, playing or just listening. We have a

154
along together in a different way, without having to take is, however, less so with a child who doesn't feel good
adjustments and upbringing into account. (video- about himself, which is often the case with physically
ilustration) (2). handicapped children.

Older children (4-12 years) like to play together. This For sure, it is not an easy task to have to live with a
goes with their particular phase of development: physical handicap, especially when it is a serious one
unaware, inadvertent and spontaneous, together with and one which dictates one's way of life. The physically
other children. (video-ilustration) (3). As the children handicapped child feels it personally and realizes that
grow older - namely in adolescence - they become there are things it cannot do. It cannot move well,
increasingly aware of "being different" and find cannot wald, cannot tald and cannot play. It feels more
themselves in exceptional circumstances more ofte. At and more lacking, inferior, unsure and dependent on
this time in particular it is important for a child to belong others for help. The consistent confrontation with its
to a group and to be indispensable. own limitations makes the child feel dejected, unhappy
and angry. All of these feelings are intensified in
puberty.
C. Emotional development.
The answers to the questions normally asked during
The possibilities for physical and social development
this time: "Who am I? What can I do? What is it that I
depend stronly on the child's emotional state.
want?" are much more difficult for the physically
When a child feels good mentally, he feels stronger and handicapped cild. His body is work, recreation,
is more motivated to work on his own development. This relationships and sex are not easy to fulfill. The question

155
"Why?" is inevitable, especially when a child has feelings and bring them alive.
become handicapped at an older age, either through
Expression is movement, and inner stream of emotions
and accident of through illness, or when an illness
moving in and out and making space and relaxation
proves to be progressive one. In addition to feelings of
possible. Through such relaxation it is possible for a
inferiority, loneliness and insecurity, fellings of
child to move again, in all sense of the word.
aggresion and anger are present, especially at this time.
It goes without saying that it is extremely important with
Therapy is a fear of the future, of the unknown, a fear of
this form of music-therapy to do one's work with the
pain and of death.
greatest care. People's reactions to musica differ from
Emotions are often bottled up inside and not discussed.
individual to individual and are often unpredicatable. It is
Isolation and a feeling of getting nowhere impede the
not always possible to foresee what kind of reactions,
child in every way. It is of the greatest importance at this
memories or feelings will be awakened by certain
time for something to be done about all these fellings
pieces of music. Therefore, conditions for this form of
and to break through to be child and try to get him in
music-therapy are: insight, education, experience and
motion again.
good cooperation with other members of the treatment-
Music experience - either in an active or a passive way - team. (video-ilustration) (4 y 5)
is therefore a most suitable means.

Feelings can be recognised in music and can,

IN CONCLUSION
therefore, be supported and relieved. Music can arouse

156
Is there, after all, a certain sequence in importance of Video Ilustrations
different aspects of music-therapy where physical,
social and emotional development are concerned? Yes
and no. 1 . WIEBE

It may be clear that by applying music-therapy in the

treatment of physically handicapped children, Wiebe is athetotic boy of 8. The uncontrolled
therapeutical effects are only achieved when a child has movements of his body make moving very difficult for
a felling of well-being. him. Nevertheless Wiebe wants to do as much as

The primary aim of therapy therefore is to ensure this possible without any help. So, he makes on himself

feeling that is a stable mental attitude. New aims can great demands, with the disadventage of being too

then be formulated which are directed at physical, social concentrated on only his own activities.

and emotional development, depending on the

individual needs of the child. There -where possible -
Aim of music-therapy:
obstructions can be broken down or completely
removed and the child's development can be stimulated - relaxation

- in all its facets - so that it can develpom as fully as - varying of movements by using various instruments
possible and remain: "in motion".
- playing together

157
2. MINIMOL The way of expression of a child is very individual.
Where as one child should like to veat through the
drums, the other likes playing the guitar silently.
We allways st song of Nordoff-Robbins: "Hallo", to great
eachother. On the video we sing and move : "Who can
clap his hands" and "Who can dance around". Mark the DIK had a car-accident at the age of 8 and was admitted
different ways of interaction between child and parents. to L. Now he is 18 and painly conscious of the limitations
of his life, which make him often angry or sad.
Fortunately Dik can express own music. On the video he
3. TABLE -DRUM
sings a self made songs about the street where he lived
before the accident, where he played with his friends
and was a happy boy: "When time could stand still ...".
Four children at the age of 5 are sitting around the
table-drum special made for group-activities. You'll see
several aspects of sharing the drums, waiting one's
5. JOOST
turn, paying attention to eachother, etc.

Next to making music the child can express by listening

4. DIK
to music.

158
On the video you'll see JOOST. He got a brain tumour learning, and helps learning disabled children to
when he was 6 years old. When he was admitted to L. overcome their difficulties.
he could not walk or speak anymore and was suffering
This is a report of two succesful cases,
from painfull spasms in his body. Listening to baroque-
previously labelled as desperate and hopeless, and
and folkmusic relaxed him and therefore Joost came for
how music brought about a breakthrough.
musictherapy every day. One time every week a
collegue and I played his favourite music "life" for him, to
bring the music to him as close as possible. Gareth

After many years of teaching, I returned to

BR EAKI N G D O WN L EAR N I N G BAR R I ER S WI T H
University and was studying for a Diploma in
M U SI C
Specialised Education (Remedial). I was given Gareth
M AY G AERTNER as one of my casestudies. I was told that he desperately
needed help, and lots of love.

This paper describes how music promotes

emotional and psychological growth in children with Gareth was 9 years old, and had been at school
Learning Disabilites and Behavioural Problems. It for four years. He had spent two years in the first class
shows how music penetrates the mental barriers to and been promoted on account of his age. This was his

159
second year in the second class, and according to his head and shoulders above his classmates. Most of
teacher, he had learnt nothing. "What am I going to do them were small and dainty for their 7 years, whilst
with this problem?" she asked. Gareth was tall for his 9 years. He was ridiculed and
teased for being "stupid". The teacher made fun of him
in front of the class. "You see, he doesn't even know
"I don't know anything. I don't know my ABC. I
that !". "Ooooh !" mocked the class.
can't read. I can't write. I can't do my numbers. The
children call me "domkop". Oh yes, I know that letter. lt's
an f for failing. I am always failing". Gareth stammered As I led Gareth away for his remedial lesson, we
and stuttered as he spoke. His posture was such, that approached the classroom where he'd spent the first
he actually looked like an f. He looked thoroughly two years of his life. He shrank back and clasped my
miserable, completely without hope, an absolute failure. hand as the shrill voice of the teacher reached us down
My heart went out to the little fellow. the corridor. I pitied the children who had to endure that
screaming all day long. Gareth was pale and trembling
as he scuttled past the classroom as quickly as he
His Headmaster was a kind, caring man, and I
could. He couldn't speak. He made noises; he tried to
met some outstanding teachers at that school, but
form words, but nothing would come out. lt took a while
unfortunately, Gareth had had no contact with them.
to calm him. I could see that my task was to get him to
His class teacher had the attitude of a martyr. "Poor me,
relax, to build up his confidence and hope, to change his
why should I be burdened with this problem ?" He was
self-image, and to change his teachers and

160
classmates'image to him, as well as to teach him to read The first sign of a breakthrough came with
and write. A formidable task, indeed ! sound, rhythm and movement. "Come on, Gareth". I
called out, "Lets dance!" and I improvised, "A for apple,
a, a, a. B for ball, b, b, b, b,.b. C for cat, c, c, c. D for dog,
I spent hours preparing exciting activities for his
d, d, d, d. I layed and sang and danced around the
lessons, but he was too tied up in intricate knots for
room, urging Gareth to join in. Suddenly this rigidly stiff
anything to penetrate. He couldn't repeat the sounds
little boy became a break-dancer! It was thrilling! He
after me. I HAD to get through to this boy. I HAD to break
literally unwound with strangejerky movements. Then
down the barriers. He HAD to have a breakthrough
he began to jig around the room with me, singing and
intoreading. How ? HOW?Lord help us! Suddenly
even yelling, "A for apple, a," etc...
lknew. Music! Music! Music ! Of course, Music! I took
my ukelele to school. I played and sang a few songs with
his classmates. lt helped everyone to relax. The teacher These sessions progressed to Gareth making up
was pleased to have free time to mark her books, and his own songs, rhythms and dances whilst I
was happy with her class of contented children at the accompanied him on the ukelele. I had some
end of the singsong. During our time alone together I percussion instruments like bells, tambourines,
used my voice and my ukelele to help Gareth to relax, xylophones, woodblocks and drums scattered around,
and to teach him. amidst the letters of the alphabet, on the table, chairs,
window-sills and on the floor. The letters of the alphabet
were bright, plastic shapes. There were also cards with

161
a single letter on each. Gareth either pointed to the During our lessons, I encouraged Gareth to
letters, or held them high whilst we sang and danced. strum the ukelele whilst I changed the chords. We sang
He sometimes picked up a percussion instrument to together. His rhythm was very good. One day I
beat out a rhythm with great vigour or to tap it gently, to suggested that he help me during the sing-songs in
suit his mood. Next came the games, linking the letters class. He looked frightened at first, but later, with
and sounds to make words, then we progressed to flash shining eyes, he agreed.
cards with words on them. We had two lessons a week.
Often we were back to square 1, because of his daily
The class sing-song began the usual way. I
experiences at school. Progress was slow, but it was
nodded to Gareth and he came to sit beside me in front
definitely progress.
of the children. We sang. "She'll Be Coming Round The
Mountain" with Gareth strumming, and my fingers on
I had visited Gareth's home, and met his humble, the strings. The effect on the children was electrifying :
loving parents, so I knew that he was well-cared for, their eyes widened, their mouths dropped open, they
respected and loved. I kept up little sing-songs in the forgot to sing. Some pushed forward to have a turn,
classroom, for the enjoyment of all, hoping to change saying. "lt must be easy if Gareth can play ". They soon
the children's, and the teacher's attitudes to each other, discovered that it wasn't so easy, and no-one strummed
and to Gareth. as well Gareth had strummed. The moment of truth
came when teacher's pet, the little girl who was always
top of the class, came forward confidently, tried

162
unsuccessfully, and retreated hurriedly with a very red similar way. He never stuttered when he sang, and we'd
face. Gareth and I consoled her, as we consoled all the often have long duets.
children. He usually said something like "Don't worry, I'll
show you and you'll see how easy it is ! ". Gareth was
urged by his classmates to play again. He was given a Towards the end of the school year, I took

rousing applause. I was overjoyed to hear some Gareth up to the University for my micro-crit lesson. A

children inviting Gareth to play with them during the video was to be made of this lesson. I pretended that it

lunch-break, which he usually spent alone. was the technician's birthday, and we played and sang
"Happy Birthday" to him. lt was wonderful to see how
Gareth began to smile, and to speak
happy and relaxed Gareth was. We were able to show
spontaneously. His posture changed : he stood up
how much he had leamt, as he worked his way through
straight, and no longer looked like an f. As is the case
the numerous exercises, games and tests. He was
with most dyslexics, some days he shone in his efforts
definitely the star of the "show" ! A week later I took
to learn, other days he sank back into confusion.
Gareth and his parents to the University to watch the
However, music was the key to opening his locked door.
video of the lesson. Gareth was chuffed to see himself
lt was the shoe-hom, which allowed knowledge to slip in.
on TV, and his parents were thrilled with his progress.
lt was the conveyor-belt into leaming. Sometimes I'd
sing quietly to him, with words such as "Hello Gareth,
how are you today ? You've come to sing and leam and After much discussion with his parents, the
play". The music would penetrate and he'd respond in a school principal, his teacher and my Senior Lecturer at

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the University, I wrote a detailed report, and sent it with David
the results of IQ tests and diagnostic tests, to the
Director of a special Remedial School for children with
David was 12 years old, and was a relatively new
Learning Disabilities. To our great joy and relief, Gareth
pupil at the school where I was a new teacher. He had
was accepted.
come from another country, with a long history of
Learning Disabilities. He had leamt some spoken
I've had very satisfactory reports of Gareth. He English, but his school work was zero. He had had
loves his new school, and has settled down well. He is a remedial lessons from the school's remedial teacher,
cheerful and outgoing child, has become a chatterbox, and extra coaching from three of the other teachers at
and has learnt to read and write, AND he has been the school.
promoted to the following class each year, because of
his ability and not because of his age.
I had a class of seven year olds, and seven
With apologies to William Shakespeare, I
classes for music and singing. I was asked to take
misquote,
charge of David, when my class went off to gym and
"If music be the food of love and leaming, play speech lessons. I had every confidence in the ability and
on! good intentions of my colleagues. I was told that noone
had been able to do anything with him, that he was a
desperate case. This reminded me of Gareth, the pupil

164
I'd taught the previous year. May be David needed for announcements of the week's activities, and a time
ukelele lessons! for some "cultural expression".

About forty 6 year olds sang " She'll Be Coming

Round the Mountain". I played the piano, and they sang
A couple of days later, I attended a workshop
with great gusto. As an encore, we sang it again, but
given by a visiting Music Therapist from Israel. Graciela
this time I played the ukelele. I had any number of
Sandbank practised Music Therapy at a Haifa Clinic for
volunteers for the strumming, so I had a relay of
Learning Disabled children. I heard her saying things
children con-dng to "help" me. They were a roaring
that I firmly believed, and this gave me the courage to
success, and were given a deafening applause. Our
go ahead with my plan for David. Graciela Sandbank
audience was not concerned, or perhaps hadn't even
was enthusiastic about the use of music in the
noticed, that I had changed the chords.
remediation of Learning Disabled children. She said
that music allowed learning to flown in, that it opened "a When David came to my classroom for his
back door, when the front door was closed". reading lesson, the ukelele "happened" to be lying on a
cupboard. I greeted him pleasantly, and asked his
permission to finish marking a pupil's book. As I had
I was asked to provide a musical item for the
hoped, he spotted the ukelele, and put out a hand to
School Assembly. This was the gathering of the entire
touch it. He ran his fingers across the strings, and
school, from 6 years to 12 years of age. This was a time
jumped back nervously, apologising for making a noise.
for prayer, for an address by the School Principal, a time
His relief was great when I smiled and told him to take it

165
and play, whilst I finished my work. I liked the sounds he and F Major chords and he practised them. We were
made, and he held the instrument with ease and soon able the manage the whole song. David was very
comfort : there was no awkwardness at all. I asked excited. He had achieved something. Whilst clapping
David if he'd like to learn to play the ukelele, and he him on the back, and praising him, he said "Well at least
nodded eagerly. He said that it couldn't be too difficult to I can do what the six years old did this moming ! ". I said
play, because he'd seen and heard the little boys that that he could do much more, and proceeded to tell him
morning. the secret of the moming's "duets" : that I had changed
the chords, whilst the boys had strummed. That
appealed to his sense of humour, and he laughed with
The C Major chord requires only one finger
glee. He was pleased to know that he was far more
pressing a string, so I showed him how to play it. I drew
advanced than the six year olds.
a sketch of the C Major chord, explaining how to
I quickly wrote out the English version of "Frere
interpret it. He practised playing the chord whilst I wrote
Jacques" and "My Bonnie Lies Over the Ocean". He
out the words of the song. "She"11 Be Coming Round
managed the chord changes well, and soon learnt the
The Mountain".
melodies. I never once mentioned reading. Whilst I
He strummed and we sang, until we passed the
sang, and later when we sang together, my forefinger
place of the chord change to G7 when he stopped,
followed the words, to point out the chord changes.
because he didn't like the sound of it. His ear had told
What David didn't know, was that the music was
him that a change was necessary. I showed him the G7
allowing reading to slip in. Music had opened the "back

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door". He was so engrossed in making music, that he He readily agreed. His barriers were down. I had
didn't realise that he was exercising and sharpening his his whole-hearted support and co-operation : he was
visual perception and discrimination, and his auditory motivated. These are surely very important aspects of
perception and discrimination. His visual memory was leaming. I made flashcards, each one bearing a word
storing up a treasury of words. His auditory memory from the first song. He read them all ! I made flashcards
too. He was exercising his eye-hand co-ordination. He of the words of the second song "Frere Jacques". He
was leaming to concentrate. The list of leaming skills knew them too. I shuffled the cards, but he was still
was endless ! word perfect. The school-bell rang for the end of the
lesson, and David went off with a contented smile.

Two days later, David had another lesson. lt

After about 20 minutes of musical fun, David
followed the pattern of the first lesson. He played and
stopped playing and said, "You are suppposed to be
sang the three songs, hesitantly at first, until he could
teaching me to read.
play them without any pauses for the chord changes.
I replied "What will your parents and the
Again, my finger moved under the words. Again, he was
headmistress say?"
having a reading lesson in disguise. I had preparad
l think they'll say that you are very kind", he some songs to add to his repertoire, and their mattching
answered. flashcards, so when he said, after about 20 minutes,
"We'd better do some reading now.", I was ready to flash
"Well, shall we do a little reading, so that we
the cards with the new words printed on them. He knew
can honestly say that we did do some work ?" I asked.

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them all. I tested him on the previous lesson's words. the ukelele whilst she played the piano-accordion. He
He remembered them all. I formed sentences with the was nervous of his peers, but his mistakes were
cards : these sentences were from the songs. He read drowned by the piano-accordion and the hearty singing.
them without hesitation. Maybe his memory was doing He was given a rousing applause, and everyone was
most of the work, so I made up sentences mixing up the warm with praise and enthusiasm. David was happy : it
songs, e.g. "Brother John will be coming round the was rather pleasant to be admired for a change ! It
mountain". certainly helped his image.

"She'll be ringing the bell for breaskast

""Are you sleeping, my Bonnie, wearing pink I'm not going to say that leaming was easy after
pyjamas ? that, and that David lived happily ever after. He had a lot
of hard work ahead of him, for not only was he far
David laughed when he read them. Not only was he
behind his classmates, but English was a foreign
reading, he comprehended too ! I was very proud of
language for him, too. However, it was a beginning.
David, and patted him on the back, saying, "Let's go and
Music had worked a little miracle. lt had succeeded
show off to the headmistress!". She was a very, very
where all else had failed. Music was the key that
surprised lady.
opened David's door to that wonderful adventure called
-- Reading, and of course, LEARNING.
One of his teachers planned a sing-song with his
class, and readily agreed to encourage David to play

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 L O S P E R S O N A JE S I N T E R N O S E N la cual estos pacientes son dbiles mentales. Estn los
M U SI C O T ER API A factores orgnicos, consttucionales pero tambin los
familiares y sociales, que determinan la psicologa del
M ARCELO G ABRIEL G INDLIN
dbil mental.

La Musicoterapa es una ciencia que tiene mtodos

Mi ms sincero agradecimiento a Ricardo y Diana y objetos de estudio propios.
Struzer, porque ellos despertaron en m la pasin por la
La teora Lumininn, ideada par el musicoterapeuta
Muscoterapia.
argentino Ricardo M. Struzer que postula que "Cada
instrumento o grupo de instrumentos se sita en una
Es ms fcil para algunos profesionales de la salud escena y representa una situacin homologable a
educar a los dbiles mentales con arquetipos, pautas y cualquier situacin que a cada uno le toca vivir" me
modelos de conducta, quitndoles la posibilidad de sirvi como disparador para encarar una investigacin
explorar, de conocerse y desarrollarse y y un tratamiento teraputico sistemtico.
condicionndolos con modelos que a largo plazo, no En este trabajo expondr la metodologa de abordaje
son beneficiosos. Los sumergen en mecanismos musicoteraputico desarrollada a lo largo de un ao y
caducos, creando una dependencia del paciente para medio, con pacientes dbiles mentales adolescentes,
con el terapeuta. con 3 encuentros semanales de 1 hora de duracin en
No se puede decir que sea slamente una la causa por la Primera Escuela Hebrea para nios con dificultades

169
en el desarrollo orgnico, y/o emocional, "Ha Makom Cuando el sujeto sale de una situacin entra
Shel" (Buenos Aires, Argentina). inmediatamente en otra, conformada sta por mltiples
estmulos ambientales, en relacin o no con otros
Me decid a incursionar en el tema de la percepcin del
cuerpos.
discapacitado mental y su insercin en la familia y en la
cultura, desde un punto de vista comunicacional, dado El sujeto mismo puede evocar, voluntariamente o no,
que el medio social y familiar es en gran medida diferentes sensaciones corporales.
determinante de la personalidad del paciente como as
De esta manera, podemos hablar de la evocacin de
tambin de sus formas de comunacin. El objetivo
imgenes, sonidos y sentimientos a travs de nuevas
fundamental no est puesto en la enseanza de
circunstancias que actan sobre el cuerpo, como as
modelos y maneras nuevas de comunicacin, sino en
tambin de comportamientos reflejos, que de alguna
situar los aspectos expresivos, tanto a nivel corporal
manera fueron aprendidos.
como de emisin sonora, en torno a la creatividad
personal como camino hacia la recuperacin desde un El ambiente presenta innumerables estmulos y la

punto de vista teraputico. percepcin acta selectiva y asociativamente.

La estimulacin sensorial comienza por situar al cuerpo La percepcin, segn Patrick Reddy, es "el nexo

del paciente como emisor y receptor de estmulos en mediador entre los individuos y su ambiente".

una situacin dinmica, donde las nuevas respuestas a

nuevos estmulos forman una cadena interminable.
El relato de Helen Keller pone de relieve el papel

170
decisivo que cumple la percepcin en nuestra vida ambientales varan y tiene que ir adaptndose, y frente
diaria: "La percepcin es el proceso por el cual se a estos climas reacciona como le permiten su cuerpo y
rene e interpreta la informacin. Sirve como enlace su psiquismo.
mediador entre el individuo y su ambiente. Sin la
Generalmente hay respuestas observables.
percepcin careceramos de experiencia de toda
Entre el sonido y el movimiento producido, hay una
experiencia, y no sera posible la sociedad humana.
intima relacin. Los movimientos que. los pacientes
La percepcin nos permite sentir el mundo que nos
realizan en la sesin de Musicoterapia tienen distintas
rodea y asignar un significado a este aflujo sensorial.
maneras de manifestarse para alcanzar objetivos.
No respondemos al mundo externo - los sucesos,
Cualquier sntoma denota un estado.
objetos y personas-, en forma directa; ms bien
El cuerpo tiene un lenguaje propio.
transformamos estos estimulos exteriores en un
sistema interior al cual le atribuimos sgnificado". Es tarea de los investigadores (que por cierto hay mu-
chos), estudiar los factores ambientales que influyen
Segn Jos Bleger, "el medio ambiente del ser humano
directa e indirectamente sobre el sujeto y su ectructura
es un ambiente social, del que provienen los estmulos
de la personalidad.
fundamentales para la organizacin de sus cualidades
psicolgicas". Es tarea del profesional de la salud mental y corporal, el
proporoionarle un bienestar al paciente, al ayudarle a
De acuerdo a mi experiencia, el ser humano est
encontrar las herramientas necesarias que elborar
inmerso en una atmsfera donde las condiciones

171
internamente, para que se pueda desenvolver mejor en Al expresar que los movimientos que 1os pacientes
los diferentes climas por los cuales atravesar, realizan en sesin son pasos (secuencias) para
transitando con sus deseos, teniendo un estado alcanzar objetivos, quiero decir que stos desarrollan
psicolgico y corporal absolutamente personales. en cada sesin una trayectoria determinada.

El ser humano tiene que adaptarse al medio donde, a Entindase por trayectoria a todas las conductas
veces la tecnologa le da un maltrato bien intencionado, expresivas, tanto a nivel sonoro como corporal, que
pero necesita reestablecer su equilibrio por sobre todas desarrollan los pacientes en cada sesin.
las cosas. Por eso es que la labor del musicoterapeuta,
Las trayectorias en los planos:
como profesional de la salud mental y corporal es tan
- armnico;
importante.
- de las alturas;
Es aqu donde esta tcnica de abordaje
musicoteraputico, que surgi en m como idea y que - de las velocidades
decid llevar a la prctica, cobra efecto.
- de las intensidades;
Pasar a continuacin a describir cmo sta se
- de las texturas del sonido;
desarrolla:
componen lo que yo denomino Trayectoria global del
La msica, en sus combinaciones internas, conjuga
paciente en cada sesin.
climas de tensin como as tambin de reposo y
resolucin. El compositor, cuando crea una obra, expresa una idea

172
y desarrolla uno o varios temas, que al ejecutarla movimiento, viene regularmente acompaado de un
provocan en el oyente una respuesta determinada. sonido y a la inversa.

Toda expresin sonora transita sobre el propio tiempo La problemtica del grupo de pacientes dbiles
total que dura la obra. Hace un recorrido particular y mentales a mi cargo, pasaba principalmente por la
personal. dificultad de expresarse y comunicarse y por la
identificacin de los valores e ideas no
Es el compositor quien lo configura. Deposita todos sus
correspondientes a su edad, lo que les provocaba
conocimientos y sus sentimientos y va eligiendo,
conflicto.
segundo a segundo, las trayectorias que desarrolla y
las asume. El compositor llega a un objetivo Las edades oscilaban entre 11 y 15 aos,
determinado, que no siempre est al final de la obra. El
Se identifcaban con modelos infantiles, lo que se
producto sonoro es el reflejo de su expresin, de su
reflejaban en el tpo de msica que escuchaban.
bsqueda, de sus encuentros y de sus desencuentros.
En sesin se erotizaban y tenan conductas corporales
Todos estamos inmersos en climas, en una
masturbatorias individuales y/o grupales.
multiplicidad de fenmenos y acontecimientos donde
Adems de conductas repetitivas y agresivas,
nos desenvolvemos.
reiteraban determinadas palabras, frases, sonidos y
A veces es difcil discriminar los estmulos que llegan a
dibujos.
nuestro cuerpo de una manera ntegrada. Lo que nos
sugiere una imagen, es decir, un cuadro, una luz, un

173
Por el clima sonoro familiar y social en el que vivan, la cada sesin.
repeticin, la agresin y la mala comunicacin no les
Poco a poco iba trabajando con las distintas
permita dar curso a todas las emociones que se les
problemticas que emergan en las sesiones a partir de
despertaban, como si tampoco a sus impulsos
la exploracin creativa de nuevas trayectorias que les
sexuales. Estaban en una situacin donde se
posibilitaran llegar a una recuperacin.
acrecentaban las demandas familiares, sociales y
Es clave considerar a los pacientes responsables y
grupales. Esto les exiga respuestas y cambios.
artfices de sus propias trayectorias.
Los padres se hacan cargo de sus hijos discapacitados
El eje principal en las sesiones era la comunicacin, no
y responsables de la mayora de sus actos.
como expresin indiscriminada sino como un
Cualquier esituacin nueva -y por ende no habitual-,
reconocimiento de la expresin de cada uno y de los
provocaba conductas no esperables por los padres,
dems.
generando el consabido miedo a lo desconocido.
Quiero recordarles que para m, trayectoria es toda
A esas conclusiones arrib en las primeras sesiones en
conducta expresiva, tanto a nivel sonoro como
las que realic un diagnstico de grupo.
corporal, que desarrollan los pacientes en cada sesin
Por eso decid utilizar la sesin de Musicoterapia como en los planos: armnico, de, las alturas, de las
marco de elaboracin de sus problemticas, velocidades, de las intensidades, y de las texturas del
considerando a los pacientes como autores - sonido, componiendo sus respectivas Trayectoras
compositores- de las trayectorias quc desarrollaban en globales.

174
Y he aqu el tema de los personajes internos. Trabaj en primer lugar las trayectorias en los planos
armnico, de las alturas, velocidades, intensidades y
Son aquellas conductas de personajes, ya sea que
texturas del sonido y del movimiento; cada una por
pertenezcan o no a la familia del paciente, pero que
separado y explorndolas con los sonidos y
tienen una vital importancia en el momento de
movimientos corporales.
reaccionar y de tomar decisiones.
Todo esto se hizo metdicamente y con el ritmo de
Los pacientes traen a la sesin toda la problemtica
trabajo que el grupo posibilitaba.
relacional del afuera. Y se trabaja con eso en la sesin.
Cada paciente exploraba y elaboraba trayectorias,
No es cuestin de realizar Musicoterapia con los
tantas como le era posble, y despus las expona a los
padres, sino utilizar todos los elementos que puedan
dems ntegrantes.
reemplazar personas desde la expresin sonora y
corporal; entendiendo esto desde el punto de vista de En segundo lugar, a partir de las situaciones conflictivas
que cada persona tiene una Trayectoria global que los pacientes traan a sesin desde el afuera -de
determinada. las cuales yo elega una sola y nica, alrededor de la
cual se desarrollara la sesin del da, intentaba
No se trata de traer fotos u objetos que representen
caracterizar cada uno de los personajes representados
personas o hechos sino de caracterizar, desde lo
por su Trayectoria global- que intervena en ese
sonoro y lo corporal, a nivel grupal, la situacin en la
conflicto.
que la Trayectoria global del discapacitado est en
conflicto con otras trayectorias globales. Cada paciente -excepto el que traa la situacin que se

175
trabajaba en ese momento- asumia la caracterizacin - trayectorias no coordinadas.
de un personaje distinto.

En tercer lugar, el paciente que haba traido la situacin

Por ltimo, s era necesario, se charlaba sobre el tema.
con la que se trabajaba en esa sesin deba, a partir de
Pero lo importante en todo esto era el crear, el explorar
los distintos planos integrados, asumir su Trayectoria
prcticamente desde la accin -aunque interviniera lo
global para desenvolverse y enfrentarse creativamente
verbal-, arribando as a un nuevo universo, porque el
a la situacin, a fin de lograr una mejor recuperacin.
campo de las trayectorias es un universo sonoro y
Es aqu que pude observar lo que denomin corporal, en donde los sentimientos, emociones, y
Trayectorias globales, que clasifiqu de la siguiente deseos se pueden expresar perfectamente.
manera:
Esta tcnica que ide, obtuvo excelentes resultados.

Ya no era la palabra la nica encargada de simbolizar y

- trayectorias ricas en Planos; transmitir.

- trayectorias pobres en planos; Incursionando en este tema de la Interaccin, que es

en definitiva la comunicacin -desde un punto de vista
- trayectorias continuas;
corporal y sonoro-, conjugando el movimiento y el
- trayectorias discontinuas (con sobresaltos o cambios);
sonido con el juego de roles homologables a los
- trayectorias coordinadas; personajes que intervienen en las diferentes
situaciones conflictivas, obtuve resultados altamente

176
positivos, logrando un encuadre de contencin para la conocerse. Forma parte del crecimiento personal.
reelaboracin de experiencias traumticas.

As, los pacientes recrean sus conflictivas, las recono-

Esta es la nica manera en que la red de
cen, las internalizan y pueden enfrentarse
interrelaciones humanas como contienente para los
creativamente a nuevas situacones comunicacionales
deseos personales, vaya mutando hacia un ambiente
parecidas o no a las ya vividas.
menos agresivo y represivo. del que todos somos
Los pacientes lograron cambios evidentes, adquiriendo responsables.
una mayor expresin corporal y sonora, pensamientos
El deseo de un bienestar, de un placer, por el hacer, por
y mensajes ms elaborados, identificacin con valores
el crear, el de un sentirse vivo y sentir a los dems,
ms acordes con su edad, mayor desinhibicin, mayor
surgi en estas sesiones de Musicoterapia. En este
sentido de la privacidad, mayor sentido de pertenencia,
espacio otorgado para disfrutar, vibrar, cantarle a la
afirmacin de su personalidad, mayor seguridad
vida, a quienes estn descubriendo que el camino que
personal, mayor autoestima, mayor discriminacin
se transita se comienza a partir de un sonido, un canto,
entre el deseo del otro y el propio y por ltimo, un mejor
un movimiento, una meloda.
decenvolvimiento frente a su familia, su entorno social y
grupal. ... Y disfrutar del caminar, y sentir amor hacia lo que nos
reconforta, y nos hace felices VALE LA PENA.

Hay que vivir intensamente, sentirse, aprender y

177
 L A PO SI BL E M ET AM O R F O SI S - documentacin sobre el despertar de los insondables
M U SI C O T ER API A EN L A G L O BAL I D AD D E L O S "potenciales humanos" y del poder de evocacin de los
L E N G U A JE S mismos, de parte del sonido. La seleccin de dos
sujetos adultos plurihandicapacitados,
S TEFANIA G UERRA L ISI
institucionalizados desde hace aos y agravados por
una regresin profunda ms all de la diagnosis, en la
1.- RI-ANIMA-AZIONE filosofa del mtodo de trabajo empleado
"musicoterapia en la globalidad de los lenguajes", est
2.- LAS MUSICAS
ligada a las intenciones de una experimentacin-
Giovanni Maria Rossi investigacin en casos de no colaboracin, de rechazo
defensivo a cualquier propuesta no de rutina, hasta la
pasividad total.
3.- LOS CASOS Y LA ACTIVIDAD DESARROLLADA

Maria Chiara Bolner - Enrica Martinelli

En el filmado, aunque sea en una rpida panormica,
se ha querido documentar el estado existencial en
RI - ANIMA - AZIONE institutos para graves, en los que inevitablemente las

"Ri-Anima-Azione"* es la palabra que puede resumir el llamadas tcnicas de rehabilitacin pierden los

mensaje que queremos transmitir con esta objetivos, reducindose, donde subsisten, a
manipulaciones pasivas de mantenimiento, reforzando

178
a menudo, eventuales rechazos a los contactos, o total en parangn ms humano o humanizado, el
pasividad mecnica de los movimientos. comportamiento intencional imitativo o colaborador de
un chimpanc, o hasta a prever la eutanasia como
solucin o fin de un estado deshumano. En estas
El merodear-bambolearse repetitivo de los cuerpos,
condiciones de base se aleja de la practica actualmente
vacos de intenciones comunicativas, en un mismo
posible en nuestras realidades institucionales, no solo
espacio en rituales sensorial-motores obsesivos como
la visin de setting musicoteraputico, sino tambin el
entidades cerradas sobre sus propios sensorismos,
de "anima-azione-musicale" (alma-accin musical) en
que aun rozndose viven como islas, introduce una
el sentido ms profundo de la palabra. El pedido es a
reflexin sobre la tendencia de considerarlos
menudo, de animacin como entretenimiento con la
insensibles tambin al dolor fsico, a la discriminacin
msica hasta donde existen sujetos interactivos o. para
entre placer y disgusto, hasta hipnotizarlos ms o
los ms graves, como msica de fondo ni siquiera
menos inanimados psicolgicamente. Estas palabras
personalizada.
no son metforas exageradas, reflejan en cambio un
debate muy actual entre ciencia y moral a cerca de los
imaginarios confines de la conciencia humana; Me parece fundamental exponer con sentido realista
ltimamente han habido posiciones tomadas (en las molestias que encuentra una intervencin
particular por los jesuitas) para defender la identidad individualizada con el sonido, comprendida sobre todo
humana donde algunos cientficos pretenden falte en la voz y la conexin sinestsica a las estimulaciones
estados letrgicos, en estados de coma, hasta definir sensorial motoras, para la comprensin de un contexto

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requeriente y en una cultura general. Estos reconocen tocadiscos porttil de uno, se sobrepona la msica
la predileccin de la msica por parte de los ambiente (a fuerte volumen) de la radio o de la
handicapacitados. hacindolo casi un estereotipo, con televisin y las fonaciones de ms o menos diez
el que se necesita medirse justamente para actuar en personas. El binomio "handicapmsica" se ala
modo teraputico. A menudo basta poner una msica simplicsticamente al otro "msica. alegra", por lo que la
rtmica en el ambiente tambin vistosamente reaccin al ambiente deprimente e Inconscientemente
conectada a luces psicodlicas y casi siempre a fuerte el aturdimiento sonoro. El primer recurso teraputico
volumen, como para cubrir sonidos ecollicos y es la restitucin de una oasis de silencio en el que se
estereotipias vocales, para decir que se hace pueda susurrar de nuevo la musicalidad afectiva que
musicoterapia. comunica el Sentido, adems de la posible
comprensin de la palabra y confa a los contactos
tnico-fnicos de los cuerpos con el cuerpo, con sus
En estos casos se obtiene el apoyo de
puntos de susceptibilidad vibracional (mapa tctil).
comportamientos obsesivos con el aumento, en
Restablecer la escucha de s en la accin de percibir el
algunos casos de autismo, del aislamiento por ejemplo
propio poder creativo sonoro, la coincidencia entre
con una pequea radio acaso apoyada a los labios,
propiocecin y meloda cintica y, donde exista una
sensibles a las vibraciones. En nuestros casos, el
concentracin defensiva, el desbloqueo a travs de la
primer objetivo ha sido a travs de "todos los sentidos"
ayuda del masaje o de las rotaciones guiadas,
restituir la escucha, saliendo justamente de un
provocadas o de todos modos anticipadas a travs del
reverbero sonoro de reparto en el que a la cancin del

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sonido. La sincrona-sinfona con el ambiente, evolutiva con pocas noticias sobre el nacimiento
graduada sobre la psicofsica subjetiva es uno de los (descrita genricamente en trminos tcnicos y no con
primeros recursos de la metodologa de la globalidad detalles que permitan reconstruir la experiencia
de los lenguajes, centrada sobre la comunicacin: por corprea sensorial para nosotros determinante), y
la observacin de los comportamientos psico- sobre las vicisitudes sea fsicas que psquicas
sensomotorios, por un relieve de las preferencias de sucesivas. Las anotaciones sobre los cambios de
todos los sentidos y de las asociaciones sinestsicas comportamientos describen los efectos sin conocer las
implcitas, para una programacin dinmica causas y a menudo el pasaje de descargas agresivas
individualizada que toma en examen todos los lados de hacia el mundo externo (cosas o personas) a los
la esquela de observacin. Esta prev la individuacin autolesionismos, es visto en clave positiva as como la
de un mapa corpreo-ionicotctil que registra las pasividad general con prdida de capacidad de pedir.
posibles corazas caracteriales, los puntos memoria del
cuerpo, los puntos de mayor susceptibilidad o la
sordera tctil solicitados por los sonidos amniticos, o La adaptacin a los lmites institucionales, con la

las reflejologas tnicas entre boca-mano-mente. manifestacin de las necesidades subjetivas para un
aplastamiento hemo-tnico-fnico total, hasta un
enmudecimiento fsico y psquico, y a menudo agorado
Es necesario precisar, que para los adultos ms y perseguido pacientemente con la fe que antes o
graves, normalmente se puede hacer referencia a despus suceder aun en los casos reticentes, sea por
diagnosis de irreversibilidad que resalen a la edad parte de la familia que de los institutos. Seguramente,

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los dos casos escogidos, en este sentido, han realizado autistas de enajenacin al ambiente. Nuestro primer
grandes progresos de adaptacin: la primera, objetivo ha sido pues el volver a poner a estas personas
cerebrolesa ciega, tiene sus rituales obsesivos de en contacto con el mundo que las circunda, volviendo a
abertura de puertas y ventanas (vas de salida) que crear una red de relaciones afectivas a travs de la
cierra sola, la otra que se muerde con violencia la carne musicoterapia en la globalidad de los lenguajes. La
de los brazos, se pone sola o pide a su modo las aplicacin metodolgica prev provocaciones
mangas rgidas que bloquean las articulaciones de los sensoriales buenas, que miran a restablecer la
brazos. continuidad entre el sujeto y el mundo. La definicin
"buenas" lleva a la observacin de las elecciones
subjetivas y a menudo esto requiere un trabajo largo,
Esta solucin desesperada ha sido escogida por el
pues el primer pasaje para recuperar es la pro-tensin,
mismo ortopdico, frente a la imposibilidad de impedir
vista la situacin de deniego y a menudo verdadero y
el obsesivo autolesionismo y en alternativa a la
propio temor y defensa, frente a lo que no es de rutina.
costumbre aun familiar de atarla, que ha reforzado o
Con esta metodologa la protensin no es inductiva
dado cuerpo a una deformacin de la columna
desde el externo, solo puede provocarse a travs de la
vertebral en constante torsin, con una fuerte tensin
multiplicidad de los estmulos sugeridos por los
lateral del cuello para alcanzar al brazo (para
comportamientos ms o menos "simpticos" que se
morderlo). Ambas parecen tener muy profundizadas las
observan. La empata que busca el educador
prohibiciones, mientras hoy el handicap inicial se puede
musicoterapeuta es necesaria dada la bsqueda
decir agravado por un aumento de las modalidades

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inconsciente de simbiosis en un estado regresivo En la pelcula se pueden notar las dificultades de
prenatal de graves como A. y E.. En musicoterapia se relacin aun tctiles que se superan progresivamente
habla del Principio ISO (R. Benenzon) o de Espejo con esta intervencin que genera, despus del primer
Sonoro (M. Scardevelli), donde se toma inspiracin por momento defensivo, una especie de estupor
el ritmo de sus bamboleos sensorismos o de sus quiescente y de lento abandono que favorece el primer
iniciativas sonoras. En nuestro caso justamente porque desbloqueo del diafragma con una espiracin profunda
nos encontramos frente a estados de rechazo total o de y con algunas emisiones vocales. La calidad de las
huida es a menudo necesario obtener una adhesin a vocales y de las articulaciones tonicofnicas y la
la realidad a travs del sentido primario de indicacin para una elaboracin musicoteraputica de
comunicacin que es el tacto (muy desarrollado en A los puntos que se tienen que estimular sensorialmente
que es ciega) frecuentemente entendido como y psicomotoriamente y del timbre (spero-lisodulce-
estimulacin oral o despertar de los puntos ms viscoso-brillante-suave...) traducido sinestsicamente
sensibles del "mapa tctil". El uso de los sonidos en la eleccin de materias para manipular-pedipular.
amniticos soplados con una pajilla en un vaso de agua
(vibrados a distancia de 1 cm. del cuerpo aprox.)
determinan una especial "escucha de la piel" ms que Antropolgicamente la MANO es la segunda boca que

de los odos, restableciendo las esperas tnicas se tiende hacia adelante y transforma la realidad

prenatales. creativamente hacindola resonar hasta una

espontnea continuidad entre accin de
manipulaciones tnicas y acompaamiento evolutivo

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fnico de las acciones. Estas mismas una vez se manifestadas (tambin por un nio pequeo que
realizaban a travs del aparato bocal que librado, empieza a dominar a su manera los objetos y las
sustituido por las manos, respira, canta reforzando el sensaciones del mundo) y de todos modos as re-
sentido aun a nivel mnemnico, no solo las variaciones evocables.
tnicas sino tambin las varias calidades y cantidades
que las provocan determinando:
Las secuencias de la pelcula muestran las dificultades
satisfaccin del poder sobre la realidad percibida
y las estrategias personalizadas para hacer volver al
conocimiento de las diferencias exploradas ms grave en adherencia psicofsica a la realidad
justamente porque est huyendo obstinadamente de la
sistematizacin de los datos tnicos experimentados en
realidad de la misma. Segn la filosofa del mtodo, la
fnicos.
huida de la realidad est ligada a memorias de
sufrimiento, a desconfianza y es por lo tanto, sobre el
En este sentido, antiguamente se hablaba de msica contenido afectivo, sobre la continuidad entre
hija de la memoria y de msica-matemtica (relacin educacin musicoteraputica y muchachas, que se
entre cantidades, pesos, medidas y "formas") funda todo el trabajo preliminar centrado sobre la
impresiones fnicas sobre la realidad. Es como decir conquista de:
que la asimilacin mental del mundo externo es
- un principio de placer
completa cuando todos los datos plurisensorialmente
- de relacin con el ambiente
percibidos se fijan en sonoridades internas a menudo

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- de poder y no de impotencia respecto al mismo renunciado a lo activo como a lo malo, o sea como
imagen negativa de si, culpabilizada, negada, no
- de re-escucha de un S capaz de producir efectos,
aceptada. Los momentos expresivos no a caso se
- de un S capaz de provocar respuestas sea de
alternan con inhibiciones y autolesionismos que sin
parte de una materia que se modifica, que de parte del
embargo, como documenta la pelcula, tienden a
otro que le responde con los sonidos relativos a su
disminuir hasta desaparecer cuando el sujeto se siente
experiencia plurisensorial.
Acogido, Aprobado, Esperado en sus iniciativas,
Aplaudido, AMADO. Segn el tono-fono- simbolismo,
(elemento portante de esta metodologa que
Considerando la continuidad entre sonido y gesto en el
constantemente lleva los lenguajes no verbales al
lquido amnitico, el acompaamiento vocal y a travs
verbal), la inicial A es el signo tnico-fnico de una
de una amplificacin adecuada con instrumentos
Abertura comunicativa total, en un cuerpo a cuerpo,
musicales, determina aquel estado de satisfactoria
que es la ausencia misma de la intervencin
omnipotencia primaria y vuelve a dar al Ser el necesario
teraputica.
"Proto-Agonismo" permitiendo nuevamente la
satisfaccin de un S activo y no pasivo.

La palabra ESCUCHA como primer objetivo, alcanza a

este punto de la intervencin , su plenitud semntica:
Digamos que esto del pasivo al activo es el pasaje ms
ESCUCHA como ACOGIDA. No se puede ni escuchar
complejo, all donde la persona vuelta pasiva haba
ni acoger sino reduciendo la distancia hasta un cuerpo

185
a cuerpo - corazn a corazn, que en estos casos a por objeto hacer descubrir la Voz secreta y la
menudo casi gravsimos hasta ve el eventual "musiquilla" que las vuelve simpticas y reproducibles,
instrumento musical como separador o como nuevo por consiguiente aferrables con una profunda
objeto de aislamiento. permanencia ms all del momento de la accin. Con
frecuencia en el reparto, en diferentes momentos de la
jornada, fuera de la sesin de musicoterapia donde se
Acordarnos que al inicio ramos resonantes en una
presente una ocasin de asociacin por analoga, stas
caja de resonancia respondiente, puede servir para
van pronunciadas creando una red de pequeas
comprender mejor como sean ms adecuadas la voz y
memorias gratificantes: en fin un tejido conectivo segn
la amplificacin de la accin en sonidos antes que
el principio del placer, que solo el sonido puede as
pequeos instrumentos musicales aun simples, que en
rpidamente y sinestsicamente re-evocar. Por
cambio, una vez que se asegura a la Persona, pueden
ejemplo los sonidos onomatopyicos de la espuma
reforzar la protensin con las sorpresas exploratorias
probada espontneamente, no solo con la boca - mano
que poco a poco aprende a ritualizar, con siempre
y con la planta del pie (que en este mtodo viene
mayor conocimiento y elecciones subjetivas. Las
definido "lengua del cuerpo" que prueba y distingue la
selecciones no son necesariamente sonoras, pueden
realidad), pueden renovarse durante el "bao
ser inicialmente tctiles - olfativas, como vemos a
teraputico" o el lavado de las manos, as como el ritmo
menudo en la pelcula. Una materia sonora como la
puntiforme de la cascada de arroz puede ser renovada
risa as como una placa sonora pueden ser lamidas,
durante un temporal, mientras A. lo escucha cerca de
olidas, plasmadas... El trabajo musicoteraputico tiene

186
los vidrios de la ventana que abre y cierra... En fin, en papeles, plsticos, arena..., sino tambin de improvisar
esta ptica como la psicomotricidad que se refiere no a la orquesta de una encina, del viento, de la hoja que
la sesin sino a la vida entera de la persona en toda vuela... atribuyendo timbres sensibles no al odo sino al
ocasin, incluso el significado de las posiciones durante alma del handicapacitado que est concentrado, por
el sueo y los afectos del alma revelados por los ejemplo, sobre este objeto del jardn ignorando todo el
movimientos tnicos articulados, as psicomusicalidad resto, incluso el mt. hasta hacerlo coincidir tan bien
es el sostn sonoro interno de cada accin, incluso la como para reconocerlo. Tiene que ser capaz de con-
del pensamiento y la profundizacin de todo aquello vibrar con el otro pues centrado en la escucha tnica
que sucede fuera de nosotros: rfaga que escuchamos como inspiracin dinmica para una extempornea
sobre la piel tiene una sonoridad diferente del sabor de composicin muy atenta a los tres parmetros: espacio
una mandarina aplastada contra el paladar y deglutido. - tiempo - intensidad, se poda decir constantemente
El M. T. en la globalidad de los lenguajes debe afinar dictados por el comportamiento del otro. Se entra de
para si mismo, en un training de formacin esta manera, poco a poco a su "sentido musical" no solo
permanente, esta percepcin sinestsica, para tener hasta amplificar siempre ms fcilmente sus
una intuicin creativa, de las experiencias interiores del manifestaciones, pero incluso a anticiparle hasta decir
otro segn el modo de contraerse - extenderse o que el sonido se hace profeca del movimiento. Es la
gesticular en un momento dado. En este sentido se manera ms exacta, no solo sugestiva, para definir el
poda decir que debe ser un msico en grado no slo poder arrastrante del sonido respecto a la superacin
de tocar todos los instrumentos de la realidad, incluso de engaos, inhibiciones que bloquean la accin

187
expresiva. El gesto llamado por el sonido, tiende a cada sesin constituyen para nosotros, la prueba de
cumplirse. En la pelcula se ve muchas veces despus una mayor disponibilidad y capacidad de comunicacin
de un desligamiento guiado de los miembros con la que tiene el significado ms amplio de buenas
meloda cintica, una vez individuada una constante espectativas, hasta la aparicin de la sonrisa e de la
musical de sujeto (pequea frase con sus expresin vocal relacional.
caractersticas extensivas) cuanto se espere que el
sujeto realice la protensin por si misma. El objetivo
est en que la memoria de bienestar de estos ltalo Calvino nos ayuda a penetrar poticamente

momentos de abandono de las defensas, de la esta "Metamorfosis" de la regresin, como posible

interrupcin de autolesionismos sustituidos por un reatravesamiento consciente de la propia

retorno bueno al propio cuerpo (auto unin en lugar del evolucin ontogentica:

mordisco en el caso de E. o manos en la cara

escuchando el espejo interno guiado por la sensacin
Para la mayor parte de los moluscos, la
de la piel lisa para A.) vaya ms all del momento de
forma orgnica visible no tiene mucha importancia en la
estimulacin, constituya durante los momentos
vida de los miembros de una especie, dado que ellos no
depresivos de tiempo vaco de los das de estas
pueden verse el uno al otro o solo tienen una vaga
muchachas, ese recuerdo - reacuerdo interior
percepcin de los otros individuos o del ambiente. Esto
agradable que influye en un mejoramiento ms general
no excluye que el estriado de vivaces colores y formas
de su "calidad de vida". Estas agradables memorias en
que aparecen bellsimas a nuestra vista (como en

188
muchas conchas gasterpodos) existan, otra parte; ahora quieren convencerme que de los dos
independientemente de toda relacin con la visibilidad. orificios que tena uno era la boca y el otro el ano, y que
por lo tanto ya entonces tena mi simetra bilateral, ni
ms ni menos de los trilobites y todos vosotros, mas
Como yo cuando estaba colado a aquel escollo,
como recuerdo, yo estos orificios no los distingo
quieren decir? pregunt Qfwfq - con las olas que suban
absolutamente, haca pasar cosas por donde me daba
y bajaban, y yo parado, plano plano, chupando lo que
la gana, hacia adentro o hacia afuera era lo mismo, las
haba para chupar y pensando sobre esto todo el
diferencias y melindrosidades han llegado despus, De
tiempo?. Si es de entonces que quieren saber, puedo
vez en cuando de dejaba llevar por la fantasa, esto si;
decirles poco.
por ejemplo, de rascarme bajo las axilas, o de cruzar
las piernas, una vez tambin de dejarme crecer los
bigotes a cepillo. Uso aqu con ustedes estas palabras,
Forma... no tena, quiero decir no saba que la tena,
para explicarme; entonces no poda prever tantos
mejor dicho no saba que se poda tener alguna. Creca
detalles, tenla clulas, ms o menos unas iguales a las
un poco por todas partes, como viene; si es esto lo que
otras, que hacan siempre el mismo trabajo, ms o
ustedes llaman simetra radiada, quiere decir que tena
menos. Pero visto que no tenla forma senta dentro
simetra radiada, pero en verdad nunca le he tomado
todas las formas posibles, y todos los gestos y las
atencin. Por qu deba haber crecido ms de una
muecas y las posibilidades de hacer ruidos
parte que de la otra?. No tena ni ojos ni cabeza ni
impertinentes tambin. En fin no tena lmites con mis
ninguna parte del cuerpo que fuese diferente de alguna

189
pensamientos. En la pelcula, se puede seguir este efecto relajante,
sea en el caso de A., que a su vez tiende a articular la
voz en un ascendiente meldico, que en el caso de E. ,
(de "COSMICOMICHE" [COSMICOMICAS) de ltalo
que sonre emitiendo un sonido quedo muy similar al
Calvino
ronroneo del gato. Tratando de coger las activaciones
tnico-fnicas especficas, se poda decir que Aurora
oscila rpidamente la lengua sobre el paladar (casi una
Descripcin con verificacin del mtodo de
simulacin del birimbao) en "dlululul". Imitndola se
intervencin en las sesiones filmadas
comprende que esta vocalizacin lleva a una total
Platn conoca ya el valor teraputico del "terpnos concentracin articulatoria que impide, o ms bien
logos" que se puede traducir "palabra dulce". El supera aquella mental. Resulta espontneo reflexionar
acompaamiento progresivo del desbloqueo tnico, sobre la denominacin "birimbao" respecto a este
con la palabra pronunciada suavemente, con ritmo sonido y al instrumento que lo amplifica, al uso vocal
siempre ms amplio, como las rotaciones de que los monjes tibetanos hacen para favorecer el vaco
desligamiento de los miembros, o las presiones de la mente racional con fines meditativos. Se puede
circulares del masaje, es la base de la intervencin decir que inconscientemente Anna ha creado un
musicoteraputica a travs de la voz y el "mantra" suyo para entrar en un estado esttico: en
"tonofonosimbolismo" especficos del mtodo de la efecto esta emisin se acenta cuando est sobre el
globalidad de los lenguajes. columpio (medio contenedor tranquilizador que lleva a

190
la ausencia de gravedad y a la oscilacin rtmica con ciertas poesas mgicas que son como los discurso
prenatal). Considerando las vibraciones abdominales bellos de los que crece en las almas la cordura. El alma
de la vocal "U" se puede coger mejor esta energa se entrega al cuidado del "ENCANTAMIENTO". (citacin
suspendida desde el vientre al paladar, con una lengua de el "Frmaco sonoro" de S. Barile en "Essere secondo
tensa, funciona como estrangul vibrante. Es la Natura" [Ser segn la propia Naturaleza) n 16, agosto
extensin de su sonoridad en palabras dulces, de 1987). La empata que se establece con A. a travs
persuasivas, que permite el abandono de las defensas de la globalidad vibracional de los contactos y de la voz,
y un estado de escucha hasta el relajamiento. lleva a una cancelacin activa del estado de
desconfianza habitual que le permite volver a descubrir
el placer del propio cuerpo sensorial. Este cambio del
Platn echa las bases de una posible psicoterapia
estado mental y fsico est marcado (como se pude
verbal explicando en su dilogo entre Scrates y
constatar tambin en la pelcula) por una o ms
Carmides como el "terpnos logos", palabra dulce,
espiraciones profundas. La nueva irrogacin de
montona monocorde, acta sobre el estado
oxgeno se propaga benficamente en todo el
psicosomtico que crea el estado de "sofryne", una
organismo, incluso el cerebro, determinando estados
condicin de calma, concentracin, escucha. Dice
de atencin ms largos e influye positivamente sobre la
detalladamente: "Cada cosa, el mal o el bien no entra
tensin muscular localizada especialmente en el cuello
en el cuerpo y en todo hombre si no desde el alma, de
y en los hombros. Estos son los puntos de la tensin
la cual proviene todo, como de la cabeza proviene todo
primaria del nacimiento (campo anterior) en estos dos
aquello que corre a los ojos. El alma oh beato, se cura

191
casos tnicamente congelados en actitud de ponrselas de nuevo (tanto profundizada estaba la
"obstinacin", con protensin hacia adelante y bajada prohibicin de quitrselas), ha transformado los
de la frente y cierre de las clavculas en una denegacin mordiscos en succin dulce de la piel que antes
al "desarrollo de si" (cerrarse de hombros). La alternaba con laceraciones improvisas. Ya no se
desesperada obstinacin no es solo una metfora que muerde ms y acepta botar lejos de si las mangas,
vive en el cuerpo, es ms bien la razn misma para A. vuelve al reparto sin ponrselas. No obstante la
de la prdida de la vista por repetidos golpes contra la imposibilidad de echarse boca arriba, logra echarse de
mesa, relacionadas probablemente con la imposibilidad un costado con la cabeza apoyada al brazo derecho
de resignarse a la institucionalizacin, como prdida de volcado hacia atrs como el izquierdo; esta posicin de
presencias afectivas, costumbres, olores... Para E., que espontnea extensin de todo el cuerpo seala lo
se muerde los brazos atados detrs de la espalda mximo del relajamiento. En estos momentos ideales
durante aos y hoy bloqueados a la altura de los codos ya empieza a rer, desbloqueando el diafragma para
por dos tubos rgidos, ha sido la causa de la despus emitir entonaciones muy quedas, prolongadas
deformacin asimtrica de la columna vertebral, ya que, inicialmente en "U", se transforman en sonidos
descrita. agudos "I". Esto en relacin con la subida de la
corriente energtica, siempre hacia abajo en la posicin
erecta pero doblada hacia adelante y, en este caso en
Es interesante constatar que durante nuestras
cambio en extensin total hacia lo alto. En este estado
sesiones (ms de una hora) una vez librada de las
sea los perfumes naturales de frutas y flores, que la
mangas que al inicio quera, obsesivamente,

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msica meldica, ltimamente le provocan estados de La "protensin-motivacin" se activa buscando, a travs
conmocin, con lgrimas y sonrisas, como en una de estimulaciones plurisensoriales, el gradiente
reactivacin emotiva de memorias sinestsicamente especfico de la Persona. Segn las fases de un
despertadas. El cuerpo, al inicio de las sesiones, recorrido metodolgico, en casos con actitudes
refractario y casi impermeable a las propuestas regresivas cono los presentes, las estimulaciones
sensoriales ya est en escucha activa, con un tono iniciales son tctiles-auditivas (teniendo en cuenta el
muscular captante, "reactivo". Esta es la "protensin" primario bao vibracional hemo-tnico-fnico del
que esperbamos, justamente porque aun favorecidas regazo). Las materias son el agua, sea percibida en
por las ocasiones externas, no puede ser inducida. En sonidos amniticos que por inmersin especialmente
la metodologa de la "globalidad de los lenguajes", la de las manos. En ambos casos ha habido una
MANO, la BOCA, la MENTE, para la reflejologa espontnea catadura olfativo-oral. El enviscamiento en
psicofsica necesitan de estos mismos pasajes: la pedipulacin aumenta el estado de atencin-
responsabilidad en el deslizamiento: pies como lenguas
- protensin (motivacin-deseo)
del cuerpo, prueban, gustan la materia que poco a poco
- toma de la realidad (mordente)
se la vuelve ms densa con arena, arroz reventado...
- transformacin (creatividad)

- asimilacin (conocimiento)
El acompaamiento onomatopyico con extensin en la
voz y en los instrumentos de los sonidos "lquidos,
speros, viscosos, granulares..." requiere una

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"improvisacin", adherente a los cambios sensoriales y "reconocimiento por olores y sabores (por ejemplo de la
a las respuestas tnicas. La capacidad del msico es la mandarina, del limn ... ). Pareca casi imposible al inicio
de estar en continua bsqueda y experimentacin con pues, se asuman vorazmente tambin las cscaras,
una simultaneidad asociativa de timbres ms tarde nominando musicalmente las diferencias
sinestsicamente escogidos. Es cantar y/o tocar gustativas se ha logrado un atento discernimiento.
hemotnicamente en simbiosis con el sujeto que vive Tonofonicosimblicamente, estas diferencias eran casi
msicas de espuma, de aire, de agua de seda rozante... chupadas, cortadas, deglutidas en la pronunciacin:
a flor de piel. La globalidad de los lenguajes mira a la DOLLLCCE se debe pronunciar evidenciando la accin
transposicin de un lenguaje en el otro, dando al sujeto de los dientes que inciden en "DO", de la lengua
un continuo dilatarse de experiencia asociativa- implicada en "LLLL", mientras la invasin complacida
sensorial, hasta reforzar la memoria y, por gradiente, el del jugo est en la lquida "CCCE". La msica que
eventual "pedido". Para madurar sta es necesario el amplifica la palabra crea una atmsfera envolvente que
"discernimiento", inicialmente ausentes en estos dos compendia todos los sentidos implicados. La variacin
casos, dado el rechazo defensivo total y, el del gusto en limn ACCRRRE, en alcaparra
absorbimiento oral-olfativo de todo (en la pelcula se ve PIICCANNTE, en el diverso DULLCCE de la banana, ha
el indistinguido llevar hacia la boca el arroz, la espuma, llevado a distinguir no solo las cscaras de la pulpa sino
la harina... todo, si no inhibido). Por eso se han tambin a escoger la banana (en el caso de A.)
aumentado a las estimulaciones tctiles-sonoras demostrando de probar, reflexionar, reconocer antes
aquellas olfativas-gustativas, mirando al "saboreo", al con el tacto (como ciega), llegando por ltimo a

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rechazar una cosa buscando otra. La reconquista del ms despus de aos de tcita rabia y canalizada en
PLACER e del derecho perdido del DESEO, de la autolesionismo. Desde los sonidos rechinados entre
SELECCIN, de PREFERENCIA, de PEDIDO, los dientes hasta el volver a emanar la VOZ, como re
posibilidades negadas progresivamente por la emersin de la "PERSONALIDAD".
institucionalizacin hasta la renuncia y a la
"ingurgitacin insensible", han sido reactivadas
metafricamente desde el sentido del gusto hasta el Stefania Guerra Lisi

"gusto de vivir' y con estas tambin las expectativas

buenas, la ESCUCHA del otro, la continuidad en vez de
Pero no era absolutamente tan atrasado como para no
la fractura con el mundo externo, que CONSUENA y se
saber que adems de mi exista otra cosa: el escollo al
ACUERDA con las propias preferencias. En ambos
que me haba colado, se entiende, y tambin el agua
casos todo esto ha permitido una "nueva puesta en
que me alcanzaba con cada oleado, pero tambin otras
juego" de todos los sentidos, restituyendo la capacidad
cosas ms all, vale decir el mundo. El agua era un
de expresarse sonoramente: desde la risa hasta la
medio de informacin creble y exacto: me llevaba
pronunciacin de palabras encontradas de nuevo por
substancias comestibles que yo sorba a travs de toda
parte de A., que canta su "CHAAUUU" saliendo de la
mi superficie, y otras incomibles pero de las que me
habitacin. Tambin E. continua elaborando las
haca una idea de lo que exista alrededor. El sistema
pequeas melodas de su placentera experiencia
era el siguiente-. llegaba una ola, y yo, colado al escollo,
volviendo al reparto con los brazos libres, sin morderse
me levantaba un poquito, pero imperceptiblemente, me

195
bastaba aflojar un poquito la presin y slaff, el agua me
pasaba por debajo llena de substancias, sensaciones y
* Reanimacin: Ri=Re, Anima=Alma, Azione=Accin.
estmulos. Esos estmulos que sabias nunca como
Vale decir Reaccin del Alma.
giraban, a veces cosquillas como para morir de risa,
otras veces escalofros, ardor, prurito, de modo que era
una alternativa continua de diversin y de emociones. 2. LAS MSICAS
Pero no crean que all estaba pasivo, aceptando con la
Durante la sesin se han subseguido muchas y
boca abierta todo lo que venia: despus de algn
diferentes intervenciones del sonoro a travs de
tiempo me haba hecho una experiencia y era veloz en
instrumentos musicales, pero tambin a travs de
analizar que tipo de cosas estaban llegando y a decidir
materiales que de todos modos emiten sonidos.
como tena que comportarme, para aprovechar en el
mejor de los modos o para evitar las consecuencias
ms desagradables. Todo estaba en jugar con la Aqu, quiero describir en especial, cual es mi accin
concentracin, con cada una de las clulas que tena o operativa en sesin, usando el sintetizador. Explico mi
en relajarme en el momento preciso: y poda hacer intervencin como msico, que ha conglobado
selecciones, rechazar, atraer y hasta escupir. diferentes procedimientos.

As supe que existan los otros, el elemento que me 1.- Antes de nada el instrumento: se trata de un
circundaba estaba lleno de sus rastros. sintetizador KORG 01/W FD. que me permita una

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grande cantidad de sonidos ya programados, 3.- Me he dado cuenta del aspecto interpretativo de
ofrecindome al mismo tiempo, tambin la inmediata este entendimiento, un aspecto en parte contrario a mis
manipulacin de los mismos, en el momento operativo, convicciones rogersianas; pero solo en parte, porque
en sesin, a travs de un modulador que est en sX, un en realidad no parta de una msica ma preconstituda
pedal/volumen, un pedal/Hold y otros dispositivos del y pregrabada (como haba hecho en otros contextos:
aparato que no explico. cfr. la descripcin que hago en el Cuaderno n. 14, pag.
48-50, QUADERNO DE MUSICA APPLICATA PCC),
pero actuaba directamente en sesin, a partir de los
2.- Mi intencin, de acuerdo con Stefania Guerra Lisi
acontecimientos sonoros del momento, en actitud de
y los otros operadores, era sobre todo, el de
empata rogersiana, sobre todo de atenta, emptica
engancharme a los sonidos vocales emitidos por las
escucha.
pacientes, imitando, amplificando, dilatando, repitiendo
y elaborndolos, formando una faja armnica
envolvente, que sustituyera casi un "regazo sonoro" en 4.- Parece claro que tena que dejarme llevar por una
el que el paciente se habra podido sentirse a su gusto. creatividad igualmente emptica, teniendo presente
ayudado a expresarse libre y creativamente-. contemporneamente los conceptos basilares de
justamente el revs del "aturdimiento sonoro ambiental" "reflexin", "respuesta dialogante", propuesta invitante",
del reparto. "sonido contenedor" etctera.

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 Es igualmente claro que no he usufructuado de lenguaje verbal y del cdigo lingstico.
ninguna msica preconfeccionada, ni he hecho
citaciones a memoria o interpretado partituras o piezas
de composiciones de autores clebres, ni he elaborado 6.- A propsito de lenguaje pentafnico tengo que

temas conocidos o de todos modos compuestos por mi decir tambin, que me es particularmente congenial,

o por otros para otros contextos. por otra parte, es notoriamente un lenguaje universal
(hace parte del ISO Universal del que habla Benenzon)
y, a mi parecer, es particularmente adopto para
5.- No he excluido "tapetes armnicos", basados "tapetes armnicos" tranquilizantes, envolventes,
sobre todo en el lenguaje pentafnico, en estabilizantes. Cierto, se debe tomar mucha atencin
acompaamiento en momentos de "pasaje" (me atrevo de los parmetros del sonido cuando se expone un
a llamar as momentos que yo considero de no "tapete pentafnico"; por ejemplo una zona toda hacia
especfica actividad sinestsica estimulada por los el agudo o, viceversa toda hacia el grave, toma un valor
operadores), con timbres que he escogido siempre a particular. Para no hablar del aumento de los
partir de los acontecimientos sonoros ambientales del reverberos y de los efectos varios, de la que es
momento, sobre todo vocales de las pacientes. Quiero inmediatamente rica la produccin electrnica.
aadir que, a mi juicio, justamente a travs de los
acontecimientos vocales, las pacientes me revelaban
en buena parte su identidad sonora. La voz, fuerza 7.- He puesto especial atencin en el anticipar y/o

arquetpicas y as revelante del yo, mucho antes del acompaar los acontecimientos motorio-figurativos, los

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masajes las rotaciones guiadas, basndome mucho ejemplo que, una de las estimulaciones sinestsicas
sobre las posibles sinestesias, as como me haban mejores, segn yo, es la realizada con la paciente A.,
sido descritas de antemano por Stefania Guerra Lisi, en con dilogo sonoro voz de la paciente/Sintetizador,
el anlisis de algunos timbres por mi propuestos, "Este mientras que como tapete sonoro hay la reproduccin
es un sonido azul, este es amarillo, es negro; este es grabada del sonido del tero y del latido cardiaco.
quieto, este se mueve, este sube, este baja; este es
amargo, este dulce, este es mar, este es cielo" etc.
10.- Me parece muy importante tambin, hacer notar
como exista una implicacin total y un entendimiento
8.- Considero tambin que aqu se vuelve operacin perfecto de todo el grupo teraputico en la interaccin.
indispensable, porque terpica (dado a esta palabra
sobre todo el significado ligado al verbo griego
"terapeuein"=servir), la que el msico exclusivamente 11.- Quiero tambin aclarar que he usado varios

elitario tiende a despreciar, porque no es una creacin sonidos de percusin, que tena a disposicin en un

bien compuesta, sino ms bien imitacin de la patch del Sintetizador, sobre todo cuando las

naturaleza, imitadora; imitacin de un sonido que ya me pluriestimulaciones motorio-sensoriales eran veloces,

otorga otra fuente y no una creacin artstica. para ofrecer una ayuda sonora que apoyase y
sostuviese estas estimulaciones.

9.- Pasando a algunos particulares puedo decir por

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12.- En algunos momentos en los que las pacientes tambin, y me ha hecho comprender una vez ms, la
me parecan en discreto relax neuro-muscular, he enorme disponibilidad que tiene que haber de parte del
creado algunos "mondos expresivos" tonales meldico- msico que quiere penetrar en estos meandros
armnicos, mayores/menores, sobre todo para la musicoteraputicos.
paciente E., pues me la haban descrito como muy
interesada a este tipo de mundo sonoro.
Giovanni Maria Rossi

13.- Aado que, en el video tambin las partes del

inicio y del final, que no pertenecen a momentos de 3. LOS CASOS Y LA ACTIVIDAD

sesin verdadera y propia, son comentadas con DESARROLLADA EL AMBIENTE EN EL QUE SE

msicas mas recabadas de las tantas sonoridades REALIZA LA TERAPIA

improvisadas durante las sesiones o al inicio o al final La actividad de musicoterapia se realiza en el instituto
de la sesin, a modo de "almohada sonora" tambin psico-mdico-pedaggico que acoge
para los operadores mismos, a veces bastante aproximadamente 100 muchachas portadoras de
"exprimidos" en plena intervencin teraputica. handicap medio-grave.

Como se puede notar la "Globalidad de las En respuesta a los nuevos proyectos inherentes al
estimulaciones decididamente me ha implicado a mi mejoramiento general organizativo, se ha hecho

200
solicitud al Centro Trentino de Musicoterapia a fin de el objeto de promover el bienestar de la persona a
que fuese iniciado un proyecto experimental. A este travs de la reconquista del placer de lo bello en un
propsito el Centro mismo se ha empeado a iniciar recorrido que encierra la estimulacin de todos los
una serle de sesiones con dos muchachas sentidos.
plurihandicapadas graves, con la supervisin de la
profesora Stefania Guerra Lisi.
LA ACTIVIDAD REALIZADA

Las sesiones se desarrollan semanalmente, con la

presencia de dos operadoras del Centro Trentino de Nuestros encuentros se han realizado basndose

Musicoterapia que frecuentan la escuela de Ass, un sobre un esbozo terico y practico que nos proporcion

asesor musical docente en la referida escuela, M. la profesora Stefania Guerra Lisi. En efecto, despus

Giovanni Mara Rossi, un operador video. de un primer momento de programacin "en teora", la
misma profesora en grupo con nosotros se ha ocupado
directamente de los primeros encuentros con las
METODOLOGA REALIZADA Y OBJETIVO muchachas. De esta manera hemos podido establecer
un plan de trabajo que, partiendo de las anteriores
indicaciones desarrollara y se ampliase mediante
Como dijo la Prof. Stefania Guerra Lisi, la metodologa
nuestra actividad, supervisionadas por la misma
realizada es la de "la Globalidad de los lenguajes", con
profesora.

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 familiar.

Sin lugar a dudas, ha sido de notable importancia para

nosotros y para la muchachas, la presencia del asesor
Hechas estas premisas vamos a describir ahora cada
musical, que a travs del uso del sintetizador,
uno de los casos y las variaciones que se han relevado.
transformaba en sonido todos los materiales usados
durante la sesin.
PACIENTE A.

El ambiente que se ha ido creando, resultaba pues

significativo para la experiencia de la muchachas, Nace el 11 de enero de 1958 y es internada en un
normalmente acostumbradas a ambientes rumorosos y Instituto en el 1964.
seguramente menos "envolventes". La diferencia
substancial que hemos notado est en el hecho de que
las muchachas respondan en manera diferente segn La diagnosis habla de hipopsiquismo grave, IQ. muy

la presencia o ausencia de la profesora. Esto porque la bajo, debilidad motriz lenguaje hipoevolucionado,

falta de esta ltima, segn nuestra opinin, el ritmo deambulacin torpe, impedimento motor global.

dado a la sesin era tal vez ms tranquilo y

seguramente nuestro modo de comunicar (uso del
En el 1978, una segunda diagnosis que habla de
dialecto, acentos, cadencias ... ) para ellas era ms
alienacin cerebroptica, Hipotiroidismo, incontinencia,

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hipobulismo; A. viene definida impulsiva, autolesionista, sintetizador. Por lo que concierne a los materiales
priva de lenguaje, solo presencia de gaido sumiso y usados al inicio, el agua no suscitaba ninguna reaccin
continuado y fenmenos insignificantes. Se aade: en ella al igual que el papel y la harina. Tambin el
ciega por amaurosis por catarata. primer contacto con la espuma para barba ha 'do
rechazado excepto cuando se la extenda sobre los
instrumentos musicales.
El primer periodo de la terapia ha sido caracterizado
por carencia de expresin, rigidez en las rotaciones,
rechazo al contacto con los materiales, Cuando se encontraba con los nuevos materiales
comportamientos autoagresivos si era contrariada o tenda a deglutirlos con voracidad (ej.: arroz soplado ... )
tensa. En cambio, se ha demostrado siempre activa en ocupndose muy poco del sonido producido
la exploracin de ambientes y objetos al punto de hacer contemporneamente. Pero S. G. Lisi nos hizo notar
creer que la ceguera no exista o casi. que al contacto con todo nuevo material, A. inspiraba
profundamente desbloqueando el diafragma.

Desde el inicio cualquier instrumento musical que ella

"encontraba", era motivo de inters e inmediatamente Continuando con las sesiones notamos lentamente una
exploraba los sonidos golpendolos fuertemente con la mayor confianza con los materiales propuestos hasta
mano abierta. Por consiguiente tambores, guitarras, llegar al punto de buscar ella misma, algunos como la
sonajas y en las ltimas sesiones tambin el harina blanca con la que frotaba sobre su cuerpo,

203
anteriormente ramos nosotros que la ayudbamos a tranquila y disponible la actividad propuesta.
hacerlo. Por primera vez, despus de este ltimo Justamente en uno de estos encuentros se han
progreso, se alejaba del aula pronunciando un sonoro verificado algunos acontecimientos para nosotros
"Chau!" y nos dejaba a todos llenos de estupor. interesantes:

Durante las siguientes sesiones, ella misma indicaba

los puntos de su cuerpo sobre los que deseaba ser
Mientras A. estaba sobre el tapete Erica ha tocado
estimulada sobre todo usando harina blanca, diciendo
involuntariamente la pierna de la muchacha con los
"a ki", que en nuestro dialecto significa "aqu". Al mismo
cabellos; apenas se dio cuenta A. los ha cogido
tiempo indicaba el punto de su cuerpo con el ndice de
pasndoselos sobre los labios sonriendo. Mientras se
la mano.
levantaba ha tocado casualmente la hebilla hecha a
circulo, que en aquel momento usaba Erica e
inmediatamente ha aparecido interesada por esta
En los ltimos encuentros, la responsable del reparto
novedad, entonces, despus de haber jugado algunos
nos la entregaba con muchas reservas e incredulidad
segundos, la ha apoyado sobre su cabeza con una
con respecto a nuestra intervencin porque la
sonrisa que pareca traducir una cierta satisfaccin.
muchacha estaba muy agitada y presentaba actitudes
Invitada por Mara Chiara a escoger si tener consigo la
autoagresivos muy evidentes (golpeaba la frente contra
hebilla o restituirlas, decidi volver a poner con sus
los muebles y se daba puetes en la cabeza). Durante
propias manos, la hebilla sobre la cabeza de Erica.
el desarrollo de la sesin se demostraba al contrario,
Despus de nuevo con aire de satisfaccin se dej

204
llevar por un aplauso.

Despus del primer ao de vida, el pediatra descubre

un retardo psicomotor global y del lenguaje.
Durante la misma sesin notamos que el uso de
Sucesivamente , la nia se somete a varios y es
palabras y onomatopeyas haba aumentado. Decida
hospitalizada por breves periodos en diversas clnicas.
claramente que cosa deseaba dicindolo a travs de un
"dame! dai!". Ademas gritaba todava "ki (aqu)" e
indicaba el botn de la manca para hacrselo abotonar.
Despus de la ultima hospitalizacin (1980) la
diagnosis es la siguiente: Turbas psicticas de la
conducta en sujeto microcfalo.
Al contacto con las naranjas (gusto) lograba por si sola
a pelarlas con mucho cuidado y despus de algunas
pruebas, sabia escoger si comer la cscara o la pulpa.
Por algunos meses E. ha frecuentado normalmente la
guardera aun sin manifestar inters alguno por el
ambiente y las personas. Ms tarde ha sufrido de
PACIENTE E
insomnio y ha tenido crisis prolongadas de llanto, sobre
todo cuando la contrariaban, tales como para pedir la
Nace el 8 de abril de 1976, 20 das despus del hospitalizacin. En noviembre de 1980 es
trmino, por parto entocico y gravidez normal. institucionalizada e introducida al interno de un reparto
muy numeroso (20 personas ms o menos, con

205
portadora de handicap medio-graves y de edad contrario han inducido a manifestaciones
notablemente superior a la suya. La nia es por lo tanto autolesionistas notables, que parecen ser debidas a
particularmente engreda por las compaeras y las sufrimiento fsico.
responsables. Por lo que concierne la alimentacin por
A pedido de los responsables es entonces llevada a un
ejemplo, a ella le son reservados privilegios,
reparto para sujetos mucho ms graves pero de edad
sustituyendo a menudo la comida de medio da,
inferior a los anteriores.
rechazado por ella, con golosinas procedentes de la
mesas de las responsables del reparto (bananas,
tortillas y sobre lodo chocolate). La auto agresividad hasta ahora relevada, encuentra
limite en una serie de medios coercitivos-. desde los
puos que atan las manos delante al busto a aquellos
No obstante todo, E, ha evidenciado desde el inicio
que los atan detrs. Este ultimo remedio compromete
sntomas de inadaptacin que se presentan luego
notablemente el desarrollo correcto de la columna
como comportamientos autoagresivos en actividades
vertebral, llevando a una torsin de los cuerpos
estimuladoras a veces excesivas, sobre todo
vertebrales.
arrancndose los cabello hasta quedar en algunos
puntos calva.
Como ultimo "remedio" fueron confeccionadas mangas
de yeso y cartn con los cuales se bloqueaba la
Con el pasar del tiempo la crisis no se han atenuado, al
articulacin del codo y por lo tanto E. se hallaba en la

206
imposibilidad de llevar manos y antebrazos a la boca. actuaba en manera mayor la estimulacin visiva.
Con la intervencin de las maestras de la "Escuola Aquello que ha facilitado la relacin con la muchacha ha
Elementare Speciale" las mangas de yeso son sido una intuicin de la operadora Mara Chiara que ha
sustituidas con otra de cartn y tela adhesiva que, por notado en E. una preferencia por los sonidos agudos y
un ao, bajo el control directo de las maestras se van as las primeras estimulaciones con agua y uso de
reduciendo de 30 cm. a 6 cm. de largo. masajes rotatorios eran acogidos sin ansia excesiva.

Pero las vacaciones veraniegas han llevado de nuevo Al inicio las estimulaciones con harina y espuma para
la situacin a la anterior medida. barba no han provocado en ella (aparentemente)
ningn tipo de reaccin, pero el aumento de arroz
En los primeros encuentros de musicoterapia, E.
soplado ha suscitado grande sorpresa acompaada
manifestaba el mismo comportamiento relevado en
por un desbloqueo del diafragma. Desde este
otras situaciones educativas: alcanzar la puerta y
momento, la situacin ha ido mejorando siempre, hasta
abandonar inmediatamente la habitacin. Por
buscar una especie de contacto continuo, sea visivo
consiguiente era imposible proponerle que se siente,
que corpreo con las dos operadoras. E. empezaba
tanto meno echarse sobre el colchn. Su actitud era
luego a aceptar de quedarse echada sobre el colchn
aquella de rechazar todo lo que se le propona. El
(a causa del handicap fsico que no le permita
recorrido efectuado calca casi exactamente el de A. con
quedarse sentada) y durante los ltimos encuentros se
la diferencia que en E. en los ltimos encuentros se
dejaba llevar a rodaduras que la llevaban fuera del

207
colchn mismo pero a un mayor contacto con los propio "grupo familia" sin pedir de nuevo los tubos.
materiales puestos en el piso (papeles, pasta, arroz,
harina amarilla ... ). Todo esto estaba siempre
acompaado con una meloda producida por el En el caso de la penltima sesin E. se ha demostrado

sintetizador. segn nuestro parecer, particularmente disponible a

nuestras estimulaciones. Esto lo hemos relevado a
travs de una actitud de abertura jams encontrada
Desde el inicio de la terapia hemos preferido quitar los antes: cada contacto con los materiales propuestos
"tubos" de los brazos de E. que pero se opona con provocaba en ella sonoras risas y por consecuencia
fuerza y no obstante la dificultad fsica si doblaba, desbloqueos del diafragma.
recoga y se volva a poner los instrumentos
contenedores. Despus de ms o menos un mes,
notamos un cambio: E. no buscaba ms los tubos Por ejemplo, mientras se la ayudaba a lavarse las

quitados, realizaba la actividad propuesta sin sealar a manos, el ruido del agua, el salpicar de la misma sobre

actitudes autoagresivas o sino acercaba los brazos la cara en el momento en el que se agachaba para

pero bloqueaba inmediatamente la agresividad y se tomar y el consiguiente sonido, han producido una

limitaba a chupar. carcajada tal que ha contagiado a todos nosotros.

Durante este periodo iba acompaada hasta el Adems hemos relevado el aumento del contacto visivo

208
y corpreo especialmente con Erica. En efecto durante Erica Martinelli
todo el trabajo buscaba con ella el contacto continuo
con una mano mientras la otra manipulaba los
diferentes materiales. BIBLIOGRAFIA

1 - R. BARTHES, "Leon", Gallimard, Parigi 1980

A este propsito surge una pregunta: Esta forma de 2 - J. BLACKING, "Come musicale l'uomo", Ricordi-

contacto fsico sustituye para E. el contenedor dado por Unicopll, Milano 1987

los tubos?. 3 - J. BLACKING, "Formae Mutis", Feltrinelli 1983

4 - P. BORELLI, "L'importanza della funzione uditiva

Para concluir, podemos afirmar que el inters y la nello sviluppo psico-affettivo" de Energa, Caracter,

participacin de la muchacha en las actividades Sociedad n 2 - 1983

propuestas ha tenido sin duda una incrementacin 5 - J. CAGE, "Silenzio", Feltrinelli, Miln 1971
siempre mayor relevado sobre todo en la expresin
6 - G.CERONETTI "Il silenzio del corpo"", Adelphi, Miln
satisfecha, en el relajamiento general y en la
1979
interaccin con nosotros.
7 - A. DANIELOU "Musica, metodo di reintegrazione",
Astrolabio, Roma 1974
Mara Chiara Bolner
8 - F. FORNARI, "Psicoanalisi della musica", Longanesi,

209
Miln 1984 - "?Ri-Uscire! ", Borla Roma 1990

9 - P. GARDEY, "Audiopsicofonologia" en Ciencias 83 - "Il racconto del Corpo", Borla, Roma 1992

10- S. GUERRA LISI (Varias contribuciones) - "Continuit 1 ", Borla, Roma 1993

- BRUTTI-SCOTTI Quaderni di "Psicoterapia - "Continuit 2", Borla, Roma 1992

Infantile" (Autismo i Psicosis) n 7-12, ""ll viaggio
- "Integrazione Interdiscipinare", Ed. II Pensiero
dellEroe", Borla Roma
Scientifico, Roma 1983
- "MusicArtherapy": Musicoterapia l, Minerva Musica,
- "Comunicazione ed Espresione nella globalit
Roma 1989
dei linguaggi", Ed. Il Ventaglio, Roma 1981
Musicoterapia 2, Minerva Musica, Roma 1989
12- P.H. MUSSEU-J. CONGER-J. KAGAN, "Lo sviluppo
Musicoterapia 3, Minerva Musica, Roma 1990 del bambino e la personalit", Zanichelli, Bologna 1983

-Quaderni di Musica applicata n 10-11-12-13-14, 13 - G. M. ROSSI, "L'improvvisazione" en "Musica e

Pro Civitate Christiana, Ass Assemblea", Pucciniana, Brescia 1983

11- S. GUERRA LISI (Textos) 14 - G. M. ROSSI, Contributi in "Quademi di Musica

Appllicata", n 12-14, PCC Ass
- "Il metodo della globalit dei linguaggi" Borla,
Roma 1986 15 - N. RUWEL, "Linguaggio, musica", Einaudi 1913

- "Come non spezzare il filo", Borla, Roma 1988 16 - G. STEFANI-F. FERRARI "La psicologia della

210
musica in Europa e in Italia", Clueb, Bologna 1985 but has asked me to read out what she has written. Pixie
started working with Thomas six years ago. Thomas
17 - A.A. TOMATIS, "La nuit uterine", Stock, Paris 1981
was then 21/2 years old and newly diagnosed as
18 - T. VERNY-J.KELLY, "Visa segreta prima della
suffering from cerebral palsy, severe epilepsy and
nascita", Mondadori, Miln 1981
autism.
19-PLATONE, "Carmide" obras completas; Laterza BA
71
When Pixie first met Thomas he was propped up in an
armchair at home. At that time he was unable to sit up,
reach out or make himself understood in any way
T H O M A S `S M U S I C
except through the most negative means.
P IXIE H OLLAND Y S ARAH H ALL

These were: He appeared to induce severe fits at times

(GOOD AFTERNOON) of stress, particularly at weekends when family life was
hectic with his three brothers at home.

I would like to introduce you to Thomas (SHOW

PHOTOGRAPH) through myself his mother. And he repeatedly kicked out his right leg in response to
Unfortunately Pixie Holland is unable to be here today intrusive confrontation.

211
 musical ones to be played again.

Pixie told me that she soon realised that Thomas was

different from her previous experience. When they first
After the test all hell broke loose with the inevitable
met he looked frail, stressed and guarded. He did not
medical intervention, tests, injections, examinations,
seem like a child of 2 1/2 but like a cunning wise old
worried faces and miserable parents.
man. She had worked with autism and profound mental
handicap but had not experienced multiple disabilities in
one child. Were the problems cognitive, physical or the His initial response to all this was an unnerving calm.
effects of epilepsy? It is now perhaps worth recounting a Autism was ruled out in spite of our confident diagnosis
brief history of Thomas's life as our experiences in early (based on close observations of a friend's child).
childhood rebound on us all our lives. From the start the
doctors were more baffled than us. At his Caesarean
birth Thomas seemed the perfect baby but after I had At eleven months old, during a severe bout of 'flu he had

insisted on the 6 month development test being done a lengthy febrile fit, his first. He was rushed to hospital

again, they at last realised something was wrong. with suspected meningitis and had a night of total

Before that his mental development was in advance of horror, rectal valium to bring him out of the fit and too

his age but he failed to improve physically. He had the high a dose of oxygen, giving him partial paralysis down

full range of baby babble but his smiles were directed his left side. More needles, more terror, culminating in a

not at people but at his toys, moving his arms for the monstrous scene with him being held upside-down to

212
draw blood from his neck. At that moment I, too, up like a balloon, giving him severe pain in his joints. We
withdrew into an autistic-like state,it was the only way to were long past crying, we just existed from day to day.
cope. Reading Hospital then admitted defeat, and after But, to everyone's surprise, he didn't die, in fact he
giving him a brain scan, sent it and us to Great Ormond started to improve.
Street to see a neurologist. The scan showed an under-
developed brain, an inconclusive diagnosis as Oxbridge
graduates can show similar brain patterns. Later we Realising we were entirely on our own, we researched

were asked to return to Great Ormond Street to meet autism and sought out an expert. Dr. Ricks diagnosed

the neurologist's colleagues. It was like a biblical scene, him as suffering from early onset of autism. Meeting him

us clutching Thomas to our bosoms with 40 or so when Thomas was 18 months old saved him from being

"elders" of the medical profession firing questions at us. categorised as suffering primarily from cerebral palsy.

Afterwards we were signed off with a vague "Take him Many such children languish in institutions entirely cut

home and look after him". So, several months later, we off from the special needs of these frail spirits.

were in hospital with a tragic shell of a baby. He was

unable to eat, communicate in any way, with severe
We were now left with an entirely unresponsive and
bronchitis and a fit every 10 minutes, day and night. We
floppy child. However, with a structured life at home and
felt that his small life had no joy or meaning for him and
a great deal of cossetting the fits began to decrease, but
decided to take him home to die in peace and dignity.
he had forgotten how to smile, lift his head or initiate
We withdrew all drugs, which by now were blowing him
movement at all. His baby babble was all gone and he

213
was mute. So we decided to start Thomas's life from the I tried to reach his world through sound and build a safe
beginning, establishing contact with a gentle version of connection in order to let communication occur.
the Holding Method and giving up all drugs as we find Gradually I was able to experience how he was feeling.
that even the simplest formulae act bizarrely on autistic In my singing I was able to mirror back to him his
people. Then Music Therapy was offered to Thomas as sadness, anxiety, contrariness or humour. Things did
part of a study group organised by Tim Williams, the not happen quickly. There were weeks when nothing
psychologist with the Reading Services for Autism team. happened at all and there were weeks when we had
miracles.

I would like now to read Pixie's words to you.

In the early stages when I was intrusive with sound he
kicked out his right leg. Immediately, I placed a drum at
PIXIE
his foot. When the drum sounded he stopped kicking.
His body language and attitude said "how dare you!
That was not my intention". As I became more intrusive
I played it by ear. We started working on the floor,
he kicked out again. I replaced the drum at his foot, the
Thomas propped against Sarah, I sat opposite. He did
drum sounded and he immediately stopped kicking. We
not reach out, hold anything or look at me.
had our very first connection and communication.

214
In the short time we have today I can only give you That in itself is a miracle as, at that age, it was the only
glimpses of some of these miracles. time he could sit up on his own.

I remember: Thomas lying on the bed desperately pale and ill, the
pain vibrating on the surface of his skin, watching the life
flow back into his body, the colour to his face as I played
Thomas's fingers hovering tentatively over the piano
and sang.
keys and the very first, barely audible sounds he made.

A video session. With tremendous effort to himself,

Later, glissandos with his elbow.
reaching out to me in the sound, placing his fragile hand
on top of mine whilst I played, holding my fingers,
leaning his whole body onto my lap and then the red,
Incredible chords played with wrist and thumb.
tear-stained faces of the three adults present.

His depth of musical understanding.

18 months ago, the day I buried by beloved dog, Ben,
just five minutes before Thomas arrived at my home for
Sitting bolt upright on a chair beside me at the piano. a session, Thomas took control. The only time he has

215
ever played continually for over an hour. I accompanied intrusive than his had. You will see him draw closer to
him, silently crying. We had exchanged roles. He was Pixie, absorbing himself into her music. You might also
my therapist. He understood how I felt and he was there see his fingers holding just above the keys as if playing
for me, he was my friend. silet music because the keys have elctriced.

SHOW VIDEO

I would like to show you a very short excerpt from one of

the videoed sessions. The scene is this:
Even though Pixie, the instruments and the situation
were utterly unfamiliar to Thomas he did not withdraw
from the reality of the situation. He used displacement
Pixie and Thomas are seated side by side at the piano.
activities to protect himself at first, rocking to and fro and
Thomas on lap of helper to give extra height for him to
waving his head about. Though at that time the fits
use his hands freely. I am seated off-camera.
seemed to be an implacable foe, he has never
succumbed to a fit during a therapy session or when
You will see that Thomas is using great physical effort to listening to music at home of at school. If he feels a fit
be in contact with the piano, making deliberate approaching he displaces it with violent leg movements
movements forward with his whole body as he feels (literally "kicking the habit"). After moving to the piano
unable to stretch out his arms, often turning sideways during the early sessions I felt for the first time his
on to use his elbow to play, which of course is less involvement in an activity that pleased and interested

216
him and in which he could interact with Pixie of his own is clear to me that the Music Therapy has not only been
free will. Even though in most of the sessions he an exercise in musical appreciation but a blueprint for
appears to be an observer and listener, it is as if he Thomas's life in other spheres. For the first 8 years of
were monitoring the shape of the harmony though not his life, I have been constantly by his side, protecting
actually participating so that when he did play it was a and encouraging him towards independence. By using
continuation of the same melody not an interjection. the same strategies as in the music sessions, that of
gently withdrawing, first with him on my lap, then in the
same room and now short period on his own with a
Thomas`s particular form of autism freezes
person he trusts, I am secure in the knowledge that he
spontaneous movement. He becomes hypo-active as
can cope on his own, not by using stereotopic activities
opposed to the majority of children with autism who
but using his hands and his listening ear for his own
become hyper-active under stress, the dark and light
entertainment.
sides of the same moon if you like. Pixie's music
overcomes this blanketing of movement and emotion so
Thomas can bypass the strictures ot his autism and I would now like to return to Pixie's word.
express himself freely on the piano. The friendships that
we take so much for granted are not lightly won
between ourselves and people with autism, but Pixie I consider the experience of working with Thomas to be

and Thomas are true friends with a common interest, a one of the most profound in my life. In connecting to his

partnership not based on compassion, pity or avarice. It innermost depths I am able to reach my own.

217
Most of us live in two realities, the outer one I One morning last week I awoke with these words:
experience as I write and my inner self, that is in
tandem. The inner reality is a spiritual world which is
difficult to enter from the outer world, our normal ln the music

everyday place of communication. For whatever reason My soul can reach yours and enfold it in mine own,
Thomas has been unable in the past to build an outer
I can hold it, caress it, cradle it
reality, and therefore dwells in his innermost self. The
music acts as a bridge for me to enter into his inner And in that cradling I can

world. In music, many subtle communications are not Receive your pain
held in consciousness. I believe that my work lies in the
And hold it
place where the unconscious converges with the
conscious. The area that Jung describes as the alchemy And it will change.

taking place. The music allowing the form of feelings The fabrications of the
and words to separate the conscious mind from the
Melody and Harmony
unconscious. The struture of the music forming the
framework to contain the emotions and so bring them Weaves the warp and weft of
out into consciousness. A wicker cradle

218
A container allow me to communicate with him at the deepest levels,
I will be highly intrusive encouraging him to hold my
In which to hold the pain.
gaze. At first it puzzled me as I expected to see in his
eyes a very frightened little boy. Instead I saw a grave,
When I confront Thomas he has no escape, nowhere to grey-eyed look that went to my very depths, a
go. He is unable to interrupt me, push me away, speak communication like none other.
or remove himself. I imagine this must be very painful
for him. All he can ever do is just "Be". My learning from
One part of me wonders whether I have the right to
Thomas is how to just "Be".
intrude, demand from this innermost self.

There are no words for the sounds and silences

My own view is necessarily subjective and I am unable
Thomas and I create in our music together. Perhaps his
to prove anything. How can I possiblv understand the
very silence only shows me the importance of all my
gargantuan effort Thomas has to make to release his
sounds.
many layers of defence, one by one, to allow me access
to his wonderful spirit, his cheeky side, his sad side and
I am clear that through music we are in communication his gravity? He, too, will have experienced these sides
at all times throughout our sessions, on the rare of himself, perhaps for the very first time.
occasions when I sense Thomas trusts me enough tO

219
 reached. In the meantime we must use our creativity to
find a different language, new words to convey the
I believe the music has added another dimension to
profundity of the experience of music therapy.
Thomas's life and that he has been able to
communicate in his own way. Within the music I have
sensed his emotional feelings, enabling me to
SARAH
experience and express them in sound, thus allowing
him more conscious access to them.
The future I faced seven years ago with such dread now
looks so bright. The milestones of childhood that
As music therapists we can go on researching and
seemed important then have faded into insignificance
scientifically trying to prove the effects of music therapy
now we have realised the importance of communication
with our clients but perhaps we need to turn the focus
and trust between us. Our other children can use
towards ourselves the therapists. Maybe the power
spoken words and gestures to convey information and
underlying our communications is in the unconscious of
now Thomas too has abandoned many of his negative
both client and therapist, I suggest that we should look
attempts to make himself understood and uses music
deeply into ourselves as people and draw into our own
and facilitated communication instead. Through these
consciousness words from our inner selves, words to
means we have discovered Thomas to be a wise,
describe the possible communion reached between
watchful and ironwilled child, keen to learn and well
client and self. It is only then that understanding is
worth getting to know. He has the interests and

220
knowledge of most 8-year olds and wishes to be treated foremost with their disabilities coming a very poor
as such. One of the first sentences another child with second. Perhaps you could consider that the protective
autism wrote with the aid of facilitated communication and over anxious parent may be so because of the giant
was "Thank God for no more squeaky voices". put-down-of-ignorant-parent conspiracy lurking within
many professionals and above all remember that if you
enjoy your work the chances are that your clients will as
I suspect we have all been guilty of talking down to non-
well.
verbal people. The "does

he take sugar?" syndrome is even more rife today now

I know for certain that without the first unlocking of that
that people with handicaps are out in the community.
citadel gate guarding Thomas inner world that he would
Inability to construct audible words is frequently caused
still be locked fast within that bleak wilderness that
by a motor disability and is not indicative of a person's
autism can create. Without Pixie and her music he
ability to think intelligently, or understand speech.
would be the lost boy he once was.

Pixie is so right in what she says, we must be clear

about our own motives before implanting our ideas on
others and have as much respect for those with a
mental handicap as we would have for an elder in our
chosen profession, seeing clients as people first and

221
 M U SI C , AN XI ET Y AN D T H E M EN T AL L Y music effects G.S.R., heart rate and respiratory rate.
H AN D I C APPED - A R EVI EW This evidence has in turn resulted in a variety of clinical
projects examining the impact of music on various
J EFF H OOPER
aspects of client behaviour (Stevensll, Reiberl2,
Reardon and Belll3, Mossl4 and Zimmerman, Pierson
There is evidence to suggest that the prevelance of and Markerl5). A wealth of work has been undertaken
anxiety among adults with a mental handicap is greater among the non-handicapped population into the use of
than that in the general population (Novosel1). This music in stress reduction, however a comparatively
anxiety is found particularily in the form of phobic small body of research has investigated the effect of
reactions (Corbett2, Ballinger and Reid3) or as relaxing music on the anxiety of the mentally
manifested by behaviour disturbance. The behavioural handicapped.
treatment of that anxiety appears largely to centre on Relaxation techniques often require the subjects to
the use of relaxation training, either as a treatment in its watch and imitate. The demand this places on
4 5
own right (Lindsay and Baty ) or in conjunction with concentration and attention may prove too great for
6
systematic desensitisation (Guralnick ). many mentally handicapped people and so exclude
Since the late nineteenth century researchers have them from treatment.
studied physiological responses to musical stimuli Could relaxing music offer a viable alternative?
7, 8
(Gilliland and Moore Zimny and Weidenfeller , Ellis and Certainly Stoudenmire16 has shown that music is as
Brighouse9 and Shatin10). They have established that successful as relaxation training among the non-

222
handicapped. His subjects were 108 undergraduate Subject B: 5 control sessions
female students.
5 treatment sessions (recorded music)
In a pilot study (Hooper and Lindsay17 ) I investigated
Subject C: 10 treatment sessions ('live' music)
the effect of music on the anxiety of four mentally
Subject D: 5 control sessions
handicapped women with moderate and mild mental
handicap. 5 treatment sessions ('live' music)

Recorded music (a specially choosen selection of Pulse rate was recorded at baseline and before and
Baroque music) and 'live' music (quiet singing to guitar after each session as a physiological measure of
accompaniment) were compared with a control anxiety.
condition (tea drinking).
There was a three minute resting period before the pre-
The subjects listened to relaxing music. Two of the treatment pulse rate was taken. A second measure of
subjects listened to recorded music, the other two anxiety, a behavioural rating scale, placed the
subjects listened to 'live' music. They were introduced to emphasis on observation of the subject rather than on
no relaxation techniques. Each subject was randomly self-report. Due to the degree of mental handicap it was
allocated to one of four different treatment schedules. impractical to use self-report measures - the subjects

Subject A: 10 treatment sessions (recorded music) would have encountered difficulty in comprehension
and in answering.

223
Each subject was rated at baseline and before and after the pre and post-treatment behavioural and pulse rate
treatment from a two minute video. The ratings were scores. The cumulative scores obtained for subjects B &
carried out by raters unaware of the nature of the D five treatment sessions were doubled in order to allow
research study. for a direct comparison with subjects A & C's ten
treatment sessions.
The ratings involved the observation of nine body parts
and an assessment of how relaxed each one appeared. The eight minus scores confirm the positive effect of
The ratings were carried out on a five point scale from music on each subject's pulse rate and behavioural
completely relaxed (O) to very anxious (4), and they rating, and suggest that in either form - 'live' or
were added together to provide a behavioural rating recorded, relaxing music could be used with the
score. mentally handicapped to reduce anxiety.

While we will be looking in more detail at one particular (Figure 2) A second bar chart compares the treatment
subject, the demands of time preclude a detailed effectiveness of the relaxing music with the control
discussion of each individual's response. However, the condition. It shows the difference between the pulse
following two bar charts illustrate the impact of relaxing rate scores recorded before and after each session.
music. The differences were added together to give the
cumulative pulse rate score shown for each subject.
(Figure 1) The first bar chart shows the cumulative
The cumulative behavioural scores were obtained in a
pulse rate and behavioural score for each subject. The
similar manner. The bar chart indicates that, in
cumulative score is the total of the differences between
comparison with the control condition, both music

224
conditions had a more significant effect on anxiety. It eight-minute treatment sessions listening to my own
also suggests that there was little difference in the singing accompanied by guitar. She responded
treatment effect between 'live' and recorded music. positively to (Figure 3) treatment. The effect of
treatment on her pulse rate varied for the first five
It appeared that, as with the non-handicapped
sessions. She seemed to need this time to come to
population, music could be used with the mentally
terms with the individual attention. However in the last
handicapped as an alternative to other relaxation
five sessions her pulse rate was consistently lower
techniques.
(Figure 4) after treatment. Sarah's behavioural rating
And so, now we move on to consider one of the subjects
decreased
in more detail.
significantly on all but one occasion, and there was a
Sarah, had a mental handicap coupled with a history of
trend towards an increasing degree of relaxation
hysterical and psychotic behaviour. She was extremely
following treatment.
anxious and frequently became aggressive. She was
A closer examination of her case notes indicated some
unable to sit in one place for any length of time and
degree of generalisation, and suggested that there was
constantly clenched and unclenched her fists. Auditory
evidence to support the long term effect of listening to
hallucinations caused her to scream, bang her head
relaxing music (Hooper and Lindsay18). An entry
and beat her fists against the wall.
described how, on the evening after the ninth treatment
Sarah was choosen as a subject for the pilot study. As session, she became anxious after being taken to bed.
Subject C she was randomly allocated to spend ten Soft music was played on a tape recorder and she fell

225
asleep. tearful, and screamed abuse, pulled other resident's
hair and tore clothing. These behaviours were the
The treatment took place at a time when Sarah's
manifestations of her extreme anxiety.
behaviour was particularily disturbed. Her case notes
included a number of entries which described agitated The subject was regularily involved in recreational
behaviour. These were possibly related to pre- musical activities. She either met with me on the ward
menstrual tension and menstruation, as her period after breakfast for a 'sing-song', or she played untuned
occurred half-way through the treatment period. It was percussion instruments with friends in a session
important therefore to offer her the opportunity to relax, directed by me from the piano. This may seem rather
and listening to music would appear to have too summary a description of treatment. The activities
encouraged this experience. It was noted by staff that had a superficiality which precludes any detailed
she was prepared to sit still for short spells, and on therapeutic analysis, and my concern lay primarily with
occasions she was "quite chatty". Both behaviours evaluating the long-term effect of the treatment on the
indicated that she had become less anxious. subject's anxiety.

In a further study (Hooper, Lindsay, Richardson19) I

carried out a more detailed examination of the long term
The ward staff kept a daily record of the incidence of
effect of music on anxiety. I measured the impact of
inappropriate behaviour. They monitored each incident
recreational musical activities on a mildly mentally
irrespective of the degree of the behaviour displayed
handicapped woman who was displaying a range of
and they did so without the subject's knowledge. The
inappropriate behaviours. She was hyperactive and

226
subject's behaviour was recorded in this way at treatment brought about an immediate drop to an
baseline, for one week, and throughout a nine week average level of 0.24 daily incidents for the final three
treatment period. weeks - the lowest recorded level during the entire
treatment period.

The treatment period was divided equally into a

treatment phase, reversal phase (a return to baseline The results suggest that the subject responded very
conditions), and a further treatment phase. (Figure 5) favourably to treatment. Involvement in music sessions
The graph charts the total number of episodes of brought about an immediate reduction in inappropriate
inappropriate behaviour which occurred each week. It behaviours after both the baseline and reversal
shows a high incidence of inappropriate behaviour at conditions.
baseline - a rate of 2.43 incidents per day. With the
introduction of music therapy there was an immediate
drop to a daily rate of 0.71, followed by a further drop to It would also appear that the treatment effect was

0.29 when the behaviours were all but extinguished. lasting.

The third week of treatment saw a slight increase to a It was not until the second week of the reversal phase
daily rate of 0.43 incidents. During the reversal phase that the inappropriate behaviours returned to the
the rate of inappropriate behaviours after remaining baseline level. Significant changes were also brought
stable for one week returned to a level close to the rate about by the removal and reintroduction of the music
monitored at baseline. However, the reintroduction of treatment. There was an increase in inappropriate

227
behaviours during the second and third weeks of the therapeutic relationship had the most significant effect
reversal phase followed by an immediate drop in on her anxiety Compare the lack of treatment effect
inappropriate behaviours at the start of the second during the control sessions with the decreases in pulse
treatment phase. The subject particularily enjoys a rate and behavioural (Figure 6) rating once treatment
family visit, a shopping trip and evenings spent dancing. began. (Figure7) It is perhaps all too easy, as music
If one of these factors had been influencing her therapists, to overlook the potential for change which
behaviour, the level of inappropriate behaviour would exists in musical activities that do not call on specialised
have remained unchanged by the reversal and second improvisation skills. However, if we believe that our role
treatment phases. and the role of music as a therapy is to enhance and
improve quality of life, and if we acknowledge that a
These results may show the effect of music sessions on
musical activity becomes therapy when it can be shown
the subject's behaviour, but they do not make clear
to have a significant and positive impact on an
whether the music or the developing relationship was
individual's quality of life, the results of both studies
effecting the change. Would time spent each day just
confirm the value to us, as music therapists, of both the
chatting with me have produced the same pattern of
relaxing and recreational uses of music in reducing
response?
anxiety.
The results of subject D, whose schedule was the only
one involving a direct comparison between a musical
and non-musical therapeutic relationship, suggest that REFERENCES:
this would not have been the case. A musical

228
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1970; 75(2): 156-159. British Music Therapy 1991; 5(2): 10-13.

14 Moss V A. Music and the surgical patient - the effect

of music on anxiety. AORN Journal 1988; 48(1): 64-69.
Q U N E C E S I T A E L P A C I E N T E D E M I
15 Zimmerman L M, Pierson M A, Marker J. Effects of
I N ST I T U C I N ?
music on patient anxiety in coronary care units. Heart
and Lung 1988; 17(5): 560-566. S ILVIA B EATRIZ J ENSEN

16 Stoudenmire J. A comparison of muscle relaxation

training and music in the reduction of state and trait Todo es posible,
anxiety. Journal of Clinical P R l(',-y 1975; 31(3): 490-
...lo imposible lleva slo Un poco ms de tiempo.
492.

17 Hooper J, Lindsay B. Music and the mentally

handicapped: the effect of music on anxiety. Journal of Dinamarca considera al discapacitado como un
British Music Therapy 1990; 4(2): 19-26. individuo ms dentro de la sociedad, con sus

230
posibilidades, dificultades, deberes y derechos " y con mismos derechos bsicos que los dems ciudadanos
el respeto que se le merece, simplemente por ser del mismo pas y la misma edad. "
persona.
El discapacitado psquico tiene derecho a vivir junto con
Un poco de historia... su familia o su familia sustituta. Tiene derecho a
participar en todos los aspectos de la vida de la
En 1959 se hizo la primera reforma en la ley para los
comunidad, incluyendo actividades de tiempo libre. Si
discapacitados mentales, psquicos y fsicos,
necesita ayuda y apoyo de la institucin a la que
cualquiera sea su grado de discapacidad. El objetivo
pertenece, la misma debe efectuarse en un ambiente y
era considerar al discapacitado como un ciudadano
bajo circunstancias tan cerca de lo normal como sea
ms, con las mismas posibilidades, deberes y derechos
posible. "
que los dems. Entre otros, derecho a una vivienda
decente, independientemente del grado de
discapacidad. La meta era darle al discapacitado la
-"El discapacitado psquico tiene derecho a tener
posibilidad de un entorno en el que pueda
seguridad econmica y un adecuado nivel de vida.
desenvolverse lo ms independientemente posible.
Tiene derecho a un trabajo productivo o a otra actividad
En 1968 se volvi a ratificar la ley, en la Liga que le de sentido a su vida".
Internacional para discapacitados, bajo la organizacin
de la ONU, (Organizacin de las Naciones Unidas), en
Jerusaln. -"Los discapacitados psquicos tienen los Recin en 1980 empezaron todos estos cambios a ser
posibles. El estado traslado sus obligaciones y

231
responsabilidades, para con las personas con institucin, aislada de la sociedad.
discapacidades mentales, fsicas y en un amplio
Cuando el objetivo comenz a ser que los pacientes
sentido, a los municipios. La municipalidad deba
tuvieran una vida tan normal como fuera posible, se
asegurarse de que hubiera la suficiente cantidad de
decidi que tambin era necesario darles la posibilidad
lugares en hogares, para todos los adultos que
de vivir en casas en diferentes barrios, y vivir como
tuviesen necesidad especial de cuidado y tratamiento,
cualquier otro ciudadano de la sociedad.
si las mismas no podan ser abarcados por hospitales u
hogares comunales. Si pensamos en la importancia del lenguaje y en la elec-
cin de las palabras, vemos tambin el proceso aqu.
El proceso estaba en marcha. La mentalidad danesa
En 1959 el discapacitado era considerado Como un
estaba preparada para hacer algo por los
enfermo, un paciente, En 1960-1970 empez a
discapacitados mentales, fsicos y psquicos. El sistema
utilizarse el trmino cliente, o sea el que paga por
otorgaba una buena base. Todos estaban
recibir un beneficio. Eh 1980 se cre la palabra
positivamente preparados para el cambio y de acuerdo
"beboer". Significa el morador, o sea, la persona que
en que las posibilidades que se le ofrecan a esta.
vive en... En la eleccin misma de la palabra, estamos
personas no eran satisfactorias.
diciendo que la persona es un individuo, que vive en tal
En Nordjylland, Norte de Dinamarca, los pacientes casa y que tiene una familia o grupo de convivencia,
vivan en "Hammer BaKker", una institucin que como cualquier otro miembro de la sociedad. El
albergaba alrededor de 1000 personas con diferentes discapacitado no es un discapacitado, sino una
grados de discapacidad. El lugar funcionaba como una persona, miembro de la sociedad, a quien se lo respeta

232
como individuo, con las posibilidades y dificultades que general.
pueda tener. Por lo tanto lo llamar , en el resto del
A su vez, cada casa dicta sus objetivos a partir de los
trabajo morador.
objetivos de la municipalidad, y teniendo en cuenta las
En la actualidad hay una lnea de unin entre la ley necesidades y posibilidades del grupo de moradores
general que describe los deberes y derechos de los que viven en su casa. Cada persona contacto debe
discapacitados, hasta el mismo morador. desarrollar un programa de evolucin con el morador
que tiene a su cargo, y este programa tiene como
objetivo ayudar al desarrollo del individuo, teniendo en
Ley de derechos para discapacitados psquicos, fsicos cuenta los objetivos de la casa. De esta manera hay
y mentales. correlacin de la ley general al morador y viceversa.

fl (Los trminos nuevos, empleados en el reciente

prrafo, sern explicados a lo largo del trabajo).
Municipalidad

fl
BELTOFTEN
Morador

Beltoften es un hogar que fue construido en 1988, para

Cada municipalidad dicta sus objetivos en cuanto a la
10 personas con dificultades motoras y debilidad
forma de abordaje del morador, a partir de la ley

233
mental severa. Sus edades oscilan entre 30 y 60 aos, y con discapacidades motoras.
se encuentran en diferentes niveles evolutivos. Debido
El lugar cuenta tambin con un colectivo para
al grado de discapacidad de los moradores, se decidlo
discapacitados, que es utilizado tanto por el centro de
edificar en el mismo lugar el centro de actividades,
actividades como por ambas casas. De esta manera
para que pueda ser utilizado por los moradores. De
pueden los moradores ser trasladados a diferentes
esta manera no necesitaran ser trasladados a
lugares, donde se desarrollan actividades, hacer
diferentes centros de actividades, y podran tener ms
paseos o salir de compras.
tranquilidad en su vida diaria.

El objetivo es poder darle al individuo lo que necesita y

esto est contemplado ya desde la construccin del LOS MORADORES

edificio. El lugar est construido en forma de T. En la

parte central se encuentra el centro de actividades, y a
El objetivo en cuanto a los moradores , es que lleguen a
los costados hay 2 casas en las que viven 5 moradores
ser tan independientes como sea posible, y que puedan
en cada una. Cada individuo tiene su pieza. Ellos
sentir que tienen posibilidad de elegir lo que quieran
mismos han participado, en la medida de lo posible, en
hacer o lo que necesiten.
la eleccin del amueblamiento, pintura y la disposicin
de las mismas. Cada casa tiene adems un living y La mayor parte de los moradores de Beltoften no tienen

cocina en comn, lavadero, depsito y 2 baos equipa- lenguaje verbal. Debemos aprender a captar las

dos con las facilidades necesarias para los moradores seales que nos comunican y ser consecuentes en

234
nuestras respuestas. A partir de las seales emitidas, independientes. Quin sabe? A lo mejor nos
debemos mostrarles qu entendemos con esa seal y encontramos con que tienen ms potenciales de los
de esta manera lograr un feed-bach y una que creamos.
comunicacin.

Las razones de la falta de lenguaje verbal pueden ser

UN DA EN LA VIDA DE UN MORADOR
varias: lesiones cerebrales, lesiones causadas por la
medicacin, falta de estimulacin y dems. Pero eso no
es importante para nosotros, No trabajamos a partir del El personal del lugar comienza a trabajar temprano a la
diagnstico. La causa de la dificultad no debe maana. Debe despertar y levantar a los moradores,
frenarnos. Debemos probar diferentes posibilidades y baarlos, vestirlos y darles desayuno. Algunos son ms
darles oportunidades a los moradores, para seguir su independientes que otros pero todos necesitan ayuda,
desarrollo y evolucin. No pensamos tanto en lo que no
A las 9.30 parte cada morador al centro de actividades.
pueden hacer, sino en qu posibilidades tienen y cmo
Algunos hacen uso de otros centros de actividades,
ayudarlos.
situados en otros puntos de la ciudad, por razones de
Si pensramos que los moradores no pueden lograr las socializacin o beneficios personales. Estn en dicho
diferentes metas planteadas, a causa de sus lugar hasta las 15.30, luego de lo cul vuelven a sus
deficiencias, los frenaramos, como frenaramos a hogares. A la tarde, ya en sus casas, deben encargarse
cualquier otra persona normal. Ellos tambin tienen de hacer la comida junto al personal, llevar a cabo los
necesidad de conocerse a s mismos y a ser personas proyectos programados y acostarse a ms tardar a las

235
23 horas, para comenzar descansados un nuevo da. vez al ao, un proyecto determinado, teniendo en
cuenta qu es lo que el morador necesita para ser ms
Los moradores estn en el centro de actividades 4 das
independiente, ms persona, para poder integrarse en
a la semana. El 5 da lo tiene libre y es llamado su da de
forma plena a la sociedad en la que vive, para aceptar a
hogar. Ese da, el morador y el profesional a cargo,
otros y ser aceptados,
hacen todas las cosas practicas que no hall llegado a
hacer a lo largo de la semana, como limpiar su pieza,
hacer compras, ir al banco o al mdico, recibir visita o
La idea principal es preguntarse:
simplemente ir al centro de la ciudad, a dar un paseo y
disfrutar del da. El da de hogar suelen disfrutarlo con -Qu necesita mi morador , como persona, para seguir

la persona de contacto. su evolucin?

Cada profesional tiene un morador a su cargo, y es -Cmo lo logro?

considerado la persona de contacto de dicho morador a

su funcin es asegurar de que las necesidades fsicas,
Los proyectos que se desarrollan en Beltoften en estos
psquicas y sociales de su morador sean contempladas
momentos son:
, tanto en lo prctico como en lo personal.
Kurt tiene necesidad de comunicar sus necesidades a
La persona de contacto tiene a su vez la responsa-
los dems. No tiene lenguaje, es espstico y tiene muy
bilidad de efectuar un programa de evolucin y
poca movilidad en las extremidades superiores, torso y
desarrollo para su morador. Por lo tanto, efecta una
cabeza.

236
 Proyecto: Libro con fotos sobre cosas y Inge tiene necesidad de ser ella misma, sin exigencias
situaciones de la vida diaria, las cuales puede sealar y del entorno.
as explicar lo que necesita.
Proyecto: Relajacin con msica, en la cama de
Ellen tiene necesidad de hacerse entender. agua.

Proyecto: aprendizaje del idioma de los sordos Arvid; tiene necesidad de ser mas independiente.
(hablar por seas) y entrenamiento sonoro.
Proyecto: decidir por cuenta propia, lo que quiera
Annie tiene necesidad de animarse a decidir sola y ser comer, sin tener que pedir permiso a los dems.
ms independiente. Proyecto: aprender a elegir.
Kjeld no acepta el contacto de otros, especialmente en
Elegir qu ropa se va a poner cada da.
sus manos.
Hans Jorgen tiene dificultad de aceptar el contacto de
Proyecto; masaje y contacto en las mismas.
otros.
Kamma necesita aprender a elegir por s misma y
Proyecto: contacto corporal.
mejorar su trato personal con los dems.
Hanne tiene dificultad de comer correctamente en la
Proyecto: estar junto con un profesional y disfrutar
mesa, tanto en cuanto a modales, como en el tipo de
la relacin de dos, en su pieza.
dieta.
Anne Grethe tiene necesidad de tener un poco ms de
Proyecto: entrenamiento alimenticio.
estructura en su vida. .. Proyecto: entrenamiento y
sistema en las necesidades bsicas de ir al bao,

237
La persona contacto decide cunto tiempo tiene que En Beltoften trabajan 3 personas para 10 moradores.
durar su proyecto y cuando debe ser evaluado. Con la
Las actividades a eleccin, son tanto grupales como
evaluacin se puede apreciar si hay mejora y evolucin,
individuales, internas y externas. No hay limites en
en la conducta del morador y por lo tanto, si es un buen
cuanto a lo que se pueda hacer. La imaginacin del
proyecto.
profesional es su nico lmite. "Todo es posible, lo
imposible lleva solo un poco ms de tiempo".

CENTRO DE ACTIVIDADES Cuando se nos ocurre una actividad, la examinamos

bien, tomamos en cuenta los diferentes pasos que el
El lugar de pertenencia del morador es, por supuesto,
morador debe atravesar para lograr el resultado
su casa. Pero para darle contenido a su existencia se
deseado, y comenzamos a ponerla en practica.
ha decidido crear centros de actividades. Estos ofrecen
diferentes actividades que puedan cubrir las De esta manera, nuestras actividades actuales son:
necesidades de los moradores durante el da. El
- actividades fuera del centro (externas):remo, natacin
personal debe elegir las mismas, junto con los
y equitacin.
moradores, y siempre a partir de sus necesidades y
- actividades dentro del centro (internas): actividades
posibilidades. Si el morador no puede participar en la
creativas, juegos sociales, msica y canto, leer libros,
eleccin de una actividad debido a sus propias
pintar, cermica, collage, hacer papel, hilar y dems.
limitaciones, esta ser elegida por el profesional pero
siempre a partir de las posibilidades del mismo. - tratamientos individuales : musicoterapla, masaje y

238
pintura al agua. La forma de abordar a los moradores, puede ser
grupal o individual. En lo individual se puede trabajar
- almuerzo : Los moradores almuerzan en el centro de
con el campo afectivo y de contacto sensitivo, as
da y esto es considerado una actividad tambin. Hay
tambin como con estados de nimo como enojo,
diferentes pasos necesarios para cubrir el proceso:
agresin, alegra, tristeza, melancola o apata.
poner la mesa, hacer la comida, recoger la mesa y
ordenar. Todos los moradores que tienen posibilidad, En cuanto a lo grupal, musicoterapia de la posibilidad
participan de dicha actividad. de trabajar con la relacin individuo-grupo. La clave
aqu, sera trabajar con la apertura creativa,
espontaneidad, contacto y comunicacin entre los
MUSICOTERAPIA
moradores, teniendo adems una ventaja secundaria:
Hay diferentes posibilidades de hacer musicoterapia, el mejoramiento de la coordinacin motora y el ampliar
ya que tomamos en consideracin las necesidades del el lenguaje corporal.
morador.
Se ha constituido una orquesta de moradores. De esta
La msica es considerada un lenguaje simblico no manera se trabaja con un producto en comn, los
verbal, y por lo tanto es un medio propicio para trabajar moradores pueden salir a mostrar lo que pueden y
con contacto, comunicacin y estimulacin de los hacer conocer su cultura al resto de la sociedad.
sentidos. En nuestro caso es especialmente til,
cuando penamos en la escasa evolucin del lenguaje
En Beltoften, debido al nivel de posibilidades de los
verbal del morador,

239
moradores, es ms adecuado el trabajo individual, para posibilidades son totalmente diferentes, y por lo tanto,
mejorar la forma de comunicacin. los objetivos tambin lo son. A continuacin describir
el abordaje teraputico, en el tratamiento de Ellen,
Antes de comenzar el tratamiento musicoteraputico
Dorthe, Annie y Kjeld. De esa manera se podr
con un morador, tengo necesidad de hacer un plan de
observar cmo la forma de trabajo, responde a la forma
trabajo. Los pasos a seguir son:
de pensamiento general del lugar.

1- Eleccin de la persona
l- Eleccin de la persona.
2- Cul es el problema.
-Ellen Bech, 56 aos, dbil mental y usa silla de
3- Qu quiero lograr. ruedas. Tiene movimiento en su cuerpo pero no tiene
4- Cmo puedo hacer para lograrlo. coordinacin ni fuerza motora para mantenerse
erguida, por iniciativa propia. Ellen ha vivido siempre en
5- Dnde debo empezar.
institucin. Las actividades de las que participa
6- Plan de trabajo. actualmente son: natacin, actividades creativas,
7 -Evaluacin . juegos grupales. ayudar en la "situacin almuerzo y
musicoterapia.

Como musicoterapeuta, tengo a mi cargo 4 moradores

en tratamiento individual. sus dificultades y

240
2 - Cul es el problema, Debo empezar entrenando los msculos faciales,
como se entrena cualquier otro msculo. Al mismo
Ellen no tiene lenguaje, pero emite un sonido fuer-
tiempo debo trabajar con coordinacin y ritmo.
te, largo y constante. Por intermedio de este, y sealar,
comunica sus necesidades al personal y los dems
moradores.
6-Plan de trabajo.

Durante un ao trabajamos 4 das a la semana.

3- Qu quiero lograr. Como el nivel de concentracin de Ellen era escaso,
slo trabajamos de 15 a 20 minutos cada da.
Quiero trabajar con ese sonido y tratar de
Debamos entrenar los msculos y aprender a colocar
modelarlo para llegar a lograr el lenguaje verbal.
las vocales en la boca. Mas tarde debamos agregar
diferentes consonantes, para luego relacionarlas y de
4- Cmo puedo hacerlo. ah formar palabras. Al mismo tiempo debamos
trabajar con ejercicios de coordinacin y con ritmos,
Los msculos faciales y de la lengua de Ellen son
que bamos a poder trasladar luego al ritmo del
flcidos. No puede manejar el movimiento de su boca
lenguaje verbal.
para emitir diferentes sonidos.
7- Evaluacin.

Al principio, Ellen evolucion increblemente

5- Dnde debo empezar.
rpido. Entenda las consignas, trabajaba con

241
inteligencia y ahnco. Aprendi a colocar las vocales y Rasgos psicticos. El objetivo en el trabajo con Dorthe
consonantes en la boca. Tambin poda emitir slabas es mejorar el contacto corporal y la aceptacin de estar
con diferentes sonidos (ma,pe,li,po,ko,etc.) y repetir con otros. Trato de romper las barreras de
ritmos. comunicacin que tiene para con otras personas. El
trabajo es decididamente musicoteraputico, con uso
Cuando empezamos a juntar slabas para formar pa-
de instrumentos musicales a eleccin de Dorthe, hacer
labras, la evolucin decay notoriamente. Creo que
msica juntas, espejar sus sonidos y movimientos, por
Ellen se encuentra en un lugar en su proceso evolutivo,
ahora estereotipada y ecollica.
donde debe "animarse" a hablar. No lo ha hecho en 56
aos y debe adaptarse psquicamente a tal experiencia.

Debido a que el grado de concentracin es mayor - Annie Horlm, 47 aos, tiene macrocefalia, usa
ahora, slo trabajamos una vez por semana, una hora. silla de ruedas y es espstica. Tiene muy poca
El objetivo ahora es que Ellen pueda mantener lo movilidad de brazos y cabeza. El nivel intelectual de
logrado y apuntar a que pueda empezar a crear tanto Annie es increblemente alto. El objetivo del
sonidos, como ritmos o palabras. Pero debe tener tratamiento, es estimular su intelectualidad para que no
tiempo para internalizar todos los conocimientos e pierda todo lo que sabe. El trabajo es tanto productivo
impresiones que ha logrado hasta ahora. como creativo. Creamos canciones, melodas y
hablamos de temas de inters (desde lo personal hasta
poltica). No hay lmites para lo que Annie pueda
- Dorothe Nielsen, 42 aos. Idioma ecollico.
plantear.

242
 La integracin de estas dos formas de abordaje
simultneamente, hace que Kjeld pueda trabajar tanto
- Kjeld Bertelsen, 30 aos, espstico, usa silla de
su aspecto fsico como sonoro, de una manera
ruedas. Kjeld tiene muy buen movimiento de sus
dinmica y en una experiencia alegre, llena de
extremidades inferiores. Evolutivamente se encuentra
exigencias, descubrimientos y posibilidades.
alrededor de 5 o 6 meses. Todo le llama la atencin.
Puede trasladarse libremente, reptando por el suelo
hacia cosas que despierten su inters. No se alimenta
"TODO ES POSIBLE ...,
por iniciativa propia . Parece no haber inters .

Kjeld tambin tiene tratamiento fisioteraputico, por lo

tanto hemos decidido trabajar en forma conjunta, LO IMPOSIBLE LLEVA SOLO UN POCO MAS DE

fisioterapeuta y musicoterapeuta. TIEMPO "

La fisioterapeuta trabaja entrenando su postura

corporal para lograr mayor amplitud de sus ... y es realmente satisfactorio trabajar en un ambiente
movimientos y mejor manejo de su cuerpo. Yo, como de creatividad y posibilidades, tanto para el morador
musicoterapeuta, trabajo son sus sonidos, con como para el profesional.
instrumentos musicales y ritmos, tratando de captar su
inters y lograr una mejor y mayor comunicacin.

243
M U S I C O T E R A P I A : A B O R D A JE F U N D A M E N T A L importancia de la utilizacin de esta ltima tambin en
EN EL T R AT AM I EN T O D EL D I SC APAC I T AD O Instituciones de Educacin de personas DA.
AU D I T I VO
Ms que una contribucin a la reeducacin auditiva, al
L IA R EJANE M ENDES B ARCELLOS desarrollo del habla y a la mejora del equilibrio
emocional, la Musicoterapia se constituye en un
abordaje fundamental tambin para la evolucin
Didier Anzieu, un psicoanalista francs de la actualidad, psquica de aquellos que tienen, en cualquier
afirma textualmente en su libro O Eu Pele, que el momento, el desarrollo de la audicin interrumpido.
espacio sonoro es el primer espacio psquico del ser
Siendo as, levanto la hiptesis de que la msica (y sus
humano. Para investigar sobre la importancia del
elementos constituyentes) es esencial para el
sonido en el desarrollo del psiquismo humano y llegar a
tratamiento de un nio DA, tratamiento ste que debe,
esta afirmacin Anzieu se apoya en tericos como
antes que nada, tener por objetivo la reconstitucin de
Xenakis y Tomatis.
la evolucin auditva contribuyendo para el desarrollo
A partir de sus ideas yo decid pensar y reflexionar psquico de aquel que perdi la capacidad de oir.
sobre lo que resulta en una gran incoherencia para
Conozco la recomendacin de profesores de
muchos: la utilizacin de la musicoterapia con
educacin de discapacitados Auditivos para la no
discapacitados auditivos - DA. Adems, pretendo abrir
utilizacin de la vibracin del sonido, por el hecho de
una discusin sobre la diferencia entre la msica en la
que los nios corren el riesgo de no interesarse en oir,
educacin especial y la Musicoterapia, y sobre la

244
lo que es mucho ms dificil para ellos, y si de continuar Sera interesante sealar que cuando hablo de trabajar
nicamente sintiendo las vibraciones. con la vibracin significa darle prioridad a este aspecto,
esto es, utilizar un sonido sin la preocupacin de que
Apesar de haber sido advertida para no utilizar el
est adentro del campo auditivo del nio.
sonido de esta forma, opt por hacerlo, por dos
razones: Como en general trabajamos con nios que tienen
siempre un residuo auditivo y como siempre debemos
porque no es posible trabajar con el sonido y retirar o
saber cual es ese residuo, no es difcil utilizar las
apagar las vibraciones. El sonido es el resultado de
frecuencias que pueden ser odas (por via area) o solo
estas vibraciones.
percibidas (por via sea).
porque discuto esta recomendacin. A mi modo de ver,
As, se pasar despus a utilizar sonidos con
se debe empezar a trabajar con la vibracin, ya que es
frecuencias adecuadas para que el nio sea
como el sonido es percibido por el feto, y adems, que
estimulado, poco a poco, a ese interesar por ese
es la manera por la cual todos los nios DA pueden
mundo fascinante, hasta entonces, muchas veces,
percibirlo. Entretanto uno debe estar absolutamente
prcticamente desconocido: el de oir el sonido.
atento para no reforzar o estimular la permanencia del
nio en este estado de audicin, o sea, se debe Nos corresponde guiar, y de cierta forma, direccionar al
estimular para que l sea llevado a interesarse por el nio de este nuevo mundo. Nosotros somos y seremos
mundo de los sonidos. Para que l sienta placer en los agentes y continentes de sta nueva forma de ser
entrar y permanecer en ese mundo. en el mundo, de aquel que poco a poco va evoluyendo

245
en la manera de lidiar con ese mundo al cual est evolucin del sistema auditivo en el sentido filogentico
siendo introducido. Es una nueva manera de estar en por el ontogentico, pero me gustara llamar la atencin
ese paisaje sonoro (como nos dice Schaffer) de la que los cambios del ritmo cardaco, por ejemplo, son
cual el nio pasa a hacer parte, a medida que emite, y al percibidos por el feto (y no escuchados) como riesgo de
mismo tiempo percibe los sonidos -en una relacin vida. Se trata de nuestra primera arma de sondaje y
dialctica con los mismos. ms tarde de control.

De todos nuestros radares la audicin es la que

funciona de da, de noche y en todos los momentos.
Tomatis describe, de forma hasta potica, a mi modo
de ver, la evolucin de la audicin y dice que la Cuando algn obstculo se antepone a nuestro campo
ontognesis repite la filognesis. visual ella contina percibiendo o, an cuando falta
luminosidad, es a ella que recurrimos.
Nos habla de la primera funcin de la audicin, en el
sentido filogentico, como antena o radar, con Nuestro sistema auditvo ejerce su funcin como un
largos tentculos cuyo objetivo esencial era la de complejo capaz, no solo de percibir presiones
orientarse en la direccin de peligros a gran distancia, acsticas, como tambin de analizarlas. Y es en este
solo perceptibles an por las vibraciones, o prximos momento que nuestra intervencin, como
de donde podra surgir un acontecimiento que podra musicoterapeutas, se torna imprescindible. Si no es
ser fatal. posible desenvolver el campo auditivo de un nio, es en
la funcin de analizar las presiones acsticas que nos
No voy a hacer todo el paralelo de la repeticin de la

246
vamos a detener Es en el desarrollo de la percepcin acariciados por una voz, la misma que nos hablaba ya
que vamos a trabajar, permitiendo as que apesar de en lo ms profundo de nuestra noche uterina.
que el campo auditivo permanezca sin alteraciones, el
Al mismo tiempo que saboreamos golosamente todo lo
nio utilice de la forma ms amplia y adecuada posible
que toca en nuestra boca, bebemos vidamente esta
sus condiciones y su potencial.
voz que se derrama sobre nosotros. El alimento vocal
es tan necesario a la formacin humana como lo es el
mamar, en su esencia.
La mayor funcin del odo es absorber el lenguaje;
estudios realizados en laboratorio evidenciaron la Nuestras clulas, nuestro cuerpo entero tiene
posibilidad de que el feto escuche en la cavidad necesidades de nutricin imperativas, pero nuestro
intrauterina. Se dice que los diferentes sonidos de la psiquismo nasciente tiene tambin sus imperativos
cadena del habla llegan a alcanzar el aparato auditivo nutricionales.
en formacin. El feto participa, desde ya, de la vida
Poco a poco tomamos conciencia de la posibilidad de
sonrica del mundo del cual ir a hacer parte. Luego
hacer sonidos. Agudos, graves, cortos, largos, fuertes o
nuestra audicin, que est adaptada a un medio
dbiles. Este es el juego que se graba en el aprendizaje
lquido, debe sbitamente acomodarse a los sonidos
del hombre mucho antes de estar listo para la marcha.
que le llegan por via area.
Hay un fenmeno humano constante, precioso y frgil,
Tomatis entonces nos habla del parto sonoro. Nos
y que por sto tiene que ser bien protegido, que es el de
muestra que comenzamos a ser encantados y
tomar conciencia de nuestra posibilidad de emitir

247
sonidos y de nuestra propia escucha.

Al inicio, el conocimiento del mundo es un conocimiento Para ilustrar las idas que present hasta aqu, me
sonoro; an ms, parece que penetramos en este gustara mostrar el tratamiento musicoteraputico que
mundo por conocimiento de nuestra voz. vengo desenvolviendo con un nio discapacitado
auditivo. Para sto cuento con el permiso de la familia.
El juego incesante, el vaivn sonoro, incoherente para
el adulto pero altamente significativo para el beb, ese
bao sonoro en el cual somos envueltos, ese
Se trata de un nio, nacido en el Brasil el 14/06/86, por
sumergirse en un mundo ruidoso, es nuestro primer
parto normal, de padres ingleses. Sebastian, (ser
despertar para la vida, nuestra primera marca de
utilizado su nombre verdadero porque aparecer en el
autonoma, de tomada de conciencia de datos
material audio-visual que ser presentado), tiene
imprescindibles de la realidad.
actualmente seis aos y tres meses de edad e inici la
Y cualquier obstculo a ese juego podr acarrear un Musicoterapia cuando tena dos aos y nueve meses.
perjuicio considerable a su estructura ulterior. Est siendo atendido por mi desde marzo de 1989 y
tuvo hasta la presente fecha un total de 157 sesiones
de 45 minutos. Actualmente la frecuencia es de una
Esta introduccin me parece que describe y ratifica la
sesin por semana, desde que pas a estudiar en la
importancia del sonido en nuestro desarrollo y el papel
Escuela Britnica, en 1991.
que la musicoterapia debe asumir cuando la captacin
Sebastian tuvo meningitis bacteriana en abril de 1988
de este sonido ha sido interrumpida.

248
(con un aos y diez meses) que le dij como secuela liquadora, brilladora y mquina de costura elctrica, en
una sordera neurosensorial. Hasta entonces haba la cual colocaba las manos mientras la madre cosa,
tenido un desarrollo satisfactrio, pero la madre relata para sentir la vibracin.
que el desarrollo del habla haba sido un poco ms
No existen en la familia antecedentes con relacin a
lento que el de los dos hermanos mayores. En esa
prdida auditiva.
poca Sebastian ya haba adquirido algunas palabras y
se estaba convirtiendo en un bilinge apesar de que la Las audiometras hechas en campo libre indican una

familia solo habla en ingls entre s, (sto se explica prdida profunda de la capacidad auditiva de

porque la empleada es brasilera). Sebastian. El responde con un movimiento de cabeza al

sonido de un tambor con intensidad fuerte
Se trata de una familia de nivel socio-cultural alto. El
(aproximadamente 120 dB)1 y con un guiar de ojos a
padre habla cinco idiomas y la madre cuatro. Los hijos
un xilfono (entre 500 y 1000 Hz2 con
estn siendo educados en la Escuela Britnica donde
aproximadamente 100 dB). El resultado de la
Sebastian ya estudia tambin. La madre toca el piano,
timpanometria fu normal pero no present reflejo
con estudios en msica erudita.
estapdico3.
En relacin a la histria sonora de Sebastian la madre
relata que lo arrullaba, siendo sto muy dificil para ella, 1
Decibel (dB) unidad utilizada para medir la intensidad del sonido.
2
porque despus de la enfermedad, Sebastian paso a Hertz (Hz) unidad que mide la frecuencia del sonido.
3
Reflejo Estapdico es el reflejo de atenuacin o acomodacin que
recostar la cabeza en su pecho para sentir su voz. Le puede reducir la intensidad de la transmisin sonora hasta 30 dcibeles.
La funcin de ese mecanismo es, en parte, permitir la adaptacin del
odo a sonidos de diferentes intensidades; y en parte,proteger la cclea
gustaban los aparatos electrodomsticos como de vibraciones nocivas causadas por sonidos excesivamente intensos.

249
Se trata de una informacin importante para nosotros especializada en DA en noviembre de 1988 y cuatro
musicoterapeutas pues es este reflejo que atena los meses despus a la musicoterapia por un
sonidos con una intensidad que pasara de nuestro musicoterapeuta amigo de la familia. Esta hizo una
umbral del dolor. Si Sebastian no posee ese reflejo es recomendacin de que Sebastian debera ser
fundamental que se tenga el cuidado de no emitir trabajado en ingls, como ya lo hacia la profesora
sonidos de intensidades extremamente fuertes pues especializada. La familia pensaba que sera ms facil
sto se constituira en un desplacer. Estaramos para l, adquirir solamente un idioma y la prioridad
corriendo el riesgo de no interesarlo, o ms que sto, sera dada al ingls, con lo que yo me puse de acuerdo.
de alejarlo del mundo de los sonidos, ya que para l no
sera un placer. Es importante sealar que Sebastian se
utiliza de un aparato auditivo del tipo retroauricular que Es importante relatar que Sebastian no frecuent, en

amplifica el sonido aproximadamente en 40dB. ningun momento, instituciones o escuelas

especializadas para discapacitados. Fu trabajado por
Sus primeros examenes fueron hechos en Manchester,
la profesora especializada en discapacitados auditivos
Inglaterra, y en julio de 1990 en la John Trace Clinic, en
hasta 1991, cuando la familia percibi que ella no tena
los Estados Unidos.
ms ingls suficiente para trabajar con l. Desde 1992
El diagnstico de discapacidad auditiva fu hecho Sebastian concurre solamente a la Musicoterapia y
cuatro meses despus de la meningitis e frecuenta la escuela para nios normales.
inmediatamente se le coloc el aparato al cual me referi
Se debe enfatizar la importancia de la madre que
anteriormente. Fu derivado a una profesora

250
trabaja con l todos los das y toda la familia que se fu Se mostrar inicialmente los audiogramas4 de
a una clnica especializada en los Estados Unidos -John Sebastian para que se puedan tener informaciones
Trace Clinic, para ser orientada de como debera sobre su campo auditivo.
tratarlo.
El proceso musicoterapeutico, para fines didcticos, fu
dividido en 3 partes, hasta el momento:

vibracin

sonido y ritmo

msica y expresin

Es importante sealar que estas tapas pretenden

rehacer el camino que un nio normal recorre
sonoramente, de forma ldica - lenguaje natural y
preferido por nios de esta edad. As, en su proceso,
todo es hecho a travs de juegos sugeridos por l y
aceptados por m o viceversa, como si yo fuera casi una
nia jugando con l. En verdad es as que me siento
cuando estamos juntos. Percibo que l, mismo que

4
Audiograma - registro grfico que muestra las variaciones de la
agudeza auditiva de un individuo, indicadas por el audimetro.

251
muchas veces sean colocados lmites, me v y se El tambin introduce muchos recursos que trae de casa
relaciona conmigo, en muchos momentos, tambin y de la escuela, los cuales jams desprecio. Por el
como si yo fuera un nio al cual le da ordenes, sugiere, contrario, incluyo estos objetos en actividades que le
juega y hasta con quien se pelea. dan placer y que nos llevan a utilizar sonidos y ritmos,
como tambin el cuerpo. Lpiz, papel, muecos,
Es evidente que aunque me sienta como un nio no
herramientas de plstico, espadas, aviones, tapitas de
pierdo de vista mi papel. As juego, peleo, sugiero lo
botellas, barcos, lapiceros, pegamento, tijeras, libros,
que me parece estar de acuerdo a sus necesidades y
tintas y animales; estos fueron y son los objetos que
aprovecho sus intereses, pero estoy atenta para
eventualmente pueblan nuestro mundo, que se animan
direccionar el proceso, ser el continente del cual l
conjuntamente con instrumentos musicales, sonidos y
necesita muchas veces, el facilitador cuando surgen
ritmos, donde el placer se insiere no solo por el juego
dificultades y un la persona, principalmente, en quien
sino tambin por la riqueza de este mundo sonoro que
puede confiar para protegerlo, en caso de necesidad.
le es presentado siempre y en el cual se fu integrando
Tengo como fundamento terico que me orienta, el
poco a poco.
abordaje Humanista Existencial. El es el centro de la
relacin y todo sucede a partir de l y para l. La A travs de fotografas hechas por m, a los 4 meses de
creatividad es la llave maestra desde el principio, atendimiento, intentar mostrar la primera etapa del
pues necesito de su atencin para lo que me propongo trabajo.
y para sto debo llamar su inters. Utilizo la
En esta etapa se da prioridad a la vibracin. Se utilizan
improvisacin con voz, cuerpo e instrumentos.
instrumentos de percusin como panderas, latas con

252
sonajeros adentro, utilizadas aqu como tambores A partir de la treinta y ochoava sesin pasa a hacer
(tocados con batacazos) y otros instrumentos parte del tratamiento una practicante del curso de
principalmente para sentir la vibracin. El tambin formacin de musicoterapeutas del Conservatorio
escoje la guitarra y el teclado con amplificacin con la Brasilero de Msica de Rio de Janeiro.
misma finalidad.
En la 66a. sesin (8 de Mayo de 1990) Sebastian trae
En la segunda etapa, que llame de sonido y ritmo, papel y lapicero. En esta sesin el hace algunos dibujos.
paso a hacer uso de la voz con el objetivo de aumentar Se dibuja a si mismo y a la musicoterapeuta. El no tiene
la extensin vocal de Sebastian, que al principio la orejas pero la musicoterapeuta si las tiene.
utiliza apenas con pequeos intervalos -segundas y
A partir de ah paso a aprovechar todas sus
terceras. Trabajamos los diferentes parmetros del
sugerencias para hacer un trabajo de esquema
sonido y del ritmo, lo que es de extrema importancia
corporal. Introduzco junto con el sonido la nocin de
nosolo por el aspecto psquico, ya enfatizado
silencio que lo fascina. Pasa a transgredir todas mis
anteriormente, rehaciendo un juego inicial del nio, sino
sugerencias o ordenes de silencio que le son dadas
tambin porque el habla es constituida de inflexiones
dentro de los juegos y emite sonidos a plenos
rtmico-sonoras. Nios D.A. que no sean trabajados en
pulmones, por el placer de la transgresin. Muchos
ese sentido no tendrn estas inflexiones presentando
juegos son hechos, donde el movimiento acompaa el
un habla de retotono y con un ritmo regular, esto es,
sonido, y el reposo al silencio, ya contando ahora con la
comosi fueran robots.
participacin de la practicante. Sebastian comanda
sonido y silencio en el teclado, asociados a

253
movimientos de la musicoterapeuta o de la practicante, diferentes tamaos y orientacin espacial. Todo
y as visualiza el sonido; manda en los movimientos inserido en juegos y diversiones, sonorizadas y con
del otro forzando a paradas en posiciones absurdas, ritmos.
por algn tiempo. Esta es una actividad que le da
mucho placer.
Surgen convenciones de diferentes ritmos asociados a
Fuera de sto, partes del cuerpo son trabajadas; juegos
diferentes medios de transporte: caballo, helicptero y
de tensin y de relajamiento son realizados; acciones
carro, que aparecen por Sebastian haber traido estos
como dormir / despertar; andar / parar; reir / llorar; y as,
objetos, o por ver figuras de stos. Poco a poco se van
son realizadas por todos nosotros, dando la
organizando juegos ms complejos de discriminacin
oportunidad que todos comanden y obedezcan. Se
de diferentes ritmos y de utilizacin de instrumentos
aprovecha la oportunidad para aumentar su
musicales u objetos convencionados para determinada
vocabulario.
accin. Se ver sto en la segunda serie de diapositivas
Algunas sesiones despus el vuelve a dibujar. En estos que fue realizada por el practicante en 14/11/91 y que
dibujos aparecen, adems de las orejas, los aparatos, ya nos conduce a la utilizacin de la guitarra como
dibujados tambin separadamente para que yo los instrumento de acompaamiento de melodas
pudiera percibir bien. improvisadas que nos conduce a la tercera etapa.

Se trabaj tambin, a partir de los instrumentos, En esta etapa el trabajo esta orientado para la
diferentes materiales como metal, madera y plstico; expresin, no solo a travs de la msica, sino tambin a

254
travs del cuerpo, como se puede observar en el Despus de algun tiempo se pasa a una actividad
trabajo de espejo, incluso con sonidos. donde se improvisa no solamente melodas pero
palabras sueltas que hacen parte de nuestra vivencia.
Pasa a utilizarse la msica como elemento de
expresin. Yo toco una guitarra, en las cuerdas sueltas En la primera sesion despus de dos meses de
para que Sebastian, que se utiliza de una otra guitarra, vacaciones en el ao 92, Sevastian vuelve a dibujarse
pueda interactuar conmigo y as tener una gratificacin. sin orejas. Paso entonces a trabajar nuevamente este
Las frecuencias, de las cuerdas sueltas, que van de 83 aspecto.
a 329 Hz., tocadas con intensidad fuerte pueden ser
odas por Sebastian. La improvisacin con la voz es
hecha en un modo griego porque la afinacin de las Conclusin.

cuerdas sueltas nos lleva a sto. Me gustara concluir, una vez ms partiendo de lo que

Se puede observar en el video, que Sebastian tambin nos dice Tomatis: es de poderse oir que nace la

improvisa con la voz en estos modos griegos. La facultad de escucharse. Y del poder de escucharse que

madre, que vi y escuch a Sebastian cantar cuando nace la facultad de hablar.

film, observ la importancia de esta actividad ya que Para Anzieu, antes que la mirada y la sonrisa de la
en la escuela, mientras los compaeros cantan, madre que alimenta y cuida, produzcan en el nio una
Sebastian solo imita los gestos porque no sabe las imagen de s que le sea visualmente perceptible y que
letras ni las canciones cantadas. sea interiorizada para reforzar su self y esbozar su yo,
el bao meldico (la voz de la madre, sus cnticos, la

255
msica que ella proporciona) pone a disposicin un
primer espejo sonoro del cual el nio se vale al principio
ANZIEU, Didier - O Eu-Pele. Casa do Psiclogo. S.
de sus llantos (que la voz materna calma como
Paulo. 1988.
respuesta), despus por sus balbuceos y, en fin, por
GUYTON, Arthur - Tratado de Fisiologa Mdica. Ed.
sus juegos de articulacin fonemtica.
Guanabara Koogan S.A. R. J. 1969.
El espejo sonoro y despus visual, solo es
TOMATIS, Alfred - L`Oreille et le Langage. Ed. Seuil.
estructurante para el self y despus para el yo si la
Paris. 1978.
madre expresa al beb alguna cosa de ella y de l, y
alguna cosa que diga respecto a las primeras
cualidades psquicas vividas por el entonces nasciente
self del beb.

La musicoterapia, deber trabajar en el sentido de

reconstruir esas etapas sonoras, tan importantes para
la estructura de aquel que tuvo su desenvolvimiento
auditivo interrumpido.

Bibliografa.

256
 of communication and of expression.

M O VEM EN T SO U N D VO I C E: F R O M
ST ER EO T YPI N G T O C R EAT I VEN ESS I N A THE CASE
M U SI C AL T H ER APEU T I C AL EXPER I EN C E A. is a boy 13 years old, whose diagnosis is generally
called "psychomotor delay" caused by a bigger
S ILVANA N OSCHESE Y E LIGIA L EVITA
dilatation of the right ventricle. He has practiced some
rehabilitative treatments: psychomotor therapy - 10
SUMMARY years; physioterapy - 3 years; logotherapy - 2 years. Its
attention and interest of sounds has taken his parents
The work describes a musicaltherapeutical study
up musicaltherapeutical study.
requested by parents of handicapped children and
concerns one child whose diagnosis is generally called
"psychomotor delay". It includes the description of the
OBJECTIVE
case, the choice of study and of method used. The
objective of the study is the exploitation of the Bring to light over the stereotypes his healthies parts

unexpressed behaviours, the research oh healthies and his unexpressed behaviours offering him the

parts over the sterotypes behaviours found during the opportunity to listen to himself using creatively his need

observations. The instruments of work have been to repeat.

sound / image / colour / movement used as instruments

257
SYSTEMATIC OBSERVATIONS OF RELATION Istrumental production: his preferred instrument was a
OF A. WITH SOUND plastic tube. When A. sounded it combines the sounds
with animals voice and his internal production (breath)
and musical instruments (trumpet).
Listening: A. likes loud sounds and prefers in the music
the rythmic element.
STUDY : 1st PART

- Sound production like listening of himself

Voice: vocally invents a lot of sounds and he is able to
reproduce well some sounds of the environment. He is
able to reproduce the sounds with voice of central
- birth of communication through "reconversion of
octave of the piano, preferring the rising sounds.
the play of the sounds in other languages

Movement: in the room he moves too phrenetically and

- discovery of an expressive movement through the
yumps here and there in the setting. He continually
use of materials and use of dramatization
founds objects to play.

- voice: a vital sound that stimulates the movement

Creativeness : he likes to create figures and characters
of the body
with all the materials available.

258
 With elastic string enjoied himself doing "glissandos"
with the vocal "A.". Observe the rules in the setting
- cardboard cylinder: explored before with body,
explored with voice, played into and out whit hands and
with drum-sticks, and then enriched with clothes,
- sound production: listening: game of "I Play - You
becomes, animated and changes into puppet. A. is the
listen - You play - I listen" observing the instrument,
character of the sound and of the movement: produce it
don't using only loud intensities, accompaning the
and direct it.
sound with the voice; the drum becomes the means for
our initial sound dialogue

STUDY: 2nd PART

CONCLUSIONS

OBJECTIVES Through the work made till now we have verified the
gradual appropriation of proposed languages. Sound,
Change the protagonism of A. in a coprotagonism, learn
listening, sound dialogue has taken A. to an awareness
to listen the other waiting for his own turn Make A.
of his expressiveness. His demostration of pleasure in
protagonist of his rehabilitation
the relation with therapeutists and the conquered
confidence have permitted both an exploration of his
- to the cilinder has been added an elastic string as internal space and an active listening of external space.
an istrument to control the space and the body of A. Today A. invents, creates, reproduces, speaks with less

259
anxiety and more participation.These results permit us L A M SI C A C O M O I N ST R U M EN T O D E
to expect a progressive improvement of I N SER C I N SO C I AL D EL D ESC APAC I T AD O :
communication with himself and a growth of relations U N A EXPER I EN C I A C H I L EN A
with other people.
B ERTA P EREDO M ANZO
- the operator speaks with A. to help him to
understand the sense of the happening underlinng the
positiveness changing, the aggressiveness of RESUMEN:
distructive moments during creativeness situations.
Playng A. demostrates great pleasure to create
En base a los principios orientadores de la Educacin
something of personal and to change it with the other.
Especial Chilena se ha realizado desde hace 14 aos
un trabajo de insercin social del discapacitado mental;
- Story "Wolf A. and hunters" through the el cual se ha fundamentado con experiencias y
dramatization, the instrumental production and sound conocimientos empricos. Esta experiencia educativa
dialogue starts a new communication... se plante como objetivo general "el mejoramiento del
perfil social del alumno; fomentando relaciones
adecuadas con el entorno social en los diversos
aspectos de la convivencia humana". Para concretarlo
se seleccionaron alumnos deficientes mentales leves
que pertenecan a estratos sociales bajos; con todos los

260
problemas inherentes a su condicin social. El conjunto
de alumnos fue sometido a un programa de desarrollo
Fase Inicial: 1978 - 1981
musical que comprende fases de a) orquestas rtmicas,
b) Instrumental y una tercera fase de integracin
laboral como msicos profesionales. El mtodo El programa tom como grupo de estudio 15 nios
pedaggico empleado tiene caractersticas propias deficientes mentales leves, que posean edades
presentando concordancia con los mtodos de cronolgicas entre 9 y 11 aos, y coeficientes
Martenot Kodaly y otros. intelectuales, segn terminologa de la poca, entre 60
y 69 (a su dficit intelectual se asociaban problemas
neurolgicos concomitantes); provenientes de estratos
Al finalizar el programa se logr la mejora de las
socioeconmicos bajos, donde la escolaridad de los
relaciones sociales, la autoestima y la insercin laboral
padres era menor a cuatro aos y donde existan
de los jvenes.
graves problemas sociales (alcoholismo, prostitucin,
etc.).

Actualmente el programa continu, habindose

ampliado a dficit sensoriales (ciegos y sordos).
Dichos nios en sus clases regulares recibieran
formacin y adiestramiento musical bsico, que se
plante como objetivo principal captar el inters del
DESCRIPCIN DEL PROGRAMA
educando hacia la actividad musical; potenciando la

261
expresin libre y placentera del sentimiento infantil,
evitando la rigidez del sistema educacional.
Despus de 2 aos de trabajo exista un creciente
inters de los nios por participar en las Actividades
musicales; inters que fue manifestndose en una
Este perodo de diagnstico dur aproximadamente 5
exigencia por parte de ellos para ir progresando en la
meses, en los que fueron seleccionndose nios que
complejidad de los instrumentos de percusin
presentaron destrezas rtmicas, las que fueron
utilizados, agregando LA MSICA COMO
evaluadas en base a una serie de ejercicios de
INSTRUMENTO DE INSERCIN SOCIAL DEL
expresin corporal y percusin.
DISCAPACITADO. UNA EXPERIENCIA CHILENA.

El grupo seleccionado continu recibiendo el programa

INTRODUCCIN
de formacin bsica; pero adems, se le entreg un
adiestramiento especial en diversas tcnicas en En Chile los dos grandes principios que rigen la
percusin, creciendo en complejidad. Esto fue Educacin Especial son los de Normalizacin e
realizado tomando como msica gua canciones Integracin. Por Normalizacin se entiende el esfuerzo
infantiles, en un principio, para luego pasar al pedaggico por llevar al nio a la norma, y por
acompaamiento de trozos seleccionados de msica integracin el lograr la insercin plena del
selecta. discapacitado al conjunto de relaciones sociales. Para
lograr esto se cuenta con diversas herramientas entre

262
las que se destacan las surgidas de las reas labor que se sita en ese contexto y que se inici hace
Vocacional, Recreativa y Artstica. Dentro de esta 14 aos en base a conocimientos empricos surgidos
ltima, msica de por s, juega un rol fundamental al de la misma actividad educativa y, que se Plante como
permitir que el nio o joven educando manifieste a objetivo general "el mejoramiento del perfil social del
travs de un excelso medio las inquietudes y alumno, fomentando relaciones adecuadas con el
sentimientos ms sublimes de su espiritualidad, puesto entorno social en los diversos aspectos de la
que permite superar las diferencias biolgicas, - convivencia humana".
hereditarias o adquiridas poniendo en contacto su ser y
se a los instrumentos simples (claves, panderos,
sentir individual con el ser y sentir colectivo.
sonajeros, tringulos, etc.) una batera acstica.

A pesar de la importancia que tiene la msica en el

II Fase Instrumental (1982 - 1985)
contexto de la educacin especial en Chile, existe una
clara diferencia en cuanto a preparacin de material Posteriormente se incursion en la prctica de

bibliogrfico y de apoyo, equipamiento infraestructura e instrumentos meldicos.

insumos; para desarrollar un programe adecuado a

travs de la Musicoterapia.
Esta etapa del aprendizaje radic en la destreza
acstica de los nios, puesto que la mayora no lea ni

El presente trabajo es una visin retrospectiva de una escriba. Los alumnos repetan frases musicales y

263
reconocan elementos simples de teora musical - progresivamente su autoestima, la que condicion una
(notas, valores acordes). Los instrumentos utilizados mejora secuencial en las relaciones sociales del nio.
eran rgano electrnico, guitarra y bajo elctrico. Notoriamente se manifest una valoracin por parte del
Paralelamente a esta progresin en la complejidad de hogar hacia el hijo, pasando en algunos casos de un
los instrumentos ocurra algo similar con los temas abandono efectivo casi total y menosprecio, a un
musicales, los que fueron ms completos y variados. orgullo por los logros alcanzados y por la demostracin
de que el nio poda realizar una actividad
Durante todos estos aos los alumnos fueron
positivamente valorada por la comunidad.
demostrando su progreso en diferentes escenarios,
frente a pblico adulta y de los ms variados estratos y
condiciones sociales; para lograr una presentacin
III Fase Profesional ( 1985 a 1a fecha)
armnica y desenvuelta. El nio tuvo que recibir una
formacin valrica con respecto a hbitos y actitudes, Al cumplirse aproximadamente 7 aos de iniciada la

destacando la responsabilidad y la presentacin experiencia se plante la necesidad y el desafo de

personal. ampliar los objetivos de la misma para seis nios del

grupo inicial, ya que manifestaban claramente su
inters por seguir avanzando en el mundo musical. Por
As mismo; el verse aplaudido y valorado por adultos esta razn se inici un programa de insercin laboral a
que sentan respeto hacia el progreso tcnico y no travs de la msica; integrndose al grupo un ex
lstima hacia la discapacidad, fue mejorando alumno no vidente, como vocalista. El conjunto

264
formado empez a recibir, adems de la preparacin
netamente musical, una preparacin comercial mnima
Esto implic una amplia integracin entre jvenes
(celebracin de contratos, normas laborales, etc.).
normales y discapacitados generndose un clima de
integrndose al mercado laboral como grupo
alegra, compaerismo y amistad que se dio en
profesional; recibiendo una labor de seguimiento por
trminos de respeto e igualdad.
parte de la Escuela Especial, siendo acompaados en
sus compromisos por la profesora gua.
Durante esta fase de preparacin profesional, los
jvenes pasaron a realizar una actividad paralela: la de
Un objetivo importante de esta fase fue lograr que los
ensear la aprendido como Monitores a nios de la
jvenes a travs del trabajo musical remunerado
Escuela Especial y algunos de la comunidad (ayudaron
aportaran a sus familias y pudieran adquirir sus propios
especialmente en la formacin de un nueva grupo).
instrumentos, lo que fue logrado ampliamente.

Actualmente continan unidos; teniendo un promedio

Al finalizar el perodo; a los jvenes se haban unido dos
de 24 aos de edad, habindose insertado plenamente
nios normales provenientes de un Liceo de la ciudad,
a la vida social, siendo conceptuados como una de las
amplindose la Orquesta Profesional el integrarse
mejores orquestas profesionales de la regin y
trompetas.
habiendo realizado presentaciones en escenarios
nacionales y extranjeros. (Brasil 1991).

265
Los jvenes mantienen sus hogares en base a los En efecto, los alumnos demuestran alegra por
ingresos generados por esta actividad. participar, y un inters prioritario por continuar en
dichas actividades.

Otros Dficit
Despus de un ao de trabajo con nios con dficit
auditivo se ha logrado notables avances en su
Al ampliarse en la Escuela la cobertura de atencin a
rendimiento, existiendo en estos momentos jvenes
nios con dficit sensorial (ciegos, sordas); fueran
con un promedio de edad de 17 aos que practican
incorporados a las clases de Msica, adaptndose el
batera acstica e instrumentos electrnicos (rgano,
programa a sus limitantes.
bajo y guitarra).

El objetivo es ayudarlos a desarrollar sus

CONCLUSIONES
potencialidades mejorando su coordinacin motriz,
1.-La msica es un instrumento de insercin social del
ritmo y lenguaje; operndose preferentemente en
discapacitado, logrndose a travs de ella un
orquestas rtmicas e instrumentales, ya que se ha
mejoramiento en la autoestima del nio, el nivel de
comprobado que es sta una de las actividades ms
relaciones sociales intra y extra familiares; as como
atrayentes del que hacer musical.

266
una insercin plena en el mundo laboral utilizando la de Talca.
msica como medio de sustento econmico.

Agradezco a mi hijo Claudio Filippi Peredo, quien actu

2.-En Chile es necesario la Constitucin de entidades COMO colaborador en el desarrollo del presente
superiores de formacin profesional en musicoterapia, trabajo y en algunas fases del Programa.
necesitndose la generacin de personal idneo,
infraestructura, equipamiento e insumos adecuados.
Tambin es necesario un mayor acercamiento con las BIBLIOGRAFA

experiencias educativas y cientficas que se realizan en Datos recopilados de experiencia personal.

otros lugares para potencias el desarrollo de las
tcnicas musicoteraputicas.
M U SI C O T ER API A EN EL N I O - AD O L ESC EN T E
AU T I ST A
AGRADECIMIENTOS
M ONICA P ETRUCH DE T ANNY Y E DNA M ISHORI
Se agradece a Corporacin Escuela Especial Espaa y
Damas del Ropero Espaol, por la confianza y apoyo
prestado a las actividades musicales de la Escuela Padres, hermanos, maestros y terapeutas del nio
Especial. Tambin se agradece a secretara Ministerial autista se enfrentan con un nio que no responde en
de Educacin, Regin del Maule e Ilustre Municipalidad

267
absoluto, o responde escasamente a los medios la persona misma. Puede sonrer o rer pero solo para
normales de comunicacin; que a veces parece no l, parece que no oyera ni se diera cuenta de lo que
advertir el movimiento o la actividad a su alrededor. est ocurriendo a su alrededor. Este mundo propio esta
Usamos deliberadamente la palabra "no parece" lleno de obsesiones y ritos. Cualquier cambio de sus
porque an si el nio advirtiera algo, puede carecer de hbitos, rutinas o ritos puede provocar un violento
poder para responder y comunicarse. Con mucha estallido o inclusive una posterior regresin.
frecuencia se puede observar que el nio advierte ms
A menudo rehuye el contacto fsico, si bien hay nios
de lo que parece. En cada caso nos hallamos frente a
autistas que parecen tener necesidad de contacto fsico
un doble problema de captacin y comunicacin que
y afectuoso.
debe ser resuelto.
Su capacidad verbal es mnima, muchos no hablan
El autismo es un abandono de la comunicacin y se
absolutamente nada, otros responden con frases
traduce en una incapacidad o rechazo para establecer
cortas o palabras aisladas, algunos utilizan un lenguaje
contactos humanos, fsicos o emocionales. El nio no
ecollico, etc..
puede comunicarse normalmente con la gente y vive
dentro de su propio mundo desvinculado con su La primera meta del tratamiento clnico de un nio

ambiente. Incluso cuando sus sentidos de las autista es lograr que se comunique porque sin esto no

percepciones se encuentra bien ordenado fsicamente, puede producirse ningun desarrollo.

esto no se traduce en un contacto con la gente. El nio Cuanto mas disminuido es el nio. en mayor medida
parece que mirara a travs de la otra persona pero no a constituye un individuo nico, un individuo que no tiene

268
cabida dentro de ningn esquema establecido, y no convencional. La msica constituye un lenguaje
puede tomar parte en la actividad general (Juliette universal. que no necesita de palabras que permite
Alvin, "Msica Para El Nio Disminuido"). entaolar una comunicacin an con aquellas personas
las cuales se encuentran por alguna lesin negadas del
La msica, como medio teraputico, constituye un
habla.
medio de comunicacin; an en el mas bajo nivel, los
reflejos involuntarios muestran que algo ha sido 2. MEDIO NO-AMENAZANTE: El clima creado a
estimulado y ha respondido. travs de la msica, es por lo general un clima de
liberacin, que estimula la participacin y la integracin
Mencionaremos a continuacin algunas de las
an en los niveles mas bajos en que se encuentran
cualidades de la msica que son aprovechadas en la
algunos individuos.
labor teraputica:
3. MEDIO ELSTICO Y ADAPTABLE: Toda actividad
1. COMUNICACIN NO VERBAL: La msica constituye
musicoteraputica puede adaptarse a las distintas
un lenguaje. Se trata de un lenguaje no verbal que se
necesidades y posibilidades de los nios en los distintos
haya en los primitivos estadios del desarrollo,
niveles evolutivos en los que se hallen.
anteriores al lenguaje verbal. La msica remite a
canales de comunicacin elementales ya que la 4. SENSACIN DE XITO: La sensacin de "poder
reaccin estimulo-sonido-respuesta se da en el hacer msica"; "poder comunicarse y expresarse", trae
individuo desde lo prenatal. Como bien sabemos, el acompaada una sensacin de xito que reduce la
lenguaje verbal es el lenguaje de comunicacin frustracin con la que muchos de estos seres viven

269
constantemente y aumenta la motivacin, la necesidad
de cambios, la iniciativa personal, la creatividad.
1. La msica como medio teraputico en el
5. LA MSICA COMO REPRESENTACIN DE LOS desarrollo del la comunicacin y el mundo afectivo del
AFECTOS: La msica constituye un lenguaje capaz de nio autista.
transmitir los contenidos inconscientes con facilidad, sin
2. La comunicacin que se entabla a travs de la
la represin propia del proceso intelectual. La msica
msica siendo aqu la msica adems un objetivo en si
no pertenece propiamente al mundo de 1a informacin
misma, "Grupos musicales".
sino que constituye un mundo propio, el mundo de la
expresin de los sentimientos.
1. LA MUSICA COMO MEDIO TERAPEUTICO

LA ACTTVIDAD MUSICOTERAPEUTICA EN EL
INSTITUTO "YACHDAV " ENCUADRE

Nuestra labor musicateraputica, puede abarcar y 1) Sesiones individuales de 30 minutos de duracin,

tomar aspectos de todas las reas de funcionamiento dos veces por semana.
del nio (cognitiva, motrica, perceptiva, comunicativa,
2) Sesiones de grupos, 50 minutos de duracin, una
afectiva). En nuestro instituto nuestra labor puede ser
vez por semana.
vista desde dos aspectos principales:
Grupo de hasta 12 participantes.

270
3) Terapia familiar a travs del uso de la debilitar de esta forma los mecanismos de defensa.
musicoterapia.
En grupo, la actividad est orientada a tomar
4) Sesiones de grupos de parejas padre o madre - conscienca del otro, a efectuar actividades en
hijo autista a travs del uso de musicoterapia. conjunto, a escuchar y a aprender a postergar los
deseos personales en funcin del grupo. Todo esto sin
5) Dinmica de grupo para padres. Verbal.
perder la individualidad de cada uno y sin llegar a
reprimir las necesidades personales.
OBJETIVOS PRINCIPALES Es aqu donde obtienen legitimizaciones las conductas
Estimular la comunicacin partiendo del nio, "menos aceptadas". Se les trata de buscar un marco
descubriendo sus preferencias, ayudando u orientando adecuado para que puedan ser descargadas. Se puede
en los casos que presentan dificultades de eleccin, observar esto claramente en la pelcula de video, en el
estimular la iniciativa personal y la creatividad. grupo de adolescentes, uno de los participantes en
lugar de elegir pareja empieza a saltar. La
Tratamos de encontrar aquellas actividades que le
musicoterapeuta modifica la msica que est tocando
resulten atrayentes y en las cuales se siente cmodo y
en el rgano de acuerdo al ritmo de los saltos, y uno de
a partir de ellas desarrollar la interaccin y la
los estudiantes de musicoterapia que se encuentra a lo
comunicacin haciendo hincapie de que las sesiones
largo de todo el ao, comienza a saltar junto con l. El
se desarrollan en un marco de confianza y "no
mensaje es "aqu y ahora puedes saltar e inclusive yo
frustrante" para que el nio pueda entregarse ms y
saltar contigo". Al mismo adolescente se lo ver en la

271
misma pelcula en otra actividad musicoteraputica en de reconocimiento del ser en diferencia del otro ( se
la cual la misma conducta no es aceptada y en la cual ejemplifica en la pelcula de video).
debe postergar la satisfaccin de sus necesidades por
Con familias trabajamos la comunicacin entre los
el xito de una tarea grupal siendo sta una actividad
diferentes miembros de la familia y el nio autista, en un
que requiere un nivel mayor de maduracin emocional.
intento de desarrollar y abrir canales de comunicacin
Es tambin en el aspecto emocional cuando entre ellos y proveer tareas y actividades familiares que
trabajamos sobre los sentimientos bsicos, la puedan ser utilizadas en la vida diaria.
diferenciacin y la expresin de los mismos. Tratamos
El nio autista es un integrante ms en la familia, no
de detectar y entender el estado de nimo con el que el
todo gira a su alrededor ni por otro lado debe
nio o el adolescente viene a la sesin y ofrecerle
exclurselo de todo quehacer familiar por sus
distintas maneras de exprese (de acuerdo a sus
dificultades. El trabajo teraputico orienta a una
posibilidades). En un primer nivel detectar y definir el
"normalizacin" de la familia, a una divisin justa de la
sentimiento o la sensacin en un segundo nivel intentar
atencin de las obligaciones, deberes y derechos de
entender las causas que lo originaron.
cada integrante de la familia, teniendo en cuenta las
Trabajamos tambin sobre la toma de consciencia de s necesidades especiales del nio autista como tambien
mismo; quien soy, cmo soy, qu me gusta hacer, qu las necesidades, las resistencias, el pesimismo o
no me gusta hacer, etc.. No todos los nios pueden idealizaciones de los dems integrantes de la familia
llegar a un nivel alto de conocimiento de si mismo. (hermanos mayores o menores y padres).
Hemos llegado en algunos casos a un cierto comienzo

272
El trabajo con familias tanto en grupo como MEDIOS
individualmente se desarrolla en un clima emocional
Los medios utilizados pueden ser divididos en tres:
que permite un proceso de redesarollo que lleve al
trabajo vocal, corporal e instrumental.
paciente y a su familia a la posibilidad de ejercer al
En el nio autista el trabajo vocal y corporal resulta por
mximo sus verdaderas capacidades.
lo general de mayor dificultad que el instrumental.
En las sesiones de la dinmica de grupo se habla
Tanto la voz que es la extensin de uno mismo y es
acerca de las dificultades, las expectativas, las
considerada el instrumento humano, como el cuerpo, el
frustraciones que sienten los padres, partes de ellas se
contacto corporal y la utilizacin del espacio parcial y
reflejan en el trabajo de terapia familiar y/o en las
total, son generalmente medios directos por los cuales
sesiones de grupo de parejas padre-madre-hijo autista,
se traba la comunicacin interpersonal, es sacar de
que se realizan a travs de la musicoterapia.
adentro de s mismo hacia afuera, hacia el mundo
No todos los padres participan en sesiones de grupos o externo; es romper la barrera del aislamiento en el que
reciben terapia familiar. Hay padres que participan solo se encuentran estos individuos.
en dinmica de grupo verbal. Con el tiempo la
El instrumento musical tomado como objeto
participacion de padres en las actividades de
intermediario permite establecer contacto y entablar
musicoterapia es mayor y es ofrecida por parte del
una comunicacin que permite actuar
instituto como una propuesta, no como una obligacin.
terapeuticamente sobre el nio sin desencadenar
estados de alarma. Posee adems la caracterstica de

273
adaptabilidad a las posibilidades de cualquier individuo construir junto con l, el tratamiento para ayudarlo a
sea cual fuere el nivel en el que opera. Para lograr un mejor manejo y conocimiento de su cuerpo,
determinados nios menear maracas o golpear un para una mejor comunicacin con otro sujeto en un
tambor, ofrecer las mismas sensaciones de espacio que pueda organizarse y ordenarse mejor.
gratificacin y xito, y por lo tanto contribuir a
Ofreceremos todas las posibilidades sin imponer
fortalecer su seguridad personal, al igual que para otros
ninguna. El nio podr pasar libremente de una
lo ser ejecutar una pieza musical en un instrumento
actividad a otra y nosotros estaremos con l para
ms complicado.
ayudarlo y estimularlo.
El individuo es un todo nico. Tratamos de encontrar y
reforzar aquellos aspectos ms libres y sanos con los
cuales se sienta ms cmodo y no imponerle un plan de 2. GRUPOS MUSICALES

trabajo trazado de antemano. Habr quien pueda En la primera parte de este trabajo, hemos tratado de
utilizar varios de los medios y habr quien consiga explicar hasta que punto es utilizada la msica como
comunicarse solo a travs de uno de ellos. medio a travs del cual el nio puede expresarse sea

Utilizaremos la improvisacin vocal con quien disfrute cual fuere el nivel evolutivo en el que se encuentre y

de expresarse o exteriorizarse con su voz, y la donde reciben legitimacin conductas que por lo

expresin corporal con aquellos que el contacto general no son aceptadas por la sociedad.

corporal y el movimiento resulte gratificante aunque En los grupos musicales 1os objetivos "parecieran" ser
confuso, posiblemente. Trataremos en este caso de modificados y es aqu que:

274
a. La msica como objetivo y como valor en si misma: b. La msica es vivenciada como un todo y no como la
El nio debe adaptarse a exigencias tanto en el orden suma de sus partes; en una experiencia grupal de
de la conducta como tambin en el orden de la hacer y percibir la msica con la gratificacin y alegra
adquisicin de habilidades, como el aprendizaje de un profundas que esto significa.
instrumento, de notas musicales y la posterior prctica
diaria (todo en la medida de sus posibilidades).
Principios didcticos de 1os grupos musicales.
La capacidad de algunos nios autistas de expresarse
en un ms alto nivel, a travs de pintura, matemtica, a. Encuadre

msica, etc. ("SPLINTER SKILLS"), y obtener logros La actividad tiene principio, desarrollo y final. Este
valorados por la sociedad facilita una mayor integracin encuadre claro otorga al nio un marco cmodo para la
en la misma. organizacin personal que se requiere para participar

El aprovechamiento del potencial que existe en cada en la actividad, lo que posibilita mayor independencia,

nio a travs de exigencias graduadas, consecuentes y control de la situacin y seguridad personal.

sistemticas, permite proponer objetivos de mayor

dificultad y a largo plazo basados en la realidad de cada
b. Estimulacin de los aspectos adaptivos de la
nio y llegar de esta forma a un nivel ms alto de
conducta del nio
habilidad.
Su capacidad de adaptacin a los dems miembros del
grupo, capacidad de ejecutar un instrumento y

275
disminucin de los movimientos de autoestimulacin. rgida a movimientos m sueltos y creativos.
Uno de los resultados que se repiten en cada nuevo
2) Dror - posee odo musical pero se encuentra
encuentro es que durante la ejecucin musical casi no
dependiente de las notas musicales. Estimularemos el
existen los movimientos estereotipados ~ de
desarollo de una habilidad en la ejecucin de un
autoestimulacin tan autnticos de estos nios.
instrumento respetando este aspecto que le resulta
cmodo, estimulando paralelamente su odo musical
para otorgarle mayor libertad y apertura en la ejecucin
c. Tratamiento indirecto del problema
musical. Utilizaremos con l los distintos ritmos del
A travs de los aspectos en los cuales el nio se siente
rgano electrnico para que tenga que adaptarse a
ms cmodo y seguro, trataremos de llegar a aquellos
ritmos externos y de esta forma liberarse un poco de su
que resultan ms problemticos. Ilustraremos esto con
propio ritmo estereotpico, lento y montono.
dos ejemplos:

1) Moshe - posee un buen sentido de ritmo, es

d. El instrumento musical como un medio de expresin.
lento y tiene dificultad de expresarse en movimientos
libres y espontneos. Empezaremos utilizando el A travs del dominio del instrumento musical es
autoharpa que presenta un manejo acorde a sus modificado el .~o del instrumento como medio primitivo
caractersticas y estimularemos gradualmente, de expresin emocional que responde a las
aprovechando su sentido de ritmo, el pasaje a la necesidades inmediatas del nio pasando a ser un
batera que lo ayudara a salir de la situacin esttica y medio de expresin en un principio no inmediato, que

276
exige un mayor nivel funcional en las distintas reas del musicales son los siguientes: piano, rganos
desarollo. electrnicos, sintetizador, xilfono bajo, metalfonos,
vibrfono, flautas dulces, batera, autoharpas.

Al principio hemos utilizado posters especiales de

e. Principio de cambio y expresin de espontaneidad.
60x90 cm., en los cuales estaban escritas las partituras,
Despus de conseguido el encuadre original, estable y
que permitian concentrar las miradas y la atencin y
constante, habiendo recibido los nios ya una cierta
nos permita mayor control sobre el grupo. En esta
seguridad personal y control de la situacin
etapa el trabajo se bas principalmente en el aspecto
empezamos a introducir cambios en forma graduada.
visual. Con el tiempo fuimos pasando a partituras
Los cambios son tanto en los instrumentos musicales, comunes teniendo cada participante la suya. Aqui ya
en la funcin que cumple cada uno en el grupo, en la existe una relacin musical interna entre los
ubicacin dentro del espacio de la sala. Todo sto para participantes entre s. La ejecucin en conjunto
evitar entrar en un modelo que se repite y que genera depende ya de la responsabilidad de cada ejecutante y
estereotipos y perseveracin, que son algunos de los de su atencin a los demas miembros del grupo.
problemas que presentan esto nios.

En un comienzo se tocaba solo meloda y

Informacin general. acompaamiento. Hoy en da las piezas estan divididas
en dos, tres y hasta cuatro voces, teniendo cada uno su
Los instrumentos que se ejecutan en los grupos

277
funcin especfica. inconveniente sin que esto produzca o genere violentos
estallidos como ocurra al principio.
Poseemos un extenso repertorio de piezas clsicas,
folklricas y populares y hemos comenzado a dar Uno de los integrantes ha avanzado a un nivel tan alto
conciertos fuera del mbito del instituto en un intento en la ejecucin del piano y el rgano que concurre a un
mas de comunicacin y de integracin con el mundo colegio de la comunidad una vez por semana para
externo. Empezamos con cuatro participantes. Hoy en tocar canciones que los nios del colegio acompaan
da son nueve los participantes. Uno de ellos posee un cantando. Es su "trabajo" y de esta forma se trata de
alto grado de expresividad en la voz, lo que le permite entrar en la comunidad mostrando que tambin un nio
cantar en forma fluida y clara siendo acompaado por autista posee algo propio de alto valor que ofrecer a la
los dems ocho participantes. El avance mas notorio sociedad.
que han tenido es en el rea de la expresividad, que les
permite pasar de "fuerte" a "piano" y viceversa de
acuerdo al sentimiento que se genera de la pieza que CONCLUSION

se ejecuta siendo todava el rea donde as y todo Los principios que nos guan en nuestra labor
tienen mayor dificultades. La comunicacin entre ellos profesional y que son comunes a la concepcion general
tambin se ha desarrollado en forma notora. Han de nuestro instituto consideran al problema bsico del
aprendido a respetar el turno de otros, cuando se nio autista como un problema de comunicacin. Las
ensaya, a esperar el propio turno para empezar a tocar, necesidades y tendencias personales del nio marcan y
a dejar de tocar en algun momento por algun orientan nuestro trabajo.

278
 M U SI C T H ER APY I N I N F AN T I L E AU T I SM

En los dos aspectos de musicoterapia que hemos PROF. SERAFINA POCH, PHD,MT(NAMT)
mencionado (la msica como medio teraputico, por un
lado y los "grupos musicales" de orientacin didctica,
por otro lado), sel punto de partida es el nio- Many theories had been presented to explain the cause
adolescente autista y sus necesidades, ante el cual or causes of infantile autism, Kanner syndrome, but
ponemos en servicio todo nuestro conocimiento y there is no one for shure, until now:
sensibilidad, nuestras dudas y constantes bsquedas
para tratar juntos de encontrar nuevos y mejores
1.- Genetic origin: NISEN (1965),
canales a travs de los cuales su mundo interno pueda
KALLMAN(1953),KANNER, LESSER (1952), KANNER,
expresarse y comunicarse.
EISENBER (1956).etc.

2.- Somathogenic origin: KANNER (1959), RIMLAND

Este trabajo ser acompaado por una pelcula de (1958), BENDER (1947,1956,1958,1959,1968),
video. FREEDMAN (1954), ORNITZ, RITVO (1968), GEIGER-
MARTY (1968), etc.

3.- Psychogenic origin: KANNER,EISENBERG (1955),

KANNER (1944) HIRSBERG,BRYANT (1954),
BERGMAN,ESCALONA (1949), FREEDMAN (1954),

279
LUTZ (1968), BETTLEHEIM (1948, 1950, 1952, 1955, frequent, a was for me a great oportunity to can work
1967, 1968, 1969), etc. with 59 cases at Creedmoor. I could do a research
about the MUSICAL PREFERNCES OF AUTISTIC
4.- Psychogenic theories centered on the concept of
CHILDRE This study was the subject of my PhD theses
mental re- tardation: BETTLEHEIM (1967), WASSING
(1 ).
(1965),etc.
I was working us a music therapist in the Recreation
5.- Psychosomatic or multiple factors: LOPEZ
Therapy Depar ment, during 1967.
IBOR(1966), BENDA and MELCHIOR (1950),
PROVENCE (1955), ANTHONY (1958),TRESGOLD I had to work in four wards, with 20-25 children .Ages: 3
and SODDY, GOLDFARB (1955), BOSCH (1962), etc. to 12.

My experience with this patients goes back to 1965,in When I started working as music therapist with autistic
Montreal: two cases of autism,in individual treatment,8 children in group (1967) I could not found, any writtings
hours day, at the Hopital MOnt Providence.At New York on that subject. Individual treatment of this children,
University Medical Center, the Institut of Rehabilitation: only: SHERWIN ( 2), GOLSTEIN (3 ) and NORDOFF-
one case,during summer 1966. At Creedmoore State ROBBINS.
Hospital Child Psychiatry Department,Dir. Dr. Lauretta
The research were made with:
Bender: 59 cases, in 1967 In Spain 15 cases, from 1970
59 autistic .- 12 mental defective.- 17 emotionally
to the present.
disturbed.5 epyleptics.- 4 mentally retarded with
Taking into account that the Kanner syndrome is nQt
emotional problems.2 Down syndrome, with emotional

280
problems.- 2 psychopathic tendencies, comp.

The researcn was centered on the study s reactions of 2.-"The swan"from "The Carnaval des Animaux" Saint-
autistic patients, compared with the rest of the Saens.
mencioned patients.
3.-"Teh little drumer boy" Ye-Ye rhytm
The conclussions were based on:
4.-"The little drumer boy" by synphonic orchestra.
1.- The daily observation during the Music Therapy Mantovani
sessions from March to Dicembre 1967, in sessions of
5.-"Petenera" Cordoba(Spain) folk dance.Folk
two and a half hour, three times a week, in groups of 20-
ensamble.
25 patients.
6.-"All through the nigth" Lullaby.Orchestra "101 Strings".
2.- Research on the personal preferences through: a)
7.- "Hungaric Dance" N. 1.-J. Brahms. Symphonic
External behavior of each patient: attitude, mannerisms,
orchestra.
facial expression and activity of the patient, BEFORE,
DURING and AFTER the musical audition through 8.-"El cant dels ocells"(The bird s song).Catalan folk
records. song, by Joan Baez.

9.-"66 trombons".-March. "The Music Man"(film).

Records used:

1.-"Lord,I implore your protection"J.S.Bach,organ (short b) Research on the influence of Music in his drawings

281
freeexpression. inhibition They seems to not hear anything.

c) Research on the personal characteristics in playing b) For the less affected: Agressivity toward
freely a musical instrument: piano or "Tone Educator"== themselves, increasing of compulsive mannerisms...
"Resonator Bells".(in England).
IV.- A sedative music, not depressive, stir the most
passive patients to action, physical, intelectual or social.

MUSICAL PREFERENCES OF AUTISTIC CHILDREN : V.- They do not accept predominantly rhytmic music
Conclussions:~) The most important were that becouse the rhytm us all mechanical form of expression
tend to increase his basical ANXIETY. The severe
I.- Autistic children react tremendously to musical
autistic children react incre sing his compulsive
stimulus, similar to psychotic children and much more
mannerisms and the less affected,isolating more.
than the other patient
VI.- The type of Music prefered by them seems to be:
II.- Autistic children posses a sort of unborn sense of
beauty who makes them to select the most beautiful, a) Short compossitions, the leiv-motif of the
inspired, emotive and even, the most well performed (in inspired composit ions, the most emotives and
the sense to generate emotion and sweetness). delicates, classical or folk, performed with a maximum
of modulation and expressivity.
III.- When the musical composition it is inadequate to
his hypersensitiveness, his reaction is: b) Musical instruments preferred: organ, arp,
guitarre, piano, String Orquestras or folf string
a) For the more affected autistic children: total

282
ensambles, with slow tempo, better, at the begining of Later on I found the theory of LOPEZ-IBOR( 6 )
treatment. Mantovani stil seems were adequate, for according which this children seems to presents
exemple. "oscillations of vitali ty". For him the problem of autism it
is related with traits of depressive states.
VII.- His drawings shown a good sensibility and
comprehension of the affective athmosphere and IX.- After nine montt of Music Therapy sessions, in
certain intelectual relations implied in the theme of the group with other type of patients, was evident a fact:the
musical compositions lisened during drawing. That is decreasing interest in music. His narrow field of interest,
important becouse reflects the existence of latend polariced in himself and in music were expending in
intelectual capacities in this children, which are not other directions, drawings, dance, history talling, simple
detected throu the tests based on verbal games, interest for outdoors...This fact it is exactly what
comprehension and expression. Music Therapy pretends. But music was lasting
imprecindible companion. In fact if they could feel
VIII.- His personal manner to performed freely a
interested in other things, was due to the Music, which
musical instrument --the piano or the methelophone--
contunue to be for the a companion.
shows a discontinuity o the muscular force of pression
of his fingers applied to each key of the instrument.I was X.- The efectivity of this music therauy group
obserwing this fact on the "level meter" of the sessions,shown :
magnethophon when I compared the way to play of the
An improvement of these children. Two of them
autistic children with normal children, 5 to 6 years o
could leave the Hospital for his home.One was "Ben"(7).

283
 After nine month, according to the testimony of a the halls - the majority of the children lacking any kind of
visiting Professor of Psychology from New York verbal expression- or by the shouts, the mannerisms,
University, these chilren appeared to be neither autistic the stereotypes,the inappropiate laugther, the totaly
nor psychotic becouse: absent looks, the impassibility, etc.

a) they were capable of affective relations with

those who took care of them and with their compeers.
THE FUNDAMNETAL NEEDS OF THE AUTISTIC
b) they were capable of playing simple games CHILD:

c) they vocalizet much more The concept of "Early Infantile Autism" or "Kanner
Syndrome", descrived by Leo KANNER in 1943, is
d) but above all,they were much less troubled
based on the study of 11 children pre senting two
and much more happy.
pathological characteristics:
The level of all sections,wards,had been raised
a) Extreme isolation
and even thei caretakers showed more enthusiasm and
dedication,when they could see that the children b) Obsesive persistencyin the maintenance of his
improved. identity, not only in himself but in his environment,
people and thinks. From my observation, before
When I arrived at the hospital to take the place of
knowing LOPEZ IBOR, theory:
one Recre tion therapist, in three of the four wards,one
could only be impressed by the silence which reigned in c) Traits of anxiety and depression.

284
 WHY MUSIC THERAPY IS FUNDAMENTAL I N
AUTISM AND PSYCHOSIS
The therapeutic actions to act over this pathological
traits could to be on the direction of: The problem is how to influence the the autistic child, a
human being who pathologicaly is enclosed in himself to
the point that even in some occasions he is insensible to
-- Tray to destroy the psychogenic mechanisms
phisical pain.
which makes the r an affectioante experience.
The emotional life of this child is blocked. This means
-- Tray to lower the level of anxiety.
that the frank and openly affectionate approach of
-- Tray to supply a stable, tranquil, free, organiced someone, the therapist for exemple, is rejected, at the
atmosphere, but over all, esthetic and affective begining of treatment; it moves the child to isolate
atmosphere, which can provide vital experiences. himself even more, to flee, or to continue ofmaintaining
a distance, apparently insensible.
-- Tray to make autistic child to discover the
surrounding world, experiencing it with maximum The child fears any new experience becouse he
vitality, with poetic vision. conceives it as yet another means of suffering..
However,only maternal love type can open the closed
-- Tray to educate these children by means of
door of the child and penetrate to his interior; it is the
affection and therefore, of art.
only possible lenity which can act efficiently.

285
If this is so, we have a vicious circle: a maternal
archetype is the only thing that can help the child and
THE QUALITIES OF MUSIC WHICH ARE
this is precisely what he rejects. It is only by means of
ESPECIALLY IMPORTANT FOR THESE
affection that we can cure these children.
CHILDREN

In Music Therapy could be a principle according to

Therefore,we must look for a substitute which be which the human being looks in the music for that which
absolutly different in appearence but which is similar in he lacks.
essence; something which can suggest maternal
The autistic and psychotic child looks to and finds in
affection human warmth, but without being of a
music the following:
personal nature .
1) Affection: We all know that the music is the language
of affection. of our emotions.All human emotion is
Music can achieve this aim.It can be the element capable of being expressed by means of music and
capable of breaking down the barriers of anxiety and understood, not with logic, but by means of an
anguish which surround the child. It can be the first link emotional understanding. We feel "affected" by music.
in the chain which leads to his recovery or amelioration.

Music, as recogniced by many authors, is essential and

These children, as is true of any new-born child, are
unsubstitutable in autism and psychosis.
capable of fee ling the effects and emotions of music

286
long before -- inthe new-born ca se-- they are capable has lived and been lulled by the maternal heart rhytm,
of understanding our world. Every time I played "Silent etc. But it seems to me that the effectiveness and
Nigth" in a recording by string orchestra and organ, or durability lie not in rhytmic element but in the affective
play myself at the piano, to my a my niece, a baby of content of the human voice, the singing voice, the
two-month, she felt moved and cried each time. melody, much more than the rhytm alone.

In Creedmoor State Hospital, autistic and psychotic It is not the rhytmic which is curative in these children
children prefered emotional music to candy, or to go but the melodic, or harmonic element, which can
outside to play. provoke emotion, and to evoke affection.

The affection which the child feels througth music has We know that the autistic child is as an automatoh,
the advantage of being free of any negative content; it is sometimes, immersed in a series of stereotypes which
like feeling an ideal affection, an ideal maternal love. express his pathological anxiety. Rhytmic music, where
the rhytmic element predominates over the melodic
element, is the opposite of what these children need,
Rhythm or melody?
precisely becouse it can increase their automatisms.
That the new-born child is affected by music is We want to break these series of vicious circles in which
demonstrated by the universality of the cradle song he is enclosed without being able to get out of them by
throughout man`s history. It is said that the importance himself. For this reason, I am against any to much
of the cradle song lies in its rhytm. I agree that a very rhytmic exercises, or to much rhytmic music, or
even, slow rhytm, can lead to sleep and that the fetus mechanical activity, in the first stages of treatment.

287
 adequate are metallophones and xylophones.Among
other instruments, they usually prefer, in addition to the
2) Sedation: These children need, due to their anxiety, a
lyre, the organ, piano with muted soundboard, the
type of music which is soothing without being
guitar.
depressive; the least rhytmic possible, with a simple
melodic line and of great beauty and emotiveness. In The technique NORDOFF-ROBBINS it is what I did use
moments of great tension, of tantrums, why not try from 1967, spetially on musical dialogue and
music first instead of words or medication?. improvissation.This technique it is always very we
accepted by these children and with a very good results.
3) Possibilities of expression: The language of music is
pre-logical (8), similar in structure to the language of the 4) Possibilities to relate with oneself:
child. Due to the lack or distortioned verbal expression--
a) The knoledge of the body is fundamental as a mean
in psychosis--.these children need to express
of selfidentification.This can be achieved througth the
themselves in a not traumatic way but rather gratifying..
dance .
Free musical expression, on an instrument, is the ideal
By means of circular movements,to the waltz or ballet
means for this. And melodic instruments, from my
music,etc. th musictherapist can hold these children in
professional experience, are better than percussion
one`s arms to make them dance or follow the music.
instruments.These children prefere lyres and harps
Becouse of the enormous pleasure the child experimen
string instruments than drums, almost in the first stages
ments, he let`s himself be touched and forgets his
of treatment. Among percussion instruments, the most
previous resistance to physical contac. By means of the

288
dance, the child explores his own body in a pleasant don`t talk or answer by speaking, do so with this
way. With this children, such experiences must be plea- method.
surable, if we want them to open up to others
Doying so, I could found a peculiar fact: the delaved
spontaneously.
response. At times a child has not unswered me
inmediatly, only to do so a half hour or more later,
singing his unswer, not talking.
Dance sessions can take place by simply seating the
child and taki his arms and other members of the body, In this sense, it is important to use a simple melody to
moving them to the music rhytm. This movements announce his name. If possible chosen by the child.
should never be mechanical but rather soft and circular.

b) The music, free expression or record lissening,could

5) Possibilities to relate with others:
be the sour ce of his fantasies; a perfect mean of
This could be accomplished by means of musical
creativity, but over all the companion of a lonesome
dialogue, questions and unswers put to music, musical
child.
games, group dance, etc...
c) Personal identification: A marvelous method consists
in questioning the child: "What is your name?" and "How
are you?"(learned from the sessions of Paul 6) Possibilities to relate with phenomena and things:
NORDOFF,1966), at the beginning of the
a) Time: The music has the power to bring us to realitv
session.Children love this kind of activity. Many that
and througth the fantasy taking us far awav from this

289
reality, at the same time. Fot this children it is bring back the atention of psychotic, schyzophrenic or
fundamental the councious experience of time. Music autistic children.
can do it, withougth any logical reasoning.
When, in 1966, I had to treat a psychotic adolescent,
b) Meteorological phenomena: Music can imitate them previously autistic, at "Essex County Hospital" (New
and could be the way to bring child atention on them, Jersey), I found that the only way to attract her atention
specially if we make possible for the child both and bring back from her compulssives behaviors, were
experiences: natural and musical phenomena at the to show things or phenomena at the same times that the
same times. For ex. the scene of rain, from the Wald descriptive music or songs of those phenomena or
Disney`s "Bambi", or the Grofe` s "Grand Canyion" things. The firsth time was into the hospital` s foret with
Suitte, storm evocation. the birds singing and songs about birds sung by me.
Was the firsth time that she realize the existence of the
c) Things: To lisen or play to a child a music that evocate
birds and her reaction were of happiness. The same
the things, animal sounds or places, can help to the
with the rain, which I made it to experience directly on
child to learn about the In the firsth place before that
her face and back to the room a descriptive music of
music atract his attention and can provoke emotion.
rain. And with the storm, thunderclap, airplain, car, etc...
Music can give us an emotional comprehension of
This medium were the only one to attratc her to reality.
things. Teaching a child the concept of a thing by cold
reasons, rationally, is the same us teaching him From that experience I Had develop what I had call
nothing, becouse he is incapable of capturing such "Therapy of wonderment" (Terapia del asombro o de
knowledge. The same more, when the therapist tray to maravillarse)( 9 ).

290
The quality of "to wonder" is latent in every child when the beggining of the treatment., spetially. If the firsth
he awake to world arround him, a reality that he has contact with a thing is bei surrounded by a certain
never experienced before. In traditional pedagogy, the dramatism, surprise, stetic and emotional
saying goes: "Nothing enters the intelligence which has athmosphere, it will be engraved in his mind, always.
not previously passed through the senses". But this
There is nothing like music to awaken the creativity of
leaves out something fundamental as I realized when I
the child, even autistic or psychotic. I found that music
treat that girld.The old saying should really be: "There is
was the most effective way to awaken interest, much
nothing that enters the intelligence which has not
more than drawings, photographs and candy.
previously passed through the senses, but in an
METHODOLOGY:
affective and vital way". Becouse no development is
possible neither corporal, nor intellectual, nor spiritual,
without affection.
STAGES IN TREATMENT: A) PREPARATION :
With these children, the problem is nor in their senses
I.- To get INFORMATION from: Psychiatrist, Clinical
but in the lack of interest and in the blocket affective live.
Psychologist or Teacher (if patient is in Spetia]
They have not interest in things as things, or persons as
Education School). Mother and father (separatly). Social
persons, but only in the affe tive meaning that they have
Worker
for them. For that, if we want the child to reorn to reality,
or to learn, we had, seems to me, to sorround thing
persons or situations with amotion,affection, beauty, at II.- OBSERVATION period: arround 15 days.

291
 A.- The child relations with: a) Familly .- b) Natural de: Interno: Vive en:

compeers in the war school, outdoors. Padre: Madre: Nmero de Hermanos:

B.- Expression of the child: a) corporal. b) facial Situacin familiar:

c) verbal d) graphic (scribles, drowings, scripture) e)

play f) DANCE g) SONGS h) MUSICAL Grupo asignado: Fecha:

INSTRUMENTS.

C.- Preferences and rejections: a) Persons.-b) I. DIBUJO

animals.- c) food.- d) toys.-e) things.- f) place g) time.-h) A) Dibuho libre

weather.-i) DANCES.-j) SONGS.-k) RECORDS.-l) Tema:

MUSICAL INSTRUMENTS.
Estilo: Esquemtico: Figurativo:

Color: 1 color: 2-4 col.: Ms: Predomina:

From 1971 I have been using this "Exploratory Exam" Dimensin figs.: Grande: Pequea: Mediana:

(lO): Distribucin: Zona superior: Central: Inferior:

APENDICE I Economa espacial: Pocos espacios blancos: Muchos:

EXAMEN EXPLORATORIO b Presin: Fuerte: Dbil: Insegura: Discontinua: Serpenteado:

Nombre: Dinmica: Equilibrio: Inestabilidad: Riguidez: Kinestesias:

Edad cronolgica: Edad mental: Habla: Vibraciones galvnicas:

292
Proporcin: S: No: c) I-II ...................... S: No: Inverso: S: No:

Originalidad: Artstico: Creativo: Corriente: Deforme: II-III ...................... S: No: Inverso: S: No:

B) Autorretrato; c) Mi familia: d) Mi pueblo. III-IIII ...................... S: No: Inverso: S: No:

II. CAPACIDAD DE EJECUCIN MUSICAL LIBRE Hasta:

A) Instrumento preferido: D) Uniformidad:

b) Ejecucin musical: Ritmo libre: Muy acelerado: Acelerado: Normal:

Manipulacin: Adecuada: Inadecuada: 1 mano: 2 manos: Lento: Muy lento: Desordenado:

Riqueza: 1 nota: Varias: Muchas: esc. asc.: esc. desc.: Cada dos minutos: S: No: Slo al principio:

alterada: libre:

Modo: Golpeado: Normal: Fuerte: Dbil: III. RECONOCIMIENTO DE SONIDOS

Forma: Creativo: Normal: Repetitivo: Glissandos: a) Altos b) Medios c) Bajos

Sincopado: Otros: S No S No S No

C) Imitacin:

a) I-II-III ....................... hasta: IV. EXPRESIN VOCAL

II-II-II ........................ S: No: A) Cantar una cancin:

III-III-III ................... S: No: Tema:

Hasta: Taratea: Canta:

293
Intantil: Folklrico: DO SOL RE SI FA MI LA

Msica pop: Religioso: Color: Animal:

Clsico: Cosa: Nmero:

B) Anlisis de la voz:
III.- EVALUATION:
Tono: agudo: medio: alto: afina: desafina: modula:
IV.- GOALS: a) Generals b) Personals
Matiz psicolgico: Inhivido: Seguro: Tembloroso:
c) Inmediats d) Indefinit time

GENERAL GOALS and TECHNIQUES:

V. PREFERENCIAS MUSICALES --Goal: The stablishment of a possitive relationship with

Le gusta: No le gusta: Indiferente: the patient, througth a warm, affectionate and total

Pasodobles: Valses: acceptance of the child.Without this condition, will be

useless anything else. Techniques: Free expression
Marchas: M. Coral:
with dance, instrumental music, drawings, etc
Moderno calidad: Moderno mala calidad:

Concierto:
--Goal: Tray to know the childs desires and thougths.
Techinique: Drawing without music and with music.This
is a good projective technique, even if the child make
VI. CAPACIDAD DE ASOCIACION
only scribbles.This can be analizet too.

294
Tray to lower the level of anxiety: "to make believe" that we are atraveling by: plain, tren,
boat, car, autocar, etc... or far away to places near the
Technique: music lisening in orther to modified his state
chil place, first, and then far away to places elected by
of mind, his "mood", with "mood music", according the
the child.All this with songs or recorded music adequate
Dr. ALTSHULLER s ISO principle (1945)(1l).
to the trip.The good effects of this technique were
EGO support:
remarcables allways.
Technique: Daily greating songs askind their name,
Development of faculties and language: This two aims
etc...
will take place us a consequence of the precedent
Free expression with musical instruments, dance, goals.I never place us first goal the development of the
drawings, manipulative ganes with music us language, becouse the lack of language is a syntom but
background, etc... To create situations in which the child not the cause.They dont have any functional problem
can succeded. To remark the possitive aspects of the for the lack of language.The cause it is emotional.It is
child. Follow the child actions and plays, instead the not good idea to place this child in Logopedia first
child follows the music therapist.It make the child feel becouse could enfoce the emotional cause instead to
important. Tray that the child open up to others and destroy it.The child will talk when he will feel
toward the world arround him, beggining with those who secure,accepted,in the rigth moment for him.Never by
are closset to him. in a hurry with this patients. Techniques: Musical
dialogue, etc.
Technique: Dance therapy, square dances, singing
games, dramatisations popets. Musical trips: Consists in

295
 here, in short, for the fact that, for me, it is the first time
that I can see again, after ten years an autistic child
THERAPEUTIC POSSIBILITIES IN AUTISM:
treated by me at the "Princess Sophia" Spetial
FORHAM says: "It has been said that therapy is useless
Education School, in Madrid, from 1978 to 1981.
in infantile autism.It all depends on what one
understands by therapy. If one means mental
development, then therapy occurs." - "CARLOS" is now a boy of 18 which has leaved
"Princess Sophia" Spet. Education School, in Madrid. He
Dr. Lauretta BENDER, in dec. 1967, at the Creedmoor
looks very tall and thin. From the repports of his
State Hospital (New York), when I explained in a clinical
teachers "Carlos":
session the results obtained and procedures employed
with the patients in her department in which I have Is well integrate in his class with a good relationship with
worked us a Music, Recreation and Art therapist: " We his peers. He is polite and very affectionate of his
have had the feeling, too, that it is possible to go very far teacher. He has good personal authonomy. He
with these children in the process of their recovery". participate in games and his attitude is always positive.

Stil short attention periodes. He can aadapt himself

easily in diff rent situations at school.
A CASE HISTORY: "WHAT HAPPEN WITH "CARLOS"?.-
His conversation is logical and coherent but stil do not
This is a case history,presented at the "World Congress
mantein a large, normal conversation. Seems that has
of Music Therapy" (Paris,1983) (12) like to mention it
difficulties in go out from himself.

296
He loves music and follow the rhytm perfectly. His very rigid, emotionally cold, insecure and very much
drowings are imaginatives and creatives showying his influenced by her mother.The father very aphatetic.Low
personality and peculiarities. social class, and familiar poor social relations.

He can read, writte and count until 100. Can sum and His adaptation at the school was very difficult: he cryed
subtract. constantly total isolation from his peers and pathological
fear to be alone in the room.
"Carlos" will be placed in a protected factory to work.
The first Music Therapy sessions touk place in front of
- -"CARLOS were a 5 years old boy who was diagnosed
the Music Therapy room, in the hallway, becouse he
as infantile autism when I took care of them in MUsic
would not want to come in. I put on a record: Brahms
Therapy, at mencionated Spetial Schoo in Madrid, in
"Lullaby" by Mantovanis orquestra, several times the
1978.
same each day. At the 3th session come in, but with the
His sintomatology was extreme isolation, absolute
door open. I never forced these children.I wait. Another
mutism, fears, hyperativity, short attention
record that he loved was BIZET :"Los pescadores de
span,extreme anorexy, quick tempered when some
perlas" Act. I : "Je crois entendre ta vois" by Frank
thing was changed, depressive traits, rocking
Pourcel Orquestra.
movements, etc...
IN free expression at the piano, "Tone Educator" and
The familly life was peculiar: he was an unwanted child
methalophons, "Carlos" showed a musicality and
by his mother and over all by his grandmother, who had
musical creativity un comun, remarcable. which alert me
avery neurotic personality.The mother of the child was

297
on the latent capacities of this child. His extreme desire Progressibly: "mujica"--musica (music).- "disco"
and necessity of expression, which have been blocked (record).- "mujica bonita" (nice music).- "azul" (blue).-
from birth, by his mother and grandmother. "rojo"= (red).- "piano", etc.

With "Carlos" I made a discovery myself: the This child apparently was not paying attention in his
conveninece of fallowing the child in the musical class, becouse I could found that he knew many
dialogue, in orther to stimulate his creat tivity and gave alphabetic lettres: m, p, s, r, l, d, r, n, and all the vocals.It
him ego support. With "Carlos" this were the key for a was when I put him in front of a typewritting machine.
very good progress, toguether with thi rest of
When I left the school, in June 1981, "Carlo was
techniques.
speaking, playing with other children, could started
The first words pronounced was as a consequence of to reading, etc.
feel well and warmtly accepted, more shure of themself
After see "Carlos" a few month ago, I was asking me
and less anxious and depressive.
what could be his development now if the Music
The first word was: "guagua" (agua== watter), when I Therapy sessions would continue, instead to stop when
have shown a pos ter with a lake and very higth stil the child was needing them.
mountains.
I think music therapy it is fundamental for autistic and
The next were in front of a poster with a farm with anima psychotic children
nounce clearly each animal voice while pointing it: cat,
dog, horse, hen. duck.

298
Bibliografical notes (7).-Poch, S.- "Ben" Un caso de esquizofrenia Infantil".-
En: Actas Luso Espaolas de Neurologa, Psiquiatra y
(1).- Poch, S.- "Musicoterapia para nios autistas".-PhD.
Ciencias Afines.Madrid.- Jul. 1973.- n. 4.-pag. 603-618.
Thesis.- University of Madrid.-1971.-Faculty Philos. and
Arts (8).-Michel, A.- "La Psychanalyse de la Musique".-
P.U.F.-pag. 153.-Paris 1951.
(2).-Sherwin, A.C.-"Reactions to Music Autistic
Children".-Amer.J. Psy. chiatry. -1953, 109, pag. 823- (9).-Poch, S.- "Musicoterapia para nios autistas.
831. Historia de la Musicoterapia Espaola".-Tesis de
Doctorado.Resumen.-Publ. por la Autora.-Madrid.-
(3).-Golstein, C.-"Music and Creative Arts Therapy for
1972.-pag. 36 a 39.
an Autistic Child Journal of NAMT.-Dic. 1964.- pag. 135-
138. (10).-Poch, S.- (9) pag. 51 a 55.

(4).-Nordof, P. and Robbins,C.- "Music Therapy for (11).- Altshuller, I.- "Four Years Experiences with Music
Handicapped Children' Rudolf Steiner Pub.- at Eloisa Hospital".-Amer. J. Psychiatry.-lOO pag. 792-
Blauvelt,N.Y.- 1965. 794.-Mayo 1944

(5).-Poch, S.- (1) pag. 495-498. Idem, published by the (12).-Poch, S.- Proceedings of the "World Congress of
author, in abstract: Madrid 1972.-pag. 45 to 50. Music Therapy". Paris, 1983.-pag. 100.

(6).-Lopez-Ibor, J.J.- "Las neurosis como enfermedades

del nimo". Madrid Edit. Gredos, 1966.-pag. 570.

299
 theory applies, with certain modifications, to music
therapy with other client groups, particularly with
F AC I L I T AT I N G BASI C EM O T I O N AL children and adolescents who have suffered abuse, or
C O M M U N I C AT I O N I N C R EAT I VE early childhood trauma, or those who have
I M PR O VI SAT I O N AL M U SI C T H ER APY WI T H psychosomatic disorders.
ST EVEN , A 4 YEAR O L D BO Y WI T H C O M PL EX
C O M M U N I C AT I O N D I F F I C U L T I ES
( D I AG N O SED AU T I ST I C ) In the first part of this lecture I shall discuss the origins of
basic emotional communication in terms of musical-
J ACQUELINE Z OE R OBARTS emotional dynamic form and its active, or pro-active,
functions in early infant development/early object
relations.
Introduction:

In the second part, this theoretical base will be

This paper will present theoretical background and
reconsidered in relation to improvisational music
clinical material to elucidate musical dynamic form as
therapy intervention with young children with autism or
basic emotional communication in the music therapy
complex communication difficulties (the term frequently
process, and to evaluate the appropriateness and
used prior to diagnosis of the very young child
efficacy of this music therapy process in the treatment
presenting communication difficulties within the autistic
of children with autism. In principal, this perspective and

300
spectrum). Part I.

Thirdly I shall present case material of Steven (a 3 year The literature on infancy research and mother-infant
old when he began music therapy) whose complex interaction (Bruner, Brazelton, Stern, Trevarthen,
communication difficulties and developmental delay Papousek & Papousek, Beebe, etc.) is becoming
were later diagnosed as classic 'Kanner' autism. The increasingly familiar and useful to music therapists. This
case material on audio and video aims to demonstrate domain of psychology investigating the beginnings of
the music therapy process in facilitating Steven's relationship, social interaction and communication,
capacity for emotional communication, and shared, seems to require the universals of musical form to
cooperative play; leading to freeing him from some of provide appropriate, objective description of
the restrictions of his pathology. human phenomena. Early interaction has been termed
'protoconversation' (Bateson; Trevarthen) or basic
emotional communication, and would seem to be
The discussion and interpretation will combine infant musical field, a musical spectrum of tone and rhythm,
developmental, psychodynamic and musical-dynamic
in which the fluctuations of tonal-rhythmic intensity,
perspectives.
melodic contour, temporal patterns, tempo changes,
motif, use of anacrusis, cadence, and so on, actively
form and maintain inter-subjective states of relationship.
Psychobiologist and infant psychology researcher,

301
Colwyn Trevarthen, states that the origins of these and the musical improvisational nature of mother-
dynamic patterns of communication are found in the infant interaction. In the psychological field of infancy
'patterns and controls of spontaneous mother-infant research there is rich material scientifically
intersubjectivity in the 3 months preceding and following documenting the musical forms of interpersonal
normal full-term birth (De Casper and Carstens, 1981; communication (Papousek & Papousek, Fernald,
Trevarthen, 1992a; 1992b). These patterns have been Fridman, and so on). Musical dynamic form is thus
shown to be universals of behaviour and presented in the objective 'data' of early human
communication (Darwin, 1872; Trevarthen, 1993b) relationship and 'intersubjectivity' (Trevarthen, 1974).
which manifest cross-culturally. Micro-analytic studies Musical-emotional processes are now widely regarded
of mother-infant interaction have shown in detail the as fundamental to psychic processes basic to
features and infra-structures of basic emotional psychological growth (Brazelton, Trevarthen, Stern,
communication, mother and infant both adjusting 'the Murray).
timing, form and energy of their expression to obtain
inter-synchrony, harmonious transitions and
complementarity of feelings between them in an The dynamic and organisational field of mother-infant

emotional partnership of 'confluence'. (Trevarthen, relationship has many correlations with that of music

1992a). Daniel Stern's descriptions of 'vitality affects' therapy process.

and affect attunement' illustrate clearly the direct The 'innateness' of musical responsiveness has been
connection between musical and emotional expression, given a further new perspective with significance for

302
developmentalists, for new psychoanalytic thought as referring to 'innate musicality'. This term seems to
well as for music therapy theory and practice: that the include organizational and affective-conative
infant has a 'ready-made circuit for dialoguing'. This components of inter-personal responsiveness.
concept of inherent intersubjectivity, proposed by
Norwegian sociologist and cybernetician, Stein Braten,
is described in terms of 'a dyadic organization involving Braten's concept of the 'virtual Other' iluminates not

a complementary participant, labelled the "virtual Other" only the two-person psychology of infancy research but

as a part of the rudimentary self-organization.' (Braten, concurs with the dynamic intra- and inter-psychic

1988). He uses the metaphor of the dance to illustrate processes of psychoanalytic concepts concerning ego

this principle: '..proto-conversation comes about, as the development and personality integration. For example:

virtual dance in the innate organization of the infant Early object relations of Klein;
becomes a realized dance; when the adult steps into the
Bion and his theory of alpha function transforming
place of the virtual other, maintaining one organization
beta elements; the carer as not only container, but
of dialogic closure, not two. Quoting Martin Buber,
transformer;
Braten summarises: "The innate You is realized in the
actual meeting of You." ' Winnicott's writings about the 'good enough'
mother, the holding function and transitional
phenomena;
This 'innateness' would appear to be that same
The spectrum of transference and counter-
innateness, of which music therapists speak when

303
transference issues. perspective, which has particular application to therapy
with autistic, psychotic and severely deprived children
and adolescents. Alvarez's account of 'reclamation'
This supports new findings in infancy research and
emphasises that the caretaker has to be animate, 'live
infant psychiatry and has instigated new directions of
company' in order to provide holding, to be a
psychoanalytic understanding and increasing interest in
container/transformer for those children who have
the 'here and now', in empathic modes of interaction as
insufficient ego development or have little capacity even
active components of the therapeutic process in the
to maintain intentionality. She draws attention to
psychotherapy setting. The correlations between music
mothers' function as 'alerters, arousers, and enliveners
therapy and psychotherapy process at this level are
of their babies and perceives this as a valid extension of
obvious and increasingly recognised by both
the therapist's function. This is familiar ground to the
professions.
creative music therapist. Alvarez draws attention to the
'quasi-musical', affective nature of the mother-infant
interaction and its function in 'reclamation' concerning
The integration of these new developments in modern
ego development.
psychoanalytic theory and practice is examined in detail
by Anne Alvarez (Principal Child Psychotherapist at the
Tavistock Clinic, London) in her recent book "Live
This has direct correlations with Brazelton's 'reciprocity
Company"(1992). From this original synthesis arises
envelope' (Brazelton, 1991), Trevarthen's 'emotional
her 'theory of reclamation', a clinical and theoretical
narrative' and Daniel Stern's concept of the 'pre-

304
narrative envelope' as a basic psychodynamic building bridge between the (autistic) child's inner world and
block of the infant's representational world (Stern, external reality'.
1992). Emotions are thus regarded as integral to
Psychological and neurological research has shown
motivational structures, which are in turn, fundamental
that, in the case of the child with autism, primary and
modes of development.(Kernberg, 1976; Emde, 1988;
secondary dyadic organization is impaired; the
Emde et al, 1991; Stern, 1977,1985,1992; Trevarthen,
'emotional partnership' of mother and infant becomes
1974,1987,1990a,1992a;). Trevarthen summarises
increasingly disturbed and distorted in terms of these
this aptly:
specifically musical forms I have mentioned; the
mutuality of mother-infant basic emotional
communication or protoconversation is difficult to
'Emotions are regulations, not products, of
establish or maintain.
psychological activites. They are CAUSES, not
effects, of perception and action. (Trevarthen, 1992a)

In his Theory of Autism, founded on the views of Kanner

(1943) and Bosch (1970), Peter Hobson defines the
Part II.
autistic child as having 'a biologically based impairment
Music therapy as a treatment for autistic children spans
of affective-conative relatedness with the environment,
some 40 years (Toigo, 1992; Robarts, 1993). Music
which has especially far-reaching implications for their
therapy was generally observed to provide a means of
social relations.' He points out that 'autistic children
'two-way communication' (Alvin, 1976) and to 'form a

305
seem to lack the coordination of sensory-motor- words.' They seem to lack 'inner language'. (Kolvin,
affective behaviour and experience that is a usual 1993).
feature of intra-individual as well as inter-individual
mental life. They lack the preparedness to respond to
the "signal properties" of the world, and especially of Frith (1989,1991) describes the autistic child as lacking

other people, with coherent patterns of action and 'a central cohesive organising force'. This 'central

bodily expression. Neurologically, subcortical structures processing failure' is at the root of the autistic child's

and especially the limbic system have an essential role detachment and fragmentation, difficulty in modulating

in the genesis of such behavioural patterns, and it is states of arousal (difficulty in 'switching off' rather than

probable that dysfunction of these structures is a 'switching on'). This gives rise to the secondary

common cause of autism (Damasio & Maurer, 1978).' phenomena of stereotypies and ritualistic behaviours,

(And we have heard Karl Pribram suggest that the 'evasive' withdrawal. These are viewed by Frith and by

organic impairment may be sited in the brain stem Dawson as modes of self-regulation in

itself). Hobson adds that this composite impairment response to inner and outer stimuli, or 'cooling-off'
accounts for 'autistic children's inability to 'participate in strategies (Frith, 1989,1991; Dawson, 1989b).
the affective life of others' and that 'their restricted grasp
of the modes of relatedness leads to a severe
impairment in symbolic thinking and feeling. A further These strategies are strongly reminiscent of Brazelton's

outcome is their disability in learning how to 'mean' with descriptions of neonates and their 'burst-pause' or
episodic style of relating to the mother, in order to

306
accommodate their immature physical-emotional self- and self-organisation, and to lessening the restrictions
organisation. of his pathology.

In the case study of Steven we shall see how music In particular, musical improvisational processes which
therapy processes can engender an emotional constitute 'temporal and emotional organisation'
relationship with an autistic child by using musical will be identified in their role of providing the autistic
improvisation, the dynamic forms of the musical child with the 'central cohesive organizing force' that
improvisation being carefully, clinically directed to Frith describes him as lacking. Such experiences, far
support the child's individual and sometimes from being ephemeral, can have far-reaching effects on
idiosyncratic responses. the autistic child, offering him musical-emotional
experiences or, in Hobson's words, 'affectively charged
The study demonstrates the dynamic form of music-
interpersonal relations' (Hobson, 1991), modulated or
making, used
modified in such a way as to 'attune' to the autistic
with a creative and clinically informed improvisational
child~s needs and emotional-develoomen~ 1 nf
approach, as being both the medium and mediator of
functioning from moment to moment.
therapeutic change and growth. In this way, music
therapy can instigate and support change which may
generalise to other settings, contributing to the autistic CASE MATERIAL: STEVEN
child's capacity for cognitive learning, social adaptation

307
O/H 1.

Steven was born, the second child in his family. The The diagnostic impression of Steven when he was 3
birth was by caesarian section. His development was years old was:
normal until the age of 1 1/2 years. He was noted as a
Autistic disorder - childhood onset; language delay,
'placid' baby.
learning delay.
At 18 months his lack of progress in language and
abnormalities in social development were noted.
Extract la (audio)Session 2, December 17, 1991
He communicated by gesture (limited); he did not
babble, but screeched; related only to family members;
he abreacted strongly to voices of strangers. He had WORKING MUSICALLY WITH RESISTIVE
temper-tantrums, if his routine were upset; however, he REACTION
did not cry if hurt or if toys were taken away from him. He
1. Tonally centred music brings Steven's crying into
showed no awareness of danger. He was physically
tonality of the music. = gives musical context and leads
energetic, often spinning himself around in circles, or
to possibility of containment and transformation (Bion)
jumping up and down, flapping his arms. He was a
'fussy eater', liking a very limited range of food, mostly 2. Silences for Steven to respond or initiate

crisps and biscuits. He showed no symbolic play, except emotional communication (in any modality - kicking

with a telephone. floor, vocal, etc.) = 'burst-pause' neonatal pattern of

relating (Brazelton)

308
 3. Overlapping his response in order to avoid too ---------------------------------------
much exposed directness of 'turn-taking' at this stage.

4. Matching emotional intensity, using dissonance

= BASIC EMOTIONAL
and harmonic texture, melodic-rhythmic patterns and
COMMUNICATION/MUSICAL DYNAMIC FORM
contour, dynamic contrasts = higher level of
organisation/stability into self-expression.
fostering:-

Extract 2 (audio) Session 7, February 12, 1992 1. emotional regulation

2. emotional communication

3. awareness of self/self-other
BEGINNINGS OF MORE CONSCIOUS VOCAL
COMMUNICATION 4. development of relationship and social interaction
(use of voice in communication; flexibility of response;
1. Vocal exchange
co-operation - initially at evoked levels of musical
2. Playful mood
response)
3. Matching and musically enhancing tone and
5. pleasure and enjoyment.
character of his vocal sounds.

309
Extracts 3 and 4 Session 8, February 19, 1992 awareness within the music-making - also serve to
modulate arousal states.

5. Steven's attention and involvement is sustained

DAWNING AWARENESS OF SHARED MUSICAL
(at varying levels) for 4 minutes of shared, co-operative
COMMUNICATION
play.

6. Note: his glances to the door, indicating need for

1. 'open-ended' muBic~ using wholetone scale at
withdrawal period, but he overcomes this through his
first, so no perfect cadences to arrest on-goingness-
musical involvement.
2. therapist matches timbre of drum/cymbal to
enhance symbiosis
Extract 5a Session 8, February 19, 1992
3. therapist varies matching or mis-matching his
beat, reflecting his changes in pulse, and seeking not to
be too closely matching his playing all the time. Note: FURTHER EXPERIENCE OF SHARED PLAYING
Steven initiates a beat; he also follows a quaver IN CLOSER PHYSICAL PROXIMITY
movement (evoked level of musical awareness); then
1. Simple, sparse melodic line - non-threatening and
follows an accelerando with more conscious
on-going, yet offering space for Steven's responses
enjoyment/excitement.
2. beginnings of turn-taking; he joins in in tempo
4. silences increase self-awareness/self-other

310
 3. encouraging signs of flexibility and creativity; Note: Steven's enjoyment of exaggerated musical effect
purposeful exploratory play, including some imitation within secure play framework. (Extract 5b Session
10, April 8, 1992)
Note: 'burst-pause' or episodic form of musical
engagement

compare: Pribram's 'expectancy wave'

OTHER ASPECTS OF PLAY:

1. jumping from low platform Extract 6 Session 12, May 5, 1992

2. lying on floor pushing away musical instruments

3. kicking door USE OF ANAACRUSIS VOCALLY AND

GESTURALLY

= MUSICAL DYNAMIC FORM

USE OF ANTICIPATION/SURPRISE GAMES T O
DISTRACT AND ENGAGE HIM IN SHARED PLAY ENGENDERING TEMPORAL ORGANISATION
= ANACRUSIS (MELODIC-RHYTHMIC
..EMOTIONAL
CONTOUR OR PHRASE ON THE UP-BEAT) = A
RESPONSIVENESS/PARTICIPATION
TEMPORAL/EMOTIONAL ORGANISATIONAL
STRUCTURE

311
Steven re-engaging in reciprocal play after habitual- MORE SUSTAINED.
obsessive kicking at the door
1. use of anaacrusis in various forms to support, focus,
and develop spontaneity and flexibility of shared
musical-emotional communication
Extract 7 Session 13, May 12, 1992
2. pulse and tonality provide musical impetus and
'going-on-being' for spontaneous vocalisation
FURTHER USE OF ANACRUSIS STIMULATING
3. vocalisation - communicative despite limitations
EXUBERANT ENJOYMENT
- imitative but not always echolalic

- initiating new ideas

Note: paradox of freedom of response/structure of play
form uncertainty when phrase structure changes - habituating or 'getting stuck' in
temporally/ musically pattern

4. note; continued need for episodic pattern of

engagement/withdrawal ='cooling off', dealing with
Extract 8a Session 18, July 20, 1992
anxiety levels.

INCREASED SELF-EXPRESSIVE,
Extract 8b Session 18, July 20, 1992
COMMUNICATIVE RESPONSES BECOMING

312
 affect at physical-emotional level use of Spanish idiom!

JOINING IN & TURN-TAKING - SINGING BYE- b) playful arpeggio pattern - staccato (visual & aurally
BYE musical effect)..He begins to imitate. NB use of index
finger in playing.

- - - - - - - - - - - -- - - - - - - - - - - - -

Extract 10 Session 24, October 5, 1992

Later session involved turn-taking 'yes/no' games

= increased sense of self/self-other

1. Steven speaking to his mother - 'Mummy' and
autonomy and flexibility
jargoning approximations of words, requesting her to
FUN!
play.

2. three-way interaction (developed over next 3

Extracts 9a and b Session 21, September 1 6 , months) vocalising into horn, increased vocal range and
1992 intentionality of playing

a) meeting 'difficult to engage' mood exaggerated Extract 11 Session 40, April 26, 1993

313
MISSING HIS MUMMY - EXPRESSING STEVEN'S CAPACITY FOR COMPROMISE
SADNESS
Steven can attend to his autistic interests and needs,
while (reluctantly) engaging in the 'boring' social world:
a goodbye song with the therapist.
Separation anxiety contained via music meeting
sadness; plus security of music's steady pulse at
beginning of session; verbal acknowledgement of his
Note: he initiates language, maintains attention to his
feelings also contain.
own and my interests, and spontaneously joins in a
joyful, rather exasperated finale!

Extract 12 Session 43, June 7, 1992

---------------------------------------

HIDE AND SEEK

Although using third person/our names, Steven shows Steven finished music therapy with me last week. In the
aa clear sense of 'I' and 'you'. autumn he will go to a school for autistic children. His
school and speech therapy reports are very
encouraging, particularly as regards:
Extract 13 Session 44, June 14, 1993

314
 months, with a raw score of 13 months. However,
beginnings of imaginative play were noted as unusual in
1. spontaneous use of language rather than
view of the overall results. A diagnosis of early childhood
gesture to express his needs
autism in the classic form described by Kanner was
2. social awareness and sense of being in a
given.
group with his peers

1.2. - MUSIC THERAPY AND MENTAL HEALTH /

3. symbolic and imaginative play continuing to MUSICOTERAPIA Y SALUD MENTAL
develop well. ( ABSTRACTS)

O/H (Lorna Wing)

Psychological-developmental assessment by Lorna L I T ER AT U R I N G WI T H M U SI C / L I T ER AT EAR

Wing's clinic took place when Steven was 4.1 years old C O N M SI C A
(a year after he had begun music therapy, and 6
L ILIANA M D` ASERO
months after he had begun attending a special school
for children with severe learning disabilities). His mental
age equivalent (Merrill-Palmer Scale) was scored at 3 As a result of brain damage, generally in the left brain,
years, a year behind his chronological age. His play age the possibility of communicating can be lost. There are,
(Lowe and Costello Symbolic Play Test) was only 23 in addition, more disorders which can be associated:

315
visual, sense, motor disorders, problems with learning, Incorporate creative activities.
thinking, memory, attention, concentration, perception,
In the field of aphasia, the only previous experience was
etc. Aphasics see their sense their life changed, as from
in Poland, with M. Pachalska's team which started in
the moment of their illness nothing is like it was before.
about 1978
The world as they knew it is no more.
This workshop is run by a Neurolinguist and a
In expression workshops, work is done with pleasing
Neuromusicologist. The patients who participate suffer
experiences trying to discover possible paths towards
from different types and different degrees of aphasia.
new plans for personal, emotional, working and
Some receive reeducation and some do not.
occupational life. They have been in existence for 4
The activities carried out are as follows:
years. At the beginning they operated in the
rehabilitation centre within the framework of the day Creation of sound poems, brainstorming of different
hospital of a general hospital. For the last two years they items based on a main theme, generation of texts from
have been operating in the Argentinian Asphasiology given words, completing words or lines in songs;
Foundation, outside the hospital environment. association and integration of different cultural aspects
through musical, expressive and graphic, etc. means.
The main objectives are to:

Recover self-esteem + Improve the quality of life

+ Reappraise personal capabilities + Interrelate with

A raz de una lesin cerebral al lado izquierdo,

peers + Stimulate social contact + Organise free time +

generalmente se pierde la posibilidad de comunicarse.

316
Adems, hay otros trastornos que pueden asociarse Interrelacionarse con sus pares *Estimular los
como: los visuales, sensitivos, motores, las dificultades contactos sociales * Organizar el tiempo libre *
en el aprendizaje, el pensamiento, la memoria, Incorporar actividades creativas
atencin, concentracin, percepcin, etc. El afsico ve
En el campo de las afasias slo existen antecedentes
alterado el sentido de su vida, ya que a partir de su
en Polonia, en el equipo de M. Pachalska que comienza
enfermedad nada es como antes. El mundo tal como lo
alrededor de 1978.
conoca se ha terminado para l.
Este taller est a cargo de una Neurolingista y una
En los talleres de expresin se trabaja a partir de
Neuromusicloga. Los pacientes que participan
experiencias gratificantes, tratando de descubrir
padecen distintos tipos y grados de afasia. Algunos de
caminos posibles para nuevos proyectos de vida
los cuales reciben reeducacin y otros no.
personal, afectiva, laboral, ocupacional. Existen desde
hace 4 aos, y en un principio funcionaron en un centro Las actividades desarrolladas fueron:

de rehabilitacin en el marco de un hospital general. Elaboracin de poemas sonoros, rastreo de diferentes

Desde hace dos aos en la Fundacin Argentina de rubros a travs de un eje temtico, generacin de
Afasiologa, que est fuera del mbito hospitalario. textos a partir de palabras dadas, completamentacin

Los objetivos especficos son: de palabras y /o frases en canciones en conservacin;

asociacin e integracin de diferentes aspectos
* Recuperar la autoestima * Mejorar la calidad de vida
culturales a travs de canales musicales, expresivos y
* Revalorizar las capacidades personales *
grficos, etc.

317
 institutionalised that they appear demented but are in
fact functionally affected only, by the process of
M U SI C T H ER APY I N D EM EN T I A: A H O L I ST I C
institutionalisation.
APPR O AC H / M U SI C O T ER API A C O N L A
D EM EN C I A: U N A APR O XI M AC I N H O L ST I C A We need also a knowledge of appropiate repertoire for
those persons who are in stages 4 - 7 of the dementing
R UTH B RIGHT process, (Reisberg classification) who are unable to
take part in creative music-making and for whom
When we work with those who are suffering from therefore familiar music from their personal past is
dementia, we must have a clear theoretical knowledge essential.
of the particular disease from which the person is
Our responsibilities as music therapists include work
suffering, and what the disease means to both the
with staff, (enhancing their perceptions of the patient)
sufferer and his/her family. This will enable us to plan
and with family members, encouraging them to visit
our work so that we set up "success" and not "failure"
during music sessions to enjoy the enriched
situations.
relationships possible in that milieu. We must be
For those in the early stages of dementia, creativity in competent in counselling family menbers, because we
music-making is often possible and we need skills to build up a trust relationship through participation in
facilitate this; such work may also have value to the music and it is therefore often the music therapist who is
team in helping to correct mis-diagnosis e.g. in cases of the appropiate person to assist them in catharsis of their
pseudo-dementia, or for those who are so grief and anger over the dementia which has affected

318
their spouse or parent.All these and more are part of the pseudo-demencia o para las personas que llevan largo
work of the music therapist and it is encouraging to see tiempo internadas en instituciones que parecen
the improved responses and relationship which arise dementes, pero en realidad slo estn afectadas
during music therapy for dementing clients in small funcionalmente por el proceso de internado.
group or, for more advanced cases, individually.
Tambin necesitamos conocer el repertorio adecuado
para las personas que se encuentran en las fases 4 - 7
del proceso demencial (clasificacin Reisberg) que no
Cuando trabajamos con personas que padecen
pueden participar en hacer msica creativa y para las
demencia, debemos tener un conocimiento terico
cuales es esencial la msica de su pasado que les
claro de la enfermedad que padece el paciente y de lo
resulta familiar.
que esto significa tanto para el enfermo como para su
familia. Esto nos permitir planificar nuestro trabajo Nuestras responsabilidades como musicoterapeutas
para construir situaciones de "xito" y no de "fracaso". incluyen el trabajo con el personal del hospital
(aumentando su percepcin del paciente) y con los
Para las personas que se encuentran en las primeras
miembros de la familia, animndoles a que nos visiten
fases de la demencia, a menudo es posible hacer
durante la sesin para que disfruten de las relaciones
msica con creatividad y nosotros necesitamos las
enriquecidas que son posibles en este entorno.
capacidades para facilitar esto; dicho trabajo puede
Tenemos que ser competentes a la hora de asesorar a
tambin ser valioso para el equipo a la hora de corregir
los miembros de la familia, porque construimos una
un diagnstico equivocado, por ejemplo en los casos de
relacin de confianza a travs de la participacin en la

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msica y, por lo tanto, a menudo el musicoterapeuta es VI O L AD O R ES, Y L O S EF EC T O S D E EST A
la persona ms adecuada para asistirles en la catarsis M SI C A SO BR E SU C O N D U C T A
de su dolor y su rabia por la demencia que ha afectado
M ELISSA B ROTONS
a su esposo/a o familiar.

Todo esto forma parte del trabajo de un

musicoterapeuta y es alentador ver mejorar las The purpose of this study was to investigate the
respuestas y las relaciones que surgen durante la relationship between diagnosis of forensic clients with
musicoterapia para personas dementes en grupos mental illness and the content of songs chosen by them.
reducidos o, para casos ms avanzados, a nivel Also the effect of these subjects' selected songs on their
individual. behavior was studied.

Thirty men with criminal charges and mental illness,

ages 18-30, institutionalized in a Correctional Mental
T H E C O R R EL AT I O N BET WEEN C O N T EN T O F Health Institution served as subjects for this study.
PR EF ER ED M U SI C AN D PSYC H I AT R I C
Subjects selected three songs as a representation of
D I AG N O SI S O F C R I M I N AL O F F EN D ER S AN D
their music preference and thery were observed during
EF F EC T S O F T H I S M U SI C O N O BSER VED
music and nonmusic listening conditions. The content of
BEH AVI O R / C O R R EL AC I N EN T R E EL
the songs chosen by the subjects was analyzed and
C O N T EN I D O D E L A M SI C A PR EF ER I D A Y EL
quantified as well as the subjects' diagnosis.
D I AG N ST I C O PSI Q U I T R I C O D E

320
Statistical analysis revealed that subjects with a high edades entre 18-30 aos, con delitos criminales y
score on their diagnosis as a measure of their level of enfermedades mentales que estaban
mental illness, selected songs scoring lower in institucionalizados en un Correccionario de Salud
irrationality. Inappropriate behaviors were exhibited Mental. Los sujetos escogieron tres canciones como
slightly more during music-listening than nonmusic representacin de su preferencia musical, y fueron
conditions. observados durante el tiempo que escucharon las
canciones (condicin musical) y durante el periodo de
Results of this study indicated that "irrational" music is
silencio entre las canciones (condicin no musical).
not necessarily chosen by mental ill people and that
inappropriate behaviours are exhibited more during the El contenido de las canciones escogidas por los sujetos
time subjects listen to this music but not to a significant y las diagnosis de dichos sujetos fueron analizadas y
level. cuantificadas. Los resultados de los anlisis
estadsticos indican que los sujetos con una puntuacin
alta en sus diagnosis como medida del nivel de su
El objetivo de este estudio fue investigar la relacin enfermedad mental, escogieron canciones que
entre la diagnosis de delincuentes criminales con puntuaron bajo en irracionalidad. Conductas
enfermedades mentales y el contenido de las consideradas inoportunas fueron un poco ms
canciones preferidas para ellos. Tambin se estudi la prevalentes durante los periodos con msica, que
influencia de estas canciones sobre su conducta. durante los de silencio.
Los sujetos para este estudio fueron 30 hombres, de

321
Los resultados de este estudio indican que msica resources used in the program of assistance to
"irracional" no es necesariamente escogida por gente psychotics, which is a transdisciplinary project in which
con enfermedades mentales, y que conductas assistance is supplied to small groups of similarly aged
"inoportunas" fueron ms prevalentes cuando los people in order to establish a therapeutical and affective
sujetos escucharon msica, pero no a nivel significativo. relationship which may open channels of
communication starting from the individual's sound
identity.
M U SI C T H ER APY A F O R M O F N O N VER BAL
We shall speak about:
T R EAT M EN T I N ASSI ST EN C E T O PSYC H O T I C S
/ E L T R A B A JO D E L A M U S I C O T E R A P I A C O M O * The implantation project

F O R M A D E T R AT AM I EN T O N O VER BAL EN EL * The number of children assisted and initial results,

AT EN D I M I EN T O PAR A L O S PSI C T I C O S underlining the importance of such aspects as early
intervention and personalization of assistance.
E LIANA L OBO D O C ARMO

La Fundacin Municipal Francisco de Paula es una

The Municipal Foundation Francisco de Paula is a
institucin pblica que atiende, en el rea de la
public institution which assists a poor population in the
rehabilitacin, a una poblacin pobre en la zona oeste
field of rehabilitation in the east of the State of Rio de
del Estado de Ro de Janeiro. La Musicoterapia es uno
Janeiro. Music therapy is one of the therapeutical
de los recursos teraputicos utilizados en el programa

322
de tratamiento de los psicticos, un proyecto M U SI C T H ER APY AN D C O R PO R AL
interdisciplinar en el que el tratamiento se realiza en EXPR ESSI O N I N A G R O U P O F C H R O N I C AL
pequeos grupos, de acuerdo con la franja de edad, H O SPI T AL I Z ED PAT I EN T S / M U SI C O T ER API A
con el objetivo de establecer una relacin teraputica y Y EXPR ESI N C O R PO R AL C O N U N G R U PO D E
afectiva que pueda abrir canales de comunicacin a PAC I EN T ES C R N I C O S H O SPI T AL I Z AD O S
partir de la identidad sonora del individuo.
A LBERT C HAMORRO S ALVAT & BLANCA T RREGA
Relatamos: E STELLER

* Proyecto de implantacin.

* Nmero de nios atendidos y resultados iniciales, The evolution of a group of 11 patients with psychotic
destacando la importancia de la intervencin precoz y disorders and residual symptoms is studied. During a
la personalizacin del tratamiento. year, they were involved to a group of Music Therapy
and Corporal Expression in our hospital.

The group's musical production is described at different

moments, including melody, rythm and intensity.

We observed an improvement in communicating by

music, so we asked the patient's psychiatric caregivers
to answer a questionnaire, in order to know if this
improvement was observed in other communicative

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situations of their daily life, including verbal and non-
verbal communication.
T H E M U SI C T H ER API ST AS G R O U P L EAD ER -
A tendence to relation was observed.
A PR O PO SAL F O R A PR AC T I C AL M O D EL / EL
M U SI C O T ER APEU T A C O M O L I D ER D EL
G R U PO : U N A PR O PU EST A D E M O D EL O
Se describe la evolucin de un grupo de 11 pacientes
PR C T I C O
psicticos con cuadros residuales que asistieron
durante un ao al Taller de Musicoterapia y Expresin
Corporal del Hospital Psiquitrico "Instituto Pedro Mata".
R ACHEL D ARNLEY-SMITH
La produccin musical del grupo es analizada por
perodos, tanto la meloda como el ritmo y la intensidad.
In this paper I am proposing a practical model of group
Observndose una mejora en la comunicacin por la
leadership in Music Therapy Practice, as developed
msica, se pasa un cuestionario a los cuidadores
through clinical work with clients in Psychiatric settings.
psiquitricos de los pacientes para saber si la mejora en
The model seeks to describe the process of shifting
comunicacin se ha generalizado a otras situaciones
emphasis in responsability between clients and
de su vida cotidiana, tanto en la comunicacin verbal
therapist, for what actually takes place within a group
como en la no verbal.
session.
Se observa una tendencia a la relacin.

324
I will begin the paper with a description of the Model and desplazamiento de la importancia de la responsabilidad
subsequent discussion in the light of: entre los clientes y el terapeuta, que se produce en las
sesiones de grupo.
a) Clinical case material
Empezar la ponencia con la descripcin del Modelo y
b) The group Analytic Model of leadership developed
la consiguiente discusin a la luz de:
by SH Foulkes (introduction to Group Analytic
Psychotherapy - 1948), which seems to bear close a) El material extrado de los casos clnicos.
comparison.
b) El modelo analtico grupal de liderazgo
Finally, I will attempt to place the Model within the desarrollado por SH Foulkes (introduccin a la
context of recent papers by Music Therapists with psicoterapia analtica de grupo - 1948) que parece
similar concerns as Woodcock (1987), Odell-Miller presentar cierta afinidad.
(1991), De Backer (1992), Di Franco (1992).
Para finalizar, tratar de enmarcar el Modelo en el
contexto de ponencias recientes elaboradas por
musicoterapeutas con las mismas inquietudes, como
En esta ponencia propongo un modelo prctico de
Woodcock (1987), Odell-Miller (1991), De Backer
liderazgo de grupo en la prctica de la Musicoterapia,
(1992), Di Franco (1992).
desarrollado a travs del trabajo clnico realizado con
los clientes en sesiones psiquitricas.

El modelo trata de describir el proceso del

325
 R ESI ST EN C E I N M U SI C T H ER APY / L A utilizacin de la msica y el papel del terapeuta en la
O PO SI C I N EN L A M U SI C O T ER API A eleccin de una intervencin.

JANICE M. DVORKIN

M U SI C T H ER APY I N M EN T AL H EAL T H :
The concept of resistence will be explored in the H YPO T H ESES F O R A M ET H O D O L O G Y /
therapeutic process: how it can inhibit and, also, M U SI C O T ER API A EN L A SAL U D M EN T AL :
facilitate the therapy work, as well as describe the use of H I P T ESI S PAR A U N A M ET O D O L O G A
music in joining the patient in the resistance behavior.
G IANLUIGI D I F RANCO
Resistance will be discussed with a developmental
perspective and the use of music and the role of the
therapist in choosing an interventi on. This lecture reports on different clinic experiences in the
field of mental health. We are particularly concerned
with the use of sound and music in an established
El concepto de oposicin se explorar en el mbito del
psychiatric context, meaning by that the institution
proceso teraputico: cmo puede inhibir y, tambin,
"mental home", the inclusion of music therapy in the
facilitar el trabajo de la terapia. Asimismo se describir
territorial services of mental health, music therapy as a
la utilizacin de la msica para llegar al paciente que
means to intervene in a single case of child autism. The
presenta un comportamiento reacio. Utilizando una
deepening of these different experiences within a
perspectiva de desarrollo, se debatirn la oposicin, la

326
period from 1978 till today gives us the possibility, casos de autismo infantil. La profundizacin de estas
starting from the practical data of the clinic experiences, diversas experiencias en un espacio de tiempo de
to begin formulating methodological hypotheses. 1.978 hasta hoy asegura la posibilidad, a partir del dato
prctico de la experiencia clnica, de empezar a
As for music therapy in the field of mental health, these
formular hiptesis metodolgicas tendientes a definir
hypotheses tend to define a sort of framework, able to
una parcial sistematizacin que, por lo que se refiere al
give directions firstly to work day by day using
discurso de la musicoterapia en salud mental, pueda
references, secondly to intervene on a research level in
proporcionar indicaciones para trabajar, por un lado
order to go deeper into those aspects which open up a
con referencias a lo cotidiano o, por otro intervenir en el
possibility of positive applications particularly for
campo de la investigacin para profundizar todos
psychosis, the most serious form of psychopathology.
aquellos aspectos que abren una posibilidad de positiva
utilizacin, especialmente respecto a la psicosis como
Este informe supone la relacin de diversas forma ms grave de la problemtica psicopatolgica en
experiencias clnicas en el mbito de la salud mental, salud mental.
en especial de la utilizacin del sonido y de la msica en
el contexto psiquitrico institucional, es decir la
institucin del "manicomio", al introducir la
musicoterapia en las instituciones locales de salud
mental como instrumento de intervencin en sendos

327
A N X I E T Y A N D P L A Y I N G / A N G U S T I A Y JU E G O verbal psychotherapy.

R EGINA H ALMER -STEIN

Estudio de un caso: Musicoterapia para una paciente

con neurosis de angustia.
Case study: Musictherapy with an anxiety neurotic
patient El presente reportaje describe el proceso de terapia de
una paciente con una neurosis de angustia. Los puntos
The presented paper describes the process in therapy
especiales en este reportaje, son el estudio del
with a female patient, suffering form anxiety neurosis.
surgimiento de la enfermedad de la angustia, y el trato
Special aspects are the pathogenesis of anxiety and the
de desunin y luto. Las intervenciones
way to deal with seperation and mourning.
musicoteraputicas se basan en la idea del surgimiento
The musictherapeutic interventions are based on the comn del espacio y de la idea en que el terapeuta,
idea of the intermediary space in playing and the idea encuentra el comportamiento de comprensin del
that the therapist has to adapt to the technics of paciente correspondiente a la persona y a la fase
communication of the patient, corresponding to the teraputica. En el inicio del proceso fue prioritario la
person and the therapy state. At the beginning, an aproximacin a las emociones y en la segunda parte la
approach to feelings had priority, in the second part of prioridad, se dio al trabajo de la problemtica de las
the process it was to work on relationship. The patient relaciones. La paciente termina la terapia, puesto que
terminated the music-therapy, because relating to Ego- ella quera continuar exclusivamente su psicoterapia
development she decided to continue exclusively her

328
oral en sentido al desarrollo de su Ego which was accepted by an Interdisciplinary Team which
backed our work.

This was how we managed to work in three areas:

AD D I C T S AN D M U SI C T H ER APY - A C ASE
a) individual
ST U D Y / EL AD I C T O EN M U SI C O T ER API A -
PR ESEN T AC I N D E U N C ASO b) microsocial (family) and

O FELIA H ERRENDORF D E W AEN & DANIEL A LBERTO c) macrosocial, understanding that we used two
G ARAY main ideas as a guide: discrimination and
individualisation.

We were able to observe the following:

It should be borne in mind that drug addiction can occur
in cases of neurosis or psychosis. 1) Form of interaction and communication.

The possibilities for the care of an addict patient using 2) Inability to recognise parents and family.
music therapy can be clarified by looking at the case of
3) Family environment in which the young girl had
a young girl treated in the Institution's Day Centre.
been brought up.
Having studied her personal and family background, we
4) Difficulty on the part of the parents to accept her
were able to work (with the analysis of evaluated
using her "christian name".
sessions and the Sound History of this patient) in
5) Difficulties with her voice (tone, lack of volume,
nuclear (family) sessions, programmed within a project

329
lisping). a) individual

6) Particular substance with which she was drugging b) microsocial (familiar) y

herself.
c) macrosocial, entendiendo que utilizamos dos ejes
como gua: discriminacin e individualizacin.

Es necesario considerar que la drogadiccin puede Pudimos ver:

inscribirse sobre estructuras neurticas y/o psicticas.
1) Modalidad de interaccin y comunicacin.
El anlisis de las posibilidades de atencin del paciente
2) Indiscriminacin de padres y familiares.
adicto en MT pueden clasificarse a partir del relato del
caso de una joven tratada en el servicio del Centro de 3) Clima familiar en que se desarrollaba la historia

Da de la Institucin. de la joven.

Despus de conocer sus antecedentes personales y 4) Dificultad por parte de los padres de integrarla

familiares, pudimos trabajar (con el anlisis de sesiones desde su "nombre propio".

evaluadas y con la Historia Sonora de esta paciente) en 5) Dificultades con su voz, (tono de la misma, poco
sesiones nucleares (familiares), programadas dentro volumen, ceceo).
de un proyecto que fue aceptado por el Equipo
6) Sustancia particular con la que se drogaba.
Interdisciplinario que aval nuestra tarea.

Fue as como logramos trabajar en las tres matrices:

330
WO R KI N G WI T H AI D S AN D D R U G AD D I C T I O N / achieve their own happiness and the happiness of all
T R A B A JA N D O C O N S I D A Y D R O G A D I C C I N those who surround them and who play a part in their
lives; i.e. support them along the path towards achieving
O FELIA H ERRENDORF D E W AEN
mature adulthood.

I am interested in finding out what other music

I aim to talk to colleagues who work with drug-addicts. I therapists think about this subject and many others.
believe that given the alarming increase in drug-addicts How do they feel when facing up to a challenge which,
throughout the world, any exchange of experiences and because of its nature, makes it impossible to treat
conclusions which we may arrive at are of vital adolescent or adult addicts in chronological age groups.
importance. This serious problem, which is now on the How can we help them to undo the complex tangle of
increase due to the number of addicts who are also their lives which lead them into their illness?
affected by AIDS, ought to lead us all (both
When we find out in some cases that a patient is HIV
professionals and non-professionals in the area) to
positive do we think that their limitations are going to
think constantly about this subject.
carry on until reaching situations which will cause their
So what role can MT play in prevention and what death and that those people who we want to help, by
techniques can be used when the addiction has already looking for a path towards life, will have their possibilities
taken a grip. How can we help these people to cut off because of AIDS?
internalize the idea of limits which do not inhibit their
Who is going to help us? How much frustration
personal development ability, but which will help them to

331
tolerance do we need! la historia de su vida. Es decir apoyarlos en un camino
hacia el logro de una adultez madura.

Es mi inters saber qu piensan otros MTS sobre estos

Es mi intencin convocar a colegas que trabajen con
temas y muchos ms. Cmo se sienten ante el desafo
pacientes adictos a las drogas. Considero el valor del
que por sus caractersticas de personalidad implica
intercambio de experiencias y las conclusiones a que
tratar a los adictos adolescentes o adultos por edad
podamos arribar como prioritarios dado el aumento
cronolgica. Cmo ayudarlos a acceder a la conflictiva y
alarmante de drogodependientes en todo el mundo.
a desenmaraar la compleja madeja de su vida que los
Este grave problema al que hoy se agrega por su
condujo hacia su enfermedad?.
elevada incidencia entre los adictos el Sndrome de
Inmunodeficiencia Adquirido, S.I.D.A. nos debe conducir Cuando nos informamos en algunos casos sobre su
a constantes reflexiones a todos, profesionales y no serologa positiva pensamos que tal vez su limitacin
profesionales. va a ir sucedindose hasta alcanzar situaciones que les
van a llevar a la muerte y que aquellos a quienes
En la prevencin, cul sera el rol del MT y cuando la
queremos asistir buscando una salida hacia la vida,
adiccin ya est instalada qu tcnicas utilizar. Cmo
vern truncada sus posibilidades por el S.I.D.A.?.
ayudarlos a internalizar el concepto de lmites que no
resulten inhibitorios de sus capacidades de desarrollo Quin nos contiene?. Cuan alta debe ser nuestra
personal y s favorecer el que accedan a su propia tolerancia a la frustracin!.
felicidad y la de todos los que junto a ellos deben hacer

332
 M U SI C T H ER APY I N PSYC H O T H ER APEU T I C patient and the therapist together is an interpsychic
T R EAT M EN T O F SC H I Z O PH R EN I A / dynamic synthesis, which can be internalised and form
M U SI C O T ER API A EN EL T R AT AM I EN T O the basis of an intrapsychic synthesis in the "Inner
PSI C O T ER APU T I C O D E L A ESQ U I Z O F R EN I A World" of the schizophrenic patient.

H ANNE -METTE K ORTEGAARD When the patient and the therapist improvise together
they set out for a journey into the "Inner World" of
schizophrenic patient. By sharing the musical symbols
Understanding the general principles in music therapy of the patient and adding his own symbols and
treatment of schizophrenic patients is as follows: imaginations into the duality of the music, the therapist
- The understanding and treatment are dominated shares his own Self with the patient.
by a psychodynamic approach. In the music theraputic improvisation we are using the
- The internalisation process is to be seen as a ability to create new symbols by melting the symbols
lifelong process where the internalised objects in the and feelings of the two improvisational partners
"Inner World" of the schizophrenic patient have got their together. As the music at the same time has an ability to
own dynamic nature. seduce us and stimulate a regressive proces, the
improvisation is always followed by an integrating verbal
- The function of the music is primarily containing
dialogue.
and reverie.
In the paper, the use of improvised music in
- The improvised musical expression created by the

333
psychotherapeutic treatments of schizophrenia is - La improvisacin musical creada por el paciente y
described and illustrated by a case study. The paper el terapeuta juntos es una sntesis dinmica e
includes theories and considerations on how music intrapsquica que puede ser internalizada y puede
works in the "Inner World" of the schizophrenic patient, formar la base de una nueva sntesis intrapsquica en el
the therapist and in the space between them. "Mundo interno" del paciente esquizofrnico.

Cuando el paciente y el terapeuta improvisan juntos,

comienzan un viaje hacia el "Mundo interno" del
Diferentes grupos que nos permiten la comprensin de
paciente esquizofrnico. Al compartir los smbolos
los principios generales del tratamiento
musicales del paciente y agregar sus propios smbolos
musicoteraputico en pacientes esquizofrnicos:
e imaginaciones a la dualidad de la msica, el terapeuta
- La comprensin y tratamiento son sobre todo un comparte su propio yo con el paciente.
acercamiento psicodinmico.
En la improvisacin musicoteraputica surge la
- El proceso de internalizacin debe considerarse habilidad de crear nuevos smbolos, mezclando y
como un proceso de vida donde los objetos que se uniendo los smbolos y los sentimientos de la pareja
internalizan en el "mundo interno" del paciente que improvisa conjuntamente.
esquizofrnico tienen su propia naturaleza dinmica.
La msica tiene la capacidad de seducirnos y estimular
- La funcin de la msica es principalmente procesos regresivos al mismo tiempo. Por lo tanto la
contener y reverie. improvisacin siempre es concluida con un dilogo

334
verbal integrativo. This home has 200 beds in separate wards for the
somatic and the psychogeriatric patients.
En la ponencia ser incluida la descripcin de un caso,
con el uso de la improvisacin musical en el tratamiento The aims of Music Therapy are:
psicoteraputico de la esquizofrenia.
- offering a possibility for expression, especialy in
La ponencia incluye teoras y consideraciones sobre: the case of emotional problems.
Cmo influye la msica en el "Mundo interno" del
- a social aim: preventing or solving loneliness.
paciente esquizofrenico, del terapeuta y el espacio
- re-inforcing the sense of self respect.
comn entre paciente y terapeuta.
- improving concentration (e.g. memory training)

- stimulating communication, verbal or nonverbal.

M U S I C T H E R A P Y : A S U B JE C T W E L L W O R T H
- spending time in a meaningful way.
C O N SI D ER I N G / L A M U SI C O T ER API A: U N
T EM A Q U E M ER EC E SER EST U D I AD O The different groups I work with:

B EP L AMEIJER - STERENBERG 1. The psychogeriatric group.

Activities: we talk about the subject, we try to think of

songs, poems or proverbs that deal with the chosen
Since 1979 I have been working as a music theapist in a
subject; we sing, play instruments, listen to each other
nursing home for chronic patients.
and existing music, we move to the music.

335
2. The afasia group.

Activities: as for the psychogeriatric group. The aims of Desde 1979 he trabajado como musicoterapeuta en
the therapy are directed to: una clnica para pacientes crnicos.

a. the emotional problemas resulting from the handicap Los objetivos de la musicoterapia son, por ejemplo:
(sorrow, anger, depression).
- Ofrecer la posibilidad de expresarse,
b. the social problems (isolation, loneliness). especialmente en caso de problemas emocionales.

c. alternative possibilities for communication. - Objetivo social: evitar o resolver la soledad.

3.The youth group, 25 and older. - Reforzar el sentido de auto-estima.

Apart from the earlier mentioned possibilities attention - Mejorar la concentracin (por ejemplo,
is given to increasing their knowledge and extending entrenamiento de la memoria).
their emotional environment.
- Emplear el tiempo de forma positiva.
4. The nursing home has a repose unit. With these
Diferentes grupos con los cuales trabajo:
patients only receptive Music Therapy is possible.
1. Grupo psicogeritrico.
5. The home orchestra.
Actividades: hablamos acerca del tema, tratamos de
The aims: a. integration of patients and others. b. giving
pensar en canciones, poemas o refranes que traten del
concerts inside as well as outside the nursing home.
tema elegido.

336
Cantamos, tocamos instrumentos, nos escuchamos y 5. Orquesta de la clnica.
nos movemos hacia la msica.
Objetivos: a. Integracin de los pacientes. b. Dar
2. Grupo de afasia. conciertos, tanto dentro como fuera de la clnica.

Actividades: como para el grupo psicogeritrico. Los

objetivos de la terapia van dirigidos a:
PL AYI N G M U SI C AN D BEI N G WI T H T H E
a. los problemas emocionales resultantes de su
O T H ER S. U SI N G M U SI C AS A M ET APH O R I C AL
disminucin (tristeza, rabia, depresin). b. Los
EXPER I EN C E T O AD D R ESS T H E
problemas sociales (aislamiento, soledad). c. Las
I N T ER PER SO N AL D I F F I C U L T I ES O F
posibilidades de comunicacin alternativas.
PSYC H I AT R I C PAT I EN T S / T O C AN D O M SI C A
3. Grupo de jvenes, 25 aos o ms. Y C O N VI VI EN D O C O N L O S D EM S: U SAN D O
L A M SI C A C O M O U N A EXPER I EN C I A
Adems de las posibilidades anteriormente
M ET AF R I C A PAR A T R AT AR L AS
mencionadas, se presta atencin al aumento de sus
D I F I C U L T AD ES I N T ER PER SO N AL ES D E L O S
conocimientos y a la ampliacin de su entorno
PAC I EN T ES PSI Q U I T R I C O S
emocional.

4. La clnica dispone de una unidad de reposo. Con T ERESA P AULA L EITE

estos pacientes slo es posible la musicoterapia
receptiva.
This is a paper designed to emphasize the importance

337
of Music as a form of human interaction and also a s a experiences and a supportive/"holding" attitude of the
symbolic experience within the therapeutic setting. therapist.

The author advocates that the music therapy work with The music created in the music therapy session is a
psychiatric patients should be as much as possible dynamic symbol of the therapeutic processes that are
connected with the patient's life experiences and aimed occurring within the client-therapist relationship. In fact,
towards the achievement of two main goals: The Music is a symbolic recreation of personal and
development of satisfying relationships and the interpersonal experiences that occur in one's life.
nurturing/maintenance of the healthier parts of the self.

This paper is intended to demonstrate that the abstract

Este es un trabajo diseado para realzar la importancia
concepts of Musical Symbol and Musical Metaphor take
de la Msica como una forma de interaccin humana y
form in the most concrete aspects of the session work
tambin como una experiencia simblica dentro del
and allow for the session-achievements to slowly
contexto teraputico.
extrapolate to the patient's life out of the session.
El autor es partidario de que el trabajo en musicoterapia
Given that interpersonal relationships are one of the
con pacientes psiquitricos debera ser conectado,
most problematic areas in the life of the psychiatric
tanto como sea posible, con las experiencias vitales del
patient, it is postulated that the music therapy work
paciente, y dirigido hacia la consecucin de dos
should be based on an interactive relationship between
objetivos principales: el desarrollo de relaciones
the patient and the therapist, the sharing of musical
satisfactorias y el fomento/mantenimiento de las partes

338
ms saludables del Yo. nuestra vida.

Este trabajo se propone demostrar que los conceptos

abstractos de Smbolo Musical y Metfora Musical se
T H E ST O R Y SO N G T EC H N I Q U E: A
materializan en los ms concretos aspectos de la
T H ER APEU T I C T O O L F O R T H E YO U N G ,
sesin de trabajo y permiten logros para lentamente
EM O T I O N AL L Y H AN D I C APPED G R O U P / L A
extrapolar la vida del paciente fuera de la sesin.
T C N I C A D E L A C AN C I N D EL C U EN T O : U N A
Dado que las relaciones interpersonales son una de las
H ER R AM I EN T A T ER APU T I C A PAR A U N
ms problemticas reas en la vida del paciente
G R U P O D E J V E N E S C O N C O N F L I C T O S
psiquitrico, se postula que el trabajo de musicoterapia
EM O C I O N AL ES
debera estar basado en una relacin interactiva entre
el paciente y el terapeuta, compartiendo experiencias J OANNE L OEWY
musicales con el apoyo y la actitud de "soporte" por
parte del terapeuta.
There is a reason why certain songs and nursery
La msica creada en la sesin de musicoterapia es un rhymes have endured to become classic. As creative
smbolo dinmico de los procesos teraputicos que arts therapists we need to understand not only the
ocurren en la relacin paciente-terapeuta. De hecho, la implications of their endurance, but more importantly
Msica es una recreacin simblica de experiencias how these songs may serve oru sessions
personales e interpersonales que ocurren durante therapeutically. The therapist may carefully assess and

339
therapeutically process the child's emotional growth en clsicos. Como terapeutas creadores de arte
from session to session within the STORY SONG debemos comprender no slo las implicaciones de su
schema. This workshop is both presentation and perdurar, sino tambin cmo estas canciones pueden
observation. It includes an experiential practice of the servir a nivel teraputico en nuestras sesiones. El
technique. terapeuta puede evaluar cuidadosamente y procesar
teraputicamente el crecimiento emocional del nio,
DESCRIPTION:
sesin tras sesin, dentro del esquema de la HISTORIA
This presentation utilizes all forms of creative arts. The
DE LA CANCIN. Este taller quiere ser de presentacin
stories and nursery rhymes of young children have
y observacin e incluye una prctica experimental de la
historically grow to become a crucial facet of their every
tcnica.
day life. Yet, rarely have they become a part of our
DESCRIPCIN:
children's treatment. Most of these folk themes have an
open structure. This is most appealing to the creative En esta presentacin se utilizan todas las formas del
therapist. It allows us to further expand or even change arte creativo. Las historias y las rimas infantiles de los
entirely the basic theme according to the needs of nios se desarrollaron histricamente hasta convertirse
specific children. en una faceta crucial de su vida cotidiana. Sin embargo,
se convirtieron raramente en una parte del tratamiento
de los nios. La mayora de estos temas populares
Existe una razn por la cual algunas canciones de cuna tienen una estructura abierta, lo que resulta muy
y las rimas infantiles han durado tanto hasta convertirse atractivo para el terapeuta creativo. Nos permite

340
ampliar ulteriormente o incluso cambiar por completo el instruments than non schizophrenics does not seem to
tema de base segn las necesidades de los nios. be true.

Research indicates that the most important factor in

musical communication with schizophrenics (and
SC H I Z O PH R EN I A AN D M U SI C : R ESEAR C H
others) is the therapist's respect for the patient's
I N T O N O N VER BAL C O M M U N I C AT I O N /
musical sound field. It seems that a condition for a
ESQ U I Z O F R EN I A Y M SI C A, I N VEST I G AC I N
positive interaction and a better therapeutical treatment
D E C O M U N I C AC I N N O - VER BAL
is that both therapist and patient have the same musical
sound range.

G RETHE L UND This research has been inspired on the book "The
Language of Psychosis" by Rosenbaum and Sonne
(1979).
Music Therapy. Music therapy is a form of treatment
which gives schizophrenics the possibility of The conference will be complemented by tapings of
communicating without the use of words. therapy sessions at Viborg Psychiatrical Hospital.

The assumption according to which a specifically

schizophrenic language would not become manifest Terapia musical. Terapia musical activa es una forma
during musical improvisation / communication and that de tratamiento que da a los esquizofrnicos la
a schizophrenic would use other musical elements or posibilidad de comunicarse sin el uso de palabras.

341
La suposicin que un idioma especficamente sesiones de terapia musical en el Hospital Psiquitrico
esquizofrnico se manifestara durante las de Viborg.
improvisaciones/comunicaciones musicales y que el
esquizofrnico usara otros elementos o instrumentos
musicales que los no-esquizofrnicos, pareciera no ser M ET H O D O L O G I C AL AN D C L I N I C AL
cierta. C O N SI D ER AT I O N S ABO U T T H E U SE O F M U SI C
T H E R A P Y O N S U B JE C T S W I T H S E V E R E
Investigaciones indican que el factor ms importante de
M EN T AL D EF I C I EN C Y AN D PSYC H O T I C
la comunicacin musical con esquizofrnicos (y otros),
es el respeto por parte del terapeuta por el campo D I ST U R BAN C ES / C O N SI D ER AC I O N ES

sonoro musical del paciente. Parece ser que una C L N I C AS Y M ET O D O L G I C AS SO BR E L A

condicin para una interaccin positiva y un mejor M U SI C O T ER API A PAR A D I SC APAC I T AD O S

tratamiento teraputico, es que el paciente y el M EN T AL ES G R AVES C O N D I ST U R BI O S

terapeuta tengan el mismo campo de alcance sonoro PSI C T I C O S D E L A C O N D U C T A

musical. G ERARDO M ANAROLO , MARCO G ILARDONE & FERRUCCIO

Esta investigacin ha sido inspirada en el libro "The D EMAESTRI

Language of Psychosis" (el idioma de la psicosis) de

Rosenbaum y Sonne (1979).
Methodological and clinical considerations about the
La conferencia ser suplida con grabaciones de use of music therapy on subjects with severe mental

342
deficiency and psychotic disturbances. and pathological aspects.

In the field of psychophysical disability, the music- Therefore, it is necessary to use this instrument (i.e.
therapeutical approach presents several proposals and music therapy) to get into contact with the subject's
experiences. emotional and affective life (even if this life is archaic)
and with this, articulate an evolutionary path, which,
The idea of using the musical sonorous element as a
according to each individual case, can have a precise
therapeutic/rehabilitative instrument arises sometimes,
psychotherapeutic or rehabilitative goal.
from the incidental observance of the fascinating and
exciting power of the musical/sonorous stimulation or,
yet again, from the presence of specific competences.
En el campo de la disminucin psico-fsica, la
More easily then in other sectors, one can, while dealing aproximacin de la musicoterapia presenta numerosas
with seriously or moderately mentally deficient subjects, propuestas y experiencias.
make the mistake of considering the musical/sonorous
La idea de utilizar el elemento sonoro musical como
element to be endowed with a rehabilitative/therapeutic
instrumento teraputico/rehabilitador surge a veces de
value, without considering the necessity to integrate this
la observacin casual del poder fascinante y excitante
into a relational process or into a rehabilitation program.
de la estimulacin musical/sonora u, otras veces, de la
Indeed such an element can often carry out a presencia de competencias especficas.
pathological role, in fact, in conjunction with the less
Ms fcilmente que en otros sectores, al tratar a sujetos
envolved aspects of the subject, it reinforces abnormal
con deficiencias mentales graves o medias, es posible

343
caer en el error de considerar que el elemento la presentacin de dos casos clnicos de grave
musical/sonoro est dotado de valor disminucin mental, respectivamente con un marco
teraputico/rehabilitador, sin tener en cuenta la cerebroptico y de psicosis autista, en pacientes con
necesidad de integrarlo en un proceso de relacin o en una funcin visual limitada de forma significativa.
un programa de rehabilitacin.

Naturalmente, dicho elemento puede desempear a

T H EO R ET I C AL C O N ST R U C T S T O WAR D S T H E
menudo un papel patolgico: en efecto, junto con otros
U SE O F M U SI C F O R AT T U N EM EN T I N
aspectos menos evolucionados del sujetos o
favoreciendo una regresin en una parte del mismo PSYC H O T H ER APY / C O N ST R U C T O S

sujeto, fortalece aspectos anormales y patolgicos. T E R I C O S H AC I A L A U T I L I Z AC I N D E L A

M SI C A EN L A PSI C O T ER API A
Por lo tanto, es necesario utilizar este instrumento (es
decir la musicoterapia) para entrar en contacto con la C AROLE M ARSHALL
vida emocional y afectiva del sujeto (aunque sea
arcaica) y con ello articular un camino evolutivo que,
For many years I studied and explored the theorical
segn el caso de cada individuo, pueda tener una meta
literature of music therapy, psychoanalysis, self
psicoteraputica o rehabilitadora clara.
psychology, gestalt, T.A. and so on, without finding what
Nuestro trabajo se propone ilustrar un mtodo preciso I needed. It was not until I read Daniel Stern
para la evaluacin y el tratamiento, como mostrado en (psychoanalyst, clinical psychologist and infant

344
observer) and Suzanne Langer (aesthetics (melody, harmony, rhythm, etc.) and relate to Stern's
philosopher) that I began to comprehend the profound vitality affects. Our inner subjective time is experineced
connection between music and human subjective as a total fabric woven of these tensions varying in
experience and thus develop the theretical foundation I length, intensity and shape: these are the key measures
needed. Stern uses to establish attunement through behavior.

As Stern's work helps me understand our experiential

life, Lange's work helps me understand the essence of
Durante muchos aos estudi y explor la literatura
music and its relation to experiential life. Langer's work
terica de la musicoterapia, psicoanlisis, auto-
is to complex for me to synthesize but I will mention
psicologa, estructuralismo, T.A. y as sucesivamente,
concepts that synchronize beautifully with Stern's work.
sin encontrar lo que necesitaba. Cuando le a Daniel
For Langer music is not synonymous with emotion but Stern (psicoanalista, psiclogo clnico y observador
because music sounds so much the way emotions feel infantil) y Suzanne Langer (filsofa de esttica),
that we mistake music as emotions proper. However, empec a comprender la profunda conexin existente
this similarity allows us to use music to symbolize our entre la msica y la experiencia humana subjetiva y a
subjective realm and thus to give us insight into the desarrollar la base terica que necesitaba.
organic patterns and processes of our inner of motion
As como el trabajo de Stern me ayud a comprender
and rest, tension and release, excitation, sudden
las experiencias de nuestra vida, el trabajo de Langer
change, etc. These patterns of tension and resolution
me ayud a comprender la esencia de la msica y su
can be expressed in all of the elements of music

345
relacin con las experiencias de la vida. El trabajo de varan en longitud, intensidad y forma: estas son las
Langer es demasiado complejo para que pueda medidas clave que Stern utiliza para establecer la
sintetizarlo, pero mencionar algunos conceptos que armonizacin a travs del comportamiento.
sintonizan de maravilla con el trabajo de Stern.

Para Langer la msica no es sinnimo de emocin,

F A C U N D O `S L O S T S C E N E : T H E
pero puesto que la msica recuerda tanto la manera en
C O N T R I BU T I O N S O F M U SI C T H ER APY T O A
que se sienten las emociones, confundimos la msica
C L I N I C AL C ASE / L A ESC EN A PER D I D A D E
con las emociones. Sin embargo, esta similitud nos
permite utilizar la msica para simbolizar nuestro reino F AC U N D O . APO R T ES D E L A M U SI C O T ER API A

subjetivo y penetrar en los modelos y procesos EN U N C ASO C L N I C O

orgnicos de nuestras vidas interiores. La msica C LAUDIA I NES M ENDOZA

expresa entonces las formas de nuestras emociones o
modelos de movimiento y descanso, tensin y
relajacin, excitacin, cambio sbito, etc. Estos This work is based on the musical-therapeutic approach
modelos de tensin y relajacin se pueden expresar en taken with an adolescent who had been diagnosed as
todos los elementos de la msica (meloda, armona, having "a psychotic structure with symptoms of mental
ritmo, etc.) y se relacionan con las emociones vitales de debility". The aims were to develop several hypothesis
Stern. Experimentamos nuestro tiempo subjetivo related to "The voice and Psychosis", and also to
interior como una tela tejida con estas tensiones que contribute to the field of clinical Music therapy.

346
The challenge, the extraordinary ambition of trying to far are positive.
construct a subject from bits and pieces, from noises
and blank expressions, from assonances and body
expressions, which other sciences leave to the realm of
Este trabajo se basa en el enfoque clnico

theories, is now the challenge of Music therapy. This

musicoteraputico del caso de adolescente con

pursuit of knowledge allowed Facundo to become a

diagnstico de: "Estructura psictica con sintomatologa

subject.
de debilidad mental".

Final comments:
Tiene por objetivo el desarrollo de algunas hiptesis en
torno a: "La voz en la Psicosis" y pretende ser una
I believe that significant changes have occurred
aportacin al campo de la Musicoterapia Clnica.
between the patient and his social and family
environment, to which he can now respond without the
Es a partir de este desafo de tamaa pretensin, la

incredible trauma that this previously produced. The

ambicin extraordinaria de producir un sujeto a partir

treatment took place in a space where expressive

de recortes, "ruidos", "expresiones vacas", "asonancias

activity and dramatic sound could reflect confusing

verbales", "el cuerpo como ltima expresin" (que otras

aspects of the personality:fears, questions and

ciencias dejan como campo libre de teoras) que la

discoveries. The dynamics and the interplay which are

musicoterapia se abre camino rodeando el saber,

produced in these sessions provide a "screen" or a

permitiendo a Facundo llegar a ser Sujeto.

"mirror" from where self questioning and understanding Comentarios finales:

can begin. There is still much to learn, but the signs so

347
Considero que se produjeron modificaciones AC T U AL ES PAR A L O S M U SI C O T ER APEU T AS
significativas en la relacin del paciente con su medio Q U E T R A B A JA N E N P S I Q U I A T R A
social y familiar, a las que ha ido dando respuestas
H ELEN O DELL-MILLER
adecuadas con una marcada disminucin de la
angustia que esto le generaba. El tratamiento de
musicoterapia se constituy en un espacio en que, por This experiential workshop will use a group Music
medio de la actividad expresiva, dramtica y el juego Therapy framework with a psychoanalytically informed
que se produce en las sesiones, le proporcionan una approach, to look at current issues facing music
"pantalla", un "espejo", desde donde puede empezar a therapists who work with clients suffering from a range
reconocerse, pensarse y acercarse a la compresin of psychiatric problems. It will have two main functions;
paulatina de su mundo interior. Queda mucho por
1. Demonstrate this therapists way of working within a
recorrer. Los indicadores relacionados con su
group Music Therapy framework in psychiatry where
produccin marcan una direccin favorable en este
improvisation is used to focus on group issues, and can
proceso.
lead to a clearer understanding of problems.

2. Examine current world wide issues facing music

C U R R EN T I SSU ES F O R M U SI C T H ER API ST S therapists in the psychiatric field, and possibly arrive at
WO R KI N G I N PSYC H I AT R Y / C U EST I O N ES some common statements concerning models of
clinical practice.

348
N.B. This is NOT a situation where members have their psiquiatra y eventualmente llegar a unas declaraciones
own Music Therapy, but an experiential workshop comunes acerca de los modelos de prctica clnica.
where work issues can be examined using a Music
Nota: Esta NO es una situacin en que los participantes
Therapy group model.
tienen su propia musicoterapia, sino un taller en que se
pueden estudiar los temas de trabajo utilizando un
modelo de musicoterapia de grupo.
En este taller se utilizar un marco de musicoterapia de
grupo, con una aproximacin psicoanaltica, para
estudiar las cuestiones actuales que ataen a los
M U SI C T H ER APY I N R EH ABI L I T AT I VE
musicoterapeutas que trabajan con clientes que
PR O G R AM / L A M U SI C O T ER API A EN EL
presentan problemas psquicos diferentes. Tendr dos
funciones principales: PR O G R AM A D E R EH ABI L I T AC I N

1. Mostrar la forma de trabajo de los musicoterapeutas G ABRIELA G. PERILLI & SANTO R ULLO
dentro del marco de la musicoterapia de grupo en la
psiquiatra, donde se utiliza la improvisacin para
A two hour workshop which propose a progressive
centrarse sobre temas de grupo y poder llegar a una
clinical intervention with psychotic patients. The
comprensin ms clara de los problemas.
participants would be involved in a practical experience.
2. Examinar las cuestiones actuales que a nivel mundial This methodology has been used since many years at
interesan a los musicoterapeutas en el campo de la University of Rome, Psychiatric Departament.

349
 Therapeutic musicians trained in psychotherpy aim to
awaken pleasure at group playing through individual
En un taller de dos horas de duracin, se propone una
training.
intervencin clnica progresiva con pacientes
psicticos. Los participantes realizarn una experiencia Patients who are musicians or not musicians work on
prctica. Esta metodologa se utiliza desde hace pieces of musicaccording to their learning abilities,
muchos aos en la facultad de psiquiatra de la which are improving through steady training adjusted to
Universidad de Roma. each case.

The improved performances raise up motivation to go

further and encourage them to speak of conflicts.
EVO L U T I O N O F C L I N I C AL C ASES T H R O U G H
Chamber music or choral command respect to musical
M U SI C O T H ER APY I N AD U L T I N ST I T U C I O N AL
rules and acceptance of proposals made by the leader.
SET T I N G S / EVO L U C I N D E C ASO S
C L N I C O S A T R AVS D E D I F ER EN T ES These regressed patients are supposed to find in these
T R AT AM I EN T O S D E M U SI C O T ER API A EN groups a model of a micro-society and to evolve
PSI Q U I AT R A PAR A AD U L T O S personally and socially through interactions analysed by
therapeutists.
S IMONE Q UELIN , JOSETTE K UPPERSCHMITT , A . DEGIOVANNI
& J. DE VERBIZIER Our survey concentrates on the evolution of an epileptic
patient and of two psychotic patients.

350
 Centraremos principalmente nuestro estudio sobre la
evolucin de un paciente epilptico y dos pacientes
Los musicoterapeutas, msicos, formados a la
psicticos.
psicoterapia, se dan como objetivo de hacer 'aparecer
el placer a interpretar en grupo, a travs del
aprendizaje individual.
EN VI R O N M EN T AL F AC T O R S AN D
Los pacientes msicos, o no, trabajan trozos de msica
R EG R ESSI VE C H AR AC T ER I ST I C S O F T H E
segn su capacidad para aprender. Estas capacidades
N O N - C O M M U N I C AT I VE C H I L D I N M U SI C
se desarrollan con un aprendizaje regular y adaptado a
T H ER APY / EL M U T I SM O A T R AVS D E L A
cada caso.
M U SI C O T ER API A. F AC T O R ES AM BI EN T AL ES Y
Los progresos realizados suscitan una motivacin para C AR C T ER R EG R ESI VO D EL N I O
continuar, y la necesidad de hablar de sus conflictos.
M L UISA R IPOLLS C ABRERA
La msica de cmara o el coro, imponen el respecto de
las reglas de la ley musical, y la aceptacin de las
proposiciones de la persona que dirige. This work is approached from two different points of
view. First, there is a theoretical research about the
Estos pacientes en regresin, encuentran en este
concept itself, with an analysis of the context where the
grupo un modelo de micro-sociedad, lo cual permite
elective dumbness really takes place and the several
una evolucin personal y social, a travs de las
variations that exist.
interacciones analizadas por los terapeutas.

351
Second, there is a speech rehabilitation project with a Los objetivos planteados en el trabajo, se contrastan
subject through rhythmic musical exercises, musical con las teoras de diferentes autores, y con el anlisis
play, and self-knowledge using music therapy. del medio ambiente que rodea al sujeto, podemos
demostrar si el fomento, s el mantenimiento del
The objectives planned in the work will be contrasted
problema.
with the theories of many authors. The analysis of the
environment surrounding the subject shows how the
problem is mantained-if not increased-by the
SO U N D AN D SYM BO L : T H E I N T ER F AC E O F
environment.
M U SI C AN D PL AY I N M U SI C T H ER APY WI T H
SEXU AL L Y ABU SED C H I L D R EN / EL SO N I D O Y
El trabajo viene enfocado desde dos puntos de vista EL S M BO L O : L A R EL AC I N D E L A M SI C A Y
donde se realiza una investigacin a nivel terico sobre E L JU E G O E N L A T E R A P I A M U S I C A L C O N
el concepto en si mismo, analizando el contexto donde M EN O R ES V C T I M AS D E ABU SO SEXU AL
realmente se encuentra el mutismo electivo dentro de
J ACQUELINE Z OE R OBARTS
todas las variantes que existen.

En segundo lugar se trabaja un proyecto de

Sound and symbol are mediators of the unconscious
rehabilitacin del habla en un sujeto a travs de
realms of the psyche. Musical responsiveness and
ejercicios musicales de ritmo, juego musical, y
symbolic play images may present simultaneously or
conocimiento de si mismo mediante la musicoterapia.

352
episodically in alternation with each other within the
therapy sessions. Emotional integration and the
El sonido y el smbolo son los mediadores de los reinos
progression towards psychological health is evidenced
del inconsciente de la psique. La respuesta musical y
in both music and play phenomena, as are the child's
las imgenes simblicas del juego se pueden presentar
defences. The music therapy process involving
a la vez o espordicamente, alternndose mutuamente
symbolic play is described with particular reference to
en el curso de las sesiones de terapia. La integracin
Jungian archetypal psychology and child development
emocional y el progreso hacia la salud psicolgica se
in respect of three children who suffered sexual abuse
ponen en evidencia tanto en los fenmenos de la
in early childhood. Some of the implications of such
msica como en el juego, puesto que representan las
abuse and consequent psychic fragmentation plus the
defensas del nio. Se describe el proceso de
child's distorted capacity to symbolise is discussed. The
musicoterapia, que implica el juego simblico con
amelioration of the children's condition is illustrated in
especial referencia a la psicologa jungiana de
case study examples on video or audio tape. Analysis of
arquetipo y al desarrollo del nio, aplicada a tres nios
the musical relationship and musical components or
que fueron objeto de abuso sexual en su primera
infrastructures also support the documentation of
infancia.
personality integration.
Se estudian algunas de las implicaciones de dichos
Sound and symbol are viewed in their different, but
abusos y la consiguiente fragmentacin psquica,
related functions in music therapy with sexually abused
adems de la capacidad distorsionada de simbolizar
children
por parte del nio. La mejora de las condiciones del nio

353
se ilustra con ejemplos en vdeo o cinta. La dramatically in the UK, Europe and the USA. As referrals
documentacin de la integracin personal se basa increase in number, we find more music therapists
tambin en el anlisis de la relacin musical y los being involved in assessing children deemed to be at
componentes musicales o las infraestructuras. El risk.
sonido y el smbolo se estudian en sus funciones
This paper tries to understand the meaning of abuse
diferentes, pero relacionadas, dentro
and its effects on a child. It examines the diagnostic
de la musicoterapia aplicada a nios que sufrieron potential of music therapy using extracts from case
abusos sexuales. material and highlights a number of issues which arise
in work with this client group.

Many of the issues discussed are pertinent to a range of

T H E U SE O F M U SI C T H ER APY WI T H
client groups such as those with eating disorders or
SEXU AL L Y ABU SED C L I EN T S. / L A
substance abuse.
U T I L I Z AC I N D E L A M U SI C O T ER API A C O N
C L I EN T ES Q U E SU F R I ER O N ABU SO S
SEXU AL ES. En el Reino Unido, en Europa y en los Estado Unidos
los casos de nios que sufrieron abusos sexuales se
P ENNY R OGERS
incrementaron de forma dramtica. Al aumentar el
nmero de casos, cada vez ms musicoterapeutas
Referrals for child sexual abuse have increased estn trabajando para evaluar a los nios expuestos a

354
este riesgo. intervention of prevention and care of mental
disturbance
En esta ponencia se trata de comprender el significado
de los abusos y su efecto sobre un nio. Se estudia el A preventive intervention of psychic disturbance is
potencial de diagnstico de la musicoterapia, utilizando described. It was carried out by the author at a
material extrado de los casos tratados y se ponen de departmental service of mental health in the Lazio
relieve ciertos temas que se presentan al trabajar con Region.
este grupo de clientes.
Eight clinical patients were selected, diagnostically set
Muchos de los temas tratados se relacionan con una and were explained they would begin a new therapeutic
gama de grupos de clientes como los que presentan treatment. Finally the relatives or generally the most
trastornos en la alimentacin o abuso de sustancias. meaningful figures were singled out and involved in an
overall intervention strategy.

This intervention has two different meanings: on the one

B E F O R E T H E E V I L C A T C H E S U S .... / A N T E S
hand a secondary prevention for the above mentioned
Q U E E L M A L N O S C O JA ... patients to prevent their disturbance from becoming

FAUSTO RUSSO
more and more serious or chonic, on the other hand a
primary prevention for the involved relatives. So was
established an "observers-observed" system where it
BEFORE THE EVIL CATCHES US... The use of music was possible to monitor some behavioural parameters
therapy within a cognitive-relational pattern for an

355
of the observed chosen as markers of that particular Se han localizado ocho pacientes de ambulatorio
syndrome condition. diagnosticados, explicndoles que iniciaran un nuevo
tratamiento teraputico; se ha hallado adems a los
The patients (the observed eight) were treated with a
familiares - o a las figuras ms significativas en general
music therapy intervention.
- comprometindoles en una estrategia de intervencin
Their production was gathered around some
global.
observation poles and was the material to use as a
Este tipo de intervencin adquiere el significado de
psychotherapeutic work.
prevencin secundaria hacia los arriba mencionados
All the data and aspects coming out of each area of
pacientes, para evitar que sus trastornos se agraven o
identifiable observation were taken into account and
se hagan crnicos y de carcter primario para sus
"included" in the above mentioned therapeutic system.
familiares implicados.

De esta manera se ha creado un sistema

ANTES QUE EL MAL NOS COJA...La utilizacin de la "observadores-observado" en el cual se monitorizan
musicoterapia en un modelo cognitivo-relacional para algunos parmetros comportamentales del observado,
una intervencin de la enfermedad mental elegidos como seales indicativas (o markers) de esa
manera determinada condicin sindrmica.
Se describe una intervencin preventiva del trastorno
psquico, encaminado por el autor hacia un servicio Los pacientes (los ocho observados) eran despus
departamental de salud mental en la regin Lacio. tratados con una intervencin de musicoterapia. Los

356
resultados de su produccin se reunan en torno a unos The first session and the most meaningful one are
polos de observacin y constituan el material a utilizar described.
como trabajo psicoteraputico.
The protocols of intervention and reading are given and
Todos los datos y los aspectos surgidos de cada una de the meaning of the results achieved in the
las reas de observacin reconocibles eran despus communicative level is illustrated.
tenidas en cuenta y "revertidas" en el sistema
The report is preceded by a description of the
teraputico descrito arriba.
methodology, the theoretical bases and the possibilities
of application in music therapy intervention can offer to
the systemic-relational pattern.
A ST O R Y O F A F AM I L Y T O L D BY A D R U M /
U N A H I ST O R I A D E F AM I L I A C O N T AD A PO R U N
T AM BO R Describimos aqu una intervencin de familia en la que
se ha dejado que los pacientes comunicaran entre ellos
FAUSTO RUSSO
utilizando no el lenguaje verbal, sino el instrumental-
sonoro.
This is a description of a family therapy intervention Se describen la primera sesin y otra ms significativa.
during which we let the patients communicate using the
Se proporcionan los protocolos de intervencin
sound-instrumental language instead of the verbal one.
musicoteraputica y el significado de los resultados

357
alcanzados a nivel de comunicacin. its influence on the drug adict.

La ponencia ser precedida por una descripcin de la - Musical therapy aims. Changes in the individual.
metodologa, bases tericas y posibilidades de
- Analysing the contents of a session and how to
aplicacin que la musicoterapia puede ofrecer al
evaluate it.
modelo sistmico-relacional.

- Implantacin de la musicoterapia en el contexto

M U SI C T H ER APY AN D R O C K M U SI C . del Toxicmano. Cmo y por qu, dnde y la base para
I N F L U EN C ES I N T H E T R EAT M EN T O F D R U G la realizacin de la musicoterapia en dicho contexto.
AD D I C T I O N S / M U SI C O T ER API A Y R O C K. SU
- Influencia del rock, gustos musicales de los
I N F L U EN C I A EN EL T O XI C M AN O
toxicmanos. Diferentes puntos de vista del gusto del
T XINTO S ANCHEZ rock y su influencia sobre el toxicmano.

- Objetivos de la Musicoterapia. Cambios del

residente.
- The use of musical therapy in the drug addict
environment. How, why and where to develop musical - Explicacin de una sesin, valoracin.
therapy in that area.

- How does "rock and roll" influence. Drug addicts

musical tastes. Different points of view about rock and

358
 SH O R T - T ER M M U SI C T H ER APY I N dress and happiness.
PSYC H O SO M AT I C I L L N ESS /
M U SI C O T ER API A BR EVE EN EN F ER M ED AD El objetivo de este trabajo es presentar el caso de una
PSI C O SO M T I C A paciente portadora de una enfermedad psicosomtica
de repeticin (lcera pptica) que busc la
E LISABETH D OS S ANTOS F ELICIO
musicoterapia como tratamiento de soporte emocional.

El tratamiento musicoteraputico tuvo una duracin de

The objective of this report is to present the case of a cinco meses, con una sesin semanal en que se
patient who had a repetitive psychosomatic illness practicaban tcnicas de relajacin, prctica
(peptic ulcer) and who came to music therapy in quest instrumental, improvisacin y danza libre con msicas
for emotional support treatment. del repertorio de la paciente que proceda de una
The treatment lasted five months in weekly sessions in familia de msicos.
which relaxation, instrumental practice, improvisation El resultado fue considerado por encima de las
and free dance techniques were used, with the patient's expectativas, en funcin del breve tiempo en que la
own repertoire of music. The patient had a musical paciente obtuvo el alta mdica y mostr una visible
family background. transformacin en su comportamiento, manera de
Results far exceeded expectations, taking into account vestir y alegra de vivir.
the short time in which the patient was admitted and it
produced visible changes in the patient's behaviour,

359
M U SI C T H ER APY I N F O R EN SI C PSYC H I AT R Y / 2) The use of control in and out of the session.
L A M U SI C O T ER API A EN L A PSI Q U I AT R A
3) The place of structure within the session.
F O R EN SE
4) Conditions of Forensic Psychiatry which have
K ATIE S ANTOS & HELEN L OTH implications for therapy.

Examples will be used from case studies.

This paper looks at the different approaches to the use In conclusion, this paper will attempt to understand and
of Music Therapy with clients in forensic psychiatry articulate the specific role Music Theraphy can play in
settings. it is a descriptive paper based on literature and work with mentally ill offenders, with particular reference
the experience of the authors working in a medium to those aspects of the work which are unique to the
Secure Unit and a Special Hospital (high security). Forensic setting.
It will introduce the field of forensic psychiatry and
explain the British system and terms. A survey will be
La ponencia estudia las diferentes aproximaciones a la
made of the small amount of literature regarding Music
utilizacin de la Musicoterapia con clientes en el mbito
Therapy in forensic work.
de la psiquiatra forense. Se trata de una ponencia
Aspects of particular significance will include: descriptiva, basada en la literatura y la experiencia de
1) The introduction of therapy to a highly secure setting las autoras que trabajan en una unidad de seguridad de
- staff reactions etc. grado medio y en un hospital especial (de alta

360
seguridad). desempear en el trabajo con delincuentes enfermos
mentales, haciendo especial referencia a los aspectos
Se presentar el campo de la psiquiatra forense y se
del trabajo que son propios del ambiente forense.
ilustrar el sistema britnico. Se realizar un estudio
sobre la escasa literatura existente acerca de la
Musicoterapia en el trabajo forense.
BO D Y I M AG E I N M U SI C T H ER APY: A C ASE I N
Entre los aspectos ms destacables, se incluirn:
I N F AN T PSYC H O SI S / L A I M AG EN C O R PO R AL
1) La introduccin de la terapia en un ambiente de alta EN M U SI C O T ER API A: U N C ASO D E PSI C O SI S
seguridad, las reacciones del personal, etc. I N F AN T I L

2) La utilizacin del control dentro y fuera de las S USANA S ATINOSKY

sesiones.

3) El lugar que ocupa la estructura en el mbito de la

Music Therapy can be used in the treatment of both
sesin.
neurosis and psychosis to rebuild unity and avoid
4) Las condiciones de la psiquiatra forense que dissociation.
presentan implicaciones para la terapia.
Each person has characteristics which mark him/her as
Se utilizarn ejemplos de los estudios de los casos. different from other individuals. These differences can
En conclusin, esta ponencia tratar de comprender y be used to achieve a means of communication e.g.
articular el papel especfico que la Musicoterapia puede know your own body before knowing someone else's.

361
Gestures, looks, mimicking, body image, rhythm, the Cada persona tiene caractersticas que le marcan
sensations of the skin, etc. all from different means of como diferente de otros individuos. Estas diferencias se
communicating. pueden utilizar para alcanzar un medio de
comunicacin, es decir conocer el cuerpo de cada uno
Some of the aspects considered include:
antes de conocer el de otra persona. Los gestos, las
- The difficulty of getting close to my patient
miradas, la mmica, la imagen del cuerpo, el ritmo, las
because of mistrust.
sensaciones de la piel, etc., todo esto forma un medio
- Recognising her affection and the feelings she diferente de comunicacin.
produced in other patients at the "Hospital de Dia".
Algunos de los aspectos estudiados comprenden:
- Evaluating life.
- La dificultad de estar cerca de la paciente debido
- Communication at a group level. a la desconfianza.

Music Therapy allowed, if not for a complete cure, at - Reconocimiento de su afectividad y las
least for a general of improvement in the patient and a sensaciones que la paciente suscita en otros pacientes
reduction in suffering. en el Hospital de Da.

- Evaluacin de su vida.

La musicoterapia se puede utilizar en el tratamiento, - Comunicacin a nivel de grupo.

tanto de la neurosis como de la psicosis, para La musicoterapia permiti, aunque no una curacin
reconstruir la unidad y evitar la disociacin.

362
completa, al menos una mejora general en el estado
del paciente y una reduccin del sufrimiento.
El autor describe la experiencia de musicoterapia en un
centro de habilitacin psicomotriz, llevada a cabo con
un nio de ocho aos enfermo de psicosis autista
PO SSI BI L I T I ES O F U SI N G M U SI C T H ER APY I N
infantil y tratado desde hace dos aos con
T H E H ABI L I T AT I O N T R EAT M EN T O F
psicomotricidad.
C H I L D R EN I N T H E AG E O F D EVEL O PM EN T /
PO SI BI L I D AD ES D E U T I L I Z AC I N D E L A
M U SI C O T ER API A EN EL T R AT AM I EN T O D E
T H E U SE O F I N D I VI D U AL M U SI C T H ER APY I N
R EH ABI L I T AC I N D E N I O S EN ED AD D E
T H E T R EAT M EN T O F PEO PL E WI T H EAT I N G
D ESAR R O L L O
D I SO R D ER S / L A U T I L I Z AC I N D E L A
R OSARIO S AVINO M U SI C O T ER API A I N D I VI D U AL EN EL
T R AT AM I EN T O D E PER SO N AS C O N
T R AST O R N O S EN L A AL I M EN T AC I N
The author describes the experience of music therapy
at a psycho-motor habilitation centre, carried out with a A NN S LOBODA

eigth years old child suffering from "Child autistic

psychosis". The child has already been treated for two
This paper describes short-term music therapy work in
years with psychomotricity.
an adult psychiatric unit that specialises in eating

363
disorders (anorexia and bulimia nervosa and (anorexia, bulimia nerviosa y alimentacin compulsiva).
compulsive eating). It focuses on case examples of a La ponencia se centra en ejemplos de casos de varias
number of people suffering from these conditions, and personas que sufren dichos trastornos, incluyendo a
includes both male and female patients. pacientes varones y hembras.

With reference to literature, this paper will discuss the Con referencia a la literatura, en esta ponencia se
emotional and psychological experiences of people debaten las experiencias emocionales y psicolgicas
suffering from disorder. It examines the functions that de las personas que sufren trastornos en la
the eating disorders serve for the patients in this study, alimentacin. Se estudian las funciones relacionadas
looking at issues such as poor self-image, inability to con dichos trastornos, estudiando temas como la
tolerate painful emotions, and fear of losing control. It carencia de auto-estima, la incapacidad de tolerar las
suggests that music therapy has a valuable role to play emociones dolorosas y el miedo a perder el control. Se
in enabling people (through improvisation with the sugiere que la musicoterapia tiene un papel valioso que
therapist) to experience their emotions and gain some desempear para permitir a la gente (a travs de la
insight into the way they relate to others. improvisacin con el terapeuta) que experimente sus
emociones y comprenda su forma de relacionarse con
los dems.
Esta ponencia describe la aplicacin de la
musicoterapia a corto plazo en una unidad psiquitrica
especializada en trastornos de la alimentacin

364
T H E R EL AT I O N SH I P BET WEEN EXC ER PT S O F specific values for depressive patients? If so, what are
R EC O R D ED M U SI C AN D VAL U ES I N the characteristics of the musical excerpts connected
R EC EPT I VE M U SI C T H ER APY WI T H with a specific value? Is there a certain hierarchy in
D EPR ESSI VE PAT I EN T S / L A R EL AC I N these characterics?
EN T R E F R AG M EN T O S D E L A M U SI C A
Participants in the research programme were
G R ABAD A Y L O S VAL O R ES D E L A
depressive patients of two psychiatric hospital in The
M U SI C O T ER API A R EC EPT I VA EN PAC I EN T ES
Hague, (The Netherlands). The research was divided
D EPR ESI VO S
into a pre-test and a main test. In the pre-test, a list of 15
H ENK S MEIJSTERS, BABY W IJZENBEEK & NIEK V AN items referring to values and a questionnaire about
N IEUWENHUIJZEN personal characteristics were developed by means of
statistical analysis. Besides, 16 musical excerpts of
different styles of music and emotion contents were
While working with depressive patients, receptive music
selected.
therapy can be indicated. In one method of music
In the main test, depressive patients listened to several
therapy it is stated that a specific piece of music evokes
musical excerpts and indicated the values which had a
a specific "value", which is a subject one considers to be
personal meaning for them. By means of statistical
important in one's life. From this, the following research
analysis, the research team searched for patterns of
questions were deduced; is there a permanent
values, clusters of musical excerpts and the connection
connection between specific excerpts of music and
between the two

365
 caractersticas personales fueron desarrollados por
medio de un anlisis estadstico. Aparte de esto, fueron
En el trabajo con pacientes depresivos, la
seleccionados los fragmentos musicales de diferentes
musicoterapia receptiva puede ser apropiada. En un
estilos y contenidos emocionales.
mtodo de musicoterapia se dice que una especfica
pieza musical evoca un "valor" especfico, siendo ste En el test principal, los pacientes depresivos
un asunto que uno considera importante en su propia escucharon varios fragmentos musicales, indicando los
vida. Partiendo de esto, se deducen las siguientes valores que tenan un significado personal para ellos.
preguntas para investigar: existe una conexin Por medio de un anlisis estadstico, el equipo
permanente entre fragmentos especficos de msica y investigador busc modelos de valores, grupos de
valores especficos en pacientes depresivos? Si es as, fragmentos musicales y la conexin entre los dos.
cules son las caractersticas de los fragmentos
musicales conectados con un valor especfico? hay
una cierta jerarqua en estas caractersticas?

Los participantes en el programa de investigacin eran

pacientes depresivos de dos hospitales psiquitricos de
La Haya (Holanda). La investigacin fue dividida entre
un test preliminar y un test principal. En el test
preliminar, una lista de 15 artculos que hacan
referencia a valores y un cuestionario sobre

366
C R EAT I VE PR O C ED U R ES AN D PR O C ESSES I N Examples of individual and group therapy will be
M U SI C T H ER APY: F U N D AM EN T AL ASPEC T S illustrated with video excerpts from therapy sessions at
O F T H E N O R D O F F - R O BBI N S APPR O AC H / the Nordoff-Robbins Music Therapy Clinic at New York
PR O C ED I M I EN T O S C R EAT I VO S Y PR O C ESO S University.
EN M U SI C O T ER API A: F U N D AM EN T O S D EL
EN F O Q U E D E N O R D O F F - R O BBI N S
La presentacin ilustrar y discutir un amplio campo
A LAN T URRY & CLIVE R OBBINS de tcnicas clnicas y frmulas tericas derivadas de la
prctica improvisatoria-interactiva de Musicoterapia. Se
incluirn tpicos considerados como: los roles de los
The presentation will illustrate and discuss a wide range
elementos musicales y los componentes en el contacto
of clinical techniques and theoretical constructs
cliente-terapeuta, la libertad creativa en el contexto del
emerging from the practice of improvisational-
acuerdo clnico atrayendo al nio-msico, las dinmicas
interactive music therapy. Topics considered will
de resistencia y participacin, los temas psicodinmicos
include: the roles of musical elements and components
en musicoterapia evolutiva.
in the client-therapist contact, creative freedom, in the
context of clinical consistency, engaging the music Ejemplos individuales y de grupo se ilustrarn con
child, the dynamics of resistiveness and participation, extractos de vdeo de sesiones teraputicas en el
psychodynamic themes in developmental music Nordoff-Robbins Music Therapy Clinic de la
therapy. Universidad de New York.

367
 musicotherapy group once a week and has had
fortnightly meetings with the psychiatrist. These
M U SI C T H ER APY: D ESC R I PT I O N O F T H E
meetings have give the possibility to test the followed
T H ER APEU T I C AL WAY O F A PAT I EN T BEI N G
treatment and a reduction of the pharmacological
I N T R EAT M EN T WI T H AN AC T I VE M U SI C
therapy has been possible to result of in improvement of
T H ER APY G R O U P / M U SI C O T ER API A:
his problems.
D ESC R I PC I N D EL R EC O R R I D O
In the development of this therapeutic way we noted the
T ER APU T I C O D E U N PAC I EN T E SO M ET I D O A
following effects:
M U SI C O T ER API A AC T I VA D E G R U PO
1) The overcoming of the repetitive and sclerotic
L OREDANA V ECCHI , ANNA F USCO , PASQUALE
relational ways;
M ASTANTUONO , BRUNO C APUANO , GINA R OSELLI , GRAZIA
D E B IASE & CATERINA V OLPE 2) The increase of the capability to socialize and to
stay together, through a community experience where
"music " is the socializing object;
The activity of this laboratory is expressed through a
group in active music therapy that employs the well- 3) The reinforcement of the personal identity through
known therapeutical effects of the groups, the music. the recognition of the competitiveness and the praise of
The recording is present as final period of the groups. the group;

According to a therapeutic programme specifically 4) The decrease of anxiety through the "holding"
designed for the patient, he has participated in the function developed by the group;

368
5) The reshuffling of the aggressivenes and the problemas.
vindicative fantasies through the verbal elaboration of
En el curso del desarrollo de este recorrido teraputico
the "here and now";
hemos podido constatar los efectos siguientes:
6) The increase of co-ordination of movements as
1) La superacin de la manera esclertica y
consequence of experimenting and being in touch with
reiterativa de comunicar;
own rhythm through the sonorous production.
2) Acrecentamiento de la capacidad de socializar y
de la posibilidad de estar juntos a travs de una
En este laboratorio la actividad de tal laboratorio se experiencia de comunidad donde la msica es el objeto
efecta por medio de un grupo de musicoterapia activa, compartido;
que utiliza los efectos teraputicos muy conocidos por
3) Un sostn a la identidad personal a travs del
los grupos de la msica.
reconocimiento por parte del grupo sea como
A continuacin del programa teraputico competicin que como elogio;
expresamente trazado a su medida, l ha participado
4) Una reduccin de la angustia, a travs de la
una vez por semana en el grupo de musicoterapia y
funcin de "holding" desarrollada para el grupo;
cada quince das se ha encontrado con el psiquiatra,
eso ha permitido una averiguacin acerca del 5) Una elaboracin de la agresividad y de los

tratamiento emprendido y consentido una reduccin de fantasmas reivindicadores a travs de la elaboracin

la terapia farmacolgica debido al mejoramiento de sus verbal del "aqu y ahora";

369
6) Una mejora de la condicin motora como
consecuencia del entrar en contacto y de

ensayar el propio ritmo, a travs de la produccin

sonora.

370
 to 12 persons and go through the complete programme
of treatment, which last around 3 months. The main
1.2. - MUSIC THERAPY AND MENTAL HEALTH / method in the treatment of mental disorders in the clinic
MUSICOTERAPIA Y SALUD MENTAL
( CONFERENCE HANDOUTS) is the group psychotherapy. Music therapy, art therapy,
play therapy and relax therapy are included as
additional methods. Each patient has his own individual
therapy, which becoms a part of his complex treatment.
G R O U P M U SI C T H ER APY I N T H E The music therapy in the clinic presens receptive group-
PSYC H I AT R I C O U T PAT I EN T C L I N I C O F T H E dynamic treatment. The selection of the group
H I G H M ED I C AL I N ST I T U T - SO F I A members is done according to the requirements of the
group therapy and the staff remains the same for the
G EORGE A NTONOV A NTONOV
other methods of treatment, including the music
therapy. The group is heterogeneous as regards to age,
Patients with neurotic and somatoform disorders, mood diagnosis, individuality, culture, and personal attitudes
disorders and personality disorders are accepted in the towards music. After the group composition very seldom
outpatient department of the First Psychiatric Clinic of a new person is allowed in, and if that happens, it
the High Medical Institut - Sofia. usually becomes in the beggining of the treatment. The
music therapy sessions are held ones a week. If
Individual and group forms of their treatment have been
necessairy the sessions can be held twice a week for a
applied there. The patients are gathered in groups of 7

371
short period of time. The method has been accepted by dynamics and the concrete therapeutic situation.
the patients. Therefore no constant music compositions (for instance
for a separate number of sessions) are used. The music
therapist decides what the music programme will be in
The duration of each session of the music therapy is
his conversations with the patients (according to the
one and a half hour, of which 20 minutes is listening to
main theme) or shortly before the session when the
music played on technical instruments (gram,
terapeutic team has discussed which of their
cassetofon etc.), while the remaining part of time is
experiences should be provoked. Instrumental music is
devoted to discussions. The division of the time can be
applied mainly in order to avoid suggestions as a result
change according to the aims of the treatment.
from the text and the restrictions in the nonmusical
associations of the patients which follow them. The
initial practice was to use mainly preclasic, clasic
As the music therapy is a part of the complex treatment
romantic, and neoromantic authers and rarely jazz. Part
of the mental disorders and the group is not selected in
of the patien with lower music culture start to feel
accordance to its own requirements no common plan of
unconfortable and lose their interest to the sessions, in
its influence on the patients can be accepted. Therefore
this sessions. When discussing their feelings after
the main accent is laid upon the microstucture of each
listening to unknown slmfonic compositions, they say
separate session which itself is structured on the one
that it is difficult for them to make associations, that they
hand according to the experience from the previous
feel tense and the only thing they wanted is to finish. In
sessions and, on the other hand, according to the group

372
such situations they often feel a headache, become Vangelis, Isao Tomita, Jean Michel Jarre, Simo
nervous and they lieve the session before its end. The Lazarov/, jazz /Gershwin/, film music /E. Moricone/. The
effect is different with patients with high music culture. main criteria for the music selection are rythm and
They usualy connect the music with their work and melody. As a result the patients with different musical
share that when listening to such kind of music they culture are on equal level. In this way their out of music
restrict themselves to evaluation of the performance. ideas have been stimulated, together with provoking
They prefer to discusse the way of performance and, their esthetic interest towards un
most oftenly, they prefer to emphasize their music
known music generes.
knowledge which results in additional tension among
the remaining part of the group. The things have In case some of the patients is a musician in some of the

changed a lot when we have included in the musical sessions a receptive group music therapy has been

programmes more popular pieces of the so called carried out. The music has not been played by a musical

'serious' music /for instance Bach - 'Tocata and fuga' D instrument, but by the patient himself / as was the case

moll; Mozart - 'Eine Kleine Nacht Muzic' G dur, with V. who had graduated the Conservatory, speciality

'Requem'; Bethoven - 'Fur Elise', 'V simphonie', flute/. That way of therapy is discussed in advance with

'Mondscheinsonate'; Schubert - 'Die schone Muelerin' all the patients who support the suggestion. The music

op.25, D 795, 'Ave Maria'; List - 'Hungarian Rhapsody'; programme is discussed and specified in advance

Ravel - 'Bolero'; Debussy - 'Nocturnes' et al./ combined between the player and the music therapist, but

with the works of the electronic music / for example depending on the situation the programme can be
specified during the session itself. As a principle the

373
player should not inform in advance the group about the specially selected for this aim pieces of music which
music programme and that he will share with the lead to relaxation and relief. In such cases the time
participants in the group his own associations. In that dovouted to listening to music is about 40 minutes and a
way the undesireble element has been avoided. Group combination of separate compositions is used /mainly
confidence among the members of the group increases romantic and meditation music/.The sharing concerns
in this way and the contadictions between them become only the feelings which arise while listening and the
less. conflicts are avoided. Music therapy in our clinic is held
in the hall used also for group psychotherapy. The
The main goal which this group-dynamic oriented music
patients sit in a circle in comfortable armchairs.There is
therapy lays before itself is the emotional activation of
a conversation between the therapist and the group
the self, making easier the mutual contacts between
members in the first 10 minutes of the session, the aim
the patients and the achievement of intense group
of which is to get in touch with the dominant mood in the
dynamic. These are the principles which are taken in
group and to introduse the group into the session, as
concideration by the music therapist when choosing the
well as to help the therapist in his decision what kind of
music programme and the way the sessions are held. In
music he will use. About 20 minutes listening to music
rare occasiones only, when the group feels itself
follow the introdusing part the room is slightly obscured
overloaded with the rest of the therapeutic forms,
and the therapist is out of the circle performing technical
included in the complex programme of treatment,
functions (switching on and off the music, the lights). In
mainly the psychotropic influence of music has been
the cases when the psychotropic effect of the music is
used. The sessions have been restricted to listening to

374
relied on and the listening is longer, therapist remains in specificity of the music is intended to provoke an
the circle as a part of the group. The patients confess emotional activation of the imagination of the patient
that they feel more comfortable and relaxed then and their verbalisation of the extramusical images which
because the stereotype of the ordinary sessions is enables us to touch their inner conflict nature.
changed and their main conflict would not be worked
out (the technique is used mainly after hard sessions in
group psychotherapy). The information obtained by the musical-therapeutic
sessions is discussed with the group psychotherapist so
that the main principle of the information exchange
After listening to a specially selected musical program reffers to all therapeytic methods included to the
the patients step towards sharing their feelings and therapist scheme. The main conflicts are worked off in
experiences provoked by the music. Sometimes the the sessions of the group psychotherapy while the
same is made after listening to each particular peace of musical-therapeutic sessions in this case are aimed at
music included in the programme, but our experience drawing the attention of the patient to their mutual
show th patients prefer the first variant. In the initial feelings and experiences and at seeking the reasons for
phase of therapy the conversations are directed to them the main principle being "here and now".
aesthetic feelings of the patient and their purpose is to
Presenting the music we use one of the three known
establish an atmosphere of confidence and security.
methods: - without giving the preliminary information
Free associations are used mainly in that phase of
about the theme of the piece of music, the composer,
therapy. In the next phase of the sessions through the

375
the name etc. - with pointing the title and the name of discussion). More often we use themes-metaphores in
the composer and a brief information about the piece of which the goal-oriented thought is minimal and the
music; - with a commentary, directing the thought reality without a subject giving a shape , becomes
feelings and imaginations of the patients while listening. undefine (for example "Rebirth", "Battle" and
"Travelling"). Giving individual themes on selected
In the initial sessions when working mainly with free
musical background especially for asthenic patients has
associations we use the first method of giving the music.
been practiced. Starting from the main conflicts of the
In this way the indivial perception of patient is not over-
patient the music therapist proposes an exemplary
burdened preliminary by a direction which gives thhe
subject more often taken from fairy tailes. This
possibilities to obtain clear information his problems.
approache proves to be effective with patients who due
In a more advanced phase of treatment the musical-
to different disturbances accept the role of silent "wall-
therapeutic sessions sometimes go with certaine theme
flower" and do not participate in the group process.
proposed to provide material for associations of the
In most cases when the themes are proposed for the
participants. The theme is first discussed with the
group to freeassociate we preffer to propose a music
therapeutic team. And it is of crucial importance for it to
programme using the third variant, already mentioned.
coincide with the main problems of the group itself .
Proposing definite themes in the music-therapeutic
Such topics can be "My family", "The partner next to me"
sessions is an indirect way of giving the patient a task by
or "The partner in my dreams and wishes'' (the theme
stimulating their perception and imagination in a given
was offered to a group concentrated to the attitudes to
direction. The fear of giving concrete intimate
its eventual future partner and provoked a vivid group

376
information is remove and they are helped to exhibit In some music-therapeutic sessions some elements of
their inner conflicts in less usual and easy for them psychodrama are used so far. The non-verbal
ways. techniques are used in the initial sessions when the
group cohesion, confidence and wish for work have
The second variant of giving the music programme we
been worked off. In more advanced stage by the use of
practise in the final phase of the therapy when the goals
psychodramatic techniques, sudenly emerged strong
of the music therapy are directed to overcoming the
feelings in the participants when listening to the music
deficits of emotional and aesthetic experiences of
such as grief, rage, loneliness, have been worked off as
patients.
well seeking the reasons for them. In some cases in the
music-therapeutic sessions through psychodrama a
The last music therapeutic session in completing the deeper conflict situation of the patient has been worked
therapy is carried out freely . Patients themselves off projected in their extramusic associations.
choose the music for listening and the way of carrying
out the session. Often some of them who can play a
Conclusions:
music instrument performs a favorite piece of music but
also some of the music desires of other group 1) The receptive group musical therapy in which the
members. In this way they more easily overcome the musical material is not provided by a technical device
moment of separation with each other and with the but is performed by a participa in the group is better
therapist. accepted by the patients. It has been noticed that after

377
such a performance of the music programme the group this way is usefull from a diagnostic point of you.
cohesion is strengthened and the patients more readily
share their experiences.
4) In the music-therapeutic sessions exellent results
are obtained by using elements of psychodrama. Appart
2) The mixing different kinds of the music in from using nonverbal techniques, the psychodrama
programme is accepted with the greater interest by the playing of the initial problem can be mad which is
patients. Those of them who accept the "serious" music projected in the associations of the patients provoked
as difficult and incomprehensible, seldom have visual by the music listening or of a conflict emerged among
images and think that they have a poor imagination, an some patients in the course of session.
activation of their fantasy actlvity is observed. In our
opinion this is due to the great extend to their feeling of
being in equal position with the melomans in the group. In asserting the music therapy as a therapeutic method
we face some difficulties.

Some of them are connected with the reserved attitudes

3) Proposing of selected themes for group free-
towards the method of many psychoterapists. Some of
association is accepted willingly by the participants. This
them think that a music therapy has not an active
gives the possibility for chaneling the thaughts, feelings
principle and can not be used for a change. The
and images of the patients in the desired by the
psychotherapists who have convinced themselves in
therapist direction. The received associative material in
the serious value of the music therapy face mainly

378
technical difficulties, lack of audiocassetes with musical INDICE
selections for the needs of music therapy on the market.
Also to a great extend due to the former isolation in
INTRODUCCIN
which they were put concerning the most advanced
achievements of the method. AUTISMO E ESQUIZOFRENIA

TRATAMIENTO PSIQUITRICO

BIOGRAPHY DATA I- DESARROLLO DEL TRABAJO

George Antonov - 31 years old. Graduated in 1) Periodo

psychology from Sofia University. Graduating theme -
2) Seleccin de los pacientes
"Group music therapy"; Now working as psychotherapist
in the Drug Abuse Department.Training in psychodrama 3) Caracteristicas de los pacientes trabajados

under the direction of Dr. Ella Mae Shearon. 4) Objetivos de este trabajo

5) Numero de sesiones

M U SI C O T ER API A EN PAC I EN T ES PSI C T I C O S 6) Actividades y distribucin del horario de las sesiones

7) Seleccin musical
EULENICE BARBALHO DE ANDRADE
8) Ambiente

379
9) Material utilizado psiquitricas y de la manera como se manifestan para
poder hacer uso adecuado de la teoria y de la tcnica
II - RESULTADOS OBSERVADOS
musicoterpica. Asi, presentamos un resumo a
a) Pacientes sometidos al tratamiento musicoterpico
respecto de la psicose.
b) Pacientes no sometidos al tratamiento mencionado

c) Recuadros que detallan los datos

AUTISMO E ESQUIZOFRENIA

A pesar de que algunos autores no diferencian el

OBSERVACIN autismo de la esquizofrenia, la mayoria de ellos
prefierem esa distincin. Bakwin expresa que "el
autismo infantil presenta un cuadro clinico particular y
BIBLIOGRAFIA merece un lugar aparte debido a la edad precoz en la
cual aparecen los sintomas. Rimland seala aspectos
que diferencian a ambos. Por definicin, la
INTRODUCCIN
esquizofrenia infantil suele seguir a un periodo de
A musicoterapia debe fundamentarse sobretodo, en desarrollo normal; el autismo en cambio, se presenta
comprensin dinamica del paciente y particularmente, desde la ms temprana infancia.
en el conocimiento de las pautas de transferencias y
Las historias clinicas de nios autistas casi
contratransferencias. Para esto, el musicoterapeuta
invariablemente los describen como dotados de una
debe valer se del conocimiento de las sindromes

380
salud excelente y como atractivos y bien constituidos. la esquizofrenia las pautas de lenguaje extravagante de
En contraposicin, se describe a la mayoria de los autismo, que tienen una uniformidad sorprendente en
nios esquizofrnicos como dotados de mala salud los distinto casos, ni las proezas de la memoria y de
desde su nacimiento, con numerosos rasgos actos mecnicos.
caracteristicos que no se encuentran en los nios
autistas. Rimland seala ms adelante que el nio
esquizofrnico muestra generalmente una conduta Los estudios de otros aspectos diferentes, tales como

adhesiva, una fuerte tendencia a amoldarse a los la incidencia del autismo y la esquizofrenia en mellizos,

adultos como plstico o pasta. E1 nio autista, por el las caracteristicas de las personalidades de sus padres,

contrario, es tipicamente hurao y desobediente. En la y la historia familiar de alteraciones mentales, sealan

infancia y ms tarde en la niez, permanece distante, en su totalidad distinciones tajantes entre los sindromes

con aparente desconocimiento o indiferencia a la de autismo y esquizofrenia. Los estudios de Schopler Y

presencia o ausencia de los dems. Singer y Wynne tienden a apoyar estos diferenciales,
enumerados tambin por Rimland. E1 autismo infantil
La necesidad compulsiva de uniformidad encontrada
precoz debe diferenciarse de la esquizofrenia si se
en los nios autistas no es comn en la esquizofrenia
quiere que la investigacin en estos campos sea
infantil. Las alucinaciones, comunes en esta ltima, no
significativa.
se conocen en los casos de autismo. E1 desempeo
motor de los nios autistas es, por lo que se sabe, mejor
que el de los esquizofrnicos. No se han registrado en TRATAMIENTO PSIQUIATRICO

381
Pese a las grandes divergencias respecto de la La utilizacin de drogas despert algumas esperanzas,
clasificacin y etiologia del autismo infantil precoz, la pero hasta el presente las pruebas son insuficientes, y
mayoria de los autores parecen estar de acuerdo en ha transcurrido muy poco tiempo para permitir una
que el problema principal en el tratamiento es el de evaluacin justa de ella. De acuerdo con Mahler el
estimular al nio a interactuar con personas pronstico es desolador y la mayoria de los demas
significativas. Con este objetivo se han intentado una autores estn de acuerdo. (extraido).
variedad de mtodos, que reflejan una vez ms la
posicin terica de aquello que los postulan. Los
tratamientos han incluido atencin por internacin y por MUSICOTERAPIA CON LOS PACIENTES

consultorio externo; psicoterapia supresiva tipica; PSICTICOS

psicoterapia con estimulacin especial; asesoramiento INTERNADOS EN EL HOSPITAL ADAUTO

familiar; escuelas diurnas con orientacin teraputica; BOTELHO-PR
escuelas con internados provistas de personal
I- DESARROLLO DEL TRABAJO:
especializado y con madres sustitutas; instrusin y
frustacin y equipos para tratamientos con internacin
dirigidos hacia el desarrolo de la imagen corporal y de 1) Periodo: Marzo a Diciembre de 1979.
las relaciones objetales por medio de frustaciones
reguladas. Todos ellos han constituido sorprendentes
fracasos. 2) Seleccin de los pacientes:

382
Se selecion diez pacientes cuyas edades variaban comunicacin no verbal.
entre O9 y 15 aos, con diagnstico semejante y
Los pacientes mostraban:
usando las mismas medicinas:
- un intenso retraimento de las relaciones
. Haldol 5 mg.
interpersonales;
. Neozine
- frecuentes agitaciones psicomotoras;
. Cloprozim
- rechazo de contactos;
De este grupo de diez pacientes, cinco recibieron
- frecuentes diarreas;
asistencia musicoteraputica y cinco formaron otro
- indiferencia al frio o al calor;
grupo con fines de comparacion.
- frecuentes insomnios;

3) Caracteristicas de los pacientes trabajados:

La prdida de amor que con tanta frecuencia
Una de las principales dificultades de esos pacientes es
caracteriza estos pacientes pude ser muy mejorada
su incapacidad para comunicarse verbalmente. La
por la msica.
mayoria de estos pacientes eran mudos. Aquellos que
utilizaban el lenguaje, lo hacan de manera
desconcertante. E1 tratamiento con la msica es
4) Objetivos de este trabajo:
notablemente adecuada porque es un tipo de

383
E1 empleo de las actividades musicoteraputicas 6) Actividades y distribucin del horario de las sesiones:
tuvieron como objetivo general, la interacin social de
Las actividades utilizadas en la primera mitad de la
los pacientes y como objetivo especifico, el de anular o
sesin (10 minutos) comprendian:
cambiar las manifestaciones patolgicas.
- canciones de cuna;
En resumo:
- canciones para identificacin y cumplimientos;
- abrir canal de comunicacin;
- canciones favorita de los padres;
- ampliar el nvel de comunicacin;
- canciones referentes a distintas partes del cuerpo;
- disminuir las agitaciones psicomotoras;
En la parte ms activa de la sesin (15 minutos) yo
- evitar el aislamiento y vida vegetativa;
estimulaba a los pacientes a utilizar sus cuerpos
- establecer contactos; libremente para saltar, correr, brincar, con los ritmos
adecuados. Yo estimulaba a praticar juegos en circulo
- estimular el mejor relacionamento entre el paciente y
en los cuales necesitaban tomarse de las manos entre
las enfermeras;
si y con las enfermeras. Estos juegos promovian las
relaciones interpesonales. Yo utilizaba canciones
5) Numero de sesiones: 03 semanales. infantiles del folklore brasileno.

En la parte final de la sesin (10 minutos) yo los

estimulaban a relajar con msica erudita.

384
 . En esta calle hay un bosque

7) Selecin musical: . Vamos hermanita

a) Msica erudita: . La barca rebot, ...

. Aria para cuarta cuerda - Bach

. Melodia en fa - Rubinstein 8) Ambiente:

. Nocturno en Mib - Chopin Las sesiones tuvieron lugar en la sala de msica, donde
habian todo material de trabajo. No habia nada fijo en
. Acalanto de Brahms
las paredes para no distraer los pacientes.
. Quin es el infante?

b) Canciones infantiles del folklore brasileo:

9) Material utilizado:
. Teresita de Jess
. Ficha de Musicoterapia
. Sapo cururu
. Ficha de Evolucin clinica
. E1 clavo pele con la rosa
. Discos y cintas casetes
. Carnerito, carnern
. Tocadiscos y tocacintas
. Ciranda, cirandita
. Esteras

385
. Instrumentos musicales: los de la banda ritmica. Los pacientes no sometidos al tratamiento
musicoterpico, tuvieron los siguientes resultados:

II - RESULTADOS OBSERVADOS: - la mayoria aument el numero de agitaciones

psicomotoras y nmero de diarreas;
a) Pacientes sometidos al tratamiento musicoterpico:
- mantuvo el mismo nivel de comunicacin;
Tras diez meses de tratamiento, se observ que los
pacientes consiguieron: - las dosis de medicinas se elev;

- permitir contactos, incluso dejarse peinar los pelos;

- controlar el cuadro de diarreas; c) Recuadros que detallan los datos:

- disminuir agitaciones psicomotoras;

- ampliar los intercambios con las enfermeras y los PACIENTES SOMETIDOS AL TRATAMIENTO
dems pacientes; MENCIONADO:

- conciliar el sueo; nombre Sexo edad diagnostico N de agitaciones N de diarreas

antes posttrat. antes posttrata.

- reducir un tercio la dosis de medicinas;

A.V. M 09 299 06 01 10 03
b) Pacientes no sometidos al tratamiento mencionado:
S.S. F 15 296 19 06 07 01

386
J.M. M 12 295 04 01 09 -

J.P. M 14 295 22 07 04 - OBSERVACIN:

I.M. M 10 299 20 05 13 04
Los resultados presentados en estos recuadros, fueron
extraidos de la ficha de evolucin clinica de cada
paciente,diez meses antes del comienzo del
tratamiento y diez meses despus del mismo.
PACIENTES NO SOMETIDOS AL TRATAMIENTO
MUSICOTERPICO:
BIBLIOGRAFIA

nombre sexo edad diagnstico N de agitaciones N de diarreas 1- Benenzon. Rolando Omar. Musicoterapia en la

antes posttrata. antes posttrata.

psicosis infantil. Editorial Paids, B. Aires - 1976

E.A. M 09 299 29 33 12 11

A.M. F 15 295 30 34 08 10 2- Leinig. Clotilde Espinola. Tratado de

L.M. M 12 295 15 12 11 09 Musicoterapia. Sobral Editora Tcnica, S. Paulo, 1977
M.A. M 14 296 27 28 15 13

V.C. M 09 299 19 20 20 22
3- Polisuk. Julio e Goldfeld. Sylvio. Pequeno
dicionrio de termos mdicos. Livraria Atheneu Ltda,

387
RJ. 1980

La Institucin a la que hacemos referencia est

organizada en dos instancias de trabajo.
4- Gaston. E. Thayer. Tratado de Musicoterapia.
Editorial Paidos - B.Aires, 1968

a) Perodo de admisin: que incluye la

evaluacin fsica y psiquitrica del individuo, tarea a
A B O R D A JE M U S I C O T E R A P E U T I C O D E L A S
cargo de un psiquiatra y de un psiclogo, quienes
AD I C C I O N ES EN L A C O M U N I D AD
realizan un diagnstico presuntivo.
T ER APEU T I C A
A continuacin, el residente5 accede a la internacin, y
MT. GABRIELA L AURA B ELLO Y MT. SERGIO D ANIEL es incorporado a la dinmica de la Comunidad
F RIDMAN Teraputica, la cual incluye psicoterapia individual,
psicoterapia grupal, psicoterapia familiar, asambleas
multifamiliares, musicoterapia, grupos educativos,
A-Introduccin:
asambleas, recreacin.
Es nuestra intencin comunicar a Uds. nuestra
Queremos aclarar que en nuestra experiencia no
labor musicoteraputica realizada en una Comunidad
hemos tenido casos de Sindrome de Abstinencia, ya
Teraputica de la ciudad de Buenos Aires, Repblica
Argentina desde el ao 1989. 5
Residente: Este es el trmino adoptado por esta Comunidad
Teraputica para referirse a aquellas personas internadas en la misma.

388
que estos residentes no participan de Musicoterapia al En dicha Institucin residen adolescentes y
encontrarse en esta situacin. Bsicamente, durante adultos cuyas edades oscilan entre los 13 y 42 aos en
este perodo (diferente en cada individuo), se trabaja su mayora del sexo masculino, con trastornos de tipo
sobre su integracin al grupo de pares a travs del adictivo (a drogas y/o alcohol). Gran parte de esta
trabajo comunitario. poblacin pertenece a una clase sociocultural baja con
escolaridad interrumpida, algunos de los cuales
b) Una vez que el residente se encuentra
acceden por propia voluntad al tratamiento y otros
adaptado a la dinmica comunitaria, es nuevamente
acuden por decisin de la Justicia (algunos por
evaluado y se lo deriva a la instancia siguiente del
Juzgados de Menores), ya que se encuentran con
tratamiento, en la cual se trabaja sobre la problemtica
causas penales en curso.
especifica del residente a travs de los distintos
espacios psicoteraputicos (recordamos que el Muchas veces nos preguntamos acerca de la
enfoque es individual-grupal y familiar a la vez). demanda de tratamiento de estos residentes (en
especial los ms jvenes); qu motivos los han llevado
Por ltimo, hacia el final del tratamiento, a las
a internarse en dicha Comunidad Teraputica. Algunos
actividades anteriormente citadas, se suman el trabajo
acuden por propia conviccin luego de una experiencia
y el estudio puertas afuera de la Comunidad
lmite (sobredosis, haber recibido la confirmacin de
Teraputica (bien puede ser capacitarse en una
HIV positivo). En otros casos hemos observado que
profesin, o retomar la antigua actividad, etc).
ingresan por presin, ya sea del Juez interviniente en la
causa o bien de sus padres.

389
 Esto nos hace pensar en el inicio del tratamiento, Nuestra experiencia nos ha demostrado que la
en cuestiones tales como la conciencia de enfermedad, conducta adictiva y todo lo que ella involucra, se monta
el situarse en tratamiento, objetivos....material decisivo sobre la estructura de base o de personalidad del
en el momento del abordaje. individuo.

Sin embargo, a los fines de conceptualizar sobre

el tema, citaremos una clasificacin de la escuela de
B- Acerca del cuerpo y la msica en el adicto:
Luigi Cangrini respecto de las causas probables de la
En primer lugar queremos aclarar lo que es para
instalacin de la adiccin en el individuo.
nosotros la llamada "adiccin".

Quizs hayan Uds. escuchado hablar muchas

1. Toxicomana Traumtica. La droga aparece luego
veces que no existe la adiccin, sino los adictos.
de una situacin traumtica.

2. Toxicomana Psictica. La droga, en este caso

*Residente: Este es el trmino adoptado por esta
bloquea una estructrura psictica.
Comunidad Teraputlca para referirse a aquellas
3. Toxicomana Neurtica. Se da en casos de
personas internadas en la misma.
familias conflictivas. (sobreinclusin de uno de los
padres mientras el otro permanece en la periferia).
Pues bien, estamos de acuerdo con este punto de
4. Toxicomana por desorganizacin social. Se d en
vista.

390
los dos extremos de la escala social. (Tanto por
hiperconsumo como por hipoconsumo).
En el espacio de Musicoterapia en el marco de la
Comunidad Teraputica, hay un protagonista;
protagonista que a su vez ser el escenario en el cual
Siguiendo al mismo autor, podemos agregar que
se jueguen los "aqu y ahora" de la sesin.
la adiccin se monta sobre cinco estructuras de base, a
saber: Escenario ste, en el que se jugar la terapia no-
verbal; y, en l, historias, recuerdos, evocaciones,
conductas aprehendidas se pondrn en movimiento, se
1. Depresiva actualizarn en cada gesto, en cada momento.
2. Esquizofrnica El cuerpo es el escenario en el que se jugar la
3. Psicpata terapia no-verbal. Cuerpo-conducta; Cuerpo sentir;
Cuerpo que lleva inscripto en s toda su historia, historia
4. Borderline
que porta y vive en el aqu y ahora del sujeto.
5. Esquizoide
En el adicto, el cuerpo es tambin un escenario,
en donde se realizarn los encuentros con aquellas
Volviendo a nuestra experiencia, podemos decir queridas-odiadas sustancias y objetos. Los labios, el
que en su mayora hemos tratado casos de adiccin cigarillo; la nariz, el polvo; la piel, la jeringa El cuerpo es
por desorganizacin social y toxicomana psictica la puerta de entrada, y, a travs de l, lo objetivo se

391
volver en subjetivo. Esta imagen est en continuo proceso de
construccin, porque en ella se inscriben, dia a dia los
El cuerpo se encuentra entre dos realidades: la
rastros de nuestras propias experiencias.
interna y la externa. Es dificil establecer un lmite entre
ambas Por eso, en el abordaje corporal, damos prioridad
al papel de la accin, al salir de la rigidez, al revivir del
Todo esto nos sirve para entender un poco ms al
cuerpo. A travs del accionar del mismo, se van
cuerpo del adicto un cuerpo rgido, contracturado,
reconociendo los diferentes segmentos corporales, se
bloqueado, con grandes dificultades al contacto
los v integrando y as es como se construye una nueva
corporal con el otro.
imagen corporal. Este reconociento se da primero por
A qu nos referimos cuando hablamos de
medio de la propia sensibilizacin del cuerpo; y, en
trabajo corporal?
segundo lugar, por medio del interactuar con el cuerpo
En Musicoterapia, trabajamos con personas, que del otro.
en su cuerpo y por su cuerpo sienten, desean, crean,
A su vez, para lograr todo lo antedicho, es
expresan, hablan..... Personas que tienen un cuerpo
necesario ofrecer un marco continente, en el cual se
real, visible, y una representacin interna, una imagen
pueda accionar, sentir, decir (decir desde lo corporal,
de ese mismo cuerpo. Muchas veces, esta imagen
gestual, decir aquello que no es posible hablar),
tiene poco que ver con el cuerpo real. Ms bien tiene
reflexionar sobre estas vivencias en un clima de
que ver con la devolucin que el o los otro/s nos hacen
confianza, no persecutorio, para no quedar solamente
de la misma a travs de la mirada o la palabra.

392
en el terreno de la movilizacin. grupo. Queremos asimismo destacar el aspecto
dinmico de este fenmeno, pues la identificacin
Decir tambin desde lo sonoro. Decir desde la
musical se produce en cada momento de la historia de
produccin sonora del Grupo (tema que retomaremos
cada individuo.
ms adelante), decir desde el material musical que
ellos traen a sesin.

Respecto de este tema, en el periodo 1989-1990, Estilo musical Conjunto musical

llevamos a cabo una investigacin con la poblacin

citada anteriormente (establecimos un recorte entre los Heavy metal Kiss
13 y 23 aos). Black Sabbath

A continuacin mostramos un cuadro en el cual se AC DC

podrn observar una serie de conjuntos musicales y

autores, correspondientes a lo que llamaremos
Rock argentino Vox Dei
IDENTIFICACION MUSICAL DEL ADICTO,
Sui Generis

Entendemos por IDENTIFICACION MUSICAL Soda Stereo

DEL ADICTO, todo aquel material sonoro comn a
Virus
estos individuos en un determinado momento de su
Sumo
historia. La msica funciona aqu como un parmetro o
JAF
elemento ms de identificacin en el individuo y en el

393
 Patricio Rey y sus Redonditos de Ricota ...... Wish you were here

Patricio Rey y sus Redonditos de Ricota

Nueva Trova Cubana Silvio Rodriguez
Vox Dei ........ La Biblia

Rock Sinfnico Pink Floyd

Ante este variado espectro musical, podemos
plantear tres hiptesis acerca del por qu esta
Rock The Rolling Stones
poblacin se identifica con este material sonoro.
Led Zeppelin

Deep Purple

a) Por apareamiento de estmulos.

New Age Vangelis Supongamos la siguiente situacin: K bajo

efecto de la droga (D), escucha una determinada
meloda (M1). Posteriormente, sin efecto de droga (D),
al escuchar M1, recuerda, siente, evoca, asocia dicha
Msicas que escuchaban mientras se drogaban:
msica con el primer momento (D).

Pink Floyd ..... The wall

K + D + M1 = Placer

394
K - D + M1 = Placer Para terminar, queremos aclarar qu
entendemos por apareamiento de estmulos. La msica
puede traer a la memoria sensaciones perceptuales
Prueba de sto es lo que hemos observado al
(tales como olores, colores), recuerdos, asociaciones,
trabajar en sesin con el material sonoro surgido de la
que dependen exclusivamente de la historia vital de
investigacin anteriormente citada: J relata que al
cada individuo.
escuchar Wish you were here record una reunin
con amigos en la cual se drogaban, y refiere haber
tenido sensaciones similares a las sentidas con la b) Por parmetros del sonido.
droga. La droga, si bien no est presente, en el
Remitindonos nuevamente al material
segundo momento se fantasea.
investigado, hemos realizado una clasificacin de ese
universo sonoro desde el punto de vista de los
parmetros del sonido.
M J M J
Esto es a los efectos de formular nuestra segunda
D Placer D Placer
hiptesis: habra un clima sonoro producido por la
1 Momento 2 Momento
combinatoria de los parmetros del sonido, que
(droga fantaseada) resultara atractivo para estos individuos en el
momento de drogarse.

395
 Estableceremos en primer lugar tres tipos de
climas, de acuerdo a la variacin de los parmetros
(extrayendo la informacin contenida en el cuadro 1-
Clima manaco: Sensacin de vertiginosidad, de
Identificacin musical).
aturdimiento (hiperestimulacin sonora). Ejemplo
musical: Highway star (Deep Purple); I just want to
make love to you (The Rolling Stones). Clima

Clima Velocidad Altura Intensidad Densidad

depresivo: Sensacin de muerte, tantico. Ejemplo
sonora musical: Mother (Pink Floyd); Angie (The Rolling
Stones).

a- Manaco rpida agudo-grave fuerte alta

Clima psictico: Desestructurante, reiterativo,

redundante (efecto hipntico). Meloda circular, no
b- media media-grave media media-baja lmite (sensacin de estar inmerso en el agua, el ms
Depresivo regresivo de los tres). Ejemplo musical: La creacin del
mundo (Vangelis); A saucerful of secrets (Pink Floyd).

c- Psictico media-lenta grave-media- media-dbil alta-media-baja

Aclaramos que todos estos adjetivos fueros
aguda

396
extrados de las asociaciones efectuadas por los identificacin a un grupo musical especfico
residentes en sesin.

Parmetros del sonido

c) Por identificacin.

Definiremos en primer lugar qu es identificacin.

cada siete das, bajo la coordinacin de dos
Citando a S. Freud: ... es la equiparacin de un yo a
musicoterapeutas.
otro yo ajeno, equiparacin a consecuencia de la cual el
primer yo se comporta, en ciertos aspectos como el La sesin comienza con la convocatoria de los
otro, le limita y, en cierto modo, le acoge en s. No sin residentes al comedor, momento en el cual ellos deben
razn se ha comparado la identificacin a la acondicionar el espacio (retirar las mesas y sillas,
incorporacin oral, canbal, de otra persona. La barrer el piso, etc.).
identificacin es una forma muy importante de Posteriormente se procede a dar comienzo a la
vinculacin a la otra persona; es probablemente, la ms sesin, en la cual intervienen los musicoterapeutas y
primitiva ... los residentes; no se incluye ningn otro integrante del
La identificacin opera en estos adolescentes a staff teraputico.
diferentes niveles. Entre ellos podemosen contrar: Una vez cerradas las puertas, se dan cinco
minutos de tolerancia para el ingreso de pacientes que
por razones justificadas no lo hicieron en el horario

397
correspondiente. Luego de ese lapso, no se permite el emergente).
ingreso, por cuestiones relacionadas con la dinmica
La charla es libre, no existe el interrogatorio; la
de la sesin.
pregunta disparadora es Cmo estn?. Y es a partir
de este momento en que se comienza a tejer la trama
de la sesin. A veces sobre hechos cotidianos (de la
Trabajamos todos a un mismo nivel (sentados en
vida en la Comunidad Teraptucia; discusiones,
crculo, en el piso), con ropa cmoda y habitualmente
comentario de alguna salida-recadas; materiales
descalzos.
surgidos en otros espacios teraputicos). En esta
Durante el transcurso de la sesin no se permite
primera parte no solamente atendemos a lo verbal,
fumar en el saln.
sino que leemos lo corporal: una gripe, disfona,
contractura, etc.

C.2.- Sesin: Sobre este material (digital y analgico) que v

surgiendo, se v a ir desarrollando la sesin. No
descartamos por esto las propuestas autogestivas del
Ya instalados en el lugar, se abre el espacio a un grupo.
dilogo previo a la actividad propiamente dicha: el cual
Uno de los musicoterapeutas toma a su cargo la
implica la libre participacin de los integrantes del grupo
direccin de la actividad, mientras el otro realiza una
y a partir del cual leemos el aqu y ahora del grupo (lo
398
lectura de lo que v aconteciendo, involucrndose o no Pasiva
en el hacer del grupo.

Estos roles no son fijos; alternativamente uno

toma un rol pasivo activo en cada sesin.

Respecto del involucrarse: si bien las consignas

son por lo general verbales, uno de los Activa corporal:

musicoterapeutas puede intervenir desde lo no-verbal, Consiste en un trabajo de movilizacin corporal

con el objetivo de reforzar la consigna anteriormente individual y de integracin grupal. En algunas
dicha en forma verbal. Tambin puede intervenir a los oportunidades se realiza un trabajo especificamente
efectos de modificar, resaltar, integrar diferentes individual, atendiendo a las necesidades de cada
situaciones del contexto no verbal. integrante del grupo (contracturas, bloqueos, por ej.).
Pero, destacamos que nuestro trabajo apunta tambin
a la integracin, al trabajo con el/los otro/s.
Bsicamente utilizamos tres tcnicas, a saber:

Activa corporal
... En un trabajo que consista en copiar (imitar) la
Activa musical
imagen del otro, nadie repar que D tiene escoliosis ...

399
... E dice haberse movido mientras escuchaba la Improvisacin musical (instrumentos de percusin-
msica, sin embargo estuvo quieto en el mismo lugar y voz).
posicin; slo haba movido una vez los brazos. Al
Composicin de canciones. (Ellos son los autores de las
sealrsele sto, refiere que lo haba imaginado ...
letras y, a veces, inclusive de la msica). Generalmente
el ritmo elegido es el blues el rock. Cantan
Activa musical: grupalmente, a veces incorporando instrumentos de
percusin el piso (que es de madera), mientras uno
Nos referimos aqu a la produccin sonora del
de ellos ejecuta la guitarra.
grupo (voz-instrumentos). Habitualmente se realiza la
grabacin del producto sonoro, el cual luego es
escuchado por el grupo y por nosotros, lo que nos Este es el blues de Casa Joven Este es el blues de Casa Joven

permite verbalizar sobre el mismo. (Primero se un blues de diversin ... blues de rock`n roll y realidad ...
verbaliza sobre la vivencia, sobre lo sentido/expresado.
Este es el blues de Casa Joven Este es el blues de Casa Joven
Luego, sobre lo escuchado).
un blues con compasin ... Blues de amor y sinceridad ...

Nuestra experiencia nos permiti observar tres Este es el blues de Casa Joven Este es el blues de Casa Joven
tipos de produccin sonora:
un blues de estimulacin, s seor. blues de paza y properidad ...

Este es el blues de Casa Joven Este es el blues de Casa Joven

400
s seor ... s seor ... s seora ... blues de perros de verdad ... Vacaciones en el hotel (Los Ratones Paranoicos)
Nos despedimos de este blues De nada sirve (Moris)
dejndonos de truchar ...
Blues (pertenece a su cultura adictiva)

El oso (Moris)
Asociacin libre de canciones. Nos referimos a
Pens que se trataba de cieguitos (los Twist)
episodios que ocurrieron con cierta regularidad en
sesin, en los cuales espontneamente surgen Cancin de la madre (cancin tumbera - de las
canciones o fragmentos de canciones. Por momentos crceles o institutos de menores)
todo el grupo se integra y participa cantndolas; por Pjaro Chog (cancin folklrica)
otors, un subgrupo. Tambin se dio el caso de que uno
Blues (pertenece a su cultura adictiva).
slo de ellos tomara la voz.
Cuando River fue campen (Cancin de
simpatizantes de un club de football que suele cantarse
Slo se trata de vivir (Lito Nebbia) en los estadios. La meloda pertenece a la cancin Son
Mujer amante (Rata Blanca) cosas mas, del conjunto de rock nacional Los
abuelos de la nada).
Presente (Vox Dei)
Cambalache (Tango de Enrique Santos Discpolo).
Crsito es el camino (cancin de un programa de
rehabilitacin de adiccin, con orientacin religiosa) Sapo cancionero(cancin folcklrica argentina)

401
 veces, se remite a otros espacios teraputicos.

Qu tendr el petiso? (Bailanta-Cumbia argentina.

Ricky Maravilla).
Realizamos la audicin de una cinta con msica
A partir del material que surge de estos tres tipos electrnica experimental preparada por nosotros. Uno
de produccin sonora, se trabaja en sesin en un de los pacientes refiere que al haberla odo ha sentido
momento posterior. sensaciones similares a las que senta cuando inhalaba
los vapores del Poxi-Ran (pegamento de contacto de
alta toxicidad). Una de las asociaciones que el paciente
Pasiva: pudo establecer fue entre las frecuencias ms altas
Consiste en la audicin de material sonoro (agudo) de la cinta y el zumbido caracterstico que oa
grabado, escogido por los musicoterapeutas o cuando comenzaban a hacerle efecto los vapores que
propuesto por el grupo. Generalmente utilizamos la inhalaba del Poxi-Ran.
msica como estmulo productor de evocaciones,
asociaciones y proyecciones. Habitualmente el material
Retomando entonces la estructura de la sesin,
que surge es de gran riqueza simblica. Muchas veces,
posteriormente al trabajo especfico (en base a las tres
los propios adolescentes dicen: Era como estar
tcnicas anteriormente citadas), se realiza una
soando ... flotando ...
verbalizacin acerca de lo ocurrido y lo vivenciado por
Sobre este material se trabaja en la sesin; y, a
cada uno de los pacientes; intentando llevar al terreno

402
de lo verbal dicha experiencia. Con el material de esta poblacin. Recordamos aqu el trmino al que
recabado, se trabaja en esa sesin, en sesiones hacamos referencia en el apartado B: Identificacin
posteriores, o bien se deriva al mbito de la musical).
psicoterapia individual. (El material puede ser llevado
Adems, todas las conceptualizaciones y grficos
por el propio paciente, o tambin existe la posibilidad de
que acompaan el presente trabajo, son vlidos
darlo a conocer en la reunin de equipo con el
especficamente para esta experiencia en particular.
terapeuta a cargo del mismo).
Una generalizacin de stos nicamente podra
llevarse a cabo luego de muchas experiencias
similares, que corroboraran o refutaran las hiptesis
D- Conclusin.
por nosotros planteadas.
A modo de conclusin, podemos referir que todo
Inclumos aqu tambin los aspectos relativos al
lo expresado a lo largo de este trabajo fue un intento de
encuadre, ya que entendemos que cada grupo es
conceptualizar acerca de la gran cantidad de
nico, singular; y que, habiendo diferentes modalidades
fenmenos observados en esta Institucin durante
de abordaje, cada musicoterapeuta elegir la ms
estos tres aos.
adecuada a ese grupo.
Respecto de sto, queremos aclarar que el
material sonoro expuesto en este trabajo es propio de
la poblacin antes referida (ya que en la nmina de
canciones se incluyen ejemplos musicales especficos

403
Datos Bibliogrficos Yara, J.A.; El adicto, la comunidad teraputica y sus
familias, Buenos Aires, 1990.
Bleger, Jos; Psicologa de la conducta. Editorial
Paids, Buenos Aires, 1987 (7 edicin). Yepes, A; Graetzer, G.; Gua para la prctica de msica
para nios de Carl Orff, Buenos Aires, Ricordi
Fregtman, C.D.; Cuerpo, msica y terapia. Ediciones
Americana, 1983.
Bsqueda, Buenos Aires, 1 edicin, junio de 1983.

Fregtman, C.D.; Holomsica. Editorial Kairs,

Barcelona, 1 edicin, 1989.
D E L A AR M O N A D EL ESC U C H A A L A M EL O D A
Fregtman, C.D.; Terapias no verbales en la comunidad D EL I N T ER PR ET AR BI - ESC U C H A / BI -
de da. Revista Actualidad Psicolgica n 47, Buenos I N T ER PR ET AC I N D EL I N ST R U M EN T O
Aires, 1980. PSI C O AN AL T I C O

Grimson, D.: La cura y la locura. Ediciones Bsqueda, MARCELO BIANCHEDI Y ELIZABETH T. DE

Buenos Aires, 1983. BIANCHEDI

Jennings, S. y colaboradores; Terapia creativa. Editorial

Kapelusz, Buenos Aires, 1979.
En esta presentacin trataremos de hacer uso de un
Ey, H.; Bernard, P.; Brissel, Ch.; Tratado de psiquiatra. modelo musical6 para describir-trasmitir nuestra
Masson, Mxico, octava edicin, 1980.
6
Al decir modelo musical estamos utilizando la palabra modelo no
como modelo didctico ni nicamente analgico; creemos, como se ver

404
idea/conviccin acerca de la tara analtica en sus ms parecido a un com-unin, ser-uno-con o a un
elementos esenciales. En trabajos anteriores trmino fue tomado por bion de la teologa, para
(Bianchedi, E. T. de (1990); Bianchedi M. et al.(1992)) aplicarlo por analoga al estado de devenir uno la
hemos expresado una conviccin nuestra acerca del realidad ltima incognocible de la experiencia
mtodo y la labor en psicoanlisis: creemos que todo emocional de la situacin analtica. Pensamos que
cambio psquico (o cualquier crecimientos mental) solamente en ese estado (emocional y no racional) es
durante el trabajo clnico es un proceso que posible la escucha--o bi-escucha, como la llamaremos-
necesariamente se debe dar a ambos miembros de la -tolerando el/los participantes estar sin deseo y sin
pareja analtica. En este trabajo vamos a referirnos al comprensin (Bion, 1967), al unsono.
problema de la escucha y de la interpretacin
Creemos que un modelo musical es apropiado para
denominndolas bi-escucha y bi-interpretacin para
describir y transmitir nuestras ideas. Pensamos que en
acentuar la equivalencia de ambos participantes del
la escucha (en un estado de atencin flotante de
psicoanlisis en relacin a esto fenmenos.
paciente y/o analista) durante la sesin psicoanaltica
Vamos tambin a utilizar el concepto bioniano de at- se detectan armonas--o dis-armonas--que resultan
one-ment (bion, 1970) para referirnos al marco mental luego en alguna meloda que se transmite (interpreta)
en el que se debe/puede estar para ser receptivo de lo en la formulacin, sea esta una asociacin libre, un
verdadero de la personalidad--propia empata; es modelo, una interpretacin o una construccin. Y que
todo esto se da en una clave, la de continente-
a lo largo de este trabajo, que los elementos musicales son
fundamentales en la constitucin del ser humano en cuanto miembro contenido en K (Bianchedi, E.t. de, 1985)
comunitario de una realidad presente.

405
El escuchar, el asociar, el componer-crear y el apertura creemos que ofrece la posibilidad de producir
formular-interpretar son elementos fundamentales y encuentros con la realidad psquica: lo homologamos
constitutivos del devenir en la dada psicoanaltica, a como cuando se enciende o prende un aparato de
entendiendo por dada psicoanaltica la presencia e alta fidelidad, y, siguiendo con la analoga, el ruido de
interaccin de los dos miembros que la constituyen. El imaginacin que se escuchara al prenderlo, equivale
dilogo psicoanaltico presenta permanentes al ruido de imaginacin que suponemos se genera
variaciones en los roles, los tonos, las claves, los cuando analista-analizando se disponen a escuchar-
modos y/o las ejecuciones. se mutuamente. Creemos que la disposicin a este
tipo de escuchar-se, (sonorizar las imgenes) les
Vamos tambin a enfocar este problema desde la
permitir a ambas revelar dimensiones temporo-
conviccin operativa que considera que la vitalidad
especiales mutuamente desconocidas. Esta situacin
personificable se manifiesta por el resultado de un
se ver facilitada por las sucesivas convalidaciones
equilibrio dinmico entre fuerzas antagnicas en
dadas por la reiteracin prctica y terica del proceso
permanente contraposicin (contrapunto?); la actitud
psicoanaltico y por las experiencias previamente
analtica es una resultante de ese interjuego y el
convenida en cada combinacin particular.
analista es (o debiera ser...) un fiel receptor-transmisor
de esa vitalidad en juego. Contemporneamente es sabido que el tiempo del
continum personal, comunicario y universal, sigue su
La apertura de una sesin analtica comienza con la
curso sin interrupciones. Pensamos, sin embargo, que
interrupcin transitoria del continum vital
a partir de ese momento, y en ambos participantes,
habitualmente entendido como realidad externa. Esta

406
puede y suele potenciarse y ampliarse la concepcin En la intimidad psicoanaltica, esta actitud de apertura a
del tiempo psquico en mltiples sentidos, por la integracin de la realidad psquica permite que lo
ejemplo, el dinmico, el temporal y el espacial. privado sea hecho pblico y que lo pblico sea hecho
privado. Cuando co-existe este esfuerzo de
Consideramos la escucha analtica como un mtodo
compromiso de escucha analtica un pensamiento
que implica una serie de funcionamientos que hacen
ininteligible puede transformarse en uno inteligible7; al
posible la realidad de esa escucha; no es solamente
pasar de un anterior espacio auto-generativo a otro
una disponibilidad acstica que atiende y entiende los
espacio ahora avalado por mutuas garantas, adquiere
componentes sonoros o silenciosos de un lenguaje,
poder de difusin, es decir, de hacerse inteligible.
sino es una disposicin que abre la tonalidad de la
sensopercepcin en sus distintos niveles y cualidades Creemos que despus de ese instante de armona se
que se integrarn en conformaciones fono-audio- hace meloda. Dicho muy brevemente: creemos que
visuales. en el contexto del trabajo psicoanaltico, la armona de
un pensamiento se logra por el mbito creativo
El funcionamiento de la integracin fono-audio-visual
construido en comn y por el ritmo de frecuencias e
crea componentes aptos para ser psicoanalizados.
intensidades con que se escucha e interpreta su
Cuando la dada psicoanaltica est en resonancia
meloda.
biquivalente, la realidad psquica de ese instante se
revela por el esfuerzo de integracin sonsoperceptiva
que se realiza en comn. 7
Inteligible: decs de lo que es materia de puro conocimiento, sin
intervencin de los sentidos. Definicin del Diccionario de la Real
Academia, 1956.

407
Msica es sonidos, ruidos y silencios en ritmos que En este caso el dicho imaginativo kantiano: La materia
armonizan melodas. La Naturaleza Musical puede ser sin la forma es ciega, y la forma sin la materia es vaca,
concebida como un conjunto de ritmos, sonidos, ruidos debera entenderse como un proceso dinmico en
y silencios que le dan su tono constantemente.8 permanente interdependencia; como un antecesor
conceptual de una relacin continente-contenido
En lo humano, la nocin de ritmo se inscribe a partir del
bioniana (Bion, 1962), que, si fueran los personajes
contacto piel a piel y probablemente derive del contacto
Membrana-Proptplasma, podran decirse
primordial de protoplasma con sus membranas.9
mutuamente: quiero crecer, por un lado, y espera un
Imaginemos al protoplasma como un estado
poco, por el otro; as lo hacan tambin Mama y Feto
orgnicamente amorfo que, a travs de un polirritmo
(Bion, 1979)--si fueran nicamente las palabras lo que
constantemente expansivo, consigue un equilibrio
les hicieran posible hablarse y entenderse
formal, dinmica y temporalmente estable que se
(comunicarse) entre s.
contiene por su membrana, en cada una de su
La Conciencia sera, en este sentido, la parte del
diferenciaciones posibles.
Protoplasma capaz de Membranizar proto-
8
En las grandes concentraciones urbanas, al decir de Murray Schafer pensamientos. El protoplasma, como el proto-
(1967) se vive en una cloaca sonora, que dificulta la entonacin entre
sus habitantes. pensamiento, al formalizarse y organizarse en
9
Marce Beaufils, en su libro Musique du son, musique du verbe dice
la percepcin sonora debi ser para el hombre en sus comienzos la pensamientos, prolifera posibilidades de difundirse y
plenitud de un estado de conciencia; todo se pasaba como si nuestro
cuerpo no fuera al principio sino un detector viviente, por eso mismo
creador de una sensibilidad y de una eficiencia maravillosa situado en
medio de un fluido que le precedera en el ser. Citado por A. Aberastury (1972) en su trabajo la voz como msica en la temprana comunicacin
madre e hijo.

408
diferenciarse incesantemente. tiempos y espacios10 hasta ese momento no re-
conocidos, pasan a formar parte de pensamientos
A nuestro entender, uno de los mayores esfuerzos de la
nuevos. Suponemos tambin que stos se generan
humanidad es posibilitar que los pensamientos vivan en
por estmulo y contacto con otros pensamientos y
una activa libertad creciente, es decir, con garantas de
evolucionan por la frecuencia e intensidad (ritmo) de
una vitalidad de renovacin constante <el conjunto
sus inter-influencias. Una vez consolidada la nocin de
creciente dominado +continente-contenido por Bion
pensamientos nuevo, similarmente a lo que ocurre en
(1962)>.
el fenmeno de la mitosis, surge la posibilidad de
Imaginamos el mtodo psicoanaltico como una
poderlo re-conocer, reproducir y diferenciar. Luego, por
especie de membrana psquica que hace proliferar la
sucesivos contactos, se crea la necesidad de constituir
difusin y diferenciacin de pensamientos; estos, al
smbolos que sern utilizados para substituirlos. Estos
adquirir nuevas perspectivas y dimensiones de
smbolos formaran una trama intersticial que habilitar
espacios y funciones capaces de alojar nuevos
pensamientos y as sucesivamente11. La trama mental
est constituida por una red de pensamientos que
intercambian permanentemente sus valores a travs

10
Tiempo en psicoanlisis es equivalente a Tempo en msica? El
Temperamento, que es la identidad de esa msica, que es su Per
Sonare, es una faceta ms de la per-sonalidad en anlisis?

409
de sus smbolos. Creemos que la interrupcin momentnea del
continuum vital habitualmente concebido como
El contexto de esta trama psicolgica, en el que se
realidad externa probablemente corresponde a la
mueve habitualmente el psicoanlisis, le confiere, a
sugerencia tcnica que Bion nos ha legado al invitarnos
quien practica, un cierto automatismo personal que lo
a estar sin memoria, sin deseo y sin comprensin.
invita a construir conjeturas imaginativas sobre la
Desde esta perspectiva, la meloda vendra a ser la
existente. Resulta obvio que lo psicolgico tiene que ver
construccin psicoanaltica en el interior del aqu y
con la co-existencia de las personas humanas y que la
ahora de la sesin--aquello que ya no es re-
realidad funcional del psicoanlisis es un hecho vincular
construccin sino creatividad naciente.12
estrictamente inter-humano. Desde este punto de vista,
todas las diferentes indicaciones tcnicas desarrolladas Volviendo a nuestro tema inicial, ya dijimos que hay
en la disciplina psicoanaltica tienen algo en comn. Sin muchos modelos posibles para referirse a la escucha
embargo, entre sus teoras, tambin co-existen del analista, a lo que ocurre en su mente cuando entra
inquietantes concepciones que incitan a des- en contacto con esa otra mente que es su paciente; la
antropomorfizar sus orientaciones conceptuales: los fuente de comprensin es la dualidad psicoanaltica, de
pensamientos sin pensador (Bion 1967) es una de dos mentes interactuando. El binomio madre-hijo o
ellas.
12
Loa novedoso criterios musicales de Murray Schafer entusiasman a
msicos como Yehudi Menuhim (vdeo: Historia de la msica). Los
criterio contrastantes de Feyerabend, discordando con los de un Lakatos
11
Al introducir Prigogine la nocin de estructuras disipativas de espacio- o un Popper no armonizan en lo epistemolgico, y sin embargo, tanto en
tiempo evolutivos del Universo, ha planteado nuevas perspectivas de una situacin como en la otra, por disonancia y contrastes se estn
indagacin en el microcosmos de la mente humana. aproximando a msica y ciencia.

410
protoplasma-membrana puede ser su origen, siendo La meloda que en ese moemtno se escucha, es una
estas, de nuevo, conjeturas imaginativas acerca de la fantasa, que se pro-crea por sus resonancias
mente en evolucin. Nos interesa tratar de hacer otro armnicas. La coloratura... el color musical, su
modelo que incluya una posibilidad ms de indagar los temperamente, corresponde a un momento realizado
sucesos psquicos en su estado original--in status previamente y que est por se escuchado de nuevo.
nascendi. esta sera la condicin ideal de un momento
psicoanaltico logrado: la de realizarse en un bi-
La interpretacin madura, cuando la parte meldica
escucha que se sonorice plenamente en
de la experiencia psicoanaltica est por expresarse en
reciprocidades audi-fono-visuales, aunque estas
el vnculo. Su capacidad musical se ha entonado
tengan que referirse a momentos plenos de dolor. En
satisfactoriamente y por eso es escuchada su
una reciente experiencia realizada en comn por uno
evocacin. La alta fidelidad de la interpretacin es la
de nosostros con la musicloga Cristina Zamani, se
pare del contacto que se hizo posible por la rtmica de
lleg a la conclusin de las interv-valaciones
las re-sonancias selectivamente armonizadas. All entra
universalmente ms difundidas en la entonacin
toda la variedad de gamas de gneros posibles de ser
humana, se realiza en tercera menor descendente y
escuchados, desde un adagio o un allegratto, un vals o
cuarta justa ascendente.
un rock. En el momento de la maduracin interpretativa
se esta realizando el acto de seleccin natural de lo Contacto, poesis, envoltura musical, expresadas en
que se prendi en la escucha y se est aproximand a ese re-sonar materno. La interpretacin como un
la creacin que v a realizar-se en comn. pre-sonare-mam-simbolo, que con sus resonancias

411
arrulladoras, detiene las vilaciones perturbadoras13 que la meloda, por pertenecer al terreno de la fantasia, es
no habin sido escuchadas plenamente. Es un imaginar inexistente, todo lo contrario, existe justamente porque
un punto equidistante desde donde parte y al mismo moviliza y transforme cantidades inmensas de
tiempo llega la fantasa. Fantasia y emocin pareceran opciones a ser pensadas14.
colocarse aqui en une equivalencia temporo-espacial;
En el contexto de la interpretacin psicoanaltica, es
"prender" el aparato es como "prender-se" a la fantasa
importante que una forma vaga de pensar tenga opcin
que est por ser.
a hacerse coherente. La intuicin y la sensibilidad
La melodia es una fantasa, que no se percibe salvo hacen madurar las razones que pujan para que un
como perturbacin. Se origine en un espacio que le es pensamiento sea "parido"; este se hace coherente,
dado por consensos. Consensualmente se dice que cuando se logra la armonia entre todos los factores que
esto es rojo, o que aquello es triste o alegre. Los estan interviniendo. La realidad psicoanalitica se
mrgenes de seguridad de "rojidad", o de "alegra o suatenta en la armonizacin multi-sono-audio-visual
tristeza" de una melodia, pertenecen al mundo de las capaz de lograrse en ese instante.
creaciones da la fantesia; esto no equivale a decir que
E1 aspecto narrativo de una descripcin anlitica, como

13 14
El lego generalmente asocia la perturbacin mental a graves Esto pertenece al area de problemas meta-linKuisticos, donde tambin
alteraciones del comportamiento, que puede variar en una gama amplia lo sinsico y lo para-lingustico intervienen en el componente estilistico
de posibilidades expresivas, desde el extremo del silenciao catatnico o al que nos estamos refiriendo. Un bostezo, un suspiro, una carcajada,
del estupor melanclico a la violencia fsica de un paranoico o de un una sonrise, un cualquier hecho "cuasi-vegetativo", pueden ser indicios
exquizofrenica. Concebir la perturbacin mrnysl vomo ls rxistencia del a veces tiles para ser interpretados como vestigioa de realidades
congflicto de dos fantasics antpodas que quieren expresarse transferenciales y contra-transferenciales re-presentificados en el "aqui
simultaneamente es un hecho que solamente puede ser convalidado a y ahora".
travs de la experiencia de esa perturbacin en la seccin psicoanalitica

412
su estilo interpretativo, no parecen depender tanto de la la melodia presentificada, que surge naturalmente, sin
diccin y fonacin de como esta verbalizada, sino de pensarla, e interpretarla de modo que la "escucha" del
como est entonando-sintonizando en el momento del paciente la reciba?
"at-one-ment" bioniano al que noa hemos referido al
Misteriosa funcin, de la que estamos dotados sin
comienzo.
saberlo y que nos hace brotar el comentario, la
En la interpretacin intervienen modulaciones, asociac16n, la "interpretacin". A veces disonante, otras
inflexiones, sincopas, pausas y ritmos, propios de esa veces contrapuntistice; la polifona de los objetos
diada de intercomunicacin personalmente hablada. internos presentes y ausentes que se con-gregan en
Con el avance y profundizacin de la experiencia de las tonalidades del con-cierto in-cierto y dan diferentes
una situacin analitica, es probable que se vaya coloraturas a los tonos de las voces. Seremos
creando un personal "dialecto psicoaniltico comprendidos? Importa eso? Hacemos un correlato
particularizado". Por lo general esto suele ser entre este polifonie y la polisemia de nuestras palabras.
beneficioso para ambos participantes, aunque, a
En el aqu y ahora de la sesin psicoanlitica, el
veces, cueste re-conocer qu~ instrumentos
virtuosismo lingustico, el conocimiento de la mtrica-
psicoanaliticos se estn utilizando en esa particular
literaria, de la prosa-potica, o de la capacidad de
situacin interpretative.
decifrar cdigos, no son los nicos ingredientes
Cual es la funcin que, en la mente del analista, ea indispensables pare el entendimiento y la comprensin
capaz de transformar todas eatas impresiones global del drama que se est generando en ese
(perceptuales, intuitivas, de conocimiemtos previos), en contexto. Se trata mas bien de una partitura polifnica-

413
naciente que exige una entonacin particular y que se en ambos miembros de la pareja terepeutica, llamando
interpreta en la clave de la rapsodia de ese dialecto. esto un "bi-escuchar"; y denominando "bi-
interpretacin" a la verbalizacin sonora hecha en la
Y se realiza el con-cierto. A veces hay aplausos fuera
comunicacin verbal. E1 componente musical es visto
de tiempo. A veces, silbidos, o toses en momentos
tambin como parte natural de todo vinculo humano, y
inadecuados. Casi siempre es una "sinfonia
esencial para 8U comprensin. Asi, por ejemplo, se
inconclusa", que continuar--continuar?-en la sesin
considera que el sentido polismico de une palabra es
de maana. Pero otras veces, la bi-escucha y la bi-
el simil polifnico de una melodia. Los autores vinculan
interpretacin harn sentir a ambos miembros
la creatividad en el contexto de la sesin psicoanaltica
presentes que han participado de una experiencia
utilizando los conceptos de armonia y melodia para
nica, intrasmisible (no se la puede "grabar", aunque a
referirse a la interrelacin, cuyo resultado sonoro es la
veces alguno de los dos lo intente hacer...), y no es
interpretacin.
repetible. Sin "bis"; aunque a veces, fuera de programa,
se agrega una mirada, un tono, un gesto, una sonrisa o
una lgrima al despedirse "haste la prxima..."
BIBLIOGRAFIA

Aberastury, Arminda, (1972),"La voz como msica en la

RESUMEN temprana comunicacin madre e hijo", en Revista de
Musicoterapia, II, 1.
En este trabajo se emplea un modelo musical pera
referirse a la combinacin del escuchar psicoanalitico

414
Beaufils, Marcel, Musique du son, musique du verbe. Bion, Wilfred R., (1862), Aprendiendo de le experiencia,
Paids, Buenos Aires, 1975. (1967) Volviendo a pensar,
Comentarios, Horm, Buenos Aires, 1970.
Bianchedi, Elizabeth T. de, (lS90) "Cambio psiquico. E1
-------- (1967) "Notas sobre le memoria y el deseo", en
devenir de una indagacin", en Revista de
Revista de Psicoanlisis, XXVI, 3, 1969.
Psicoanlisis, XLVII, 1.
-------- (1970) Atencin e interpretacin, Paids,
-------- (1985) En clave de continente contenido", en
Buenos Aires, 1974. (1979) The dawn of oblivion,
Letture Bion1 _ , Borla, Roma, 1987.
Clunie Preas, Perthshire,1979.

Bianchedi, Marcelo, (1975), "La voz como vehiculo de

Schafer, Murray, (1967), Limpiesa de odos, Ricordi,
integracin en la expresin comunicativa", en Revista
Buenos Aires, 1992.
de Musicoterapia,
Zamani, Cristina, (1992) Comunicacin personal
III, 1. 1975.

----- et.al., (1992), "Pro-creando espacios en la mente",

en I Conareso sobre la Creatividad en psicoanlisis,
prevensin, psiquiatria y alternativas en psicoterapia,
Buenos Airea.

415
 SO N O R O - PL ST I C O EN H O SPI T AL posibilidades de actuacin de la Educacin Artistica en
PSI Q U I T R I C O el campo reeducacional especificamente en aquel
ligado al sector de la salud mental.
J ARA DE J ESUS B ILEMJIAN (E DUCADORA DE A RTE Y

H ABILITADA EN M SICA ) Y M ARLCIA R ODRIGUES La investigacin fue realizada durante 1991 y

C OUTINHO (E DUCADORA DE A RTE Y H ABILITADA EN A RTES repetida en 1992. E1 local donde se desarroll esta
P LSTICAS ) investigacin fue el nico hospital con atendimiento
diario que hasta el presente existe en GoiAnia. Este
hospital est anexado al Hospital Psiquiatrico del
Profesores Orientadores:
Estado -- Complejo Hospitalar Adauto Botelho -que
Lia Rejane Mendes Barcellos (Musicoterapeuta) atiende con un equipo multidisciplinar una clientela
Dr. Daniel Emdio de Souza (Mdico psiquiatra y estimada de 20 pacientes diarios.
Psicoanalista) La propuesta utilizo un lenguaje corpo-sonoro-
musical-plstico como factor viabilizador de la
organizacin verbal, pues consideramos que el
E1 proyecto de investigacin "Sonoro-Plastico en
lenguaje de la expresin artistica antecede al lenjuaje
Hospital Psiquiatrico" surge de la intencin de dos
de la comunicacin verbal.
educadoras artisticas -- Jaira Perdiz de Jesus Bilemjian
e Marlcia Rodrigues Coutinho, habilitadas en msica y En el inicio de esta investigacin fue levantada la
artes Plasticas respectivamente -- de establecer las hiptesis de la existencia de una correspondencia entre

416
los componentes bsicos de la estructura mental y las integradamente y fueron incluidos trabajos ligados a la
estructuras sonoro-plasticas cuya correspondencia expresidn corporal y al teatro.
podria ser demostrada atravs de una prueba sonoro-
plastica.
b) Hubo una recoleccin del pasado sonoro-Plstico de
Sobre esta hiptesis estructuramos una
cada paciente -- lo que se hizo a traves de un
propuesta de trabajo cuyo objetivo general es
cuestionario respondido por el paciente y por alguna
acompaado de algunos objetivos especficos:
persona responsabale por l ante la institucin.
valorizar la comunicacibn no-verbal como medio de
facilitar la expresin del mundo interior de los
individuos. c) Recibimos las informaciones sobre los pacientes por

Para esto decidimos desconsiderar exigencias parte de la asistente social y por el medico psiquiatra

estticas y ofrecer estmulos artisticos como responsable por los pacientes hospitalizados.

motivadores iniciales de resultados

sonoro-plasticos . d) Aplicamos la investigacidn denominada "Prueba

Sonoro Plstica" realizada en grupo abierto. Esa prueba
fue realizada en tres momento diferentes durante 1991
Adoptamos algunos procedimientos bsicos:
y otros tres durante1992.
a) La exPresidn sonoro-plstica fue elaborada

417
e) Considerando los datos recogidos hasta la resultados observados en las vivencias. Una evaluacin
realizacibn de los procedimientos mencionados fueron mas precisa fue obtenida repitiendo la experiencia de
programadas 22 vivencias anuales. Estas vivencias 1991 en 1992. Las 22 vivencias anuales fueron
fueron semanales realizadas durante el periodo distribuidas as :
vespertino (desde las 14:00) hasta las l8:00 horas). E1
trabajo se apoya en la libre expresin y en la
improvisacin sonoro-plastica. La propuesta fue a) En el primer momento hubo diez vivencias.

vivencial y enfoc las necesidades e intereses "aqu- Aqu se utiliz la msica grabada asociada a la

ahora" del grupo como tcnica de interaccin. Los expresin corporal, seguida de la expresin plstica.

contenidos desarrolados fueron los que emergieron del Esta es una sensibilzacin corpo-sonoro-plstica que

grupo. El trabajo de observacin se desarroll en permiti que los pacientes se expresasen

grupos abiertos. Despues de la realizacin de cada musicalmente. Durante el ano de 1991 esto ocurri

vivencia, registrada en cintas magnetofnicas, los despus de la octava vivencia, y registramos 43

datos observados fueron anotados en una ficha de msicas cantadas. Durante 1992 esta sensibilizacin

observacin elaborada por las autoras de la pesquisa. ocurri despus de la cuarta vivencia, registrandose un

Cada educadora artstica utiliz una ficha de total de 124 msicas cantadas. Observamos que en

observacin Para evaluacin posterior. La evaluacin este trabajo en grupo abierto el grupo se organizb sin

del trabajo fue posible gracias a la comparacin de 105 intervencin de las educadoras artsticas, acogiendo la

resultados recogidos en las etapas anteriores y los msica trada por uno o mas pacientes. Huba
momentos en que el grupo decidi la msica a ser

418
cantada, y a veces un Paciente decidi cantarla solo. 1991 de las 43 msicas cantadas en el grupo 40
Raras fueron las msicas rechazadas por el grupo. El prevalecieron tonales. En el modo tonal mayor
genero musical no es puro ms dramtico. Dentro de identificamos 3, y 10 en el modo tonal menor. Apenas
esa dramaticidad se observ en las letras, en una tres prevalecieron identificadas mezclando trechos de
tonalidad, grupos de significacin de opuestos. tonalismo y modalismo -- modo elico, dos, y mixolidio,
una.
Hay en la mayoria la presencia del deseo
contenido en el "acervo fantasmatico" de cada En 1992 el grupo cant 124 msicas. Aqu
Paciente, expresado en la relacin sacro-Profana. E1 prevaleci el modo tonal ( lO7 msicas) sobre el modal
objeto sobre el cual podemos observar que el paciente (14). E1 tono mayor fue cantado en 90 msicas y el
expresa esa fantasa es o en la imagen de la mujer o en menor en 17, y apenas 14 son trechos mezclados de
la de lo sagrado. Ese objeto idealizado es percibido en tonalismo deslocndose para modalismo (10 elicos, 4
los varios simbolismos que expresan la figura materna dricos y 1 mixolidio).
primitiva (mujer, madre, enamorada, amante, pasin,
E1 estilo musical fue variado. Se cant bail,
flor, bichos). Dentro del contexto sagrado se observa el
xote, sertanejo, msicas folclricas, de corro, valses,
deseo de salvacin de esa tentacin -- deseo
himnos sagrados, samba y marchas carnavalescas.
identificado en las letras de las msicas tradas por 105
Observando esas composiciones musicales puede
pacientes de las diferentes religiones.
decirse que las msicas populares en la mayora se
Pasemos ahora al analisis musical. Registramos apresentaron sobre el ritmo binario, construccin
la presencia de msicas modales y tonales. Durante armnica elemental (I, IV, V), con pocas modulaciones

419
y melodias en torno de un nico tema meldico sin rueda..., todo esto demostrando estereotipo, simetra y
variaciones expresivas. puerilismo, as como una realidad inconsciente.

E1 objetivo de esas diez vivencias iniciales fue

propiciar un trabajo que permita un reconocimiento
b) Otras diez vivencias siguieron a las diez
corporal, utilizando un recurso expresivo dual
vivencias ya descritas, utilizando esta vez instrumentos
(corpo/voz) con posibilidades de liberacin Plastica.
musicales y materiales plasticos, al mismo tiempo,
En este momento se observ que en el primer como objetos intermediarios. Para movilizar la
contacto corporal, los pacientes se encontraban con los expresin artstica ofrecimos dos recursos (sonoro y
cuerpos tensos y rgidos. Observamos que fluiron plstico), o slo uno. Los pacientes tenan la libertad de
muchas creaciones artsticas donde 105 pacientes escoger cual. En esta etapa tuvo lugar lo que
conseguieron elaborar dentro del contorno de sus denominamos "espacio transicional". Hubo en el plano
cuerpos nuevas formas. Utilizaron colores calientes y grupal la formacin de estructuras musicales y en el
alegres. E1 tema vari de "mandala" a ramos de flores. Plano plstico la liberacin de una carga emocional
Con la arcilla surgieron muchas mascaras, formas que intensa expressada en los dibujos, por el uso de
sugieren figuras masculinas y femeninas. Pero tambin colores, de modo significativo.
vimos caricaturas, calavera, biscocho, bola,
candelabro, vaca, pato, serpiente, cenizero, vela, plato,
triturador de ajo, ladrillos, vasija, frutas, cancha de golf, Observando los pacientes en el grupo instrumental, se

barro solpeado y envuelto, cesta con frutas, ollas pudo reconocer que durante 1991 y 1992 hubo una

420
bsqueda identificadora con los instrumentos de de Raul Seixas y un conjunto de "Beatles". Dos mujeres
Percusin pesados (bombos -- varios tipos --, tambor expresan su dramaticidad sonora en un do en que
de guerra, bongo, tumbas, y livianos (panderetas, cantan "Peixe vivo" ("Pez Vivo", cancin folklrica de
cencerros, tamborines, "afouch-es", "quizos", Minas Gerais, centro del Brasil). Despues de cada
castauelas, platos). Los instrumentos meldicos como vivencia se sugera que 105 pacientes que asi lo
xilfonos, metalfonos, "celestines", flautas, pio-pios, desearen podan arreglar los instrumentos que habian
fueron menos requeridos que los de percusin. La sido damnificados durante aquella vivencia.
guitarra y la armnica (instrumentos armnicos) solo
Hubo una elaboracion plstica de temas
fueron tocados por algunos pacientes en raras
relacionados a la expresion sonora. Despus de cada
ocasiones. El ritmo que predomin tanto en 1991 como
vivencia de la expresin noverbal dimos al grupo un
en 1992 fue la marcha en 2/4 ) y variaciones
espacio final Para que verbalizaran sus emociones.
sobre ella. En algunas vivencias se reconoce el ritmo
catira y samba (culturales). En el ao de 1991, algunos Cuando en el espacio sonoro una educadora

vocalismos (golpeando la boca con la mano) que coordinaba el grupo sin interferencias, la otra

sugieren tribos indigenas, primitivas. En las ltimas educadora observaba desde su espacio Plstico todos

vivencias se observa que al recorrer a la guitarra se los movimientos de los Pacientes Y sus intercambios de

formaban dos (expresin campesina compatible con instrumentos. En las composiciones plsticas

los estmulos recibidos en la vida del paciente, encontramos trazos que sugieren viviendas,

conjuntos cantando "Maluco Beleza" ("Loco Belleza") naturaleza, alimentos, animales, transportes...,
relacionados a la historia personal de cada paciente. E1

421
color negro fue el mas requerido en los dos aos. composiciones fluctuantes, sin base, como si ya no
Despus aparecen de manera expresiva rojo, verde, pertenecieran a este mundo.
azul, amarillo, marrn, rosa, anaranjado, lila. Es
oportuno decir que estos colores y sus tonalidades
fueron los nicos encontrados en los dos anos de la c) Aqu se propone una vivencia en que el

investigacin. E1 movimiento constante de las lineas recurso sonoroplastico se lo hace a travs del drama

sinuosas revela la emotividad de los Pacientes. expresado sonora y plasticamente. Con las Paredes de

Percibimos las lineas diagonales, las lineas verticales y la sala cubiertas de Papel pardo, con los instrumentos

con menos expresividad las lineas horizontales. En usados en la etapa anterior u con los materiales

1991 hubo por parte de los pacientes gran demanda de plasticos que posibilitan la expresion plastica, inclusive

arcilla. En 1992, en la novena vivencia, surgen en el la arcilla, los Pacientes seleccionan un tema decidido

papel Canson dos expresiones plasticas que sugieren por el grupo y tratan de crear una trama.

una bsqueda de lo tridimensional. Estas expresiones En el tercer momento, propuesta la

nos recuerdan movimiento. dramatizacin sonoroplastica como actividad ldica, el

Estudiamos lneas, formas y colores. Formas grupo de 1991 escoge el tema "La Naturaleza", que

que sugieren pobreza intelectual, infantilidad, sera sugerido tambien por el grupo de 1992. En este

transparencias, escindidas en todas las formas espacio ldico el grupo presenta personajes. En el

espaciales o apenas en las partes superiores de los grupo de 199l se representaron leones, pjaros gotas

diseos, formas simetricas, yuxtapuestas, de agua, rbol de "jatob", gatos, estudiante desfilando,

422
palmera, gorila manso, caballo; grupo de 1992: arbol de
"jabuticaba", persona adepta a la religin creyente,
d) Esta es una vivencia rica en simbolismos. Se
mariposa, gato, tucano, perro, madre natureza, ngel
propone la construccin de un "arbol de mscaras",
guardian, montaa de piedra, jardin, sapo, luna), que al
coordenada en el aqui ahora por la educadora plastica.
ser expresados a traves del sonido su correspondencia
Se sugiri al grupo la construccibn de un arbol en que
se vuelve compatible con las posibilidades sonoras de
todos participen plasticamente. En esta vivencia se
los personajes. A.lgunos participaron slo con el cuerpo
encierra el trabajo de investigacin.
y la voz en esta actividad dramatica sonora.
El trabajo se inici con una actividad Plastica de
En este trabajo observamos que el grupo
contorno corporal (Primera vivencia) y fue finalizado
consigui construir una historia de comienzo-medio-fin,
con una actividad plastico-corporal (vigesimo segunda
tocando todos juntos la expresin sonora de este tema
vivencia). En esta vivencia el grupo trabaj sobre el
ldico. En el ao de 199l predomin el ritmo de marcha.
cuerpo sin tensiones. Se expresaron afectos durante la
En 1992 predomin la pulsacin marcada por el bombo.
realizacin del mismo. Los pacientes demuestraron
En ninguno de los dos grupos hubo una identificacin
entusiasmo y alegria al modelar sus rostros y descubrir
expresiva con melodia o armonia.
en las mascaras personas enteras, bonitas y con
Observamos que en 199l y 1992 los pacientes se identidad. Muchos de los pacientes que en la primera
sintieron inhibidos cuando utilizaban la hoja de papel. vivencia tenan el cuerpo rigido y tenso ahora se
Las composiciones son infantilizadas y generalmente sienten abiertos y algunos ofrecieron los brazos y las
correspondan a los personajes que representaron. Piernas Para modelar. Esa actividad exigi paciencia y

423
respeto mutuo. La elaboracibn del arbol fue llevada a 2. Cuando al grupo se le permiti la verbalizacin de
cabo por el grupo asi como por las educadoras sus emociones observamos que existen registros de
artisticas. Este trabajo es el nico expuesto en el expresiones de afecto, comunicacin no-verbal, mayor
hospital. Los pacientes se sienten orgullosos de esta interaccin grupal ampliacin de la organizacin del
actividad. grupo, tolerancia en las relaciones intra-grupales,
empata, lmites respetados, respeto al otro, rescate de
la auto-estima, etc.
A1 finalizar la investigacin se realiz una fiesta
en el hospital con la participacin de los pacientes y sus
familiares. Toda la produccin fue devuelta al hospital 3. Hubo algunos pacientes que se identificaron
despus de ser documentada y archivada. ampliamente con el trabajo y continuaron viniendo a1
hospital, inclusive despues de haber recibido el alta,
para participar de nuestras actividades. Entre estos
Conclusin
pacientes algunos nos posibilitaron una comprensin
1. Concluimos que la hiptesis de que existe una mas amplia de nuestra propuesta.
correspondencia entre las estructuras sonoro-plsticas
y las estructuras de las diferentes etapas en el
4. Para que el recurso artistico adoptado con
desarrollo psicolgico del beb recibe confirmacin.
pacientes psiquiatricos tenga xito es necesario
aplicarlo desde el inicio del tratamiento hasta el final,

424
ininterrumpidamente, y debe ser continuado por un elementos creativos y bastante estereotipados se
periodo de ps-alta hasta que se establezca la observa que el espacio sonoro esta mas preservado.
adpatacin del individuo en la comunidad.
8. En el tercer momento prevaleci la estructura
elemental musical.

5. La metodologia utilizada permite sistematizar la

actuacin de las expresiones artisticas como
9. Las selecciones musicales son compatibles con el
procedimiento terapeutico auxiliar en el paciente
grado de estmulo vivenciado en el pasado sonoro-
portador de perturbaciones mentales.
plastico de cada paciente.

6. Este procedimiento, ademas de permitir detallar el

10. En relacin a los elementos de composicin
diagnstico psicopatolgico del paciente, introduce una
musical, observamos que el grupo tuvo gran dificultad
forma de comprensin ms abarcante: la de una nueva
al tratar de expresar la meloda de forma libre, sin
comunicacin sonoro plastica.
tensiones. Lo que se vio fue ms bien un canto ritmico-
meldico de lo que la expresividad musical que las
melodas sugieren.
7. Si en la mayor parte de los dibujos de los
pacientes se aprecia un espacio grfico damnificado,
escindido, disociado, desintegrado, Pobre de
11. En este primer momento de la tercera etapa

425
vivencial los temas de los deseos varian de paciente a un predominio del ritmo de marcha, que
paciente, mas su simbolismo est relacionado a temas frecuentemente tiene una divisin binaria de tiempos,
que reflejan un simbolismo dual plasmado en la sugiriendo recuerdos de "danzas andadas" -- Pasos
presencia constante de opuestos. que ya estan incorporadas en una gran cantidad de
personas.

12 A partir de las primeras vivencias hubo elementos

que nos permitieron concluir la existencia de una En una situacin intra-uterina la percepcin del ritmo
proyeccin narcsica de imagenes, ya que los pacientes inicial incorporada al bebe es el de la pulsacin y de los
revivieron situaciones regresivas. En estas situaciones, latidos cardiacos. Sugerimos que el ritmo de caminar
al prevalecer la musica tonal sobre la tonal/modal, el que consideramos una forma de marcha es
antagonismo vivido en los textos dramaticos se opone a automaticamente incorporado en esa vivencia.
los tonos mayores de las msicas y sugiere la dificultad
de expresar este conflisto emocional. Esto nos lleva a
concluir que hay esperanzas de que la musica 14. En el cuarto momento, la construccin simblica del

contribuya como punto de partida Para ese rivivir tan arbol (mscaras y moldes de brazos y piernas) sugiere

remoto. simbolicamente la construccin de una identidad

admitida y reconocida por el paciente como su espacio
(ahora un poco ms integrado).
13. En el trabajo sonoro del espacio transicional, hubo

426
 BARCELLOS, Lia R. M. "Msica e Terapia", Presentado
en el II Congresso Brasileiro de Psicopatologia da
15. Reparar los daos ocurridos a los instrumentos
Expressao. Belo Horizonte, 1991.
musicales durante la vivencia sugiere empeo,
esfuerzo en el proceso de "restauracin" de sus BENENZ0N, Rolando. Musicoterapia en Psiquiatra.
aspectos psquicos. Barry, Buenos Aires, 1972.

GAINZA, Violeta. La Improvisacin Musical, Ricordi,

Buenos Aires, 1983.
16. E1 arte es por s misma integradora pues sin
nuestra intervencin el grupo se desarroll, progres y KANDINSKY. Do Espiritual na Arte, Lisboa, Publicaoes
ampli su capacidad de comunicacin tanto no-verbal Dom Quixote, 1987.
cuanto verbal. Esta conclusin fue basada en las
OSTROWER, Fayga. Criatividade e Processos de
respuestas de los pacientes as como en las
Criaao, 6 ed., Petrpolis, Ed. Vozes, 1987.
experiencias hechas por el equipo del hospital que
PICHON RIVIERE, E. O Processo Grupal, Martins
observ progresos significativos en algunos pacientes.
Fontes, 1988.

PORCHER, Louis, Educaao Artstica, Luxo ou

Bibliografia
Necessidade? Summus Editorial.
ANZIEU, Didier. O Eu-Pele, Sao Paulo, Casa do
SCHAFER, Murray. E1 Nuevo Paisaje Sonoro, Ricordi,
Psiclogo, 1989.
Buenos Aires, 1972.

427
WINNICOTT, D.W. O Brincar e a Realidade, Imago program on the Department for Crisis Intervention since
Editora Ltda. Rio de Janeiro, 1975. 1983.

It is used in passive, receptive group form once a week.

It lasts 75 minutes. The group of patients is open, mixed
M U SI C T H ER APY I N T H E D EPAR T M EN T F O R
and has 12 members on average. The constant parts of
C R I SI S I N T ER VEN T I O N I N M EN T AL H EAL T H
every session are the following:
C E N T E R I N L JU B L JA N A

V IDA C ELAREC
a short introduction of the music therapist (about the
way of active listening to music) is not always needed
There is no formaly adopted definition of music therapy because the informacion about music therapy quickly
in Slovenia yet (there is also no Assotiation of music spreads among patients
therapy in Slovenia yet) but there is an informal listening to music twice (10 minutes)
definition used in Mental Health Center in Ljubljana:
verbalisation of feelings and psychotherapeutic
music therapy is defined as the use of a scientific
conversation (40-50 minutes) and summery (10-15
application of music to accomplish therapeutic aims
minutes).
because it can be a diagnostic and therapeutic tool in
psychotherapy program of psychiatric patients. The main principle of crisis intervention -where in
therapy we try to help a person in crisis to function al
Music therapy has been included in the psychotherapy

428
least on his precrisis level - is reflected also in music Since music therapy is meant to be only relaxation
therapy so the primary goals of music therapy are: inone month average hospitalization of the patients in
relaxation, distraction from the problems, contact and crisis, the selected compositions are relatively short
communication with the help of specially selected music (about 5 minutes), full of consonaces, expecting
patient should experience more relaxation, he could pauses, regular rhythm and volume, with endings in
feel more secure and more spontaneous to participate ritardando, decrescendo and in major.
more easily and activly in the psychotherapy processes
in the overall program of the treatment.
There is a list of some of them:

Mozart - Ave Verum

The choice of music is led by the principle, which is
important in the psychodinamics of musical experience, Debussy - Clair de lune

that pleasure in music is present, when tensions in the Beethoven - Romance in F major
listener are relieved through tensions in music itself. But
Bach - Aria
the distance between the tensions in music must not be
too great if we want the listener (the patient) to be able Offenbach - Barcarola

to combine them (not to get lost) and to experience Massenet - Meditation

pleasure.
Chaplin - Limelight

Enya - Water mark

429
Grieg - The morning Patients do not feel intimidated to participate - they all
have always at least something to say. Many of them,
Schumann - Reveries
who otherwise remaine completely silent during other
group sessions, are able to express their feelings in
As the patients in crisis are extremely motivated for music therapy group.
treatment they are able to listen to music actively-they
My role as the therapist varies (it is more active or more
don`t value music or try to understand it or analyse it -
passive) it depends on group dynamics, but most of the
and the phisical and psychical relaxation appears soon
time I only direct their numerous, spontaneous
or through second listening to music. They listen to
verbalisations so that everybody can be accepted as he
music always in absolute silence. Music releases their
is. Everything that music brings is right. In this way
emotions, effects their mood, encourages their
every member of the group can feel secure and is able
fanthasy, evokes associations and serves for projection
to experience - at least for a short time - his already
and identification. Music can also elicit real or fictional
almost lost feelings of belonging and being accepted by
associations and memories and falicitates verbalisation
the others. Music very often helps them to recognize
of repressed, unconscious impulses, which are always
their already forgotten feelings - experiences, mostly
discussed inthe team meeting inmediately after music
the ones, which made their life worth living once upon a
therapy session. Such material is later also used in
time.
other small psychotherapy groups (which take place
In this conversation they look for parallel emotional
twice a week) or in individual psychotherapy.
reactions (with my help or by themselves) in their near

430
and remote past. Their empathy is strong and deep - my sex, age or length of hospitalisation. To those
therapeutic role is usually only to be a moderator of compositions the patients listened with the highest level
emerging interactions. of contentration and each member of a group could
verbalize his feeling.
The summary of music therapy session includes the
main thread of all verbalized feelings in the group. This I would like to enumerate some of these compositions
second group conversation homogenisises the patients and quote the patients most frequently used words.
again, creates emotional closeness and the feelings of
Debussy: Clair de lune. Relaxation, pleasure, calmness,
security are strenghted.
experience of beauty, love, associations with nature,
Just at the end of a session (this happens in 70% of all (the sky, water).
music therapy sessions) they usually express a wish to
Bach: Aria. Calness, sadness is beautiful, harmony,
listen to the music for the third time.
contact, relaxation, rest, consolation, trust in God.
In past eight years a top ten of the most effective
Massenet: Meditation. Beauty, optimism, relaxation,
compasotions (which elicited similar emotional
relaxed weeping, being wmbraced, happy childhood,
experiences, caused deep empathy, many group
happiness from the Heaven, harmony.
interactions and deep relaxation) were made on the
basis of a comparisson of patient`s experiiences after
listening to the same compositions. Similarity in Although there is no concrete evaluation of the
emotional experiences did not depend in inteligence, treatment effectiveness of music therapy in our Mental

431
Health Center, some annual statistic reports and
periodical inquiries has given informations that music
therapy sessions are given one of the highest marks
and that about 90% of all patients want to have music
therapy more frequently. It has been also established
that the headache completely vanished or diminished
during listening to music in more than 50% of the
patients, who had light headache inmediately before
music therapy.

In Mental Health Center in Ljubljana the main findings in

ten years music therapy practise have confirmed the
expectations that carefully selected music can relax the
patients in crisis in such a way taht they can easily
recognize their feelings, accept them and verbalize
them. This is not important fact only for hospitalisation
time - because patients can take their positive attitude
to active listening to music along with themselves also
when they leave hospital.

432
 Research with women in childbirth demonstrated that
listening to music while practicing deep breathing and
1.3.- MUSIC THERAPY IN GENERAL MEDICINE other stress reduction techniques was successful in
- MUSICOTERAPIA EN MEDICINA GENERAL
( ABSTRACTS) reducing body tension, requests for medication and
vocalizations of pain. The women practiced the music
therapy strategy on a regular basis two months prior to
the date of expected delivery. Once in labor, they
M U SI C T H ER APY R ESEAR C H I N PAI N AN D experienced ten contractions during which specially
ST R ESS R ED U C T I O N . H O M E AN D H O SPI T AL / selected music was played and the next five
L A I N VEST I G AC I N D E L A R ED U C C I N D EL contractions without background music. Music was
D O L O R Y EL EST R S EN M U SI C O T ER API A: EN present during the next ten contractions, then five
EL H O SPI T AL Y EN C ASA without music, in this sequence for the duration of labor,
resulting in a repeated measures experimental design
S UZANNE B. HANSER with each subject acting as her own control.
Independent observers recorded behaviors associated
with pain and compared the total number of such
The author developed a music listening protocol in
behaviors between music and no-music conditions. In
which listening to music was used to facilitate a deeply
every case, fewer pain-related behaviors were
relaxed state.
observed when music was present than when it was not.

433
This music listening protocol was adapted for older prevista para el parto. En el momento del parto,
adults experiencing generalized anxiety and clinical experimentaron diez contracciones durante las cuales
depression. The author developed a series of strategies escucharon msica especialmente seleccionada, para
to reduce body tension, challenge dysfunctional pasar a no escuchar msica alguna en las cinco
thinking, and stimulate positive imagery through contracciones siguientes. De nuevo msica en las diez
listening to music which held positive associations. contracciones siguientes, luego cinco sin msica y as
sucesivamente durante todo el parto, resultando en un
diseo experimental con medidas repetidas en el que
El autor desarroll un protocolo de escucha musical en cada sujeto ejerca su propio control. Observadores
el cual escuchar msica era usado para facilitar un independientes registraron comportamientos
profundo estado de relajacin. asociados con el dolor y compararon el nmero total de
La investigacin con mujeres embarazadas demostr estos comportamientos en los perodos con msica y
que escuchar msica al mismo tiempo que se practican en los que no haba msica. En cada caso, un menor
ejercicios de respiracin profunda y otras tcnicas para nmero de conductas relacionadas con dolor fueron
la reduccin de estrs daba muy buenos resultados en observadas cuando la msica estaba presente.
la reduccin de la tensin corporal, demandas de Este protocolo de escucha musical fue adaptado para
medicamentos y vocalizaciones del dolor. Las mujeres ancianos que sufran de ansiedad generalizada y
practicaron la estrategia de musicoterapia depresin clnica. El autor desarroll una serie de
regularmente durante los dos meses previos a la fecha estrategias para reducir la tensin corporal, mejorar el

434
pensamiento disfuncional y estimular la creacin de pre-menstrual syndrome, post-natal depression,
imgenes reafirmativas a travs de la audicin de una pregnancy, associated with women can include: high
msica portadora de asociaciones positivas. blood pressure, irregular heart beat, high risk
pregnancy, hormone imbalance, weight problems,
immune system imbalance.
M I N D , M U SI C AN D H EAL I N G : A T R EAT M EN T
The use of music in medicine has been shown to have a
A P P R O A C H I N W O M E N `S H E A L T H C A R E /
positive affect on stress related problems. Music and
M SI C A, M EN T E Y C U R AC I N : U N A imagery techniques has been shown to be effective in
APR O XI M AC I N D E T R AT AM I EN T O PAR A EL helping people access inner knowledge in order to
C U I D A D O S A N I T A R I O D E L A S M U JE R E S process life transitions. A program that incorporates

A DA M AE C ROUSE music based stress reduction techniques and music

and imagery can be an effective way to help women
become healthier in their mind and body.
Women's health care is often concerned with treating
The program involves training and experience with
problems that are related to the various physical cycles
imagery and music and music based stress reduction
and changes in their bodies. These changes are
techniques. There are group and individual sessions as
associated with stress that affects their physical and
well as a home training component.
emotional well being. Depression and other emotional
problems are often associated with conditions such as: The presentation will include explaining the content of

435
sessions, a training packet, a video tape of techniques, sntomas fsicos tambin asociados con las mujeres se
and discurssion of appropriate types of music and podran incluir: hipertensin, ritmo cardaco irregular,
imagery. Several case studies will be presented based embarazo de alto riesgo, desequilibrio hormonal,
on work with normal and high risk pregnancies and problemas de peso, desequilibrio del sistema
woman with an ovarian cyst. There will also be an inmunitario.
experiential exercise demonstrating how music and
Se ha demostrado que la utilizacin de la msica en la
imagery can facilitate an awareness of the realtionship
medicina tiene un efecto positivo sobre los problemas
between the mind and the body for the purpose of
relacionados con el estrs. Las tcnicas musicales y de
healing.
imgenes demostraron su eficacia para ayudar a las
personas a acceder al conocimiento interno para
procesar las transiciones vitales. Un programa que
El cuidado sanitario de las mujeres a menudo se ocupa
incorpore tcnicas de reduccin del estrs basadas en
de los problemas de tratamiento relacionados con los
la msica, la msica misma y las imgenes pueden
diferentes ciclos y cambios fsicos de sus cuerpos.
representar una ayuda eficaz a las mujeres para estar
Estos cambios estn asociados con el estrs que afecta
ms sanas, tanto en su cuerpo como en su mente.
su bienestar fsico y emocional. La depresin y otros
problemas emocionales se asocian a menudo con El programa implica formacin y experiencia con
condiciones como por ejemplo: sndrome pre- imgenes, msica y tcnicas de reduccin del estrs
menstrual, depresin post-parto, embarazo, basadas en la msica. Existen sesiones individuales y
esterilidad, menopausia y mastectoma. Entre los de grupo, as como un componente de formacin en

436
casa. term "nursing couple" in the light of my work with
emotionally disturbed children and their mothers.
En la ponencia se incluirn la explicacin del contenido
de las sesiones, un paquete de formacin, una cinta de Central to Winnicott's thinking was the importance of the
vdeo de las tcnicas y la discusin de los tipos de mother baby relationship and the impact of each upon
msica e imgenes ms adecuados. Se presentarn the other. I will be looking at the therapeutic use of
muchos estudios de casos basados en el trabajo con music as a means of facilitating a more positive
embarazos normales y de alto riesgo y el de una mujer interaction between mother and child, focusing on
con quiste ovrico. Tambin se realizar un ejercicio aspects such as play, listening skills and the
para demostrar cmo la msica y las imgenes pueden establishing of boundaries.
facilitar la conciencia de la relacin entre la mente y el
cuerpo de cara a la curacin.
En esta ponencia abordar el significado del trmino
"pareja de lactancia" de Winnicott, a la luz de mi trabajo
con nios que padecen trastornos emocionales y sus
T H E N U R S I N G C O U P L E / L A P A R E JA D E
madres.
L AC T AN C I A
En el pensamiento de Winnicott, la importancia de la
A LISON L EVINGE
relacin madre e hijo y el mutuo impacto ocupaban un
lugar muy destacado.
In this paper I will discuss the meaning of Winnicott's

437
Examinar la utilizacin teraputica de la msica como resistance, Transference conditions, Type of produced
medio para facilitar una interaccin ms positiva entre material and Basic view of man.
madre e hijo, abordando aspectos como el juego, la
Some thoughts on integration promoting mechanisms
capacidad de escuchar y el establecimiento de lmites. in GIM is put forward centered around the hypothesis
that "Music sounds the way moods feel".

G U I D ED I M AG ER Y AN D M U SI C ( G I M ) AN D
Se compara una forma de psico-musicoterapia -la
PSYC H O AN AL YSI S / I M AG EN Y M SI C A
Imagen y Msica Guiada (GIM)- con el psicoanlisis:
G U I AD A ( G I M ) Y PSI C O AN L I SI S:
nivel de consciencia, sesiones, produccin de material,
C O M PAR AC I N D E SESI O N ES, PR O C ESO S Y
actitud teraputica, proceso de mantenimiento, energa
T R AN SF O R M AC I N PS Q U I C A.
y direccin del proceso, resistencia, condiciones de
B JRN W RANGSJ transfer, tipo de material elaborado y visin bsica del
hombre.

A form of music psychotherapy Guided Imagery and Se presentarn algunas consideraciones sobre los
Music (GIM) is compared with psychoanalysis with mecanismos para promover la integracin con la
respect of: Level of consciousness, Setting, Production imagen y msica guiada, centrndose sobre la
of material, Therapuetic Attitude, Holding process, hiptesis que "la msica suena segn el estado de
Energy and direction in the process, Handling of nimo".

438
 sistemtica. En el ao 1991 se elabor un proyecto de
investigacin entre la Federacin Mundial de
1.3. - MUSIC THERAPY IN GENERAL MEDICINE
Musicoterapia, la Universidad del Salvador y el Hospital
- MUSICOTERAPIA EN MEDICINA GENERAL
( CONFERENCE HANDOUTS) Fernndez. En este trabajo se comunican los
resultados obtenidos hasta la fecha.

M U SI C O T ER API A EN PAC I EN T ES EN C O M A EN OBJETIVOS

T ER API A I N T EN SI VA Establecer la eficacia de tcnicas musicoteraputicas

en pacientes en coma.
L ILIANA M D`ASERO, A. FOLGUERAS , C.E. GOLDINI, R.
BENENZON, G. SCIFO, S. GUTIERREZ JIMENEZ, A. BONINO, H.
U EHARA , R. ZSCHOCKE, G. RODRIGUEZ DE G IL Y M.
MATERIAL Y MTODOS
F UENTES
Durante el periodo agosto 1991 / septiembre 1992 se
asistieron 20 pacientes.
INTRODUCCIN
Sexo: Fem.: 6 Mas.: 14
En pacientes internados en Terapia Intensiva no
Edad: > 75 aos, < 19 aos, _ 48 aos.
existen salvo en forma aislada trabajos que hagan
referencias a la aplicacin de la musicoterapia en forma Etiologas: Accidente cerebro vascular,

439
politraumatismos, post-operatorio-neuroquirrgico, musicales, estimulacin exteroceptiva a travs del
encefalitis, intoxicacin, coma posreanimacin, contacto con los instrumentos y del contacto corporal
neumopatas. con el terapeuta. Inclusin activa por parte de la familia
segn el criterio musicoteraputico a seguir.
Perodo de asistencia: > 3 meses, < 1 da.
Se controlaron los siguientes parmetros antes,
Sesiones: Frecuencia entre 3 diarias y 3 semanales,
durante y luego de cada sesin: frecuencia cardaca,
duracin entre 15 y 60. Constitucin del equipo: 4
tono muscular, respuestas motrices, prehensin,
parejas de musicoterapeutas, equipo de coordinacin y
sollozo, Score de Glasgow, sudoracin,
supervisin, musicoteraputica y clnica. Se efectuaron
gesticulaciones, respuestas asociadas, respuestas
reuniones interdisciplinarias y entrevistas con los
conscientes, evocacin de sesiones, respuestas
familiares de los pacientes para obtener la historia
oculares.
sonoro musical. La misma se vuelca en la ficha
musicoteraputica.

La confianza bsica establecida con el paciente permite RESULTADOS Y DISCUSIN.

que surja un vnculo positivo con el. Siendo este
Independientemente de la patologa, del Score de
aspecto de fundamental importancia en cada
Glasgow y de la mortalidad, todos los pacientes
tratamiento.
presentaron algn tipo de respuesta durante la sesin.
Tcnicas: voz hablada y cantada, grabaciones de las
Las ms frecuentes fueron:
preferencias musicales del paciente, instrumentos

440
- frecuencia cardaca, tono muscular y Score de paciente revivenciar experiencias gratificantes
Glasgow: 100% premrvidas relacionadas con el fenmeno sonoro
musical. As acompaamos al paciente en la crisis
- respuestas asociadas: 91%
existencial por la que atraviesa. La intervencin del
- respuestas motrices y gesticulaciones: 82% musicoterapeuta, aunque fallezca el paciente,
- sollozos: 55% promueve cambios objetivables en el paciente y en la
familia, y qn aquellos que se recuperaron demostraron
- sudoracin: 36%
ser favorables.
- otras: respuestas verbales: 27%
A esta altura de la investigacin creemos efectivo la
respuestas conscientes: 27% inclusin de la Musicoterapia en el servicio de Terapia
prehensin: 18% Intensiva.

evocacin de sesiones: 9%

I M AG ES O F T H E SEL F : C O M M U N I C AT I N G
CONCLUSIONES: WI T H PAR T PER SO N AL I T I ES I N M U SI C
T H ER APY
La musicoterapia intenta generar nuevos canales de
comunicacin fluidificando los ya existentes entre D IANE S NOW A USTIN
terapeutas, pacientes y familiares. Se tiende a
desarrollar vnculos afectivos positivos. Se le permite al

441
I will be speaking to you today about my work with
clients in private practice; clients diagnostically referred
The Jungian viewpoint is that we are born in a state of
to as neurotic, narcissistic and borderline personality
unconscious unity. The ego is identified or merged with
disorders. I call the method of treatment I employ,
the self, the central archetype of wholeness, As we
Jungian-oriented analytic musictherapy.
move towards consciousness there is a breaking up of
the original unconscious unity and the psyche
undergoes dismemberment and dispersal. Adaptation
I've been practicing for eight years and in that time I
to the real world of multiplicity, as well as adapting to
have observed how the psyche has a tendency to
parents' needs and desires, mean that aspects of
dissociate into inner fragments or part-personalities.
oneself get left out in the course of one's ego
Dissociation is a term originally used by Charcot, Janet
development. Parts of us that never get seen, valued
and Freud when they were seadying hysteria. Janet
and related to, remain unintegrated. So we aIl have
held that the psyche, through some inherent weakness,
dissociated or unintegrated partial aspects of the self.
could lack the strength to hold itself together and could
With severe early traumatic stress there will be more
"fall apart" into dissociated fragments operating
severe fragmentation. The extreme example of
independently. Freud led the way to the opposite view
dissociation can be seen in the multiple personality
that ego weakness is the outcome, not the original
disorder.
cause of a splitting of the primary unity of the psyche
which occurs under severe early traumatic stress.

442
Before I continue I would like to define some of the negative aspect. An example would be the Mother
important Jungian terms I will be using in this archetype, which in its positive form, might be felt as
presentation. Jung believed the psyche is made up of containing, nurturing and/or grounding. One symbol for
energy, the ego, the personal unconscious and the the positive Mother archetype is the earth. In its
collective unconscious. His approach to the psyche was negative constellation the Mother archetype might be
symbolic. felt as devouring and/or castrating. One symbol for this
negative aspect is the witch. Environmental factors
determine which archetypes are activated and to what
The ego is the center of consciousness and carries a
degree.
sense of "I-ness" and identity It is a cluster of functions
like willing and choosing.
Contents that are unconscious first present themselves
to the ego in the form of complexes. A complex is an
The collective unconscious is the universal, non-
emotionally charged unconscious psychic entity made
individual, deeper, layer of the unconscious and
up of a number of associated ideas and images.
contains the archetypes. An archetype is a
transpersonal, universally human pattern of psychic
experience. The archetypes pre-exist in the collective of Now, getting back to the inner fragments or part
the human race and repeat themselves eternally in the personalties, these parts involve a number of relatively
psyches' of individuals. They have a positive and a autonomous complexes which, when they interact with

443
the ego, cause changes in mood and attitude. When the of one's ego development. Edinger calls this self
ego becomes identified with one part of the personality, recollection or re-collection.
everything else falls into the anconscious (and is split off
from consciousness). These split off parts function like
"little people" with their own goals. Kohut described this These unintegrated parts of the personality emerge in

phenomenon as "vertical splitting," dreams and imaginative work. They are also projected
outward onto friends, enemies, spouses etc. as well as
objects and things. In music therapy they can easily be
At the core of each complex is an archetype made up of projected onto one's voice, musical instruments and
emotion and image. An example of this would be a part music itself. Through work with the music, these aspects
of the self a client referred to as a "negative voice. " This of the self can be differentiated, related to and
voice directly related to a negative Mother complex understood. Projections can be withdrawn and
whose center was the negative side of the Mother gradually the contents can be assimilated by the ego
archetype, When working with this part in music and art and integrated into one's self image, thereby
the image of a witch emerged. The associated emotions strengthening one's sense of identity. It is as though the
were rage and envy. occupant of a large house inhabited only one room.
Over time (through music therapy), he enters, explores
and eventually learns to make use of and live
Psychotherapy involves a process of gathering all those
comfortably in the whole house.
aspects of being which have been left out in the course

444
 merma, tanto en la continuidad como en la calidad de
su ejecucin. Si adems el paciente tiene otras
This process of self re-collection; of withdrawing
patologas relacionadas con dficits intelectuales, el
projections and owning them is the essence of the work
tratamiento pierde ms eficacia al no ser consciente de
I am presenting today. (There will be two or three case
la importancia del tratamiento y por su incapacidad
examples.)
para entender y justificar la repeticin de unos
movimientos montonos que no estn relacionados
con ningn juego.
"L A R E H A B I L I T A C I O N M O T O R A C O N
R EF U ER Z O R I T M I C O - M U SI C AL " Considerando los efectos psicofisiolgicos de la msica
y algunos principios metodolgicos de la musicoterapia,
FRANCISCO BLACO VERCHER
llevamos a cabo una experiencia de utilizacin del ritmo
musical en el tratamiento de las algias vertebrales y
INTRODUCCION otra con nios de Educacin Especial que tenan que
hacer rehabilitacin motora.
En fisioterapia es fundamental que el paciente sea
consciente de que su recuperacin se basa en la Basta una rpida mirada a la literatura
continuidad y calidad de realizacin de los ejercicios musicoteraputica para percibir significativas
que constituyen el tratamiento. Si parte de este coincidencias en aquello que se refiere a la influencia
tratamiento, lo tiene que desarrollar en su casa, cosa que ejerce la msica en el aspecto psicomotor del ser
que ocurre con bastante frecuencia, hay riesgo de

445
humano15 (HIRSCH, 1966, pp. 9; ARVEILLER, 1980, pp. auditiva del mismo, entre otros factores17. Lo cual
106; BENENZON, 1981, pp. 35 y 151; D'AGOSTINO ET significa, que cuando el ritmo se presenta slo, sin
AL., 1982, pp. 125-127; DOMENECH ET AL., 1987, pp. meloda ni armona, la respuesta se elabora a travs
14). La lectura ms detenida nos permite identificar el del movimiento como mximo exponente.
elemento bsico de la msica que provoca de manera
En muchos individuos, la respuesta surge
ms explcita respuestas directamente vinculadas con
espontneamente y se sincroniza con los pulsos
el movimiento (DUCOURNEAU, 1988, pp. 48;
rtmicos musicales18. La reaccin normal a cualquier
LACARCEL, 1990, pp. 150; JOST, 1990, pp. 140). Este
estmulo es que la respuesta se produzca
16
elemento es el ritmo , que aunque siempre est
posteriormente a ste. Sin embargo, en msica ocurre
presente en cualquier composicin musical, ya sea
que la respuesta se une al estmulo, y an ms, si
expresa o tcitamente, la respuesta fisiolgica que
intentamos producir la respuesta despus del estmulo
provoca, est en relacin directa a la percepcin
sonoro, resulta difcil o prcticamente imposible, segn
individuos.
15
"Para la psicofisiologa la msica es un lenguaje analizado por los
17
Centros Nerviosos y el sonido/msica es el lenguaje de los "Es la cantidad de ritmo y la manera en que se lo indica lo que
sentimientos, de las emociones, de los efectos, o sea, que los sonidos determina en gran parte, el monto de energa que se invierte en la
fsicos se transforman en emociones. E1 respuesta fsica a la msica". (Thayer Gaston, 1968, pp. 39)
18
sonido/msica de tal modo permite el acceso al inconsciente, por lo cual "Uno de los efectos de la regularidad rtmica es el de engendrar una
se puede convertir en un soporte teraputico en induccin motora". "La regularidad engendra movimientos o esbozos de
cuanto la escucha musical se torna en pensamiento, visin, expresin movimientos que se armonizan con el dato percibido, de tal modo que el
corporal y cenestesia". (Boscaini, 1987, pp. 70) acompaamiento motor se realiza de manera pendular, con una
16
"E1 ritmo es el que organiza y proporciona energa. Cuando el ritmo cadencia muy prxima al comps espontneo. Dicho movimiento es ya
se enuncia con sonidos de percusin, separados, la fuente de satisfaccin en s mismo al proporcionar una excitacin
actividad muscular se estimula, especficamente si en el motivo musical fcilmente mantenida y que se acrecienta por la armona que se crea
existe alguna variacin (Thayer Gaston 1968. pp.35) entre lo perceptivo y lo motor". (Fraise, 1976. pp. 103 104)

446
Podramos pensar que utilizar el ritmo musical sera ejecutar una obra musical (hemisferio izquierdo), la
negativo si el paciente automatiza los movimientos y interpretacin que hace de ella depende de la
llega a ejecutarlos sin interiorizarlos. Para alejar este regulacin del hemisferio derecho".
pensamiento es til recordar lo que Jost (1990 . pp. 142)
En nuestro entorno social, est plenamente aceptado
dice: " Las msicas llamadas dinamognicas pueden
que la msica que tiene un fuerte componente rtmico
ser utilizadas durante los entrenamientos para facilitar
estimula el movimiento y tambin lo justifica. Uno de
la ejecucin de ciertos movimientos, aumentar la
nuestros pacientes afirma en la encuesta: "Tienes la
resistencia, y mejor integrar el esfuerzo fsico sobre el
necesidad de acabar la msica, y por tanto, los
plano psicolgico".
ejercicios".
Y tambin las palabras de Despins (1989. pp. 105 -
Si la msica estimula y justifica el movimiento, por qu
106): "En la docencia, cualquier estrategia debe permitir
no utilizarla para estimular y justificar los movimientos
desarrollar una especie de sinapsizacin emotivo-
que un paciente tiene que realizar en sus ejercicios de
racional para suscitar en la mecnica cerebral un
fisioterapia?.
equilibrio dinmico entre los dos hemisferios y llevar a
cabo el principio de concordancia funcional hemisfrica
autntica. La msica, desde este enfoque, siempre OBJETIVOS Y JUSTIFICACION
ser el mejor medio para desarrollar y acrecentar en
Teniendo en cuenta los planteamientos hasta ahora
forma adecuada este fenmeno cerebral. Pues, por
expuestos, formulamos los siguientes objetivos.
ejemplo, al mismo tiempo que un nio se dedica a

447
1.- Ofrecer un modo estructurado y sistematizado para En principio, el fisioterapeuta invierte unas horas con el
realizar los ejercicios de fisioterapia respetando la musicoterapeuta facilitndole los datos necesarios para
velocidad y la duracin. componer el ritmo y preparar las grabaciones.
Despus, tendr que conocer con todo detalle la
"Estructurado", porque el ritmo musical es orden en el
estructura rtmica y la sincronizacin de los
tiempo. Ahora bien, los elementos que componen dicha
movimientos. A partir de ese momento, su trabajo se
estructura deben transmitir confianza y seguridad, y
ver gratificado porque:
para ello debemos utilizar instrumentos conocidos que
interpreten ritmos sencillos y sin sorpresas. a) E1 paciente realiza los ejercicios siguiendo la
estructura rtmico-musical, por lo que el fisioterapeuta
"Sistematizado", porque el ritmo se compone teniendo
no tiene que contar los tiempos ni el nmero de
en cuenta los gustos musicales del sujeto, su nivel de
movimientos, slo observar si son sincronizados con el
comprensin rtmica, la velocidad con que realiza los
ritmo.
ejercicios (los movimientos) sin el ritmo musical, y el
nmero de movimientos que debe hacer sin b) E1 fisioterapeuta tampoco tiene que controlar el
interrupcin. tiempo real de trabajo, ya que la grabacin tiene la
duracin que l desea.
2.-Facilitar el trabajo al fisioterapeuta y al paciente19.
c) Las posibilidades de distraccin del paciente
disminuyen con el ritmo musical.
19
"Las actividades rtmicas facilitan la tarea en conjunto debido a que
no es necesaria la comunicacin verbal; el ritmo obra como vnculo de d) En el caso de que el paciente tenga que trabajar los
unin". (Gaston Thayer, 1968, pp. 37)

448
ejercicios en casa, la grabacin de los ritmos En la realizacin de los ejercicios de rehabilitacin el
correspondientes, le ayudar de forma eficaz, sobre paciente
todo en el control de la duracin de cada uno de los
1.- Preferir trabajar con el ritmo musical que sin l.
movimientos.
2.- No tendr dificultades considerables para acoplar
e) E1 ritmo musical constituir un refuerzo en la
sus movimientos a la msica.
motivacin que puedan tener los pacientes para hacer
3.- Se sentir ms motivado para llevar adelante el
los ejercicios.
tratamiento lo cual redundar en su efectividad.

Uno de nuestros objetivos es facilitar el trabajo al

DESCRIPCION DE LA MUESTRA
fisioterapeuta y al paciente. Pocas probabilidades de
La muestra se compone de un grupo de 22 sujetos, xito tendra esta experiencia si no contamos con una
todos ellos de la poblacin valenciana de Alcasser, 12 mayora significativa de pacientes que prefieran
varones y 10 hembras, con edades que oscilan entre hacerla con ritmo (H 1).
12 y 43 aos, con patologas encuadradas dentro de las
E1 trabajo grupal es una ventaja para nuestra segunda
algias vertebrales.
hiptesis ya que la posibilidad de comprobar su
HIPOTESIS DE TRABAJO actuacin a travs de la de los dems, refuerza en el
caso del que lo hace bien y corrige a quien lo est
Con este planteamiento general, formulamos las
haciendo mal. No obstante, los ritmos musicales que
siguientes hiptesis:
vamos a utilizar forman parte del entorno sonoro en el

449
que han crecido nuestros pacientes. MUCHO - BASTANTE - POCO - NADA

La tercera hiptesis no necesita justificacin. Es nuestro 3.- Ibas con gusto a fisioterapia? SI - NO
objetivo terminal y resume todo nuestro proyecto de
4.- Hacas la tabla en casa?
trabajo.
TODOS LOS DIAS -BASTANTES DIAS - POCOS DIAS -
E1 procedimiento que vamos a utilizar para verificar o
NINGUN DIA
refutar las hiptesis de trabajo, constar de la siguiente
encuesta que cada paciente deber contestar de forma
annima. CON RITMO MUSICAL

(Las mismas preguntas anteriores y las que siguen)

Encuesta 5.- Si tuvieras que continuar el tratamiento, cmo

preferiras hacerlo? CON MUSICA - SIN MUSICA
SIN RITMO MUSICAL
6.- Te gustaron los distintos ritmos musicales de la
- Cmo te resultaba la tabla?. MUY PESADA
tabla? TODOS - BASTANTES - ALGUNO - NINGUNO
BASTANTE PESADA - NORMAL - BASTANTE LIGERA
7.- Crees que los ritmos musicales de la tabla son
- MUY LIGERA
adecuados a los movimientos?
2.- E1 tiempo que trabajabas en cada sesin, te
TODOS - BASTANTES - ALGUNO -NINGUNO
pareca?

450
8.- Si ahora escucharas alguno de los ritmos, sabras sonido y la msica en el ser humano. E1 41% (9
qu pacientes) encuentran ms ligera la tabla, mejorando 4
de ellos en un grado de la escala y 5 en dos grados. A
movimiento le corresponde? SI - NO - NO SE
ninguno le resulta ms pesada con msica.
9.- En qu sesin lograste adaptar los movimientos al
Sabemos que la nocin de tiempo es distinta cuando el
ritmo musical? PRIMERA - SEGUNDA - TERCERA
paciente hace una actividad musical, pero, en este
.- Deseas aadir algo?
caso, la contestacin es por escrito y tomndose todo el
tiempo que quiera para responder. No obstante, el
22'8% (5 pacientes), contestan que la duracin de la
RESULTADOS
tabla les parece menor con msica. E1 tiempo de
Se pueden calificar, cuando menos, de duracin en realidad, es el mismo con y sin ella.
esperanzadores, aunque la muestra no es lo
Las respuestas a la tercera pregunta debilitan nuestra
suficientemente amplia como para que las
suposicin previa en cuanto que la realizacin de los
conclusiones sean extrapolables con un grado
ejercicios de fisioterapia pueden ser largos, pesados
suficiente de credibilidad.
o/y montonos para algunos pacientes. Slo el 13'7%
E1 resultado de la primera pregunta ratifica lo que (3 pacientes), contestan que no iban con gusto a
20
Benenzon dice respecto a los efectos biolgicos del fisioterapia sin msica, y con msica s lo hacan.

20
"Ante todo son los estmulos rtmicos los que consiguen aumentar el
rendimiento corporal". ( Benenzon, 1981. pp. 14 )

451
La cuarta se refiere a la realizacin de los ejercicios en
casa. E1 22'7% (5 pacientes), mejoran este aspecto
La sptima pregunta hace referencia a la adecuacin
con la msica.
de los ritmos a los movimientos.
Las respuestas a la quinta pregunta, son contundentes.
El 77'3% (17 pacientes), opinan que todos son
Todos los pacientes prefieren trabajar con msica (100
adecuados. El 22'7% restante (5 pacientes), opinan que
%).
bastantes.
Con la sexta pregunta, pretendamos averiguar si
Con la formulacin de la octava pregunta,
habamos acertado sus gustos al crear los ritmos
intentbamos conocer el nivel de asociacin del ritmo
musicales. Las respuestas son muy favorables si
musical con los movimientos.
tenemos en cuenta las diferentes edades de los
El 54'5% (12 pacientes), contestan SI
sujetos.
El 41 % ( 9 " ), contestan NO SE

El 4'5% ( 1 " ), " NO

- Al 77'3% tl7 pacientes), les gustaron todos los ritmos.
Tambien nos interesaba conocer el nivel de dificultad
- Al 13'7% ( 3 " ), bastantes de los ritmos.
que ofreca a los pacientes el hecho de tener que
- Al 4'5% t 1 " ), le gust alguno, y
coordinar los movimientos a un ritmo musical. Lo
- Al 4'5% ( 1 " ), no le gust ninguno. planteamos a travs de la siguiente pregunta: En qu
sesin lograste adaptar los movimientos al ritmo

452
musical?. adems opinan que son adecuados (tem 7).

El 22'7% (5 pacientes), en la primera sesin. Nuestra segunda hiptesis, consideramos que es

refrendada de la misma manera, pues, teniendo en
El 36'4% (8 " ), en la segunda " .
cuenta que el paciente aprende la tabla a la vez que la
El 31'9% (7 " ), en la tercera " .
ejecuta, y que se trata de diez ejercicios con ritmos
El 4'5% (1 " ), en la cuarta " distintos, es lgico que el aprendizaje se lleve a cabo en
unas cuantas sesiones. En este caso, 20 de los
El 4'5% (1 " ), en la quinta "
pacientes (91%), lo aprendieron en las tres primeras.
Opinamos que esto es acoplarse a los ritmos musicales
CONCLUSIONES sin dificultad, y esa es tambien la opinin generalizada
que ellos mismos han manifestado durante sus
El hecho de que los 22 pacientes (100%), manifiesten
conversaciones.
su preferencia por la ejecucin de la tabla con msica,
ratifica nuestra primera hiptesis plenamente, y Por otra parte, las respuestas que venimos
tambin las afirmaciones que, a travs de las citas que considerando como secundarias, suponen un refuerzo
hemos utilizado en la justificacin de este trabajo, a esta afirmacin. El tem 7 indica que los ritmos son
hacen los distintos especialistas. Las respuestas a las apropiados a los movimientos y, la asociacin del ritmo
preguntas relacionadas de forma subsidiaria con esta con el movimiento (tem 8), es suficientemente alta,
hiptesis, justifican sobradamente el resultado, ya que pues slo un 5% de los pacientes manifiesta estar
al crear los ritmos, acertamos sus gustos (tem ), y seguro de no relacionar fuera de contexto un

453
determinado ritmo con el ejercicio correspondiente. El grupo que constituye la muestra, es un grupo que
demuestra una actitud muy positiva al tratamiento. Esto
En cuanto a la tercera hiptesis, es razonable pensar
se desprende del resultado del tercer tem, ya que slo
que, si el paciente prefiere trabajar con msica y, no
tres pacientes manifiestan no ir a gusto a fisioterapia.
tiene ninguna dificultad para adaptarse a este modo de
Por ello, pensamos que el campo de accin que le resta
trabajo, es porque encuentra alguna ventaja en ello,
a la presencia del ritmo, no es mucho, puesto que si
por lo que se siente ms motivado. Algunas de esas
nuestro objetivo es motivarles ms y partimos de un
ventajas son patentes en las contestaciones de la
grupo muy motivado y con unos lmites de tiempo -8 de
encuesta y estn recogidas en los resultados. Por una
ellos manifiestan no disponer de tiempo-, la diferencia
parte, unos pacientes (41%), encuentran la tabla
que podemos obtener, siendo poca, si es positiva,
menos pesada. Otros, tienen la sensacin de que es
siempre ser digna de tener en cuenta.
ms corta (22'7%). Algunos, que no iban a gusto a
fisioterapia, ahora, con msica, manifiestan hacerlo con Creemos que los objetivos que en su da nos
gusto (13'7%), y otros, han aumentado el tiempo de planteamos han sido logrados de manera satisfactoria
dedicacin a los ejercicios en casa. ya que la experiencia ha sido, y sigue siendo, muy
gratificante para nosotros y para los pacientes.
Con respecto a ste ltimo tem, debemos sealar que
Pensamos continuar y obtener resultados con mayor
en su respuesta con msica, 7 pacientes hacen constar
nivel de confianza al final del tratamiento; es decir, a
que no disponen de tiempo para realizar los ejercicios
medida que los pacientes vayan recibiendo el alta,
en su casa, y uno, que no tiene cassette, por lo tanto no
iremos recogiendo los datos que nos ayuden a
lo puede hacer .

454
desarrollar planteamientos futuros de trabajo. concienciada a hacer el programa y tiene la sensacin
de que cuando la ejecuta en casa es una continuacin
de su trabajo en el servicio de fisioterapia.
Opinin personal de los fisioterapeutas
Pensamos que el ritmo musical es una herramienta
A nuestro juicio, con el ritmo musical podemos controlar
muy til para establecer un orden de movimientos,
cmo queremos que el paciente realice los ejercicios de
controlando la duracin del ejercicio, el tiempo de
la tabla, pues cada movimiento est controlado por el
reposo el nmero de veces que queremos que haga
ritmo. Tambien el nmero de veces que hace cada
cada ejercicio y la duracin total de la tabla.
ejercicio, ya que en la cinta que damos al paciente con
la msica grabada se repite cada ejercicio cuantas
veces consideramos conveniente. DESCRIPCION DE LA MUESTRA DE
EDUCACION ESPECIAL
Hay que destacar la comodidad que significa para el
paciente, una vez aprendida la tabla con msica, que el Grupo de ocho nios de seis a quince aos de edad
hecho de colocar la cinta en el magnetofn le suponga cronolgica, que fueron tratados individualmente. Seis
disponer de un medio seguro para realizar la tabla con de ellos llevaban a cabo el mismo ejercicio de
la temporalizacin correcta. rehabilitacin (Fraenkel), el sptimo, haca dorsales y el
octavo, elevacin de brazo.
Es un mtodo ms ldico para hacer una tabla que es
de por s montona y al paciente se le hace pesada.
Hemos comprobado que la gente viene ms

455
HIPOTESIS DE TRABAJO quien, a travs de la observacin juzga utilizando un
tipo de escala "LICKER" con cinco graduaciones: "muy
Con el ritmo musical auditivo, el nio deficiente:
mal" - "mal" - "regular" - "bien" "muy bien". Tres de los
1.-Mejorar la calidad de los movimientos
pacientes no mejoran este aspecto con el ritmo musical.
rehabilitadores.
Dos pasan de una realizacin "regular" a "bien". Y los
2.-No interrumpir la realizacin del eiercicio cuando se otros tres mejoran pasando de "bien" a "muy bien".
sienta no controlado por el fisioterapeuta.
E1 rendimiento se refiere al nmero de movimientos
3.-Ejecutar mayor nmero de movimientos en el que el nio lleva a cabo voluntariamente despus de
mismo perodo de tiempo. haber recibido la orden de empezar en el tiempo
mximo de un minuto. Contamos los que hace sin y con
4.-Trabajar el ejercicio de rehabilitacin en su casa si
el ritmo musical. Slo un paciente no se beneficia de la
as se le sugiere.
induccin motora del ritmo musical. Los dems
disfrutan de una experiencia Positiva en mayor o menor
RESULTADOS grado.

Los aspectos que nos planteamos valorar a travs de Finalmente, la autonoma se refiere a la posibilidad de
este estudio estn estrechamente relacionados con la que el nio trabaje solo, es decir, sin el control del
calidad de realizacin el rendimiento y la autonoma del fisioterapeuta o, yendo un poco ms all, que realice
nio frente al trabajo. La calidad se refiere al modo en los ejercicios de rehabilitacin en su casa. En el primero
que el nio hace los movimientos, y es el fisioterapeuta de los casos, hay dos pacientes que no trabajan sin el

456
control del fisioterapeuta va sea con o sin ritmo musical, realizacin y un 30% en nmero de movimientos en un
y uno que s lo hace. Los otros cinco trabajan en minuto. E1 ritmo musical es suficiente motivacin para
ausencia del fisioterapeuta slo si hay ritmo musical. En seguir trabajando sin el control del fisioterapeuta y
cuanto al segundo caso, tenemos cuatro pacientes que adems trabaja en su casa.
no realizan los eiercicios de rehabilitacin en sus casas,
4.- Cinco de los nios ganan un 20% en la calidad de
en ninguna de las dos circunstancias Previstas, con y
realizacin
sin ritmo musical. Los otros cuatro, los llevan a cabo
5.- Cinco ganan en motivacin para trabajar sin la
desde que disponen de las cintas con los ritmos
grabados. mirada del fisioterapeuta.

6.- Todos ganan en el nmero de movimientos por

minuto.
CONCLUSIONES
7.- Cuatro de ellos pasan a trabajar el ejercicio en su
1.- La primera conclusin es que el ritmo musical, no ha
casa.
ejercido influencia negativa en ninguno de los casos.
Pensamos que esto es el inicio de un trabajo
2.- E1 alumno menos beneficiado por el ritmo musical
interesante que necesita una muestra ms amplia y con
ha tenido una ganancia del 15 % en el nmero de
ms aspectos a valorar. De momento, estas
movimientos en un minuto.
conclusiones pueden ser la semilla de una serie de
3.- E1 alumno ms beneficiado gana en los cuatro
investigaciones que permitan elaborar una
aspectos valorados, siendo un 20% en calidad de

457
metodologa eficaz de colaboracin entre la DUCOURNEAU, G. 1988. Musicoterapia. La
musicoterapia y la fisioterapia. comunicacin musical: su funcin y sus mtodos en
musicoterapia. Ed. Edaf. Madrid.

FRAISE, P. 1976. Psicologa del ritmo. Ed. Morata.

REFERENCIAS BIBLIOGRAFICAS
Madrid.
ARVEILLER, J. 1980. Des musicothrapies. Editions
HIRSCH, T. 1966. Musique et rducation. Ed.
Scientifiques et Psychologiques. Issy-les-Moulineaux.
Delachaux et Niestl S.A. Neuchatel.
BENENZON, R. 1981. Manual de Musicoterapia. Ed.
JOST, J. 1990. Equilibre et sant par la musicotherapie.
Paidos. Barcelona.
Ed Albin Michel. Paris.
BOSCAINI, F. 1987. Presupuestos cientficos del
LACARCEL MORENO, J. 1990. Musicoterapia en la
sonido/msica. Psicomotricidad.Citap. 26. pp.69-96.
educacin especial. Universidad de Murcia.
D'AGOSTINO y COL. 1982. La didattica musicale.
Edizioni "La Scala". Noci.
THAYER GASTON, E y COL. 1968. Tratado de
DESPINS, J. P. 1989. La msica y el cerebro. Ed.
musicoterapia. Ed. Paidos. Buenos Aires.
Gedisa. Capellades. Barcelona.

DOMENECH, J. L.; BLASCO, F. y LOPEZ, H. 1987.

Musicoterapia en la formacin del terapeuta. Nau
Llibres. Valencia.

458
 M U SI C T H ER APY AN D C AN C ER C AR E programme. As the music therapist I am supported by
the centre's resident counsellor. We begin with an
L ESLIE B UNT
introduction to the range of the instruments for both the
residents and their supporters. In the first video
Introduction example we see examples from the start of a session:
introductions and part of an initial group improvisation
Music therapy was introduced to the weekly residential
based on a rhythmic ostinato. After this short opening
programme at the internationally recognised Bristol
section the supporters leave and we focus for the rest of
Cancer Help Centre in February 1992. Previously there
the time on working with the residents.The number of
had been trial periods of music sessions where the
residents attending the centre durng any one week is
emphasis was on relaxation and social interaction
usually between eight and ten. The supporters have an
through music. The centre runs on holistic principles,
opportunity for their own group later in the morning.
providing clients and their supporters with opportunities
to explore the emotional and psychological difficulties of
living with cancer, alongside the more physical aspects Evaluation
of the disease. The music therapy is part of a group of
An external assessor looked at six sessions between
complimentary therapies aiming to improve the quality
July and October 1992 with three main aims:
of life of the residents.
1. To look at what was happening in the music
The one-off session is for an hour and a half on the
therapy sessions in the context of the overall evaluation
Wednesday morning, the mid-way point of the

459
of the therapy input at the Centre. access to feelings that could then be worked with further
in counselling or through the other therapies?
2. To look at some of the specific features of the
music therapy input with a view to improving the service. 3. Should there be any changes of the format and
length of the sessions?
3. To begin to compare processes in music therapy
and counselling.

The following very basic procedures were adopted:

Questions and method a. Before and after each music therapy sessions the
assessor did a quick 'brainstorm' with the group on the
Our overall general question was to discover how the
subject 'music and us.' She invited the group to give
residents viewed the music therapy session. There
words and phrases which described both positive and
were three other groups of questions:
negative aspects of music.
1. In terms of the developing group relationship and
b. The assessor observed the sessions as a
the therapeutic programme, was the positioning of the
participant observer and collected impressions of the
music therapy session on Wednesday morning at the
procesees and effects of the music therapy
most appropriate time?
c. The assessor collected comments about the
2. What did the session achieve in terms of the
sessions from the residents, the music therapist and the
overall aims of the Centre? Did, for instance, the music
counsellor. This was done by means of informal
therapy help the residents to express, relieve or gain

460
discussions and some semi-structured interviews, at 1. A general shift from words which describe the
different times during the week. effect of music on the individual, e.g. energising,
relaxing (most frequently found pre-session constructs)
to words which describe the effect on the group, and
Analysis
what it felt like playing together, e.g. communication,
The 'brainstorms' from the six sessions generated lists group togetherness (most frequently found post
of words and phrases that needed sorting and grouping. session constructs).
There were various key concepts that grouped many of
2. Apparent shift from passive feelings, e.g.
the spontaneous comments; these we labelled
calmness, inner peace, sadness, to more active
'constructs". The assessor then analysed these socalled
experiences or use of the music, e.g. strengthening,
constructs with a measure of frequency. She defined
positive, connections, focus.
frequency as the number of times a certain word or
3. A marked shift of energy: post session words
group of words was used by one of the six groups, not
tending to be more dynamic referring to: release of
the total number of times by all the groups (see Tables
feelings via catharsis, loss of inhibition and spontaneity.
1 and 2).
4. Post-session words seem to be more focused and
specific, e.g. the third group had the words
Observations relating to the analysis of the
sociable/sharing at the start; afterwards members of the
constructs
group talked about interactlon, unity, co-operation and

461
the desire to be in harmony. Discussion

5. Some constructs appear pre- and post-sessions, The analysis is consistent with intuitive feelings and
notably: enjoyment or fun, nostalgia or reminiscence expectations of such a before and after session
and energising. procedure. We must also take into account that the
analysis is only based on the experience of six groups.
6. Some constructs appear before and not
Each group was asked to comment on the notion of
afterwards, notably: depression/sadness and beauty;
'music and us' in a cold way at the start of the session
others such as discord/irritation, spiritual/peace,
and again at the end. It is not surprising that the words
therapeutic, do not appear as such but are reflected in
move from the rather general at the start to the more
other, usually more specific, constructs afterwards.
specific afterwards. The residents had experienced a
7. Some constructs appear afterwards and not
session where there was an emphasis on active
before, and the number of words and different
involvement in music-making. A rise in energy was
constructs used afterwards was higher. Some of these
predicted. But the contrasts in the before and after
reflected totally new idea,s, such as discovery of
constructs do tell us something about the process of th
potential / unknown talents, desire to be in harmony
music therapy and how those attending the sessions
(with the group as opposed to individually), nearness to
construed the experience.
nature, catharsis / emotional release, tuning in to (our)
There are a number of further interesting points:
inner rhythm, sensitivity / gentleness (with ourselves )
- for most groups (five out the six) it seems that a

462
sense of togetherness and desire to be in harmony with - there is a similar contrast on the negative side, the
each other has been aided by the experience of making depression and sadness induced by music (pre-session
music together (implications here for the development constructs for four out of the six groups) did not appear
of the group culture and links with the overall philosophy again afterwards. Instead there are more active
of the Centre); Only half of the groups mentioned constructs e.g. frustrating / difficult; retreat /
sharing/sociability beforehand but afterwards inhibitionandexhaustion. - the importance of music for
communication and group togetherness head the list accessing memories and the feelings associated with
(five out of the six); them although surprisingly not to the extent that the
experience of the sessions had indicated: presession
- many of the group members found the experience
constructs (2 groups) included nostalgia, or the ability of
cathartic: pre-session constructs reflecting the common
music to stir up images and memories, after the
belief that music can be energising or relaxing, post-
sessions only one group specifically mentioned
session constructs reflecting more specific constructs
reminiscence although others mentioned previous
such as emotional release, catharsis, loss or
experiences and private connections which had to do
overcoming of inhibitions and breaking down barriers.
with past memories and feelings. - post-session
- there were many spontaneous comments such as
constructs reflect the ability of music therapy to relieve
'I didn't know I had that in me', 'It's a good way to get
the residents, temporarily at least, from their pre-
that feeling off my chest" 'That was very primitive, I
occupation with their pain, illness and problems,
enjoyed that.'
spontaneous comments relating to being out of

463
yourself, sidestepping the problems, being able to look
at yourself and laugh, tuning into your inner rhythm and
The following are supportive points arising from the
focusing.
interviews and observations during the sessions. There
- the mention in the constructs of a key philosophy were many personal insights gained by the residents
of the Centre, namely for the residents to look after during the music therapy:
themselves by giving priority to their real needs, eg.
Resident A felt frustrated when playing the drum; she
references to sensitivity and gentleness (with
lived with a professional musician and she herself had
ourselves), to strengthening and being positive.
stoppedplayingthe violin. She was able to ask herself
- post-session constructs reflect the experience of why she stopped playing commenting that something
several of the residents who discovered, or positive had come out of the frustration.
rediscovered, a talent for making music with mention of
unknown talents, discovering potential and of increased
confidence after having played in the session. For some Resident B mentioned in her interview that she had felt

residents there was an unexpected pleasure to find that nervous before the session with a 'problem with music.'

they could play the instruments they had explored in the During the session she realised that since her discovery

session; for others it reminded them of music making of her illness she had suppressed a love of music. She

they had taken part in the past. Some residents stated also had the insight during the session that this 'shutting

that they now intended to take up musc again. down' to music was mirrored in the way she did not
listen to her own body, putting off attending to her

464
developing problems. The music acted a s a trigger to Summary of the evaluation
many of these feelings, enabling her to continue to open
up and talk to other staff at the Centre.
This one session during the programme indicates some
of the potential of music therapy for this client group.
Resident C found that music was a very direct way to With the present format however the residents are just
contact her emotions. She cried when she heard the beginning to become familiar with the instruments and
sounds of one of the pitched instruments which the setting when it is time to break. We often have some
reminded her of the time when her son played the same of the profoundest experiences towards the end of the
instrument at a school play. It was at this time that she session, as in many therapeutic situations. In order to
was nursing her own mother through her cancer. She explore more work relating to individual needs, for
talked with insight of the innocence of the sounds which example opportunities for playing individual 'life
reminded her of the warm contact, she had with her son journeys' on the instruments, more time is needed for
at that time. She was able to use this powerful the developing trust to be carried forward.
experience as a focus in the later visualisation work and
was able to develop the insights further in her painting
and other experiences at the Centre. There was a very positive reaction to the timing of the
music therapy group. The group know each other
sufficiently well for a sense of group trust and to have
been built up. The music therapy session helps to

465
consolidate this sense of cohesion and enables the - early comparison of processes in music therapy and
residents to explore feelings that they can then take counselling
forward into the rest of the week.

QUESTIONS:
The final video examples are of two contrasting
Main guestion: how do residents view the music therapy
improvisations, one started by a slow and quiet musical
session?
gesture and the second reflecting the group's choice of
Other groupings:
the theme 'torrent'.
- timing of the session during the week in terms of group
MUSIC THERAPY AT THE BRISTOL CANCER HELP
process
CENTRE
- contribution of session to overall aims of the Centre

- format and length of the session

EVALUATION OF SIX SESSIONS

AIMS:
BASIC PROCEDURES:
- relationship of music therapy to the overall therapy
input - before and after group 'BRAINSTORM' - 'MUSIC AND
US'
- specific features of music therapy: improvements for
the service

466
- external assessor as participant observer noting MUSIC THERAPY AT THE BRISTOL CANCER HELP CENTRE
effects and processes

- semi-structured interviews: residents, music therapist, Table 1 Pre-session constructs

counsellor
Construct Frequency (out of 6)

a. energising / stimulating 6

b. relaxing / calming 5

c. fun / enjoyment 5

d. harmony / spiritual/inner 4
peace

e. depression / sadness 4

f. discord / irritation 3

g. sociable / sharing 3

h. expressive / meaning / 2
wordless

i. sound / rhythm 2

j. nostalgia / recall of images / 2

467
mood h. frustrating / difficult 2

k.therapeutic 2 i. connections / understanding 2

1. spontaneity 1 j. strengthening / positive 2

m. beauty 1 k. sensitivity / gentleness 2

1. focus / tuning in to inner 2

rhythm

m. reminiscence 1
Table 2 Post-session constructs
n. energising 1
Construct Frequency (out of 6)
o. discover potential 1
a. communication 5
p. near to nature 1
b. group togetherness/harmony 5
q. retreat / inhibition 1
c. enjoyment/fun 5
r. exhaustion 1
d. spontaneity/immediacy 4
s. tension 1
e. catharsis/release 4
t. desire for form and shape 1
f. noisy / loud 4
u. ambiguous 1
g. concentration / attention 3

468
v. individuality 1 -- a decrease or slowing down of the onset of fatigue
(increase in muscle endurance) of functional music
w. interpretation 1
(Alain, je ne suis pas certain ce que tu veux dire par
x. passion / drama 1
"musique fonctionelle." WH)
y. trial / experimentation
-- changes in the pathways of electrical energy in the
organism,

"T H E E F F E C T S O F M U S I C O N T H E -- changes in metabolism and in the biosynthesis of

AN EST H ESI A O F T H E H O SPI T AL I Z ED C H I L D " the various enzymatic processes.

P RF . ALAIN C ARR
Since 1987 we have studied the use of music during
procedures preparing patients for general anesthesia,
We may say that sound and music have specific and done preliminary research on a new technique
biological effects on human beings: used with young children in the children's surgery unit of
-- an increase or decresse, through rhythm, of the teaching hospital in Rennes (Alain, je ne me
muscular energy (example: Roman slave ships), souviens pas bien du sens exact de "CHR": Centre
Hospitalier ...de Recherche ??>)
-- effects on the pulse, blood pressure, and
endocrine glands,

469
We have been gratified to note the level of satisfaction patients:
among those operated upon using our techniques: 90%
are happy with the results, not to mention the improved
hospital condltions which go along with our technique. 1) At the physiological level, the real effects both pre-
and post-operation, evident in the decrease in drugs
needed for the anesthesia and the lower levels of pain
We have noted also a significant decrease (about32%) experienced after the operation.
in the quantity of anesthetic medication used in these
2) At the psychological level, the impact of music
operations, since the music helps decrease the fear and
both pre- and postoperation, following a series of
anxiety felt by children facing an operation, thus
interviews with and observations of the behavior of
lowering their level of awareness.
hospitalized children.

The pain-killing properties of music in the post-

This specific technique requires research into:
operative period are also to be taken into consideration;
most (many?) patients feel less pain upon awakening, -- indications,

some none at all. -- counter-indications,

-- and limitations,

We have sought to identify the impact of music upon depending upon ...

470
-- the duration of the operation, Several weeks before the operation we meet the child
who is to be operated upon, asklng what sort of music
-- the type of operstion,
he likes and listens to. We listen to a few selections; he
-- and the pain caused.
gives his opinion. We ask him to fill out a detailed
questionnaire.

The musica1 works are:

-- either published works which we have classified as Then, a few days before the operation we meet again to
glve him the cassette and explaln how it is to be used.

calming phase 1

relaxation phase 2 Results sre scrupulously noted, so we may assess the

impact of the music on;
awakening phase 3

1) The phase of being put to sleep:

-- or works composed especially for specific patients.
Each cassette is individualized-- there is no general first, physiologlcal signs: pulse rate, blood pressure,
tape. capillary pulse, breathing rate, and also the percentage
(amount) of anesthetic drugs used.

471
 -- and finally, after the operation, to help produce a calm
and serene awakening.
2) Awakening phase: use of any pharmacological
support (products adjacents ??), the quality of the
awakening, any complications that might arise.
Method

The child hears the music on earphones connected to a

We always conduct a filmed interview with the child who Walkman. (It would be preferable to play the music
has been operated upon so we may analyze objectively through speakers; but we have not been able to do so
the observations of those who have benefitted from the thus far.)
technique.
The evening before the operation the child hears the
first part of the music. The goal is to help the child relax
and achieve a state of serenity before falling asleep.
How is the music presented?
This lasts between 20 and 30 minutes.

The morning of the operation, along wlth or in place of

In three stages: the pre-medication, the child hears the second part of
-- the day before the operation, the tape, lasting about 30 minutes.

-- in the morning before the anesthetic drugs are With earphones on, the child is taken to the operating
administered, room, where the anesthesiologist 's team takes over.

472
The music is not played during the anesthesia, so as not RESULTS
to produce any interference.
Although we are waiting until the end of 1990 to publish
As soon as the child awakens and leaves the operating detailed results of our research, we can communicate
room, the third musical phase begins; it is the the following at this time:
reawakening to life, the return, the return to
1 In terms of behavior there is a noticeable modification
consciousness marked by calm and relaxation.
between the preand post-operatives phases, as the
Twenty-four hours after the operation, the child is child passes from a state of anxiety to a feeling of well-
interviewed about his experience. being.

-- 69% of the children do not remember what happened

after hearing the music; for them the process of falling
asleep began in their room, with the music. Others
remember being taken to the operating room, even up
to the administration of the general anesthesia

-- 80% of the children report a feeling of well-being, 45%

from the beginning of the music, 35% during the music

473
 G U I D ED I M AG ER Y AN D M U SI C , AN D T H E with the contrasexual elements of the anima-animus.
PR O C ESS O F I N D I VI D U AT I O N I N T WO WO M EN
AT M I D - L I F E.
Individuation tends to take place in the second half of
D ENISE E RDONMEZ, M.MUS RMT-BC life - at the point of mid-life transition. It is the process by
which a person becomes a psychological individual a
separate, indivisible unity or whole.
The paper presents two case studies of women at mid-
life and the process of individuation occurring through
G.l.M. therapy The Shadow. The shadow is the inferior or
undeveloped part of the personality. The Shadow
normally appears in dreams, or in imagery as a
Self and the Individuation Process.
personality of the same sex.
In Jungian theory, individuation is the process of
integration resulting from the reconciliation of the
opposites within the "Self". The anima-animus archetype is the sum of the
contrasexual elements of the the parent of the opposite
sex. In women, the animus is the personification of the
Jung believed that the Self is the integrative point masculine principle. The animus or anima usually
between the conscious and unconscious. Integration is appears in dreams or imagery, as a member of the
achieved when the Shadow aspects are accepted along

474
opposite sex. hours and involves a pre-music discussion, in which the
therapist and client clarify the issue of focus for the
session. A relaxation induction is given, individually
The reconciliation of the Shadow and the anima-animus
tailored to the needs of the client, and the client moves
parts of ourselves can occur through dream work, and
into a deeply relaxed state with eyes closed. At the end
also through therapeutic processes which recognise
of the induction a focus is given to bridge the relaxation
and respect symbolism. The Bonny method of Guided
with the music and the flow of imagery.
Imagery and Music (Bonny, 1978 a and b) is one such
therapeutic modality.
The therapist chooses a tape of approximately 30-40
minutes duration.The client listens to the music and is
Guided Imagery and Music (G.I.M.) is a method of
encouraged to share images, impressions, fantasies,
therapy in which classical music is used to evoke and
and/or feelings as they occur in response to the music.
stimulate imagery in the client, so that self exploration
The therapist makes a written transcript of the imagery
and personal growth can occur.
and encourages the experience through appropriate
interventions. These interventions may be supportive,
they may seek clarification, or they may allow the client
G.I.M. involves a one-to-one relationship between
to hold an image or feeling for a period of time to
therapist and individual ciient over a number (series) of
experience it fully. At the end of the music tape, the
sessions. Typically each G . I. M . session lasts 1 1/2 - 2
therapist brings the client back to an alert state. The

475
content of the imagery session is then processed by
relating and integrating the imagery into aspects of the
Case Study: Faye
person's daily life. This is achieved by either talking
through the experience or by free drawing (mandala). The client, Faye, is a performing musician and
composer, who referred herself for therapy to resolve
problems related to performer anxiety.
The method of G.I.M. is closely aligned to Jungian
philosophy and analytic psychology where personal
issues are identified, explored and resolved. In the She is 40 years old, has been married for 12 years, but

G.I.M. experience early life memories may emerge, and has no children, by choice.

repressed emotions brought to the surface. The G. I.M.

experience allows these memories and emotions to be
In describing her childhood Faye recalled instances of
worked through, bringing about new insights, resolution
physical and emotional abuse by both parents.
of conflicts and healing at a deep level.

Faye has never been treated for emotional illness,

The following two case studies show the efficacy of
although she readily identifies stages in her life when
G.I.M. in assisting two women at mid-life through the
she was deeply depressed.
process of individuation.

476
Faye is married to a scientist. She describes him as a emotional abuse.
suspicious person and very like her mother - a very
critical and controlling man. They argue frequently and
have verbal 'slinging matches'. At the commencement of therapy Faye had recently
failed an advanced piano exam., and her self esteem
was very low and she was depressed.
Faye shows personality traits typically associated with a
dysfunctional family background and childhood abuse.
Initially she had poor ego boundaries and was unable to In the first series of G.I.M. sessions, the major gain was

identify feeling states, or to make even very simple working through body imagery consistent with abuse. In

decisions. She has a physical appearance consistent session 3, during Debussy's Dances Sacred and

with anorexic tendencies - very thin, bony, poorly Profane, her imagery was of snakes in her chest, which

nourished and anxious. were black and yellow. In session 4, during the
Pachelbel Canon, her imagery was of purple and black
(bruising)in the throat. Her heart was wide open and a
Faye's symptoms are consistent with a dissociative fairy appears to sew it up and wrap it in a gauze
disorder, with cyclothymic mood swings, anxiety attacks bandage.
and some obsessional and anorexic characteristics.
She has a dependent personality. All of these symptoms
are consistent with a childhood marred by physical and In session 5, during the Haydn Cello Concerto (slow

477
movement) she identifies with strong feminine figures - appear in the imagery, and Faye comments that her
the archetypal Queen of Light in a robe of silver and marriage is like that of Lancelot and Guenevere.
gold. During Saint-Saens: The Swan of Tuonela, she
travels to the bottom of the sea (the unconscious)
where she stand in a circle with the Queen of Light, her This session was a key session in Faye's progress in

own Higher self, her husband and myself (positive that she started to own and identify the masculine

transference). She gains strength and safety from the elements within her. Jung talks of the animus figures in a

dark water. woman's search for individuation including:- the

physical man, the man of deeds, the man of word, and
the man of meaning (O'Connor, 1985, p 139-146). In
In session 6, her imagery is greatly influenced by session 6, Faye identified with the manof deeds, Arthur
archetypal figures. During Ravel's Introduction and and his Knights. She then identified with the masculine
Allegro for Harp, she is in Merlin's cave with Cassandra. and feminine elements in Lancelot and Guenevere.
She feels her face changing and her throat choked.
Then King Arthur appears and she travels with him from
one realm to another. Arthur mixes a potion which is Session 7 was another key session in the process of

good for the world - there is food for the Knights of the individuation. The tape comprised music of Debussy:

Round Table and bread of sustenance. During The Dances Sacred and Profane, L'Apres Midi d'un

Respighi's The Dove, she images a black stone which Faun, Holst's Venus from the Planets suite, and

she takes out of her heart. Lancelot and Guenevere Vaughan-Williams Fantasia on Greensleeves. Faye's

478
imagery commenced with her in a barque, going to then returns to the asylum where she takes the walls
another realm (the unconscious). The colour of the down (the barriers of fear, or barriers to a healthy open
realm is midnight blue and black. She travels down a relationship. She then reads her husband a story
path and comes to an asylum. She wants to leave her (depicting her mothering role of him).
husband in the asylum but doesn't know how he will
cope. She stays with him, then decides she must leave
him. She closes the door on the asylum and walks into In session 8, she starts to build a new house (new sense

the forest where she finds a cheetah. Later she takes of self), and in session 9 she again calls on archetypal

down the walls of the asylum and reads her husband a images to help her process. She is in Corinth with

story. (The terms "madness" and "asylum" are those Oedipus, Medea and Cassandra. Oedipus was to have

used by my client). killed his father in order to marry his mother, Medea
killed her own children in revenge for Jason's deceit.
Cassandra in mythology was given the power of
The symbolism in this session is profoundly important. visioning, but was cursed that noone would believe her
She travels to another reaim (the unconscious). She visions. In this imagery Faye identified with the deceitful,
comes to an asylum ( a place to leave reasoning.... also devouring, craziness of her parents.
a place for her to confront her fear of 'madness'). After
some agonising moments she leaves her husband
there, and in so doing, separates herself from his In session 10, to the music of Debussy, Holst and

'madness'. She plays with the cheetah in the woods, Vaughan-Williams, she goes into her body- she walks

479
through yellow muck in her cheek bones - a black ogre own fears of madness c) she identifies with positive
appears - she is confused whether she is in her father's feminine figures (Queen of Light) and with positive
body or whether she is a child in the shadow. She masculine 'hero' figures (Arthur and his Knights) d) she
confronts the shadow and tells it to step back. An egg started building a new house (identity) for herself, and
appears, and she comments "I feel I have a face for the this aspect generalised over into her creative life. She
first time". This was a powerful session - in walking composed two new pieces for children during this
through her cheek bones she is addressing her identity. period, and one was played live on radio to a live
In confronting the shadow, she addresses the abusive audience. She gained a great deai of confidence from
father (not knowing if she is in his body, or a child in the this performance and the appreciative applause of the
shadow), and also addressing her own shadow, her radio audience.
own depression, the dark side of her identity. As soon as
she confronts the shadow, and tells it to step back, an
egg appears which leads to her profound statement "I In the second series of G.I.M. sessions, Faye 's imagery

feel I have face for the first time". process focussed on her individuation. This was
achieved through the emergence of aspects of self
(subpersonalities). In Faye there were four female sub-
Over the first 10 sessions, Faye worked through several personalities and one male subpersonality.
key issues:a) memories of being physically abused b)
confronting the madness in her family - in her
destructive father and mother, her husband and her In session 11 Faye recalls the memories of her mother

480
and father fighting, and how frightened she was as a abuse, comment that it is usual for the Inner Child to
child that she would lose her mother. During Grieg's appear in this manner - a frightened child, often in a
Romanze from the Holberg suite, she images glass in corner, cringing, hiding, or curled up. This is the
her chest and a fear of being injured. Then in session 12 kinaesthetic memory of childhood abuse.
to the music of Haydn (cello concerto, slow movement)
and Saint-Saens - Swan of Tuonela, she images herself
in shrouds of gauze. She says "I'm mummified, I can't In session 14, Faye grieves for her grandmother. Her

get mummy off". She then experiences imagery of grandmother had died in Faye's bed, and on the day of
the funeral, Faye had been sent off to a music theory
examination. She had never cried for her grandmother
death and re-birth. Firstly she experiences being eaten until this G.l.M. session. It was profoundly moving.
to the bone, like a skeleton in a coffin. St Michael and St
Gabriel appear (Guardian angels). The next piece is the
Bachianas Brazileiros of Villa-Lobos. As the female In session 19, a second sub-personality appeared. This

voice sings, Faye calls out "who are you". She answers was Faiblesse, a French name meaning "weakness".

herself "a grieving little child". At this point in the session Faiblesse was like a wooden doll. She enjoys harp

she sits up, bends over, and weeps. She names the little music. The following session Carmen appeared.

girl "Anita". This is her Inner Child, the first of the sub- Carmen is the sexual subpersonality. She enjoys

personalities to appear. G.I.M. therapists who are rhythmic music. In session 21, Faye's Higher Self

experienced in working with adult survivors of childhood appears. She links the four sub-personalities to her

481
stages of development :- Anita, the playful Inner Child; and Harp Concerto (slow movement), Faye becomes
Faiblesse, the pre-sexual adolescent; Carmen, the calm.
sexual adult; and Higher Self (the spiritual self).

The day before her piano exam. Faye has her 24th
At this point Faye was preparing to sit an advanced G.l.M. session. In the imagery she dialogues with the
piano exam. (she had failed this exam. 18 months four sub-personalities, and draws a mandala which
previously when she had started therapy with me). In integrates all four sub-personalities. According to the
the two sessions leading up to the examination, Faye's theory of Joan Kellogg, this mandala represents stage 7
imagery focused on scenes of childhood abuse. The - the functioning ego. The day following this session,
anxiety of the impending examination, provided the Faye sits her exam. and achieves an "A" result.
energy she needed to deal in the imagery with her
abusive parents. In session 23, to the music of Holst's
Mars, Anita (Inner Child) goes to the parents bedroom After this, Faye's imagery brought forth a masculine

and smashes them with a big stick. Anita is sad because sub-personality - August. He is a male dancer, and

she is now homeless. Then she cuts off their heads, dances with Faiblesse (the wooden doll). He is also

minces them up and feeds them to the fish. She then houseproud and a gourmet cookl In Jungian theory

has memories of her father throwing her in deep water, August represents the internalised masculine element

and she nearly drowning. She becomes very frightened which has been missing from Faye's life, projected

and calls on Higher Self to help Anita. To Handel's Lute instead onto her husband. The internalised male figure

482
provides the strength and objective rationality to assist Case Study: Mary
Faiblesse, the weak one. Since August and Faiblesse
The second case study is of a 50 year old unmarried
dance together the process of integration is very
woman, with whom 5 G.l.M. sessions were given over a
positive.
period of 15 months. During this time she was coping
with the relentless progression of Motor Neurone
Disease. The case study illustrates how Mary accepted
Over the 18 months of therapy, Faye developed a
the imminence of death at a subconscious level, while
sense of identity by firstly separating from the influence
maintaining denial at the conscious level.
of her parents, and from her husband. In the later part of
therapy, the major gain was an integration of the inner
self, by identifying four sub-personalities. Through the
Mary was the oldest child of a family of four, and the
integration and dialogue between the four aspects of
only girl. She trained as a Social Worker and spent 25
self, Faye was able to effectively present for a piano
years in Indonesia with a religious organisation. She
examination for which she obtained a high mark.
made infrequent visits home to Australia, but these
The results over 18 months show that G.I.M. has been increased when her father became ill and was
effective in developing ego boundaries, a healthier diagnosed with Motor Neurone Disease. When he was
concept of self, and an integration of the sub- in the terminal stage of the disease, Mary had visited
personalities which together make up the whole self. home, but had returned to Indonesia just prior to his
death. She carried guilt that she had returned to

483
Indonesia at that time instead of staying with her father. the session she was confronted by two large mountains
and there was no path around them.

Six months after the father's death, Mary developed the

first symptoms of the disease - weakness in the muscles Her imagery in session 1 also depicted many
of the legs. She attempted many cures in Indonesia disappointments. The large house she was in was
including acupuncture, herbal remedies and spiritual desolate there was no-one inside. When she finally
laying on of hands. reached the top of the staircase, she stepped onto a
mountain which was desolate, and then it deflated.
Foliowing the session Mary indicated that she wanted to
The first G. I.M. session was given in July 1990. At this
work on several issues - unresolved grief for her father,
stage both legs were weak and she crawled on all fours,
and "loss of productivity" in her work in Indonesia.
dragging her legs behind her. She denied that she had
the symptoms of Motor Neurone Disease, and in fact
the medical tests had not shown positive either. In the In the second session to the music of Ravel's
first session her imagery showed repeated frustration Introduction and Allegro for Harp, she explored a river.
with mobility. She was on a path, but the roots of the The water was a murky brown, and the mud came half
trees blocked her walking. She began to climb a way up her legs. Later, she was walking in a stream, but
staircase inside a large house. The staircase kept the river (of life) dries up and she is left in sand
elongating so that she could not get to the top. Later in (insecure). She then explores a forest where the trees

484
are very close together and uniform in shape. This is the opportunity for working on difficult issues. The music is
rigidity of her life, and her striving for perfection. She powerful, challenging, and at times soaring. In the
comes to a wooden door. It is made of coarse wood, Passacaglia and Fugue she moves towards a tunnel
and there are nails in the wood (an image of the coffin or (associated with birthing imagery). It is thick and
of the crucifixion). She knocks on the door and it opens deceptive - it looks like it is comfortable but it doesn't
stiffly. On the other side of the door is dense fog. She have good intentions. She crawls through the tunnel
can follow a yellow light up through the fog, or sit on top and comes out into something white and cold - it is dead
of the trees of the forest. She chooses the trees, which coral. She feels like a tortoise (oldest symbol for Mother
she says "have prepared a special place for me". Earth), and is very uncertain. The tortoise comes out of
the water and is dried out in the sun. It becomes a
skeleton, and its claws try to dig into the earth to find the
Session 3 took place 6 months later as she had been
amethyst. During the Partita in B min. she sees a wise
away in the North of Australia in the warmth of the sun.
old man (Jung identifies the wise old man as one of the
At this stage she was wheel-chair bound, and needed
masculine archetypes in animus projections). Mary
assistance with toileting, dressing, and feeding. Her
describes the face of the wise old man, but then the face
speech was slow and laboured and she showed
becomes a mask, and she feels let down. She becomes
difficulty in swallowing. During the induction I suggested
a bird, flapping her wings. She wants to move on but her
she take the image of an object on her journey. She
legs are caught in a cloud. She interacts with the cloud
close an amethyst stone. The tape used was the Mostly
and asks it to let go of her legs. The cloud gives an
Bach tape. The music on this tape provides the

485
ultimatum that it will let her go if she leaves one leg Session 4. In session 4 Mary is confronted by an old
behind. The cloud mocks her. Another cloud appears woman in a dark cloak (this is the 'old hag' archetype,
(possibly father) and negotiates on her behalf. The the negative mother). Mary calls to the old woman, and
second cloud requires that Mary trust it "you may not be they sit together in the sand. Suddenly the old woman is
abie to understand what is happening but just trust". The gone and in her place a striped brightly coloured snake
first cloud then shrivels up and both her legs are freed. appears. (The snake can be representative of
The symbolism of this imagery is clearly evident, in that deception). Mary becomes a big insect, and crawls up a
the disease has already cost her both legs. The cloud rocky mountain. She loses energy, but is unable to give
puts her back on earth and she scratches (still as a bird) herself a rest. She is helped by a fluffy brown cat, who
in the ground for the amethyst. She finds the original suggests she can levitate. She becomes an eagle which
stone, and it says to her "your rightfui place is buried in confronts a black cloud. She bats her wings at the cloud,
the earth. She puts the amethyst back in the earth so which finally retreats. (In this imagery of the cloud, Mary
that "everybody has it". The mandala foliowing this confronts the cloud herself, whereas in the early
session shows a spiit circle on the 1-7 axis. The 10-11 session she needed the second cloud to negotiate on
segment of the circle is barren. The amethyst stone is her behalf).
represented in several forms - one of them is
surrounded in green, and has a black eye. It is this
shape which is transformed in the next session. In the last session before her death, Mary's imagery
indicates that at a subconscious level she is preparing
for death. At the conscious level however, she is still in

486
denial. She says about her deteriorating speech "don't it in peace knowing that it will fulfil itself - one day I will
tell Mum, she'll only worry". Her mother of course was return. I feel a warm light mist over me - now I've
well aware of her daughter 's deteriorating condition. disappeared". Each of these statements indicate a
The tape for the session was the Transitions tape. The preparation for death - she lies down to sleep - she can
music was strong, masculine in quality, and provided a leave in peace knowing the seed will fulfil itself - one day
secure background for the work. she will return. At the end of the session, Mary says
"that's the end, a good finale".

Mary's imagery commences under a Banyon tree

(which characteristically has large roots visible above In processing the imagery, I asked what seemed the
the earth). Under the roots is an egg. She doesn't know most important image - she responded "discovering that
whether to open it, bury it, or take it with her. She the essence of truth was within the seed itself" I asked
decides to meditate about the egg, and a crack soon what was the significance of the seed, to which she
appears. Inside the egg is another hard shell - a seed. replied "the idea of self-healing - the essence of healing
Again she is unsure whether to open the seed or bury it. within yourself, free of the physical body - I felt fulfilled
I ask if she can see inside the seed - " yes!" she says "I thought I would come back in a transformed state one
am Iying down, I've gone to sleep. The seed is sprouting day- I've done what I was supposed to do." I asked if she
green shoots, to start a mini forest. This beautiful thing felt her work here was finished, to which she said "you
inside me - this is my life. My place is to put the seed in can only live one day at a time".
the earth - I've found what I was looking for - I can leave

487
 transformed into a snake), and tortoise (symbol of Earth
Mother). Although in the imagery she tried to do battle
The mandala for this session is entitled "The Eternal
with the cloud (disease), it was too late in the
Secret", and shows a typical "jaws of death" shape in the
progression of the disease to alter its course. One
centre of the circle - the centre of self. The jaws
wonders if this imagery had occurred in the very early
themselves are green, depicting the growth of the new
stages of the disease, whether the forces of healing
forest from the seed. The black mass is in the
could have altered the outcome, or perhaps slowed
unconscious part of the circle, clearly representing
down the outcome of the disease. The fact that the
death.
disease commenced just 6 months after her father died,
suggests a link between its appearance and the
After this session, Mary again travelled North to the sun, unresolved grief and guilt she felt over her father's
and on her return was briefly hospitalised. She died 8 death. Interesting, this issue did not come up directly in
weeks after the last session. the imagery, although indirectly there were several
images representative of him.

Over the series of 5 sessions, Mary addressed a

number of issues relating to her life. She confronted the The process for Mary then, was her own journey, an
shadow, which appeared twice in the shape of a cloud. inner journey or preparation for the final act of
She met archetypal figures on her journeys - the wise individuation - separation from the living world. That her
old man (whose face became a mask), the old hag (who last G.I.M. session gave her a sense of fulfilment - of

488
having done what she came to do - is a testimony to the Di Leo, F., Grof, S., and Kellogg, J. (1977) The use of a
profound inner experience of Guided Imagery and mind revealing drug (D.P.T.), music, and mandalas in
Music. psychotherapy: A Case presentation. Proceedings of
AATA Conference, VA Beach, 78-85.
References.
Fincher, S (1991): Creating Mandalas. Shambhala
American Psychiatric Association (1987): Diagnostic
Press, Boston and London.
and Statistical Manual of Mental Disorders. 3rd edition,
Revised. Washington, D.C. Grimal, P (1986): Dictionarv of Classical Mythology.
Penguin. England
Bonny, H. (1978a). Facilitating Guided Imagery and
Music Sessions. Monograph #1. Salina, KS: Bonny Kellogg, J., and Di Leo, F. (1979): Interpretation of
Foundation. Structure and form in mandala art work. Unpublished
paper.
Bonny, H. (1978b). The Role of Taped Music Programs
in the G.l.M. Process. Monograph #2. Salina. KS; Bonny Kellogg, J., MacRae, M., Bonny, H. and Di Leo, F.
Foundation. (1977): The use of mandala in psychological evaluation
and treatment. American Journal of Art Therapy, vol 16,
Bradshaw, J (1988): Healing the shame that binds you.
July, 123- 126.
Health Communications Inc. Florida.
O'Connor, P. (1985): Understanding Jung,
Bullfinch's Complete Mythologv (1964). Spring Books,
Understanding Yourself. Victoria. Mandarin, Australia
London.

489
 Creo que este aporte puede ser muy valioso ya que a
travs de la musica se establece un vnculo afectivo
M U SI C O T ER API A EN L A ET APA PR EN AT AL
diferente, hecho desconocido por los padres. Tanto

R UTH F RIDMAN Zoltn Kodaly como Edgar Willems dijeron la msica

debe comenzar nueve meses antes de nacer. Yo llev a
la prctica estas ideas con cientos de mams y paps.
Este trabajo describe mis experiencias con futuros
Propongo, adems, que se estudien a nivel
padres y futuro beb. He hecho un resumen de algunos
neurofisiolgico y psicolgico las manifestaciones
aspectos del primer captulo de un manuscrito que
rtmicas del futuro beb cuando la madre o el padre le
acabo de escribir y que he titulado "La Msisa y El Nio
cantan. Estudiar el aspecto rtmico desde estos puntos
por Nacer". En l relato experiencias personales y las
de vista enriquecera a quienes se interesan en la etapa
que llev a cabo en hospitales y en el Centro Cultural
del ser en formacin.
San Martn de la ciudad de Buenos Aires. Es una
experiencia fascinante, porque me permite conocer por Este es un pequeo resumen de algunos aspectos de
medio de la msica qu siente la mujer embarazada a mi nuevo libro an sin editar titulado "Msica para el
travs de las letras y msica que crean para su futuro Nio por Nacer". Espero que el editor se sonra frente al
beb. Un cuestionario que les entrego, responde a cul manuscrito y lo edite. Mientras tanto describir algunas
fue y son en la actualidad sus conocimientos y gustos experiencias descritas en el primer captulo.
musicales, cules son sus dudas, temores, cul es su Creo que como consecuencia de mis investigaciones
relacin con la familia, la naturaleza, etc.

490
me volque a trabajar con mujeres embarazadas (1)(2). E1 mdico que iba a asistirme en el parto no me
Me conmovieron sus ansiedades, sus miedos y dudas. satisfaca y alguien me habl que en el Eircito de
Sent que si la futura mam le cantaba a su beb como Salvacin se le daba atencin a la mam y a su beb.
yo lo hice con mis dos hijos, tendra un mejor vnculo y Decid que me atendiera otro mdico. Era un hombre
se sentira ms segura. Tambien invite al papa. ms afectivo pero descubr que tampoco se cuidaba a
la mujer. Se hacan solamente los anlisis de rutina. Yo
E1 primer captulo comprende entre otros los
engord muchsimo. No caba duda que el beb sera
siguientes temas: Mi maternidad, Experiencias en
muy grande. E1 primero naci con 4 kilos y 1/2 y el
Hospitales, Creando Msica para el el futuro beb, La
segundo con ms de 4 kilos. En ambos tuvieron que
Msica, madre de todas las artes.
hacerme episiotomia. Lo notable fue que cuando naci
mi primer hijo tuve un orgasmo tan maravilloso que no
Mi maternidad me di cuenta que estaba dando a luz. Con el segundo
tuve contracciones muy seguidas y estuve muy
Tuve dos hijos, uno a los 22 aos y el otro a los 26. Me
cansada. Me cost mucho su nacimiento.
result muy difcil encontrar un mdico que entendiera
a una mujer que iba a tener un hijo. Estar embarazada En la clnica trabajaba una enfermera que durante
no era facil dentro del medio en que yo viva. Trataba de muchos aos hizo las mismas tareas en Africa. Ella
pasar desapercibida y me cost anunciar el feliz acostumbraba a llevar a los bebs a las madres. De
acontecimiento a mis padres. Era un modo de poner en modo que me lo alcanzaba no bien yo se lo solicitaba.
evidencia el sexo.

491
Fue as que nos hicimos amigas y continuamos ser. Los mdicos parecen tener prisa y se hacen ms
vindonos. Ella me visitaba a menudo. Eso me traa una cesreas que las que se debieran. Se avanza en la
gran tranquilidad. Me senta tan desamparada. Quera preparacin psico-profilctica, pero, an siento que hay
ser una buena mama y tratar de equivocarme lo menos una barrera entre el obstetra y la futura mam.
posible. Pareciera que no se dan cuenta que es la madre la que
va a dar a luz. Segn la Dra. Robbie Davis Floyd (4), los
La literatura de la poca era la del Dr. Arnold Gesell (3).
ritos obsttricos se apoyan ms en la tecnologa que en
Yo ped sus libros a los E.E.U.U. y me gui en gran parte
la naturaleza. Se debera honrar ms al proceso del
por sus recomendaciones. Con mi primer hijo segu
nacimiento y al cuerpo de la mujer.
paso a paso sus recomendaciones, pero con el
segundo fui ms flexible porque haba aprendido a Creo que mis cursos benefician a los padres que van a
hacer madre y senta que la vida me deca que hiciera tener un beb. Es muy difcil, dentro del medio en que
lo que mi beb necesitaba. Eso me hizo sentir ms vivimos que los padres tomen conciencia del valor
segura y poco a poco aprend a ser madre de dos nios humano de la msica y descubran que sta es la nica
de temperamento muy distinto uno de otro. Fue una de todas las artes que puede y debe acompaar la vida
etapa difcil. Cuntas veces me preguntaba si proceda de quin an no naci (5). Por ello, decid dar cursos y
bien, si podra ser mejor. A los dos les di de mamar explicar que la msica no es un lujo sino una necesidad.
hasta que ellos lo decidieron. En una de mis clases en el Hospital Fernndez una
madre que ya haba dado a luz me pregunt por qu
Hoy la mujer, por un lado est ms protegida. Pero en
no se nos ensena todo lo que usted dice ya que somos
muchos casos la alta tecnologa no es lo que debiera

492
nosotras las mujeres las que traemos los chicos al segunda clase su guitarra y un instrumento de viento.
mundo? Esto fue filmado en video y todo lo que sucedi Cantaron una hermossima cancin compuesta por
esa maana mientras yo dictaba la clase. Tambin ellos. Eran aficionados en el campo musical. Tuve
habl con las mams que tenan a sus hijos en las cientos de cancioncillas creadas por los futuros paps a
incubadoras (6). Desde aos vengo clamando que se lo largo de mi trabajo. Nunca fui remunerada, salvo en
graben las voces de los padres o quienes los sustituyan dos oportunidades.
en lugar de que el beb escuche comerciales o
Tambin trabaj en el Centro Cultural San Martn
cualquier programa radial.
perteneciente a la Municipalidad con mujeres de
distinto estrato social. Fueron ms espontneas porque
ellas mismas haban decidido tomar el curso. Cada
Mis experiencias en hospitales
futura mam era un mundo y yo las invitaba a soar con
Mi primera experiencia comenz en el Hospital Italiano
su beb a travs de la msica. Nunca tuve la suerte de
donde trabaj cerca de un ao. E1 tiempo, espacio y
tener una habitacin confortable que fuese relajante.
horarios que se me ofreca siempre fueron muy
Trabaj en condiciones adversas pero ni mis alumnas
limitados. Eso me sucedio en todos los hospitales. Los
ni yo le dieron mucha importancia. Mis experiencias
pediatras y los neo-natlogos apoyaron siempre mi
fueron muy gratificantes porque yo influ en las mams
trabajo, no as con casi todos los obstetras y parteras
a que crearan con sonidos, a que pensaran en el
que conoc. A pesar de las dificultades hice un buen
cuerpito de su futuro bebe, en los movimientos que
trabajo. En un caso, una pareja trajo despus de mi
haca, que lo dibujara y lo mimara con palabras y

493
sonidos musicales. Desde este modo creaban un proto- consulten a un terapeuta.
lenguaje musical. Algunas muy simples, otras muy
Las cancioncillas se crean de un modo natural, sin
creativas.
exigencias, sin premios. Ser un recuerdo para el resto
de sus vidas por haber sido creadas en el amor de la
espera y de la gestacin. El beb recibe msica antes
Creando msica para el futuro beb
de nacer.
Cuando invito a una futura mam a que cree una
pequea cancin, esta accin la vuelve creativa (7).
Despierto en los padres un hecho desconocido. Se La emocin de la madre beneficia a ambos. Cuando la
enriquecen a travs de estas experiencias. La vivencia madre con el padre cantan el beb contesta con su
musical antes del nacimiento es un vnculo pre-natal cuerpo (8). Es un pequeo acrbata si tiene bastante
que da a mam, pap y el beb una dimensin de gran espacio. Los movimientos rtmicos del beb son muy
ternura. En todas las canciones hay amor, apego, importantes y las invito a que piensen que estas
apoyo, promesa de proteccin, anhelo de verlo y de manifestaciones dejen una impronta en el beb. Una de
estrecharlo en sus brazos. Tambin hay quienes tienen las investigaciones que ms me han fascinado son los
miedo de perderlo o que nazca discapacitado o tener estudios de las Doctoras Judith Kestenberg y Estelle
que dejarlo en una guardera. Yo trato de ayudar a la Borowitz (9). Segn ellas los movimientos fetales seran
futura mam cuando se presentan estos casos. Le las estructuras en accin para el desarrollo de la
propongo que lo conversemos entre todas o si no que funcin psquica.

494
Las experiencias que yo realizo creo que deberan padres en especial la mam condensa todas las
llevarse a cabo en todas las maternidades en pos de perspectivas de felicidad, de plenitud, a que aspira
una salud mental y afectiva entre padres e hijos. El vitalmente el futuro beb y sus progenitores.
ltimo trimestre del embarazo se va volando y hay que
Creo que se desconoce o no se toma en cuenta que en
saber aprovecharlo al mximo pues es la etapa en que
esta etapa la mujer tiene ms capacidad de amar, de
el rgano auditivo (6 mes) est totalmente formado. (
sentir, de expresarse, de crear y disfrutar del desarrollo
10 ) La familia se forma antes del nacimiento y sta
integro de su futuro beb.
representa a la sociedad. No nos olvidemos que la
Los primeros movimientos que la madre siente deben
mitad lo hace el beb, la otra la sociedad (11). Los
establecer sin duda alguna vnculos de afectividad y
miedos no permiten tener un buen contacto con el
emocin.
futuro beb. Las drogas y otros males que nos aquejan
no se deberan combatir a travs de. medios policiales La madre durante el embarazo est en el grado ms
sino creando bases y condiciones sociales slidas alto de su sensibilidad. Tiene la posibilidad de conocer
llenas de afecto para formar hombres libres que aspectos de su mundo interno a travs de la msica, a
respeten a sus semejantes y a s mismos. travs de sus creaciones, su amor, comunicndose de
otro modo, brindndole al futuro bebe un mundo de
sensaciones a travs de sonidos y ritmos (12).
La msica madre de todas las artes
Las disciplinas que observan, que interpretan los
Mi experiencia indica que a traves de la msica los
fenmenos propios de las primeras etapas del

495
desarrollo psico-fsico infantil pueden aportar datos y Rituals in theResolution of Cultural Anomaly". Part 1 -
orientaciones de alcance explicativo sobre tales hechos pag. 193-211. Pre and Peri-Natal Psychology Journal -
y fenmenos (13). Y finalmente, puede esperarse que Volume 4 - Number 3. Spring 1990.
los aportes de la neurologa y la psicologia gentica,
(5) Fridman, Ruth, Canciones para la Mama, la
puedan integrarse en una perspectiva de totalidad en la
Maestra y los Chicos. Centro Editor de Amrica Latina.
que caben tambin todos los hallazgos relacionados
1969. Buenos Aires.
con la musicalidad al parecer congnita de la criatura
(6) Fridman, Ruth, "Nuevas Tcnicas de Contacto
humana.
Humano con Neonatos Prematuros en Incubadoras".
Trabajo presentado en elCongreso Mundial de
BIBLIOGRAFIA Musicoterapia. San Juan de Puerto Rico. 1981.

(1) Fridman, Ruth, Los Comienzos de la conducta (7) Verny, Thomas The Secret Life of the Unborn Child.
Musical. Editorial Paids. 1974. Buenos Aires. Delta Book. 1981. New York

(2) Fridman, Ruth, El Nacimiento de la Inteligencia (8) Condon, William; Sander, W., Louis, "Neonate
Musical.Editorial Guadalupe. 1988. Buenos Aires. Movement is Synchronized with Adult Speech:
Interactional Participation and Language Acquisition".
(3) Gesell, Arnold, How a baby Grows. Harper and
Science. Vol. 183 - pag. 99-101. 1973.
Brothers. 1945. Nueva York.
(9) Kestenberg, Judith; Borowitz, Estelle, "Fetal
(4) Davis, Floyd, Robbie, "The Role of Obstetrical
Movements andDreams in Pre and Peri-Natal

496
Psychology" Edit. Human Sciences Press. New York.

(10) Woodward, Sheila, "Discoveries in the Fetal and Otras referencias relacionadas con el trabajo
NeonatalWorlds of Music". 5th Early Chilhood Music
Education Seminar. Kunitachi School of Music.
International Society Music Education (ISME) Japn. (1) Bowly, John, La Prdida Afectiva. Paids 1983.

1992. Buenos Aires.

(11) Freud, Ernest, "Pre-Natal Attachment and (2) Cass, Barbara, Beggs, "Education for Life". Ottawa.

Bonding". Editor Thomas Verny. 1987. Human Sciences. Canad.

New York. (3) Birnholz, Jason C., "The Development of Human

(12) Klaus, H., Marshall; Klaus, Phyilis, M., .The Fetal Hearing". Science. Vol 223 - pag. 516-518.

Amazing Newboard. Addison Wesleyan Publising E.E.U.U. 1983.

Company Co. 1985. E.E.U.U. (4) Thomas Blum, "Early Pre-Natal Perception and

(13) Critehley and R.A. Henson, Music and the BRAIN. Adequate Auditive Stimulation" - in J. Prenatal and

Edited Mac.Donald Critchley. R.A. Henson Editorial Perinatal Studies (283-296) Berln

William Heinemann Medical Books Limited. 1980. (5) Leboyer Frederic, Birth Without Violence. Ed. Alfred
Inglaterra. Knopf. New York. 1976.

(6) Thuman, Leon, Langness, Ana Peter, Heartsongs.

Music study Services. Colorado. E.E.U.U.

497
(7) Ostwald, P.F., Soundmaking. Ed. Charles C. "M U S I C A Y P O E S I A E N P A C I E N T E S
Thomas. Illinois. 1963. E.E.U.U. C O M AT O SO S"

(8) Rascovsky Arnaldo, Conocimiento del Hijo. 1973. M ARCELO G ABRIEL G INDLIN , SARA L EWKOWICZ Y
Ediciones Orin. Buenos Aires. P ATRICIA K ATZ

(9) Salk Lee, "The Effects of Normal Heartbeat Sound

on the Behaviour of the Newborn Infant" 1960. World
Tres profesionales del rea de la salud y la educacin,
Federation of Mental Health". Edinburgh.
compartiendo un espacio gerontolgico, tuvimos la
(10) Verny Thomas, Pre and Peri-natal Psycology. posibilidad de realizar una experiencia indita para
1987. Edited Thomas Verny, Human Sciences Press - nosotros: la de trabajar con un paciente en estado de
Inc. New York.. E.E.U.U. coma, internado en una unidad de terapia intensiva.
Esta situacin en extremo movilizante, surgida a partir
(11) Verny, Thomas "The Roots of Personality," Pre and
de la confianza depositada en nosotros por nuestro
PeriNatal Psychology. Volume 4 - Number 3 - pag. 251-
paciente y su familia, nos llev a plantearnos la
253. Spring 1990. New York. E.E.U.U.
investigacin sistematica de este tema.

Nos encontramos repentinamente trabajando con ellos

hasta superar la crisis. Al cabo de 48 hs., nuestro
paciente retorn a sala general: nuestro equipo haba
trabajado intensamente:

498
- en acompanar a la familia, descomprimiendo la con el paciente, como para poder sintetizar y transmitir
angustia frente a la emergencia; mensajes claros.

- con el paciente, a travs del contacto afectivo de De esta manera, se pudieron seleccionar los mensajes
la palabra y la msica, focalizando nuestra atencin en ms importantes a transmitir, para que esta situacin,
los vinculos interfamiliares. en la que se necesita rapidez, no le produjera a los
parientes desesperacin, impotencia y confusin.

Nuestro paciente mejor y esta experiencia permiti, a

En los escasos momentos de encuentro entre paciente
posteriori, la modificacin y fortalecimiento de los
y familia. debia crearse un ambiente adecuado, sin la
vnculos entre los integrantes de esa familia.
interferencia del andamiaje tecnolgico que permitiera
el encuentro piel a piel,para comunicar todo lo posible y Ms all del xito de esta experiencia, pronto
permitir una evolucin de la crisis. comprendimos que en la prctica nos enfrentaramos
con situaciones, a veces similares otras diferentes a la
Los resultados se vieron tanto en la familia como en el
que estamos describiendo. Y que trabajaramos en
paciente. La familia pudo bajar el nivel de tensin, lo
momentos de crisis, con posibilidad de resultados
que permiti una mayor fluidez en la expresin de sus
diferentes, dadas las diversas caracteristicas de los
mensajes y movimientos.
seres humanos, y que deberamos contar con una
estrategia previa para operar.
Slo se trat de aprovechar el tiempo que tenan para
Estar en el servicio de la Unidad de Terapia Intensiva

499
del Hospital Israelita "Ezrah" de la ciudad de Buenos tiempo funcionar como sostn en las situaciones de
Aires nos permite contar con el apoyo de los mdicos y emergencia.
enfermeros que nos brindan total libertad de accin.
Rastreamos, especialmente, las situaciones
Nuestra funcin est al servicio de reducir ansiedades familiares significativas, tratando de que los distintos
de los familiares, sin obstruir la tarea de los otros miembros aporten la mayor cantidad de datos sobre el
profesionales del rea, sino como una colaboracin, paciente as como de los vnculos que ste sostena.
construyendo un puente entre el adentro y el afuera.
La psicloga acta de puente con el resto del
Estar incluidos en un servicio nos permite el contacto equipo profesional, el que rpidamente implementa la
directo con las familias en el momento del impacto. estrategia adecuada. - La licenciada en letras,
mediante el poema, intenta rescatar el valor total de la
Nuestro equipo, interdisciplinario, est compuesto por
palabra y lo que de ella resuena, tanto por el
una licenciada en psicologa, una licenciada en letras y
poema mismo como por lo resignificado en el paciente.
un musicoterapeuta.
- E1 musicoterapeuta mediante el amplio espectro
Las funciones de cada uno de los integrantes son las
sonoro, en primer trmino transforma y aisla ciertos
siguientes:
sonidos agresivos de la maquinaria de la Unidad de
- La licenciada en psicologa es quien realiza el
Terapia Intensiva -absorbindolos a nivel acstico,
contacto con la familia, tratando de recabar la mayor
para evitar la reverberancia-, para que no perturben al
cantidad de datos posibles en cuanto a la historia
paciente.
familiar -como asimismo del paciente-, y al mismo

500
 Despus trabaja con el paciente, con el objetivo
de usar canales de comunicacin, explorados o no, a
travs del contacto, los sonidos, las vibraciones, EXPL O R I N G T H E I N N ER L AN D SC APE - AN

utilizando la menor cantidad de instrumentos u objetos I N T R O D U C T I O N T O G U I D ED I M AG ER Y AN D

musicales intermediarios, considerando al cuerpo del M U SI C

musicoterapeuta como instrumento musical (por FRANCES SMITH GOLDBERG, MA, RMT-BC, MFCC
ejemplo, por medio de la utilizacin de la voz).

Nuestra concurrencia al servicio es peridica y

The Bonny Method of Guided Imagery and Music (GIM)
contamos con la supervisin de los miembros de la
is a depth-oriented music psychotherapy method
Unidad de Terapia Intensiva y externa.
developed by Helen L. Bonny at the Maryland
En la propuesta de taller, nos proponemos realizar una Psychiatric Research Center, U.S.A., in the early 1970s
aproximacin vivencial a partir de elementos during her tenure there as a research music therapist
psicodramticos, estimulando lo que cada participante (Bonny, 1978a). The GIM method uses specially
traiga a partir de su propia vinculacin con las programmed tapes of classical music (Bonny, 1978b)
situaciones lmites. selected to match the clients' current mood and energy
En el despliegue de las escenas recreadas, se level, to evoke emotions, sensory and noetic images,
elaborarn tanto los aspectos de la tarea en s cuanto physical sensations, memories and thoughts. The
de su soporte terico. evoked material represents subconscious,
unconscious, and other mental content, thereby

501
bringing it to conscious awareness leading to significant The GIM session begins with an induction which is
personal insight into therapeutic and life issues. Further, designed to relax the body and focus the mind on inner
the music taps into deep transpersonal levels of experience. This, in combination with the music, leads
consciousness, bringing experiences which move to an altered state of consciousness. An altered state is
beyond insight to deep existential healing and defined by Tart (1969) as one in which the person feels
transformation. An individual's response is unique and a qualitative shift in his or her pattern of mental
personal to each musical program, and each hearing of functioning, not just a quantitative shift. The music is
any given musical program brings a fresh experience. started and then the client and therapist engage in a
dialogue. The client verbally reports his or her
experience as it happens and the therapist offers
GIM is used with a broad variety of clinical populations,
supportive and encouraging comments and questions
inpatient and outpatient, as well as with general
designed to help the client maintain an inner focus and
populations interested in personal growth. It has also
to move deeply into his or her experience of the music.
been found to be effective, not only with those who
After the music phase the therapist helps the client to
share the Western classical music tradition, but also
integrate the experience using both verbal and non-
with other cultural groups (Hanks, 1992). The primary
verbal techniques such as art or writing. Among the
GIM approach is individual therapy; however it has been
phenomena experienced by the client are mental
adapted for group therapy as well.
images, defined as sensory experiences in the absence
of external stimuli. These images occur in all sensory

502
modes - visual, kinesthetic/physical, auditory, tactile, the inner focus and provide dynamic movement to the
gustatory, and olfactory. Noetic images also occur. A flow of images and feelings. The taped programs
noetic image is a sense of knowing that comes outside include works of Bach, Mozart, Brahms, Berlioz,
of sensory information and is similar to an intuition, Vaughn-Williams, Mahler, Faure, Wagner, Ravel and
except that it is much stronger. The visual, Prokofiev, to name a few.
kinesthetic/physical and noetic images are most
common and often present in a manner similar to a
waking dream. According to Langer (1980), the most important
function of music is that music can be "true to the life of
feeling in a way that language cannot; for its significant
The music is central to this process and is, in fact, the forms have that ambivalence of content that words
co-therapist. Music provides both a catalyst for creative cannot have" (p. 243). Indeed, music symbolizes,
image formation and an emotionally supportive reflects and evokes the ambiguous, fleeting and
container for the experience. The music creates a conflicting life of feelings and images. Images are
holding space in which the ego can let go to the inner manifestations of the inner emotional life, providing a
experience while, at the same time, holding its own bridge between internal and external, feeling and
reality. The complex structure and texture, the cycles of thinking, self and other, including the collective
tension and release, and the dynamic richness of all the unconscious (Goldberg, in press).
elements of music from the Western classical music
tradition provide structure for the experience, sustain

503
GIM is a holistic psychotherapy method which
embraces both the psychodynamic and the
GIM is a synergistic process that goes beyond our
transpersonal. Whatever is at the top of the individual's
ability to adequately describe in words (Goldberg,
hierarchy of psychological needs is what will emerge in
1992). The archetypal and aesthetic qualities of
the GIM session. Deeply symbolic and archetypal
Western classical music combine with emotion, imagery
images representing unconscious conflicts, childhood
and the physical, emotional and spiritual state of the
traumas, relational and other psychological wounds,
person and his or her life experience to form a matrix of
spiritual and existential issues as well as many positive
synergistic energy that creates a new dimension of
experiences of the self are common. It is an organic
experience. This new dimension opens new layers of
psychotherapy, growing and developing from within the
reality and experience and actualizes the innate
client; the GIM therapist follows the client's lead. The
potential of the person for health and wholeness.
primary therapeutic process takes place during the
music experience as the client journeys through his or In this workshop participants will have the opportunity to

her symbols, images and emotions. There is a experience the group version of GIM. We will use these

development through each session and also over a experiences as a basis for further discussion of the

series of sessions that brings insight, working through method.

of issues and healing of psychological wounds as well

as rich healing and transformative experiences of the
References
nature and beauty of the self and of life.

504
Bonny, H. (1978a). Facilitating GIM Sessions. Salina, Tart, C.T., Ed. (1969). Altered States of Consciousness.
KS: Bonny Foundation. Garden City, New York: Anchor Books.

Bonny, H. (1978b). The Role of Taped Music Programs

in the GIM Process. Salina, KS: Bonny Foundation.
M U S I C O T E R A P I A :U N A B O R D A JE E N V I N C U L O S
Goldberg, F. (1992). Images of emotions: The role of
T EM PR AN O S
emotion in Guided Imagery and Music. Journal of the
Association for Music and Imagery, 1, 5-17. M ARTA G ROSMARK

Goldberg, F. (In press). The Bonny method of guided

imagery and music. In T. Wigram, R.West, & B. INTRODUCCION
Saperston, (Eds.), Music and the healing process: A
handbook for music therapy. Chichester, West Sussex,
U.K.: Carden Publications. Siempre he tenido inters en profundizar y analizar las
pequeas componentes individuales que se convierten,
Hanks, K.J. (1992). Music, affect and imagery: A cross-
a la postre, en formas variadas de conductas. Esto me
cultural exploration. Journal of the Association for Music
llev a buscar los origenes de estas componentes en
and Imagery, 1, 20-31.
las parejas de futuros padres, tal como cuando el arte
Langer, S. (1980). Philosophy in a new key. (3rd ed., estudia la personalidad del creativo que modela la
1957). Cambridge, MA: Harvard University Press. arcilla. Si concebimos a la etapa infantil y/o prenatal,
como la modeladora de las conductas neurticas u

505
obsesivas tendremos que ir a ahondar en ese periodo mensajes se expresen y luego se transmitan .A partir de
las imbricaciones y tejidos de simbolismos que crean este punto, podremos decursar el rio corriente abajo:
modelos que repetiremos recurrentemente. Es tal como porque hemos ido previniendo a los lugareos, los
cuando queremos conocer porqu existe polucin en daos que puede ocasionar el arrojo indiscriminado de
un punto de un rio determinado iriamos a remontar el desperdicios al mismo.
torrente para investigar las causas de esta polucin rio
Me parece muy grfico el ejemplo que F.Dolto da para
arriba.
explicar el origen y destino del deseo dentro de un
La pediatra y psicoanalista Francoise Dolto, grupo .Cuenta lo que hacen los gitanos para renovar a
respondiendo a la pregunta que le formularon si una sus msicos dentro de sus tribus. Cuando entre ellos, el
palabra recibida en 1a infancia puede decidir toda una mejor ejecutante comienza a envejecer hablan que
vida, dijo :-E1 deseo,ese algo interior y profundo, tiene deberia haber un chico para reemplazarlo, y, durante
la necesidad inexorable de expresarse, de las ltimas seis semanas de embarazo de alguna de las
manifestarse al exterior.Y esto no es facil,y justificar, mujeres, el mejor msico toca todos los dias para el feto
proporcionando, si es posible, los medios para su y luego , todos los dias para el bebe durante las
cumplimiento. semanas siguientes al nacimiento eso es todo.Se dejan
las cosas como estn y estn seguros de que ese nio,
Para desatar la trama de mensajes que viajan desde el
cuando crezca tocar ese instrumento.Desde antes de
deseo de los padres, durante la vida pre y postnatal,
nacer y durante los primeros tiempos despus del
hacia el destinatario, se hace necesario en un principio,
nacimiento , ellos saben que ese nio tocar ese
ofrecer los medios para que estas conductas y

506
instrumento porque asi fue designado y deseado. Los
gitanos transmiten esta tradicin a travs de las
FUNDAMENTACION
generaciones, y con mucha sabiduria. E1 nio querr
tocar ese instrumento cuando tenga la edad de desear Tomo como punto de partida a la biologia humana.El

expresarse.(1) feto recibe in-tero mensajes del mundo exterior en

forma de seal acstica y vibratoria .Donald Shetler
Mi propsito es despertar en futuros padres la
expuso numerosas referencias mdicas que
conciencia de que la ideologia que ellos sustentan
fundamentan esta afirmacin. (2)En la Argentina la Dra.
como pareja, es percibida y captada por el beb desde
Margarita Martin Romero y el Dr. Jorge Schwartzman,
el momento que es concebido. Dicha ideologia
(3) estudiaron la aplicacin de los potenciales
recorrer el curso de la vida de su hijo y ser
evocados, que son pruebas de audicin objetivas, para
transmitida por sus padres en forma consciente o
diagnstico de esta funcin dentro del tero por medio
inconsciente .Es de una de estas maneras, la
de sonidos, a travs del mtodo conocido como
conciente, en la que podremos influenciar en la
B.E.R.A. o Braistem Evoked Response Audiometry. Este
prevencin de patologas de la comunicacin.
equipo concluy demostrando que es posible producir
La fundamentacin que expondr mas adelante cita respuestas evocadas del tronco enceflico en fetos a
algunos autores que mencionan cuando el beb in- partir de las 25 semanas de gestacin y que la
tero comienza a percibir a sus padres y por otro lado respuesta normal con intensidad de estimulo de 100
cmo el grupo familiar se estructura desde la necesidad dB. es una onda de polaridad positiva de 8 a 9 mseg. de
de satisfaccin de sus deseos o ideologias. tiempo de latencia. Tambin el Dr. Jorge Martinez,

507
argentino, dice que desde este momento del beb, su Otro fundamento para elaborar una forma de abordaje
desarrollo auditivo le permite el acceso a los sonidos y con futuros padres, es que a traves de mi experiencia
nos muestra respuestas, con movimientos de su he notado cmo estas parejas se deleitan ante los
cuerpo o modificaciones de su frecuencia cardiaca, de movimientos corporales del beb-in tero. Esto explica
que ese estimulo ha llegado y que lo est cuan necesario es recibir mensajes de respuesta
procesando.Agrega que el beb desarrolla la memoria cuando uno es el que quiere comunicar. En una pareja,
con estmulos de su vida pre-natal, por lo tanto que la inclusin de un hijo, constituye cambios en el vinculo
mejor que la voz de sus padres para recordar y disfrutar entre ellos. Estos cambios son necesidades que
de la seguridad que de ellas emanar cuando las oiga tienden a ser satisfechas, o sea, la de ser padres y
de recien nacido.(4). lograrlo eficazmente.Para esto es necesario reconocer
que para que satisfaga ese deseo, hay que llevar a
Para fundamentar que el beb in-tero recibe
cabo una tarea que no solamente tiene que ver con lo
mensajes cargados de afecto de sus padres,
fisiolgico , sino con los aspectos afectivos y culturales.
preferentemente, basta con citar lo que en la actualidad
La manera en que los padres anticipan el advenimiento
constituye un acto de rutina en las nurseries, cuando a
de su hijo, seguramente influir en el modo de relacin
los bebes prematuros se les estimula el crecimiento a
que se establecer con e1. E1 Dr Jorge Martinez aclara
travs de grabaciones de las voces de sus padres. Por
que los signos de frialdad por parte de los progenitores
lo tanto, los nios necesitan de la misma manera
hacia su hijo son vividos por este como angustia y
cuidados fsicos como el contacto auditivo con sus
desunin. Se concluye entonces que se le deben
padres para su desarrollo madurativo .

508
ofrecer experiencias gratificantes y estimulos afectivos, intencionalidad de sus padres de querer llegar a 1 y la
para que se sienta reconocido como persona.(5). voluntad de sus progenitores de establecer lazos
tempranos, permite constituir un vinculo anticipatorio
La psicologia del puerperio (periodo que vive la madre
de lo que despues ser ese grupo, como as tambien el
despubes de dar a luz) dice que la funcin de apego es
equilibrio se lograr mas rapidamente. La pareja
el vinculo fundamental que se establece entre el recien
recibir un tercer integrante con mayor aceptacin,
nacido y su madre como prolongacin de su vida pre-
porque este beb fue pensado e includo con
natal. Este periodo que generalmente es vivido como
anterioridad.
una crisis momentanea, ser sobrellevado por la familia
segn la preparacin psicolgica o mentalidad Es primordial, que antes de comenzar con la tarea
saludable de dicho grupo primario. Si los profesionales especifica que mas adelante explicar, se cuente con
que intervenimos en estas situaciones podemos padres que deseen que quieran establecer un vinculo
favorecer que esta prolongacin de la simbiosis intra- precoz con su hijo.Para esto he propuesto una
uterina se continde despues del nacimiento, habremos metodologia musicoterapeutica que lleva
ayudado a una familia a proseguir con su objetivo consecuentemente a establecer un contacto intimo
explcito-la crianza del beb.(6). entre los tres integrantes de esa familia.(7). Deben
llegar a insights, darse cuenta de los que les est
La psicologia de la comunicacin establece que para
pasando y tener ganas de prepararse a estar con su
que se establezca dicha funcin, debe existir un
hijo. A partir de estos pasos previos es que la buena
mensaje y un canal a travs del cual transiten los
disposicin se manifestar en el producto que cada una
mismos. Entonces el beb que percibe la

509
de las parejas organizar como ejercicios pre-natales . pequeos. A veces se presentan dificultades para
sintetizar y explicar una emocin encontrada luego de
haberla vivido. Hay padres que, por ejemplo, dicen=-a
METODOLOGIA
m no me sale, yo no puedo, me siento ridicula, esto es
La forma de motivar a futuros padres para comenzar para chicos. Otros adultos no lo dicen, pero lo expresan
con la estimulacin, es muy diversa. Por lo tanto las con otros lenguajes=cansancio, prejuicios, risas fuera
consignas son en general abiertas y libres. Se debe si, de contexto, etc. Por suerte estas resistencias en
crear un clima propicio en donde los emergentes surjan general, son fcilmente sorteadas y anuladas, porque
sin restricciones. Existen padres que,por su formacin el clima recupera su espontaneidad y las parejas se
rigida, por prejuicios que sostienen una manera integran a las propuestas rtmicas, expresivas. La
estereotipada de ver las cosas, se muestran resistentes forma ideal de plantear este momento de trabajo, es
y temen realizar juegos -como si fueran chicos- tildando desde la libertad de manejarse con objetos
a estos de ridiculos y no les encuentran un sentido intermediarios que fueron depositados delante de ellos
lgico. Es en estos casos deber plantearme un sin una consigna especifica ni pautada, el grupo o los
enfoque distinto para que esta pareja acceda sin temor, integrantes utilizarn su imaginacin y libertad para
a sus propias vivencias infantiles. Es sumamente expresar situaciones que, de acuerdo con las historias
importante que las parejas , sepan apreciar el valor del personales, desarrollarn la temtica. Motivadores
mensaje sencillo, claro, libre de prejuicio, ingenuo, con como grabaciones de msica infantil en bajo
el que debern llegar emocionalmente a sus hijos volumen,elementos como aros, pelotas, cintas,

510
instrumentos musicales, etc. sirven como enlazadores ellos mismos en funcin de lo realizado durante el
de sonidos, palabras, escenas, que se constituirn en ejercicio. Mi colaboracin consiste en dar cuenta, a
la trama argumental del grupo. Estos ejercicios motivan modo de sealamientos, de las estructuras sonoras y
a los participantes a conectarse con sus propias grupales, de la manera en que se fueron organizando,
experiencias infantiles, para que puedan pensar y del desarrollo de la expresin, de cmo las palabras
recapacitar acerca del hijo que dejarn de ser (por lo pesaron en el juego contexto corporal, como jug lo
menos como lo eran antes) para tomar contacto con los dicho y lo cantado, para finalmente establecer puentes
padres que sern.Es interesante observar desde un de relacin entre lo observado y odo en la escena
encuadre musicoterapeutico,estas escenas de juego, presentada y la vivencia particular que cada uno de los
ya que la multiplicidad de interacciones desde lo sonoro integrantes manifest. Otro de los juegos consiste en
pre-verbal son muy ricas. realizar dibujos de bebes, para luego comentarlos.
Durante este paso,las parejas llegan a tomar contacto
Algunos de los ritmos que aparecen, si eso ocurre, los
mas ntimo con sus bebes, cotejando sus propias
grabo para recordarlos luego. El lenguaje sonoro es
visiones con lo que opinan otros integrantes del grupo.
interpretado dentro del contexto en que apareci. Esto
Poco a poco, se van acercando a tener un panorama
es que los climas obtenidos, el intercambio sonoro, las
mas completo. Otro momento de trabajo consiste en
tramas que se fueron tejiendo entre las distintas
brindar la informacin. Esclarecer que el beb los est
melodias, los modos de accin con la voz e
percibiendo inconscientemente desde que fue
instrumentos, lo conocido, lo desconocido, etc., dan
concebido, tactilmente el resto del embarazo, y
lugar a que los padres piensen y recapaciten sobre

511
auditivamente, desde el quinto mes de gestacin. Esta improvisacin y creatividad en las parejas de padres
parte en general despierta ansiedades en los padres, expectantes por recibir a su hijo. Es en este clima, que
que preguntan-entonces e1 o ella escucha todo lo que yo propongo elaborar canciones para sus bebs, como
nosotros hablamos?, recibir todas las angustias que un primer legado de cario.
nosotros pasamos? Para estimularlo hace falta alguna
La manera mas sencilla para comenzar con este
msica en especial?, Cmo podemos hacer para que
proceso, es partir de una melodia conocida y agregarle
sea inteligente? etc. La respuesta que yo doy en
letras de mensajes que quieran darle al hijo que se
general,es que el beb recibir la intencin de que sus
mueve dentro del vientre.En general, no se ven
padres quieren comunicarse con el, pero no el
obstculos para inventar letras. Lo que si se observa a
contenido. De todas maneras nosotros sabemos el
veces, es la dificultad para dirigirse a ese beb, en
valor afectivo que tiene una caricia, un mensaje
primera persona.
hablado en tono suave y melodioso. Es mas sensual y
atrapadora una frase bien entonada y expresada con Por ejemplo = te sentimos mover

melodia, que una emisin sonora monocorde y opaca. te queremos tocar, etc
No tendr el mismo alcance afectivo una cancin que
- son palabras, que a algunos padres les cuesta
un discurso a secas. Por lo tanto el beb percibir
expresar, aun habiendo realizado la motivacin
sonidos cargados de afecto que sus padres le
anterior. Prefieren referirse a un futuro beb (como si el
prodigaron en su vida intrauterina.
que est in-tero no lo fuera).
Siempre he encontrado un campo riquisimo de

512
Por ejemplo = bebito chiquito no quiere dormir hago. Me siento muy satisfecha en no valorar lo lindo o
desagradable de lo que cada padre pueda expresar,
papito y mamita te escuchan reir.
sino, justamente , que lo haga.
-no le pueden hablar al que en este momento es
Para aquellas parejas que tienes intenciones de
el beb -feto.
estimular auditivamente a sus bebs in-tero, con el
objeto de desarrollar precozmente habilidades
La forma de componer canciones, se va complejizando auditivas, les cuento las experiencias que se aplicaron
cada vez mas. Se puede partir de un ritmo elejido por con metodologas especficas encontrando ser eficaces
cada una de las parejas, para luego agregarle para potencializar dicha funcin= Donald Shetler ,
letra.Tambin se puede partir de una melodia, o Suzuki, Salk, Rene Van deCarr, Tomatis(8). Explicaron
simplemente de un texto, para llegar al producto final cmo la administracin de sonidos sobre el vientre
que mas adelante tratar de exponerles desde el punto materno, con auriculares enfocados sobre la cabeza
de vista de lo obtenido como texto, dejando de lado del fetos se convirtieron en estimulos para el
criticas de la esttica musical usada para dichos fines. aprendizaje pre-natal de funciones tales como la
De sto se podr hacer cargo un crtico musical. No es discriminacin y la memoria auditiva. E1 Eastman Pilot
mi caso, por lo tanto como musicoterapeuta, mi funcin Study, realizado entre 1981-1986 por Donald Shetler,
en acompaar a estos padres a que se descubran explica la metodologa y resultados de esta experiencia
creando para sus hijos, es la base que me motiva a destinada a parejas embarazadas que voluntariamente
sentirme profundamente comprometida con lo que se prestaron a estimular a su hijos con msica

513
preseleccionada. Haciendo un rastreo longitudinal en el parte de los rituales de crianza. Estas costumbres se
desarrollo de los nios ya nacidos, se pudo observar la transmiten oralmente de padres a hijos. En la tribu de
calidad de las respuestas musicales y de lenguaje los Massai en Kenya, un grupo de mujeres que ya ha
expresados. La religiosa Sister Lorna Zemke, en el tenido hijos, se sientan fuera del recinto donde est una
Silver Lake College, Wisconsin, EEUU, desarrolla un madre pronta a dar a luz y cantan melodas que segn
programa para parejas de futuros padres,logrando ellas, sirven para ayudar a la madre en este momento.
enormes resultados en el desarrollo neurolgico de
Me resulta muy interesante indagar en otras culturas,
bebs que fueron estimulados por sus padres con
cmo se transmiten los valores, en un momento crucial
sonidos emitidos por sus voces e instrumentos
de la vida de todo ser humano que es durante el acto de
musicales, dentro del vientre materno. Su programa
la procreacin y la crianza de sus hijos. De todas
tambien consiste en ejercicios musicales a realizar
maneras, para arribar a esta metodologa de abordaje
durante el trabajo de parto, y la importancia de la
de esta estimulacin, he hecho una sntesis del material
participacin de los hermanitos en esta tarea que ana
que he recogido hasta ahora. Trato de ofrecer un
a la familia.
encuadre de trabajo que se adapte a la idiosincracia de
Quiero consignar que muchas tribus y pueblos que la vida latinoamericana y argentina.
conservan sus tradiciones ancestrales, desarrollan
Quiero aclarar que de ninguna manera trato de
actividades rituales con msica, antes y despus del
influenciar a los grupos de padres para que estimulen a
parto. En Africa, el rol de estimulador que representa el
sus hijos, sino que los informo acerca de las
padre,est ampliamente valorizado e incluido como
investigaciones y experiencias recientes para que ellos

514
tomen la determinacin si lo quieren hacer o no. Cuando me preguntan los padres, acerca de qu tipos
de msicas son las ms beneficiosas para el beb, yo
Los ayudo para que encuentren un campo propicio
les digo que en principio deberan ser melodas
dentro del vinculo mismo, para acercarse a ese beb
repetitivas, o por lo menos en donde el tema central se
desde los sonidos, las palabras y las canciones. Si
repita a manera de Rond-forma musical caracterizada
algn padre me pide consejo de cmo
por un estribillo que se repite siempre igual, alternando
hacer de su hijo un genio antes de nacer, yo les
con estrofas que, repitiendo ciertas estructuras
respondo que conmigo no cuenten porque eso va en
musicales, sufren algunas variaciones-Este tipo de
contra de mis principios morales. Desear un hijo genio
estructura musical se encuentra en casi todas las
es, a mi entender, generar un chico neurtico e infeliz.
melodas infantiles y es caracteristica de la produccin
Si , lo que se puede desear, y es lo que me parece mas
musical del Periodo Renacentista y Barroco. Esto no
lgico y humano, que resulte un nio feliz y atento a lo
quiere decir que otros compositores no hayan usado
que ocurre a su alrededor, confiado de sus propios
este tipo de estructura circular, sino que en estos
actos.Este me parece un deseo mas saludable que se
periodos, la mayoria de los compositores deban
puede tener para con sus hijos.
atenerse a ciertos parmetros culturales y sociales, en
E1 volumen de administracin del sonido, para las donde las obras deban ceirse a un orden religioso o
parejas que quieran hacerlo, debe hacerse a 100 Db popular, segn de que periodo se hable.
desde el 5 al 8 mes y de 90 Db, durante el ltimo mes
Las melodas con estas caractersticas, de caracter
de gestacin.
recurrente y reiterativo , tienen la singularidad de ser

515
anticipatorias de la frase musical posterior, ofrecen la BREVE DESCRIPCION DE COMPOSICIONES
seguridad al oyente de que el tema central va a orse HECHAS POR LOS FUTUROS PADRES
nuevamente. E1 beb necesita sentirse protegido, y
Paso a contar, parte de lo que fue una jornada de
nosotros podemos ayudarlo desde una meloda, una
trabajo con las parejas,estas canciones fueron
cancin, cuando esta tiene elementos que ofrezcan un
transmitidas via uterina con tubos de PVC terminados
respiro de alivio al nio, porque lo que escucha, ya est
en un embudo que aument el dimetro de difusin
registrado en su memoria como estmulo previo .
hacia la pared abdominal de la madre. En general fue el
Les sugiero a los padres que ellos mismo piensen en la padre el encargado de cantar. La participacin de ellos
forma en que van a acercarse a sus hijos, con qu les otorg una sensacin de orgullo y bienestar. Esto se
frecuencia y en los contenidos. Preferentemente, hacia debi, a raiz de los comentarios que hicieron, que se
el final del embarazo sugiero que la estimulacin sea sintieron muy cerca de sus hijos.Esta experiencia la
mas frecuente, y que siga cierta secuencia en su repitieron durante los primeros
emisin.
dias de vida del recin nacido, pero sin la utilizacin de
Como habran visto, no es necesario seguir estrictas instrumentos de transmisin.
reglas, sino las que cada pareja escoja. Los resultados
son igualmente positivos para la realimentacin
afectiva de estas familias.
Roxana y Marcelo(10-3-90)

516
 incertidumbre hasta el momento del parto.(9).

Hola beb que tal,hola cmo te va, La necesidad que tuvieron R y M de hablarle-HOLA
BEBE- est fundada en que debido a la cercana
te estamos esperando para juntos jugar
afectiva que sentian por el,pudieron desmitificar al beb
ya sabemos muy bien,que vos sos Nicols
que no oye ni procesa los mensajes del mundo exterior.
que sorpresa tan grande dificil de explicar R y M no tienen un feto en el vientre, tienen a Nicols.

Ahora queremos verte, tocarte y mimar

salir a pasear juntos y bajo el sol cantar. ROXANA Y MARCELO(el mismo dia)

Esta cancin fue la primera que hicieron R y M el dia Ella es gordita como un bombon
que se enteraron que seria Nicolas el que iba a llegar.
y tiene ojos de caramelo
Este momento ayud a hablar y elaborar las fantasias
el es tranquilo y muy dormilon
que existen en la madre referidas al sexo de su beb y
permite una aproximacin mejor a su maternidad, en es tu papa y se llama Marcelo.
un caso u otro. E1 otro caso, es cuando hay mujeres
que el no saberlo, puede llevar a futuras depresiones
post-parto . Hay otros casos que los padres no quieren Vos sos chiquito y muy inquieto

saber el sexo de su hijo, manteniendo asi la fantasia y la

517
papa y mama quieren verte bebe vos sos chiquito que los padres quieren comunicarse con l. Si
y muy inquieto pensamos en una pareja patolgica, que no pueden
expresar ideas o sensaciones del bebe que esta por
papi y mama quieren darte mil besos.
venir, es probable que la simbiosis o apego que debe
establecerse durante el nacimiento con el nio, no se
E1 Dr Enrique Pichon Riviere en su articulo "Una teoria de inmediatamente en ese momento,trayendo
del abordaje de la prevencin en el mbito del grupo probablemente perturbaciones en la lactancia y en el
familiar", explica que la familia aparece como un vnculo. Es por eso que me propongo facilitar y dar un
instrumento socializador, dentro de ella se logra la lugar en esa pareja para que tengan las ganas y-o la
identidad, posicion individual. La situacin triangular necesidad de comunicar creando para su futuro hijo.
padre-madre-hijo, surge de la interrelacin de los roles
correspondientes, emergentes de las relaciones y
ANALIA Y ROBERTO(10-3-90)
diferencias funcionales y biologicas. Aqui Roxana y
Marcelo estan reflexionando acerca de la identidad de Mi dulce bebito viene a jugar con papito
cada uno de ellos dentro del sistema que ocupan.
mi dulce bebito viene a jugar con mamita
Pueden anticipar a su bebe aun no nacido y darle ya un
lugar concreto, sintiendolo y enunciandoselo. Segn el chiquito bebito toma toda la lechita

Dr Martinez el bebe no va a comprender el contenido chiquito bebito, el esta lleno de amor.

del mensaje, pero si la intencionalidad del mismo, de

518
La embarazada generalmente acude a mecanismos
maniacos, de fantasear un hijo hermoso y bueno que la
No nos imaginamos como sers
colmara de felicidad. Estas son ideas que la calman y
pero de cualquier forma te vamos a amar
permiten que el embarazo transcurra. A y R piensan
que su bebe esta lleno de amor. tu cuna esta vaca pronto la llenaras

E1 miedo a tener un hijo que NO este lleno de amor ni con toda tu dulzura y tus ganas de llorar.
dulzura, los hace recurrir al deseo de pensar que el
toma lo bueno, el alimento de su madre, estando lleno
de amor. A1 decir J y F "no nos imaginamos como seras.... amar",
alude a la fantasia natural de deformaciones en el nio,
que si bien la incidencia es baja en condiciones
JORGE Y PATRICIA(20-5-91) normales, la posibilidad existe. Las investigaciones
permiten saber que ademas de la
Hola chiquito como estas
posibilidad real, esta fantasia tiene tambien que ver con
mama y papa estan ansiosos de verte despertar
el temor de no ser capaces de educar y criar bien al hijo
el dia ya se acerca las horas pasaran
cuya consecuencia seria una criatura "malvada", que
pronto estaras en casa jugando con tus chiches llora. De alguna manera J y P lo expresan al decir "de
cualquier forma te vamos a amar" y a pesar "de tus
y haciendo a tus papis muy felices.
ganas de llorar".

519
Estas ideas ambiguas, ambivalentes, pueden ser ADRIANA Estabamos en la playa el bebe
expresadas en actitudes consecuentes .E1 problema tambien habia ido
aparece cuando el nio recibe este mensaje poco claro
Y escondido en su pasaje pero no de polizon
para el. Estas ideas se resuelven en base a la
CARLOS muy contentos al regreso descubrimos que
integracion, que permita aceptar aspectos positivos y
ah estaba
negativos al mismo tiempo, tanto en el objeto que los
motiva, el hijo, como en ellos mismos. (4-6-90) y muy juntos lo esperamos con alegria
y amor.

Todos a disfrutar, todos a disfrutar

La estrategia se elabora desde la investigacin de las
GERMAN Y vamos bebito vamos chiquito
formas que reviste el conocimiento profundo de cada
MARCELA a jugar , a reir, a cantar.
uno de los miembros de la familia incluyendo al 30 por
(25-7-91) venir, y el tipo de necesidades sobre las cuales se
organiza la interaccin, este juego de necesidades-
La hora ya llego, todos a descansar
objetivos-tareas, que el grupo familiar despliega, nos
vamos bebito, vamos chiquito
permite observar como interactan, en funcin del rol
a soar, a dormir y de nuevo a comenzar. que cada uno asume. En el caso de A y C, su bebe

520
ocupa un lugar "legal" dentro de esta pareja:-pero no de Musicoterapia durante este periodo de cambio tan
polizon En el caso de G y M esta muy clara la importante para una pareja. Evidentemente, he hallado
asignacion de roles en esta trama vincular y la forma un nivel de satisfaccin y agradecimiento por parte de
operativa de organizacion temporal. estas familias. He sentido personalmente, cierto grado
de complicidad en este bienestar generado, lo cual fue
transmitido hacia mi en hechos, por parte de las
RESULTADOS DE LA TAREA
parejas. Este espacio generado especialmente para
En la mayora de los casos expuestos, despus de padres que careciendo de comunicacin con sus bebes
nacido el beb, la homeostasis familiar fue rpidamente in-utero, la encuentran, y pueden vincularse, puede
encontrada. Los bebes mostraron signos de cubrir una necesidad de ser y sentirse padres.
comunicacin facilmente decodificables por sus padres. Aprender a recuperar los juegos y las propias
E1 estado de vigilia fue mas activo y receptivo. Los potencialides, liberando el orden de la razn del plano
periodos de sueo fueron mas prolongados que lo de ejercicio, hizo sentir a estos padres sentirse mas
lgico para este periodo post-natal. Los bebes aptos para desarrollar dicha funcion. Los resultados
formaron el vnculo simbiotico con naturalidad, como sellan un mejor acercamiento emocional y prctico a
as tambien la lactancia. sus bebes. Ayudar a padres a pensar en la situacin
nueva que les tocara vivir, me hizo pensar en la
Estos resultados, posteriores a las sesiones que haban
manera, la tcnica y el encuadre necesario, para
realizado bajo mi supervisin, durante la gestacin de
desplegar una estrategia de vinculacin.
sus hijos, hizo que yo re-pensara la funcin de la

521
Las ansiedades de los futuros padres pudieron vnculo con su reciente hijo, la deteccin y el
disminuir, para dar lugar a una conducta con un seguimiento de las expresiones comunicativas sonoras
objetivo:cantar para comunicarse y prepararse para el y corporales del mismo, fue significativa. Estos padres
futuro. Dicho de otra manera, si yo puedo hablar acerca aprendieron a detectar con naturalidad, las seales de
de lo que pienso que puede ocurrir mas adelante, sus hijos y a saber interpretarlas facilmente. Cualquier
estar menos ansiosa. Tambin si yo puedo anormalidad entonces sera evidenciada ante mi
"ocuparme" en vez de "preocuparme" por lo que vendr, funcin de profesional, pudiendo entonces actuar con
tendr ganados puntos a favor. rapidez en ese vnculo que se est desarrollando. Creo
fundamental este momento del trabajo, en donde
Para que la pareja quiera"ocuparse", en primer lugar
padres y musicoterapeutas, compartan estos cdigos
debe prepararse para esto, como ya lo explique en mi
de comunicacin, para saber si son eficaces o no lo
articulo anterior "Estimulacin Musical:una
son.
aproximacin entre padre-madre y futuro hijo". Deber
tener ganas, hacer insights, hacer contacto entre s y
con el hijo. Habiendo cumplido estos pasos, pueden
CONCLUSIONES
seguir adelante.
He recorrido un trayecto de la vida humana, como si
Otro punto importante que cabe destacar, es el efecto
hubiera remontado rio arriba. E1 haber encontrado
profilctico que deviene de practicar estas tcnicas. En
familias felices y satisfechas con su reciente hijo, luego
todos los casos de padres que tomaron conciencia de
de haber participado en sesiones de Musicoterapia, me
la importancia de un establecimiento temprano del

522
hizo pensar en el como de su logro. He hallado autores, profesionales de otras areas, la importancia de brindar
que basandose en la fisiologia y la psicologia, me han distintos lugares de expresin y abordaje de la
dado la respuesta del porque se puede arribar a un problemtica humana.
mutuo entendimiento en familias recientemente
Como ltima consideracin quiero expresar mi deseo
completadas.
que los musicoterapeutas podamos elaborar de ahora
E1 encuadre no- verbal, posibilit la aparicin de en mas, estrategias nuevas para la prevencin de
mensajes verbales, que enunciados en funcin del hijo, patologas sociales y del mbito de la salud mental y
facilitaron la disminucin de las ansiedades propias de fisica dando un aporte joven y adaptado a las
este periodo, por el cual transcurren todas las parejas necesidades de una sociedad en vias de cambio.
que van a recibir a un nuevo hijo.

La Musicoterapia, puede servir como contribucin para

el esclarecimiento de la gnesis comunicacional dentro N AT U R AL L Y- O C C U R I N G T H ER APEU T I C U SES

de sistemas familiares . O F M U SI C : I M PL I C AT I O N S F O R T H E C L I N I C AL
SET T I N G
Espero que mi aporte sirva para que la comunidad
musicoterapeutica continue pensando en la manera de CONNIE ISENBERG-GRZEDA, MMT, MTA, RMT-BC
generar salud mental, desde distintos enfoques y
abordajes .
From an ontogenetic perspective, it has long been
Tambin espero que este trabajo sirva para mostrar a recognized that music plays an important role in human

523
development. Naturally-occuring instances of
therapeutic use of music abound, changing form and
In this paper, the author will provide several vignettes of
content as they match the developmental stage of the
naturally-occuring therapeutic uses of music which are
individual. Music therapists, aware of the importance of
developmentally appropriate. The implications of these
music for man, have alternately appealed to this factor
naturally-occuring phenomena for clinical practice will
to justify the existence of music therapy as a discipline
be briefly explored.
or have denied any relationship between the
creative/healing aspects of music and the existence of
music therapy as a discipline. The ambivalence seems Vignette #1
to be more closely linked to the neverending quest for
Sonia is almost five years old. She is the older sibling in
credibility and acceptance, particularly in the anglo-
a somewhat typical professional middle-class family.
saxon societies, than it is linked to philosophical beliefs.
Her mother is a social worker and her father is an
This has resulted in a conflict between an adherence to
accountant. Sonia's younger sister is two years old.
the conception of music therapy as a mental health
There is considerable friction between Sonia and her
profession based on pre-existing theoretical
mother, although falling within the bounds of what is
frameworks into which music is integrated, and an
considered "normal". Sonia's mother's impatience with
allegiance to the conception of music therapy as an
her tends to be manifested in frequent bouts of yelling
adaptation of the naturally-occuring therapeutic life
and criticism. Even from the perspective of the objective
phenomena that characterize health.
observer, it is not always easy to discern the

524
precipitating factor.

Vignette #2

This particular afternoon spent downtown shopping had Harry and Elliot are brothers. Harry is almost years old
been difficult. Sonia's mother became exasperated as a and Elliot is 3 1/2 years old. These boys are also
result of Sonia's incessant chattering and whining, and members of a middle-class professional family. Their
felt impotent as a consequence of her inability to control mother is a university professor and their father is an
Sonia as she would have liked. Sonia experienced the administrator. Although not spared the intense
frustration that results from having succeeded in emotions, strivings, struggles and jealousies associated
attracting essentially solely negative attention from her with sibling rivalry, these boys tend to get along quite
mother. well.

Neither member of this dyad felt understood by the

other. In the car on the way home, Sonia broke into
At the supper table one evening, Harry asked to have
song. The tune was reminiscent of the blues and the
cake for dessert. His mother refused, reminding him of
Iyrics of the refrain were as follows:
the family "junk food" restriction, that is, that sweets
were limited to weekends and that during the week fruit
constituted dessert. Both children protested and began
Big people, they don't understand childs
to enumerate a variety of reasons which rendered it an
(bis)
acceptable if not a propitious moment to break the rules

525
and declare an exception. Their mother was not
influenced by the barrage of demands and steadfastly
Vignette #3
maintained the pre-established limits. The children
began to whine, to demand, to beg, to yell and to John is 4 3/4 years old. He is totally independent for his

threaten to misbehave! When it was evident that their toileting needs. The only factor that inhibits his

mother was not to be swayed, the expressions of anger independence in relation to these particular functions is

and protest ceased, and Harry began spontaneously to his fear of the dark. His parents are aware of his fear

sing a song with an upbeat rhythm. The Iyrics stated and consequently leave the bathroom light on for John

that there would be throughout the evening. On rare occasions,however,

they forget and this lapse of memory makes it
no, no, no cake today,
necessary for John to ask to be accompanied to the
but the weekend would soon be here to stay bathroom.

Harry's brother Elliot promptly joined him in song and One day, when John was home alone with his mother
both boys began to march around the kitchen, shouting and his younger siblings, he requested that his mother
out the words of their song. When they finished singing, accompany him. Unable to do so immediately, she
they returned to the table and had fruit for dessert informed him that his options were to wait for her or to
without any further protest. go immediately by himself. Unable to wait, John made
his way to the washroom hesitantly and reluctantly,

526
humming softly all the way. aware of the necessity to have a particular talent or skill
in order to create music. They all demonstrated the
ability, in a truly spontaneous and creative fashion, to
Pinchas Noy (1968) refers to the universal aspect of the
use music to help themselves control and /or master an
musical language but states that there are individual
aspect of their environment, their life experience and
differences in the capability to use the language.
their "selves". More specifically, Sonia was able to use
her song to comfort herself and to communicate to her
mother in a direct fashion her feelings regarding not
Not everyone hearing it is sensitive enough to enjoy
being understood. Harry and his brother Elliot were able
listening to it, to understand it, and to respond to it. Only
to use music to aid themselves with their impulse control
a few people can reproduce musical sounds, and even
when faced with a situation in which their desires were
fewer are gifted enough to be creative in it. The ability to
thwarted by their mother. The song allowed them to
use this language, be it as the creator, the performer, or
accept the established limits and to anticipate their
the discriminating listener, is by no means a property
future gratification. John's humming may well have
common to all mankind. Rather, it requires a special
represented his successful attempt to master his fear by
talent, of which those endowed with it have each their
combatting his sense of being alone. This is analogous
own measured share. (p.337)
to our stereotyped view of the role of whistling when
confronting danger by oneself. Sonia and the boys all
Fortunately, the children described above were not demonstrate the manner in which children can

527
creatively manage their affect through music. universal musicality and embody this concept in their
term "the music child". They do not restrict this concept
to the child with special musical gifts, but rather focus
Perhaps it is not necessary to view musicality as a
..attention on that entity in every child which responds to
possession of the few. Victor Zuckerkandl (1973) offers
musical experience, finds it meaningful and engaging,
us an alternate view of musicality other than that of a
remembers music, and enjoys some form of musical
special gift. He defines musicality as "...an essential
expression. The Music Child is therefore the
attribute of the human species." (p.7)
individualized musicality inborn in each child: the term
has reference to the universality of musical sensitivity
the heritage of complex sensitivity to the ordering and
The implication is not that some men are musical while
relationship of tonal and rhythmic movement; it also
others are not, but that man is a musical animal, that is,
points to the distinctly personal significance of each
a being that for its full realization must express itself in
child's musical responsiveness. (p.1)
tones and owes it to itself and to the world to produce
music. In this sense, musicality is not something one
may or may not have, but something that along with
Where does this musical sensitivity originate? Man's
other factors - is constitutive of man. (p.8)
musical experience, from an ontogenetic perspective,
begins in the womb. Vascular vibrations, respiration and
the mother's heartbeat are all integral components of
Nordoff and Robbins (1977) reinforce the concept of
the intrauterine environment. Sound is transmitted to

528
the foetus through the amniotic fluid and conducted baby emits his own sounds which enable him to enter
through the bones in the head. The mother's activities actively into interaction with the significant objects in his
and movements are experienced as rhythmic rocking environment. His cries are characterized by variations in
motions. The impact of this sound/vibration/motion pitch, intensity, tone quality, rhythmic motifs and tempo.
environment upon us becomes evident when we In effect, the elements of both vocal and musical
recognize the powerful effect that rocking has on infants communication are emerging, and the eventual advent
and young children in distress. A study conducted by of babbling provides the remaining building blocks of
Byrne and Horowitz (1981) demonstrated the verbal communication. The early vocalizations allow the
effectiveness of rocking as a method of comforting baby to express his needs and when the environment is
newborn infants from one to three days of age. Dr. Lee responsive, these needs are met. Sound-making
Salk (1960) studied the use of the sound of a heartbeat permits the baby to elicit a nurturing response and
as a source of nurturance, comfort and security for allows both the baby and the caretaker to locate
infants and found that newborns gain weight more themselves in space relative to each other.
rapidly, are less restless, have fewer gastrointestinal
Ostwald (1973) stresses the importance of sound as a
upsets and cry less frequently when a recording of an
means of communication.
adult heartbeat is played continuously.

No person can live in isolation from others. Sound is an

At birth, the baby's relationship with the sound
all-important medium for breaking through one's shell to
environment is no longer a purely receptive one. The

529
make contact with people. From birth to death the speech patterns resemble more and more closely those
individual screams, gasps, rattles and calls in order to of the adults who surround him.
let others know where he is and what he is doing. (p.39)

What a pity, we may add, for as we well remember,

Through a process of imitation and reciprocity, whereas Sonia was able to sing her feelings and
language is slowly acquired. Before the child is able to thoughts, her mother was not afforded as easy an
comprehend the actual content of a spoken message, expressive outlet. In our society, children spontaneously
he is sensitive to the music of the verbal communication engage in creative processes which are akin to those of
which enables him to grasp the emotional tone. For the recognized artist. As Aaron Copland (1952) says
example, an impatient tone is recognized as such prior about composition: the need to create is linked to self-
to the child's capacity to understand the content of the expression;
verbal message, itself. The child, the "Music Child",
hums, chants and whines his way to improved verbal
communication. At a certain point, however, society, in ...the basic need to make evident one's deepest feelings

the form of parental figures, intervenes. The four, five about life. The reason for the compulsion to renewed

and six year old child is reminded regularly by his creativity, it seems to me, is that each added work

parents to no longer whine or singsong, but to speak brings with it an element of self-discovery. I must create

like a big boy/girl. The child's spontaneous music- in order to know myself and since selfknowledge is a

speech is no longer allowed free rein, and the child's never ending search, each new work is only a part-

530
answer to the question "Who am l?" and brings with it related to the role of the provision for creative/healing
the need to go on to other and different part-answers. use of music within the therapeutic context and its
(p.41) impact on the developmental and environmental
prerequisites for the natural use of music will be
addressed.
In parallel fashion, young children engage in a similar
creative process of self-discovery. As Maslow (1959)
says: REFERENCES

Byrne, J.M. & Horowitz, F.D. (1981). Rocking as a

soothing inter- vention: The influence of direction and
Almost any child can perceive more freely without a
type of movement. Infant Behavior and Development, 4,
priori expectations about what ought to be there or what
207-218.
must be there or what has always been there. And
almost any child can compose a song or a poem or a Copland, A. (1952). Music and imagination. Cambridge,
dance or a painting or a play or a game on the spur of Mass.: Harvard University Press.
the moment, without planning or previous intent. (p.86)
Fleshman, B. & Fryrear, J.L. (1981). The arts in therapy.
Chicago: Nelson Hall.

The implications of these natural therapeutic uses of Fromm, Erich. (1959). The creative attitude. In H.H.
music for the clinical setting will be discussed. Questions Anderson (Ed.), Creativity and its cultivation (pp. 44-54).

531
New York: Harper and Row. Hague: Mouton and Co.

Maslow, Abraham H. (1959). Creativity in self- Salk, Lee. (1960). The effects of the normal heartbeat
actualizing people. In H. H. Anderson (Ed.), Creativity sound on the behavior of the newborn infant:
and its cultivation (pp. 83-95). New York: Harper and Implications for mental health. World Mental Health, 12,
Row. 168-175.

May, Rollo. (1959). The nature of creativity. In H.H. Saltman, M. (1977). Adult play therapy. In B. McWaters
Anderson (Ed.), Creativity and its cultivation (pp. 55-68). (Ed.), Humanistic perspectives (pp. 35-52). Monterey,
New York: Harper and Row. CA: Brooks/ Cole.

McDonald, M. (1970). Transitional tunes and musical Zuckerkandl, V. (1973). Man the musician. New Jersey:
development. Psychoanalytic Studies of the Child, 25, Princeton. Connie Isenberg-Grzeda, MMT, MTA, RMT-
503-517. BC Universit du Qubec a Montral

Nordoff, P. & Robbins, C. (1977). Creative music

therapy. New York: Harper and Row.

Ostwald, P. (1973). Musical behavior in early childhood.

Develop- mental Medicine and Child Neuroloqy, 15,
367-375.

Ostwald, P. (1973). The semiotics of human sound. The

532
 T H E PR O C ESS O F M U SI C T H ER APY WI T H A snuffles and weak cries were the backdrop to the busy
B R A I N I N JU R E D P A T I E N T I N C O N JU N C T I O N sounds of carers going about their daily tasks. As I was
WI T H M ED I C AT I O N R ED U C T I O N leaving the ward and trying to consider the prospect of
takinq music therapy sessions here I heard the sounds
D IANNE L ANGAN
of this patient:

INTRODUCTION
TAPE EXAMPLE 1: (A series of very primitive and
My second day as a music therapist at a three hundred distressed screams.)
bed Centre for Aged Care was an instant lesson about
the end of the road for some ot the more unfortunate
members of our aging society. I walked through a ward Upon locating the source of these frighteninq sounds I
in which huddled shapes, often with contorted faces was astonished to find a patient, a middle aged woman
were aiready in bed by three o'clock in the afternoon. No laying on a bed - a feedina tube into her stomach ana
patient was mobile, rarely would thev drink unaided and full length splints on her legs. Her eves were those of a
thev were all hand fed by nursing staff. A coherent trapped animal as they returned my gaze. It is not a
conversation by a patient was rare if not impossible. The surprise then that this patient became one of my
audible environment also added to the impression that regulars for therapy.
these patients were consciously or otherwise awaiting
release from their totally dependent lives. Moans,

533
This paper hiqhliqhts aspects of the case study of a
woman. forty three years of age who attended therapy
"at present such people have to live in nursing homes".
sessions for seventeen months. She had suffered major
(Bright 1982 p5). Which of course cannot offer all the
brain trauma due to severe global anoxia several years
rehabilitation opportunities that might benefit this type of
prior to our first therapy session.
patient. Perhaps it is a reflection on our health system
that although this paper was written in 1982 we still do
not seem to have progressed very far in terms of
It may appear strange to find a Patient with such a
providing adecuate care for all of our brain injured
condition in a ward within a Centre for Aged Care. but at
patients.
present our health system just does not offer very much
by way of alternatives. Briqht refers to this dilemma in
relation to her work in a Head Injury Unit. She refers to
Perhaps it is more a case of being slow to change. The
patients
ideas about recovery rates of brain injured patients are
expanding the research indicates that tne recovery
process may take lonqer than the traditionally held
"that will never again live either at home or in hostel
views of 6 to 12 months after the injurv. Research by
accommodation"
Klonoff. Low ana Clarke (1977) reported that " 76.3% of
head injured children and adolescents make a marked
and explains that recovery over a 5 year follow-up period " (in Wliliams

534
and Long 1987) 1. Why this patient ?

A music therapists ' motives for working with a

particular patient.
Several major themes were evident tnroughout tne
process of music therapy with Kate: 2. Maintaining professional separation from tne
patient and balancing it with the empathy required, not
allowing yourself as a therapist to become too involved
1. Music therapy and medication reduction.
and consecuently to lose direction.
How can the music tnerapist assist this process ?

2. How does the music therapist communicate with

I will now discuss some details of Kate's process
Such a severely damaged patients ?
tnrough the music therapy process as it relates to these
Issues of subjective interpretation. Music therapist themes.
under question. Relating communication process to
theory of mother-infant communication development.
THE MUSIC THERAPY PROCESS WITH KATE

PRESENTATION: Kate is contined to a water chair

Several questions pertinent at particular stages of
during her out of bed hours. This style of chair is rather
therapy:
like a large armchair which provides the support she
requires for sitting up. She has movement of arms and

535
legs restricted by hemiparesis of the right arm. She has
the ability to use facial expression gesture including
However. t was clear that my decision to work with Kate
hand grassing. She also uses vocalisations although no
was certainly not a purely academic one. The effect that
real verbal language in the traditional sense. Kate
the first of her screams had had remains.
appears to be quite alert with a meaningful gaze wich
will track familiar people ana selected activities.
MAINTAINING A PROFESSIONAL
SEPARATION:
WHY THIS PATIENT? Why did I choose to work with this
patient instead of the multitude of others seemed that Around the third and fourth month of therapy with Kate I

this patient was asking - crying out tor help. Those initial found myself wondering where the music tnerapy

screams Of extreme distress that first drew me to Kate sessions were heading. The major aim of my work with

's bedside were tangible and intermittentlv recurring Kate was always directed towards opening the channels

reminders of the horror of her condition. Her injury nad of comunication practically. I was continuing to try to

been caused by a medical accident and this made it develop and provide opportunities for some basic

more difficult for family and carers to accept her exchanges. for example: turn taking passing

condition. Staff made themselves available to discuss instruments. responses to my music making. trying to

Kate 's case with me and were very pleased that I could foster " attunement " using Daniel Stern s term for

devote some time to her. motner-infant interaction. (Stern 1977 ) I was continuing
to experiment. to offer new experiences and to explore

536
any relic of memory tnrough offering music familiar to
her previous life. Still the therapy was not progressing
In response and support of monitoring the reduction of
as it snould. it felt stuck and lacking direction.
medication I set out to survey some behavioural
indicators of Kate 's condition.

Two events re-directed me from this feeling of being

immersed in the situation. The first was a supervision
SURVEY:
session with a senior music therapist who after watching
video tapes of Kate 's sessions identified that I was The survey was used to give some observational

allowing Kate's strength and greedy demand (hints of support to the impressions that staff received from Kate

Melanie Klein 's greedy infant ) to dominate. I was during their daily exchanges with her. it was not

allowing involvement in each therapy session to be so intended as a valid piece of experimental research and

complete that I had been losing sight of direction. it was designed to be accessible and not a chore tor
staff.

The second event that prompted a re-direction was

through discussion with staff regarding a plan to reduce Staff were asked to record the occurrence of various

Kate 's medication. Staff wanted to find out who Kate selected behaviours daily as frecuently, sometimes or

really was " let 's get rid of some of the masking effects none.

of tranquillizers.' The behaviours were:

537
 COMMUNICATION ATTEMPTS:

NEGATIVE BEHAVIOURS: * alert

* agitated * vocal

* aggressive * smiles

* distressed * communicative ( generally)

* self-destructive * demanding

* aspears angry * eye contact

* responds to greeting

PHYSICAL ACTIVITY: * responds to instruction

* calm

* grasping The survey took place over a period of 11 weeks

beginning soon after the programme of medication
* physically active ( generally)
reduction had begun. The survey was filled in by staff
* changing facial expression on a daily basis to approximately 70% which seems to
be a positive indicator of the staff 's commitment to Kate.
Especially as I was only in the ward for 2 hours per week

538
to follow up its progress. pattern although it never again peaked as it had done at
the time of the illness.

SURVEY RESULTS
PHYSICAL ACTIVITY:
NEGATIVE BEHAVIOURS:
lt seems that staff considered Kate to be predominantly,
Kate was regularly taking 25 mg of Thioridazine - a
physically active. This information of course has limited
tranquillizer which is reportedly an average dose. A
value - it really needs to be defined (if possible ) into
reduction was made to 10 mg per day. It was not
categories of intentional compared to involuntary
sustainable after about 2 weeks. Kate contracted a
activity.
chest. infection which caused an ncrease in her
negative behaviours to the extent that staff needed to
return to original medication levels. Her negative
COMMUNICATION ATEMPTS
behaviours included self destructive behaviours such as
scratching hair pulling and digging at her gums with This was the area of results which was most helpful to

fingers with subsequent infections of the fingers. me in the understanding my music therapy practice. lt
supported my view that Kate was in fact making great
efforts to reach out to people - that she recognized both
Following this period of illness the incidence of negative her need for communication and the fact that it was
behaviours did not snow any really distinguishable through her efforts to relate to myself and staff that

539
would give her the feedback that she needed. It was elements of the process. mirroring ideas from mother-
encouraging to have my subjective interpretations of infant interaction theory. I used much repetition,
Kate's behaviour within tnerapy validated by staff reinforcement through all sense simultaneously for
observation. example a greeting would be auditory - singing. visual -
eye contact sensory - physical touching, and
emotionally perceivable tnrough sincerity upon the
Despite the unscientific quality of this survey and its
therapists part.
need for refinement and development it seems to be an
easy method of accessing information with the added
benefit of fostering communication and links to staff. ln support of using the mother-infant interaction model
with brain injury I will cite woodcocks comments which
refer to Daniel Stern 's work. He explains that an infant
Returning to the case study now I would like to re-focus
develops a sense of core self through interaction with
on the 2 major themes of medication reduction and
the mother. (Woodcock 1990) This is a vital area in
communication.
brain injury recovery as a limited self-awareness is often
an important symptom ot the injury. Finger explains that
in terms of neurological rehatilitation perceptual
Firstly the issue of communication . In my music therapy
disorders of self awareness need to be reduced to
methods I tried to use communicative attempts that
"facilitate greater recovery of higher cerebral
might be within Kate 's abilities. I attempted to isolate
functioning " (Finger 1988)

540
I do not intend to describe the music therapy process in I think of Kate's vocalisations as comprising of 'singing"
any more detail at this stage. I would however. like to and 'verbal " elements. The 'verbal" components being
p1ay a short extract f'rom a session approximately one those expressions which use less pitch and do not
year into therapy as a way of summarizing the therapy promote the impression of musical phrasing.
process. Considering the 'singing" input it seems that she is able
to use rhythm. contrasts of tone and also to include
some emotional content. ln reflection of Bright's
PLAY TAPE 2 : I call this Kate's song.
description of the typical head injury voice which is:

"a flat dead voice. which lacks inflexion. emphasis or

What I heard was a surprising comparison from the rhythm. (Bright 1980) it would seem that Kate is doing
harsh and distressing vocalisations of the first session quite well at her communication skills. I do concede that
to an extraordinary refinement and totally different I am stretching the definition of voice to include Kate's
application of Kate's vocal abilities. Kate uses pitch. sounds but it is perhaps something that therapists are
nitiations at the ends ot phrases and appears to be entitled to do as long as they recognize that this form of
developing a mayor communicative skill for herself. conceptualizing is for the purposes ot identifying a
When you consider- the time context for recovery and model or another way of understanding their patient.
rehabilitation in brain injury patients it seems that Kate
has really achieve a something.

541
A MUSIC THERAPIST UNDER QUESTION - ISSUES This experience emphasizes some of the major issues
OF SUBJECTIVE INTERPRETATION: that we all face at sometime in our proffessional life:

In the course of my work with Kate I was required to 1. What theoretical issues underlie our work?
validate tne subjectivitv of my interpretation of therapy
2. Is it of benefit to us as a profession to be
sessions. I found myself under question giving evidence
borrowing theories and models from other fields ?
in a court of law about my work with Kate. ln this
situation I was not in the position in which I could 3. Do the problems of explaining our work to others

contribute information that I thought relevant - I was lie in the fact that we are trying to use another model?

instead asked questions like: 4. Do we as a profession really need more

" Kate made no response during that flute episode - how objectivity or is it only required of us by pressures to

do you interpret that ?" justify and to be accountable in a scientitic tradition?

Was she maintainig eye contact through choice or SUMMARY

because she was facing you in the chair? The line of The challenqe of working with brain injury for the music
questioning was based on the mistaken assumption therapist is an enormous one - but it seems apparent
that music therapy is a science and therefore my that it is an area desperately in need of development
answers were quite difficult to formulate. and research. it can be seen that it is possible for a
music therapist to support the process of medication

542
reduction even if that process is not sustainable at the Therapy Association August 8-10
time. Staff working with Kate gave many indicators that
2. BRIGHT. R. (1982) Music Therapy Programmes in a
they were grateful that I was working with her. The
Head Injury Unit. In Proceedings 8th National
direction for music therapists seems to be towards the
Conference. Australian Music Therapy Association
development of rehabilitation.
August 6-8.

3. FINGER. 8..LEVERE. C. (1988) Brain lnjury and

Kinsella states that Recovery AlMI. C..& STEIN. D. Plenum Press. New YorK
and London. (editors)

4. KINSELLA. G. (1988) Observations on a case of

"information about process of recovery and the efficacy
Recovery Following Head Trauma in Proceedings l3tn
of remediation is still comparatively rare". ( Kinsella
Annual Brain lmpairment Conference. Australian
1988) It seems then that the traditional medical team
Society for Study of brain lmpairment September 2-4.
need some support. They need our ideas our work and
most of all our research 5. STERN. D. 1977 The First Relationship: infant and
mother Cambridge. Mass, Harvard University Press.

6. WILLIAMS. J. & LONG. C. (editors): (1987) The

REFERENCES:
rehabilitation of cognitive disorders. Plenum Press. New
l. BRIGHT. R. ( 1980) The Head Injury voice. In York & London
Proceedings 6th National Conference. Australian Music

543
7. WOODCOCK. J . ( 1990) Communication through My music lessons are for mentally disturbed criminal
Music: What is Communicated? Communication. offenders, receiving treatment in the aforesaid clinic.
Proceedings of British Music Therapy Annual
Conference 10th November.
When I decided to speak about my work at the clinic in
this congres, I was automatically forced to evaluate the
intrinsic worth of my task and in what way it could be a
PO PM U SI C AS L EAR N I N G T H ER APY F O R
contribution to the subject of this congres.
M EN T AL L Y D I ST U R BED C R I M I N AL
O F F EN D ER S; EVAL U AT I O N S O N T H I R T EEN
YEAR S O F PR AC T I C E
I started by collecting ideas and examples of practical
M ARCO F. NAARDEN : expierience. This however, did not lead to a hoped for
clear line of thought. On the contrary; because my
method of work is so purposefully individu al, there are
Ladies, Gentlemen. almost as many methods as there are patients.

Presenting a complete picture of the diverse methods

Please allow me to introduce myself: My name is Marco would only lead to picturing a chaotic image.
Naarden. I'm a music teacher at the Henri van der
Hoevenkliniek, a clinic for forensic psychiatry.
So I worked it out having in mind: How can I incorporate

544
my experien ce of working with music as a therapeutical A Court of Law may impose TBS when it assumes
device in a contribution to this congres. "diminished responsibi lity", based on a psychiatric
report.
It became clear to me that I had to make an evaluation
of my own professional identity, not a bad idea after One of these institutions is the dr. Henri vd
thirteen years, and translate this into a presentation. hoevenkliniek, where 75 in-patients are being treated.

But before I come to this I think it necessary to introduce The criminal records of the patients admitted include
a view of the clinic, the patients and the therapeutic robbery, burglary, violence, sexual offences, infanticide,
methods used. In extention of that, I will mention the manslaughter and murder.
importance of the music lessons within the treatment
programme. In the second part I would like to enter
matters of practice. To form an idea of the patient population some general
features may be mentioned.

About 10 % of the patients are women,and 70% of the

In Holland we have 7 institutions for the treatment of the
patients are between 20 and 29 years of age.
mentally disturbed criminal offender.
In recent years the number of young patients has
Most of these offenders are admitted to treatment
markedly increased. Most patients have lower
institutions under a special penal measure, the so called
educational levels only.
TBS.
Most of our patients have spent many years in

545
institutions of various kinds, they have been exposed to
a great ammount of agression in their youths and have
The therapeutic philosophy of the clinic contains
shown sincere antisocial behaviour.
elements of many therapeutic schools. Psychodynamic
Patients in the clinic are often involved in chaotic social and interactional concepts prevail, whilst behaviouristic
and family relationships or are socially isolated. techniques are sometimes applied.

They seldom have any friends or peer relations, and Music fits in as one of the nine creative activities. Other
many of them are seriously addicted to drugs or alcohol. skills include: drawing, photography, manual
expression, mime, acting, creative play, sculpting and
modelling.
They tend to blame others for their problems and not to
take responsibility for their own behaviour, let alone that
of others. The task facing the patient and the workers in My method of working is generally influenced by three
the clinic is to try and determine why the patient's life statements, which at first sight seem to be in conflict
has taken such a course and how he can best be helped with each other:
to adopt new forms of behaviour, so that he can return
to society. It is important in this respect to make an
inventory of the personal resources of the patient and to Op sheet I of op whiteboard:

mobilize them.

546
1) We speak about treatment and not Punishment

2) We speak about Patients but we do not always treat 2) Generally our patients tend to a haphazard
them as being ill. development of their personalities.

3) We speak about music lessons and not music- In some aspects they show maturity, in other
therapy. childishnes. To appeal to only one or the other would
not do the patient any justice. Because as I have stated
I will now go into these matters briefly, but they will pop
before, we do not approach our patients as being solely
up later on in this lecture frequently.
ill, I think it of utmost importance to appeal also to their
healthy selves, and have them take their own
1) Although this is true, the patient is usually admitted to responsibilities. The word patient implicates a possible
the hospital against his will.(sheet 2) This fact has cure. Therein lies their and our tasks.
significant implications on the degree of Patient co-
operation and motivation which is generally poor.
3) I have been appointed as music-teacher, so I teach
The great variety of aids and fields of exercise is of
music. This music-teaching however, forms an essential
great importance.
part of the therapyprogramme, so it is of importance to
Frequently, if a patient refuses to co-operate with his evaluate the therapuetical effect.
treatment, he might still develop an interest in sport,
music, or another creative skill.

547
So this makes me a teacher and a therapist at the same behaviour has led him to forced treatment in our clinic of
time. This may sometimes be confusing, but on the which my lessons take a part.
other hand it can make things also a lot easier.
It is quite a different thing to say to a pupil: "this is your
exercise, you must practice at your home."

About my teaching: As opposed to: "You must practice in your room."

What is special about teaching a patient to play a This implicates a totally different relationship.
musical instrument in general?
You involve yourself much more into their private life,
-I confer my lessons to my students. you participate in their dayly routine.

Nothing special here, that is the general mode of any

musical teachers.
Another difference regarding normal music lessons is
-Just making music can have a therapeutical effect. that we have a secondary goal apart from learning to
play an instrument, and that is the indication to follow
But doesn't that apply to all of us? I can hear you think...
music lessons.
So it must be the special relationship with my pupils
Herein lies formulated what a patient can learn by
which makes te first real difference; The reason for our
means of these lessons towards an alleviation of his
acquaintanceship is not because the pupil has a
problems.
spontaneous desire to follow music lessons, rather, the
patient has had a past in which his aberrational

548
The indication is a circumscription of certain aspects of that this effect is purposefully planned for.
these problems, more than that they are didactical,
The patient's progress is measured by the aforesaid
musical technical terms.
effect.
For instance: Let your emotions be heard; learn to
The relation between teaching and it's therapeutical
concentrate; learn to co-oporate; learn to relate with
value becomes clearer at this point. In my working
your environment; to cope with criticism in an adult way
method one supplements the other.
and to gain self-confidence out of ones own progress.

These are the many heard indications.

Of course the patient himself knows about my activities
But also developing a hobby and/or learning to master
in the clinic, as he can hear others practice and he will
an instrument could be the goal, could be relapse
mostly be informed by other patients.
preventative.
Un-underestimated is the value of an enthousiastic
Often, just doing something for their own pleasure can
fellow-patient.
be quite a new experience for our patients.
This usually is more effective then any introductional
And again one could say: "There is nothing really
talk made by me.
especial to this, all these effects can be observed in any
He enters my room already knowing:
seriously given and taken music lesson.

Of course this is true, but the difference lies in the fact

549
MUSIC IS FUN! These programmes are attuned to the specific
problems of each patient and are aimed at better
Fun... music lessons.... Learning Therapy... This means
intellectual, emotional and physical functioning. This is
that therapy is fun...
what we have to work out, and it doesn't sound like fun
BUT WHY THE HELL SHOULD IT BE?
to meat all.... [korte pauze]

However, as I also mentioned before, motivation to

These man have raped, killed people, Set fire into other treatment is, due to the forced character, very low.
peoples'houses. If, within this compulsive situation there is something
They have no right for FUN. they really enjoy, than we must follow. If you can
achieve such a form of contact, you have reached an
WHERE IS MY PROFESSIONAL IDENTITY???
important moment. If this contact is sincere, the
problems will surely occur, and he is, though cautiously
The word patient implicates as I said before a possible "in therapy".
cure, therein lies our, my task. That's more like it.

For our patients and society this means that we have to -The average rapist for instance shows no
work on minimalising the risk of relapse. consideration with others at all. He just goes on to get
To achieve this, a treatment programme is drawn up for whatever he wants. If you are working with him his
each patient. behaviour will definitely cause problems. If he is

550
enjoying himself however he might be prepared to to be of greater importance, and I shall try to find the
correct this, you can direct a little, work in a group. After correct communicative mode.
that period we can step by step formulate a goal
oriented indication, and he has some experience in
recognizing this behaviour. -The conditions for making music together refer to their
capabilities in social behaviour which in most cases is
An example of this is a man in his mid twenties. He likes
poorly developed or emotionally blocked, as is their
playing the bass guitar, but he is practically unable to
ability to solve problems. In a playful way and without
attune his playing to his fellow-musicians. He "solvesw'
labelling it we work on an important aspect of their
this problem by setting his volume at such a level that
problems.
nobody hears but him. This leads to conflicts within the
group. His goal: making music is thus disturbed by his
own shortcoming, as he reluctantly admits. Listening -The urge for excitement is in many cases closely
and considerating the others now becomes his major attached to committing crimes, therefore it must not be
condition to get what he wants. underestimated how making music can form an outlet,
an exhaust valve for emotion and agression. In that
case I dare even speak of a safety valve.
-It also happens that they simply refuse to attend the
lessons when an official indication is linked to it. I then
think the enclosed therapeutical effects of making music -To heavily addicted patients the only effect might be

551
that his mind is distracted for a moment. for further development.

-And of course there are those who want so little out of With this in mind I would like to enter the second part of
life that when they do voice a whish to participate, the my discourse:
opportunity must be grasped.
How does it look in practice.

So he might only do this, quote: "just for fun, not for my

My lessons consist of learning to play one of the
treatment" unquote. But then again he is, of course, in
following instruments: Guitar, Bass-guitar, piano,
therapy.
drums, and electronic keyboards.
His motivation grows by the results he makes and his
Also we often sing; At least 30 percent of my pupils take
resentment against the treatment might lessen.
singing lessons. This, in accordance with the meagre
It is also a moment for him when he does not, quote: singing tradition in Holland, is a very high percentage.
"have to talk again", although of course talking often Absence is low.
occurs in situations where there is no real need for
discourse.
I always start on an individual basis with each new pupil,
A confidential relationship may arise and in many cases
with the direct purpose of achieving a better
this will lead to an opening, a beginning to clear the way
acquaintance.

552
In a short preliminary conversation we shall try to 2) Pop-music is ego-fortifying, quickly results in an
determine a choice of instrument and we shall start amplification of self-esteem, of wich they have usually
playing soonest. In this phase the finding of mutual trust very little, or a very twisted idea.
is of utmost importance.

If you are able to find the correct individual mode of

I usually work with pop-music and I have diverse working, and prove to the patient that he can enjoy what
reasons for this: [sheet] he is doing it can be marvellous to see shyness of
expression just disappear.
1) Surprising results can be achieved with a minimum of
technical knowledge. 3) Pop-music strongly invites people to work toqether in
small groups, wherein everybody has a clear function.

This automatically means traininq in communication

This is of importance because there usually is no
and co-operation.
preliminary musical education of any level.
Perseverence is low, and if the idea is acquiered that it
will take hard labour and a lot of time before satisfying
4) Another factor though, is that working with popmusic
results are achieved, many patients are quickly
is the result of adressina the adult part of the patient.
demotivated.
The generation I work with has a strong affinity for this
music, and are quiet knowledgeable on the subject. If

553
they want to make music, it must be their own music, faces. [tape]
with real instruments.
By endless repetition of actions he already masters, and
a repetitive introduction of new elements he had
learned to play his melody, using a simple figure
Given his possibilities and indication we must try to find
notation and by showing him how to move his fingers.
the means of teaching, that best suits each patient.
He has to read, move his fingers and adjust his playing
For slow students it must be a matter of fact they have
to what he hears all at the same time.
the right to be slow.
This posed extreme difficulties to him. His indications
In many cases I have to work years at almost the same,
were: "listening, and adjusting your actions to your
low level.
environment, not despairing when you make an error,
This demands patience and inventivity to keep the and creating a hobby."
lessons interesting.
The last part of the indication led to the instrument
chosen, while the first and second influenced the
chosen method of learning. In the first period of our
In the following example you shall hear/see that
working relationship he demanded such high results
sometimes it takes an enormous effort for a patient to
that he was bound to fail. Something that had bothered
play "I did it my way " with one finger on a keyboard. It
him outside the music lessons as well and among other
was recorded on one of the annual concerts. (Walter
problems had led him into serious problems. He
van Mansom) For obvious reasons I cannot show any

554
became raged with anger over me or himself when Unlike for instance drawing lessons, one does not only
repeatedly failed to fulfil this demands, but the sheer joy work together in the same room, but also on the same
in making music kept him going. It took a long time for piece of work.
him to learn to trust me. His experiences in his life
trusting people had only led him to disappointment and
even abuses, as he later on started abusing others. In They have to listen to, and to react upon each other.

the end, is after approximately three years he managed This can lead to difficulties.
to perform his skills as you have just witnessed. You
More often than not the patients' attention is distracted
have without any doubt noticed that he did not at all play
at themselfes, when in luck at my directions, and very
flawlessly, but he continued, in his best suit, before an
seldom at the other patients.
audience of over a hundred people, trusting on my
accompaniment. What we did not achieve was the other Sometimes an individual lesson is solely used for

part of the indication: adjusting your actions to your exercises in listening and reacting.

environment, since as you must have noticed it was I The discovery of unexpected talent is one of the most
who did the ajusting part. Every experiment on that exhilarating aspects of teaching.
behalf led to sheer panic because his delicate trust in
Sometimes these talents can be quiet extensive, as in
my support was then being disturbed.
my last example; allow me to refer to this gentleman as
C. C. is a young man with foursquare judgement
concerning his environment, including himself.

555
He compensates low self-appraisal with agressive Appears to have absolute pitch.
behaviour.
Every time he hears a new song, he automatically takes
His indication for music lessons is: learning to value his up the song's key, and it takes him great effort to start in
own achievements. another key, even though this might better suit his voice.

Only being the best can satisfy him. He has to succeed in what he thinks is the right version.

Music is his great passion; he has an enormous record- With the help of two recordings, I was able to pursuade
collection and owns expensive audio-equipment. him that everybody has to choose the individual key
which suits ones voice.
Let me take you to the day we started working together.
C. bought an electric guitar and besides his singing also
We had singing lessons.
had guitarlessons.
It became clear that he had a good voice and was
Although not technically gifted on this instrument, he
definitely musically talented, although he disagreed with
learned to play certain songs and exercises by ear, and
me when I told him so.
soon started improvising..
He sang almost every song without effort, and could
However, he refused to take up any theoretical
improvise a correct second voice accompanying my
knowledge.
singing..
With his natural talents he was quickly incorporated into
The only mistake occured when I transposed to a
a band.
different key. C.

556
Here he discovered that to be an acceptable musician, In the next session he again displayed his disability to
talent is not all it takes. cope with criticism: C. completely let initiative to the
others, did not himself take any initiative at all and
Though he worked with expedience, he was not able to
watched scornfully laughing at how the band-rehearsal
relate his ideas to the other band-members, because
failed completely.
they simply were not able to learn as easily by listening
only. And again I confronted him with his behaviour.

This lead to serious conflicts. "Why is it always my fault" he replied in feigned

innocence.
He quit, humiliated the others and left, slamming the
door. I told him it is difficult to explain something when one
does not know the correct definitions.
In an individual lesson we discussed his behaviour.
I suggested that in this respect it might help him to learn
He put the blame on the others.
the theoretical background of what he already mastered
He stated that they were not acceptable as musicians, in practice.
and that he was the only one working for the group.
In the end we took up lessons in musical theory, much
I explained to him what I thought had actually taken against his own will.
place.
We also started an exercise in which he indicates how to
He did admit he did not allow the others any possibility be accompanied in a song that is known to him only.
to express critisism or to voice their own ideas.

557
This resulted in the following. [cassette aan "somebody formed, with C. as lead-singer and guitarist.
"] (indien weinig tijd: resulted in a... duet.
There was a standing agreement that everybody had
an equal contribution to pay in the repertoire.

In the annual concert C. outshone all others with an The following concert surprised everyone with a totally
exceptionally good rock act. different presentation.

He sung flawlessly and looked professionally agressive The music as well as the band's presentation differed
at his audience. radically.

On the other hand, one day he surprised me by They were visibly working as a real team and their
confessing his trully favoured music: Irish Folk-ballads. performance radiated fun.

He sings them with an amount of feeling, although I was C. sang two of his favourite ballads to conclude the
not allowed to compliment him on this matter. concert.

It became a major part of our individual lessons and the He among others was complimented on the whole
repertoire of the band also evolved to a greater diversity performance and C. especially on the amount of
of types of music. emotion expressed by his singing.

After having participated in my lessons for three years, I Someone stated his personal view on the quality of C's
have a group of pupils who have reached a more than previous performance, which he did not like at all.
acceptable playing-level and a new band has been

558
When I asked C. if this disturbed him in any way, C. feelings, and it gives me an opportunity to create a
replied, to my satisfaction, that this person only disliked hobby.
that performance because he did not appreciate hard-
It is important for me to be able to do something useful
rock, but that he himself felt his singing had been good.
in my spare time and I enjoy making music.
When he heard criticism of our My Way interpreter he
During music lessons you simply talk with your teacher
took his side and quoted:" Why don't you try to do better
about music, and therapeutic language is not used at
yourself".
all.
I inquiered if he could possibly have given such an
Of course I have to work on my indication, but that takes
answer three years before.
place in a recreative form." The way he subscribes his
He smilingly shook his head. letter is even more typical for what it means to him: his
name is followed by the supplement "guitar player".
In my preparation I requiered of one of the patients to
prepare a written report on what music lessons means Ladies and gentlemen, I am a lucky man to be able to
for him in relation to his treatment. say that for me work is play.

Please allow me to quote a few sentences from this For our patients I enjoy reversing this: to play music is
letter: also to work..

"The music lessons in the clinic form a welcome activity Working on an important part of their treatment.
in the treatment, because it enables me to ventilate my
And about my professional identity: There are many

559
ways in music and therapy ... share with you experiences and my personal way of
dealing with particular therapeutic issues.
I do it my way

The Oncology Department

M U SI C T H ER APY I N C AN C ER C AR E WH EN
Radiumhemmet is the oncology department of
T H ER E AR E N O WO R D S
Karolinska Sjukhuset, a university hospital in
A NNE O LOFSSON Stockholm, treating about 43.000 adult cancer patients
per year, for shorter or longer periods of time, in-
patients and out-patients.
Introduction
In the early 70 s, a Psychosocial Unit was created, to
This presentation describes how music therapy can act
study and handle psychological and social problems
as a powerful complementary to other care and medical
caused by cancer, not only to patients but also to
treatment of patients in an oncology department setting.
relatives and staff. The unit is staffed by psychiatrist,
psychologists and specially trained nurses. Except
I will give a brief presentation of the department where I clinical patient work, services include education and
work and a short background to the therapeutic needs training programmes, developmental work and
confronting the music therapist. Main focus of the research, information about psychosocial work to other
presentation, however, concerns clinical work and I will oncology units in the region and international

560
cooperation.

Music Therapy

I was appointed to the unit in 1988. My personal conception of music therapy has expanded
considerably during these years. Former experiences
My initial position was to find out a) whether music
focused on active music making, using experimental
therapy could serve a useful purpose at the department
and improvisational techniques with handicapped
and if so, b) to explore practical routines that would fit
children and youth. I now found myself exploring poetry
into the set frame of the hospital.
and art as independent expressive complementaries to
Two years later, I was joined by a nurse, presently
music, to enhance the musical experience and as
training in creative arts therapy. We now work as a
support to develop a process, initiated by music.
team, supporting each other in representing artistic and
Although every patient represents individual therapeutic
non-verbal therapies - unfamiliar in the strict medical
needs, a main objective of music therapy is getting
world.
closer to life issues and to promote coping.
Exploring the worlds of music therapy and creative arts
Music- and creative arts therapy at Radiumhemmet,
therapy, we also work across boundaries, highly
comprises mainly clinical patient work with in-patients
appreciating the possibilities to integrate different
and out-patients, individually and in groups. Other
modalities, which, we feel, affects the therapeutic work
activities include information and work shops. Aiming at
in a broadening and deepening way.
the future, we engage in further training, continous

561
supervision and preparatory research. the issues brought up:

Representing music therapy in a relatively limited field, I Encountering cancer evokes existential questions as
would like to stress the particular importance of well as psychological and emotional reactions. It
international contacts and cooperation. touches deep into the personality and previous
traumatic experiences may reappear. Progression of
A large number of our cases originate from
the disease despite treatment, implies confrontation
spontaneous contacts at the ward, but many patients
with difficult and unwanted symptoms, but most of all
are referred to music therapy by the doctor, nurse or
with a tangible life threat.
counsellor. Referrals concern states of i.e. depression,
anxiety, insomnia, tension, pain, nausea or Most cancer patients have to face a number of losses,
communication difficulties. have to accept increasing dependency and live in
constant uncertainty. It is important that subsequent
experiences, feelings and thoughts may be expressed
This presentation will illustrate how music therapy can
and worked on, in order to facilitate and support an
be used in the treatment of some of these states,
inevitable process of grieving, towards healing and
encourage healing and support personal growth.
personal growth.
Encountering Cancer
This process, particularly in an initial state, may be very
Some of you have faced cancer, personally or in your hard to verbalize.
close environment, and are thus familiar with some of

562
Modalities - creativity

Alternative modalities, such as music, art and poetry, A person who is fully occupied in managing to live
offer new or complementary possibilities of expression through the next half hour, cannot afford energy to
and communication. This fact is a strong incentive to create anything new. Instead, she fights to pull together
use music- and other creative therapy forms in cancer whatever strength is left, focusing on the most essential.
care. Recreating, remembering or recalling the richness of
her own self.
The possibilities of non-verbal expression stimulates
creativity - the process to make, to create, to shape, to
give existence.
Literature offering numerous examples, I still want to
The creative process supports what I like to call "the share an episode to illustrate my ideas;
inner motion of life" and usually leads to encountering
something new; a picture, a symbol, a feeling, an idea or
a vision. Case 1- Iris

Energetically trying out ways to meet the therapeutic Her dark skin contrasting the white bed linen, her hair

needs of the patients, I realized that creating does not left with only a stubble and her body is as frail as that of

always imply creating something new. It may be far a young bird. Sparkling eyes and a heartwarm smile.

more important to re-create. Maybe all creating is re- She is beautiful. Her room is filled with an atmosphere of

creating, in a sense? A re-creating of the self? vital forces.

563
Iris is in her late fifties, married and the mother of two
adult children. Her body is very ill and receives palliative
She expresses her deep gratitude to life, to all good
care, but no cure can hinder the inevitable. This is our
things that were hers despite problems and hard times.
first encounter and I sit down by her bedside.
"I have the most wonderful childrenl". Expressing deep
love to her husband. "When we met... he used to sing to
me..". Her eyes sparkle and she looks almost
Iris has great difficulties breathing and talking, but is
embarassed, like a young girl. "The girl that I marry will
curios about me. Music...? Yes, she has always enjoyed
have to be..." and she starts humming. Finding the lyrics
music "although I cannot do any myself". We talk about
- blessing my song book! - I fill in lost words. Her weak
the necessity of music in life. She tells me that she
voice grows stronger, louder and soon fills the whole
sometimes listens during the night, when she cannot
room. Iris she sings as no breathing difficulties ever
sleep or feels tense.
existed.
Iris falls asleep. I sit, quietly improvising on the
She died three days later in the presence of her family.
omnichord, following the rhythm of her breathing.
Shifting in and out of consciousness, she has a lot to
share and seems anxious to do so. Now and then she
The situation illustrates music in the center of life and, in
recalls fragments of songs and I try my best to support
a way, charactarizes the essence of my job.
musically. Our communication creates a weave of
memories, dressed in words and music.

564
In this situation, I functioned as facilitator, supporting emotion, energizing the "inner motion", eventually
the woman in her effort to connect and tie life s ends fascilitated key issues to be brought up.
musically. I stayed present with her, although she fell
Case 2 - Martha
asleep at times, listening to her, thereby confirming the
importance of her sharing this very private moment with Martha 's body was literally disintegrating, hardly mobile

me. and in constant pain. Sitting by for hours, days, weeks,

her husband got extremely frustrated by his inability to
help. Terrified by the present and without hope for the
Iris used personal music, in this case familiar songs, as future, the couple found themselves stuck in silence
a tool in the process of closing life. with no possibility to express thoughts or feelings.

Overcoming initial scepticism, the couple successfully

engaged in imagery and music-listening, joining in the
Imagery and Music
sessions but each experiencing individual inner
The need to do so is not always overtly expressed or the
journeys.
patient may become so ill that she cannot do anything,
really, causing frustration and anxiety. Such situations
may call for receptive music therapy techniques, such Travelling with the music, Martha on several occasions
as Guided Imagery and Music (GIM) and related experienced a feeling of flying, wheightlessness and
activities. The next case illustrates the creative process complete satisfaction - the very opposite to her real
of evoking imagery through music-listening. Stimulating situation. She also went back in time, re-living holiday

565
memories; lying relaxed on a beach, listening to the husband could re-open communication and the sharing
rhythm of the sea and watching flamingos circling high of feelings and thoughts.
up in the air.

Previously, Martha had rejected the weekly activities at

Despite her physical status, this woman managed to the ward, but suddenly she was eager to take part.
relax both physically and mentally well enough to
experience a decrease in pain during and after the
excercises. Group therapy

Her husband used these moments for emotional The weekly group therapy, "Concord", is a Swedish

release, allowing himself to cry. version of "Partage", a routine developed at the Royal
Victoria Hospital in Montreal. Our group is open
After the session, they would share experiences,
primarily to patients and relatives but also to staff,
amused by each others inner adventures, at the same
trainees etc. The group changes from week to week, but
time sensing a deeper mening in the images. It did not
must be safe for sharing. Each patient is invited
take long until Martha actually verbalized the fact that
personally and we try, as much as possible, to adapt
the two of them would never be able to go on any more
each session to the participants individual needs and
holday trips, that she would not even come home
abilities.
anymore, that she was in fact dying. With this, the ice
was broken and from that moment Martha and her

566
Based on a theme, a session includes music, poetry, creates a symbolic frame and structure. Here are
art, relaxation and discussion, finishing with some social pictures from an October session and our theme was
time with coffee and cakes. Offering group-support, "tree".
time for reflection and self-expression, these weekly
events have become popular and patients even insist
on scheduling treatment not to miss the therapy group! Case 3 - Alice

Slide presentation The following three pieces of art were made by Alice, a
young mother of two, who was my client for seven
months. She had passed a hard and long period of
1 After a brief relaxation, participants listened to a illness and lost mobility in one leg. Now, she was cured
piece of classical orchestral music. They were and expected to return to a normal, healthy life.
encouraged to try and identify whatever feeling or However, Alice wished to remain in the role of a patient,
thought that came to them. remaining weak, not having to bother about
responsibilities, receiving lots of attention and care.
"Warmth, light, sadness" - Words of Martha (Case
2)

5 Alice s childhood country - She was confused,

unable to focus, did not know what she wanted, she had
2-4 As I mentioned, sessions are based on a theme. It

567
lots of problems with the leg, did not like herself,
suffered from fatigue, felt apathetic, had sexual
problems and complained about the doctor s refusal to
prolong her sick leave. 7 Alice's figure - Gradually, Alice won deeper
insights, she began to see herself and her reactions
After progressive relaxation and listening to
and eventually wanted to do something about her
meditative music, Alice painted some images that stood
situation. During this process, she talked less and less
out to her. She returned to her childhood
about the leg, became less dependent on technical
aids, and succeeded in achieving step goals.

6 Alice's face - During therapy, I encouraged Alice to Gaining better psychological balance, Alice
do body work, focusing on centering, gravity, simultaneously got better physichal balance and
boundaries and balance. developed a positive self image. This clay figure stands
on both legs and needs no support to stay up.
One task was to create an image of herself. So,
this clay figure represents Alice - but just part of her.
Initially, one side of the face was pressed in and she
Glossary
chose to correct it somewhat. Alice looked at the
grotesque figure laughing and commented "it is rather Guided Imagery and Music (GIM): "Originated by Helen

cute". Bonny, GIM is a method of psychotherapy, healing and

self-actualization which involves spontaneous imaging

568
to music in a relaxed state, while dialoguing with a 1978, ICM Books, MD
guide. The practice of GIM requires special training."
Bonny, H: The Role of Taped Music Programs in the
K. Bruscia "Case Studies in Music Therapy" GIM Process, Monograph #2, 1978, ICM Books, MD
Bonny, H: Music & Your Mind, 1990, Station Hill Press
Inc, New York
Oncology: The science of cancer
Bruscia, K: Case Studies in Music Therapy, 1991,
Barcelona Publishers, PA Connell, C: Art therapy as part
Palliative care: "Care which serves to alleviate the of a palliative care programme, Palliative Medicine
symptoms of a disease but does not strive for a cure. 1992; 6: 18-25
People usually receive palliative care when a cure is Forinash, M: A Phenomenology of Music therapy with
thought no longer possible." the Terminally Ill, 1990, NYU Frampton, D: Restoring
K. Bruscia "Case Studies in Music Therapy"-J.Martin creativity to the dying patient, British Medical Journal,
1986; 20/27 Dec 1986, 293: 1593-1595 Hale, S:
Wounded woman: The use of Guided Imagery and
Bibliography Music in recovering from a mastectomy", Journal of
Bertman, S: Facing Death, 1991, Hemisphere the Association for Music and Imagery, 1992, Vol 1, 99-
Publishing Corp, New York 106

Bonny, H: Facilitating GIM Sessions, Monograph #1, Keiser, L: Light Search, 1988, Archedigm Publications,

569
MD Introduccin

Kenny, C: The Mythic Artery, 1982, Ridgeview Desde el ao 1935 en que Sontag y Wallace refirieron
Publishing Company, Atascadero, CA que el feto responde con movimiento a la estimulacin
con sonido se han realizado numerosos estudios en los
Mandel, S: Music Therapy in the hospice:'Musicalive',
que se comprueba la percepcin auditiva desde las 24
Palliative Medicine 1991; 5: 155-160
semanas de gestacin
Martin, J (Ed.): "The Next Step Forward: Music with the
Margarita Martin Romero y colaboradores demostraron
Terminally Il1",1989; 47-52, Calvary Hospital, Bronx,
con potenciales evocados que es posible obtener una
NY.
respuesta en fetos con una intensidad de estimulo de
Munro, S: Music Therapy in Palliative/Hospice Care,
100 dB a las 25 semanas y con una intensidad de 9O
1974, MMB, St Louis
dB desde la semana 27

En base a estos y otros estudios se ha elaborado la

Prueba de Estimulacin Sonora, que consiste en
EST I M U L AC I O N M U SI C AL PAR A
producir cambios en la Frecuencia Cardaca Fetal en
EM BAR AZ AD AS
los fetos con buena vitalidad. Descrita por autores como
M ARA E STELA P IERINI Schmidt, Gagnon, Rusconi, es un mtodo de
evaluacin de la vitalidad fetal, superior a otros por su
rapidez y su valor predictivo.

570
 E1 sonido se amplifica con un gestfono, que posibilita,
adems de neutralizar la absorcin del sonido por las
Primera Parte
paredes abdominales, que los padres le hablen y
La experiencia que vamos a relatar y observar, se
canten direccionalmente al beb.
realiz en el Hospital de Clinicas de la Ciudad de
Buenos Aires y en un consultorio privado. Colaboraron
30 mujeres embarazadas, entre las 30 y 40 semanas La prueba comienza con 5 minutos de registro de la
de gestacin, 12 de las cuales concurrieron con sus frecuencia basal sin msica , luego una meloda de
parejas. frecuencias bajas que es la Suite N 1 en Re Mayor
para violoncello de Bach, contina otro intervalo de 5
La hiptesis que planteamos es: verificar si existen
minutos y una meloda de frecuencias altas para flauta
diferencias por la audicin de distintos estmulos
de Galway. Finalmente tambin separados por
sonoros en la frecuencia cardiaca, evaluada por medio
intervalos, la madre y el padre le hablan o le cantan.
del monitoreo fetal.

En una primera fase se compar voz del padre y de la

madre, secuencias rtmicas y meldicas. Y en una Las conclusiones a las que hemos llegado son:
segunda fase, que es la que veremos en el video, se
compar msica armnica de frecuencias bajas con
frecuencias altas, y voz del padre y de la madre. 1. Verificamos cientificamente que hubo reaccin
del feto ante un estmulo sonoro ms complejo y

571
esttico musical que el ruido blanco o sonido de banda ascenso ni relajacin. Cabe sealar que la mam le
ancha usado hasta ahora en las Pruebas de Vitalidad canta una cancin infantil mientras que el pap le habla
Fetal, por lo que sera aconsejable incorporar en tono engico e intelectual.
secuencias musicales en las mismas.
5. Mientras la experiencia se realiza, se pueden
2. Cuando el feto est dormido o en periodo de observar vnculos patolgicos padres-hijo antes de que
reposo el estmulo musical produjo respuesta nazcan y as intervenir preventivamente dando pautas
aumentando la FCF (Frecuencia Cardiaca Fetal) basal para solucionar el conflicto.
y/o ascensos transitorios de la misma. (Protocolo 1)
6. La pareja ante la prueba objetiva de que su hijo
3. Cuando el feto est activo la voz de los padres o el escucha y responde se siente ms estimulada a
estmulo sonoro sea rtmico o meldico no modific hablarle y cantarle aceptando mejor la existencia de
significativamente el comportamiento fetal. este nuevo ser independiente. y afianzando la
comunicacin y el vinculo.
4. No hubo diferencias en las reacciones ante la voz
del padre o de la madre. Slo en un caso de madre
hipoacsica y con marcadas dislalias, el feto
Segunda parte
reaccionaba ms ante la voz paterna. Y en este otro
caso (Protocolo 2) la voz de la madre provoca un Lo que vemos ahora son escenas del Curso de

ascenso de la frecuencia basal y una relajacin Estimulacin musical para parejas embarazadas de

posterior, mientras que con la voz del padre no hay ms de 24 semanas de gestacin.

572
Comenzamos con una actividad de caldeamiento, un contribuir al desarrollo de su inteligencia, del odo
juego que permite agruparse y liberar tensiones. musical y de sus afectos ya que esta tarea es realizada
por los padres debidamente orientados.
Luego la consigna es crear una cancin para el futuro
beb.

Culmina con una verbalizacin de lo vivenciado y una Comentario

explicitacin de pautas para continuar con la
Un nio que escucha ya desde el vientre materno,
estimulacin musical diaria en su hogar.
sonidos estticamente organizados, y elegdos con
amor por sus padres, podr ser un nio con un mejor
desarrollo intelectual y afectivo de su persona.
Mediante el Curso de estimulacin musical se logra:

* Una profundizacin del vnculo familiar, tanto de

la pareja como con el beb. Muchos papas recien luego BIBLIOGRAFIA
de esta experiencia toman conciencia del embarazo.
DRUZIN M.: The effect of vibroacoustic stimulation on
* Los padres pueden expresar sentimientos y the nonstress test at gestational ages of thirty-two
ansiedades de esta etapa, a travs de un lenguaje no weeks or less.
verbal y en un espacio de juego y creatividad.
MARTIN R0MERO M. y col.: Potenciales evocados: su
* E1 beb comienza a ser estimulado aplicacin para diagnstico de audicin intrauterina.
auditivamente en forma esttica y sistemtica, lo que

573
READ, J. y col.: Fetal heart rate acceleration in response T R AST O R N O S D E L A AL I M EN T AC I O N :
to acoustic stimulation as a measure of fetal well-being EN F O Q U E G R U PAL M U L T I D I SC I PL I N AR I O
Am.J. Obstet-Gynecol. November 1977.
E STELA P IERINI
RUSCONI, C.: Evaluacin a travs del ultrasonido de los
factores no hipxicos que modifican la FCF,Tesis del
Doctorado en Medicina. UBA. 1992. Antes de ser un dato subjetivo, el cuerpo es una imagen
social.
SHETLER, D.: Response of the Prenatal Infant to
Musical Stimuli: A Report of the Eastman ProJect 1980- Este concepto es clave para la estructuracin de los
1986. First Research Seminar of the ISME Commission grupos terapeticos y el abordaje individual del obeso,
on Music Therapy and Music in Special Education. bulmico o anorxico.
1986. USA. Antes de la exposicin de la prctica clnica me gustara
SMITH, C. y col.: Fetal Acoustic Stimulation testing. hacer una resea de la evolucin sociolgica de la
AM.J. Obstet.Gynecol. July 1986. imagen corporal basada en un trabajo de Laxenaire y
col. de la Facultad de Medicina de Nancy, Francia. Y
establecer una correlacin entre esta evolucin
filogentica y la evolucin ontogentica de la imagen
corporal por la que atraviesan los pacientes de
nuestros grupos de obesidad, bulimia y anorexia.

574
 modelo del equilibrio y la perfeccin. Sus formas
graciosas, sin exceso de grasa ni rollos, un simbolo de
Evolucin sociolgica de la imagen corporal
la belleza platnica.
Se puede observar que en el clivaje alma-cuerpo, o
Luego la mujer de la Edad Media, de pechos chatos y
psique-soma, el acento puesto sobre uno de los
vientre redondeado, que expresan el rechazo de toda
trminos rebaja al otro como por un fenmeno de
provocacin sexual, resume el fantasma de pureza que
equilibrio. Cuando el alma estaba en primer plano,
oprima a los hombres del Occidente cristiano.
como en la Edad Media, el cuerpo era desdeado. Hoy
en dia es a la inversa, en nuestra civilizacin occidental Ms tarde recordemos a las bellezas de Rubens,
todo est concebido para la exaltacin del cuerpo. francamente adiposas. Despus de la Revolucin
Francesa, todo cambia y se vuelve a las lineas griegas.
Las innumerables transformaciones de la figura
femenina en el correr de los siglos hacen evidente que Y nos encontramos, por fin, en nuestro siglo signado
sta oscila entre los polos opuestos de la matrona de por el culto a la delgadez y a la juventud.
caderas anchas y la seductora con formas
E1 primero es reciente, ye que si nos remontamos a la
provocativas. La Venus de Willendorf (20.000 a.C.) es
poca de la guerra, de hambre y desnutricin, aquel o
una mujer obesa, con vientre enorme y senos
aquella que podia exhibir gordura era considerado un
hipertrofiados, esta Venus de femineidad agresiva
privilegiado. La obesidad era signo exterior de riqueza.
revela un culto a la fecundidad. Frente a estas figuras
Hoy en dia las imgenes culturales se invierten. Los
prehistricas la mujer de la poca greco-romana es el
ricos hacen profesin de delgadez, su riqueza pasa por

575
otros signos externos: casa suntuosa, autos potentes, actividad profesional. En nuestra cultura delgadez es
lugares de veraneo privilegiados. sinnimo de belleza pero tambin de xito social.

Esta imagen obedece a la ley de contraste hallada en la

psicosociologa: en una sociedad de hambruna, hace
Caractersticas de personalidad
falta para distinguirse ser gordo; en una sociedad de
abundancia hace falta ser delgado. Con qu perfil de pacientes nos encontramos?

En cuanto al culto de la juventud, nos encontramos con Son ellos transgresores de la regla social del culto a la

la publicidad que nos presenta madres de tres nios delgadez, de la norma del entorno?

con cuerpos de adolescentes y maridos, con la sonrisa A1 menos as se sienten y se lo hace sentir el ambiente
de aquellos que ganan sin esfuerzo. Mujeres familiar y social.
superdelgadas que comen platos hipercalricos sin
Segn la ideologa del self-control, subraya Mackenzie,
desmedro a su silueta.
socilogo americano, xito y reconocimiento social
Por otra parte nuestra sociedad, conlleva un neto pasan por el dominio del cuerpo. Esta falta de control
prejuicio antiobeso. Beck y col., en 1976, han sobre si mismo, en el obeso, seria un mal augurio sobre
demostrado que el ideal de delgadez est ms el control que pudieran ejercer sobre otros.
asimilado en las mujeres que tienen un buen nivel
intelectual y una mayor ambicin profesional. Existira
una correlacin entre medidas femeninas y nivel de E1 obeso flucta entre una conducta compulsiva hacia
la comida y un severo control de su dieta sobre si

576
mismo. Es asi como el transgredir en un minimo detalle nacidos, exponiendolos a dos franjas de luz
la dieta lo lleva a abandonarla por completo, y hundirse sucesivamente y encontrando que los bebes de padres
en la depresin, negando los logros alcanzados hasta con sobrepeso desviaban la fijacin de la mirada a la
el momento, entre otros el descenso de peso segunda franja ms a menudo y rpidamente que los
conseguido. bebs de padres con peso normal; demostrando as
una mayor sensibilidad a los estmulos externos.
Como ejemplos de conducta compulsiva nuestros
pacientes narran episodios de comer un pedazo de Algunos fragmentos de sesiones dan cuenta de esta
torta a escondidas y antes de almorzar, un paquete de caracterstica: "Viviana dramatiza un dia de su vida.
galletitas de una vez, medio pan dulce en el dormitorio,
Vuelve tarde y toda su familia ya cen, le han dejado
etc. Tienen algo en comn, el no poder decir basta, el
"las sobras". Aqu remos junto con ella y agregamos
ocultamiento, el no disfrutarlo (muchas veces comen
comentarios acentuando este sentimiento (tcnica
sin que les guste) y generalmente terminan en
sistmica). Ella contina con su dramatizacin: "Come
depresiones.
de la fuente, en la cocina o en un rinconcito de la mesa
ocupada por su familia."

Otra caracterstica de personalidad es una En otra sesin en la que trabajamos con globos, la
hipersensibilidad al medio, a los estmulos externos. agresividad de los dems y nuestra respuesta, les pido
Esta est descripta ya por Milstein, de la Universidad de que unan al gesto la palabra que ms les desagrada
Yale, quien midi la sensibilidad visual de bebs recien escuchar. Coinciden en una:" gorda!". Algunas de las

577
integrantes pueden "lanzarla" sobre otras y recibirla, en espalda..." y en sesiones posteriores descubre que
un juego que le quita su fuerte carga emocional, pero siente esta parte gorda y con rugosidades que no
una de ellas queda paralizada sin poder responder a la permiten el deslizarse de un objeto.
agresin.
Tambin se pone en evidencia la inseguridad y baja
autoestima corporal. Les cuesta ms elegir lo que ms
les gusta (una parte de su cuerpo y un instrumento, por
Una tercera caracteristica y no por ello menos
ejemplo) que lo que menos les agrada. Y generalmente
importante es la distorsin de su imagen corporal. Esta
lo feo se destaca ms, en intensidad sonora y al
est presente tanto en la obesidad como en la bulimia y
mostrarlo al grupo. En pacientes bulmicas y anorxicas
la anorexia en menor o mayor grado. Hay alteraciones
es relevante la disociacin plasmada en su cuerpo:
en las dimensiones: por ejemplo en actividades de
eligen con frecuencia un solo sector corporal en el que
dibujar el contorno, ya sea con globos sobre el cuerpo,
concentran la ambivalencia, cabeza (ojos,cabello),
sogas o grficos, se ven ms pequeos con su figura
brazos (uas y codos), etc.
actual y la futura, ideal tan estilizado como
inalcanzable, y entonces para qu esforzarse !... La cuarta caracterstica es la agresin vuelta sobre s
mismo o inhibida. Para explicar el origen de la
autoagresin presente en todas las enfermedades
En esta rea surgen los miedos e inhibiciones
psicosomticas nos remitimos a los conceptos de
corporales: "no puedo moverme mucho por el corazn,
Aulagnier de proceso originario y representacin
ni sentarme por la columna". "No llego a tocarme la
pictogrfica. E1 primero entra en funcionamiento al

578
nacer, precede al proceso primario y registra Como ejemplo, una paciente refiere "que est tratando
continuamente el encuentro del beb con su medio en de no ser tan agresiva con su padre, pero que esto la
forma de representacin pictogrfica. Una lleva a comer ms. Podriamos decir que lo que no
caracterstica privativa del proceso originario es que puede ser comunicado en un dialogo familiar fludo se
placer y displacer como expresin de afectos opuestos transforma en autoagresin.
pueden estar simultaneamente presentes en el
Recordemos tambin aquella paciente que se paraliza
pictograma. En este se graba una sola imagen que
ante la agresin de la palabra "gorda". O el caso de
representa la zona sensorial del beb junto con el
Gloria, bulmica de gran sobrepeso, en quien el trabajo
rgano materno con el cual se conecta y con el afecto
con sogas despierta recuerdos de maltrato en la
que acompaa el encuentro.
infancia: "Mis hermanos me ataban, me dejaban en el
Si de alguna manera falla la funcin materna en el fondo y se iban a jugar". A1 preguntarle cmo respondia
amamantamiento, surge tensin y displacer y el ella, simplemente no lo hacia. Qu pas con este
pictograma resultante de tal experiencia dolorosa ser impulso agresivo que no pudo ser expresado en su
alo y autoagresivo a la vez, ya que estn ligadas en 1 momento y con el objeto correspondiente?...
la zona corporal del beb y la zona materna.
Y es a partir de esta sesin que se opera un cambio
Y este primer esquema relacional seguir operando muy importante en su actitud corporal y con el grupo:
durante toda su vida. Unica forma de responder a participa ms activamente, desarrolla su creatividad, se
cualquier dolor o incomodidad que percibe. permite sentir y hablar de ello. Ha encontrado por fin
una modalidad de canalizar su agresin, ya no sobre si

579
misma sino en una sublimacin creativa. comunicarse.

Desde esta perspectiva relacionar las caractersticas

de personalidad arriba mencionadas con el abordaje
Evolucin ontogentica de la imagen corporal
que en la prctica nos ha dado ms resultados.
Bajar de peso es facil -dice el obeso- basta con
E1 tema de las transgresiones a la dieta y la conducta
proponrselo. Pero por qu es tan facil subirlo apenas
compulsiva los abordamos trabajando los lmites. A
abandono la dieta?
travs de consignas de exploracin del espacio del
Nuestra respuesta es que si no hay un cambio de
propio cuerpo, de reconocimiento de sensaciones
conducta alimentaria que acompae a la misma y una
externas e internas establecer opuestos. Tambin es
modificacin de la imagen corporal, la persona no se
importante respetar los limites del encuadre: horario,
puede mantener en ese peso alcanzado frgilmente y
lugar, concurrencia (no siempre es facil ni para ellos ni
ya que se produce un desequilibrio entre este cuerpo
para nosotros).
biologico y el cuerpo imaginarios podra surgir un
trastorno de tipo esguizofrnico subyacente del que
habla Zukerfeld. Otro punto es el de la hipersensibilidad al estimulo
externo. Trabajando la expresin sonora con
E1 coordinar el grupo interdisciplinariamente, mdicos
instrumentos y la voz, desarrollando la creatividad
psiclogos, musicoterapeuta, nos permite trabajar- el
musical y de otras reas (plsticas, manuales), es
cambio de la conducta alimentaria y las modificaciones
notable cmo se incrementa la autoestima y mejoran
de la imagen corporal, modos vinculares y de

580
los modos de vincularse y comunicarse con el medio. evolucin ontogentica de la misma a partir del
Porque enriqueciendo la expresin no verbal nos tratamiento. cmo se va logrando? Con un trabajo de
damos cuenta que nuestro cuerpo es algo ms que una sensibilizacin, de descubrir los limites corporales, sus
balanza; es vehculo de emociones, sentimientos y posibilidades de expresin, utilizando objetos
receptor del deseo del otro. intermediarios (instrumentos, globos, telas, sogas, etc.)
como disparadores de sensaciones y afectos que
Es importante traer la familia al grupo, directa o
podran ser analizados y aceptados como propios.
indirectamente, a travs de su representacin en el
paciente. Personificaciones familiares con instrumentos Progresivamente, junto con el descenso de peso, se
musicales nos muestran el lugar que ocupa cada producen cambios en la conducta corporal: el uso de
integrante, roles y estereotipos comunicativos. ropa ms ajustada, maquillarse ms, el caminar por la
Recuerdo una paciente que se paralizaba con la calle "sintiendose Brigitte Bardot" como refiere una
inclusin de un tercero en un dialogo sonoro, y que paciente, el poder escuchar otro piropo que no sea "
luego de un sealamiento pudo mejorar la relacin con gordita! ".
su padre.
Incluir o no el espejo en la sesin es algo discutible.
Se observan tambin los saboteos al tratamiento: Puede ser inhibitorio en los primeros encuentros la
"como nena, si ya ests bien". O por el contrario:"otra confrontacin con la imagen real, cuando lo importante
vez pellizcando, y tu dieta?" es trabajar cmo se ven; y asi es que encontramos a
una paciente anorxica que pellizcandose la piel nos
En cuanto a la imagen corporal planteamos una
dice: "Vio qu gorda estoy? Si es importante que se

581
miren en sus casas, que se reconozcan en sus dramatizaciones, de las que surgen actitudes,
dimensiones reales. Con frecuencia no cuentan con sentimientos en los que no se reparaba, lo que puede
espejos de cuerpo entero sino pequeos. incentivar la bsqueda de soluciones y conductas
alternativas

Incorporar tcnicas de la terepia sistmica como el

Refiriendonos a la agresin , es a travs del juego con
desafo ha dado resultado: 'Yo no creo que ustedes
objetos intermediarios que podremos descatectizarla,
puedan hacer esta dieta es muy estricta!" Frente al
encontrar modos de expresarla, sin
ascenso temporario de peso . es facil caer en el error de
inhibiciones,nuevas respuestas sin ser la comida. Una
consolar al paciente: 'No importa, es slo un kilo!", y
paciente luego de discutir con su madre, se pone a
buscar las justificaciones. En lugar de este "ms de lo
cantar en lugar de comer.
mismo" es conveniente acentuar el conflicto y no
Es muy importante la bsqueda de nuevas actividades
obturarlo con palabras acariciadoras.
placenteras como sustituto de lo que hasta ahora era la
La incorporacin de la actividad fisica, no en forma
nica respuesta a la alegria, la ansiedad o el dolor: la
compulsiva, como suele ocurrir en muchos pacientes
comida. Recuerdo una paciente que escuchaba msica
que la realizan por temporadas, sino sistemticamente
cuando tena ataques de hambre.
trae beneficios muy importantes para el cambio de vida
que propiciamos.
Para lograr modificaciones en la conducta alimentaria,
primero hay que conocerla. Para ello son tiles las

582
Conclusin Kargieman. 1982. Buenos Aires.

Y para concluir vuelvo a la primera reflexin: la imagen MINUCHIN, S: Familias y Terapia Familiar. Ed. Gedisa.
del cuerpo es una imagen social y la transgresin a la 1979. Barcelona.
conducta alimentaria (obesidad, bulimia o anorexia) es
WINICOTT: La enfermedad psicosomtica en sus
una transgresin a la pauta social de normalidad que
aspectos positivos y negativos. Rev. Uruguaya de
angustia, y que puede llevar a la muerte.
Psicoanlisis No61.

WINICOTT : La mente y su relacin con el psiquesoma.

Escritos de Pediatria y Psicoanlisis. ZUKERFELD, R.:
Psicoterapia de la Obesidad. Ed. Letra Viva. 1979.
BIBLIOGRAFIA
Buenos Aires.
BEKEI MARTA. Transtornos psicosomticos en la niez
y la adolescencia. Ed. Nueva Vision 1984. Buenos Aires.

LAXENAIRE , M ;jBARIDON, C; GUERRI- M U SI C O T ER API A EN C I R U G I A

GUILLEMOT,A.: Le corps et son image dans la societ
S ABINA PUPPO
et la culture. Psychothrapies, 1991, No3, pp. 125-130.

LIBERMAN,D. Y COL.: Del cuerpo al smbolo. Conjuntamente con otras reas inherentes al campo
Sobreadaptacin y enfermedad psicosomtica. Ed. mdico, la aplicacin clinica de la Musicoterapia en

583
cirugia ha obtenido en los ltimos aos, importantes en donde el pensamiento cognitivo fcilmente
logros cientificos que han llevado a asentar y reafirmar transforma lo abstracto en concreto, lo secundario en
bases tericas, cientificas y clinicas sobre el abordaje y primario. Se considera que el paciente en esta situacin
accionar musicoteraputico en el mbito quirrgico. experimenta una regresin, la cual involucra un modo
primitivo de pensamiento en el cual no hay puntos
El acto quirrgico en si, constituye una situacin de
intermedios: todo es absoluto. Es un tipo de
stress que involucra no slo al do central paciente-
funcionamiento mental que conlleva su propia y
cirujano, sino tambin al equipo anestsico-quirrgico y
primitiva lgica, muy parecida al lenguaje y
a la familia del enfermo. El stress asociado a una
estructuracin del no - conciente, en donde no hay
operacin afecta el equilibrio psico-neuro-
espacio para la reflexin.
inmunolgico, con su directa implicancia en la
recuperacin y reestablecimiento del paciente luego de Se sabe que diferentes sonidos y a veces
la operacin. conversaciones completas, son registrados en alguna
parte de la corteza cerebral pudiendo influenciar en la
Mientras que la cirugia es algo cotidiano para el
recuperacin de la cirugia. Muy poco ha sido escrito
anestesista y el cirujano, para el paciente onstituye una
acerca de las secuelas psicolgicas de la percepcin
afrenta a sus emociones. Para el paciente no existe
auditiva intraoperatoria. Sin embargo se sabe que
cosa tal como cirugia menor.
aumentan sentimientos de desproteccin que causan
El paciente que espera ser operado o que est siendo
reacciones psicolgicas traumticas adems de
operado, vive un estado muy particular de conciencia
disminuir por esta causa las defensas autoinmunes del

584
organismo. haber tenido registros de percepcin auditiva durante la
ciruga. Por eso, cada vez en ms quirfanos se est
La incidencia de recuerdos espontneos de percepcin
instaurando el uso de auriculares para prevenir la
auditiva es de aproximadamente el 1% en pacientes
audicin involuntaria durante la anestesia general y la
con operaciones de rutina (7/9). Sin embargo, con
probabilidad de que queden secuelas psicolgicas. La
pacientes que requieren dosis de anestesia ms
posibilidad de audicin intraoperatoria puede presentar
suaves, como por ejemplo en emergencias o
variados problemas de orden profesional y jurdico al
procedimientos cardiovasculares, los porcentajes
mdico y su equipo, al confrontar que el paciente
aumentan considerablemente.
recuerda sonidos y frases habladas durante la
La percepcin auditiva intraoperatoria no est
anestesia general. Es sumamente importante para un
relacionada con el tipo o gravedad de la operacin o la
musicoterapeuta tener en cuenta que el mtodo
intensidad del dolor, sino con la organizacin o
utilizado por el personal mdico para proteger este
estructura bsica del paciente. Una variedad de
rea tan vulnerable no solo para el paciente sino
factores personales tienden a marcar una
tambin para ellos mismos sea la msica.
predisposicin individual para desarrollarla, algunos de
Como musicoterapeutas sabemos que el valor y la
ellos son la edad, el tipo de personalidad, la
utilidad de la msica es mucho mayor que el de
predisposicin gentica, la disponibilidad del entorno
enmascarar y cubrir ruidos ambientales o
familiar y social, etc.
conversaciones, y por lo tanto, los beneficios que ella
Se toma como no tico el negar al paciente el hecho de
conlleva tienen tambin un mayor alcance y destino en

585
el que es necesario seguir investigando. La audicin de auditivas durante la anestesia, tales como problemas
sonidos puede ser beneficiosa para el paciente (y el cardiovasculares, adiccin a drogas, alcohol o
equipo quirrgico) si una seleccin musical frmacos, embarazos, abortos y cirugas previas.
personalizada para el paciente es lo que se hace
El sonido no solo es perceptible y decodificable por va
audible en el quirfano. El tomar conciencia del
auditiva, sino que todo el organismo est involucrado
potencial del sonido para modificar el estado del
en su recepcin. El principio fsico que rige sta
paciente es la primera base sobre la que trabaja el
afirmacin es que toda clula en el cuerpo humano
musicoterapeuta. La segunda base, est dada por
vibra a una determinada frecuencia, y por ende
acceder a un entrenamiento musicoteraputico antes
tambin irradia y absorbe esas frecuencias especficas.
de la operacin para optimizar los resultados de la
La Teora Luminison, creada en el ao 1970 en Buenos
ciruga y su etapa de recuperacin.
Aires - Argentina, por el Dr. Ricardo Struzer, enuncia
La distincin entre recuerdo y registro de estmulos que todo instrumento musical fue creado a imagen y
auditivos es esencial para investigar en este rea. La semejanza de una parte de nuestro organismo, y por
ausencia de recuerdos y memoria de eventos que ende la frecuencia que ese instrumento emita va a
ocurrieron durante un estado alterado de conciencia dirigirse directamente a la zona de referencia. Basada
(tal como al que induce la anestesia) no es estos principios, selecciono las melodas y los
necesariamente indican una falta de registro. instrumentos que compondrn las cintas anestsica y
quirrgica que luego detallar.
Se sabe que existen determinados factores que
aumentan las probabilidades de tener percepciones

586
Este registro general del sonido, que no solamente 1) Etapa pre-quirrgica.
ocurre a nivel del odo, no est determinado en lo ms
La finalidad del entrenamiento musicoteraputico es
mnimo por un training acadmico, nivel intelectual o
que durante la operacin, el cuerpo del paciente
cultural o por una preferencia musical: el cuerpo
responda automticamente a los estmulos sonoros
responde involuntaria e indefectiblemente a la vibracion
con los que fue entrenado. Hablo de entrenamiento ya
sonora.
que para lograr los objetivos que planteo para esta
Imaginen si, tomando en cuenta estas premisas y etapa, necesito la colaboracin activa, el compromiso y
conociendo a la persona que debe ser operada, la responsabilidad del paciente para lograrlos.
compaginramos una cinta musical que adems de
El tratamiento musicoteraputico no consiste en
impactarla a nivel fsico tambin lo hiciera a nivel
escuchar msica durante la operacin, a pesar de que
psicolgico.
ste es un mtodo actualmente utilizado para paliar los
Por una cuestin prctica divido el trabajo de efectos nocivos del medio ambiente quirrgico.
Musicoterapia en Cirugia en tres etapas coincidentes
Los objetivos bsicos de sta etapa son: concientizar,
con cada una de las etapas quirrgicas: Primera etapa:
destraumatizar y esclarecer la operacin, equilibrar los
Pre-quirrgica, Segunda etapa: Anestesia y Ciruga
ritmos internos, elevar el umbral del dolor, disminuir el
(que se trabaja dentro del quirfano), y Tercera etapa:
nivel de ansiedad y expectativa, aumentar las defensas
Post-quirrgica
autoinmunes, visualizar, delimitar y contactar la zona
comprometida y preparar al paciente para la anestesia

587
y ciruga en s. significativa o preferida para el paciente ya que la
explicacin fisiolgica a nivel lmbico, talmico e
En el comienzo de esta etapa trabajo con lo que
hipotalmico juega un importante papel en la
denomino el abanico musical, en el cual presento una
regulacin emocional.
serie de melodas detonantes y desencadenantes de
ritmos y movimientos corporales internos y externos a Utilizo la cinta quirrgica como cortina musical durante
partir de los cuales selecciono las melodas que las dos ltimas sesiones del pre-quirrgico para
conformarn las dos cintas personalizadas: la trabajar la concientizacin de la operacin y los miedos
anestsica y la quirrgica. y fantasas que genera la proximidad de la misma.

La etapa prequirrgica es la ms verstil y costosa para

el paciente. Lo ideal es trabajar ocho sesiones previas a
La cinta anestsica se trabaja antes del suministro de la
la internacin u operacin. En casos de urgencia
anestesia para potenciar el efecto de la misma. Los
generalmente no hay tiempo de dilogo con el paciente
objetivos que trabajo con esta cinta son: disminuir la
con lo cual los objetivos y procedimientos bsicos se
dosis de anestesia, descender el nivel de captacin
alteran.
sonora, disminuir la tensin muscular del paciente,
regular su presin y temperatura, aumentar el volumen El musicoterapeuta que trabaja en ciruga debe estar
respiratorio y ralentar su ritmo. durante esta etapa disponible para el paciente las 24
hs.
Recalco la importancia de utilizar para la
compaginacin de ambas cintas, msica que sea

588
2) Etapa anestsico - quirrgica. ayuda a enmascarar los sonidos de la sala operatoria.

Esta es la etapa que se trabaja dentro del quirfano La cinta quirrgica es tambin audible en forma
conciente y subconsciente para el cirujano y su equipo
Antes del suministro de la anestesia utilizo la cinta
brindndoles una informacin sonora secundaria, que
anestsica preparada en la etapa anterior. La tarea del
por sus caractersticas de tempo, alternancia y
musicoterapeuta consistir en guiar y brindar apoyo
duracin, permiten al equipo anestsico-quirrgico
mientras transcurren las melodas a las cuales el
operar con patrones cortos y ciclos variados. Se
paciente responde automticamente.
distiende asi la atencin latente que provoca la
La cinta anestsica consta de cuatro melodas que van
descarga del excedente nervioso y causa un efecto
de mayor a menor: la primera coincidir con el ritmo
alerta-distendido que disminuye el grado de stress
normal del paciente, y las restantes disminuirn
general y permite la optimizacin de la tarea conjunta.
paulatinamente en ritmo, densidad sonora, textura y
Los beneficios que obtiene el personal mdico,
frecuencia. Una vez alcanzado el estado de meseta o
anestsico y tcnico dentro de un quirfano
grado cero, caracterizado por una respiracin lenta y
musicalizado no han sido an cientificamente
profunda, pulso regular y parejo, el anestesista
comprobados.
proceder al suministro de la anestesia.
Cuando el cirujano da por concluida la operacin, el
Se coloca la cinta quirurgica mientras el cirujano
musicoterapeuta colaborar con el anestesista en la
prepara el comienzo de la operacin con el propsito
tarea de traer nuevamente a la conciencia al paciente a
de ofrecer una base sonora y ritmica constante que
travs de la segunda cinta anestsica (que va in

589
crescendo) la cual consta de las mismas melodas que Los objetivos de esta etapa son evitar la apata, la
la cinta de ingreso a la anestesia pero, esta vez en imaginacin exagerada de sintomas e inactividad
orden inverso, es decir, acelerando los ritmos para cerebral, neutralizar la focalizacin de la atencin en el
tonificar el cuerpo. dolor y el discomfort, reducir la necesidad de
medicacin postquirrgica, promover a una rpida y
La continuidad musical facilita la sedacin del paciente
efectiva cicatrizacin, acortar el perodo de
durante la cirugia; esta sedacin evita al paciente el
recuperacin, alcanzar una homeostasis general y
efecto txico debido al alto y prolongado suministro de
evaluar los efectos postshock y eutmicos.
anestesia. Este hecho ha sido comprobado
particularmente en cirugia de nios bajo efectos de La msica tiene un comienzo y un final. Mientras
anestesia general. transcurre, marca indefectiblemente el paso del tiempo.
Concientizar al paciente sobre este hecho es de suma
Diferentes estudios confirman el beneficio del uso de
utilidad, ya que al estar internado e inmovilizado el
msica tanto en la anestesia como en la cirugia, ya que
tiempo suele ser vivido como estanco o interminable. La
hace posible la reduccin de la cantidad standard de
msica brinda un marco temporal y continente, marca
anestesia con la ventaja de que el paciente se recupere
la sucesin del tiempo en movimiento.
ms rpida y facilmente y sin evidencia de cianosis.

Conclusion
3) Etapa post-quirrgica.
Las etapas pre, intra y post-quirrgica se ven

590
caracterizadas por una serie de sntomas que surgen La ciruga es una de las formas ms cruentas de
en relacin con dicha situacin, instalndose algunos ejercer la medicina. El cirujano sabe que lo que va a
de ellos de manera crnica llegando a constitur el hacer va a modificar en forma inmediata la condicin
ncleo de neurosis severas cuya situacin va del paciente. A pesar de sto, el vnculo afectivo
directamente ligada al monto de la ansiedad o de la establecido entre paciente y musicoterapeuta se ve
debilidad de las defensas para su control. reforzado por ia disponibilidad teraputica que se
convierte para el paciente en una base segura, sensible
A travs de la prctica clnica puedo decir que los
y confiable.
resultados hasta la fecha han sido altamente positivos
en cuanto a la reduccin de la medicacin pre y post- La msica conlleva estados emocionales. Las
quirrgica y del dosaje standard de anestesia; el regular emociones afectan y alteran la liberacin de neuro
monitoreo de los ritmos internos sin picos de riesgo, hormonas. Las emociones estn controladas por las
reduccin o anulacin del sindrome de confusin post- estructuras lmbicas (hipocampo, amygdala y varios
quirrgico, disminucin de la incidencia de nuseas y ncleos talmicos). El sistema lmbico en conjuncin
vmito, disminucin de la prdida de sangre con el hipotlamo vigila la entrada sensorial y moviliza
intraoperatoria, aceleracin del proceso de la salida motora con la funcin especfica de asegurar
cicatrizacin y homeostasis general. la respuesta ms beneficiosa para la preservacin del
organismo. El sistema lmbico puede ser activado por
Esta especialidad est recibiendo un renovado inters
estmulos ambientales y somticos; sin embargo,
debido a la actividad investigativa y corroboracin
tambin puede responder exclusivamente a imgenes
cientfica.

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internas generadas en la corteza cerebral durante el La investigacin de este trabajo se lleva a cabo con el
pensar. La msica conileva estados afectivos y puede apoyo de la Fundacin Musicoteraputica y se
contribuir a la ecualizacin de estados emocionales. La conparan los niveles plasmticos de pacientes
msica tiene un importante valor de supervivencia y entrenados con musicoterapia versus los que no
tiende a hacer coherentes y equilibrar diferentes reciben asistencia alguna.
actitudes y acciones.

No solamente a nivel psico-neuro-inmunolgico es

beneficiosa la implementacin de un buen programa de E L JU E G O E N L A C L N I C A

Musicoterapia a nivel hospitalario sino que se est M U SI C O T ER APEU T I C A C O N N I O S Y

comenzando a tener en cuenta el ahorro econmico en AD O L ESC EN T ES

frmacos, anestesia, transfusiones de sangre y costo G ISELA B AROK , DESIREE F LORES , M P IA L ATORRE , M
hospitalario que representa el contratar los servicios de A NDREA L AHA , DANIELA M AMMALUCCO , , M G ABRIELA
un musicoterapeuta especializado en este rea, sin M ETA , LIDIA R OMERO Y P AULA Z ETTLER
contar el beneficio particular de cada paciente que es
asistido de esta forma.
PROLOGO
Las conclusiones a las que arribo estn basadas en los
El presente trabajo surge del equipo de
datos recogidos durante las tres etapas quirrgicas de
musicoterapeutas del Hospital Municipal Infanto -
cada paciente, comparadas con pacientes que no
Juvenil Dr. Carolina Tobar Garcia de la Ciudad de
reciben este tipo de asistencia musicoteraputica.

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Buenos Aires, nica institucin psiquiatrica pblica para JUEGO
nios y adolescentes de nuestro pas. En la misma se
presta asistencia a pacientes con patologa de orden
emocional y social y tambin a su familia Pensamos en comenzar a abordar este tema citando a
algunos autores que ha reflexionado y teorizado sobre
el juego, que al consultarlos pareci muy til incluirlos.
Este hospital esta ubicado junto a los hospitales
psiquiatricos de hombres Jose T. Borda y mujeres
Braulio Moyano, tambin de atencin publica. Esta Afirma Rodufo; los primeros encuentros entre madre e

zona de la ciudad de Buenos Aires est signada por las hijo ponen en juego una constelacin de canales... si

caractersticas de estas instituciones, y la posibilidad este entramado circula por un buen carril el nio podr

que estos nios y adolescentes terminen sus das en constituirse como sujeto. Cuando esto n ocurre no

ellas es una fantasa que circula en el imaginario social. encontramos con la ruptura, con los vacos, las
perturbaciones en ese proceso... Si el bebe que luego
ser un nio fue jugando va a poder jugar. (1)
Si bien no somos ajenos a esta realidad, y estamos
dentro de este sistema intentamos pensar la salud
mental como lo que es: SALUD MENTAL. En los casos clnicos con que ilustramos este trabajo
intentaremos mostrar las diferentes instancias por las
INTRODUCCIN
que transitamos en el jugar en musicoterapia con nios

593
y adolescentes con patologas psiquiatricas severas. es la posibilidad de relatar algunos casos clnicos.
Darle a esas acciones el estatuto de ser algo mas que
puro movimiento para que esos momentos de
intencionalidad tengan el valor de deseo. (2) CASOS CLNICOS

CASO N 1

Al hablar de juego, no podemos de mencionar a Adrin tena seis aos cuando el musicoterapeuta lo

Winnicott y sus valiosos aportes al tema: ...la psiquiatra conoci. Un ao atrs , sus actitudes no diferan

se realiza en la superposicin en las dos zonas del demasiado a las que manifestaba en ese momento,

juego, la del paciente y la del terapeuta, si este ltimo cuando la musicoterapeuta abra la puesta para

no sabe jugar, no esta capacitado para la tarea. Si el recibirlo, Adrin, entraba rpidamente y comenzaba a

que no sabe jugar es el paciente, hay que hacer algo deambular por todo el saln describiendo lneas rectas

para que pueda lograrlo, despus de lo cual comienza de esquina a esquina, de pared a pared. Emita en ese

la psicoterapia. (3) entonces algunos pocos sonidos bastante difciles de

reproducir, que no superaban a los del estado de
balbuceo de un beb. Rechazaba el contacto corpora, y
Pensando en el tema que da titulo a este trabajo nos ho haba objeto o sonido que llamara su atencin. Su
surgan interrogantes cmo abordamos la cuestin del mirada desconcertaba, an siendo dirigida a un punto
juego? cmo juega un nio y cmo juega un determinado, daba cuentas de no conectarse desde
adolescente?. Una forma de comenzar a respondernos ella, podia con sus manos palpar rtmicamente sobre

594
algunos objetos que seencontraban en la sala (como escena. Lo mismo ocurri, cuando en una oportunidad,
tambores), lo mismo haca palmeando sobre las se utiliz un bombo como carro (dado que le faltaba el
espaldas de la musicoterapeuta; luego segua parche a una de las caras), en cuyo interior se
deambulando. encontraba otro nio. Una vez finalizado este juego
Adrin tom las manos de la musicoterapeuta y dio
claras seales que deseaba realizar la experiencia de
Desde lo sonoro, no encontraba repuestas a ningn
sentarse adentro del bombo y recorrer el saln
estmulo, por momentos actuaba como si realmente
acompaando con una cancin que marcaba el inicio y
estuviera sordo, aun cuando venan sonidos
el fin del trayecto.
provenientes desde el exterior de la sal. Ponerle ritmo a
todos los movimientos implic que optara por tirarse
sobre algunos almohadones y se chupara los dedos. La musicoterapeuta, rescata estas dos escenas como
Cualquier baqueta o instrumentos pequeo slo lo importantes entre tantas otras en las que prevalecan
tomaba para llevarlo a la boca y chuparlo. Con otros continuos altibajos en las actitudes anmicas de Adrin.
nios su reaccin fue similar a diferencia que la
musicoterapueta comprob que aunque no lo
manifestara, Adrin, se encontraba muy atento a todo Al regresar de sus vacaciones, la musicoterapeuta

lo que sucediera a su alrededor; en una sesin se decidi instrumentar un encuadre diferente, en primera

instal un claro juego de sonidos vocales y los silencios instancia: circunscribir el espacio con la ayuda de

delataron desde la mirada su conexin con esa esa almohadones los bombos y el grabador, que formaban

595
un circulo en un lugar determinado de la sala. Las Fue este el primer contacto corporal entre Lidia y
sesiones se iniciaban, ya no desplazndose la Adrin.
musicoterapueta junto a Adrin, sino respondindole o
a veces slo acompandolo desde un lugar fijo con
sonidos vocales o con ritmos, comenzndose a Actualmente Adrin puede acercarse a la

discriminar dos momentos en cada sesin: uno de idas musicoterapueta, busca su cara, toca su boca; esto

y vueltas fuera de este circulo y otro dentro de l. sucede cuando ella no responde a sus sonidos que han

Finalmente este ltimo momento traa aparejado un comenzado que han comenzado a ser silbicos, tienen

incrementos de sonidos vocales que se una organizacin rtmica y el paciente puede jugar con

entremezclaban entre diferentes posturas corporales las intensidades mas claramente.

de Adrin. En particulares situacin su mirada marcaba

su grado de conexin y a veces el pedido de continuar.
CASO N 2
Apareci el contacto corporal que en un primer
momento fue muy confuso. La musicoterapeuta senta Jorge actualmente tiene once aos. En un principio

que era un objeto ms. En la sesin siguiente con un pareca agresivo; luego la musicoterapuea comprob

fuerte estado gripal, con fiebre y llorando, que en realidad su manera de relacionarse era brusca.

acurrucndose sobre el cuerpo de la musicoterapeuta No se conectaba tampoco con la mirada, lo que haca

que lo acun. an ms difcil el acercamiento a l.

596
Exploraba los objetos a travs del tacto y el olfato como manera y comenz a percutirlo, dirigiendo su mirada al
tambin a veces tirndolos, observando su cada y el musicoterapeuta quien cierra la sesin incluyendo las
ruido que estos producan al caer, hasta finalmente tapas plsticas nueva mente.
optar por uno que siempre eran tapas plsticas
circulares. Esta posibilidad de eleccin del objeto
requera mucho tiempo de exploracin previa, que En la siguiente sesin Jorge puedo poner en palabras

llegaron a ser sesiones enteras; sobre todo al de su inters, ir a musicoterapia. Mientras esperaba

comenzar el tratamiento. para entrar a la sesin, se encartaba muy agresivo, le

pegaba a la madre y a los dems paciente; al entrar
cambiaba de actitud, se tiraba en el piso y esperaba, la
En una sesin haba msica instrumental de fondo. La terapeuta le ofreci las tapas plsticas y l no las
musicoterapia propuso elegir un instrumento msica, acept. En un momento eligi dos guitarras, una para la
Jorge repite su eleccin por las tapas plsticas, en ese musicoterapeuta y otra para l. Pudo proponer una
momento la musicoterapeuta intenta incluirse en la actividad e interactuar con la terapeuta, explor su
actividad, tomando las tapas que l tiraba, guitarra de la misma forma que lo hacia con los dems
desenvolviendoselas, ante lo cual Jorge no responda objetos, y propuso intercambiar las guitarras. Si bien
ni diriga su mirada; pareca ignorar la situacin. Jorge no hablaba pudo nombrar los objetos que eligi
(tapa y guitarra).

Al ofrecrsele el celestin, lo tom, lo explor a su

597
Esto se repiti con la Eleccin de Jorge por las La musicoterapia comenz a buscar sonidos
campanas, la musicoterapeuta pudo incluirse apostando a que provocaran algo en Paula, prob con
abrindose as un espacio de juego sonoro y corporal, todos los instrumentos de percusin que tena, pero
donde Jorge por primera vez se mostr placentero. Paula no se conectaba con nada.

CASO N 3 En una de las sesiones, la terapeuta decidi incorporar

el sonido de la flauta dulce, variando secuencias
Paula tenia diez aos cuando la musicoterapueta la
meldicas, reiterndolas una una y otra vez. Luego de
conoci. Mientras permaneca en la institucin pasaba
un breve lapso Paula la mir a los ojos por unos
sus horas sentada en una silla; su postura corporal era
segundos, grit y aplaudi.
extremadamente rgida, llevaba sus manos cerradas
hacia la boca y se las morda, realizaba un balanceo
permanente, emita gritos y aplauda.
La musicoterapia reconoci que sta no era una de sus
tantas actitudes (esteriotipadas), sino que estaba
apareciendo la posibilidad de una respuesta, luego
Si bien aparentaba estar totalmente desconectada del
volva a su movimientos de rocking.
mundo exterior, cuando la tocaban o acariciaban corra
su cuerpo para evitar el contacto.

En sesiones siguientes las musicoterapeuta retom los

598
ejercicios con la flauta y comprob la actitud de Paula Otros cambios que se apreciaron, fueron las
que, aplaudiendo, volva su mirada hacia ella aunque posibilidades que pudo desplegar desde el movimiento,
ya no gritaba. Reiter este esquema en sesiones desplazandose, cambiando de lugar, buscando otra
posteriores y otra de las actitudes de Paula fue silla para sentarse. introdijo variaciones de intensidada
levantarse de su silla acercndose a los instrumentos; en sus emisiones vocales y era notoria su posibilidad de
tomaba el cascabelero y lo sacuda enrgicamente, interactuar con los dems nios.
mientras la terapeuta mantena el esquema meldico.
Otra actitud sorprendente durante el proceso
teraputico mantena el esquema meldico. Otra CASO N 4

actitud sorprendente durante el proceso teraputico, Helga ingres al Sector de Musicoterapia en 1991,
fue la respuesta de Paula a las caricias en la cara y en tenia trece aos.
los hombros, inmediatamente despus de recibirlas
gritaba y aplauda.
Su actitud era pasiva, no hablaba y el nico movimiento
que realizaba era con sus manos y brazos cubriendose
Todo este trabajo fue muy lento, ya que los momentos el rostro. No aceptaba ninguan propuesta de trabajo,
de conexin de Paula, cuando existan, eran muy cuando puedo comenzar a hacerlo, era sin demostrar
breves. decisin o eleccin, sono acceda. Luego de varias
sesiones pudo incluir los objetos que a veces traia,
pudiendo despus elegir algunos del espacio. La

599
musicoterapeuta utiliz cubos de pao, con los cuales moemtno, en las sesiones posteriores, Helga pedia
Helga comenz a armar torres, poniendo sobre esta los dibujar.
juguetes, se cre un juego de armado y desarmado de
las torres, en esos momentos Helga se rea.
En otra sesin le fue relatado un cuento y se le propuso
dibujar los personajes de ste. A partir de esto dibujo a
La musicoterapeuta propuso un juego que consostia en su hermano, su mama y su papa, nombrandolos. De
tirarle los cubos lo cual la asustaba mucho, finalmente aqu en adelante ante las preguntas pudo dar nombres
puede tomarlos ella tambin y tirarlos. La que dibujaba. De este modo entraron a distintas
musicoterapeuta intent incluir instrumentos musicales, propuestas, siempre por medio del dibujo. Un ejemplo:
contarle o poner msica y por primera vez Helga se cuando se le preguntaba sobre lo que queria que le
neg. regalaran para Navidad puediendo contestar a la
preguna en forma verbal una vez hecho el dibujo.

En una sesin posterior, Helga trajo su cauderno, este

tena muchos dibujos, la terapia le pregunt si quera Se abri de este modo la posibilidad de dialogar.
dibujar y sorprendentemente la respuesta fue
afirmativa, cuando le di el papel Helga no hizo nada, la
musicoterapeuta dibuj los cubos, Helga los pint Finalizado el receso tomado por la terapeuta, se

respetando los colores que tenan. A partir de ese encontr a Helga con un fuerte desorden emociona,

600
pero a diferencia de momentos anteriories pudo
manifestar angustia y verbalizar lo mal que se sentia,
Mas alla de lo dificil que pueda resultar este primer
diciendole a la musicoterapueta por favor Desire
momento, es una instancia por la que frecuentemente
atendeme.
transitamos y que nos posibilita acceder a cierto
material que otorgue un sentido a aquel sin sentido
que nos invadi primeramente.
EXPOSICIN TEORICA

Al pensar en estos casos encontramos puntos en

comn y todo nos conducan a dicriminar diferentes Se abre aqu la posibilidad de intervener, de ofertar
moemntos por los que el musicoterapeuta transita a lo diferentes objetos sonoros, elpropio cuerpo. En este
largo de un proceso teraputico. momento de investigacin, de exploracin,
musicoterapueta y paciente pueden comenzar a
recorrer un espacio comn, con un objeto que
Un primer momento durante el cual el terapeuta
intermedie entre uno y otro. Espacio en el que son
aumenta significativamente su percepcin, registrando
convocados para un encuentro.
las diversas conductas del paciente; sin halar ningn
sentido; solo dejndose llevar por el sin sentido, de
este modo se ve invadido por diversas sensaciones: El musicoterapueta tiene un registro que algo pasa;
ansiedad, frustracin, soledad, angustia, y hasta ese nio que dos , tres, seris sesiones atrs solo era
cuestionamiento referidos al abordaje teraputico. una pregunta alguient a quien se ofreca la mirada y la

601
escucha sin que acusara recibo, se transforma para el Seguramente aparecer aqu un juego solitario,
musicoterapeuta que mira y escucha, en este nio que caracteristico de los nios muy mequeos en los que la
aplaude al escuchar la flauta, que se mueve de la silla posibilidad de algn intercambio es muy escasa.
en la que estuvo siempre, que dirige la mirada, que se
acurruca buscando contacto...
El musicoterapeuta sonoriza, proveyendo a esta
isntancia de instrumentos, su voz, grabaciones, que
Esto no implica que las pregunas que nos generan funcionaran como objetos mediadores, dando un
estos nios sean contestadas por esta cabmio que significado, un orden (puesto por ahora desde afuera) a
manifiestan en la conducta. esta primera escena.

Pensamos que la posibilidad de hacerse preguntas Sabemos que nuestro objeto intermediario es el sonido
otorga un sostn importante el tratamiento. y todos los diferentes fenmenos que tengan que ver
con l. Sonido como transferencia de energia producida
por una fuente sonora que puede ser incluso el mismo
Ahora podemos llamar juego a este momento, a estos
musicoterapeuta.
primeros movimientos del paciente en sesin?

Aqu se pone en marcha la posibilidad de accionar en

602
este espacio que se va delimitando, llenando de musicoteraputico, as como los diferentes
sonidos, de movimientos y de posibilidade de jugar; interrogantes que el mismo nos plantea. El acceso a la
sensacin que se isntala primero en el musicoterpeuta. teora nos permite responder algunas y poder repensar
La posibilidad de relacionarse (relacin como momento sobre la clnica.
previo a un vnculo trnasferencial), es posterior. El nio
comienza a buscar esta fuente sonora (grabador,
objetos sonoros), a discriminarla de la persona del Y un tema sobre el cual nos cuestinamos,

misicoterapeuta; descubre que no es ese un puro ritmo investigamos, y nos pareci apropiado escribir, es el

o movimiento, o boca que emite un sonido sino que es juego; ya que podemos ver diariamente en el trabajo

otro, diferente a l y con el que puede vincularse en con nios y adolescentes que es un espacio optimo

funcin de la aparicin de su deseo; primero, a travs para el establecimiento de un vnculo transferencial.

de la mirada, el contacto, el olfato, el cuerpo y la voz, Creemos que los musicoterapeutas contamos con una

como parte del mismo, como en los casos expuestos infinidad de recursos para la cracin de este espacio.

anteriormente.

Queremos entonces cerrar este trabajo con un parrafo

CONCLUSIONES de Carlos Fregtman (4): Hacer Musicoterapia es, en

primera aproximacin, convocar las experiencias
Intentamos a travs de este trabajo mostrar dnde y
ldicas del paciente, que permite la puesta en posicin
cmo se desarrolla nuestro quehacer
de juego; nico campo donde los marcos referenciales,

603
y por consiguiente las defensas frente al otro se 1988.
encuentran exludas.

(4) La cura y la locura Ricardo Grimson y

BIBLIOGRAFIA DE CONSULTA colaboradores. Ed. Bsqueda, 1983.

(1) El nio y el significante (Un estudio sobre las

funciones del jugar en la constitucin temprana).
Psicoanlisis de los cuentos de hadas Bruno
Ricardo Rodulfo. Ed. Paids. Estudios de Psicologa
Bettelheim. Ed. Crtica. Las ideas, 1991.
Profunda, 1986.

La creacin musical Carmelo Sata. Ed. Ricordi.

(2) Musicoterapia y psicosis infantil: vicisitudes del
trabajo interdisciplinario. El lugar de jugar en
musicoterapia. Claudia Sykuler, M Lo Prete y Marcelo Las terapias creativas Rosemarye Gordon. Ed.
Glatstein. Anuario A. Mu. R. A. (Asociacin de Kapelusz, 1990.
Musicoterapeutas de la Repblica Argentina) 1990-
1991.

(3) Realidad y juego D. W. Winnicott. Ed. Gedisa,

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M U SI C AN D I M AG ER Y I N T H E T R EAT M EN T O F states of consciousness, whatever term you choose in
C H EM I C AL AD D I C T I O N S reference to the parts of self not readily available to
awareness.
RUTH SKAGGS, M.A., LPC, CET .

To give you something of my background for this

Although there is a plethora of substance abuse
presentation: I have a Bachelor of Music degree, a
treatment centers across the country, the relapse rate is
graduate degree in psychology and post-graduate
abysmally high in both private and public institutions. I
training in family systems. I completed training in
assume that the same is true in countries throughout
Guided Imagery and Music (GIM) therapy in 1982, and I
the world. It is clear that something more than current
have had adjunct training in other expressive therapies.
treatment methods is necessary. The use of music and
I am a Licensed Professional Counselor with a private
imagery elicited through focused listening to it is an
practice in Atlanta, GA, working with individuals and
approach that I use with groups and in individual
groups. As founder of the Southeastern Institute For
practice. It is not viewed as a replacement for current
Music-Centered Psychotherapy, I conduct training
treatment approaches, but rather as an addition that
programs in GIM therapy, and I use music extensively
provides something not present in most treatment
as the nucleus for the practice of depth psychotherapy.
plans: access to the deepest, wisest, most creative
dimensions of a human. Those dimensions are found in Much of the material in this presentation is derived from
the unconscious, the nonconscious, or nonordinary my work leading groups at St. Jude's Recovery Center

605
for the past several years. St. Jude's is an inner-city, I'd like to tell you what GIM is by first telling you what it is
nonprofit residential treatment program for alcoholics not. It is not guided visualization with music in the
and drug addicts in downtown Atlanta. Most of the background. It is not relaxation and music, although
residents are male African-Americans. Often the group deep states of relaxation is sometimes a by-product.
that I lead is joined by chemically-impaired medical What it is is an active use of music specifically chosen to
professionals from a nearby private treatment program. reach into the depths of the listener and facilitate the
The medical group has included nurses, technicians. emergence of material from the psyche. Music, in this
doctors and surgeons. The socio-economicra-nge way, mi8ht well be considered as a co-therapist. In
ofgroup members includes those who grew up in low- individual work, the music portion of the session may
income housing projects and those who came from last from 35-45 minutes, with the induction and music
affluent families; those who are high school drop-outs choice based on the ISO principle, i.e., vhere like
and those with advanced educational degrees. They matches like. Qualities in the music match the client's
come from all parts of the country. The philosophy of presenting feeling states and needs. The induction
treatment at St. Jude's includes the 12-steps as includes any of a number of devices for achieving a
advocated by Alcholics Anonymous. focused awareness and a seed image which is
congruent with the music and the client's material. The
This workshop will include a theoretical basis for using
therapist assists the client through the imaging
music and imagery, examples of music choices, group
experience by helping him or her to stay involved in
participants' responses and an opportunity for you to
inner exploration through occasional questions or
experience the music and your own responses to it.

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suggestions. The therapist takes notes of the imager's memories.
responses for use in processing when the music has
ended. The method is essentially phenomenological.
In a group situation, there is usually time for only one
This approach does not attempt to choose music from
short selection of music, rather than an entire audio
the repertoire of the client's listening preferences;
cassette tape, as is used in individual work. The choice
rather, the choice is made according to the
of music and induction is based on group needs. With
effectiveness of music in this kind of depth
addicts, however, there is a common denominator. No
psychotherapy. Classical music, the genre of choice for
matter how diverse the backgrounds of the individuals,
this work, is productive because of its multiple
they all have a common purpose--overcoming their
dimensions of time, space rhythms, textures, and
addictions and maintaining recovery. That common
relationships. It encompasses the full range of human
purpose is the basis for my choices with the groups at
emotions and reflects the tension/resolution quandary
St. Jude's. Now, to give you a basis for using internal
of the human condition.
imagery.
The potential for the occurrence of important inner
changes resides within the containment of the clear
form and structure of music that has been chosen with IMAGERY

discrimination. As on-going sound, music is a reminder Thought expressed in symbols and images can be
of the safety of being in the present while the imager is traced as far back as the Paleolithic Age. Before there
engaged in mind exploration or in accessing troubling were written words, thoughts, feelings and experiences

607
were expressed in drawings, such as those preserved and Communicating," speaks of imagery as a highly
in caves. In the beginning was the image; the formation developed innate mechanism that challenges the
of words came much later. system of verbal communication that has been the
primary vehicle for maintaining and perpetuating
Human life appears to substantiate Goethe's
established beliefs and entrenched traditions. By
observation that " what is within is also without."
reconnecting individuals with their image-producing
Kierkegaard concurs when he maintains that
capacity we start the long process of returning them to
"imagination is the possibility of all reflection..." He
their true nature--to a sense of wholeness within self
believes that what knowledge, feeling or will a person
and the world.
has depends on how these things are reflected on the
imagination.

The development of language brought a distancing If we accept the paradigm that one aspect of life reflects
from man and his experience. Words became tools for other aspects, then we must recognize that the
labelling and categorizing objects and events. They chemically-dependent person knows intimately the
assumed greater importance than sensory perception. chaos of the planet. His or her own life simultaneously
Inner human experience became externalized, and reflects and is reflected by the unrest, fears, violence
individuals became separated from their internal nature. and compulsiveness present in our world. To begin, we
The person was no longer at one with the world. need to learn from addicted persons about their internal
images and the pieces and fragmentations of life
Roger Shepard, in his article "Visual Learning, Thinking
mirrored within.

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 images must first be brought to conscious awareness.
They can then be dislodged from their stuck places,
Internal images are not merely visual. They embrace all
reorganized and replaced with images that give hope,
of the senses, memories and emotions experienced in
strength and self-value.
response to life events. Physiological and kinesthetic
sensations, tasting, smelling, touching, hearing
internally are all a part of the symbolic language of the
The use of imagery in recovery is particularly beneficial
unconscious. Any or all of these types of images call
for:
attention to the need of the unconscious to be heard
and acted upon. - viewing life from different perspectives

- accessing and building a trust in the inner helper

The deep imprints of the chemically addicted person - taking moral and personal inventory of self in its

often include memory images of sexual, physical, deepest nature

emotional and/or verbal abuse. Abuse seeds the feeling - resolving internal conflicts
images of guilt, shame and worthlessness. Layered
- healing old emotional wounds
over those are images linked to their addictions--the
highs, lows, fears, degradation, helplessness and lack - providing an ongoing support system independent of

of control. These are powerful, self-defeating influences external sources

in the life of the addict. For lasting recovery, these - bringing together fragmented pieces of life

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- serving as a mental model for healthy responses many viewpoints. When viewed as open-ended, they
can take on additional meanings in time. SyMbols move
- changing moods
us through life in different ways and, at the same time,
they are moved by life processes.
It is important, however, that the images emerge from
One of the values of these multi-dimensional symbols is
within rather than without, as in a guided visualization
that they offer an assortment of metaphors that function
provided by someone else. Good recovery necessitates
to release the addicted person from the continuing cycle
the building of autonomy and a significant trust in inner
of repeated self-defeating behaviors. Symbols open up
resources. Often, the chemically dependent person has
opportunities for new ways of thinking and being.
been controlled by drugs for many years. What is
Accessing the unconscious frequently stirs deeply-
needed is the discovery of the inner helper, something
repressed memories and feeling states. Memories
not dependent on outer sources. When images arise
connected with the life of the addicted person are
from their own depths, imagers feel their authenticity.
brought into full view. Accompanying them often are
They are real, for they are from the imager's own
affects similar to those which were experienced at the
experience.
time of the original events. Both the memories and the
Images or symbols operate on different levels of
distressing emotional states can be reviewed, felt,
consciousness simultaneously. Any or all of the
reflected upon and worked through in the healing
meanings derived from the many levels can be
process.
accurate. They open the door to perspectives from

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These painful memories often arise before the what he had done to his sister. He said, "I wonder if I'll
recovering addict reaches steps four and 10 of the 12- have to make it right with her before I can get well?"
step recovery program, when moral and personal
inventories are brought into focus. The processing of
memories and feelings can overlap with the other steps. Matt had not yet reached step nine of the 12 steps. This
step requires the making of amends to those who have
For example, in a session I had asked the participants
been hurt or wronged by actions of the addict. Matt's
to see, in their mind's eye, a symbol of victory, whatever
imagery, however, propelled him forward, skipping a
symbol their imagination presented to them. Rather
number of steps through which he would yet have to
than seeing a victory symbol Matt was immediately
work. The reliving of the memory and the accompanying
drawn into a troubling memory of his "dope man"
intense emotions compelled him to confront a situation
holding a gun to his head because Matt owed him
vital to his recovery.
money. Matt couldn't understand why the memory
stayed with him so inintensely throughout the hour
session. He kept mentally processing and spoke about Teachings that come from within are powerful
his experience several times with puzzlement. Finally, motivators and are not easily forgotten. They can be
he realized that another piece of the memory was what claimed as the imager's own, offering the beginning of a
had kept him so deeply involved. He remembered that sense of self-value and self-control. One positive step,
his sister had bought him a truck, and he had sold the making amends with his sister, could, in some measure,
truck to get drug money. He was feeling "awful" about alleviate Matt's feelings of helplessness and shame.

611
 It is as if the common ground of addiction initiates
images to which they relate individually and collectively.
Personal hurts can be resolved and healed through the
The images seem to take on a life of their own, using
inner movement of images. In one session I asked
certain bodies and minds in the expression of a
group members to let their deepest unhealed hurt come
common goal.
to their awareness. (Play music used: Beethoven's
Piano Concerto No. 5, Adagio). Jay's first thoughts were
of a broken relationship with a lover. It had ended with
It is interesting to see big, ex-jock types delighting in
no closure, and he felt great pain in remembering. He
seeing thmselves as ballet dancers when, in truth, the
said that he took the pain into the music and saw
ballet is an experience quite foreign to many. What
butterflies that "took this thing, this baby, this hurt, and
they're experiencing, and what we bring out in the
wrapped it in soft blankets." He said, "I had the feeling of
discussions, is a metaphor for moving, acting and being
being cushioned, and the hurt was easier to absorb.
in different ways. Imagers actually sense the movement
The pain began to move out." An inner nurturer healed a
of their bodies as if they are physically dancing. They
wound that he had numbed with drugs.
talk about it as being "light" and "free." The sense of
Two images that recur many times during group freedom in their inner feeling is correlated with being
sessions are: (1) being conductor of an orchestra and free from addictions. Feeling freedom in the very cells of
(2) being a ballet dancer. In spite of the wide range of their bodies gives them a kind of knowledge not easily
educational and socio-economic backgrounds of group forgotten.
members, much of the imagery is similar.

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 I emphasize the reinforcement of this image by
encouraging the imager to re-experience it when in
We also talk about the enormous strength and
need of feeling confident and in charge of life. The
coordination, commitment and concentration that are
energy of the image can be used as a centering point
required of a ballet dancer. Imagers are seeing a mental
when fragmented feelings or compulsive urges prove
model for the same qualities that are needed in
distracting.
recovery, a resource to use over and over as part of
their support system.

The image of the conductor illustrates the function of

the symbol in that the conductor is truly pulling all of the
The conductor images are vividly detailed, including the
players together in a unified whole. This image is the
elegant clothes worn by the conductor on the podium.
epitome of unity amidst diversity. Many different
Some group members are quick to grasp the concept
textures and ranges of sound produced by many
that a conductor is coordinated, focused and in control
different people using different methods of sound
of the situation. The conductor is responsible and in
production are drawn together for the common purpose
charge. This image is readily accepted as a model for
of creating a magnificent whole. It is the conductor who
what they need to be, and can be, when drugs are not in
orchestrates the unification. He is a powerful symbol for
control.
the person from whose depths he or she has emerged.

613
I believe that, as the imager is experiencing herself or "saw" herself turning away and going to sleep. "I've
himself as the conductor, the diverse aspects of the never been able to do that," she said with excitement.
resulting thoughts and feelings are being brought "Whenever somebody came and offered me drugs I
together and integrated in some invisible, unspoken would take them and stay high for several days at a
manner. This can happen even though the imager is not time. I couldn't sleep as long as I was high. Turning
cognitively aware of the event. Something different away and going to sleep is something I've never done
seems to have occurred intrapsychically, although there before." When asked how she felt in doing that, her reply
may be only a vague sense of what it is. When was an emphatic, "Good!"
psychologically healthy images occur, the cycle of
defeating behavior patterns is interrupted. Even though
symbolic language cannot be fully expressed in the I suggested to Susie that she repeat this imagery often

one-dimensional communication of verbal language, as a means of rehearsing for different behavior when

the imager senses a new perspective. she is offered drugs again.

In one session, I set the stage for an internal imaginal The suggestion of using the image for mental

dialogue between each person and his or her addiction. rehearsing is more than the superficial "just say 'no' to

(Play music example: Ravel, Concerto in G Major for drugs" statement that may involve only an intellectual

Piano, Adagio.) In the sharing afterward, Susie said that response. When the whole person is engaged in the

when her addiction appeared and talked to her, she rehearsal, when the involvement reaches down into the

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instinctual, affective level of the unconscious, the "no" is
packed with a feeling of personal power. There is a
Imagery as a mood changer is particularly effective
strong linking of internal and external realities. There is
when induced by music, which in itself has the ability to
hope in seeing that there is more to life than previous
change feeling states. Music, as images in sound, will
experiences have led one to believe.
be explored in a few moments.
Images are effective mood-changers, also. Actors are
well aware of this. One of the tricks in an actor's bag is
the ability to image in order to induce a mood response The addictive person is not lacking in imagination.

appropriate to the character being portrayed. When an Rather, unaware of the power of imagination to rule

expression of despair is called for in the script, the actor behavior, the addict has focused on images that elicit

imagines a scene of despair--perhaps something from destructive moods. Addicts in my groups nod with

his or her own experience. A shift of mood occurs. Soon understanding when I point out to them that they image

the actor can express the despair being experienced their drugs before they take them. They image getting

through imagination. On the other hand, a feeling of them before they go to get them.

despair can be lifted and transmuted in the same

manner. When images of nature occur, they often bring
MUSIC
feelings of peace, order and rightness to the imager.
Such images feed the spirit, and spiritual nourishment is Now let's talk about music as the vehicle for stirring the

vital to recovery and maintenance of recovery. imagination.

615
Music, like the universal symbol of the circle, is a universal life patterns. Musical tones simultaneously
reservoir of unity and wholeness. As sound symbol it is move away from and toward other tones, very much like
analogous to the visual symbol in that it consists of a the movement in human interactions. To further the
relationship of one process to another. Every tone is a analogy, tones too close together create dissonance
whole. The overtones created by a fundamental tone and a desire to resolve the dissonance by moving the
embrace an entire octave, and every tone is within the tones a comfortable distance apart. Tones too far apart
octave. bring a sense that something is missing and an
accompanying urge to bring the tones closer together,
Chemically addicted persons often express a feeling of
or to fill in with other tones. This is similar to human
being "lost." As one person said, "I was lost in a sea, not
relationships. Too much closeness can create friction;
knowing who I was or where I came from." Within the
distance often brings an uncomfortable feeling in the
structure of music, the human psyche can wander afar,
lack of intimacy.
become "lost" in the experience of heights, depths,
complexities and diversity. In the containment of its Tension created in music through the use of dissonant
boundaries, however, there is a feeling of arriving harmonies, an increase of volume, a rise in pitch, or
home, of finding a sense of ultimate values within. combinations of these, is similar to tensions in life
situations--tensions brought on by too much happening
In the whole of the universe there is a complicated
at once. Tension is a part of life, but it must be resolved
network of communications, where everything is related
for health and growth. Music serves as an auditory
to everything else. Music, as a complex system of
model for resolution, when the music is chosen with that
communications, is both a reflection of, and a model for,

616
intention. Fugue in G Minor," in an interpretation for orchestra.
(Play music example.) In the subsequent discussion
A well-chosen composition can involve the listener in a
and sharing time, I noticed Charles looking intently
web of complex rhythmic and tonal patterns, bring mind
reflective. He said that he had a history of never
and body to an intensely heightened state of tension,
finishing anything. He had begun music school and
then unify the diverse elements in a masterful style of
dropped out. He hadn't seen his marriage through; he
completion. The listener senses that something has
had never finished anything he started. "The music
been made right.
started soft," he explained, "and then got strong. I kept
Writer K.C. Schneider explains in a somewhat different
waiting for it to get soft again and be unfinished, but it
fashion that the entire cosmos is conceived after the
finished strong--real strong!"
human pattern and, therefore, "imitating is knowing."
I suggested that he use what he had heard in the music
The patterns heard in music are reflected in human life.
as a model for finishing "strong" in his recovery and in
Through an inner experience evoked by the sound of
anything else that he wanted to finish. The musical
appropriate music, there is a certain knowing attained in
patterns provided him with optional modes for behavior,
the listening, whether or not there is cognitive
allowing him to sense on an organic level what finishing
awareness of what is being made known.
would be like.
Sometimes, though what is modeled in the music and
Because music evokes a response that involves the
imitated in the listener's experience is clearly known. In
whole person, it serves to engage the listener far
a group session one day, I played J.S. Bach's "Little
beyond mental imagery. Rhythm, for instance, strongly

617
influences body rhythms. Heart rate, respiratory rate The medical profession has discovered, also, that
and other body rhythms begin to match rhythm and music moves matter and is using sound waves to
tempo heard in the music in an act of entrainment, dissolve kidney stones. Since sound moves matter, it
where human pulse matches music pulse. Melodies makes perfect sense to me that sound also moves,
shape moods, harmonic patterns bring feelings of ease shapes and reorganizes intrapsychic responses.
or tension. A variety of instrumental textures adds Internal images evoked by music are symbolic
richness to the listener's inner landscape, somewhat recodings of the external stimulus of sound. This is the
like a painter apply ing colors to his canvas. inner human response similar to the response of matter
to a sound stimulus. The ever-changing patterns of
Some years ago Hans Jenny discovered that playing a
sound facilitate the changing of internal images and
violin near a drum head with grains of sand on it would
symbols. Some sort of higher level processing captures
cause the grains to move around and formulate
the intrinsic structure of the music and immediately
geometric patterns. Patterns in the sand would change
transforms it to representational forms within the mind
as the music tones changed. From this early discovery,
and body.
Jenny developed a science known as cymatics,
whereby entire pieces of music can be charted with the
use of appropriate instruments. The final shape formed
The listener responds to structured, well-proportioned
by the multiplicity of tones and patterns in an entire
music with an inner structuring and proportioning. In the
composition can be seen on resulting visual charts.
same manner, externally moving shapes and sounds
bring inner movement. Music that has a soaring quality

618
often brings images of soaring or flying, accompanied bypassing usual defenses, the imager is likely to access
by feeling images of lightness and freedom. It is as if the previously hidden or unacknowledged psychic contents
listener has actually been flying. in a fairly short time.

As can be observed then, music, as imagery in sound, is The form, shape and vitality of music help to shape
a strong and immediately engaging stimulus for vague memories into vivid details of the past.
emerging images from the listener. The auditory Sometimes the images are symbolic rather than literal,
imagery stimulates other sensory responses--tactile, representing events, objects or persons. Yet the
olfactory, gustatory and visual. Such sensory stimuli dynamic process of the sound source infuses the
serve effectively in the retrieval of memories and the symbols with an intensity that reels the imager inward
evocation of affect surrounding them. toward an experience of focused involvement.

Frequently, listeners make direct reference to the

influence of music upon their images. Susan, for
Since most of the music that I use in therapeutic settings
example, said, "The music was like my recovery. At
is nonverbal, resistance to words--the everyday,
times I want to rush through, and at times I want to learn
familiar and sometimes threatening mode of
more. I have to calm down and listen."
communication--is largely removed. When images are
induced by music rather than by the spoken words of (Play music example: Bach, Harpsichord Concerto, D
the therapist, the risk of imposing the therapist's belief minor, BWV 1052, allegro.)
system on the client is significantly reduced. In

619
Gerrie's comment was that the speed and slowing down rhythms stubbornly resist changes in the cycles.
of the music was "a lot like when I was on (crack) Girdano and Everly suggest that, behaviorially, humans
cocaine. Only when I was on cocaine and slowed down, are different people at different times of the day. Drugs
I got depressed." She said, The slowing down today with taken at one time of day have a stronger effect than the
the music was relaxing and good." Remember this piece same dose taken at another time.
of music because I'm going to refer to it again.
Scientists believe that the addictive power of crack
stems from the steep rise and rapid fall of brain levels
when the drug is smoked or taken intravenously. Such
Gerrie's response points out how mind and mood-
actions are an assault on natural biological rhythms,
altering chemicals disturb the equilibrium of bodily
violently interrupting bodily cycles that promote stability
functions. Girdano and Everly in their book, "Controlling
and health. It isn't surprising that such an invasive
Stress and Tension: A Holistic Approach," explain that
procedure strongly affects emotions. Well-chosen mind
both the natural world and the human body run on time.
and mood-altering music is a strong influence on the
Time in the natural world is seen as solar, lunar and
restoration of equilibrium and the reeducation of mind
seasonal time. With the human, there are fluctuating
and body to their value in achieving integration of parts
times of energy, hormones, metabolism and
of the self.
temperature. Biological rhythms are naturally recurring
cycles of activities governed by the nervous and Cellist William Pleeth says, "Nothing is separated from
hormonal systems. Each cycle has a beginning and an anything else. This whole scene is an unwrapping of an
end; each has a zenith and a nadir level. Basic biological endless universe." The whole scene exposes both the

620
destructive and constructive elements existing side by In another session, the same man spoke again of the
side, both within the individual and in the collective world direct influence the music had on his imagery. I had
of all peoples. Mind, mood, and body can be altered asked the group members to see, in their mind's eye,
without difficulty. The choice is profound. Will the the obstacles to their recovery. (Play music example.
altering elements be life-giving or life-destroying? Bizet: Carmen Suite No. 1, "Intermezzo.")

It seems that the ability of music to restore balance from This man saw himself sitting with his father and his wife,
imbalance and harmony from discord serves to lift the while looking at a pornographic magazine, another of
level of consciousness in every cell, atom and mental his addictions. In external reality this had never
process in the listener. When the foundations of mind happened, since both his wife and his father
and body have been aligned and redirected, conscious disapproved of his addiction to pornography. "In the
recovery becomes possible. image, things were really tense," he said. "Then the
music started, and spring came into the room. I could
In one session, a professional man spoke of the Bach
hear birds singing and could look out and see flowers in
piece I had just played as being balanced, flowing,
bloom. We all relaxed. The porno magazine lost its
mathematically perfect, "the way I used to be," he said.
power. We were just talking together. When the music
He expressed his love of music and said he had
became fuller my mind wandered off. When the music
stopped listening when he got into drugs. I urged him to
cameback to just the flute and the harp, the scene of us
begin listening again as a resource in his recovery. He
talking together returned--like we had been through
responded to this with enthusiasm.
something. It was a nice feeling." When the music

621
brought him images symbolic of birth and renewal, the After spending a brief time getting the group (all male)
compulsivity of his addiction was no longer tugging. It focused on their breathing, I planted a verbal seed
had lost its power. The sound of a few solo instruments, image. "See in one of your hands a symbol of your
the flute and harp, encouraged inner dialogue. It addiction," I suggested, "however that symbol appears
facilitated a return to quiet, intimate conversation. to you." Then I played the Bach "Concerto for
Harpsichord" mentioned earlier. Let me give you the
Another man responded in this way to the same music.
same experience and see how you respond. If you have
He said he saw a young man on a street corner, doing a
no addictions, you might imagine a symbol of something
(drug) deal. He said, "I saw the rocks he had. Then the
you're holding on to that you'd like to let go. (Experience
music drew me off the street into the Corps de Ballet.
music and imagery.)
The dance was powerful, and I forgot about the dope
man. I didn't even notice the time." There were 17 men in the group. When the music
ended, they couldn't wait to share their experiences.
Even listeners unfamiliar with classical music become
Many raised their hands simultaneously for their turn in
surprisingly attentive to it. In planning the first group
speaking.
session at St. Jude's I knew that, with the wide diversity
of backgrounds in the population, music preferences A1, a garbage worker from an outlying town, said, "I'm
would probably include rap, gospel, soul and jazz, as stunned." He said that his symbol, in his left hand, was
well as rock. Still, I chose to use what had been so his money. His practice had been to get his pay and
effective in the past--classical music. How glad I am that come to Atlanta for his cocaine. "I saw myself with my
I made that choice! money in my hand, coming to Atlanta to find my

622
cocaine," he said, "but it never appeared! I heard the door shut and ran from the room. When I pointed out the
music go this way, da-de-da (he hummed a brief strength he showed in throwing the rock down and
passage), and I would wait for it to happen again. But I leaving, he replied emphatically, "I didn't just leave. I
could never see my cocaine or my druggie friends!" ran."
Fascinated by his experience, he said he couldn't wait
Several said the music sounded like 18th century music,
until the next session. He added a final, "I'm stunned."
as, indeed, it was, and their imagery included seeing
What was taking place in the imagery was an themselves in 18th century scenes, living simpler lives.
interruption of his cyclical behavior--get money, buy All who experienced this imagery expressed a feeling of
drugs, get high, go to work, get more money, buy drugs, peacefulness.
get high. Breaking the cycle on an inner level provided a
The style of any period of music is the expression of
strong intervention for getting unstuck from an
composers as they react to the political, economic,
entrenched, self-defeating weekly pattern of action.
artistic, religious and philosophical forces that shape
Bob's symbol was a rock (his cocaine). He saw himself their environment. The form, structure and manner of
in a room with a table, and he threw the rock down on expression of a piece of music connects the listener to
the table. He told with great excitement of how the table the cultural climate in which it was written. The Baroque
legs started dancing. His drug friends in the room era (1600-1750), during which Bach wrote the
started dancing, also. The refrigerator in the room harpsichord concerto, was a time of conflict and, at the
began to dance. Bob opened the refrigerator door and same time, an age of reason. The social turbulence
saw a beer, another of his addictions. He slammed the inherent in the vast gaps between the very wealthy and

623
the great masses of the poor was balanced by an keep the listener on the hook until the final notes. One
emphasis on rational thought. Major scientific findings has the sense that all has been said that needs to be
were made by Repler, Galileo, Newton, Descartes and said, and something is finished. All of the interactions,
others. There was also intense religious devotion however, are safely contained within a defined
among the people as well as a general love for music- structure, with the predictability of repeated passages
making. Bach's music reflects the period's love of and . a clarity which allows all instruments to be heard.
ornamentation combined with well-proportioned, well-
That session affirmed for me that the highest and best
ordered living. It is music of order and reason. Listeners
in everyone responds to the highest and best in music.
to Baroque music are infused with, and respond to, the
concepts of the period. Music and the imagery that it inspires provide stretching
and expanding experiences that open addicts to parts
Group members were very interested in why I had
of themselves they may have never known. Through
chosen that piece, said they like it and that it had kept
music, they can leave the egocentrism of the addict's
them awake. Many commented that it was the first time
world and embrace a larger vision of humanity
they had not heard the sound of the heavy traffic on the
unencumbered by a limiting dependency on drugs.
street only a few feet outside!
As a system of a highly-functioning order, music
I chose this piece because, for the entire eight minutes
permeates the human mind, body and spirit with its
of this movement, there is continuing interaction
nature. In a polyphonic composition, individual themes
between the harpsichord and the chamber orchestra,
are stated clearly and definitively. At times they bend to
with no cessation of movement. The actions in sound

624
diverse changes, at times they listen in silence to the I use for my drug. I kept running away from it. I used to
statement of other themes. All the while, the themes are pawn my sister's stereo to get money," he explained. He
weaving together interactively amid an environment of continued, "Then the music jumped in and scared me. It
complex dynamics. It is the quintessential example of was like my dope man. I locked my left arm and called
unity in diversity, of a healthy balance between on my right hand for help. I don't want to do that (drugs)
individuation and togetherness. What most humans again."
seek is a sense of individual uniqueness in communion
This man's experience revealed that he had within
with the whole. Music draws the listener in to experience
himself not only the compulsion that drove himto do
that individual and collective wholeness at an existential
shameful things, but also the means for overcoming the
level.
compulsive urges. Calling on his right hand for help was
It has been my observation that such inner experiences symbolic of focusing on the strongest and healthiest
also help chemical dependents to clarify feelings about part of his nature.
themselves and their addictions, provide insights into
Niles, in the same session, said, "I saw my right hand
different behavior, and offer a barometer of attitudinal
grabbing hold of the penitentiary bars. In the
changes that have already occurred in their treatment.
penitentiary there would be certain times of the day that
For example, using the same harpsichord concerto in I would just hate." He added, "Then, I had an image of
another session I asked participants to see a symbol of the sun reflecting everywhere, and I felt a lot of heat. In
their addictions in one hand and a symbol of recovery in my left hand I saw my little girl. That brought a pleasant
the other. One man said, "In my left hand I saw the bowl feeling."

625
For many, thoughts of their children bring thoughts of affects body rhythms and influences mood and mental
recovery and a desire to succeed in their treatment. states. Music, then, has the power to affect the listener
Peter saw "death in my left hand," he said. "In my right negatively as well as positively. Incessantly loud music
hand I saw my daughters as a symbol of life." On drugs with relentless, hard-driving, aggressive rhythms
for 26 years, he had never seen his daughters when he characteristic of hard rock, brings responses of a similar
was "clean." He would be seeing them a few months nature from the listener. As without, so it is within.
later and wondered how different it would be in relating
I explain this to the chemical dependents at the same
to them. He poignantly spoke of his desire for a new
time that I encourage them to use music as a part of
relationship with them.
their support system in recovery. Frequently, their
Leonard saw "the glass I used when I was getting high," responses to music that I play for them are images of
he said. "I didn't enjoy it this time, though. It just didn't themselves in nature scenes, with accompanying
feel right." feelings expressed as "feeling good," "natural," "being in
a peaceful land." "serene," "clear, beautiful," "being able
These responses reflect the breaking of cyclical
to let go of the troubles of my mind." These are feeling
behavior on an inner level. In line with Goethe's belief
states not experienced by many of them for a long, long
that "what is within is also without," healthy intrapsychic
time-often for years. The ordered time of healthy music
changes are expressed in positive, growth-producing
tends to restore, on a cellular level, the balance of
actions. But, in a reversal of that paradigm, we are what
minds and bodies debilitated by long drug use. On the
we hear when we listen to music. Examples have
other hand, the assaultive nature of hard rock, heavy
already been given as to the manner in which music

626
metal and the like, returns addicts to the chaotic, Cliffs, NJ: Prentice-Hall, Inc.
confused states of their drug days.
Machlis, Joseph. (1984). The enjoyment of music. (5th
As a support system that is not dependent upon people ed.). New York: W.W. Norton & Co.
or circumstances, music of a quiet, structured, uplifting
Rudhyar, Dane. (1982). The magic of tone and the art of
nature can provide access to the addict's own ability to
music. Boulder, CO: Shambhala Publications, Inc.
achieve an inner sense of rest and balance. This inner
Samuels, Mike and Samuels, Nancy. (1975). Seeing
quiet is a strong, contributing factor to the feeling about
with the mind's eye. New York: Random House, Inc.
drugs expressed so simply yet powerfully by Leonard,
"It just didn't feel right (this time)." Shepard, Roger. (1978). Externalization of mental
images and the act of creation. In Randhawa, Bikkar S.
and Coffman, William E. (Eds.). Visual learning, thinking
REFERENCE LIST:
and communication. (pp. 133-189). San Diego, CA:
Cirlot, J.E. (1962). A dictionary of symbols. New York: Academic Press.
Philosophical Library.
Tame, David. (1984). The secret power of music. New
Gehorsam, Jan. (1992, January 3). Does crack cocaine York: Destiny Books.
make you crazy? The Atlanta Journal. pp. C1, C3.

Girdano, Daniel and Everly, George. (1979). Controlling

stress and tension: A holistic approach. Englewood

627
 EF F EC T O F VI BR O AC O U ST I C T H ER APY O N Age distribution:
BL O O D PR ESSU R E. SPEC I F I C EF F EC T S O F
20-29 years : 6%. 30-39 years : 17%. 40-49
F R EQ U EN C I ES AN D C H O I C E O F M U SI C
years : 16%..

O LAV S KILLE 50-59 years : 18%. 60-69 years : 20%. 70-79

years : 14%

In 1989 Olav Skille wrote an article on the effect of 80-89 years : 3%

VibroAcoustic Therapy (VAT) on blood pressure and
pulse. The study was based on 82 therapy sessions21.
During VibroAcoustic Therapy the patient is exposed to
The findings described a marked, but varying effect on whole-body excitation from sinusoidal, regularly
the measured functions. The medium values were : pulsating, sound-pressure waves in the VibroAcoustic
Syst. BP -4,34- Diast. BP -5,35. Pulse - 4,49. area (30 Hz - 120 Hz). The frequencies are chosen
Rising values were found in about 25 % of the cases. according to the purpose of the treatment. The sound-
pressure waves are mixed with music. The client is
Of the patients 30% were men and 70% women.
exposed to the therapeutic sound system sitting in a VA
chair or lying in a VA bed. The therapy cassette-tapes
were supplied by VibroSoft
21
Skille, Olav : Variations in Blood Pressure and Pulse during
VibroAcoustical treatment. Pilot study. In: ISVA Bulletin no. 2, 1989.
International Society for VibroAcoustics.

628
A therapy session normally lasts between 20 and 29 N=

minutes. m= sd=
The results can be summed up in the following table: ASBP 1 24 8,92 9,94 - 4,34 9,44 57 - 9,98 7,65

TABLE OVER CHANGE IN VALUES ADBP 3 22 8,86 10,58 - 5,35 7,69 58 - 9.09 7,66

AP 8 18 4,78 4,16 - 4,49 7,20 56 - 8,43 5,08

Group A = values measured after 5 mn rest and at end

BSBP 4 16 7,06 3,51 - 4,29 9,44 62 -12,74 8,94
of session
BDBP 5 22 7,41 7.73 - 4,23 10,67 55 - 8,51 9,92

Group B = values measured at arrival and after 5 min BP 12 19 5,32 5,69 - 3,16 7,18 51 - 7.14 5,06

rest

Group C = values measured at arrival and at end of CSBP 3 12 8,33 6,09 -12,20 12,94 67 -16,75 9,35

session CDBP 5 14 6,00 7,69 - 7,98 11,23 63 -11,38 10,03

SBP = Systolic Blood Pressure. DBP = Diastolic Blood CP 2 13 5,40 5,84 - 7,40 8,25 67 - 9,86 5,54

Pressure. P = Pulse

Table 1: Changes in Blood Pressure. (Skille 1989)

Group Un- Rise m= sd= Whole group Fall m= sd= Cally Brnstad, registered nurse working at TRILAX
chan-
N= Rise Rise n= Fall Fall Centre in Steinkjer, carried out a similar study based on
ged

629
334 therapy sessions22. 8.22

Rising values in 29.3 % of the cases. m = + 7.69, sd =

6.68
Fndings:
Unchanged values in 2.4 % of the cases.
SYSTOLIC BP:

Whoie group: m = - 6.53, sd = 10.92.

PULSE:
Falling values in 71.2 % of the cases. m = -10.88, sd =
8.53. Whole group : m = - 4.51, sd = 7.88.

Rising values in 24.6 % of the cases. m = + 6.82, sd = Falling values in 68.8 % of the cases. m = - 7.29, sd =
5.15. 5.91.

Unchanged values in 4.2 % of the cases. Rising values in 21.6 % of the cases. m = + 5.58, sd =
5.57.

Unchanged values in 8.7 % of the cases.

DIASTOLIC BP:

Whole group: m = - 5.18, sd = 11.4.

VARIATIONS:
Falling values in 68.3 % of the cases. m = -10.52, sd =
Corresponding reaction: Reduction of SBP and DBP :
22
Br0nstads, Cally: Rapport nr 2 vedr0rende effekten av VibroAkustisk
terapi pa blodtrykk og puls. Unpublished report to ISVA. 1990 51.8 %

630
Corresponding reaction: Increasing SBP and DBP: 10.8
%
CONTROLLED RESEARCH - ESTONIA.
Increased SBP and reduced DBP: 13.2 %
An Estonian research team23 has studied 40 patients
Reduced SBP and increased DBP: 17.7 % and have come to the conclusion that 10 treatment
sessions seem to be the most effective number of
Unchanged SBP and reduced DBP: 3.0 %
treatments.
Increased SEP and unchanged DBP: 0.6 %
The patients were first consulted by various physicians,
Unchanged SBP and increased DBP: 1.2 %
- therapist, neurologst and cardiologist, and the
Reduced SBP and unchanged DBP: 1.8 % patients with diagnosis hypertension were treated by
the VA-team.

Patients treated
The study shows that one can expect reduction in either
SBP or DBP in about 70 % of the cases. Corresponding N= 25. 72% female, 28% male.Age: 21-60 years.
reactions in both SBP and DBP can be expected in
Professions: Leaders of social and industrial enterprises
around 50 % of the cases, whereas a general increase
and employees of the same enterprises.
can be expected in only 11 % of the cases.
23
There were no cases with corresponding unchanged Saluveer,E, Tamm, S., Ojaperv. I.: The use of VibroAcoustic Therapy
on 40 Psychiatric patients in the Dept. of Medicine, Tallinn Pedagogical
readings in both SBP and DBP. Institute, USSR Estonia.
Paper read at 2nd International seminar on the use of VibroAcoustic
Therapy, Steinkjer, 14.-16.4. 1989.

631
 BP syst before Week >130 Diast >80:
Complaints: Depression, asthenia, hypochondria, treatment, 1: 44,6% 56,0%
hypertension. after treatment, Week >130 Diast >80:
Subjective symptom reports: Cry often, Head-ache, 1: 32,0% 52.0%
Tachycardia, Lack of concentration, Restless dreams, BP syst before Week >130 Diast >80:
Constipation, Indigestion, Easily stirred up, treatment, 5: 47,6% 38,2%
Stomach troubles, Poor appetite, Sweating, Trembling
after treatment, Week >130 Diast >80:
of hands, Apathy.
5: 38,2% 48,8%

Table 2: Changes in Blood Pressure. 5 week study.

An analysis of the changes in blood pressure shows the (Saluveer & al 1989)
progress of BP changes during the 5 weeks of the
described project:
The Estonian research team is summing up their
findings by describing the results on blood pressure this
5 WEEK STUDY OF THE EFFECT OF VAT ON BLOOD way:
PRESSURE.

(% values: The number of patients within the described

1. The treatment of elderly patients was more effective.
area)

632
2. Women are more easily cured than men (They In 1992 Olav Skille studied the specific effect of the
became less tired, less head-ache, less distressed, less therapy cassettes which had been in use during 1988 -
trembling of hands) 1991. 621 therapy sessions were included in the
material. The therapists had a choice of 97 therapy
3. During the course of treatment the blood circulation
cassettes, each doublesided. They therefore had 194
was improved.
therapy program alternatives. Several alternatives were
a) acro-cyanosis is diminishing. Temperature of
not used at all, others only a few times.
limbs rises.
For statistical reasons all programs which had been
b) systolic and diastolic blood pressure drop
used less than 10 times were rejected.
c) Head-ache and nausea vanish. Improvement of
cerebral biood circulation
GENERAL DATA: n = 621.

Systolic variations: Mean Syst. BP : 127.1, sd = 18.3

The Estonian team say that the VA-methods can play a
Increase ( 1 - 23 mm Hg) : 16,0 %
considerable part in the treatment of patients wlth
hypertension. Good results have already been Unchanged: 12.5 %
achieved.
Decrease ( 1 - 40 mm Hg) : 71.5 %

633
Diastolic variations: Mean Diast. BP : 77.4, sd = 12.3 use
Increase ( 1 - 32 mm Hg): 22.1 % d

Unchanged: 14.9 % 1. Cassette Peter Christian Hamel : NADA + 53

# 001 a 68 Hz
Decrease (1 - 40 mm Hg): 63.0 %
2. Cassette Kitaro : Silk Road + 40 & 60 Hz. 10
# 002 a
Variations in Pulse: Increase (1 - 20 beats/sec) :
3. Cassette Rising Sun : Summer Suite + 44 34
14,5 %
# 008 a Hz.
Unchanged 10.9 %
4. Cassette Rising Sun : Summer Suite + 42 41
Decrease (1 - 38 beats/sec) : 74.6 % # 008 b Hz.

5. Cassette Deuter : Cicada + 54 & 62 & 68 15

# 012 a Hz.
SPECIFIC DATA ON THERAPY PROGRAMS (40 Hz 6. Cassette Deuter : Cicada + 70 & 68 & 64 & 10
roughly equals the tone E) # 012 b 58 & 46 & 86 Hz
Cassette Composer/Artist + Tim 7. Cassette Otto Romanowski : E-vib + 40 Hz. 14
number Frecuency(ies) added es # 019 b

634
8. Cassette Arve Tellefsen : Pan + 39 & 54 & 16 14. Kitaro : Oasis + 66 & 57 & 66 & 86 15
# 022 a 58 & 63 & 66 & 72 Hz Cassette # Hz.
069 a
9. Cassette Stephen Halpern : Spectrum 13
# 029 a Suite + 68 & 38 & 41 & 44 & 50 & 15. Zamfir, George : Music by 11
55 & 63 Hz Cassette # Candlelight + 51 & 40 & 59 & 67
089 a & 86 Hz.
10. Lyghte/Noll : Cosmic Crystal + 44 57
Cassette # Hz. Table 3: Music and frequencies used in this research
047 a study (Skille 1992)

11. Lyghte/Noll: Healing Temple 29

Cassette # Journey + 68 Hz
The choice of cassettes are partly dependent on the
047 b
patients' condition, but are also reflecting the taste of
12. Roach, Steve: Quiet Music + 57 26 the therapists, as there were many musical alternatives
Cassette # Hz. for each frequency and/or frequency area. Until now we
059 a have had no objective evaluation of the effect of the

13. Roach, Steve: Quiet Music + 42 52 different therapy programs. The following table may

Cassette # Hz. give some indication towards evaluating the effect of the

059 b programs. However, we have no indication showing a

direct correlation between the effect on BP and Pulse

635
and the reduction of symptoms experienced by the Cassette # Systolic BP Dastolic BP
patients. Pulse

It may be of some interest to note the frequency of use m= 127.1, sd = 18.3 m= 77.4, sd = 12.3
for these therapy programs. It is not incorrect to
suppose that the frequency of use is reflecting the
subjective evaluation of the therapists and patients on n = m= - sd = m= - sd = m= - sd =

the effect of the programs. There is no direct correlation 621 7.1, 9.7 4.5, 9.5 4.9, 6.7

between the frequency of use and the measured effects

on BP and pulse values.
001a m= - sd = m= - sd = m= - sd =
The effect of the tapes may be of a purely physical 9.8, 10.4 5.0, 8.2 5.0, 7.1
nature, but it is more likely that we observe an effect
002a m= - sd = * m= - sd = *m= - sd =
which both affects soma and psyche. Many patients
8.2, 10.9 9.4, 8.3 9.1, 8.2
observe paliiative effects on conditions of psycho-
somatic nature. (Cfr. the Estonian study) 008a m= - sd = m= - sd m= - sd =
4.0, 9.2 4.2, =12.3 5.3, 7.8

008b *m= - sd = m= - sd = m= - sd =
8.3, 7.4 5.2, 7.4 6.3, 6.6
EVALUATING THE EFFECT OF THE 15
012a m= - sd = m= - sd = m= - sd =
THERAPY TAPES

636
 5.5, 10.4 3.4, 6.5 6.2, 7.3 6.2, 7.8 3.9, 6.5 4.9, 5.0

012b *m= - sd = m= sd = m= - sd = 069a m=- sd = m= - sd m= - sd =

7.8, 5.9 +1.0, 9.8 2.2, 4.2 10.4, 11.8 4.0, =12.0 4.2, 4.9

019b m= - sd = m= - sd *m= - sd = 089a m= - sd = * m= - sd = *m= - sd =

5.7, 8.8 2.9, =12.4 7.5, 4.7 7.3, 9.9 5.3, 4.8 6.9, 4.2

022a m= - sd = m= - sd m= - sd = Table 4: Comparison between the tapes used and their

6.3, 10.9 5.5, =10.0 3.5, 4.9 effect on BP and Pulsa.

029a m= - sd = m= - sd = m= - sd = (Skille 1992)

2.9, 10.0 3.6, 8.0 0.7, 6.6
From this table we can find no therapy program with a
047a *m= - sd = m= - sd = m= - sd = general, reducing, effect on SBP, DBP and Pulse. The
7.7, 7.1 3.3, 5,5 4.3, 5.0 programs marked with *, however, show significantly
better effect than the mean values. There are 7
047b m= - sd = m= - sd = m= - sd =
programs which are marked with * in any area. Of these,
6.9, 7.9 3.4, 8.7 4.9, 5.7
only cassette # 089a contains "normal music" with
059a m= - sd = m= - sd = *m= - sd =
different frequencies for each melody (multifrequency
8.1 9.3 4.3, 8.6 7.7, 5.4
tapes). Cassette # 012b is a190 a multifrequency tape,
059b m= - sd = m= - sd = m= - sd = but is composed for meditative listening. The effect on
DBP must be noted, and may be explained by the

637
unique frequency at the end of the program - but as we We here can see a significant difference in DBP
do not have any tests showing the effect of the same variations which can be observed in the two groups of
tape without this frequency at the end (it might f.ex. be patients. The variance in SBP is of no significance. This
substituted by 43 Hz, which is one octave below 86 Hz), observation supports the Estonian observations that
this must remain to be only an assumption. VAT may be used to treat elevated Blood Pressure.
(Table 2)
There is more substance to the observation that most of
the tapes are single (or double) frequency tapes in the
40 - 44 Hz area. The 57 Hz tape has a significant effect
Diastolic BP Variation Systolic BP Variation
on Pulse only. It may therefore be correct to state that
Low DBP
frequencies in the 40 Hz area, combined with music Group
specially composed for relaxation, have the most n = 85
m= + 1.3, m= 113.2 m= - 6.1,
predictable effect on lowering BP values in the patients. m= 59.7, sd= sd= 8.6 sd= 12.9 sd= 10.8
4.4
Elevated
EFFECT OF VAT ON PATIENTS WITH DBP Group

ELEVATED AND LOWERED BLOOD PRESSURE n = 103

m= -13.4, m= 138.5, m= - 7.8,
m= 97.7, sd= sd=10.9 sd 23.3 sd= 11.1
It may be of interest to have a closer look on the effect of 8.3
VAT on patients with elevated (DBP > 90 mm Hg) and Table 5: Effect of VAT on Low and Elevated Blood
low (DBP < 65 mm Hg) Blood Pressure. Pressure (Skille 1992)

638
 Pulse Skille 1989 - 4.5 7.2 n= 82
The decrease in BP values may be explained by a Br0nstad - 4.5 7.9 n= 334
muscle relaxing and vasodilatory effect of these 1990
frequencies, but we need more controlled and directed Skille 1992 - 4.9 6.7 n= 621
research in order to be able to make exact statements. Table 6: Consistency of measured effects 1989 - 1992.
(Skille 1992)

COMPARISON BETWEEN 3 STUDIES OF

VARIATIONS IN BLOOD PRESSURE AND The consistency of measured values can be considered
PULSE. to be satisfactory. The difference of values between
Table 5 and 6 is noteworthy.
m sd

Systolic BP Skille 1989 - 4-3 9-4 n= 82

Br0nstad - 6.5 10.9 n= 334 CONCLUSION
1990
The aim of this study has been double:
Skille 1992 - 7.1 9.7 n= 621
Diastolic Skille 1989 - 5.4 7.7 n= 82 1) It is necessary to describe the effects of VAT as
BP extensively as possible in order to have the method
Br0nstad - 5.2 11.4 n= 334 accepted as a reliable means of therapy for certain
1990
disorders.
Skille 1992 - 4.5 9.5 n= 621

639
2) It is necessary to provide data for composers who facilitate counseling objectives with those who are
want to make therapy programs for VAT. We here meet dealing with medical problems (Standley, 1986).
both medical and artistic challenges, which really can
Despite the volume of research demonstrating the
make further studies interesting for research projects in
value of music in a variety of medical/dental treatments,
Music-medicine.
there is not yet consensus on which techniques or
procedures are most effective. The profession of music
therapy is still evolving as a viable component in the
M U SI C I N M ED I C I N E: R ESEAR C H AN D
array of medical treatments (Maranto, 1991). As
C L I N I C AL APPL I C AT I O N S
medical music therapy: develops, its methodology will

J AYNE M. STANDLEY have to conform to the specifications of the medical

model, i.e., a priori treatment protocols dictated by
specfic diagnoses and proven options, predictable
Introduction outcomes for a known frequency and duration of
Research into the uses of music in medical treatment is applications, and systematic documentation
ongoing. To this point it has generally been procedures to readily identify positive or negative health
demonstrated that music st-imulates physiological consequences (Standley, 1992b).
effects that may have clinical significance in multiple Formal, quantitative synthesis of the accumulating
medical settings (Newmark, 1991). Music has also been research literature can provide justification for music
shown to promote a general feeling of well being and to therapy techniques in applied health practices. Such a

640
procedure is the meta-analysis, the application of a Meta-Analyses
variety of statistical formulae to the results of a body of
Fifty-five studies conducted between 1957 and 1991
homogeneous research to compute effect sizes, i.e.
qualified for inclusion in the two meta-analyses by
quantitative summaries of the properties and findings of
containing empirical data; by utilizing actual, not
individual studies. Effect sizes can then be compared
simulated pain stimuli; by utilizing music as an
and contrasted across multiple variables (Glass,
independent variable; by utilizing subjects who were
McGaw, and Smith, 1984) and these overall results, to
actual patients with medical/dental diagnoses; and by
some extent, generalized.
reporting results in a format amenable to replicated
The purpose of this paper is to synthesize the pooled data analysis. The procedures followed the three basic
results of a series of meta-analyses of 55 studies steps outlined by Getsie, Langer, and Glass (1985): 1) a
utilizing 129 dependent variables measuring the effects complete literature search was conducted to find all
of music in medical treatment (Standley, 1986; 1992b: possible members of the defined population of studies
In Press) with current medical research to identify and whether published or unpublished sources; 2) the
authenticate effective music therapy medical characteristics and findings of the collected studies
techniques and, further, to develop these techniques were identified, described, and categorized; and 3) the
into clinical procedures which meet the criteria of composite findings were statistically analyzed and
standard medical protocol. converted to computed effect sizes.

Estimated effect sizes ranged from 3.28 to -.59,

meaning that the music condition was sometimes more

641
than three standard deviations greater in desired effect variables.
than the control condition without music while the four
variables with a negative value indicated that for those
dependent measures the music condition was less Table 1. Meta-Analysis Results: Generalizations

beneficial than the nonmusic condition. (It should be from the Research Literature About the Use of

noted that these four negative results were from studies Music in Medical Treatment

with multiple dependent measures and all contained

other dependent measures which showed a very
SEX Women (ES=.70) respond to music with somewhat
positive reaction to music.) The overall mean effect size
greater effect than do men (ES=.57)
for all 129 dependent measures was .88; therefore, the
average therapeutic effect of music in medical
treatment was almost one standard deviation greater AGE Children and adolescents (ES=1.12) respond with
than that without music. greater effect than do adults (ES=.86) or infants

After each study was evaluated and categorized (ES=.47).

according to its unique characteristics, a value on a

linear scale of effect was calculated for each dependent
PAIN Music has greater effect when some pain is
variable, then multiple comparisons were made, i.e., by
present (ES=.95) than when it is not a usual symptom of
subjects' diagnosis, age or sex; type of experimental
the diagnosis (ES=.70), though music seems to
design or sample size; and independent or dependent
become less effective as the pain increases.

642
TYPE The most conservative measure of music's
effect is
MUSIC Live music presented by a trained music
therapist (ES=1.10) has a much greater effect than does
recorded music (ES=.86).
DEPENDENT patient self-report (ES=.76) while
systematic

MEASURE behavioral observation (ES=.94) and DEPENDENT Effects vary greatly according to the
physiologic measures (ES=1.0) result in basically specific
equivalent effect sizes.

MEASURES dependent measure utilized. Greatest

DIAGNOSES Effects vary widely according to effects are reported for respiratory rate, EMG, amount
diagnosis. Music is less effective when severe pain is a of analgesic medication, and self-report of pain.
usual symptom or the diagnosis has serious Smallest effects are measured by length of labor in
implications. Effects are greatest for dental patients and childbirth, amount of anesthesia, days of
those with chronic pain, i.e., migraine headaches. hospitalization, and measures of neonate behavior.
Minimal effects are reported for obstetrical, coma and
cancer patients with lowest effects, again, being
reported for neonates. Table 1 cites generalizations that can be made from the
meta-analysis results about the uses of music in

643
medical treatment. Analyses by sex showed that women tissue (as in childbirth, surgery, or cancer), then music
reacted more favorably to music than did men, even proved to be more effective.
though obstetrical studies with severe ischemic pain
Even though the number of empirical studies using live
represented a large portion of the research on females.
music was small (N=12), these data do seem to confirm
By age, adolescents had a stronger reaction than did
the more pronounced medical impact that the music
adults or children, perhaps because of their strong
therapist has when adapting the musical event to meet
preference for and cultural identification with music.
the specific needs of the patient as opposed to results
Infants, those with the shortest life span involvement
obtained with the use of commercial, pre-recorded
with music, had the least response.
selections.
Across diagnoses, it appeared that effects were
Results for specific dependent measures revealed that
differentiated by issues of severity, including level of
respiration rate was most affected by music, followed by
pain, degree of anxiety, and prognosis. When pain was
EMG and amount of analgesic medication used by
the only diagnostic characteristic considered, the effect
patients. Again, especially low effects were achieved
size was greater (ES=.95) than when pain was not a
when infant behaviors were monitored (movement,
usual symptom of the diagnosis (ES=.70). Further
ES=.17; crying, ES=.30; and weight gain, ES=.46).
comparison clarifies the extent to which music
specifically alleviates physical distress. When the pain Research Based Music Therapy Medical Protocols

was temporary (as with dental problems and

headaches) and not the "deep" pain of ischemic muscle

644
Results of this comprehensive, quantitative research Reduction of pain, anxiety, or stress.
analysis can then utilized to delineate specific
Enhancement of chemical anesthetic/analgesic to
techniques for using music in medical treatments with
reduce amount of medication required, duration of use,
such delineation continuously updated through the
and aversive side effects.
addition of ongoing research results. Additionally,
Reduction in length of hospitalization.
techniques can be organized by the intended function of
the music to accomplish specific therapeutic objectives, Diagnoses:
expected results by diagnosis, general procedures for
Surgery - Music used preoperatively to reduce
utilizing the technique effectively, and suggested
anxiety and to reduce amount of anesthesia (Chetta,
documentation of effects through behavioral,
1981; Gardner & LIcklider, 1959; Spintge, 1982; Spintge
physiological, and self-report measures.
& Droh, 1982); used during surgery, especially with local
anesthesia, to reduce anxiety and mask operating room
sounds (Kamin, et al., 1982; Stein, 1991; Tanioka, et al.,
Technique 1. Passive Music Listening (Alone or Paired
1985) ; used postoperatively in the recovery room to
with Anesthesia, Analgesia, Suggestion, Relaxation
promote wakefulness and reduce discomfort(Locsin,
Techniques or Imagery)
1981; Sanderson, 1986); used for first 48 hours
Music Function:
following surgery to reduce amount of analgesic and
To serve as an audioanalgesic, anxiolytic or sedative. adverse effects of anesthesia (e.g., vomiting,
Therapeutic Objectives: headaches, restlessness, etc.(Siegel, 1983; Steinke,

645
1991 ). Neonates - Music used with premature or sick
infants to promote weight gain, to reduce pain or stress,
Kidney dialysis - Music used to reduce discomfort
and to reduce length of hospitalization (Ammon, 1968;
and serve as a distraction during this frequent (2 to 3
Caine, 1991; Chapman, 1975; Lininger, 1987; Owens,
times/week), long term (months or years), lengthy (4
1979; Marchette, et al., 1992).
1/2 to 5 hours) procedure involving pain, nausea, and
restricted movement (Colgrove, 1991; Rider, 1985; Immunology - Music listening used to increase
Schuster, 1985). levels of IgA. (Music combined with imagery is
contraindicated at this time, Tsao, et al., 1991),
Burn - Music used to reduce pain and anxiety in
hydrotherapy, intravenous fluid therapy, skin grafts, etc. Office Treatments - Music used during stressful
(Barker, 1991; Schieffelin, 1988; Schneider, 1982). office treatments such as dental procedures, abortions
and other painful gynecological procedures,
Cancer - Music used to reduce pain and enhance
bronchoscopy, and podiatry treatments to reduce
analgesic effects of medication or used during
amount of selfadministered anesthesia and analgesia
chemotherapy to reduce nausea and vomiting (Curtis,
(Bob, 1962; Corah, et al., 1981; Gfeller, et al., 1988;
1986; Frank, 1985; Standley, 1992a).
Jacobson, 1957; Metzler & Berman, 1991; Monsey,
Coma - Music used to decrease intracranial
1960; Oyama, et al., 1983; Shapiro & Cohen, 1983).
pressure (Roberts, 1986).

Coronary Care-Music used to lower pulse rate

Documentation:
(Bonny, 1983; Crago, 1980).

646
Record one or more of the following measures: Begin the music prior to the pain/fear-inducing stimuli.

Use earphones when possible or a pillow speaker as an

alternative.
Physiological: Blood pressure, pulse, amount of
medication used, blood analysis of stress hormone Suggest that music will aid pain relief, comfort, anxiety,
levels. etc.

Behaviorally observed: Overt pain/anxiety Maintain a pain-free association by not assisting

responses, time in recovery room, length of medical staff with pain-inducing procedures, especially
hospitalization, number of anesthetic/analgesic side when working with children.
effects experienced.
Allow the patient to control as much of the procedure as
Self-Report: Ratings of pain/anxiety, State-Trait possible: volume, cassette manipulations, starting and
Anxiety Scale (Spielberger et al., 1970), pain/anxiety stopping music, etc.
adjective selection.
Reinforce overt signs of relaxation, cooperation, and
verbalizations with no pain or anxiety content.

Procedure:

Use patient's preferred music and equipment with Technique 2. Active Music Participation
quality reproduction capabilities.

647
Music Function: pain perception (Codding, 1982; Hanser, et al., 1983;
McDowell, 1966; Sammons, 1984; Winokur, 1984).
To focus attention and/or structure exercise (tempo,
Selected music used at birth to enhance joy in the event
repetition, duration, force, or fluidity).
(Clark, et al., 1981). Music and prescribed exercises
Therapeutic Objectives: used after birth to reduce pain from contractures and to
Reduction of pain from physical movement or muscle help uterus return to normal size while rehabilitating
contractures. abdominal muscles (Brook, 1984; Burt & Korn, 1964).

Increased joint motility. Chronic Pain - Music paired with appropriate

exercises for involved muscles (Cofrancesco, 1985;
Increased motor abilities (duration, strength,
Staum, 1983; Wolfe, 1978).
coordination).
Respiratory Deficiencies - Music used to structure
Shortened labor in childbirth.
deep breathing exercises or therapeutic coughing to
Increased respiration ability (capacity, strength). relieve congestion (singing, pianica, harmonica) used to
Diagnoses: structure breathing and enhance lung capacity
(Behrens, 1982).
Childbirth - Music used during pregnancy to
structure Lamaze exercises and to reinforce focusing of Patients Prescribed for Physical Therapy (PT) -
attention (Clark, et al., 1981). Used in labor and delivery Music used to structure PT regimen for stroke, burn,
to focus attention, to structure breathing, and to reduce orthopedic, cerebral palsied, and paralyzed persons

648
(Barker, 1991; Cofrancesco, 1985; Staum, 1992). Select exercises appropriate to diagnosis or as
prescribed by a physician or physical therapist.
Gait Disturbances - Music paired with walking and
gait training to increase duration and to improve gait Evaluate patient's baseline capacity for exercise in
length, width, and rhythm (Staum, 1983). terms of speed, duration, repetitions, etc.

Documentation: Select style of music which matches above traits and

also desired kind of motor movement (i.e., disco music
Record one or more of the following:
for forceful movements, waltz music for fluid
Physiological: Amount of analgesic medication
movements).
used, electromyographic (EMG) muscle response,
Model appropriate movements and teach patient to
exhalation strength (spirometer), degrees of movement
match them to music.
in joints (goniometer).
Change music in successive approximations as patient
Behaviorally Observed: Frequency and duration
progresses. In this category, patient's music preference
of exercises, pain-free verbalizations; length of labor in
is important but is secondary to the music's properties
childbirth; overt pain responses; walking distance; gait
for matching the desired exercise.
length, width, and/or duration.
Teach focusing (if exercise routine requires it) by
Self-Report: Ratings of improvement, ratings of
pointing out musical elements for which the patient
pain, personal log of exercises completed.
might listen.
Procedure:

649
Reinforce exercising (see Example 1), pain-free Management of illness and personal affairs, i.e.,
verbalizations, matching the exercise to the music, selection of treatment options and making personal or
focusing attentiveness, and overt signs of patient's family decisions.
motivation to succeed or progress.
Diagnoses:

Patients or families in distress, including those

Technique 3. Music Counseling with traumatic injuries or illness, permanent disabilities
or disfigurement; terminal prognoses; hospitalized
Music Function:
children; organ transplant patients, etc. Music used to
To initiate and enhance therapist / patient / family
initiate and maintain counseling interaction (Levine-
relationships and to facilitate patient adjustment to
Gross & Swartz, 1982).
medical problems.
Documentation:
Therapeutic Objectives:
Record one or more of the following:
Reduction of distress/trauma/fear related to
Physiological: Amount of analgesic or sedative
terminal or serious illness or injury to self or significant
medication used, blood pressure, pulse, stress
others.
hormone levels.
Acceptance of death, permanent disabilities, or
Behaviorally Observed: Verbalizations free of
scarring. Enhancement of effective interpersonal
distress or fear, actions implementing decisions, overt
interactions in times of distress.

650
signs of distress/fear, family interaction patterns. Serve as an advocate for the patient or family who has
made a firm decision about the course of treatment by
Self-Report: Ratings of attitudes such as
being supportive and giving assistance in
satisfaction/contentment, diary of feelings, attitude
communicating with the medical hierarchy.
scales.
Teach effective interpersonal relationship abilities, i.e.,
Procedure:
positivism, avoidance of guilt for self or imposition of
Use live music listening, music participation, or music
guilt on others, openness in stating feelings, avoidance
composition to offer opportunities for pleasure,
of blame.
reminiscence, verbalization, closeness, etc. Use song
Assist terminally ill persons who wish to get closure on
content for initiating discussion. (The therapist's
some aspect of their life, such as drafting a living will,
presence and warmth are crucial, so the use of
selecting music for the funeral, recording a song to
earphones or the patient listening to music alone are
leave to a loved one, etc.
contraindicated.)
Assist permanently disabled persons to identify and
Identify source of any patient distress by listening or by
develop assets and abilities.
watching patient reactions.
Reinforce reality-based (acceptance) verbalizations
Help patient identify decisions that can or must be
and those free of blame, bitterness, guilt, regrets, etc.
made, all possible options, consequences of each
Also reinforce verbalizations about the present rather
option, preferred option, and actions to implement
than the past.
selected option.

651
Provide music and leave the room if the patient is reinforcement for attentiveness to educational tasks, as
uncommunicative. Continue offering opportunities for reinforcement for learning, and as a structure to provide
communication during later visits. academic information. Music activities used with family
members to teach parents the importance of helping
children maintain developmental milestones and avoid
Technique 4. Music To Teach Developmental or
regression (Chetta, 1981; Marley, 1984; Miller, 1984).
Educational Objectives
Documentation:
Music Function:
Record one or more of the following:
To reinforce or structure learning.
Physiological: Not applicable.
Therapeutic Objectives:
Behaviorally Observed: Number of academic
Prevention of developmental regression due to tasks completed, correctness of academic work, time
hospitalization. spent on task, amount of information learned, incidence
Increased academic/medical learning. of independent self-care (i.e., feeding self, toileting
independently, walking instead of being carried, etc.),
Diagnoses:
positive verbalizations.
Hospitalized Children (birth to 18 years) and their
Self-Report: Log or checklist of independent self-
families; Adults who need medical knowledge about
care tasks performed daily.
their illness and lifestyle implications. Music used as

652
Procedure: during the hospital stay.

Use child's preferred music activities to reinforce or Reinforce children for on-task behavior, learning,
structure desired developmental maturity. assignments completed, independent self-care.

Tell child ahead of time the criteria for participation if Reinforce families for positive interactions and for
music is to be a reinforcer. At music time, determine if allowing children to be independent.
educational or developmental criteria were met and
Use familiar melodies paired with medical information to
provide music contingently.
teach adults about their illness.
Determine the teacher's specific educational objectives
for the child and materials being used, and develop
educational music activities accordingly. Technique 5. Music Stimulation

Leave activities or music "assignments" with the child Music Function:

that will structure independence and increase positive To stimulate auditorily and increase awareness of other
interactions with others in the environment. forms of stimuli.

Invite parents to participate in a music activity with the Therapeutic Objectives:

child. Tell them ahead of time that you will be cuing them
Increased overt responses to stimuli (auditory,
to reinforce the child for independence and cooperation.
sensory, olfactory, and visual).
Leave parents a checklist of age-appropriate
developmental milestones which they might reinforce Reduced depression/anxiety due to sensory

653
deprivation in sterile environments. Record one or more of the following:

Diagnoses: Physiological: Vasoconstriction (plethysmograph),

respiration rate, pulse, blood pressure.
Comatose or brain damaged patients/stroke
victims/premature neonates - Music used to elicit Behaviorally Observed: Overt gross or fine motor
physiological and overt responses which are then responses such as sucking, eye blinks, head
increased through reinforcement (Grundy, 1989). movement, mouth movements; auditory responses;
pleasure responses, such as smiling; positive
Patients in sterile environments (such as burn
verbalizations.
victims, organ transplant patients and those with
contagious diseases) or long term hospitalization - Self-Report: Ratings of depression/anxiety.
Music used to reduce depression or anxiety due to
Procedure:
deprivation and to increase patient awareness and
For elicitation of response:
pleasure (Barker, 1991).
Use patient's preferred music, which might be
Muscle contractures - Music combined with
ascertained through family interviews. With infants,
vibroacoustic stimulation (Skille et al., 1989) or with
lullabies are traditional and effective.
electroacupuncture (Jing, et al., 1991) for relaxation and
pain relief. Use pillow speaker so that music source may be moved
in space for maximum stimulation.
Documentation:

654
Combine music with pleasurable multi-stimulation For reducing deprivation:
activities which include physical stroking, moving visual
Use patient's preferred music.
stimuli, pleasurable olfactory stimuli, and other auditory
Combine music with age-appropriate multi-stimulation
stimuli such as patient's name and family voices.
activities, such as looking at slides or pictures to music,
Watch for and identify overt responses. If no overt
reminiscing about memories related to smells (e.g.,
responses occur, use physiologic measures to
flowers, vanilla flavoring, lemons, etc.), or touching a
determine any response to selected stimuli.
variety of surfaces (e.g., velvet, sandpaper, or fur). Use
Discontinue non-contingent stimulation when response variety of puppets and toys with children. If sterile
begins to occur. Give selected stimulus, wait until conditions prohibit use of real materials such as these,
patient emits response, then reinforce immediately with use guided imagery techniques with music to imagine
other multi-stimulation activities. multisensory events.

Pair eliciting stimulus with verbal command so that Reinforce pleasure responses and creative thinking
patient will begin to respond to the human voice. (imagination).

Begin moving the patient's body in an overt response

timed to coincide with any physiologic events that are
Technique 6. Music Biofeedback
apparent.
Music Function:
Continue with these procedures and lengthen the chain
To serve as reinforcer or structure for physiological
of events to which the patient will respond.

655
responses. Poor Circulation - Music used to increase blood
flow to extremities through temperature measurement
Therapeutic Objectives:
(Standley, 1992a).
Increased awareness, self-control, and
Documentation:
monitoring of physiological state.
Record one or more of the following:
Diagnoses:
Physiological: Blood pressure, pulse,
Epilepsy - Music used to reduce frequency of
vasoconstriction, stress hormone levels, EEG waves,
seizures by inducing relaxation as reaction to stress or
EMG muscle tension, temperature (internal and
prior to fatigue (Scartelli, 1982).
peripheral), seizure frequency, migraine frequency, etc.
Coronary - Music used to lower blood pressure,
Behaviorally Observed: Overt signs of relaxation,
heart rate, tension responses (Bonny, 1983).
verbalizations free of content about stress.
Habituated Tension Responses - Music used to
Self-Report: Log of relaxation practice and
lower blood pressure, lower stress hormone levels, and
incidence of physiological problem, ratings of
to relax muscle tension (Epstein, et al., 1974; Hoffman,
improvement.
1974; Martin, 1987; Scartelli, 1982).
Procedure:
Migraine Headaches - Music used to reduce
frequency through relaxation responses to stress rather Use patient's preferred music.
than tension responses (Budzynski, et al., 1970).

656
Use headphones if possible. Therapeutic Objectives:

Pair music with selected biofeedback procedures for Reduction of depression/anxiety due to isolation.
specific physiological problem. Noncontingent
Increased pleasure and feelings of well-being.
background music may be used to enhance patient's
ability to relax or contingent music may be used as
Diagnoses:

reinforcement for patient maintaining desired Patients capable of joining a group and desiring to do
physiological response. so, especially children and persons with long-term

Transfer ability to relax from the biofeedback clinic to hospitalization. Music used for pleasure, group

other locations through the use of procedures that can interaction and to reduce stress of hospitalization

be paired with music in any setting (home, work, car, (Bailey, 1983; Froelich, 1984; Goloff, 1981).

etc.). Documentation:

Reinforce relaxation, desired physiologic state, and Record one or more of the following:
positive verbalizations about improvement.
Physiological: Pulse (self-monitored).
Technique 7. Group Music Therapy
Behaviorally Observed: Pleasure responses, such as
Music Function: smiling or laughing; positive verbalizations free of
"illness" content; time spent in group and out of hospital
To provide pleasurable and positive interpersonal
room.
interactions.

657
 Self-Report: Ratings of pleasure or feelings of well End session with relaxation/guided imagery to music to
reduce discomfort and prepare patients for rest.
being.
Suggest patients try similar techniques at night when
Procedure: falling asleep.
Use variety of age appropriate activities that maximize
Reinforce pleasure responses, "non-sick"
time in music. Match types of activities to areas in which verbalizations, music participation, spontaneous
they are conducted, i.e., quieter activities in areas for contributions to musical activities, and musical talent of
the seriously ill.
participants.
Combine focused listening and participation activities to
reduce fatigue.
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Standley, J. (In Press). Music as a therapeutic scoliosis. In C.D. Maranto (Ed.). Applications of Music in
intervention in medical/dental treatment: Research and Medicine (pp. 141-162). Washington, D.C.: National
clinical applications. In T. Wigram & B. Saperston (Eds.). Association for Music Therapy, Inc.
Music and the Healing Process: A Handbook of Music
Tanioka, F., Takazawa, T., Kamata, S., Kudo, M.,
Therapy. London: Carden Publications, Ltd.
Matsuki, A., & Oyama, T. (1985). Hormonal effect of
Staum, M. (1983). Music and rhythmic stimuli in the anxiolytic music in patients during surgical operations
rehabilitation of gait disorders. Journal of Music under epidural anaesthesia. In R. Spintge & R. Droh,
Therapy, 20, 69-87. Music in Medicine (pp. 285-290). Basel: Editiones
Roche.
Staum, M. (1992). The role of music therapy in physical
rehabilitation. In R. Spintge & R. Droh (Eds.). Tsao, C., Gordon, T., Maranto, C., Lerman, C., &
MusicMedicine (pp.267-270). St. Louis, MO: MMB Murasko, D. (1991). The effects of music and directed
Music, Inc. biological imagery on immune response (S-IgA). In C.D.
Maranto (Ed.). Applications of Music in Medicine (pp.
Stein, A. (1991). Music to reduce anxiety during
85121). Washington, D.C.: National Association for
Cesarean births. In C.D. Maranto (Ed.). Applications of
Music Therapy, Inc.
Music in Medicine (pp. 179-190). Washington, D.C.:

666
Winokur, M. A. (1984). The use of music as an
audioanalgesia during childbirth. Unpublished master's
We also acknowledge the contributions of the following
thesis, The Florida State University, Tallahassee,
professionals who have shared in this work: Veronica
Florida.
Cosgriff, Jane Ng, Jennie Selman (music therapists),
Wolfe, D. (1978). Pain rehabilitation and music therapy. Rita Simon (art therapist), Suzanne Stewart and Ann
Journal of Music Therapy, 15(4), 184-206. Irwin (physiotherapists), Eileen Crozier nnd Rosemary
Hamill (speech and language therapists).

"K I N E T I C M E L O D Y " - M U S I C T ' H E R A P Y A N D

MS:
PAR KI N SO N ' S D I SEASE ( PD ) ;
The observation that music may, have a therapeutic
A JOINT PAPER BY J ULIE S UTTON HEAD MUSIC THERAPIST)
effect in people with PD it not new. Oliver Sacks, in his
AND D R . MICHAEL S WALLOW (HONORARY CONSULTANT

NEUROLOGIST )
seminal book "Awakenings" (1) reports a number of
patients with Post-encephalitic: Parkinsonism in whom
music was dramatic in its, effect on movement,
We acknowledge the support of the Northern Ireland transforming immobile subjects into freely moving,
Music Therapy Trust in the, preparation and execution people.
of this paper, which is presented jointly .

667
The music had to have an emotional component and to The degeneration of the nigro-striatal pathways and
be rhythmic - one of his patients said that she was only associated deficit in the neurotransmitter dopamine are
moved by music which moved her. Stern (2) the most important neuropathological features in
investigated the trick movements which PD patients patients with primary PD (SLIDE 2). The exact function
discovered to counteract "freezing episodes". These of these structures is still not fully understood, but they
included marching music or singing to oneself. The play a major part in the control of movement,
technique of conductive education as applied to PD particularly those of a semiautomatic nature (e.g.
includes the use of music with strong rhythms, walking) and in the process by which voluntary
characteristic of Hungarian folk song (Nanton 3). movement (mediated by the cerebral cortex) gradually
Perhaps this is not too surprising when one thinks of the becomes more automcatic to the point at which the
strong association between music and movement which movement is "stored" in the cerebellum. The basal
is apparent in marshing to military bands and in ganglia may well. be involved in the "programing" of
worksongs and chants where music aids motivation in such movements .
repetitive tasks and helps to reduce fatigue.
The clinical features of PD are usually described under
four headings (SLIDE 3). The tremor, recognised by
James Parkinson in his paper titled "Paralisis Agitans"
The pathology of PD lies in the, basal ganglia, a
(4) is an involutary , 3 per second rhytmic shake, often
complex neuronal network, lying deep in the brain with
described as "pill-rolling", It occurs at rest, the patient
important conections to the motor cortex and the
can sometimes contro1 t for short periods at will and
cerebellum and with a major sensory input (SLIDE 1)

668
(as Parkinson observed) it ceases temporarily on accompany this type of progresive disability.
voluntary movement of the limb. Bradykinesia describes
the extreme slowness of movement which is often the
most obvious feature of the disease. The slowness My own interest in music with PD patients arose from

initially affects particularly automatic movements such personal observation that playing rhythmic music on the

as walking, arm swing, axial movements and body sway piano helped patients to walk more regularly to increase

and speech. Rigidity manifests itself as a feeling of the length of paces, to vary speed and to covercome

stiffness, which is often painful, and is described as "freezing" episodes. It seems that the music, as Sacks

"cogwheel" in type. The postural difficulties which many observed, has to be rhythmic but also to have a strong

PD patients have later in the disease result in FX lack of melodic component, especially if the tune is pleasant. or

balance and falling, particularly in crowded places emotionally rewarding to the pacient. A similar effect

where sudden changes of direction are needed. Many can be observed in movements of the upper limbs, as in

of the clinca1 features of PD can be controlled - at least the case of a clergyman who had great difficulty in

in the early stages - by drugs, particularly those performing the repetitive circular movements of

containing laevo-dopa, but the rehabilitation of motor shaving with an electric razor. As a result of his music

deficits may also be helped by the physical therapies therapy sessions he discovered he could perform this

and it is in this area that music may have an important movement without.any difficulty to the accompaniment

part to play as well as in helping patients to cope with of the Blue Danube Waltz, a favourite piece of his.

the emotional and psychological problems which always

669
As a resalt of these personal observations a music difficulties. Individual and group music therapy sessions
therapy project was set up in Belfast with a group of six took place each day and measurements were repeated
patients and further observations were made during a At the end of the project. Although the documented
residential course of two weeks with a larger group, changes in this group of patients were not statistically
sponsored by the U. K. Parkinson's Disease Society - significant there was a trend towards improvement and
the first "Skylarks" venture. During this period two music participants were noted to be more movile and more
therapists and a physiotherapist worked together alert, with positive changes in posture and less fatigue.
devising a system of exercises with music to try to Nine patients commented particularly on the benefit of
achieve maximum function and to test the patient's relaxation.
reactions to such an approach, The results of this
project, which involved eleven patients aged between
.51 and 84, have heen carefully documented by Cosgriff JS

(5). My first contact with PD was shortly after moving from

London to Belfast in 1987. I joined a short-term
research project invulving a team of two speech and
The patients were carefully assesed by a neurologist
language therapists (6), two music therapists (7) and
and measures of walking ability upper limb movement
nine people with PD. Meeting for four afternoons every
and rhythmics skills were formulated Self-administered
week for 3 weeks, five mayor areas identified by the
questionaries identified the man problem areas in each
speech and language therapists were explored through
patient and therapy was directe towards these specific

670
a musical input. (SLIDE 4). 'I'here was inevitable overlap explore the media as they wished in individual and
between the areas and as the project developed the group sessions. ( SLIDE 5 ) This was a difficult, intense
session format evolved into distinct periods of speech project which proved to be exhausting for all involved
and language therapy, of music theraspy and of a without doubt, the clients made self-expresive use of
combination of speech/language therapy techniques the media and all verbalised this experience as
and goals presented musically. One major finding was beneficial to a greater or lesser extent. However, the
the importance for each person to become aware of stresses of the strange situation everything was
and monitor their I ' D - their rate of functioning, their "unknown" - combined with a prevailing 'holiday'
physical limitations, their speech difficulties. The social, atmosphere had a strong influence.
mutually-supportive music-making enabled this
monitoring process with some ease. At the same time,
we became aware of the emotional effect of PD upon Inspired by the eight people who bravely look part in the

the person and of the deeper level of music's potential second Skylarks venture, by the work of my colleagues

to reach this. and by my own experiences, later that same year I set
up a three-month project with three people with PD in
Belfast. In discussion with Jennie Selman, who had
ln 1988 two music therapists (8) and an art therapist (9) written about intensive work with one man with PD (10),
took part in a two-week project set in a residential it was clear to both of us that music affected the person
'holiday home' setting. The overall aim was to offer the instantly in a measurabale physical way. More
two arts therapies and for the eight people taking part to significantly, it was the intensity of the music expressed

671
by the person that interested me, and the effect of this "On one level, the very "ongoing" nature of music
deep-felt musical I involvement upon the physical (existing in time and through time) and the "holding",
condition. The more involved the person was, the more stabilising effect of structured music have much to offer
intent their participation, then the more they seemed to the person with PD: co-ordinated movements (such as
be liberated from the PD. I identified six areas of walking) - when set to music - become fluent and less
response to the co-improvised music (SLIDE 6) and likely to break down. On another, deeper level, music
produced three short case studies at the end of the 12 improvised for the person, with the person, can directly
.sessions of individual music therapy. The three people address the emotional state, This supports meaningful
taking part contributed by a final questionnaire and expression of feelings that may be directly or indirectly
through informal discussion before and after each related to the PD. These very feelings are often
session. It was agreed that I record each session on channelled through what might be considered by some
audio cassette and at two points video recordings were as a "negative" aspect of the condition; for instance,
made, with all recordings available to client and when tremor becomes an integral part of the music, it
therapist. The conclusions from this project are also becomes creative, and "positive".
summarised in my final report thus:
Actively involved in music-making and engaged by the
". . . that rnusic therapy is of value and importance was music, thee person's attention is focused primarily on
seen clearly through the readiness and variety with the music. The physical manifestations of PD become
which each participant responded. part of the music and as thus are accepted. The more
involved the person is in the music and the more the

672
music is theirs, the more they are liberated from the retain the potential for movement but cannot produce it
efects of the condition. at will. The block may be a neurochemical one and there
has been some evidence from Japan to suggest that
"It is important to respect the individuality of each
freezing episodes are due to noradrenaline deficiency.
person ... music therapy ... is governed by their own
Given that music does have such an effect we need to
sense of time and possible progress rate. The music
know more about the sort of music, the sort of patients
therapist must surely accommodate this; therefore
who benefit and the best at way of using it. Julie Suttan
music therapy ... is a long term project." (11)
suggests that some integral aspects of the
symptomatology of PD can become part of the music
MS: and thus exteriorised and accepted by the patient with
benefit (13). How does this work? Spech disturbance
The work that we have documented so far suggests that
and communication difficulties are some of the most
music has a definite therapeutic effect in relation to
frustrating aspetts of PD. The loss of facial expression
several of the problems commonly experienced by
and body language are part of ths problem and we
patients with PD. However, these observations also
need more evidence of how music can help with this.
raise a number of questions (SLIDE 7). Luria (1982)
Finally we have to look at the "carry over" effect of our
spoke of the "kinetic melody" of automatic movement
treatment and to see whether these techniques could
(12) and believed that the tricks used to overcome
possibly have any effect on the long term outlook in PD.
freezing and blocking by people with PD were due to re-
establishment of cortical control. Many such patients It is evident that more research is needed to try to

673
answer some of these questions. However, this raises
some further problems (SLIDE 8). PD is A progressive
JS:
condition, but liable to considerable fluctuations,
particularly in response to long-term drug treatment. We have learned a great deal from our experiences of

This makes it difficult to conduct controlled trials, in a working with people with PD. he original observations of

medical sense, and there is also the difficulty in the physical effects of music have been extended to

measuring small and subtle changes over a period of additional areas, such as combined work with other arts

time. The most promising model would seem to be the therapist., physiotherapists and speech and language

single case study, observed over a relatively long therapists. The impact of music therapy upon the

period, with careful documentation and subjective as person with PD remains striking, particularly in terms of

well as objective parameters. self-expression and self-worth. The perceived effects

are as individual as the person concerned, but common
threads emerge. The following comment from people
PD is not a very common condition and most music involved in individual therapy reveal the two central
therapists would encounter only an occasional case. features - the emotional and the physical:
With this in mind we propose that an agreed research
"Harry" - "[Music therapy has, helped me] in overcoming
protocol should be made available to any therapist who
rigidity and stabilising activity... As sessions progressed
wishes to contribute to this research and that this could
movements in proper time came almost naturally.
be done on an in ternational basis.
[Music therapy has helped with] control of tremors..."

674
"Mary" - " [Music therapy ) helps lift depression and 1) The music therapist is working with a client(s) with
makes me feel more active, It helps with movement. recognised clinical Parkinson's Disease.
helped me feel more alert."
2) There is access to basic neurological assessment
"Joe" - "[Music therapy has helped my] concentration information , including case history. (Information should
and trying to forget I had PD; it has given me extra self- include drug therapy, stage of the disease and
confidence." function.)

3) The therapist and /or a co-researcher is/are willing to

administer appropriate cuestionnaires (in relation to a
This paper has detailed the range of research projects
'quality of life' profile and psychiatric profile).
initiated by the therapy team in Northern Ireland. The
findings suggest that there are noticeable, measurable 4) Therapist and client(s) agree to documentation by
effects of music therapy with his client group and point video recording at regular intervals and for the duration
to the need for further research work . With this in mind of music therapy sessions to be a minimum of 10
we wish to coordinate an international study linking months.
music therapist worldwide working with people with PD.
5) Therapist and client agree to share (a) video-
We end the paper with the launch of this study and invite
recordings of sessions (b) information about the
anyone working in this area to take part. In order to
therapy, all of which will be treated with confidentiality
clarify how the international PD study network would
(e.g. no real names used anonymity preserved). (SLIDE
operate, we list the requirements for inclusion as:
9)

675
Music therapist interested in this international study are The Northern Ireland Music Therapy Trust
invited to contact the authors |at the following address.
c/o 15 Deramore Drive Belfast BT9 5JQ Northern
We will then send you the Sutton-Swallow Standard
Ireland
Protocol for assessment and documentation the work.
after an agreed period we will collate the information
and produce the final report. This is an exciting and - as References:
far as we are aware - unique project. We are delighted
1 Sacks, O. (1982) Awakenings. London, Pan Books
to have been able to launch this at the Spanish World
(Picador) ( First published 1973)
Congress.
2 Stern et al (1980) Akinetic freezing and trick
movements in Parkinson's Disease". J. Neural Transm.
Dr. Michael Swallow Suppl. 16, 137-l41

Hon. Consultant Neurologist 3 Nanton, V. (1986) in : Cottam & Sutton (eds)

Conductive Education. England/Kent, Croom Helm Ltd.

4 Parkinson, J. (1817) "An essay on the Shaking

Julie P. Sutton
Palsy" (facsimile) ;
Head Music Therapist
5 Cosgriff, V. (1988) "Intensive Music Therapy in a

676
2-week Residential Programme for people with 13 As (11)
Parkioson's Disease". Bulletin Australian Music Therapy
L A M U SI C O T ER API A EN EL T R AT AM I EN T O D E
Association
PAC I EN T ES PO R T AD O R ES D EL VI R U S D E L A
6 Speech and language therapists: Eileen Crozier.
I N M U N O D EF I C I EN C I A H U M AN A ( H I V O VI H ) .
Rosemary Hamill
HUGO UEHARA, SILVIA VILLAGRA, VIRGINIA TOSTO
7 Music Therapist.: Veronica Cosgriff, Julie Sutton

8 Music therapists: Jennie Selman, Julie Sutton.

Additional support given by Helen Hutchinson INDICE TEMATICO

9 Art therapist: Rita Simon

10 Selman, J. (1988) "Music therapy with Parkinson's INTRODUCCION

Disease". J. British Music Therapy 2 (1 ): 5-9 EL. PACIENTE Y SU ENFERMEDAD
11 Sutton, J.P. (1988) "Music therapy as an MUSICOTERAPIA: MODALIDAD
individualised treatment: Parkinson's Disease (The use
MUSICOTERAPIA: MTODOS, TCNICAS Y
of clinically improvised music with three individual
RECURSOS
patients)" Final report for U. K . Parkinson 's Disease
Society CONCLUSIONES

12 Luria, A. R. ( 1932) New York, Liverwright CITAS BIBLIOGRFICAS Y BIBLIOGRAFA

677
 para detectarlo y se identificaron los objetivos del virus
en el interior del cuerpo.
INTRODUCCION
Actualmente no hay medicacion, ni vacuna, y la
"Era creencia general, hace solo una dcada. que las
epidemia continua su expansin. As las cosas, importa
enfermedades infecciosas haban dejado de constituir
preguntarse en que situacin nos encontramos hoy en
una amenaza para el mundo desarrollado. Los nuevos
relacin con el problema del SIDA."(1)
desafos a la salud pblica vendran, se pensaba, de
agresiones no infecciosas, como el cancer, Rescatamos este ltimo interrogante planteado por los
cardiopatas y enfermedades de tipo degenerativo. Tal descubridores del HIV hace ya unos aos.
confianza se vino a bajo a principio de los ochenta con
Fundaciones, servicios hospitalarios y diversas
la aparicin del SIDA. Se trataba de una desvastadora
instituciones del mbito privado y estatal se han visto
enfermedad causada por una clase de agentes
urgidas a ofrecer sus servicios a un universo de
infecciosos -los retrovirus- encontrados en seres
pacientes cada vez ms amplio y heterogneo.
humanos escasos aos antes. A pesar de la alarmante
naturaleza de la epidemia, la ciencia respondi con Siendo estas las exigencias que la realidad plantea, hoy

presteza. En los aos transcurridos desde 1982 hasta desarrollamos el tratamiento musicoterapeutico

1984, se definieron los perfiles de la epidemia, se aisl includo en el equipo de salud especializado que se

un nuevo virus -el virus de la inmunodeficiencia brinda a los pacientes portadores del HIV, en el Hospital

humana (HIV)- y se demostr que provocaba la Municipal "Francisco J. Muiz", de la Ciudad de Bs. As.,

enfermedad. se puso a punto un ensayo en sangre Argentina: en la Sala 16 destinada a la internacion de

678
mujeres, dos veces por semana por la tarde. multifactoriales.

Existen tres tipos de portadores: a) Asintomticos, b)

Con Complejo relacionado con el Sida (CRS) y c)
EL PACIENTE Y SU ENFERMEDAD
Sidosos.
Pensamos al sujeto portador del HIV, como una unidad
A1 estudiar su medio socio-cultural observamos:
(uno) nica singular que padece una enfermedad
escasez de recursos y posibilidades. graves
infecto-contagiosa cuyas vias de transmisin mas
problemticas familiares. marginalidad. adicciones.
frecuentes son: relaciones sexuales (homo-
promiscuidad, delincuencia.
heterosexual), uso comn de agujas para inyectarse
drogas por via intravenosa. Esto genera prejuicios y Por lo expuesto es que consideramos que el paciente
marginacin. Se habla de grupos de riesgo cuando esta situado en una posicin vital muy particular y se ve
deberiamos hablar de conductas o comportamientos situado frente a lo irremediable ( enfermedad que an
de riesgo. no tiene cura).

Dadas las caractersticas complejas y variables del HIV, Es all donde se experimentan el lmite y la finitud.
al actuar directamente sobre el sistema inmunolgico;
E1 SIDA plantea a quien lo padece al menos dos tipos
desde el punto de vista clnico. se manifiesta a travs de
de dificultades: la adaptacin a la enfermedad
sntomas (enfermedades oportunistas). Su tiempo de
(esquema corporal y conductual) y la modificacin del
desarrollo no esta sujeto a una cronologa especifica,
esquema vincular afectado por una enfermedad mtica.
sino que es particular en cada paciente por motivos

679
Por lo general surgen varias reacciones: miedo, individuo a un estado que le permita reintegrarse en su
inseguridad, huda. ansiedad, discriminacin, negacin comunidad. Si podemos encontrar donde ocurre la
y nuevas valoraciones. deshabilitacin y la desadaptacin. tendremos un punto
de partida muy til. Una primera dificultad es que
MUSICOTERAPIA: MODALIDAD
nuestra organizacin hospitalaria, pblica y privada,
"Qu queremos significar con rehabilitacin?. Cuanto
suele ser incoherente para los enfermos. Adems,
ms claro est lo que queremos lograr. ms prximos
desde el punto de vista emocional el hospital es el peor
estaremos a ello. Rehabilitacin significa, para
lugar imaginable para internar a un paciente. Es sufi-
nosotros, adquirir nuevamente, por tratamiento
ciente visitarlo al atardecer o, pero an, por la noche.
apropiado, una conducta o actitud que le permita
(2)
reanudar sus actividades en la mejor manera posible.
El SIDA nos convoca a una revisin permanente de
Cabe destacar que hablamos de conducta, de actitud.
nuestros puntos de vista acerca de la vida, la muerte,
ello significa que lo fundamental es la mente del
los afectos y la dinmica de los vnculos humanos.
paciente.
Emergiendo de esto contexto surgi la idea de
Estamos ocupandonos de una rama de la ciencia
acercarnos al paciente con una visin comprensiva de
donde no son fundamentales las mediciones, no es
la enfermedad: visin opuesta a aquella militareista
posible determinar valores estadsticos ni extrapolar
(hay que vencer el virus, vas a ganar la batalla).
sentimientos pensamientos y emociones.
Perspectiva que consiste en conocer, comprender y
La rehabilitacin es la base de la restitucin del
aprender a convivir con el virus, y con lo que ste

680
implica. espacio para la simbolizacin de emociones y conflictos
contenidos emocionales muy intensos e ntimos, en los
que convergen los valores, las creencias. los supuestos
MUSICOTERAPIA: METODOS, TECNICAS Y
en fin todos los hilos que hacen a la trama sobre la que
RECURSOS
una persona teje su vida. Son afectos profundos. a
Siguiendo a la Dra. J. Verdeau-Pailles. decimos de la veces no son decibles con facilidad... pero que pueden
msica que "su contenido es afectivo: esta integrado comenzar a esbozarse a travs de un gesto de un
por las emociones, los estados de nimo que las sonido (un suspiro, un gemido un susurro, un grito...).
palabras son incapaces de expresar. La msica llega
A ms de un ao de comenzado este
ms all de las palabras y permite conumicar en
proyecto.habiendo asistido a alrededor de setenta
aquellos casos en que la expresin verbal podra
pacientes, en sesiones grupales y/o individuales de
solamente ser aproximada y pobre. Este es el motivo
acuerdo a las condiciones clnicas en las que se
por el cual aparece como el lenguaje de la
encuentran: podemos afirmar el logro de los siguientes
afectividad"(3).
objetivos: elaborar proyectos a corto plazo y modos
Nosotros como musicoterapeutas acudimos para concretos de llevarlos a cabo, adquirir actitudes
ofrecer otros modos de decir...DE DECIR QUE?...la relacionadas con el cuidado de si misma y de los otros,
asociacin HIV-Muerte, la culpa, el contagio, el fortalecer la autoestima, a travs de los procesos
abandono, la maternidad, la marginalidad, la creativos (hacer, construir, ejecutar), integrar un grupo
discriminacin, la soledad; es decir, se les ofrece un de pertenencia evitando la soledad y el aislamiento.

681
mejorar la calidad de vida personal, vivenciar duradero en poco tiempo, posibilidad de asistencia a
situaciones placenteras que permitan la aparicin del pesar de los impedimentos fsicos o estados muy a
deseo de bienestar y la trascendencia a travs de vanzados de la enfermedad, promocin de una
grabacin de cintas. internacin ms activa.

Las tcnicas y recursos utilizados en distintos Frente a la problemtica del SIDA. un aspecto que nos
momentos con audicin de cintas grabadas. expresin toca de cerca es la edad promedio (entre 15 a 35 aos)
musical a travs del canto y su grabacin. estimulacin coincidente con nuestra propia edad. En consecuencia
de las expresiones escritas, grficas y plsticas del son numerosos los puntos en comn, como ser:
movimiento a partir de la msica, ejecucin de periodos socio-polticos importantes en el desarrollo de
instrumentos musicales, creacin de canciones (letra y un momento histrico del pas, una identificacin
meloda), utilizacin del cuerpo como instrumento y musical correspondiente.
participacin de otros profesionales y/o familiares.
Del aqu y ahora reflexionando sobre lo anteriormente
Dada la alta rotacin de pacientes se hace dificultoso expuesto nos preguntamos acerca de nuestro rol como
un proceso terapetico a largo plazo hecho por el cual, musicoterapeutas. En efecto, no es sencillo sostenerlo,
las sesiones musicoterapeuticas se inician y finalizan all donde se nos exge:
en el mismo dia. tomando las temticas que las
- conciencia de la propia finitud y limitacin.
pacientes traen en ese momento. En estas condiciones
se ven claramente las ventajas que la musicoterapia - resPonsabilidad y cuidado de los pacientes y de

ofrece: establecimiento de un vinculo consistente y nosotros mismos.

682
- coherencia entre el sentir, el decir y el hacer. econmico, educativo, religioso) tanto en las
condiciones que enferman como en las que sanan. A
As nos encontramos con el SIDA. Una realidad de la
pesar de esto, no nos alejamos de aquel primer punto
cual ya no podemos decir que es cercana, sino ms
de vista ya que apuntamos a la otra cara de la misma
bien que nos involucra. Queremos expresar con esto,
moneda.
que somos parte del fenmeno, y que aunque
tengamos la intencin de aportar una alternativa Evidentemente tendremos en cuenta este factor, a la
teraputica no tradicional a los pacienter portadores del hora de planificar las actividades.
HIV, no somos ajenos a los miedos, los prejuicios y los
E1 camino recorrido hasta aqu no ha sido sencillo, ni lo
conflictos que esta enfermedad provoca. Es por eso
ser pero sabemos que contamos con el apoyo mutuo
que en un intento permanente de llevar nuestra tarea
dentro del equipo de musicoterapeutas. Esto es
con la mayor responsabilidad forma parte de la misma
esencial. Esto garantiza poder llevar adelante alguno
la supervisin quincenal y el estudio para un mejor
objetivos que an no hemos podido concretar y otros
ejercicio profesional.
que seguro surgirn.

CONCLUSIONES
"LAS IDEAS SOBRE ENFERMAR Y MORIR HAN
A1 comenzar. nuestro enfoque estaba puesto en el PRODUCIDO MAS ENFERMEDAD Y MAS MUERTE
punto de vista clinico. Luego, nos dimos cuenta de la QUE LA PROPIA ENFERMEDAD" (4)
importancia del aspecto humano, cultural (social,

683
 GHANDI. - Fregtman, C. Cuerpo musica y terapia. Ediciones
Bsqueda Buenos Aires, 1982.

- Redfield, R. Infeccion por HIV: Cuadro clinico.

CITAS BIBLIOGRAFICAS
Ciencia e investigacin, 1983.
(1) GALLO, R. y MONTAGNIER, L. EL SIDA en 1988.
- Rubio, J.M. Psicosis/Intervenciones en la
Ciencia e investigacin, 1988, p. 10.
emergencia. Musicoterapia en Psiquiatria, supuestos
(2) SCHAVELZON, J. CANCER enfoque psicolgico.
antropolgicos. Grfica Guadalupe, Buenos Aires,
Editorial Galerna, 1978, p. 87,88,50. 1991.
(3) VERDEAU-PAILLES, J.Desde el poder de la msica
- Saur, J. Persona y Personalizacin. Edit. Carlos
a los objetivos terapeuticos. Asociacin Argentina de
Lolh Buenos Aires, 1989.
Musicoterapia, Bs. As., 1987.
- Verdeau-Pailles, J. Las tcnicas psicomusicales
(4) GHANDHI, M. La cura natural. Revista Uno
activas de grupo y su aplicacin en Psiquiatria.
Mismo, Bs. As., No 112, 1992. p. 1O2.

BIBLIOGRAFIA

- Fineberg, H. Dimensiones sociales del SIDA.

Ciencia e investigacin, 1988.

684
 PR EPAR AT I O N F O R BI R T H : AN (rythm-sound-movement) has been p]aced in an
EXPER I M EN T AL PR O PO SAL . interdisciplinary context within courses for
psychoprofilaxis on the child-birth, in order to help the
M ARIA V IDESOTT
mothers and the couples to live a self-conscious and
fulfilling experience of birth and to establish a positive
1. Hypothesis communication with the child, since the very beginning.

1.1. Recent acquisitions in the field of fetology and Such consciousness and communication can
infantile neuropsychiatry with regard to the perception have an effective prevention function with regard to the
of movements, rhythms and sounds in intrauterine life establishment of difficult or in any case risky
and in the field of psychoanalysis, psychology of music motherchild and parents-child relationships.
and of music-therapy on the importance of sound as Furthermore, prenatal sound- and musical activities can
originary experience have opened up new and enhance the relationship of the child with his or her
interesting fields of research and intervention. A mother and with the outside world after birth, and they
research about the importance and the significance of can contribute to the mother experiencing a fullfilling
the sound-musical experience during the time of pregnancy through relaxation, more selfconsciousness
pregnancy and child birth has been carried on in this and more consciousness of the changes that are
direction. occurring to her and through the containment of her
anxiety.
1.2. The general hypothesis of this research is the
following: the fundamental paradigm of music-therapy

685
1.3. On the basis of such hypothesis and within the listening to oneself as listening to one's own internal
context of the meetings that take place during courses sounds, rhythms and movements, and as listening to
on the psychoprofilaxis for pregnancy (autogenous the child, to his or her movements, to his or her life
training, exercise, information regarding pregnancy, within the mother and, simultaneously, as "other" vis-a-
childbirth and the newbom), a number of sound-musical vis the mother. Listening to oneself seems to be
activities have been introduced. The primary goal of this essential in order to experience pregnancy fully and
experience was to make future parents fully conscious therefore to contain the anxiety related to this period of
of the importance of the rythm-sound language which is her life. Learning to listen to the child becomes
perceived by the child also within the uterus. And this fundamental for the acceptance of the separation
was done in order to enrich such language and use it as mother-child and for a fulfilling experience of the first
an intermediary for communicating with the child both months of the life of the child, a life which is lead
before and after birth. listening to, understanding and respecting his or her
rhythms and his or her needs.

2.1.2. By listening activities mainly we mean paying

2. Activities
attention to the internal movements-sounds-rhythms
2.1. Activities were proposed predominantly on the
proper to the child, and secondarily listening to external
grounds of listening, using of voice and information.
sounds and musical passages. This activity is finalized
2.1.1. Before being conceived as an activity, to a double goal: the relaxation of the mother and,
listening was conceptualized as an affitude: as consequently, of the child, and the process of

686
enhancing thoughts and images for the child within the this selection, also "The Pearl" (Brian Eno), "Down the
mother through the stimulation of imagination and moon" (Andreas Vollenweider), "Music Relax" (Franco
memory. Loi)."Radici" (Antonio Grande)

2.1.3. Our choice of music has taken into account 2.2. Through a number of experiences of more
the indications coming from interviews we had with the conscious vocality, we proposed to the mothers the
mothers in which their preferences would emerge: possibility of using their voice as a musical structure and
classical or popular music. To this purpose, we not only as an instrument of the spoken language. The
proposed passages with specific st characteristics: importance of such structure for the motherchild
regular rhythm (which is containing and soothing), communication during the prenatal period and during
timbre of strings, (particularly rich in frequencies) and the first months of life, is self evident. In fact it is
rather grave and warm sounds (for example horns, essentially a communication based upon expressive
which mothers found reassuring and embracing). Our language. Besides the maternal voice is the sound
preference has fallen on the music of the Barocque which is mostly present among the exogenous and
period (especially on the Branderburgische Concerts of endogenous sounds and the one which is most rich in
Bach). A second series of music we have selected frequences; therfore it is also the sound which is most
includes musics that evoke water and air sounds, and stimulating and expressive of affective tonalities.
that can recall the sounds of the amniotic liquid within
Furthermore, since voice is strictly connected to
the womb. We have chosen, again on the bases of the
breathing, the consciuos use of voice must entail deep
preferences indicated by the mothers with regard to
and relaxed breathing - or respiration - which is a

687
fundamental aid in any situation of -tension, and in sounds); choral singing of nursery rhymes, of lullabies
particular during labour and childbirth. To this regard, it and rhymes, which the mothers remember and which
is necessary to recall the parallelism mouth-vagina we have collected in a booklet.
which has been established by bio-energetics and
2.3. We have then devoted some periods to the
which allows to act directly upon the relaxation of the
information on the intrauterine sound perception and on
perineum and the vagina by relaxing the jaw and the
the development of the child in relation to sound
muscles of the neck..
experience. Each meeting offered a considerable space
Finally, the use of voice tuned for singing and for for dialogue and for the mothers to meet one another,
nursery rhymes, in the end, recalls the moments of taking into account their natural and deep desire for the
pleasure experienced during childood. communication of their discoveries, their feelings and
their experiences during this particular time of their life.
With regard to the use of voice the following
activities have been organized: breathing with the
uttering of sounds during the expiration phase, before
3. Verification instruments
first freely and then in a structured way, according to
determinate pitches; movements of the mouth with 3.1. In order to test this activity, we have set up two

emission of sound and with emission of free sounds and questionnaires and handed them out to the couples

noises, with special attention to the listening of body (one at the beginning of the course, and one a couple of

resonances (also throught putting one's hands in months after the birth of the baby).

various parts of the body in relation to the diff erent

688
To double-check our questionnaires, we handed them C group). Finally, 86,7% favoured the involvement of
out to a group constituted of mothers and their partners their partners during the meetings (against 60%- in C
who had participated in a course for childbirth group). Finally, 86,7,% declared that the information
analogous to the one in which the sound activities have received during the course favoured the relationship
been experienced. Therefore, we took into with the child during pregnancy.
consideration a sample constituted of two distinct
This analysis shows that some mothers have
groups: Intervention Group (I), and Control Group (C).
been stimulated by the meetings to speak more often
To the two groups of pregnant mothers we associated
with the child during the last months of pregnancy, and
the groups of their partners, who took part in two
that in some cases they have also decided to sing. All
meetings during each course.
the mothers stated that they had been listening to music
3.2. The following elements have been drawn from the during the last period of pregnancy, predominantly to
comparison of the data gathered from the two classical or popular music and that they hade
questionnaires. 90% of the people judged positively the increasingly chosen the music they wanted to listen to,
course and 93,3% (versus 80% in C) deemed useful- much more than they had done before starting the
the indications they received for a fulfilling experience course. 86,7{7o of the mothers stated that, during
during the last months of pregnancy. 73,3% expressed labour, they made use of the suggestions received
a positiveopinion on the course for labour, and 86,7% during the course, and 40% of these was able to keep
go for childbearing (against 50% of the C group) and for breathing under control through the use of voice. Our
the period after the child birth 66,7% (versus 30% of the suggestions also favoured communication during early

689
weeks of life. Analogous positive evaluations and responses were
found in the questionnaires filled out by the fathers.
All the mothers have related to their child by
singing lullabies and nursery rhymes and other sounds,
both in the I group and in the C group. This shows that
4. Conclusions
singing is a spontaneous expression of the mother-child
communication. On the contrary, the answers differ with 4.1. The observation of the women during the last

respect to other forms of sound experience. All the months of pregnancy furtherly confirmed the results

mothers of the I group had their child listen to the which emerged from reading the questionnaires. The

musics they chose (while only 70% of the mothers did time of pregnancy is a time during which the mother is

so in C group) and 73,3% of the mothers in the I group endowed with a special energy and during which she is

(against the 50% in the group C) had their child listen to more open to new experiences for her child. Therefore

the same music that they had been listening to during this is a period fit for the introduction of sound-musical

their pregnancy, noticing (in 66,7% of the cases) that activities as an instrument to favour communication with

the child reacted in a relaxed and soothing way. Finally the child and to help for the preparation and welcoming

73,3% (against 70% in the C group) tried to sing during of this new person. It seems useful to add sound

times of special tension in order to get relaxed and to activities to the courses for child-birth-preparation as an

soothe their baby. All those who tried this technique enriching element. It is important that the leaders of

(against 87,5% in the C group) obtained positive results. these activities are qualified people, both in the field of
music-therapy and in the field of psychology with a

690
special attention to the psychoprofilaxis of birth. father even before birth and becomes aware of the
presence of two people who are to take care of him or
4.2. Anyhow, our experience has shown the necessity
her. Doubtless, this is also an element of gratification for
of having ffme available to perform such activities. In
the father.
fact, it is preferable to suggest these activities during the
whole of the second half of pregnancy, rather than 4.4. Even if at the time of pregnancy, women
concentrating them during the last month. The best concentrate their attention on labour and child birth and
results are obtained with smaller groups (five or six only secondarily they think of the time after the child is
people) in which each woman can express herself more born, it is important that the course gives as many
freely, especially through non-verbal languages. In any stimuli as possible regarding the use of sounds and
case some positive choral moments can be created music for the first months of life. We think it is
even in a larger group. Musical activities contribute to fundamental to offer women further instruments in
group cohesion, which is particularly important for order to accept and experience without anxiety their
containing the anxiety of the woman and for the support post-partum crisis and in order to be able to better
that she can enjoy. They have shown positive effects communicate with their child. In any case, it would be
also on other acffvities engaged by the group in order to useful after birth to conffnue the acffvity organizing
get ready for labour. musical experiences and movement experiences for
the mothers and for the newborns during the first year
4.3. In addition, musical activities are a good way of
of life.
involving the fathers in the birth-event: through voice
and through singing the child gets to know his or her

691
4.5. It is important that the activities take place in a - R. BENENZON, Manuale di musicoterapia, Borla,
comfortable enviroment, allowing to work on a floor Roma 1983.
equipped with mattresses and pillows, and with a good
- S. BERTOLINO, L'esperienza sonora in epoca pre e
stereo, and possibly also with some musical
neonatale, in Alle origini dell'esperienza musicale,
instruments.
Quaderni della SIEM, n. 2 (1 semestre 1992); Ricordi
4.6. On the basis of such positive experience, we Milano 1992, pp. 75-94.
assume that our suggesffon could be extended also to
- E. BICK, L'esperienza della pelle nelle prime relazioni
situations which are considered risky, such as pregnant
oggettuali, Boringhieri, Torino 1974.
women with communicaffon problems or with especially
- F. BORRUTO, Comportamento fetale alla
self-evident conflicts. In such way this experience could
stimolazione sonora, in "Motricita e vita psichica del
have posiffve effects not only as prevenffon, but also as
feto", (1982), p. 65-83.
therapy.
- M.G. CARBONETTO - L. FILINGERI, n dialogo
nascosto. Interazione madre-bambino durante la
Bibliografia
gravidanza, La Salamandra, Milano 1984.
- A.A.V.V. Motricita e vita psichica del feto, Ed.
- R.L. CARROZZINI, Nascere oggi, CISSPAT, Padova
Internazionali, C.I.C., Roma, 1982.
1988.
- M.L. AUCHER, En corps chante, Hommes et Groupes
- L. CHIOZZA, Corpo, affetto, linguaggio, Loescher,
Editeurs, Paris 1987.

692
Torino 1981. - L.M. LORENZETTI, Fetologia, neonatologia e
musicoterapia, PCC, Assisi 1984.
- F. FORNARI, Psicoanalisi della musica, Longanesi,
Milano 1984. - L.M. LORENZETTI, L'esperienza originaria del
movimento/suono/ritmo/sogno nel bambino:
- F. GAGLIARDI - L.M. LORENZETTI, Euritmia e
prospettive musicoterapeutiche, in L.M. LORENZETTI
musicoterapia, Quaderni del teatro di Pisa, Pisa 1984.
(a cura di), Suoni, silenzio, comunicazione vitale, PCC
- R. GAGNON, Effects of low-frequency vibration on
Assisi, 1990, p. 47-91.
human termfetuses, in "American Journal of
- L.M. LORENZETTI, Musicoterapia ed epistemologia,
ObstetricsandGynecology",1989,n.161,pp.147985.
PCC, Assisi 1984.
- U. GALIMBERTI, n corpo, Feltrinelli, Milano 1984.
- L.M. LORENZETTI, Dalla educazione musicale alla
- A. INANNIRUBERTO - E. TAJANI, I movimenti fetali
musicoterapia, Zanibon, Padova 1989.
nelle gravidanze fisiologiche, in "Motricita e vita psichica
- L.M. LORENZETTI (a cura di), Suoni, silenzio,
del feto", pp. 39-64
comunicazione vitale, PCC, Assisi 1990.
- M. IMBERTY, Suoni emozioni significati, CLUEB,
- G.M . PORZIONATO, Psicobiologia della musica,
Bologna 1986.
Patron, Bologna 1980.
- L. KREISLER - M. FAIN - M. SOULE, n bambino e il suo
- P.L. POSTACCHINI, Psicopatologia generale e
corpo, Astrolabio, Roma 1976. - L.M. LORENZETTI,
neuropsichiatria infantile, PCC, Assisi 1984.
Psicosomatica e musicoterapia, PCC, Assisi 1984.

693
- G.M. ROSSI, Introduzione alla vocalita, PCC, Assisi 1991, pp. 77-82.
1988.
- D.W. WINNICOTT, Gioco e realta, Armando, Roma
- M. SCHNEIDER, n significato della musica, Rusconi, 1974.
Milano 1971.
- F. ZANCHI-G. CELLA, La "risonanza" di un incontro.
- R. SOIFER, Psicodinamica della gravidanza, parto e Tre giornate con Frdrick Leboyer, in "Riza
puerperio Borla, Roma 1985. psicosomatica (1988), pp. 68-72.

- B. STREITO, Lo strumento voce; unaprospettiva nella

prevenzione primaria, in L.M. LORENZETTI (a cura di)
"Musicoterapia e strutture socio-sanitarie di territorio", T EC N I C AS N EU R O - SO N O R O - M U SI C AL ES

Educazione e Scuola, Ancona 1987. APL I C AD AS A PER T U R BAC I O N ES D EL

SI ST EM A N ER VI O SO .
- J. TAFURI (a cura di), Didattica della Musica e
percezione musicale, Zanichelli, Bologna 1988. MT. GABRIELA WAGNER, DR. RICARDO ALLEGRI

- E. TAJANI, La motilita fetale evocata tramite stimoli

sonori, in Suoni, silenzio, comunieazione vitale, a cura En el presente trabajo ,se expondran los .siguientes
di L.M . Lorenzetti, PCC, Assisi 1990. - M. VIDESOTT, aspectos relacionados con la aplicacin de la
Attivit con i suoni nellapreparazione alla nascita: una musicoterapia en la rehabilitacin del paciente con
proposta sperimentale, in L.M. LORENZETTI (a eura perturbaciones del sistema nervioso.
di), Luoghi e forme della musieoterapia, Unicopli Milano

694
 La descripcin de estas funciones alteradas y el definir
el criterio de normalidad son dos problemas
I. LA EVALUACION NEURO-SONORO--MUSICAL
importantes a resolver
II. ESTUDIO DE LAS FUNCIONES MUSICALES EN
E1 primer cuadro de "disfuncin cerebral" fue descrito
LOS PACIENTES AFASICOS
por Proust en 1886. E1 se refiere a un caso de alexia
III. TRATAMIENTO MUSICOTERAPEUTICO DEL
musical En cuanto al trmino de amusia, esta fue
PACIENTE CON PERTURBACIONES DEL SISTEMA
introducida por Steinhals en 1871 y qued incorporado
NERVIOSO
a la terminologa mdica con Knoblauch en 1888
Ustvedt en 1937 describe, 14 casos de amusias de los
cuales 13 fueron de orgen cerebrovascular Weltheim y
I. LA EVALUACION NEURO-SONORO-MUSICAL.
Botez propone
Las funciones musicales de los pacientes del estudio
elementos bien definidos para la realizacin de un
adjunto realizado, estudiados por el Dr Ricardo Allegri
trabajo de evaluacin de las funciones, musicales
fueron evaluados mediante un protocolo desarrollado
(1969) Elsholz (1980) publica un trabajo sobre 1a.
entre 1980-83.
evaluacin de las amusias. Es importante recalcar que
Un cuadro de perturbaciones del sistema nervioso ambas propuestas estan dirigidas a pacientes llamados
puede estar o no acompaado por alteraciones de aficionados cultos o que han tenido un aprendizaje
distinta magnitud de las funciones musicales. musical formal.

695
Uno de los objetivos de esta investigacin para la calidad de los sonidos.
elaboracin de un protocolo, fue tratar de elaborar una
En la segunda etapa se dara la percepcin de la
ficha de evaluacin neuro-sonoro--musical con la idea
meloda en sus aspectos rtmicos primero y meldicos
de que pueda ser utilizada -tanto para evaluar
luego.
pacientes sin formacin musical como con una buena
En lo referente a la expresin de la meloda los
preparacin previa a su afasia
aspectos ritmicos aparecen primero y luego los
La elaboracin del protocolo de referencia se ha hecho
relacionados con los sonidos.
tomando en cuenta distintos trabajos relacionados con
el desarrollo musical de los nios, otros relacionados En la participacin en el canto al unsono el primer
intento se dara a nivel de adherirse en grupo en un
especificamente con algunos aspectos como por
ejemplo el ritmo, as como todos los aspectos tono propio (no en la tonalidad en que canta el grupo

expresivos y receptivos de la relacin sonido-ser sino en un registro que es propio). Ms adelante el nio

humano. ser capaz de adherirse en el tono elegido por el grupo.

Comenzaremos dando algunas referencias a lo Los elementos bsicos de la funcin musical segn

propuesto por Bentley (1967) en cuanto a los distintos Wertheim y Boetz son el sentido rtmico, el sentido de

momentos en el desarrollo musical de los nios. los sonidos (percepcin de la intensidad, duracin,
timbre y altura y capacidad para percibir los intervalos
La percepcin se da como previa a la expresin. Lo
musicales) y por ltimo se necesita transformar esta
primero que se percibiria estaria en relacin con la
percepcin musical en emocin. En cuanto a lo

696
expresivo en lo musical los elementos receptivos expresin verba1.
mencionados serviran como base para su desarrollo.
(1969).
En base a los puntos antes expuestos hemos
La investigacin de las funciones musicales se realizar
elaborado una ficha musicoterapeutica que incluye los
con distintos objetivos y la intencin es que la
siguientes datos:
evaluacin musical pueda ser utilizada como:

- punto de partida para la elaboracin de un plan

teraputico de rehabilitacin en musicoterapia. A - Datos personales

- aporte a los estudios relacionados con la B.- Preferencias particulares del sujeto.

localizacin de funciones de ambos hemisferios as C.- Preferencias particulares de la familia

como distinguir aquellas. funciones de la actividad
D.- Evaluacin rtmica
musical que involucran en especial el hemisferio
dominante. - Pruebas de ritmo

- elaboracin de una clasificacin de las amusias - Adecuacin a ritmos externos,

basada en las funciones. - Reproduccin de esquemas rtmicos.

- base para la eventual elaboracin de mtodos - Reproduccin rtmica de canciones.

tereputicos de rehabilitacin del 1enguaje tomando en
E.- Evaluacin del canto.
cuenta las funciones musicales tendientes a facilitar la

697
F.- Experiencias relacionadas o fenmenos sonoros. INSERTAR FIGURA

G.- Testificacin del encuadre no verbal.

H.- Test de discriminacin auditiva. Estructuras musicales, con los mismos elementos

La evaluacin rtmica comprende las 3 pruebas de

ritmo de Mary Stambak (1971), Una prueba para
Figura 1
evaluar la capacidad del paciente para adecuarse a
ritmos externos, la evaluacin de su capacidad para
reproducir esquemas rtmicos; de estructura musical o Esta evaluacin nos. permite elaborar luego un plan
sea que tengan una distribucin regular de tiempos teraputico de reeducacin rtmica para cada paciente,
fuertes y dbiles (comps y tiempo) y por ltimo la Dems est recalcar la importancia del ritmo en la
reproduccin del ritmo de las canciones que se evalan palabra.
en el tem "Evaluacin del canto".
Al evaluar el canto del paciente tomamos, en cuenta
distintos aspectos que comprenden:

Ejemplos: Su capacidad para iniciar el canto en forma voluntaria a

Stambak Nro. 14 pedido del terapeuta. Se observa si su eventual

incapacidad se debe a un problema relacionado con la
memoria. con aspectos motrices o con aspectos que
tienen que ver con una perturbacin sensorial. Se toma

698
en cuenta si es capaz de centar con letra, si presenta los aspectos emocionales ligados a lo musical-sonoro.
ciertas alteraciones y en qu medida, etc. Tambin se "Experiencias relacionadas con algn fenmeno sonoro
evala hasta qu punto puede separar la letra de la o musical" da lugar a que el paciente pueda comentar
meloda. Por otro lado se registran los datos que los distintos aspectos; significativos para l, como ruidos o
pacientes puedan aportar en relacin a su imagen sonidos de su casa y recuerdos como el disco favorito o
vocal luego de la instalacin de su afasia: "Mi voz es, el primer baile, etc. A veces surge material relacionado
ms ronca", "Mi voz es ms aguda", "No tengo voz, no con su internacin previa a la afasia. Ejemplo: "Estando
tengo cuerdas vocales, se me aflojaron y no les, puedo casi inconsciente reaccionaba a la msica moviendo los
hacer sonar". dedos del pie, para marcar el comps o como pidiendo
ms."

Las canciones que se evalan son: "Adios muchachos",

"Himno Nacional" y el "Arrorr". La testificacin musical propuesta por Benenzon (1981)
nos permite observar cmo se vicula con los
instrumentos musicales con los que vamos a trabajar y
Se toman en cuenta el canto y el reconocimiento
cules son los ritmos y formas, de expresin sonoras
auditivo tanto vocal como instrumental.
propias, del paciente.

Los otros dos puntos siguientes estn en relacin con

En algunos casos puede estar alterada la

699
discriminacin auditiva y para evaluar este punto
tomamos en cuenta la propuesta de Ins, Bustos
Resumiendo podemos decir que esta evaluacin trata
Snchez. quien elabor una serie de ejercicios de
de abarcar adems de los aspectos relacionados con la
recuperacin para nios con dificultades del hable (
historia sonora del peciente, los aspectos receptivos y
1379) .
expresivos relacionados con lo rtmico y lo meldico
incluyendo la palabra cantada.

Un aspecto de su propuesta comprende la

discriminacin auditiva de sonidos producidos por una
Una vez realizada la evolucin se elabora un plan
enorme variedad de fuentes sonoras registradas en un
teraputico individual o grupal de corto alcance que se
cassette y su asociacin con una serie de imgenes.
modifica luego de acuerdo a las necesidades del
Estos sonidos comprenden- los ruidos producidos con
paciente.
el propio cuerpo, los ruidos y sonidos del medio
ambiente ruidos de la naturaleza, instrumentos
musicales, figura fondo auditiva o sea la superposicin II. TRATAMIENTO MUSICOTERAPEUTICO DEL
de dos sonidos puestos anteriormente memoria PACIENTE CON PERTURBACIONES DEL
auditiva (secuencia de tres sonidos) e interpretacin de SISTEMA NERVIOSO.
acontecimientos registrados en forma sonora. Ej.: se
Se presenta un video ilustrativo .
abre una botella y se sirve su contenido.

700
III. ESTUDIO DE LAS FUNCIONES Las mayores alteraciones aparecieron en aquellos con
MUSICALES EN LOS PACIENTES AFASICOS afasias globales (n=9), estando comprometidos los
aspectos rtmicos en el 88,8% de los casos.

Resmen:
Introduccin:
Fueron evaluadas las funciones musicales de 41
pacientes afsicos. En ellos se encontr que la funcin Los trastornos de las funciones musicales se
ms comprometida (63%) fue la ritmica cuya lesin mencionan poco dentro de los sndromes
sistematicamente apareca en el rea postrolndica neuropsicolgicos. Esta falta de atencin no puede ser
parietotemporal medial. Solo el 31 % tena falla en los explicada por la infrecuencia de este trastorno sino por
aspectos meldicos lo que demuestra su poca la vaguedad de su evaluacin en las baterias
importancia en las lesiones de hemisferio izquierdo. La neuropsicolgicas tradicionales, y la variabilidad de la
discriminacin auditiva estaba alterada en el 26.8 %. formacin musical tanto en los pacientes como en los
profesionales.
En los pacientes con afasia de Broca (N=14) las
alteraciones musicales fueron raras, el 35% tenian E1 objetivo de esta publicacin es presentar nuestros
trastornos rtmicos y el 28,5% meldicos. resultados preliminares de la evaluacin sistemtica de
esta funcin en los pacientes afsicos.
Mas de la mitad (66%) de los pacientes portadores de
una afasia de Wernicke (n=12) mostraron compromiso
en los aspectos rtmicos.

701
Material y mtodo:

Sobre 140 pacientes afsicos evaluados en nuestro *Aspectos Ritmicos:

Servicio, fueron seleccionados 41 segn los siguientes
Los aspectos ritmicos fueron evaluados desde el
criterios de inclusin:
"tempo espontneo del paciente". Se siguieron los
modelos ritmicos segn el mtodo de Stambak en
imitacin y lectura (24). Se incluy la reproduccin
* Pacientes afsicos
ritmica de melodias sencillas y complejas y se observ
* Dominancia cerebral izquierda (segn test 18) las posibilidades de adecuacin a "tempos externos".

* Fluentes premrbidos en hablar castellano

*Aspectos meldicos:
* Lesin vascular nica en hemisferio cerebral
Estos aspectos se evaluaron por los diferentes modelos
izquierdo corroborada por Tomografia Axial
de emisin de voz, evocacin espontnea y si integra
Computada de cerebro.
palabras aisladas, frases o estrofas completas de
* Evaluacin de las Funciones Musicales:
canciones. Tambien si logra aislar letra de meloda y si
(Protocolo desarrollado por la Prof. Gabriela WAGNER efecta el recitado de las mismas sin la meloda.
y evaluado en nuestro pacientes por las MTs Viviana
SANCHEZ, Graciela ALCOBA y Liliana D'ASERO)
*Discriminacin Auditiva:

702
Se evalu a partir de una adaptacin del test de L.TAMAROFF)
BUSTOS SANCHEZ (7): en l, el paciente debe asociar
La localizacin anatmica de las lesiones fue evaluada
sonidos, ruidos y palabras con imgenes. Se explor
con la tcnica de mapeo tomogrfico de Mazzochi-
tambin el sonido figura-fondo asociandolo a dos
Vignolo (1978) (16) que permiti la divisin de las
imgenes correspondientes.
lesiones en anteriores o prerolndicas, posteriores o
post-rolndicas, globales o pre y posrolndicas y
subcorticales, y la posterior superposicin lesional.
Para evitar la dispersin de las variables, estos
aspectos fueron clasificados globalmentes en
conservados o perturabos.
Resultados:

Nuestros pacientes afsicos tenan trastornos en las

*Evaluacin del lenguaje: (Dr R.F.ALLEGRI/Dr funciones musicales en un nmero significativo de
L.TAMAROFF) casos (32/41casos-78,1%).

En la categorizacin de los sndromes afsicos se

utiliz la clasificacin de formas clnicas de la Escuela
En ellos encontramos que la funcin ms
de Boston (9)
comprometida son los aspectos ritmicos que estan
alterados en el 63% de los pacientes.

*Evaluacin tomogrfica: (Dr R.F.ALLEGRI/Dr

703
Los aspectos meldicos estan alterados en 13 de los encontrandose afectado en el 55,5% de las afasias
41 pacientes (31 %) lo que demuestra globales y en el 28,5% de los Broca.
comparativamente la poca importancia de los mismos
en las lesiones del hemisferio izquierdo.
La discriminacin auditiva se encuentra alterada slo
en los Wernicke (33%) y en los globales (55,5%).
Con respecto a la discriminacin auditiva esta
comprometida en 11 de los 41 pacientes (26.8 %) todos
ellos con lesiones postrolndicas parietotemporales. Si comparamos los compromisos de las funciones
musicales con la localizacin anatmica, es anecdtico
resaltar que en los pacientes con lesiones puras
Si comparamos los trastornos de las funciones subcorticales las funciones estaban conservadas.
musicales con los tipos de afasias veremos que el
aspecto mas comprometido es el rtmico, que se
encuentra afectado en el 88,8% de las afasias globales, La divisin topogrfica en pre, post y pre-post rolndica

en el 66% de los Wernicke y slo en el 35 % de los los porcentajes son muy similares a el de los tipos

Broca.(Graf 1) clinicos de afasias. (Graf.2)

La superposicin de los mapeos tomogrficos de las

lesiones en los 26 pacientes con trast. rtmicos nos
En el aspecto meldico el compromiso es menor
muestran el rea en comun de compromiso del lobulo

704
temporal (fig 1) postrolndica parietotemporal medial, mostrando el
respeto del lbulo frontal.

Los aspectos meldicos estan comprometidos en 13

Conclusiones:
de los 41 pacientes (31 %) lo que demuestra
Las lesiones de hemisferio izquierdo responsables de
comparativamente la poca importancia del mismo en
afasias pueden determinar tambien trastornos en las
las lesiones de hemisferio izquierdo. Estos resultados
funciones musicales
se pueden correlacionar a lo referido por Dorgeuille
(1966) quien refiri que la alteracin meldica en el
canto es producto de lesiones de hemisferio derecho
En ellos encontramos que la funcin ms
(8).
comprometidas son los aspectos ritmicos que estan
alterados en el 63% de los pacientes. Resultados
similares fueron referidos por diversos autores quienes
Bogen y Gordon (1971)(5) y Gordon y Bogen
describieron alteracin del ritmo por lesin de
(1974)(10) inyectando amital sdico intracarotideo
hemisferio izquierdo (6)(17). Segn Peretz (1985) la
encontraron que en la inyeccin de hemisferio derecho
produccin y la percepcin ritmica es un rol del
se altera exclusivamente el aspecto meldico y en las
hemisferio izquierdo (21).
del izquierdo se alteran ambas, pero ms la produccin
La reconstitucin lesional (fig n 3) mostr que la zona rtmica.
de compromiso mas sitemtico correspondia al rea
Con respecto a la discriminacin auditiva est

705
comprometida en 11 de los 41 pacientes (26.8%), todos los pacientes con afasia de Broca son raras el 35%
ellos con lesiones postrolndicas parietotemporales. tienen alteraciones rtmicas y el 28,5% meldicas.

La discriminacin de sonidos es rol predominante del Barbizet (1972) (4) refiere que los afsicos motores que
hemisferio derecho, la discriminacin de melodias no son capaces de pronunciar palabras son capaces de
familiares del izquierdo (21). articularlas cantando. Esto habla de que el acceso a la
pronunciacin de la palabra toma vias diferentes e
La agnosia para los sonidos figurados esta siempre
independientes.
asociada a sordera verbal o afasia sin embargo
Henschen y col (12) admiten que puede existir Esto condujo en Boston a crear una forma de
aisladamente producida por lesion temporal bilateral. reeducacin basada en el canto "terapia de entonacin
Spreen y col (22) la correlacionan a lesiones del meldica" para los afsicos motores (2).
hemisferio menor.
Yamadori (1977) refiri 21/24 pacientes afsicos tipo
El estudio de las amusias no lleva a determinar la Broca que conservaban la capacidad de cantar (26).
dominancia para uno u otro hemisferio, sino que
concibe una organizacin fundamentalmente
bihemisferica (19) Los pacientes con afasias de Wernicke muestran
alteraciones en el aspecto ritmico y la discriminacin
auditiva en la mitad de los pacientes.
Si el tema es discutido desde las formas clinicas de
afasias encontramos que las alteraciones musicales en

706
En aquellos con afasias globales aparecen las mayores cerebrales, no pueden ser confundidas desde el punto
alteraciones de las funciones musicales sobretodo los de vista neuropsicolgico resaltando la importancia de
aspectos ritmicos que estn comprometidos en el una evaluacin ms especializada y de una terapia
88,8% de los pacientes. alternativa en la rehabilitacin de los pacientes
afsicos.

La asociacin de amusia con sordera verbal o afasia es

posible (13) (25), pero no obligatorio (3). Study of the musical functions in aphasic
patients

Summary:
Durante cerca de un siglo la mayor parte de los trabajos
han sostenido la existencia de una asociacin entre la Left hemisphere lesions responsible for aphasia can
afasia y la amusia como resultado de una alteracin del also bring about troubles in musical functions.
hemisferio izquierdo. Pero esta asociacin no se
41 aphasic patients were evaluated with a neuromusical
encuentra sistematica-mente, las afasias y las amusias
medical protocol being found that the most involved
si bien coexisten tambien se encuentran disociadas.
function is the rhythmic aspect which is altered in the
63% of the patients who sistematically get the lesion in
the medial postrolandic parietotemporal area.
Asi creemos que si bien las facultades lingusticas y
musicales pueden compartir ciertas estructuras Melodic aspects are involved in the 31 % of them,

707
comparatively showing their little importance in the left (2) ALBERT M.,SPARKS R. y HELM N. Melodic
hemisphere lesions. intonation therapy for aphasia Arch.Neurol, 29, 130-
131, 1973
Auditory discrimination is altered in the 26.8%, all of
them with postrolandic parietotemporal lesions. (3) ASSAL G. Aphasie de Wernicke chez un pianiste.
Rev.Neurol. (Paris)29, 251-255, 1973.
Musical alterations are rare in Broca having rhythmic
alterations the 35% of them and melodic alterations the (4) BARBIZET J. Role de l'hemisphere droit dans les
28,5%. perceptions auditives. In: Barbizet J, BenHamida M,
Duizabo P(Eds.), Le monde de l'hemiplegie gauche,
Wernicke aphasias show alterations in the rhythmic
Masson, Paris,1972
aspect and auditory discrimination in half of the patients.
(5) BOGEN J Y GORDON H. Musical tests for
The greatest musical function alterations appear in
functional lateralization with intracarotid amobarbital.
global aphasias being involved the rhythmic aspects in
Nature, 230, 524-525, 1971.
the 88,8% of the patients.
(6) BRUST J. Music and Language: musical alexia
and agraphia. Brain, 103, 367-392, 1980.
BIBLIOGRAFIA:
(7) BUSTOS SANCHEZ Metodo de evaluacin de la
(1) ALAJOUANINE T. Aphasia and artistic realization Discriminacion Auditiva.
Bran 71, 229-241, 1948.
(8) DORGEUILLE C. Introduction a l 'etude des

708
amusies Tesis de Medicina, Paris 1966. (14) LECHEVALIER B, EUSTACHE F, ROSSA Y et al.
Les troubles de la perception de la musique d'origine
(9) GOODGLASS H, KAPLAN E: The Assessment of
neurologique. Rapport de Neurologie. Congres de
Aphasia and Related Disorders. Philadelphia, Lea &
Psychiatrie et Neurologie de Langue Francaise,
Febiger,1972.
Masson 1985
(10) GORDON H Y BOGEN J Hemispheric
(15) LECHEVALIER B. Histoire des agnosies
lateralization of singing after intracarotid sodium
musicales Conferences d'histoire de la medecina-
amobarbital. J.Neurol.Neurosurg.Psychiatry, 37, 727-
LYON cycle 86-87 Collection Fondation Marcel Merieux
739, 1974.
LYON.
(11) GRISON B. Une etude des alterations musicales
(16) MAZZOCHI F y VIGNOLO LA. Computer assisted
au cours des lesions hemispheriques. Role de
tomography in neurospychological research. A simple
l'hemisphere mineur dans la reconaissance et l-a
procedure for lesion mapping. Cortex 14, 136-144,
realisation melodique. Tesis de Medicina, Paris, 1979.
1978
(12) HENSCHEN S. On the function of the right
(17) MAVLOV L. Amusia due to rhythm agnosia in a
hemisphere of the brain in relation to the left in speech,
musician with left hemisphere damage: a non auditory
music and calculation. Brain, 49, 110-123, 1926.
supramodal defect. Cortex, 16, 331-338, 1980.
(13) JELLINECK A.Amusia.On the phenomenology and
(18) OLDFIELD RC. The assessment and analysis of
investigation of central disorders of the musical
handedness. The Edinburg Inventory.
functions Folia Phoniatr, 8, 124-149, 1956.

709
Neuropsychologia, 9 97-113, 1971 (26) YAMADORI A, OSUMI Y, MASUHARA S et
OKUBO M. Preservation of singing in Broca's aphasia.
(19) ORGOGOZO JM,MAZAUX JM Agnosies visuelles
J.Neurol.Neurosurg.Psychiatr. 40,221-224, 1977.
et auditives E.M.C.Paris,Neurologie 17021 B10,4.8.03.
ESTUDIO DE LAS FUNCIONES MUSICALES E N
(20) PERETZ I, et MORAIS J. Modes of processing
LOS PACIENTES AFASICO
melodies and ear asymetry in nomusicians.
Neuropsychol, 18, 477-489, 1980.

(21) PERETZ I. Asymetrie hemispherique dans les

amusies Rev.Neurol.(Paris) 141,3, 169-183 ,1985.

(22) SPREEN O,BENTON AL et FINCHAM RW.

Auditory agnosia without aphasia Arch.Neurol. 13, 84-
92, 1965.

(23) SPINNLER H; et VIGNOLO LA. Impaired

recognition of meaningful sounds in aphasia. Cortex 2,
337-348, 1966

(24) STAMBAK: metodo de evaluacion ritmica

(25 WERTHEIM N. et BOTEZ M. Receptive amusia: A

clinical analysis. Brain 84, 19-30, 1961.

710
n Pte Ed Sexo Etio Afasia T. A.C. Asp. Asp. Disc.
Pre Pos PrePost Sc. Ritm. Melod. Audit
1 PC 66 MASC ACVH TRANS:MIX * P C C
2 MR 69 FEM ACVI GLOBAL * P C P
3 SM 65 MASC ACVI BROCA * C P C
4 PE 65 MASC ACVI GLOBAL * P P P
5 BC 53 MASC ACVH WERNICKE * P C P
6 ZC 53 MASC ACVI BROCA * P C C
7 RM 57 MASC ACVH BROCA * C C C
8 DA 64 MASC ACVI BROCA * C P C
9 AC 28 MASC ACVI GLOBAL * P C C
10 BJ 59 MASC ACVI BROCA * C C C
11 CG 35 MASC ACVI WERNICKE * C C P
12 FF 60 MASC ACVI GLOBAL * C C C
13 CM 39 FEM ACVH GLOBAL * P C P
14 AL 40 MASC ACVH CONDUCC * * P C C
15 SL 61 MASC ACVI WERNICKE * P C C
16 RA 50 MASC ACVI TRANS:SE * P C C
17 NI 59 FEM ACVI BROCA * C C C
18 CR 62 MASC ACVI GLOBAL * P P C
19 VE 40 MASC ACVI WERNICKE * C C C
711
20 SH 28 MASC ACVH BROCA * C C C
21 LH 69 MASC ACVI BROCA * P C C
22 GA 62 FEM ACVI GLOBAL * P P P
23 CJ 63 MASC ACVI BROCA * C C C
24 GJ 61 MASC ACVH TRANS:MO * P P P
25 CR 63 MASC ACVH WERNICKE * P C P
26 PC 81 MASC ACVI WERNICKE * P P P
27 GD 27 MASC ACVH WERNICKE * P P C
28 FP 66 MASC ACVI BROCA * P P C
29 PE 58 MASC ACVI BROCA * C P C
30 PU 65 MASC ACVI BROCA * C C C
32 LC 36 MASC ACVI WERNICKE * P C C
33 PR 59 MASC ACVI GLOBAL * P P P
34 FC 29 MASC ACVI BROCA * P C C
35 OA 73 MASC ACVI WERNICKE * P C C
36 SP 25 FEM ACVI BROCA * P C C
37 MN 67 FEM ACVI WERNICKE * P C C
38 SA 59 MASC ACVI WERNICKE * C C C
39 GM 68 MASC ACVI WERNICKE * C C C
40 LM 75 MASC ACVI GLOBAL * P P C
41 MR 69 FEM ACVI GLOBAL * P P P
712
Referencias TABLA sobre ESTUDIO DE LAS Asp.Ritm: aspectos rtmicos
FUNCIONES MUSICALES Asp.Melod: aspectos meldicos

Disc Audit: discriminacin auditiva

EN LOS PACIENTES AFASICOS. P= Perturbado
n= nmero de paciente C= Conservado
Pte= paciente

Ed= edad

etio= etiologa

T.A.C: tomografa axial computada de cerebro

Pre: lesin prerolndica

Pos: lesin posrolndica

PrePos: lesin pre-posrolndica

Sc: lesin subcortical

713
 Many experienced Music Therapy clinicians have
expressed doubts about the appropiateness of
II. MUSIC THERAPY AND EXPERIMENTAL quantitative and experimental research for illuminating
RESEARCH / MUSICA E INVESTIGACION
EXPERIMENTAL clinical processes in Music Therapy, particularly for
those approaches utilizing creative methods and with
psychotherapeutic orientation. In response,
clinicians/researchers throughout the world are turning

D ESI G N I N G , C O N D U C T I N G AN D PR ESEN T I N G to the alternative paradigm of Qualitative Research

T H E F I N D I N G S O F Q U AL I T AT I VE ST U D I ES: A (also referred to as Naturalistic Research,

WO R KSH O P F O R M U SI C T H ER APY Phenomenological Research, Hermeneutic Research,

R ESEAR C H ER S / D I SE O , R EAL I Z AC I N Y etc.)

PR ESEN T AC I N D E L O S R ESU L T AD O S D E One of the methodological difficulties in operating from

L O S EST U D I O S C U AL I T AT I VO S: U N T AL L ER a new scientific paradigm (world view) --such as that of
PAR A L O S I N VEST I G AD O R ES Qualitative Research-- is to generate standards for
observation, description, theory-formulation, theory-
K ENNETH A IGEN
testing, ethical issues and reporting forms that are
consistent with the philosophical/mentaphysical
underpinnnings of the new paradigm, and are not just
714
"imported" from previous methodologies. The absence
of a methodological orthodoxy can be liberating for the
Muchos clnicos de Musicoterapia expertos expresaron
Qualitative Music Therapy Researcher, yet it can leave
sus dudas acerca de la idoneidad de la investigacin
a plethora of practical problems in implementing
cuantitativa y experimental para ilustrar los procesos
qualitative studies. This workshop will address the
clnicos de la Musicoterapia, especialmente con
following issues, as well as any others brought up by
respecto a las aproximaciones que utilizan mtodos
those attending.
creativos y una orientacin psicoteraputica. En
1) Selecting the focus of a study and criteria for respuesta, los clnicos/investigadores de todo el mundo
allowing the focus to evolve over the course of the estn centrndose en el paradigma alternativo de la
study. investigacin cualitativa (tambin denominada
investigacin naturalstica, investigacin
2) Selecting an appropiate method.
fenomenolgica, investigacin hermenutica, etc.).
3) Choosing reporting forms, including the
Una de las dificultades metodolgicas para operar
presentational and analytical role of various narrative
desde un nuevo punto de vista cientfico (visin del
devices.
mundo) -como el de la investigacin cualitativa- es
4) Establishing the trustworthiness of the study's
generar normas para la observacin, descripcin,
findings. (Trustworthiness fulfills the function of validity,
formulacin de teoras, comprobacin de las mismas,
reliability and objectivity in Qualitative Research.)
715
temas ticos y formas de recopilacin que tienen que 4) Determinacin de la fiabilidad de los resultados
ver con la cimentacin de este nuevo paradigma y que del estudio (la fiabilidad satisface la funcin de validez y
no son slo "importados" de las metodologas objetividad en una investigacin cualitativa).
anteriores. La ausencia de una ortodoxia metodolgica
puede resultar liberante para el Investigador
Cualitativo, pero puede dejar una pltora de problemas R ESEAR C H I N M U SI C T H ER APY:
prcticos para la realizacin de los estudios cualitativos. Q U AN T I T AT I VE O R Q U AL I T AT I VE? /
Este taller abordar los temas siguientes, as como I N VEST I G AC I N D E L A M U SI C O T ER API A:
cualquier otro que deseen presentar los asistentes: C U A N T I T A T I V A O C U A L I T A T I V A ?

1) Seleccin del enfoque de un estudio y los criterios D ORIT A MIR

para permitir que dicho enfoque evolucione en el curso
del estudio.
In this paper I introduce two burning questions in our
2) Seleccin de un mtodo de trabajo idneo.
profession these days: one is concerned with the
3) Eleccin de las formas de recopilacin, incluido el meaning of the music therapy experience and the
papel de presentacin y analtico de varios dispositivos second one deals with finding the right research
narrativos. modalities in order to explore the meaning and to
understand the M.T. experience on a more deeper level.
716
Through a review of the music therapy literature; I show My conclusion is that the utilization of qualitative
that, up until lately, most studies in our field are based research methods in our field will help us illuminate the
on quantitative research methods and try to find the art, the beauty, and the essence of our work as music
rational for it. Then, I talk about the differences between therapists.
quantitative and qualitative research and take as an
example a specific study in order to highlight these
differences.
En esta conferencia presento dos temas actuales: El
primero se trata de la experiencia musicoterapeuta. El
The main part of the paper focuses on the qualitative
segundo es sobre modelos de investigacin para
research modality which is also called "grounded
explorar y entender el significado de la musicoterapia
theory". I give an explanation of this approach, describe
en un nivel ms profundo.
its main characteristics, and show how each element is
relevant to the music therapy process and the
Basndome en una mirada en la literatura, muestro

undertanding of it. I conclude this part bringing my own

que, hasta hace muy poco tiempo, la mayora de los

doctoral research as an example of using a qualitative

estudios en nuestro campo se basan en sistemas de

research design in order to understand the holistic

investigacin cuantitativos, y trato de encontrar lo

meaning of the music therapy experience for music

racional a todo esto. Hablo sobre las diferencias entre

therapists and for music therapy clients.

investigaciones cuantitativas y cualitativas y tomo como
ejemplo un estudio especfico para destacar las
717
diferencias. T H E EF F EC T S O F D I C S M U SI C T H ER APY /
L O S R ESU L T AD O S D EL SI ST EM A D E
La parte importante de la conferencia, se basa en la
I N F O R M AC I N D O C U M EN T AL Y
investigacin cualitativa, que se denomina "teora del
C O M U N I C AC I N D E M U SI C O T ER API A - D I C S
establecimiento" ("grounded theory"). Yo doy una
explicacin sobre el tema, demuestro sus P IETER V AN D EN B ERK
caractersticas principales y la relevancia de cada una
de ellas en el proceso de la musicoterapia y su
entendimiento. Termino esta parte presentando mi The DICS Music Therapy is a Documental Information
propia investigacin doctoral como ejemplo de and Communication System, a computer network
utilizacin de una lnea de investigacin cualitativa para offering facilities in both areas: the field of data
entender el significado completo de la experiencia de la communication as well as the field of data bank. The
musicoterapia para terapeutas y pacientes. system is directed towards one specialty, Music
Therapy; DICS Music Therapy is based on an
Mi conclusin es que el uso de los mtodos cualitativos
international human network.
en nuestro campo nos ayuda a iluminar el arte, la
belleza y la esencia de nuestro trabajo. The DICS Music Therapy connects computers
stationed at the approved training schools for Music
Therapy and at professional institutions, such as
associations of music therapists in USA, Australia and
718
various European countries. de formacin de musicoterapia y en las instituciones
profesionales como las asociaciones de
The paper consists of a demonstration of the DICS
musicoterapeutas en EE.UU., Australia y varios pases
Music Therapy computer network, an overview of the
europeos.
actual situation and a report of a number of projects
were DICS Music Therapy was used by music La ponencia consiste en una demostracin de la red de
therapists, music therapy trainers, students and ordenadores de Musicoterapia DICS, una perspectiva
researchers. de la situacin actual y un informe acerca de cierto
nmero de proyectos en que musicoterapeutas,
profesores de musicoterapia, estudiantes e
La Musicoterapia DICS es un Sistema de Informacin y investigadores utilizaron la Musicoterapia DICS.
Comunicacin de Documentos: una red de
ordenadores que ofrece facilidades en dos reas -en el
campo de la comunicacin de datos, as como en el
campo de los bancos de datos. El sistema se dirige a
una especialidad, la Musicoterapia, y se basa en una
red humana internacional.

La Musicoterapia DICS est conectada con

ordenadores ubicados en las escuelas homologadas
719
 AN T I - AN XI ET Y M U SI C AN D H EM I SPH ER I C AL In the conclusions there is a tendency to go laterally to
R EPER C U SSI O N / M SI C A AN SI O L T I C A Y one hemisphere or the other, depending on the
R EPER C U SI N I N T ER H EM I SF R I C A subject's anxiety level and his/her relation with the kind
of music listened. This result suggests the importance of
TERESA FERNANDEZ, TRINIDAD VIRUES & PEDRO
considering the psychological aspects in this type of
FIGUEREDO
studies.

The qualitative changes within the psychological proofs

With the general objective of knowing the hemispherical
showed a correlation with the variations in the
repercussion of anti-anxiety musical fragments listened
encephalograms, supporting the therapeutical effect of
by patients with pathological anxiety, we studied the
the musical selection, and marking the possibility of
behavior of the alpha activity in 32 subjects and its
introducing music to reduce the psycho-
relation with the decrease of anxiety, through
pharmacological treatment, in those cases in which this
psychological tests and the recording of the biotrainer
treatment was necessary.
or biofeedback during the whole experience. The
cerebral mapping technique was used for the first time
for this purpose with a new program, incorporating a Con el objetivo general de conocer la repercusin
neurometric study which quantitatively expressed the hemisfrica de fragmentos musicales ansiognicos y
subjective variations. ansiolticos escuchados biauralmente en sujetos
720
portadores de ansiedad patolgica, se estudi el psicolgicas mostraron correlacin con las variaciones
comportamiento de la actividad alfa en 32 sujetos y su a nivel electroencefalogrfico, lo cual apoya el efecto
relacin con la disminucin de la ansiedad a travs de teraputico de esas selecciones musicales y seala la
pruebas psicolgicas y el registro del biotrainer o posibilidad de considerar su introduccin
biofeedback durante toda la experiencia. Se utiliz la complementaria con una disminucin parcial del
tcnica del mapeo cerebral, usada por primera vez tratamiento psico-farmacolgico, en los casos en que
para este fin y con un programa novedoso, ste resulte necesario.
incorporando el estudio neuromtrico que
cuantitativamente expres las variaciones constatadas
a nivel subjetivo. H O W T O EST ABL I SH A M U SI C T H ER APY
R ESEAR C H C L I N I C . PR O C ESS D ESC R I PT I O N /
En las conclusiones se seala una tendencia a
lateralizar hacia uno u otro hemisferio en dependencia C M O EST ABL EC ER U N A C L N I C A D E

del nivel de ansiedad presente en el sujeto y de su I N VEST I G AC I N M U SI C O T ER APU T I C A.

relacin con el tipo de msica escuchada, lo que D ESC R I PC I N D EL PR O C ESO

sugiere la importancia de considerar aspectos de tipo H ANNE -M ETTE K ORTEGAARD

psicolgico en este tipo de estudios.

Los cambios cualitativos dentro de las pruebas

Three main areas are considered in the introduction of
721
this topic: integrar a una organizacin clnica un programa de
investigacin en la musicoterapia, incluyendo la
1. Problems experienced on trying to integrate a
cooperacin y participacin de otros miembros del
music therapy research program within a clinical
equipo interdisciplinario y puntos ticos referidos a los
organization, including cooperation and participation of
pacientes.2. Encontrar un diseo y una metodologa
other members of the interdisciplinary team and
apropiada, que permita al investigador
introduction of some ethical points which refer to the
musicoteraputico tener en cuenta tanto lo aspectos
patients.2. Finding an appropriate design and
cuantitativos como cualitativos.3. Considerar los
methodology which may allow the music therapy
problemas que se experimenten tanto como terapeuta
researcher to bear both quantitative and qualitative
como investigador.
aspects in mind.

3. Consideration of the problems experienced

because of being both a therapist and a researcher.

En la presentacin del tema se considerarn

tres reas principalmente:

1. Los problemas experimentados al tratar de

722
 T H E D EVEL O PM EN T O F T H E M U SI C AL incidence of these interventions on the global children's
I N T EL L I G EN C E: A D I R EC T - AC T I VE R ESEAR C H development.
/ EL D ESAR R O L L O D E L A I N T EL I G EN C I A
The method has included different phases: the
M U SI C AL : U N A I N VEST I G AC I N D I R EC T A Y
participation of the children in collective and individual
AC T I VA
tests and the compilation of questionnaires, the
S ILVANA N OSCHESE , ANTONIO IANNACCONE & PINA B OGGI observation of the subject within the group and the
C AVALLO achievment of sonorous-graphic and motor articulate
proposals.

The object of the study has been a sample of children

Our work has been inspired by Gardner`s Multiple
aging 3-5 years included in a biennial taining program in
Intelligence Theory and represents the second stage of
sound-music movement. A longitudinal study (three
the longitudinal project of training in sound-music and
repeated measure-ments) of their cognitive ability
movement. It is the result of the interaction between
growth has been performed.
psychological and musical spheres.
The children experienced the free discovering of sound
The former aspect has been developed with the
and silence, of their own "trace" transformed into colour,
methodical analysis of a wide series of cognitive
the use of their body for communcative plays in a non-
competences, the latter by means of "direct
directive context and the possibility of being "the
observation"; the mutual aim has been to control the
723
subject" of the intervention. The operators have verified cognitivas, mientras que el segundo se desarroll por
the existence of a Musical Intelligence whose medio de la "observacin directa": en ambos casos el
development is not only connected, but needs the objetivo fue controlar la incidencia de estas
stimulation of all the expressive and communicative non intervenciones sobre el desarrollo global de los nios.
verbal means.
El mtodo incluy fases diferentes: la participacin de
The results of the research have been of extreme los nios en pruebas colectivas e individuales y la
interest, both on the side of the educational intervention compilacin de cuestionarios, la observacin del sujeto
and the analysis of the cognitive development of the en el mbito del grupo y el logro de propuestas sonoro-
subjects. grficas y motoras articuladas.

El tema del estudio fue constituido por una muestra de

nios de edades comprendidas entre los 3 y 5 aos,
Nuestro trabajo se inspir en la teora de las
incluidos en un programa bienal de formacin en
Inteligencias Mltiples de Gardner y representa la
sonido-msica-movimiento. Se realiz un seguimiento
segunda fase del proyecto longitudinal de formacin en
longitudinal (tres comprobaciones repetidas) del
sonido-msica y movimiento. es el resultado de la
crecimiento de su capacidad cognitiva.
interaccin entre las esferas psicolgica y musical.
Los nios experimentaron el libre descubrimiento del
El primer aspecto se desarroll a travs del anlisis
sonido, del silencio, de su propio "rastro" transformado
metdico de una amplia gama de competencias
724
en color, de la utilizacin de su cuerpo para los juegos This research, at the basis of this dissertation, has
comunicativos en un contexto no directivo y hasta la resulted from the casuistic acquired by doctor
posibilidad de ser "el sujeto" de la intervencin. Los Palmirotta and his collaborators, including whom the
operadores comprobaron la existencia de una lady doctor Maria Rosaria Tagliente. This casuistic has
Inteligencia Musical cuyo desarrollo no slo esta been acquired in over ten years of activity (carried on in
relacionado, sino que necesita la estimulacin de todos the Ontopsychology Centre of Bari and in the country
los medios expresivos y comunicativos no verbales. Residence Centre "Solinio" - Cassano Murge - Ba - Italy)
in the field of psychosomatic psychotherapy and of
Los resultados de la investigacin fueron
music-therapy. These activities are addressed above all
extremadamente interesantes tanto desde el punto de
to healthy people, willing to go deeper into their
vista de la intervencin a nivel de educacin, como por
psychophysic well-being level.
el anlisis del desarrollo cognitivo de los sujetos.
A psychologist lady doctor, thanks to a ontotherapic
training of authentication and to the ontopsychologic
PSYC H O SO M AT I C M U SI C T H ER APY / music therapy, "discovers again" her body.
M U SI C O T ER API A PSI C O SO M T I C A Consequently she revises the mechanicalistic and
"organistic" idea of the official medicine, actually unable
F RANCESCO P ALMIROTTA & M R OSARIA T AGLIENTE
to operate for the well-being of the individual, and to
take him back to his own psychosomatic health.
725
The dissertation underlines the potentiality of the music Una psicloga, gracias a su formacin ontoterpica de
therapy to awake the "organic conscience". The music autentificacin y a la musicoterapia ontopsicolgica,
therapy is a very good method to improve in healthy "descubre de nuevo" su cuerpo. Consecuentemente
people their well-being, their capability to create and to revisa la idea mecanicista y "organicista" de la medicina
"auto-realize" themselves. oficial, incapaz de lograr el bienestar del individuo y
devolverle su propia salud psicosomtica.

Este trabajo subraya el potencial de la musicoterapia

Esta investigacin, base del trabajo, es el resultado de
para despertar la "conciencia orgnica". La
la casustica adquirida por el Dr. Francesco Palmirotta y
musicoterapia es un excelente mtodo para mejorar el
sus colaboradores, entre los que se encuentra la Dra.
bienestar de la gente sana y su capacidad para crear y
M Rosa Tagliente. Esta casustica ha sido adquirida a
autorrealizarse.
lo largo de diez aos de actividad (llevados a cabo en el
centro de Ontopsicologa de Bari en la Residencia de
campo Centro "Solonio" - Cassano Murge - Ba, Italia)
F R O M M O N O D Y T O PO L YPH O N Y O R F R O M
en el campo de la psicoterapia psicosomtica y en el de
SI G N T O SEN SE. L O U D - L O W: A SI G N I F I C AN T
la musicoterapia. Estas actividades estn dirigidas
F UNCT ION / DE L A M ONODIA A L A
sobre todo a gente sana, deseando profundizar en su
nivel de bienestar psicofsico. PO L I F O N A O D EL SI G N O AL SEN T I D O .

726
 F U ER T E- SU AVE: U N A F U N C I N to the sense, using the technical resource of alternance,
SI G N I F I C AN T E in order to reach a sliding in signification that gives
sense to the production of sounds.
P ATRICIA C LAUDIA P ELLIZZARI
This paper is the final result of a full-time research work
with groups of psychotic patients which has been done
The text follows the way from Monody to Polyphony,
during ten years at the "Braulio Moyano"
with special reference to the issues of "form" and
Neuropsychiatric National Hospital (Hospital
stylistics which are the features of the above mentioned
Neuropsiquitrico Braulio Moyano), and it is a part of
periods; and from which it is possible to note that both
the book "Psychoanalytic Music Therapy", soon to be
musical and psychological phenomena are structures
published, which tries to explore essential issues of
having identical mechanisms, regarding their
music therapy theory and technique.
constitutive logic if not their substance.

This paper is developed in constant play with analogies

El texto recorre el trayecto que va de la Monodia a la
that equal psychosis, resulting from a failure in the
Polifona aludiendo a los avatares de "forma" y
symbolization process; and the cosmovision of the
estilstica que caracterizan a dichos perodos; a partir
subject in monody, regarding its historical perspective. It
de lo cual se visualiza que el fenmeno Musical y
ends with the description of a clinical register. In this
Psicolgico son estructuras con idnticos mecanismos,
experience, it has been tried to pass from the bare sign
727
sino en substancia en su lgica constitutiva. inherentes a la teora y tcnica musicoteraputica.

El trabajo se desarrolla en un constante juego de

analogas que equiparan a la psicosis, resultante de un
P E R S O N A L I T Y P R O JE C T I V E I N T E R V A L S T E S T
fracaso en el proceso de simbolizacin, con la
/ T EST PR O YEC T I VO SO N O R O D E L A
cosmovisin del sujeto de la Monodia en su perspectiva
histrica. Culmina con la exposicin de un registro PER SO N AL I D AD

clnico en cuya experiencia se intenta tramitar el pasaje C ARLA S AVIO

del puro signo al sentido utilizando el recurso tcnico de
la alternancia con el propsito de acceder a un
deslizamiento significante que otorga sentido a la The "Personality Projective Intervals Test" was
produccin sonora. developed by Carla Savio in 1972. The P.P.I.T. is
constituted by 4 patterns of 42 pairs of musical intervals.
Este escrito es producto de una investigacin realizada
Subjects are requested to choose and refuse one
con grupos de pacientes psicticos a lo largo de diez
interval between each pair. Responses are represented
aos de trabajo full-time en el Hospital
in 4 graphics which individuate some responses'
Neuropsiquitrico Braulio Moyano y forma parte del
pattterns that C. Savio has related to the relational style
libro "Musicoterapia Psicoanaltica" de prxima
of the subject referring to mother, father, sister, brother,
publicacin, que pretende indagar sobre cuestiones
sex, society and onself.
728
Mrs. Savio has already performed a clinical validation ha referido al estilo relacional del sujeto con respecto a
on a large amount of people, both children and adults. la calidad de la relacin con la madre, el padre, la
However, until how no psychometric validation was hermana, el hermano, el sexo, la sociedad y el YO.
done.
La Sra. Savio ha ya realizado la validacin clnica en
The aim of our work is to validate psychometrically the una amplia variedad de poblacin, tanto en nios como
P.P.I.T. in 100 adults taken from normal population. The en adultos. Sin embargo, hasta la fecha no ha realizado
subjects were evaluated with a self administering rating ninguna validacin psicomtrica.
scale, with a personality questionnaire (M.M.P.I.), a
El objeto de nuestro trabajo es comprobar la validez
standardized psychiatric anamnesys (ANAM) and a
psicomtrica del P.P.I.T. (Personality Proyective
tape recorded semistandardized psychiatric interview.
Intervals Test) en una poblacin de 100 adultos
normales. Los sujetos fueron evaluados a travs de la
escala de autovalorizacin, con un cuestionario de
El "Test Proyectivo Sonoro de la Personalidad" fue
personalidad (M.M.P.I.), anamnesia clnico
desarrollado por Carla Savio en 1972. Est constituido
estandarizada (ANAM) y una grabacin de video de la
por 4 modelos de 42 parejas de intervalos musicales. El
entrevista psiquitrica estructurada y semi-
sujeto debe elegir o rechazar un intervalo en cada
estructurada.
pareja. Las respuestas estn presentes en 4 grficos
que identifican los modelos de respuesta que C. Savio
729
2.1.- PSYCHOLOGY AND MUSIC - PSICOLOGIA De acuerdo con Dowling y Harwood (1986) existen
Y MUSICA. (ABSTRACTS)
pruebas de que reacciones emocionales intensas
escuchando msica implican un aumento de la

M U SI C AL I N D U C T I O N . C H AN G ES I N T H E actividad de nuestro sistema nervioso autnomo

ST AT E O F SPI R I T AN D C O G N I T I VE (Autonomic Nervous System).

C O M PL EXI Z AT I O N / I N D U C C I N M U SI C AL . Sin embargo, de acuerdo con algunos experimentos

C AM BI O EN EL EST AD O D E N I M O Y empricos (vase Francs, 1985), el oyente deber
C O M P L E JI Z A C I N C O G N I T I V A estar dotado de algunas cualidades especificas que
faciliten el sentimiento de la msica. As, adems de
J OS A NTONIO A DRIN T ORRES
una capacidad auditiva normal para la transmisin del
sonido, finura en la discriminacin sonora (altura tonal y
Tal y como se ha demostrado en recientes timbre), sentido del ritmo, etc., los oyentes debern
investigaciones, la msica es capaz de generar poseer cierta facilidad para fantasear, imaginar y
alteraciones psicofisiolgicas en nuestro organismo: generar experiencias estticas y sinestsicas durante
alteraciones en el pulso, ritmo cardaco, en la la percepcin musical.
respiracin, presin arterial, etc. (Harrer & Harrer, Al margen de estos cambios que se producen
1977). automticamente en nuestro sistema nervioso

730
autnomo, algunos experimentos han encontrado que As it has been proved in recent research, music can
la msica genera cambios en el estado desnimo, la generate psychophysiological alterations in our
cognicin y la conducta (Kenealy, 1988; Martn, 1990). organism: alterations in pulse, cardiac rhythm,
breathing, blood pressure, etc. (Harrer & Harrer, 1977).
El presente estudio analiza los primeros datos
empricos sobre la incidencia de ciertos elementos According to Dowling and Harwood (1986), there is
estticos en las estados desnimo interiores y en la proof that intense emotional reactions when listening to
reestructuracin cognitiva. Para ello, hemos realizado music implie an increase in activity in our autonomic
un diseo experimental que, partiendo de la teora de nervous system.
Vygotski (1929), contempla la posibilidad de que
However, according to certain empiric experiments (see
estmulos con cargas afectivas positivas y negativas,
Francs, 1985), the listener would have to have certain
simultneamente presentados, produzcan una catarsis
specific qualities which give him with a musical feeling.
en el sentido de una mayor riqueza cognitiva y
Thus, apart from a normal auditive capacity for sound
creatividad. Esta investigacin representa uno de los
transmission, fineness in sound discrimination (pitch
primeros intentos de operacionalizar un elemento
and sound colour), a sense of rhythm, etc... listeners
esttico como es la msica, para descubrir la
would also need a certain capacity for fantasy,
composicin y elementos relevante del arte.
imagination, for generating aesthetic and synaesthetic
experiences during musical perception.

731
Besides the changes which are automatically produced
in our autonomic nervous system, some experiments
have shown that music generates changes in the state D R EAM S, PL AYI N G AN D M U SI C / SU E O S,

of spirit, cognition and conduct (Kenealy, 1988; Martin,

JU E G O Y M S I C A

1990). J OS D E B ACKER & JAN V AN C A M P

This study analyzes the first empiric data on the
incidence of certain aesthetic elements on interior
A closer examination is being made from the point of
states of spirit and in cognitive restructuralization. To
view of pychodynamic work and thought of the various
this end we have carried out an experimental design
analogies between musical utterances and dreams. In
which, based on the theory of Vygotski (1929),
free musical improvisations one can touch similar
contemplates the possibility that stimuli with positive
mechanisms as in dreams. Just as with dreams, musical
and negative affective charges, simultaneously brought
utterances in free improvisations are therapeutically
up, would produce a catharsis in the sense of a greater
interpreted within a field of associations. In this
cognitive and creative wealth. This research is one of
document, musical expression is also related to normal
the first attempts to operate on an aesthetic element,
child's play. As an introduction is given for a first
such as music, in order to discover composition and
symbolism in child's play, so too, musical utterances
relevant elements of art.
can be seen as a kind of symbolic system, a field of

732
oppositions within which certain meanings can be Se realiza un estudio ms profundizado desde el punto
originated. In this connection, the question is further de vista del trabajo y pensamiento psicodinmico de las
examined as to whether a first symbolism does not diferentes analogas entre las expresiones musicales y
already appear at a purely musical level, even before los sueos. En las improvisaciones musicales se
certain meanings become clear, or can be interpreted, pueden alcanzar mecanismos similares a los de los
at speech level. In other words, this is a request for the sueos. Como en los sueos, las expresiones
acceptance of music as a therapeutic medium. In its musicales en las improvisaciones libres se interpretan
therapeutic function, music does not only have a teraputicamente dentro de un campo de asociaciones.
preparatory moment (preparation for verbal reflection En esta ponencia la expresin musical se relaciona
and interpretation), but also its own function, i.e. that of tambin con el juego normal del nio. As como el juego
a proto-symbolism on a purely musical level. Also the representa el primer simbolismo del nio, tambin las
transfer falls within the bounds of musical utterances expresiones musicales se pueden interpretar como una
and interactions, and provides the possibility of especie de sistema simblico, un campo de
interpretation at a purely musical level. oposiciones dentro del cual se pueden originar ciertos
significados. Dentro de esta conexin, se estudia el
The entire document is illustrated with examples (video-
tema para comprobar si un primer simbolismo no
audio) from the music therapy practice.
aparece ya en el mero nivel musical, incluso antes de
que ciertos significados estn claros o se puedan

733
interpretar a nivel hablado. En otras palabras, esta es la SI ST M I C A A L A I N F L U EN C I A D E L A M SI C A
peticin para la aceptacin de la msica como medio SO BR E L A G EN T E
teraputico. En su funcin teraputica, la msica no
G ERTINA J. BEZUIDENHOUT
slo tiene un momento preparatorio (preparacin para
la reflexin e interpretacin verbales), sino tambin su
propia funcin, es decir la de proto-simbolismo a nivel Music is undeniably part of everybody's everyday life
meramente musical. Tambin el transfer entra dentro and it has been aptly described by Fox as "the world-
de los lmites de las expresiones e interacciones wide feature of life" (1983, p212). The influence of music
musicales y proporciona la posibilidad de interpretacin on man and the way in which music can influence
a un nivel puramente musical. human behavior in different contexts, makes it essential
Toda la ponencia se ilustra con ejemplos to develop a conceptual framework for explaining and
(audiovisuales) extrados de la prctica de la describing the influence of music on man.
musicoterapia. A serious deficiency and a major problem in the field of
music therapy and music psychology is the fact that it
has not been clearly and fundamentally conceptualized
A SYST EM S APPR O AC H T O T H E I N F L U EN C E within a broader context. There is still a limitation as to
O F M U SI C O N PEO PL E / U N A APR O XI M AC I N an epistemology for music therapy and music
psychology and this lack of a proper conceptual
734
framework has in the past resulted in fragmentation, interactions, exchange and transactions, cybernetic
diverse theoretical models, contradictory assumptions complementarities, distinctions and boundaries, social
and findings, with considerable disagreement and context and change will be discussed. Furthermore
numerous disputes. reference will be made as to the self-regulating control
cycle and the circular organization of systems, and how
One way of solving the diversity and near chaos that
this relates to the influence of music on people.
prevail in this field would be to develop a theoretical
model and a definition which describe the complex and
comprehensive character of music, encompassing all
Indudablemente la msica forma parte de la vida
levels of human behaviour, and thus to provide a more
cotidiana de cada uno y Fox la describi acertadamente
comprehensive premise for the study of the influence of
como "la caracterstica mundial de la vida" (1983, pg.
music on people. A cybernetic and systemic approach
212). La influencia de la msica sobre el hombre y la
might be the answer to the problem.
forma en que la msica puede influenciar el
Cybernetics and Systems theory as a meta-theory in comportamiento humano en contextos diferentes, hace
psycology, proposes such a new epistemology and will que resulte esencial desarrollar un marco conceptual
in this paper be discussed with relation to music therapy para explicar y describir la influencia de la msica sobre
and music psychology. Cybernetic and systems el ser humano.
constructs such as recursiveness, relationships and
En el campo de la musicoterapia y la musicopsicologa,
735
la falta de una conceptualizacin clara y fundamental La teora ciberntica y sistmica, como meta-teora en
dentro de un contexto ms amplio constituye una grave psicologa, propone una nueva epistemologa de este
deficiencia y un problema arduo. An existe una tipo que se debatir en esta ponencia en relacin con la
limitacin con respecto a una epistemologa para la musicoterapia y la musicopsicologa. Se ilustrarn los
musicoterapia y la musicopsicologa y en el pasado la constructos cibernticos y sistmicos como la
falta de un marco conceptual adecuado se tradujo en recursividad, las relaciones e interacciones, el
fragmentacin, modelos tericos diferentes, intercambio y las transacciones, las
suposiciones y descubrimientos contradictorios, con complementariedades cibernticas, las distinciones y
notables desacuerdos y numerosas controversias. los lmites, el contexto social y el cambio. Se har
tambin referencia al ciclo de control autorregulado y a
Una forma de solucionar la diferencia y el caos que
la organizacin circular de sistemas y a la forma en que
prevalecen en este campo sera el desarrollo de un
estos se relacionan con respecto a la influencia de la
modelo terico y una definicin que describa el carcter
msica sobre la gente.
complejo e inclusivo de la msica, abarcando todos los
niveles del comportamiento humano, proporcionando
as una premisa ms completa para el estudio de la
T H E I N F L U EN C E O F M U SI C O N C O G N I T I VE
influencia de la msica sobre la gente. La respuesta al
F U N C T I O N I N G I N ST U D EN T S AT T EN D I N G
problema podra ser una aproximacin ciberntica y
PR AC T I C AL C L ASSES I N H U M AN AN AT O M Y /
sistemtica.
736
 L A I N F L U EN C I A D E L A M SI C A SO BR E L A interacting with the parties in this larger context. Both
F U N C I N C O G N I T I VA D E L O S EST U D I AN T ES precomposed music and music improvised in a
Q U E ASI ST EN A C L ASES PR C T I C AS D E therapeutic setup, can thus be seen as systems that
AN AT O M I A H U M AN A enter the interactional context with man, whether it be in
therapy or in everyday life.
G ERTINA J. BEZUIDENHOUT
Much research has been done on the influence of music
on the emotive and cognitive subsystems of the
The influence of music on man is an undeniable factor
individual. In this research the improvisational technique
which can be researched, evaluated and described by
proposed by Bradford Keeney to enhance therapeutic
the Cybernetics and Systems theory. Man functions
skills, was used as a creative technique to study,
within different time-spatial contexts where he interacts
evaluate and describe the influence of music on the
with other systems in the environment, and which has
congnitive functioning observed in a learning
recursive influences on him. Music can be seen as a
environment or context. This method provides for a
system with its own dynamic interaction between the
presenting gallery or situation analysis where all the
parts, and functioning as a whole. A musical
variables are evaluated for the direct and indirect
composition cannot be seen as a live system open to
influence they have on cognitive functioning. In the
influences from outside, but it can enter into relationship
bridging gallery, the context is further developed to lead
with man becoming part of the larger context, and
to the therapeutic gallery in which goals are set, and
737
strategies developed. In research it is also necessary to parte de un contexto ms amplio e interactuando con
include a feedback gallery to make sure the strategies las partes en este contexto ms amplio. Tanto la msica
were effective, or to make alterations to the goals or compuesta como la improvisada se pueden entonces
strategies. considerar sistemas que se inscriben en el contexto de
interaccin con el hombre, tanto en la terapia como en
la vida cotidiana.
La influencia de la msica sobre el hombre es un factor
Se llevaron a cabo numerosas investigaciones sobre la
innegable que se puede investigar, evaluar y describir
influencia de la msica sobre los subsistemas emotivo y
con la teora de la Ciberntica y los Sistemas. El ser
cognitivo del individuo. En esta investigacin la tcnica
humano funciona dentro de diferentes contextos
de improvisacin propuesta por Bradford Keeney para
espacio-temporales, en los cuales interacta con otros
incrementar las habilidades teraputicas fue utilizada
sistemas del entorno y que tienen influencias recursivas
como tcnica creativa para estudiar, evaluar y describir
sobre el mismo. La msica se puede considerar como
la influencia de la msica sobre la funcin cognitiva
un sistema con su propia interaccin dinmica entre las
observada en un contexto o entorno de aprendizaje.
partes y que funciona como un todo. Una composicin
Este mtodo proporciona un marco de presentacin o
musical no se puede considerar un sistema vivo abierto
anlisis de situaciones en que todas las variables se
a las influencias procedentes del exterior, pero puede
evalan segn la influencia directa e indirecta que
entrar en relacin con el hombre llegando as a formar
tienen sobre la funcin cognitiva. En el marco puente, el
738
contexto se desarrolla ulteriormente para llevar al Ontopsychological research has elaborated a
marco teraputico en que se fijan las metas y se methodology, with a view to acquiring a revitalizing
desarrollan las estrategias. En la investigacin es movement, based on this universal rhythm taken from a
tambin necesario incluir un marco de realimentacin holistic understanding of one's own body; in order to
para asegurarse de que las estrategias sean efectivas assist one's own inner perception and the quest for
o modificar las metas o las estrategias. potential organic sanity and creativity.

O R G AN I SM , M U SI C AN D M O VEM EN T I N
O N T O PSI C H O L O G I C AL M ET H O D O L O G Y / Partiendo de la constatacin comn en cada cultura de
O R G AN I SM O , M SI C A Y M O VI M I EN T O EN L A que el organismo del hombre inmerso en la naturaleza
M ET O D O G A O N T O PSI C O L G I C A participa en sus ritmos vitales, se origina en
consecuencia la investigacin de este ritmo natural en
C LAUDIO F ASSARI
el que se fundamenta tambin la realidad humana.

La investigacin ontopsicolgica ha permitido elaborar

Research on the natural rhythm that is the basis of una metodologa que, a partir de este ritmo universal
human reality starts from proof that is common to each recogido a travs de la comprensin holstica del propio
culture, according to which the organism of man in a cuerpo, permite adquirir un movimiento revitalizador,
natural situation participates in its vital rhythms. tanto para la percepcin propia e introspectiva como
739
para la potencialidad orgnica de la salud y creatividad. One could move from the logical thinking of everyday
life to the archaic thinking of the unconscious and vice
versa.
T H E T H ER APEU T I C EXPER I EN C E O F M U SI C I N
The basis of the article is the theory that musical and
T H E L I G H T O F T H E H U M AN D EVEL O PM EN T
psychic occurrence are isomorphous. According to that
PSYC H O L O G Y / L A EXPER I EN C I A
theory music is a psychic process, and has its origins in
T ER APU T I C A D E L A M SI C A A L A L U Z D E L A the states of tension within man appearing in sonant-
PSI C O L O G A D EL D ESAR R O L L O H U M AN O acoustic form through the ear. This means that music is

K IMMO L EHTONEN an external; perceptible manifestation of that inner

process; a kind of process that individual uses to
transform his inner i.e. physical not lingual, experiences
The purpose of this article is to set new light to the origin of meaning into external audible form. The article
of the human musical experience through the handles the forms of music as means of achieving
development theory that combines the development psychic harmony and music as a transitional and self
theories of Jean Piaget and Sigmund Freud. The main object.
idea of the article is to show how an individual could
When focusing upon psychoanalitically or
move within his different developmental phases and the
psychodynamically oriented psychotherapy, which is
modalities of thinking related to them by using music.
740
based on the theory that problems and conflicts in un individuo puede moverse dentro de distintas fases
childhood have a remarkable influence on a person's de desarrollo y las modalidades de pensamiento
later life, we can ask the question whether the theses relacionadas con las mismas. Es posible moverse
concerning the structures of music describe the desde la forma de pensar lgica diaria al pensamiento
structures of the psyche as well? Is not psychotherapy arcaico del inconsciente y viceversa.
very much like music, a process of "externalising the
La base de esta ponencia es la teora segn la cual el
internal", where physical, archaic, not lingual,
evento musical y psquico son isomorfos. Segn esta
nondiscursive singnificances form a person's "interior"
teora, la msica es un proceso psquico y tiene su
are transformed into external narrative signals,
origen en los estados de tensin humanos que
symptoms, associations-i.e. that have their origins in the
aparecen en forma sonora-acstica a travs del odo.
unconscious processes in the human mind?.
Esto significa que la msica es una manifestacin
externa y perceptible de este proceso interno; una
especie de proceso que el hombre utiliza para
El objetivo de esta ponencia es aclarar el origen de la
transformar sus experiencias significativas internas -
experiencia musical humana a travs de la teora del
fsicas y no verbales- en una forma externa audible. La
desarrollo que combina las teoras del desarrollo de
ponencia estudia las formas de msica como medios
Jean Piaget y Sigmund Freud. La idea fundamental de
para alcanzar la armona fsica y la msica como auto-
esta ponencia es mostrar cmo, utilizando la msica,
objeto y objeto de transicin.
741
Cuando nos centramos en la psicoterapia de M EN T AL T EM PO , A C O N T R I BU T I O N T O M U SI C
orientacin psicoanaltica o psicodinmica, que se basa T H ER APY / T EM PO M EN T AL , U N A
en la teora de que los problemas y conflictos de la C O N T R I BU C I N A L A T ER API A M U SI C AL
infancia tienen una influencia considerable sobre la vida
Y ASUJI M URAI
posterior de una persona, nos podemos preguntar si
las tesis relativas a las estructuras de la msica
describen las estructuras o tambin la psique. La The natural, congenial tempo for an individual is called
psicoterapia no es, como la msica, un proceso de mental tempo, and it is ordinarily measured by tapping
"exteriorizacin de lo interior", donde los significados on a desk for 10 seconds with the second finger of the
fsicos, arcaicos, no-verbales del interior de una hand we write with.
persona se transforman en seales, sntomas,
Since both E. Kraepelin and E. Kretchmer studied
asociaciones narrativas externas, es decir que tienen
mental tempo, many researchers have investigated it
su origen en los procesos inconscientes de la mente
and stressed that mental tempo was closely connected
humana?
with one's temperament and character.

This author has studied, in clinical setting, mental tempo

of chronic schizophrenics (137 males, 93 females), and
found that the more severe their illness was, the higher

742
their mental tempo was. That is to say that mental audience, the character and genesis of mental tempo
tempo became slower in accordance with the recovery are to be discussed.
from illness.

In another research, in which mental tempo of both

El tempo natural y congenial de cada individuo se llama
discharged and reentered patients was investigated,
"tempo mental" y normalmente se mide golpeando
the patients with slower mental tempo were able to live
ligeramente sobre una mesa durante 10 segundos con
outside the hospital successfully, whereas many of the
el dedo ndice de la mano derecha (izquierda en caso
patients with faster mental tempo reentered the hospital
de ser zurdo).
by exacerbation.
Desde que E. Kraepelin y E. Kretchmer estudiaron el
From all this data, mental tempo was thought to be an
tempo mental, muchos investigadores siguieron su
index of mental strain, and a decreased tempo was
ejemplo y destacaron que el tempo mental estaba
considered to be related to the stability of emotional life.
estrechamente relacionado con el temperamento y
This means that mental tempo is one of the important
carcter de cada uno.
tools to be to be used in the future for music therapy
evaluation.
Este autor estudi, en el curso de las sesiones clnicas,
el tempo mental de esquizofrnicos crnicos (137
At the presentation, the past researches will be
varones y 93 mujeres) descubriendo que cuanto ms
discussed, and by measuring mental tempo of the
grave fuera su enfermedad, mayor era su tempo
743
mental, lo que significa que el tempo mental era ms asistentes, se tratarn el carcter y la gnesis del
lento al recuperarse de la enfermedad. tempo mental.

En otra investigacin en la que se estudi el tempo

mental de pacientes dados de baja y pacientes que
I S M U SI C A L AN G U AG E? T H E VAL U E O F
haban vuelto a ser ingresados, las personas con el
M U SI C AS A C O M M U N I C AT I O N SYST EM I N
tempo mental ms lento podan vivir con xito fuera del
C O M PAR I SO N WI T H VER BAL L AN G U AG E /
hospital, mientras que muchos de los pacientes con
tempo mental ms rpido volvan a ingresar en el E S L A M S I C A U N L E N G U A JE ? E L V A L O R D E

hospital por exacerbacin. L A M SI C A C O M O SI ST EM A D E

C O M P A R A C I N C O N E L L E N G U A JE V E R B A L
A partir de todos los datos recopilados, se consider
que el tempo mental es un ndice de la tensin mental y T OMAS N ORDLUND
que un tempo mental reducido podra estar relacionado
con la estabilidad emocional de la vida. Esto significa
The paper is a comparison between music and
que el tempo mental es una herramienta importante
language, referring to previous investigations in this
para su utilizacin en la evaluacin de la musicoterapia.
field. The aim is to highlight the communicative factors
En la presentacin se debatirn las investigaciones y, in music of interest to music therapists. In short, the
junto con la medicin del tempo mental de los paper discusses the following basic questions wich
744
engage most music therapists: Rather than giving any definitive answers, the paper
gives a platform on the bases of human communication
* What are the differences between music and
related to music, and an inspiration for making further
verbal language?
investigations in specific topics of music communication.
* What is the content of communication in music?

* Is music a language of the unconscious?

El trabajo es una comparacin entre msica y lenguaje,
* How does the communication process work?
haciendo referencia a las investigaciones previas en
* Does music consist of commonly interpretable este campo. El propsito es destacar los factores
universal symbols? comunicativos de la msica que pueden ser de inters
para los musicoterapeutas. En resumen, el trabajo
* And, very important: are these the relevant
debate las siguientes cuestiones que conciernen a la
questions?
mayora de los musicoterapeutas:
A broad view of the ongoing discussion about the
* Cules son las diferencias entre msica y
relation between language and music is given, covering
lenguaje verbal?
the fields of music ethnology, communication theory,
language acquisition and theories of music as a system * Cul es el contenido de comunicacin en la
of thoughts/a cognitive system. msica?

745
* Es la msica un lenguaje de la inconsciente? investigaciones en temas especficos de la
comunicacin musical.
* Cmo funciona el proceso de comunicacin?

* La msica consiste de smbolos universales PR O C ESS M U SI C : A T O O L F O R M U SI C

comnmente interpretables? T H E R A P I S T S ? / M S I C A P R O C E S A D A : U N A
H ER R AM I EN T A PAR A EL M U SI C O T ER APEU T A?
* y, muy importante: son stas las cuestiones
relevantes? M ARTYN P ARKER - EAMES
Una amplia visin sobre la discusin en curso a cerca
de la relacin entre lenguaje y msica ser expuesta,
Traditionally, Music Therapy practice has based itself
cubriendo los campos de la etnologa musical, teora de
around two musical forms: improvisation and structured
la comunicacin, adquisicin del lenguaje y teoras de
music. While both have considerable strengths as
la msica como un sistema de pensamientos - un
therapeutic tools, they also have limitations. The refusal
sistema cognoscitivo.
of a client to partake in an improvisation because of the
Ms que dar ninguna respuesta definitiva, el trabajo lack of structure and familiar end product is a common
proporciona una plataforma basada en los scenario. Similarly, many clients are put off playing a
fundamentos de la comunicacin humana relacionada highly structured piece of music because of negative
con la msica y una inspiracin para desarrollar associations of having to be "talented" to play music. In

746
practice many music therapists use a mixture of the two Tradicionalmente, la prctica de la Musicoterapia se ha
forms to maximize the effect of their work. Yet, a third basado en dos formas musicales: la improvisacin y la
option exists; a form of music that does not require a msica estructurada. Ambas tienen una fuerza
musical training to produce a satisfactory piece of considerable como herramientas teraputicas, pero al
music, yet still achieves the therapeutic goals. mismo tiempo tambin presentan limitaciones. Suele
ocurrir que un cliente se niegue a participar en una
Process music is a generic term for music that is
improvisacin, debido a su falta de estructura y
produced not as a reuslt of inspired composition, but as
costumbre. Igualmente, muchos clientes no pueden
the result of following a process. It is a music form which
interpretar una pieza de msica altamente estructurada
a great many of the modern composers experimented
debido a la conviccin negativa de que es necesario
with, the most famous of which and sometimes credited
"tener talento" para interpretarla. En la prctica, muchos
as its creator, was John Cage.
musicoterapeutas utilizan una mezcla de las dos
This paper explores the use and potential of process
formas para aumentar al mximo la eficacia de su
music as a tool for Music Therapists making reference
trabajo. Sin embargo, existe una tercera opcin: una
to existing musical works and using examples from the
forma de msica que no requiere una formacin
authors work in psychiatry and education.
musical para interpretar satisfactoriamente una pieza
musical, an alcanzando las metas teraputicas.

747
La msica procesada es un trmino genrico para la T EM PO I N D EPR ESSI VE D I SO R D ER S / EL
msica que se hace no como resultado de una T I EM PO EN L O S T R AST O R N O S D EPR ESI VO S
composicin inspirada, sino como resultado del
G ABRIELLA G. PERILLI & SANTO R ULLO
seguimiento de un proceso. Se trata de una forma de
msica con la que muchos compositores modernos han
In this work the experience of depressed patients
experimentado, el ms conocido de los cuales y quizs
results from the objective measure of "spontaneous
al que se atribuy su creacin fue John Cage.
tempo". The findings show differences between this kind
En esta ponencia se examinan la utilizacin y el of patients and other patients with other syndroms in
potencial de la msica procesada como herramienta respect with this parameter.
para los musicoterapeutas, haciendo referencia a los
trabajos musicales existentes y utilizando ejemplos
extrados de los trabajos de los autores en el campo de En este trabajo se describe la experiencia con

la psiquiatra y la educacin. pacientes depresivos, como resultado de la medicin

objetiva del "tiempo espontneo". Los resultados
muestran diferencias entre este tipo de pacientes y
otros con distintos sndromes con relacin a este
parmetro.

748
 singing, her rhythm. The Evolutional Psychology of
Sound will allow us to recreate the conflicts, and to re-
APPL I C AT I O N O F SO U N D ' S EVO L U T I O N AL
harmonize, through a therapeutical relation, the
PSYC H O L O G Y I N M U SI C T H ER APY /
affective spaces that were affected. There, where words
APL I C AC I N EN M U SI C O T ER API A D E L A do not reach, sound will do it.
PSI C O L O G A EVO L U T I VA D EL SO N I D O
Actual music has alienating conditions, and others
S ARA R OMANO , LYDIA B ATTISTON & MADILDE D ELLA which generate isolation. The high volume causes
CELLA serious acoustic damages. The visual combination
causes hallucinations. The content is aggressive. The
In the intrauterine life one's own bodily sounds and the
ontogeny repeats the philogeny. The history of music
sounds of the mother's body mark the rhythm of our
repeats itself in the individual's sonorous history. It is
development. These sounds, through the prenatal
possible to reach the darkness of the subconscious
memory, have a very special value in the posterior life.
mind through sounds. We can find the evolutionary
The reproduction of these sounds generates specific
stage of the individual through a sonorous
reactions, fulfilling or altering the baby and the
reconstruction. It is also possible, transcending the
individuals who suffer recessive processes to that
verbal, to reach the conflict's expression.
particular stage. Later, we incorporate the external
world's sounds: the mother's voice, the melody of her Collective work by professors and students of the

749
Evolutional Psychology Department. permite recrear los conflictos, y rearmonizar en la
relacin teraputica los espacios afectivos afectados.
Situado en alguna nebulosa lejana hago lo que hago All donde la palabra no llega, llegar el sonido. La
para que el universal equilibrio de que soy parte no msica actual posee condiciones alienantes y
pierda su equilibrio. generadoras de aislamiento. El alto volumen provoca
daos acsticos graves. La incorporacin visual es
Antonio
alucinatoria. El contenido es agresivo. La ontogenia
Porchia
repite la filogenia. La historia de la msica se repite en
En la vida intrauterina los sonidos corporales propios y la historia sonora individual. Es posible llegar a la
del cuerpo materno van marcando el comps de oscuridad del inconsciente tambin a travs de los
nuestro desarrollo. Estos sonidos, a travs de la sonidos. Hallando el momento evolutivo en el que se ha
memoria prenatal, tiene un valor muy especial en la detenido el individuo, a travs de la reconstruccin
vida posterior. La reproduccin de los mismos genera sonora, es posible llegar, trascendiendo lo verbal, a la
reacciones especficas colmando o alterando al beb y expresin del conflicto.
a los individuos que sufren procesos regresivos a dicha
Trabajo conjunto de alumnos de la ctedra y
etapa. Posteriormente incorporamos los sonidos del
profesores.
mundo externo: la voz de la madre, la meloda de su
canto, su ritmo. La Psicologa Evolutiva del Sonido, nos Placed in a far away nebula I do what I do

750
to keep the universal balance this purpose a factor analysis was performed on 30
scales. For each of the major factors - activity,
from which I am part.
evaluation and potency - three of the most informative
Antonio scales were selected. They can be used as a form of the
Porchia semantic differential for measuring the effect of music
on Bulgarian speaking experimental subjects.

APPL I C AT I O N O F T H E SEM AN T I C
D I F F ER EN T I AL F O R I N VEST I G AT I N G T H E El diferencial semntico es un mtodo apropiado para
I N F L U EN C E O F M U SI C / APL I C AC I N D EL investigar la influencia de la msica. Su aplicacin
D I F ER EN C I AL SEM N T I C O EN L A requiere la construccin de una serie de escalas
I N VEST I G AC I N D E L A I N F L U EN C I A D E L A pertinentes. Para ello se llev a cabo un anlisis de
M SI C A factores sobre 30 escalas. Por cada uno de los factores
ms importantes - actividad, evaluacin y potencia - se
IRINA S HLESINGER seleccionaron las tres escalas con ms informacin. Se
pueden utilizar como diferencial semntico para medir
The semantic differential is an appropriate method for
el efecto de la msica en los sujetos del experimento
investigating the influence of music. Its application
blgaro-hablantes.
requires the construction of a set of relevant scales. To
751
 recall and retention of sequential verbal material.

M EL O D Y: AN I N T ER N AT I O N AL M ED I U M F O R
L AN G U AG E AC Q U I SI T I O N AN D L EAR N I N G / La utilizacin de la msica como impulso estructural, en
L A M EL O D A: U N M ED I O I N T ER N AC I O N AL el que la msica se encuentra conjuntamente con el
P A R A A D Q U I R I R Y A P R E N D E R E L L E N G U A JE material a aprender, se emple para ayudar a nios,
tanto disminuidos como normales en sus habilidades
D AVID E. WOLFE & CANDICE H OM
de aprendizaje, sociales y motrices. Esta utilizacin de
la msica para dirigir instrucciones y facilitar el recuerdo
The use of music as a structural prompt in which music
y la retencin de palabras y/o acciones se utiliza
occurs concurrently with the to-be-learned material has
comnmente en la prctica de la musicoterapia. La
been employed to assist children, both disabled and
investigacin actual estudia los efectos de particulares
normal, in learning academic, social, and motor skills.
combinaciones de entrada de estmulo hablado y
This use of music to convey instruction and to facilitate
cantado, utilizando melodas conocidas o no sobre el
the recall and retention of words and/or actions is
recuerdo y retencin de material verbal secuencial.
commonly used in music therapy practice. The present
investigation examined the effects of particular
combinations of spoken and sung stimulus input using
both familiar and unfamiliar melodies on immediate
752
 procesos mentales culturales, superiores y mediatos.
Las funciones mentales superiores incluiran tanto los
2.1. - PSYCHOLOGY AND MUSIC - PSICOLOGIA procesos ms primitivos como aquellos ms avanzados
Y MUSICA (CONFERENCE HANDOUTS)
que dependen de las formas de mediacin. Los
"sistemas semiticos" que median los procesos
psicolgicos superiores incluyen desde algo tan simple
M U SI C A, I M AG EN Y EM O C I O N . U N A
como un gesto hasta la complejidad del discurso
PER SPEC T I VA VYG O T SKYAN A
literario. En definitiva, el desarrollo y composicin de los
( T R AN SM U T AC I O N AF EC T I VA Y C O G N I T I VA A
procesos mentales superiores depende de las formas
T R AVES D EL AR T E)
de mediacin semitica que son suministradas por el
ALVAREZ, J.; IGARTUA, J.; ADRIAN, J.A. Y PAEZ, D. medio social y cultural (Kozulin, 1 990).

En el trabajo "Psicologa del Arte", presentado como El arte es lo social en nosotros y el hecho de que su
tesis doctoral en 1925 en el instituto de Psicologa de accin se efecte en un individuo aislado no significa,
Mosc, Vygotsky desglosa ya las que seran las ideas que su esencia y raices sean individuales. De una forma
centrales de su sistema psicolgico. En dicho sistema el simplista, argumenta Vygotsky, suele entenderse lo
autor establece una dicotoma entre las funciones social con lo colectivo, como la existencia de muchas
mentales naturales, inferiores e inmediatas y los
753
personas. Pero para el, lo social aparece tambin all
donde existe solamente un hombre y sus vivencias
Por lo tanto, su visin del problema puede expresarse
personales. Por otro lado, toda teora del arte se halla
del siguiente modo; habr que partir de la relacin
supeditada a los puntos de vista adoptados en la teora
existente entre las emociones y la fantasa, puesto que,
de la percepcin, en la teora del sentimiento y en la
nuestras emociones poseen no solo una expresin
teora de la imaginacin o fantasa. El arte representa
corporal, sino tambin una expresin anmica, todo
una tcnica social del sentimiento, un instrumento de la
sentimiento se fija en una idea, por consiguiente, la
sociedad, mediante el cual incorpora a la vida social los
emocin se expresa no solo en las reacciones mmicas,
aspectos mas ntimos y personales de nuestro ser.
pantommicas, secretorias y somticas de nuestro
Constituye uno de los sistemas de smbolos ms
organismo, sino ademas precisa una determinada
complejos que ayuda a transformar los sentimientos
expresin mediante nuestra fantasa (Echevarra &
humanos originales en lo que Vygotsky denomin la
Paez, 1989; Ortony, Clore & Collins, 1988; Scheff,
reaccin esttica. Sera ms correcto decir que el
1983). Toda emocin se sirve de la imaginacin y se
sentimiento no se convierte en social, sino que por el
refleja en una serie de REPRESENTACIONES e
contrario, se hace individual, al vivir cada uno de
imagenes fantsticas las cuales hacen las veces de una
nosotros la obra de arte; se hace individual sin dejar de
segunda expresin. Con mayor razn podramos
ser social (al igual que el lenguaje).
afirmar que la emocin, adems de una accin
perifrica, posee una accin central (Leventhal y
754
Tomarken, 1986; Frijda, 1986; Scherer, Wallbott & un mecanismo destinado a provocar unas reacciones
Summerfield, 1986). emocionales determinadas. Busca analizar las
emociones del arte, pero en la obra de arte stas no
existen, ella slo es estmulo para que aquellas se
De este hecho se parte para teorizar que el sntoma
produzcan.
distintivo de la emocin esttica es precisamente la
El mtodo de estudio que se propone es el "mtodo
retencin de la manifestacin externa, mientras
objetivo analtico": hay que tratar de tomar por base no
conserva al mismo tiempo su fuerza. Y es a travs de su
el autor ni el espectador, sino la propia obra de arte. Es
obra mencionada donde trata de demostrar que el arte
cierto que, por s misma, la obra artstica no representa
representa una emocin central o una emocin que se
el objeto de la psicologa. Sin embargo, recordemos la
resuelve primordialmente en la corteza cerebral. Las
situacin del historiador, quien estudia, por ejemplo, la
emociones del arte son unas emociones inteligentes.
revolucin francesa por materiales en los que los
En lugar de manifestarse en agitaciones y en
objetos de su estudio no estn dados ni includos; se
temblores, se resuelven principalmente en imagenes
apoya en el estudio de evidencias indirectas como
de la fantasa.
cartas personales o documentos de la poca, sin
Vygotsky est convencido de que no puede haber
posibilidad de acudir a la experiencia misma de las
teora del arte sin psicologa del arte por la sencilla
personas que participaron en el evento. Similar es el
razn de que el procedimiento artstico es, ante todo,
caso de la investigacin judicial, donde la investigacin
755
se centra en pruebas indirectas como huellas o distincin entre "forma" (trama o plot) y "material"
testimonios. Vemos, por tanto, que toda una serie de (contenido o fbula) en la obra de arte de tipo narrativo
ciencias necesitan recrear previamente el objeto de (Zunzunegui, 1989). Todo aquello que es preexistente
estudio con ayuda de mtodos indirectos o de a la obra de arte, todo lo que el autor tom listo, como
reconstruccin, es decir, analticos. Se concluye las palabras, los sonidos, los clichs, los personajes, las
diciendo que cualquier investigacin psicolgica del historias, los acontecimientos, es decir, aquello que
arte debe comenzar con el propio objeto de arte, como exista antes del relato y que puede existir fuera e
por ejemplo un trabajo de literatura, en vez de acudir al independientemente de l, pertenece al material de la
estudio del autor o del lector. Sin embargo, el estudio de obra de arte. La forma supone el modo de distribucin,
la obra de arte no debe simplificarse conformando un de ordenacin y estructuracin del material. Dicha
catlogo de los recursos tcnicos utilizados. Este ordenacin es considerada como una tcnica o recurso
anlisis "anatmico" se ha de completar con el estudio (device) artstico. As, uno de los recursos artsticos
de la "fisiologa" del trabajo de arte; es decir, se hace ms importantes en la prosa es la utilizacin de la
necesario descifrar los roles funcionales que cada "trama" (plot) respecto a un material que representa la
recurso y cada tcnica artstica estn cumpliendo historia (fbula), es decir, lo que ha ocurrido de hecho.
(Kozulin, 1990). La trama o plot es el principio generativo de todo
texto literario, en donde la composicin de los
Vygotsky asume, parcialmente, el planteamiento de los
elementos es igual de importante como lo es el orden
formalistas rusos. Desde esta perspectiva se efecta la
756
de los sonidos en la meloda o el orden de las palabras individual, sino partiendo de las propiedades objetivas
en la frase. En definitiva, la trama (la forma o cmo se del trabajo de arte que hacen posible que surja la
cuenta un relato) guarda la misma relacin con la respuesta catrtica. De ah que el inters real del
historia (el material) que el verso con respecto a las psiclogo debe recaer en la comprensin de la relacin
palabras que lo constituyen, y que la meloda en entre mecansmos semiticos y fenmenos
referencia a las notas que la conforman. psicolgicos (Wertsch, 1988); y es aqu donde se centra
el inters de Vygotsky. El psiclogo examina
A diferencia de los formalistas, Vygotsky apost por el
naturalmente toda obra de arte como un sistema de
estudio de la interaccin entre la forma y el material;
estmulos organizados consciente y deliberadamente
dicha interaccin es lo que denomin catarsis
de forma que provoquen una reaccin esttica, al
(transmutacin afectiva). Vygotsky tom el concepto de
analizar la estructura de los estmulos reconstituimos la
catarsis prestado de Aristteles para referirse a la
estructura de la reaccin. El arte es pugna de fuerzas,
descarga de emociones que aparecen en el lector o en
juego dialctico entre forma y contenido, que al
el espectador cuando se encuentra bajo la influencia de
encontrarse generan un equilibrio dinmico de
un trabajo de arte. La "purificacin" catrtica no slo
opuestos; equilibrio en el que las emociones que
descarga la tensin sino que transforma los
estimula el "material" o "contenido" son neutralizadas
sentimientos humanos (Kozulin, 1990). A la hora de
por las de la "forma", de manera que se produce la
estudiar el fenmeno de la catarsis Vygotsky plantea
denominada catarsis emocional en la que reside la
que se debe iniciar el estudio no desde la experiencia
757
especificidad del arte. No hay que confundir el arte con PROCEDIMIENTO
la simple emocin, ni con un simple mecanismo de
Se trata de una investigacin experimental en la que se
contagio emocional. La catarsis, tal como la concibe
utilizaron extractos de pelculas de 3 minutos de
este autor, corresponde a un estado emocional no
duracion. Las pelculas fueron: "La naranja mecnica",
identificable con ninguna de las emociones corrientes,
de S. Kubrick, "Apocalypse Now", de F. Ford Coppola,
es ms bien, un punto de superacin y solucin del
"Ran", de A. Kurosawa y "Dos hombres y un destino".
sentimiento.
Sobre las tres primeras pelculas se eligieron escenas
TRISTES, y sobre la ltima se tom una escena
ALEGRE.
INVESTIGACION EXPERIMENTAL
Las variables independientes fueron: 1) condicin
METODO
musical (variable intersujeto): a) Pelcula con su msica
SUJETOS
ORIGINAL, b) Pelcula con una msica ALEGRE y, c)
Se seleccionaron 65 estudiantes de psicologa con una Pelcula con una msica TRISTE; 2) tipo de pelcula
media de edad de 23.1 aos, siendo el 78.5% mujeres y (variable intra-sujeto), se observaron las cuatro
el 21.5% hombres. pelculas, todos los sujetos y siempre en la misma
secuencia u orden: a) La naranja mecnica, b)
Apocalypse Now, c) Ran y d) Dos hombres y un destino.

758
Para las tres primeras pelculas la condicion musical 2a fueron las siguientes: "Theme for Ernie" (John
(msica alegre) es la que supone la condicion Coltrane), "Pars Texas" (Ry Cooder), "Nude" (Camel) y
"contradiccion forma (msica)-contenido (escena)". "Funeral de la Reina Mara" (Purcell). Las piezas que se
Para la cuarta pelcula es la condicion musical 3a utilizaron, evaluadas como alegres por los sujetos,
(musica triste) la que supone la condicin de fueron las siguientes: "East San Lus" (Steely Dan),
"contradiccion forma (msica)-contenido (escena)". En "Fanfarria" (Camel), "Out of town" (Yellow Jackets),
estas condiciones de contradiccin se supone que se "Spring" (Vivaldi). Podremos observar que se
dar la transmutacion afectiva (catarsis) y, por tanto, la emplearon piezas desde msica clsica (Purcell y
complejidad afectiva-cognitiva postulada por Vygotsky. Vivaldi) hasta blues (Ry Cooder), pasando por el rock
(Camel y Steely Dan) y el jazz (John Coltrane y Yellow
Se realiz un estudio piloto con 30 sujetos quienes
Jackets).
tuvieron que juzgar en qu medida cada una de las 14
canciones presentadas (6 piezas clsicas y 8 Por tanto disponemos de una diseo factorial mixto
modernas) inducan una serie de estados emocionales. 3x(4), multivariado-multivariado, con tres grupos
Se seleccionaron para el presente estudio las piezas experimentales. La investigacin se llev a cabo con
que puntuaron ms alto en los tems de alegra y las videos que se visionaron en grupo (en el Aula Magna
que puntuaron ms alto en los tems de tristeza en la de la Facultad de Psicologa). A los sujetos, de forma
escala de induccin emocional. Las piezas colectiva, se les dieron instrucciones de forma verbal al
seleccionadas, evaluadas como tristes por los sujetos, inicio de la experiencia. Se visionaron cuatro videos
759
diferentes de forma consecutiva pero despus de la Igualmente, se mantuvieron constantes en las tres
visin de cada fragmento de pelcula se instruy a los condiciones experimentales la proporcin por sexos.
sujetos para que contestaran a las variables de:
identificacin afectiva, resonancia emocional y
relevancia cultural, diferencial semntico de evaluacin MEDIDAS DEPENDIENTES

esttica y emociones sentidas. Con el fin de que los

sujetos contestaran los aspectos sealados, tras cada
La mayor parte de las variables dependientes utilizadas
film se efectuaba una pausa. Una vez rellenos los
en esta ocasin ya se usaron en una experiencia de
cuestionarios se pasaba a la siguiente pelcula y as en
laboratorio sobre msica y emocin (Paez, Adrian y
relacin a las cuatro.
Alvarez, 1 992a; 1 992b):

1.- Estado de nimo: evaluado por el MAACL (versin

MEDIDAS PRELIMINARES en castellano de la escala con 72 tems, en Echevarra

Se han utilizado como variables control de sujeto el y Paez, 1989). Se tom una medida pre-test y una

inters en arte y el conocimiento previo de las pelculas. medida postest para comprobar el impacto afectivo de

Por ltimo, al final de la tarea se pregunt a los sujetos: la tarea. Se crearon indicadores de afectividad negativa

si les satisfizo la tarea, si estaran dispuestos a repetirla (hostilidad, depresin y ansiedad) y positiva (felicidad,

y si les ha producido algn estado de nimo. calma-relajo, amistad-contacto social), balanza afectiva

760
y cambio afectivo del pre al post-test (supone una resta 3.- Diferencial semntico de evaluacin esttica: Con
entre el balance afectivo del postest menos la balanza tres indicadores de "valenciaevaluacin positiva"
afectiva en el pretest). (agradable-desagradable, bonito-feo, admirable-
despreciable, etc.), "potencia" (grande-pequeo,
2.- Identificacin afectiva, resonancia emocional y
mayor-menor, etc.) y "activacin-actividad" (pasivo-
relevancia cultural para cada pelcula: Versin de
activo, rpido-lento).
Larsen y Laszlo (1990) modificada por los autores de la
presente comunicacin. El indicador de identificacin 4.- Induccin emocional: Versin modificada del DES de
afectiva est compuesto por tems como "te identificas Izard por los autores de la presente comunicacin, con
con el/la protagonista de las escenas", "entiendes los dos indicadores de "emociones positivas" (feliz, alegre,
sentimientos y actuaciones de los protagosnistas", etc. etc.) y "emociones negativas" (triste, asustado, enojado,
En cuanto al indicador de resonancia emocional y etc.) inducidas. Los sujetos deban responder de
relevancia cultural se compone de tems como "las acuerdo con la intensidad percibida respecto a cada
escenas de la pelcula te indujeron o evocaron uno de los estados emocionales (1 =nada, 5=mucho).
sentimientos o emociones", "las escenas te parecieron
relevantes, pertinentes o importantes en relacin a tu
forma de vivir o a tu propia experiencia", etc. El formato RESULTADOS

de respuesta era de 1, totalmente en desacuerdo a 7, MEDIDAS DE FIABILIDAD Y DE REDUCCION DE

totalmente de acuerdo. DATOS
761
 factoriales no se ofrecen por razones de espacio).

Se efectuaron una serie de anlisis factoriales de Se realizaron anlisis de consistencia interna (alpha de
componentes principales (rotacin varimax) sobre cada Cronbach) para cada una de las escalas utilizadas. Los
una de las variables de medidas repetidas: resultados globales son satisfactorios. Respecto a la
identificacin afectiva, resonancia emocional y escala de estado de nimo, la dimensin de afectividad
relevancia cultural, evaluacin esttica e induccin positiva en el pretest nos ofreci un coeficiente alpha de
emocional. Los resultados obtenidos nos muestran la Cronbach de .87 y de .85 en el postest; la dimensin de
existencia de un primer factor de identificacin afectividad negativa del pretest obtuvo un coeficiente
emocional y un segundo de resonancia emocional- de .85 y de .86 en el postest. En cuanto a la escala de
relevancia cultural. La escala de evaluacin esttica inters por el arte obtuvo un coeficiente de .64. Por
nos ofrece los tres factores clsicos obtenidos en las ltimo, se analiz la consistencia interna de las
investigaciones que utilizan el diferencial semntico de variables dependientes de identificacin afectiva,
Osgood (Osgood, Suci, Tannenbaum, 1957): valencia o resonanacia emocional y relevancia cultural,
evaluacin positiva, potencia y actividad. Por ltimo, los evaluacin esttica e induccin emocional subjetiva
anlisis efectuados sobre la escala de induccin para cada pelcula, cuyos valores rondan desde .48 a
emocional nos muestran dos factores, el primero que .78 (ver tabla 1).
alude a las emociones positivas y el segundo a
TABLA 1.- Coeficientes de consistencia interna (alpha
emociones negativas. (Los resultados de los anlisis
762
de Cronbach) de las principales variables dependientes arte (F(2,68)=0.14, p>.10), el conocimiento de las
para cada pelcula diferentes pelcula (todos los anlisis chi-cuadrado no
fueron significativos a un nivel de p > .10), en la
afectividad negativa (F(2,62) = 0.87, p > .10), en la
Pelculas
afectividad positiva (F(2,62)=0.03, p>.10) y en la
1 2 3 4
balanza de afectos (F(2,62)=0.35, p> .10).
Identificacin afectiva y relevancia .53 .48 .58 .78

cultural
EFECTOS DE LA MANIPULACION EXPERIMENTAL
Evaluacin esttica .65 .68 .77 .78

Induccin emocional subjetiva .75 .76 .76 .65

1.- Condicin musical e Identificacin emocional

y resonancia emocional-relevancia cultural
EQUIVALENCIA DE LOS GRUPOS EXPERIMENTALES
Se efectuaron diversos anlisis de varianza de un factor
Se comprob la equivalencia de los grupos
(ONEWAY; uno por cada segmento de pelcula que se
experimentales en el inters por el arte, el conocimiento
vision) tomando como variable independiente la
de las pelculas utilizadas y el estado de nimo previo a
condicin musical y como variable dependiente la
la experiencia de laboratorio. Podemos afirmar la
identificacin emocional.
equivalencia de los grupos en cuanto a el inters por el
763
Respecto a la primera pelcula no se observaron
diferencias significativas entre los grupos
TABLA 2.- Medias en identificacin afectiva en funcin
experimentales en la identificacin emocional
de la condicin musical para cada segmento de pelcula
(F(2,62)=0.11, p>.10). Tampoco se apreciaron
diferencias significativas en relacin a la cuarta pelcula
24
(F(2,62)=1.93, p>.10). Condicin musical

S se encontraron diferencias significativas en cuanto a Segmentos Obra

la identificacin emocional en relacin a la segunda de original Contraste Congruencia

pelcula (F(2,62)=3.41, p<.05) y respecto a la tercera pelculas

(F(2,62) =3.35, p<.05). Las diferencias de medias van Naranja mec. 6.08 5.75 5.90

en el sentido de una menor identificacin emocional en Apocalypse 5.21 4.90 6.63

la condicin de contraste o contradiccin forma- Now

contenido . Ran 5.91 4.55 6.50

No se aprecian diferencias signicativas por condicin

24
Condicin de la banda musical. En la condicin original se present la
en relacin a ninguna de las pelcula en resonancia escena tal como sta era en realidad; en la condicin "contradiccin" se
emparejaba una escena triste con una msica alegre (pelculas 1, 2 y
emocional-relevancia cultural (todas las F menores de 3) o una escena alegre con una msica triste (pelcula 4a); por ltimo,
en la condicin de "congruencia" se emparejaba una escena triste con
1 y p>.10). una msica triste (pelculas 1, 2 y 3) o una escena alegre con una
msica alegre (pelcula 4a).

764
 Dos hombres 14.34 13.27 14.40 observa que en la condicin de contraste-contradiccin
y un destino
forma-contenido se obtiene la media ms baja (26.01,
en comparacin con la media de 26.52 de la condicin
obra original y de 28 de la condicin de congruencia).
2.- Condicin musical y Evaluacin Esttica
En cuanto a la potencia, no se observan diferencias por
Se efectuaron diversos analisis de varianza de un factor
condicin en la segunda pelcula (F(2,62) = 2.18, p >
(ONEWAY; uno por cada segmento de pelicula que se
.10) ni en la cuarta (F(2,62) = 1.55, p > .10). S se
vision) tomando como variable independiente la
observan diferencias en cuanto a la primera pelcula
condicin musical y como variables dependientes los
(F(2,62) =5.25, p<.01) y en relacin a la tercera
tres indicadores de evaluacin esttica: valencia-
(F(2,62)=6.18, p<.01).
evaluacin esttica, potencia y activacin-actividad.

Con respecto a la valencia-evaluacin positiva, se han

encontrado los siguientes resultados. Respecto a las TABLA 3.- Medias en potencia esttica en funcin de la
tres primeras pelculas no se aprecian diferencias condicin musical para cada segmento de pelcula
significativas por condicin (todas las F menores de 1 y
p>.10). Con respecto a la ltima, se aprecian
diferencias por condicin, aunque estas son
tendenciales (F(2,62) = 2.80, p < .10). En este caso, se
765
 Condicin respecto a la tercera pelcula (F(2,62) = 1.42, p> .10) ni
25
musical respecto a la cuarta (F(2,62) = 1.79, p> .10). Se aprecia
Segmentos Obra un efecto tendencial en la segunda pelcula (F(2,62) =
de original Contrast Congruenci 2.45, p < .10) y un efecto significativo de la condicin en
e a la pelcula primera (F(2,62)=3.72, p<.05). En este ltimo
pelculas

Naranja mec. 11.30 9.30 8.72

caso, se observa en la condicin de contradiccin una
puntuacin intermedia (8.65) en comparacin con la
Apocalypse Now 11.21 9.20 9.63
condicin "obra original" (9.04) y en comparacin con la
Ran 11.95 9.00 10.18
condicin "congruencia" (7.86). La misma tendencia de
Dos hombres y un 11.13 10.77 11.95
destino
resultados se observa en relacin a la pelcula
segunda, con una media de 8.75 en en condicin de
"contradiccin", de 9.34 en la condicin "obra original" y
En cuanto a la actividad-activacin, no se han 8.40 en la condicin "congruencia".
observado diferencias significativas por condicin

25
Condicin de la banda musical. En la condicin original se present la 3.- Condicin musical e Induccin emocional
escena tal como sta era en realidad; en la condicin "contradiccin" se
emparejaba una escena triste con una msica alegre (pelculas 1, 2 y
3) o una escena alegre con una msica triste (pelcula 4a); por ltimo, Se efectuaron diversos analisis de varianza de un factor
en la condicin de "congruencia" se emparejaba una escena triste con
una msica triste (pelculas 1, 2 y 3) o una escena alegre con una
msica alegre (pelcula 4a).
766
(ONEWAY; uno por cada segmento de pelcula que se observa una induccin emocional ms negativa en la
vision) tomando como variable independiente la condiccin de " contradiccin " .
condicin musical y como variable dependiente los dos
indicadores de induccin emocional: emociones
positiva y negativas tras la visin de cada uno de los TABLA 4.- Medias en emociones negativas en en

films. funcin de la condicin musical para cada segmento de

pelcula
No se aprecian diferencias signicativas en las
emociones positivas tras la visin de los segmentos
flmicos por condicin en relacin a ninguna de las Condicin
26
pelculas (todas las F menores de 1 y p>.10). musical

Segmentos Obra
Respecto a las emociones negativas, no se apreciaron
de original Contrast Congruenci
diferencias significativas ni en la pelcula segunda
e a
pelculas
(F(2,62)=1.88, p>.10) ni en la cuarta (F(2,62)=0.16,
p>.10). Se observa un efecto tendencial de la condicin
26
Condicin de la banda musical. En la condicin original se present la
musical en relacin a la pelcula primera (F(2,62)=3.14, escena tal como sta era en realidad; en la condicin "contradiccin" se
emparejaba una escena triste con una msica alegre (pelculas 1, 2 y
p<.10) y un efecto significativo en la pelcula tercera 3) o una escena alegre con una msica triste (pelcula 4a); por ltimo,
en la condicin de "congruencia" se emparejaba una escena triste con
(F(2,62)=3.98, p<.O5). En estos dos ltimos casos se una msica triste (pelculas 1, 2 y 3) o una escena alegre con una
msica alegre (pelcula 4a).

767
Naranja mec. 3.03 3.35 2.70 Los datos indican que la visin de los cuatro films indujo
Apocalypse Now 3.24 3.61 3.09 una estado de nimo negativo. As, la media de
Ran 2.97 3.20 2.40 afectividad negativa en el pretest fue de 7.24 mientras

Dos hombres y un 1.26 1.24 1.18

la del postest fue de 9.86 (t(64) =-1.71, p<.10); la media
destino de afectividad positiva en el pretest fue 45.20 y en el
postest fue 42.00 (t(64)=2.71, p<.O1); y, por ltimo, la
media en la balanza afectiva en el pretest fue de 37.95 y
CAMBIO AFECTIVO POR LA VISION DE LAS
en el postest fue 32.13 (t(64) = 2.36, p < .05).
PELICULAS
EFECTOS DEL CONTENIDO Y DE LA FORMA
ARTISTICA
Se compar el estado de nimo del pre-test con el del
post-test con el fin de ver si se obtuvo un cambio
afectivo como consecuencia de la visualizacin de las El objetivo principal del estudio era analizar los efectos

pelculas. Los indicadores de estado de nimo fueron la del contenido de la escena flmica (historia triste versus

afectividad negativa, positiva y la balanza afectiva (que alegre) y de la banda musical que acompaaba cada

supone una resta de la afectividad positiva menos la segmento (msica original, contradictoria, congruente)

negativa). en las distintas variables dependientes consideradas.

Para contrastar nuestro modelo consideramos a las
768
tres pelculas tristes como una nica condicin esttica (F(1,62)=9.05, p<.O1) y menores de actividad
(contenido triste). A partir de aqu se efectuaron para dicho segmento en comparacin con el segmento
diversos anlisis de varianza para un diseo factorial triste (F(1,62)=74.57, p<.O01). Por ltimo, el segmento
mixto (2)x3 en donde el contenido de la historia de contenido triste, frente al de contenido alegre, indujo
representaba una variable intrasujeto y la banda ms emociones negativas (F(1,62)=367.20, p<.O01) y
musical supona la variable intersujeto (MANOVA). menos emociones positivas (F(1,62) = 285.02, p <
.001).
Los resultados globales son concluyentes: para todas
las variables dependientes consideradas, se observa En cuanto a los efectos principales de la forma o banda
un efecto principal del contenido flmico significativo musical nicamente se obtuvo un resultado significativo
(ver tabla 5). Los sujetos se identificaron menos con los en la variable actividad esttica (F(2,62)=4.61, p<.O5) y
personajes de los segmentos flmicos de contenido tambin se aprecia un efecto tendencial en la variable
triste (F(1,62) =436.26, p<.O01) y tambin se daba una potencia esttica (F(2,62)=2.57, p<.10). Por ltimo, se
resonancia emocional y relevancia cultural menor aprecia un efecto de interaccin respecto a la
respecto a estos segmentos frente al segmento de identificacin afectiva (F(2,62)=2.91, p<.10), respecto a
contenido alegre (F(1,62)=148.94, p<.O01). Por otro la potencia esttica (F(2,62)=4.93, p<.O5) y respecto a
lado, los sujetos evaluaron ms positivamente el las emociones negativas sentidas (F(2,62)=4.44,
segmento de contenido alegre (F(1,62)=1203.37, p<.O5).
p<.O01), dieron puntuaciones mayores en potencia
769
TABLA 5.- Efecto de la forma (banda musical) y del - Escena de contenido 5.74 5.07 6.25
28
contenido (tipo de historia narrativa) en la identificacin triste

afectiva, resonancia emocional y relevancia cultural, - Escena de contenido 14.35 13.27 14.40
alegre
evaluacin esttica e induccin emocional (medias)
RESONANCIA
EMOCIONAL-
RELEVAN-CIA
VARIABLES CONDICION DE LA
CULTURAL
DEPENDIENTES BANDA MUSICAL27
- Escena de contenido 12.04 12.45 12.71
triste
Original Contradict Congrue
- Escena de contenido 17.04 16.27 17.45
oria nte
alegre
IDENTIFICACION
EVALUACION DE LA
AFECTIVA
VALENCIA ESTETICA

- Escena de contenido 8.37 8.05 8.68

triste
27
Condicin de la banda musical. Se utilizaron tres condiciones
experimentales intersujeto, en donde el tipo de musica se combinaba - Escena de contenido 26.52 26.09 28.00
con las escenas de las pelculas. En la condicin original se present la
escena tal como sta era en realidad; en la condicin "contradiccin" se
emparejaba una escena triste con una msica alegre o una escena
28
alegre con una msica triste; por ltimo, en la condicin de "congruencia" Hemos computado las tres escenas de pelculas tristes en un nico
se emparejaba una escena triste con una msica triste o una escena indicador (contenido triste) para contraponerlo al indicador que se refiere
alegre con una msica alegre. a la pelcula con contenido alegre (contenido alegre).
770
alegre alegre

EVALUACION DE LA EMOCIONES
POTENCIA ESTETICA NEGATIVAS
INDUCIDAS
- Escena de contenido 11.49 9.16 9.51
triste - Escena de contenido 3.08 3.38 2.73
triste
- Escena de contenido 11.13 10.77 11.95
alegre - Escena de contenido 1.26 1.24 1.18
alegre
EVALUACION DE LA
ACTIVIDAD ESTETICA

- Escena de contenido 9.00 8.63 8.06

CONCLUSIONES
triste

- Escena de contenido 6.96 6.18 6.35 1.- Se ha encontrado que la msica y los estmulos
alegre dramticos utilizados indujeron cambios de estado de
EMOCIONES nimo.
POSITIVAS
INDUCIDAS 2.- El contraste exacerbado induce menor identificacin

- Escena de contenido 1.71 1.69 1.65

y ms emociones negativas. Estos resultados van en
triste contra de una visin simplista de que dos estmulos
- Escena de contenido 3.10 2.93 3.24 menos negativos son mejores que uno negativo y uno
positivo mezclados. Sugieren que un cierto grado de
771
contradiccin provoca una mejor identificacin y una antes mencionado.
reaccin afectiva ms positiva que la simple
5.- Sin embargo, al contrario de lo postulado por
presentacin de estmulos claramente positivos unidos
Vygotsky, no encontramos una catarsis (disminucin de
a estmulos negativos.
la afectividad negativa y/o mejor balance de la
3.- Se prefiere el estmulo positivo. Los sujetos se afectividad positiva) en la mejor condicin esttica
identificaron ms con los personajes de la escena (original).
alegre en comparacin con la identificacin provocada
por las escenas tristes. As mismo, el segmento alegre
se evalu ms positivamente, indujo ms emociones BIBLIOGRAFIA

positivas y menos negativas en comparacin con las ECHEVARRIA, A. & PAEZ, D. (1989): Emociones:
escenas tristes. Perspectivas Psicosociales, Madrid, Fundamentos.

4.- La mejor condicin esttica (la presentacin original FRIJDA, N. (1986): The Emotions, Cambridge,
de los estmulos dramticos) produce mayor Cambridge University Press.
identificacin, mayor evaluacin de potencia esttica y
FRIJDA, N. (1988): The Laws of Emotions, American
menor induccin de estado de nimo negativo. La
Psychologist, 43, 349-358.
condicin que exacerbaba la contradiccin entre la
msica y el contenido del film produca lo contrario de lo KOZULIN, A. (1990): Vygotsky's Psvchology: A
Biography of Ideas, London, Harvester Wheatsheaf.
772
LEVENTHAL, H & TOMARKEN, A.S. (1986): Emotions: Madrid (Espaa).
Today's Problems, Annual Review of Psychology, 33,
SCHEFF, T.J. (1983): Toward Integration in the Social
565-610.
Psychology of Emotions, Annual Review of Sociology, 9,
ORTONY, A.; CLORE, G. & COLLINS, A. (1988): The 333-354.
Cognitive Structure of Emotions, London, Cambridge
SCHERER, K.; WALLBOTT, H. & SUMMERFIELD, A.
University Press.
(1986): Experiencing Emotion, Cambridge, Cambridge
OSGOOD, C.E.; SUCI, G.J. & TANNENBAUM, P.H. University Press.
(1957): The Measurment of Meaning, Urbana,
VYGOKTSKY, L. (1972): Psicologa del Arte, Barcelona,
University of Illinois Press.
Barral.
PAEZ, D.; ADRIAN, J.A. y ALVAREZ, A. (1992a):
WERTSCH, J.V. (1988): Vygotsky y la formacin social
Vygotskian Perspective on social Psychology of
de la mente, Barcelona, Paids.
Emotions: First Empirical data about the Role of Art,
ZUNZUNEGUI, S. (1989): Pensar la Imagen, Madrid,
XXV International Congress of Psychology, Brussels
Catedra- Universidad del Pas Vasco.
(Belgium).

PAEZ, D.; ADRIAN, J.A. y ALVAREZ, A. (1992b): Msica

y Emociones. Perspectivas Vygotskianas de las
Emociones, I Congreso Iberoamericano de Psicologa,
773
 T H E PH EN O M EN O L O G I C AL R EC O VER Y O F phenomenology it is necessary to keep in mind that the
M U SI C AN D O N T O PSYC H O L O G I C AL M U SI C return to phenomena, to the original donation that it
T H ER APY intends to accomplish, is subordinate to the putting into
operation of the phenomenological epoch, in the
ARCO A RIANO
sense that only after accomplishing a process of
"reduction", of "purification" of subjectivity the
In an ontopsychological perspective the utilization "phenomenon" can emerge in its authentic essential
of music as therapy presuppones the capacity to re- data. "He who wishes to affirm himself phe
contact and recover in operational terms the original nomenologically - writes Husserl - must first learn to
dimension of music which, even if unconscious, has see, must practise"29, that is, what is requested is the
always lived in every man. Therefore ontopsychological initial effort to take himself out of his own habits, to leave
music therapy starts by putting aside every the obviousness of what is given, the occultation of the
preconstituted musical element and arrives at an preconstituted, to be able thus to recover in the
apprehension of music as it originally gives itself as experience lived the intuitive immediacy of life in its
being, before being bridled by categories. We can thus original data. Thanks to the epoch the world is taken
say, proposing an interpretative approach, that it starts back to the life of the consciousness, because it enables
from phenomenology of music, from its
phenomenological recovery. Hinting at "Husserlian" 29
E. Husserl, Die Krisis der europaischen Wissen- schaften und die
transzendentale Phanomenologie; trad. it., Milano 1983, p.268.
774
us to discover the "universal correlation" of world and the world of sound.
consciousness of the world, "it leads us to recognisisng
What is thus revealed is an order which precedes every
through self-reflection, that the world which is for us,
category "arrangement". This original order is not to be
which in its sense and in its being thus is our world,
understood as a metaphysical staticity, but as a living
derives its sense of being exclusively from our
order that accomplishes itself in the experience of man
30
intentional life" . Leading the discourse on the music,
starting from corporeal intelligence. In ontopsycological
the phenomenological passage is that which through
music therapy musis is in fact phenomenologically
the suspension of the world of sound already
learned "from the indide". The music therapist does not
constituted leads to the unveiling of a world of pre-
appeal, that is, to an outside, to an "external" music, but,
catesory music, intentional correlative of a "purified"
evading rational formalizations, makes music, plays a
subjectivity. Recovering music phenomenologically
rythym which are direct projections of his organismic
means therefore reaching the intuitive evidence of that
order31. "We are not dealing - states Meneghetti - with
which is given first of all, the intuition of music of
the musicality which the music therapist has as musical
"phenomenon". This musical "first" represents an
culture, as memorized rythym, as stereotypes drawn
original world of music, an "Ur-Grund" source of the
from the best dance music that exists, but it does
sense of every possible conceptual structuralization of
31
In Ontopsychology whit the term "organismic" what is intended is "the
synchronis between soul and body, perceived as a unitary coming into
30 consciousness". "The organismic is unity of consciousness in the
E. Husserl, Ideen zu einer reinen Phnomenologie und
phnomenoloqischen Philosophie; trad. it., Torino, 1981, p.207.
775
concern rythyms which are drawn from and filtered by ordered vitality, health, in that thus he makes of himself
its own organismic health.32 From what has been said the mediator of the intentionality of life itself.
what emerges is - in an ontopsychological perspective -
is how fundamental the figure of the music therapist is.
He must be "healthy", that is, "he must be an exact 2.2.- NEUROPHYSIOLOGICAL VARIATIONS IN
THE MUSIC THERAPY RESEARCHES -
instrument, constantly in tune with himself; fist of all, he
VARIABLES NEUROFISIOLOGICAS EN LA
must evidence in himself that basic harmony that he INVESTIGACION MUSICOTERAPEUTICA
( ABSTRACTS)
must then provoke in others"33. It is therefore from his
own organismic health that the music therapist must
recover that musical originality we have hinted at and A F R AM EWO R K F O R Q U AL I T AT I VE R ESEAR C H
must recover it in the sense that he must not play a I N M U SI C T H ER APY / U N M AR C O PAR A L A
music "already constituted", codified, but that original I N VEST I G AC I N C U AL I T AT I VA EN
music of the subject which, as ever acting life, precedes M U SI C O T ER API A
all historical-psychological sediments. Only thus can he
be authentic operator of vital functionality, provoker of K ENNETH B RUSCIA

organic act". A. Meneghetti, La musicoterapia nell'ottica ontopsicologica,

Roma, 1988, p.27.
32
A. Meneghetti, op.cit., p.92. A conceptual framework will be proposed for qualitative
33
A. Meneghetti, La musicoterapia nell'intendimento ontopsicologico,
Roma, 1986, p.14. research in music therapy. Included will be an
776
examination of research topics and questions which are These phenomena may be examined at several
indigenous to the paradigm and revelant to the field, different levels, including: holistic description, analysis,
and methodological adaptations necessary in clinical differentiation, conservation, reconstruction, and
settings. Research topics will be identified based on a corroboration. Methodological issues inherent in doing
distinction between those pertaining to the discipline qualititative research in a clinical setting will be
(assessment, treatment and evaluation within the client- examined, and adaptations will be proposed.
music-therapist relationship) and those pertaining to the
profession (how therapists interact and organize
themselves). When researching these topics within a
Un marco conceptual ser propuesto para la

qualitative framework, three phenomena are proposed

investigacin cualitativa y cuestiones que son

to be of primary interest:
apropiadas como ejemplo y relevantes para el campo,
y adaptaciones metodolgicas necesarias en
1. the in-vivo process of client-music-therapist
ambientes clnicos.
interactions
Los temas de investigacin sern identificados
2. the experience of client(s) and/or therapist, and
basndonos en una distincin entre aquellos que
3. the musical products that result from the in-vivo pertenecen a la disciplina (valoracin, tratamiento y
process and experiences therein. evaluacin dentro de la relacin cliente-
musicoterapeuta) y aquellos pertenecientes a la
777
profesin (como los terapeutas interactan y se adaptaciones.
organizan entre ellos).

Durante la investigacin de estos temas dentro de un

T H E PH YSI O AC O U ST I C M ET H O D / EL
marco cualitativo, tres fenmenos son propuestos
como de inters primario: M T O D O F I SI O AC ST I C O

1. El proceso en vivo de la interaccin cliente- P ETRI L EHIKOINEN

musicoterapeuta

2. La experiencia de cliente(s) y/o terapeuta, y The Physioacustic Method is a new application of sound
3. Los productos musicales que resultan del proceso therapy. So the basic research is at a very early stage.
en vivo y las experiencias en el mismo. The scientific evidence of the real, long term benefits is
scarce. Much of both, pure and applied research is
Estos fenmenos pueden ser examinados en varios
necessary to explain the mechanisms, which are
niveles diferentes, incluyendo: descripcin holstica,
effective in this method. The trials conducted at this
anlisis, diferenciacin, conservacin, reconstruccin y
moment seem promising especially in the general
corroboracin. Puntos metodolgicos inherentes al
relaxation and recovery and in the treatment of various
hacer investigacin cualitativa en un ambiente clnico
kinds of stress related syndromes, especially pains and
sern examinados y se propondrn algunas
hypertension.
778
Music is an essential part in the physioacoustic therapy. technology tools, proper therapy techniques and co-
It has both a psychological and physiological effect. operation with a motivated patient create a functioning
Psychologically, it creates a security and comfort. total system.
Physiologically high frecuencies of music cause
intracellular resonances.
El Mtodo Fisioacstico es una nueva aplicacin de la
The Physioacoustic Method is one of the new sound
terapia sonora, por lo que la investigacin se encuentra
therapy techniques. It can be used in a precise and well
todava en fase inicial. Todava son escasas las
controlled way to correlate the input into the body with
pruebas cientficas de beneficios reales a largo plazo.
the physiological and psychological responses. Still we
Para explicar los mecanismos de este mtodo, son
have to remember that all therapeutic work includes a
necesarias tanto la investigacin pura como la aplicada.
number of different variables which sometimes are
Las pruebas realizadas hasta el momento parecen
difficult to control.
prometedoras, especialmente en la relajacin y
Healing is a process where the behavioral factors play a recuperacin generales y en el tratamiento de varios
predominant role. The patient himself is the most tipos de estrs relacionados con sndromes,
important link in the chain of therapeutic events. Nothing especialmente el dolor y la hipertensin.
in human life is permanent, but more consistent
La msica es una parte esencial de la terapia
therapeutic results can be expected when high
fisioacstica y tiene un efecto psicolgico y fisiolgico.
779
Desde el punto de vista psicolgico, crea seguridad y herramientas proporcionadas por la alta tecnologa, las
confort, mientras que desde el punto de vista fisiolgico tcnicas adecuadas de terapia y la cooperacin con un
las altas frecuencias de la msica provocan paciente motivado crean un sistema total que funciona.
resonancias intracelulares.

El mtodo fisioacstico es una de las nuevas tcnicas

C L I N I C AL PR AC T I C E I N M U SI C T H ER APY: A
de la terapia sonora. Se puede utilizar de forma exacta
G L O BAL PER SPEC T I VE / PR C T I C A C L N I C A
y controlada para coordinar el input al cuerpo con las
respuestas fisiolgicas y psicolgicas. Sin embargo, es EN M U SI C O T ER API A: U N A PER SPEC T I VA

necesario recordar que todo trabajo teraputico incluye G L O BAL

cierto nmero de variables diferentes que, a veces, son C HERYL D. MARANTO

difciles de controlar.

La curacin es un proceso en que los factores del

While music therapy is practised throughout the world,
comportamiento desempean un papel predominante.
there is a great divergence in its clinical practice.
El mismo paciente es el vnculo ms importante en la
Variables that contribute to this divergence include:
cadena de eventos teraputicos. En la vida humana
cultural differences, theoretical orientations, political
nada es permanente, pero se pueden esperar
climate and the status of music therapy within each
resultados teraputicos ms consistentes cuando las
country.
780
In this lecture, an attempt is made to describe and practice that may be helpful in understanding both the
classify various international clinical orientations and similarities and differences in clinical practice among
practices in music therapy according to: theoretical various countries, so that there may be a greater
orientation, type of technique (receptive, exchange of clinical information in the future.
improvisational, re-creative), and specific clinical
An important implication of this work is the development
population. Both common and unique music therapy
of an international definition of music therapy which
practices will be identified and emphasized.
synthetizes the divergence of practice, yet represents
Information for this presentation is solicited as part of a all practices. In addition, international standards for
book, Music Therapy: International Perspectives, education and training in music therapy, standards of
currently being edited by the presenter. practice, international codes of ethics, etc. (tasks of the
Representatives from 50 countries have been asked to World Federation for Music Therapy) must be based
contribute chapters describing professional and clinical upon a thorough and comprehensive knowledge of
practice in their respective countries. The information clinical practice in each country.
submitted by these authors will be analyzed and
classified in the manner described above.
La musicoterapia se practica en todo el mundo, pero
The ultimate goal of this presentation is to provide an
existe una gran diferencia en su prctica clnica. Las
international classification system of music therapy
variables que contribuyen a esta divergencia incluyen
781
las diferencias culturales, las orientaciones tericas, el clasificar la informacin remitida por estos autores
clima poltico y el estatus de la musicoterapia en cada siguiendo los criterios arriba indicados.
pas.
El objetivo final de esta ponencia es proporcionar un
En esta ponencia se hace un intento de describir y sistema de clasificacin internacional de la prctica de
clasificar las diferentes orientaciones y prcticas la musicoterapia que pueda resultar til para
clnicas en la musicoterapia, de acuerdo con la comprender tanto las analogas como las diferencias
orientacin terica, el tipo de tcnica (receptiva, de existentes en la prctica clnica entre los diferentes
improvisacin, recreativa) y la poblacin clnica pases, para que pueda haber un mayor intercambio de
especfica. Se identificarn y estudiarn las prcticas de informacin en el futuro.
musicoterapia comunes y nicas.
Una implicacin importante de este trabajo es el
La informacin para esta ponencia forma parte de un desarrollo de una definicin internacional de la
libro, Music Therapy International Perspectives musicoterapia que sintetice la divergencia en la
(Musicoterapia: Perspectivas Internacionales), que la prctica, an representando todas las prcticas.
autora est actualmente corrigiendo. Se pidi a los Adems, las normas internacionales para la educacin
representantes de 50 pases que enviaran sus y formacin en musicoterapia, las normas de la
contribuciones describiendo la prctica clnica y prctica, los cdigos deontolgicos internacionales, etc.
profesional en sus respectivos pases. Se analizar y (tareas de la Federacin Mundial de Musicoterapia) se

782
deben basar en el conocimiento ntegro y exhaustivo de education. Recently there has been an increased
la prctica clnica en cada pas. interest in Music Therapy in general medicine areas.
With such interest there is an implied challenge to Music
Therapy to produce research which is more
M U SI C T H ER APY I N M ED I C AL SET T I N G S: T H E scientifically rigorous, perhaps more comparable to that
C H AL L EN G E F O R M O R E R I G O R O U S found in research with new drugs.
R ESEAR C H , ESPEC I AL L Y I N M U SI C AN D
A look at some recent Music Therapy research in the
M U SI C VI BR AT I O N APPL I C AT I O N S / L A
medical and pain areas indicates a deficit in scientific
M U SI C O T ER API A EN ESC EN AR I O S rigor, particularly in the careful description on music
M ED I C I N AL ES: EL PR O BL EM A D E stimuli used. This is especially apparent in recent
I N VEST I G AC I O N ES M S R I G U R O SAS, vibrotactile-vibroacoustic studies where music
ESPEC I AL M EN T E EN APL I C AC I O N ES M SI C A vibrations have been applied for pain relief and in claims
Y VI BR AC I O N ES M U SI C AL ES of treatment for numerous diseases, disorders and

D ONALD E. MICHEL & KRIS C HESKY disabilities.

This lecture undertakes a critical review of some of the

research in Music Therapy and offers a new framework
Music Therapy and Medicine have long been closely
for future research, especially in the use of music and
associated, especially in psychiatry and special
783
music vibration. Seminal research with the Music reas de la medicina y del dolor, indican un dficit en el
Vibrations Table (MVTTM), and the relief of pain rigor cientfico, especialmente en la cuidadosa
produced under such framework, is described. The descripcin de los estmulos musicales usados. Esto se
needs and possibilities for further research are ve generalmente en los estudios vibrotctiles-
discussed. vibroacsticos, donde las vibraciones musicales se han
usado para el alivio del dolor y en declaraciones sobre
la curacin de numerosas enfermedades e
La Musicoterapia y la Medicina durante mucho tiempo incapacidades.
se han encontrado estrechamente asociadas,
Esta conferencia se encarga de hacer un examen
especialmente en la psiquiatra y en la educacin
crtico sobre algunas investigaciones en la
especial. Recientemente ha habido un aumento
Musicoterapia y ofrece nuevas estructuras para futuras
interesante por la Musicoterapia, en las reas
investigaciones, especialmente en el uso de la msica y
generales de la medicina. Con tal inters existe un reto
de la vibracin musical. Tambin se describe las
relacionado con la Musicoterapia para realizar
investigaciones seminales llevadas a cabo con "The
investigaciones que sean cientficamente ms
Music Vibration Table (MVTTM)" (Mesa de Vibracin
rigurosas, quizs ms comparables al desafo de las
Musical) y el alivio del dolor que se ha producido bajo
investigaciones sobre las drogas nuevas.
tales estructuras. Se discuten las necesidades y
Un vistazo a algunas investigaciones recientes, en las posibilidades para futuras investigaciones.
784
 general pleasant feeling).

Forty-eight patients had disorders of the functional

VI BR O AC O U ST I C T H ER APY R ESEAR C H I N
nervous system: stress neurosis, somnipathy, et. the
G EN ER AL M ED I C I N E / I N VEST I G AC I N D E
100% of patients had positive effects after treatment.
L A T ER API A VI BR O AC ST I C A EN M ED I C I N A
G EN ER AL Thirty-seven patients had arterial hypertonia. They had
also other complaints (headache, spasms in feet,
L AINE S IMSON & RIINA R AUDSIK
stricture of abdomen artery, constipation, psoriasis,
etc.). Only one patient`s blood pressure did not
We have intensively been using vibro-acustic treatment normalize after the treatment. 100% of the above
since December 1991. 156 persons - 81 women, 55 mentioned other complaints disappeared.
men and 20 children- were treated during this year. The In our opinion following diseases are contra- indicated
average period of treatment per person was 10 times, to vibro-acustic treatment:
25-30 minutes daily, period.
- Acute sclerosis of brain blood vessels
Fifty-one patients came to us with back aches (pain in
- Cholelithiasis and nephrolithiasis (in case of
vertebral column, neck and lumbar region). The 75% of
floating stones)
patients had positive results after treatment (pain
disappeared, muscles of the back were relaxed, - After surgical operation
785
- Pregnancy fueron tratadas. El tiempo medio de tratamiento por
persona fueron 10 sesiones, de 25 a 30 minutos diarios.
- Often bleeding duodenal ulcer and gastric ulcer.
Cincuenta y uno pacientes acudieron a nosotros con
It is necessary to be careful with persons who have
dolores de espalda (dolor en la columna vertebral y
polycystic kidney.
regin lumbar). El 75% de los pacientes tuvieron
Positive effect after treating pain in the back remains for
resultados positivos despus del tratamiento (el dolor
2-3 months, in case of other diagnosis for over half a
desapareci, los msculos de la espalda se relajaron,
year.
consiguieron una agradable sensacin general).
There must also be mentioned the fact that this
Cuarenta y ocho pacientes tenan desordenes
treatment exasperates chronic focuses of inflammation
funcionales del sistema nervioso: stress, neurosis,
during the first three stages of the cure. Healing starts
insomnio, etc. El 100% de los pacientes consiguieron
from the 6-7 time and in our opinion the minimun
resultados positivos despus del tratamiento.
number of treatment periods is 10.
Treinta y siete pacientes tenan hipertensin arterial,
quejndose de dolores de cabeza, espasmos en los
Hemos estado usando intensivamente un tratamiento pies, estrechez de la arteria abdominal, estreimiento,
vibroacstico desde Diciembre de 1991. En ese ao psoriasis, etc. Solo la presin arterial de un paciente no
156 personas - 81 mujeres, 55 hombres y 20 nios - se normaliz despus del tratamiento. El resto de las
786
molestias mencionadas desapareci. Tambin debe ser mencionado el hecho de que este
tratamiento agrava los focos crnicos de inflamacin
En nuestra opinin las siguientes enfermedades estn
durante las primeras tres etapas del mismo. Los
contraindicadas para un tratamiento vibroacstico:
resultados positivos comienzan a partir de las sesiones
- Esclerosis aguda de los vasos sanguneos del 6 o 7, y en nuestra opinin el nmero mnimo de
cerebro. sesiones deben ser de 10.
- Cholelitiasis y nefrolitiasis (en caso de piedras
flotantes).
Q U AN T I F I C AT I O N O F Q U AL I T AT I VE ASPEC T S
- Despus de una operacin quirrgica.
O F M U SI C U SED I N VI BR O AC O U ST I C
- Embarazo. T H ER APY ( VAT ) / C U AN T I F I C AC I N D E L O S
- lcera duodenal sangrante y lcera gstrica ASPEC T O S C U AL I T AT I VO S D E L A M SI C A
U T I L I Z AD O S EN L A T ER API A VI BR O - AC ST I C A
Es necesario tener cuidado con personas que tienen un
( VAT )
rin policistico.

El efecto positivo del tratamiento del dolor en la espalda O LAV S KILLE

dura de 2 a 3 meses, y en otros casos hasta ms de

medio ao.
In Music Medicine we often find the terms "anxiolytic
787
music", "relaxing music", "analgesic music" etc. The only, and that much work remains before we can see
definitions of the music which is used are often vague, the outline of a completed method.
and are dependent on some generally acknowledged
The International Society for VibroAcoustics has the
values of "good", "suitable" or "acceptable" music. Such
collection of data and ideas from scientists who use VAT
use of altruism may have satisfied the therapists until
as one of its main purposes. At this stage the
now, but if music is to be used as an instrument for
coordination of work, projects and ideas is of great
medical use in itself, we need more precise descriptions
importance.
of the music we use, and for this purpose the altruistic
approach is unacceptable.

This study has been made to demonstrate the

En la medicina de la msica a menudo encontramos los

importance of further work in order to arrive at a

trminos "msica ansioltica", "msica relajante",

pharmacology of music which can be used in music

"msica analgsica", etc. Las definiciones de la msica

medicine. The methods presented in this study may be

que se utilizan a menudo son indefinidas y dependen

used as a guideline for similar research projects in

de algunos valores generalmente reconocidos de

vibroacoustic transmission of music/sound to the

msica "buena", "adecuada" o "aceptable". Dicha

human body and for heard music as the way of

utilizacin podra haber satisfecho a los terapeutas

transmission. It is important to note that this

hasta ahora, pero si se debe utilizar la msica como

presentation does represent the work of one person

instrumento de por s para la utilizacin en medicina,
788
necesitamos descripciones ms precisas de la msica utilizan la terapia vibro-acstica como uno de sus
que utilizamos y para ello la aproximacin altruista objetivos prioritarios. En esta fase, son muy importantes
resulta inaceptable. la coordinacin del trabajo, de los proyectos y de las
ideas.
Este estudio se realiz para demostrar la importancia
de ulteriores trabajos para llegar a una farmacologa de
la msica que se pueda utilizar en la medicina musical.
T H E E F F E C T O F M U S I C V S . M O T H E R `S V O I C E
Los mtodos presentados en este estudio se pueden
O N N B I C U I N F A N T S `O X Y G E N S A T U R A T I O N
utilizar como directriz para anlogos proyectos de
L EVEL S AN D F R EC U EN C Y O F BR AD YC AR D I A /
investigacin de la transmisin vibro-acstica de
APN EA EPI SO D ES / EL EF EC T O D E L A
msica/sonido al cuerpo humano y de la msica
escuchada como medio de transmisin. M SI C A VS. L A VO Z D E L A M AD R E EN N I O S
N BI C U C O N N I VEL ES D E SAT U R AC I N D E
Es importante observar que esta presentacin no
O X G EN O Y F R EC U EN C I A D E BR AD I C AR D I A /
representa el trabajo de una sola persona y que an
EPI SO D I O S D E APN EA
queda mucho trabajo por hacer antes de que podamos
ver el perfil de un mtodo completo. JAYNE M. STANDLEY & RANDALL S. MOORE

La Sociedad Internacional de Vibro-acstica recopila

los datos y las ideas procedentes de los cientficos que The purpose of this study was to ascertain the effect of
789
prolonged music listening on oxygen saturation levels, oxygen saturation levels were noticeably increased. It
frequency of Oximeter alarms and frequency of was also noted that these infants never developed the
bradycardia/apnea episodes of oxygenated infants in post auditory depression of oxygen saturation levels
the Newborn Intensive Care Unit (NBICU) and to characteristic of the music group.
contrast these effects with responses to recordings of
the mother's voice. Subjects were 19 low birth-weight
infants being treated in the NBICU are of a regional
El propsito de este estudio consista en averiguar el

medical center with each being tested for three

efecto prolongado de estmulos auditivos,

consecutive days. Ten infants listened to music and 9

especficamente musicales a la voz de la madre en

listened to a recording of their mother's voice.

casos de niveles de saturacin de oxgeno en sangre,
frecuencia de las alarmas del oxmetro y frecuencia de
Results showed that babies responded differentially to
bradycardia / episodios de apnea de los recin nacidos
the auditory stimuli across time. Overall, the data seem
en incubadoras de la UCI de los maternados. Los
to indicate an immediate and positive response for the
estmulos auditivos se efectuarn cada 20 minutos/da
music group while music was playing but also indicate
durante 3 das consecutivos documentados cada 2
the development of negative effects during the post
minutos durante las sesiones de audicin y durante 10
auditory observation period as the experiment
minutos durante los silencios anterior y posterior. Los
progressed. Less positive responses were noted initially
casos fueron 20 prematuros siendo tratados en la UCI
while the mother's voice played until day three when
790
de un centro mdico regional. 10 escucharon nanas
grabadas comerciales cantadas por voces femeninas y
O BSER VAT I O N AL R ESEAR C H - C ASE ST U D I ES
10 escucharon grabaciones de la voz de su madre
I N VI BR O AC O U ST I C T H ER APY /
mientras hablaba.
I N VEST I G AC I N O BSER VAC I O N AL - EST U D I O S
Los resultados demostraron que los bebs
M O D EL O EN T ER API A VI BR O AC ST I C A
respondieron de forma diferente durante estimulacin
auditiva. Sobre todo, los datos parecen indicar una T ONY W IGRAM
respuesta positiva inmediata del grupo estimulado
musicalmente mientras sonaba la msica, pero
Research into the influence of sound in the form of
permiti indicar el desarrollo de efectos negativos
music as a physical treatment is still at an early stage. In
posteriores a la audicin. La respuesta a la voz de la
clinical fields, ethical considerations make it difficult to
madre indicaba un efecto menos positivo inicialmente,
undertake complex physiological measurement
pero hacia el tercer da, los niveles de saturacin de
procedures with clients who have mental or physical
oxgeno disminuan notablemente. El anlisis de los
disabilities or handicaps.
datos mostraban que los bebs, oyendo la voz de su
madre, jams desarrollaron la depresin posterior a la Evaluation of the use of low frequencies combined with
audicin caractersticas del grupo que escuch msica. music (vibroacoustic therapy) has included studies on
variations in blood pressure, pulse, EDA, mood and
791
observable behaviour. fase temprana. En los campos clnicos, las
consideraciones ticas hacen difcil llevar a cabo
Objective studies were undertaken on clients with
procedimientos complejos de medidas fisiolgicas con
cerebral palsy and developmental disability, and on
pacientes que tienen incapacidades fsicas o mentales,
clients with challenging behaviour, anxiety and self
o minusvalas.
injurious behaviour using within subjects and between
groups design. Vibroacoustic Therapy sessions were La evaluacin del uso de bajas frecuencias combinadas
randomly interspersed with placebo treatments, and in con msica (terapia vibroacstica) ha incluido estudios
addition to blood pressure, heart rate on level of muscle en las variaciones de la presin sangunea, pulso, EDA,
tone, observable changes in behaviour were measured nimo, y comportamiento observable.
through a multi channel event recorder over time.
Estudios objetivos fueron llevables a cabo en pacientes
The positive results of these studies require replication, con parlisis cerebral e incapacidades de desarrollo y
and also indicate the need for further consideration of en pacientes con comportamiento retante, ansiedad y
the physical effect of sound as a significant and comportamiento auto-lesionante, usados con sujetos y
influential factor in all area of music therapy practice. entre grupos designados. Sesiones de Terapia
Vibroacstica fueron aleatoriamente intercaladas con
tratamientos de placebo y adems de la presin
La investigacin de la influencia del sonido, en forma de sangunea, velocidad del corazn y nivel de tono
msica, como tratamiento fsico est todava en una
792
muscular, cambios observables en el comportamiento 1.- Objectives:
fueron medidos a travs de una grabadora multi-canal.
We propose a "Sonorous-plastic test" that may
Los resultados positivos de estos estudios requieren contribute to the diagnosis of psychotic patients.
una repeticin y tambin indicar la necesidad de una
2.- Antecedents:
mayor consideracin del efecto fsico del sonido como
In order to arrive at the conclusions presented here we
un factor significante e influencial en todo el rea de la
developed a study in which Jara Perdiz de Jesus
prctica de musicoterapia.
Bilemjian -- art educator and musicist -- prepared the
musical tape and the Sonorous-plastic test, Marlcia
Rodrigues Coutinho the plastic analysis of the drawings
2.3.- DEVELOPMENT OF THE MUSICAL
FUNCTION / DESARROLLO DE LA FUNCION which resulted from the test and Dr. Daniel Emdio de
MUSICAL . (ABSTRACTS)
Souza -- psyquiatrist and psychoanalist -- established
the viability of the proposal.

SO N O R O U S- PL AST I C T EST / PR U EBA This test, denominated "Sonorous-plastic test", was

SO N O R O - PL ST I C A developed during 1.991 and 1.992 in the Adauto
Botelho Psyquiatric Hospital, in Goiania, Brasil. During
J AIRA P ERDIZ D E J. BILEMJIAN
this period the test itself was examined several times.
The majority of the patients that frequented the hospital
793
participated in the test. music and produces the images which materializes
plastically.
Our work was carried out in Goania, midwest of Brasil,
and Anpolis (about fifty miles from Goinia). In
Anpolis we carried out our work in two hospitals with
1.- Objetivos.
intern patients.
Estamos proponiendo, con la presentacin de este
3.- Methodology:
trabajo, una "Prueba sonoro-plstica", que contribuya al
The test consist of a tape recording with four musical diagnstico de pacientes psicticos.
themes and artistic material (drawings) that correspond
2.- Antecedentes.
to those themes. (This is intented to meliorate the
psychotic patient and improve his living standard.)
Para llegar a las conclusiones aqu presentadas,
desarrollamos un estudio en que Jaira Perdiz de Jess
4.- Mode of presentation:
Bilemjian - educadora artstica y habilitada en msica -
We offer the possibility of presenting our work with the elabor la cinta magnetofnica musical y la
help of a video tape of approximately twenty five prueba/texto "Prueba sonoro-plstica", Marlcia
minutes. This tape contains the inmediate plastic Rodrigues Coutinho el anlisis plstico de los dibujos
response provoked in the patient in the very instant in resultantes de la prueba y el Dr. Daniel Emidio de Souza
which he listens to the tape. The patient listens to the - psiquiatra y psicoanalista - colabor a travs de una

794
evaluacin de la viabilidad de la propuesta. plsticos (dibujos) que corresponden a tales trechos
musicales.
Esta prueba denominada "Prueba Sonoro-Plstica" fue
desarrollada durante los aos de 1.991 y 1.992 en el Con este trabajo queremos contribuir a una mejor
Complejo Hospitalario Adauto Botelho, en la unidad de comprensin del ser psictico y consecuentemente
tratamiento externo, la Unidad Hospital-Da. Durante para una mejor cualidad de vida del hombre que sufre.
este perodo la prueba fue examinada varias veces. La
4.- Modo de presentacin.
mayora de los pacientes que frecuentaban el Hospital
participaron en la prueba. Ofrecemos la posibilidad de presentar este trabajo con
la ayuda de una cinta de vdeo con duracin
Nuestro trabajo ha sido realizado en Goinia, capital del
aproximada de veinticinco minutos. Esta cinta contiene
estado de Gois, situado en la Regin Centro-Oeste del
el resultado plstico inmediato provocado en el
Brasil.
paciente en el instante en que ste la escuchaba. El
La prueba referida tambin fue desarrollada en otros paciente escucha el sonido y produce una imagen que
dos hospitales psiquitricos bajo rgimen de asilo. l concretiza plsticamente.

3.- Metodologa.

Utilizamos para la prueba una cinta magnetofnica

PR O T O - R H YT H M S: BASI S F O R N O N VER BAL
grabada con cuatro trechos musicales y materiales
T O VER BAL D EVEL O PM EN T / PR O T O -
795
 R I T M O S BASES PAR A EL D ESAR R O L L O N O the rhythm those emissions conform. However, in the
VER BAL AL VER BAL first cry, the word and the musical manifestation come
forth, having both of them a common origin: intonated
R UTH F RIDMAN
proto-rhythms.

Proto-rhythms are a line of investigations based on the

Los proto-ritmos es una lnea de investigacin basada
sonorous vocal expressions of infants, and its relations
en la expresin sonoro-rtmica del llanto de un recin
to the first cry. I taped and studied them through musical
nacido. Grab, descodifiqu a travs de signos
symbols. The model for this study, is the cry of the first
musicales su expresin vocal. Al no tener acceso a
six minutes of a new-born baby. At that time, I did not
medios mecnicos deben existir ciertas emisiones
have access to electronic devices, therefore there can
acsticas que para los objetivos de este trabajo no son
be certain acoustics omissions that for the objetives of
en modo alguno determinantes.
this work they are not determinant.
Nadie ensea a un bebe a llorar. Las expresiones
Nobody teaches a baby to cry. The vocal sonorous-
vocales sonoro-rtmicas de un infante no son producto
rhythmic expressions of an infant are not a product of
del pensamiento, son parte de su herencia biolgica. Es
his mind, they are part of his biological inheritance. It is
probable que por habrselas considerado tan obvias y
posible, that, because they have been considered
espontneas no se repar en el ritmo que conforman
obvious and spontaneous, nobody has taken account of
796
sus emisiones. Sin embargo, ya en los primeros llantos and emotional effects? There are many factors which
de un neonato bien integrado fsicamente existe trigger this off.
organizacin rtmica. Este hecho, aparentemente
The initial results of a detailed study will be explained, in
simple es sumamente importante, pues del primer
which significant sound elements appear called "sound
vagido surge la palabra y la manifestacin musical
cells". These seem to be the element which triggers off
teniendo ambos un tronco en comn: los proto-ritmos different psycho-physiological states.
entonados.
These musical elements generally last a very short time
during exposure to the melody. They can be encoded
and used by both composers and music therapists
SO U N D C EL L S / C L U L AS SO N O R AS
when choosing music pieces and sound programmes to

J ACQUES J OST & ESTER P INEDA propose to the patients.

Some elements of this kind (sound cells) are currently

used in two large french hospitals (the Hpital Necker
The credibility of music therapy now requires serious
and the Hpital de L'Hotel-Dieu in Paris).
scientific research into the sound phenomena which
work in human beings on a psychological level.

Why does one kind of music lead to particular affective La credibilidad de la musicoterapia exige actualmente

797
una seria investigacin cientfica sobre los fenmenos Actualmente, unos elementos de este tipo (Clulas
sonoros que actan en el ser humano a nivel psico- Sonoras) se utilizan en dos grandes centros
fisiolgico. hospitalarios franceses (Hpital Necker y Hpital de
L'Hotel-Dieu en Pars).
Por qu una msica suscita particulares efectos
afectivos y emocionales? Son numerosos los factores
desencadenantes.
F R O M U T ER U S O N WAR D : T O C O M M U N I C AT E
Se expondrn los primeros resultados de una
BY SO U N D S / A PAR T I R D EL T ER O :
investigacin minuciosa en la que aparecen elementos
C O M U N I C AR C O N SO N I D O S
sonoros significativos, llamados "Clulas Sonoras", que
parecen ser el elemento desencadenante de diferentes F RANCESCA L ACCETTI
estados psico-fisiolgicos.
Pregnancy from a psychodynamic point of view,
Generalmente, estos elementos musicales son de muy
determines a lot of changes and reorganizations in
corta duracin en la exposicin de la meloda. Podran
woman's mind: an expectant mother experiences new
ser codificados y utilizados tanto por los compositores,
vissues, especially she relives sensations and feelings
como por los musicoterapeutas en la eleccin de las
of her own mother-child relationship; regression is, in
obras musicales y programas sonoros propuestos a los
fact, peculiar of her pregnant condition.
pacientes.
798
An expectant mother does not know if her child will be Therapy in the course of pregnancy to protect the
male or female, during the first months, healthy or not, expectant mother and her future parent-child
she must besides experience a new balance within the relationship avoiding communication conflicts to
couple with her partner; so she could develop anxiety parental fears, memories or projections.
with bad influences on pregnancy child birth and on
future parents-child relationship.
El embarazo es un momento en el que, desde el punto
Music Therapy can give an opportunity to the pregnant
de vista psicodinmico, se producen en la mujer una
woman to comunicate with her future baby and so
serie de cambios y re-organizaciones en las que se
thinking to him or her like a real human being; for this
experimentan vivencias nuevas y se reviven
Music Therapy will be a great help to the expectant
sensaciones y sentimientos referidos sobre todo a la
mother during pregnancy. In fact the mother because of
relacin con la madre y al mismo papel de hija. La
ther psychological regression, brings to light her own
regresin, por tanto, es una de las caractersticas
sonorous ways of comunication learning throughout the
importantes de este estadio.
pregnancy, to talk with her baby, using sound: the baby
perceives at first only sound vibrations but finally he/she
El hecho de no saber cmo ser el nio ni de qu sexo

can perceive the sound.

ser durante los primeros meses, el tener que movilizar
las propias capacidades de ser madre, el nuevo
For this I propose an experimental use of Music
equilibrio que se crea en la pareja que espera el nio,
799
son situaciones ansigenas que si no estn bien de un proyecto-investigacin para una posible
contenidas pueden influir negativamente en el curso del intervencin con la musicoterapia durante la gestacin
embarazo, en el parto y en la relacin entre padres e para contribuir a amparar a la mujer en espera y
hijos. preservar as la relacin con el hijo de posibles
conflictos que tienen su origen en la dificultad, por parte
Durante la gestacin resulta pues muy beneficioso el
de los padres, de escindir la relacin comunicativa con
acercamiento al futuro nio aprendiendo a pensar cada
su hijo de los miedos, recuerdos y proyecciones.
vez ms en l/ella como si se tratara de un ser humano
concreto; la posibilidad de comunicar con l en este
perodo se puede materializar con el uso de la
T H E M U SI C AL - EM O T I O N AL N AT U R E O F
musicoterapia.
L U L L ABI ES AN D PL AYSO N G S AS R EF L EC T I VE
En principio a travs de la vibraciones y despus a
R ESO N AN C ES O F T H E PAR EN T AL C O AL I T I O N
travs de los mismos sonidos, el nio que va a nacer
/ L A ESEN C I A M U SI C AL Y EM O C I O N AL D E L AS
percibe el sonido. La madre, ayudada en ello por la
C AN C I O N ES D E C U N A Y D E N I O S C O M O
regresin que est viviendo, descubre sus propias
R ESO N AN C I A R EF L EC T O R A D E L A C O AL I C I N
modalidades comunicativas y sonoras, aprendiendo a
PAT ER N AL
lo largo de los nueve meses, la manera de dirigirse al
nio a travs de los sonidos. Esta es pues la propuesta

800
 S ARAH L PEZ The musical analysis from which this paper draws,
consisted of traditional, statistical, semiotic, spectral
and graphic analysis of the music and texts of forty-
The effectiveness of a lullaby or playsong depends on a
seven lullabies from the Western Hemisphere, Japan,
particular sequential structure of events both musical
Africa and Rusia and forty-seven playsongs from the
and empathic, resulting in a quiescent or stimulated
same cultures. This analysis provided the basis for a
bonded state of the participants. Most people intuit the
theoretical definition of these types of songs. Extensive
process of a lullaby. The experiential effects prove to be
review of developmental and psychological literature
quite powerful in adults and children alike. However only
provided the basis for comparison of musical and
a few researchers have explored the possible musical
empathic interaction with newborns and their parents.
and emotional correlations of the effects of lullabies and
playsongs empirically with newborn infants, from a
musical point of view (Lpez, 1991). This paper La efectividad de una nana o de una cancin infantil
presents a preliminary discussion of the musical- depende de una particular estructura secuencial de
emotional nature of lullabies and playsongs, through acontecimientos, tanto musicales como por empata, y
comparative analysis of the songs and developmental tiene como consecuencia un estado de unin tranquilo
literature. Results from an exploratory testing of the o estimulado por parte de los participantes. La mayora
effects of sung lullabies and playsongs on seventeen de la gente intuye el proceso de una nana. Los efectos
newborn infants are given elsewhere (Lpez,1.991).
801
de la experiencia demostraron ser bastante poderosos, frica y Rusia y cuarenta y siete canciones infantiles de
tanto en los adultos como en los nios. Sin embargo, las mismas culturas. Este anlisis sirvi de base para la
slo pocos investigadores estudiaron empricamente definicin terica de estos tipos de canciones. El
las posibles correlaciones emocionales y musicales de estudio en profundidad de la literatura de desarrollo y
los efectos de las nanas y las canciones infantiles en psicolgica est a la base de la comparacin de la
recin nacidos, desde un punto de vista musical interaccin musical y por empata entre los recin
(Lpez, 1991). Esta ponencia presenta un estudio nacidos y sus padres.
preliminar de la naturaleza musical y emocional de las
nanas y canciones infantiles, a travs de un anlisis
comparativo de las canciones y de la literatura M U SI C AS A C AT AL YST F O R PER SO N AL
desarrollada. Los resultados de una prueba D EVEL O PM EN T : T H E EF F EC T S O F T H E
experimental de los efectos de las nanas y canciones BAL I N ESE G AM EL AN O N T H E M U SI C AL AN D
infantiles sobre diecisiete recin nacidos se presentan C O M M U N I C AT I O N SKI L L S O N A G R O U P O F
en otro trabajo (Lpez, 1991). El anlisis musical en el M I L D L Y AN D M O D ER AT EL Y M EN T AL L Y
que tiene su punto de partida esta ponencia consisti H AN D I C APPED AD U L T S / L A M SI C A C O M O
en el anlisis grfico, estadstico, semitico y de C AT AL I Z AD O R PAR A EL D ESAR R O L L O
espectro de la msica y la letra de cuarenta y siete PER SO N AL : L O S EF EC T O S D EL G AM EL AN
nanas procedentes del hemisferio occidental, Japn, BAL I N ESE EN EL T AL EN T O M U SI C AL Y
802
C O M U N I C AT I VO D E U N G R U PO D E AD U L T O S by the Communication Assessment Profile for adults
L I G ER A Y M O D ER AD AM EN T E M I N U SVL I D O S with a mental handicap (CASP) and self esteem levels
measured by the Khalid semantic differential technique
R AYMOND A.R. MAC D ONALD, PATRICK J. O` DONNELL &
were postulated.
J ANET W ALLACE
The workshop were co-ordinated and run by
Strathclyde (Scotland) Orchestral Productions, a music
This study investigates the benefits of music workshop
and theatre production company who work exclusively
in structured group situations for a population with
with individuals with special needs.
special needs.
Results emphasize significant gains in musical ability
Forty subjects, who at the time of the study were adults
and communication skills with a ceiling effect being
resident at mental health institutions, took part in this
observed in the measurement of self-esteem. Several
experiment which focused on the structured group
explanations of this ceiling effect will be proposed.
playing of a Javanese Gamelan. The experimental
hypothesis was that participation in the experimental
group would produce significant improvements in Este estudio investiga los beneficios de talleres de
musical ability as measured by Elmes musical tests, msica en situaciones de grupos estructurados, para
devised and validated for use in this study. Also una poblacin con necesidades especiales.
significant gains in communication skills as measured
803
Cuarenta sujetos, que durante el tiempo del estudio necesidades especiales.
eran adultos residentes en instituciones de salud
Los resultados pusieron de relieve ganancias
mental, formaron parte de este experimento que se
significantes en habilidad musical y capacidad de
centr en grupos estructurados tocando un Gamelan
comunicacin, con un efecto tope observado en la
javans. La hiptesis experimental era que la
medida de la autoestima. Varias explicaciones de este
participacin en el grupo de trabajo producira mejoras
efecto tope sern propuestas.
significantes en la habilidad musical medida por los
tests de Elmes, adaptados especialmente para este
estudio. Tambin una ganancia significante en la
EC H O R EPET I T I O N / L A VU EL T A EN EC O
habilidad para comunicarse medida por la Valoracin
de Perfiles de Comunicacin para adultos con una D OMINIQUE P ERROUAULT
minusvala mental (CASP) y los niveles de autoestima
medidos por la tcnica Khalid de diferencial semntico
This text evokes the difficulties in using echo repetition
fueron recogidos.
in therapy. It presents positive and negative effects
Los talleres fueron coordinados y dirigidos por which can be provoked by it and suggests a framework
Strathclyde Producciones Orquestales (Escocia), una for the analysis or these phenomenons, from three
compaa de producciones teatrales y musicales que levels which are while echo, strange echo and clear
trabaja exclusiva-mente con individuos con echo, to which correspond three silences: silence of
804
death, of wait and of absence. C U T T H E N O I SE / C O R T A C O N EL R U I D O

Este texto presenta las dificultades de la utilizacin de la R EN C OUPAUD

continuacin en eco en la terapia. Pone en claro los
efectos tanto positivos como negativos que puede
From a few years until now, the new technologies have
provocar y proponer una trama de anlisis de los
made possible to cheapen the production cost s of
fenmenos de eco, a partir de tres niveles que son: el
everyday machines used in the professional, domestic
eco blanco, el eco extrao y el eco franco, a los cuales
and entertaining areas; causing a considerable rise in
corresponden los silencios de muerte, de espera y de
the number of these machines, and invading our
ausencia.
environment to facilitate the tasks that before were
tedious and low profitable (machinery for construction,
cars, home machines, sound equipment, etc. ...)
2.4.- ACOUSTIC AND SOUND PERCEPTION -
ACUSTICAY PERCEPCION SONORA
( ABSTRACTS) The good use of these technological advances carries
an unavoidable highly contaminant waste: "Noise",
which added to the one generated by human being`s
daily activity reaches highly dangerous levels for

805
people`s health and well-being; causing a clinical picture This collective is an easy way of penetration because
which varies according to the contaminant agent: most of the population has a direct or transverse
headaches, insomnia, stress, digestive problems and, relationship with the students. Therefore, the plan used
as an extreme case, permanent deafness. was to implicate the teacher, so the teacher can
implicate the student and the student can implicate
We are aware that the fight against noise is fated to
his/her relatives.
failure, if it is planned with repressive methods such as
laws dictated by any executive power, due to their
difficult following and the problems or consequences
De un tiempo a esta parte las nuevas tecnologas han
caused by the imposition of the sanctions.
hecho posible el abaratamiento de los costes de
An educational attitude and a change of mentality in our produccin de mquinas herramientas de uso cotidiano
society will produce more shortterm, positive results en el mbito profesional, domstico y ldico,
because the citizen will understand the problem and will ocasionando un aumento considerable en el nmero de
know the reasons of the "this or that must not be done". estos ingenios e invadiendo nuestro entorno para
facilitarnos las tareas que antes nos resultaban
Following this latter attitude we have thought in working
tediosas y poco rentables (maquinaria para la
with the population through a common group: the
construccin, coches, electrodomsticos,
schooling collective.
reproductores de sonidos, etc.)

806
El feliz uso de estos avances tecnolgicos trae consigo Una actitud educativa y concienciadora de la sociedad,
un inevitable material de desecho altamente dar mayores resultados positivos a medio plazo, ya
contaminante; "Ruido", que sumado al propio generado que el ciudadano entender el problema y sabr los
por el ser humano en su actividad diaria, llega a cotas porqus del "no se debe hacer esto o lo otro".
altamente peligrosas para la salud y el bienestar de las
Siguiendo esta ltima actitud hemos pensado actuar
personas, ocasionando un cuadro clnico muy variado
sobre la poblacin a travs de un grupo comn; el
en funcin a su exposicin al agente contaminante;
colectivo escolar. El colectivo escolar es un va de
cefleas, insomnio, stress, trastornos digestivos y en
penetracin fcil debido a que la mayor parte de la
ltimo caso la sordera permanente.
poblacin tiene alguna relacin directa o transversal
Somos conscientes que la lucha contra el ruido est con el alumnado. Por tanto, el planteamiento empleado
abocada al fracaso si se plantea con mtodos fue implicar al profesor, para que este implique al
represivos como puedan ser las Ordenanzas dictadas alumno y este a su vez implique a sus familiares.
por cualquier poder ejecutivo debido a la dificultad del
seguimiento de las mismas y los problemas o
consecuencias derivados de las sanciones aplicadas. P R O P O S A L O F A P R O JE C T I V E S O U N D T E S T
No obstante, valoramos positivamente esta forma de F O R T H E EVAL U AT I O N O F T H E EXPR ESSI VE
actuar para casos puntuales en los que no hay ms PO T EN T I AL I T I ES O F T H E I N D I VI D U AL /
remedio que actuar enrgicamente. PR O PU EST A D E U N T EST PR O YEC T I VO
807
 SO N O R O PAR A L A EVO L U C I N D E L AS This test can be useful for a follow-up of the changes
PO T EN C I AL I D AD ES EXPR ESI VAS D EL occurred in the individual and in the group as it can
I N D I VI D U O demonstrate, in a way which is surely not exhaustive but
effective, the degree of communication involvement
R ENATO D E M ICHELE
either on affective or on motory levels or on the ones of
the ability of sound actuation. This is a feedback which
Why a projective-sound test? can give useful elements to adjust the aim within the
setting.
A music therapist has to manage many variables linked
to the different parts of the patient he contacts through
lived sound experiences within the music therapy Por qu un test proyectivo-sonoro?
setting. The possibility to obtain at the start information
Un musicoterapeuta se enfrenta con muchas variables
about the level and the ways of any sound activation
relativas a los diversos aspectos del paciente
and sensitisation of the individual is helpful. If it is
contactados a travs de la actuacin sonora, dentro del
properly considered together with a non-verbal
setting musicoteraputico. Una posibilidad de
framework, it helps to evaluate and orientate, either
activacin y sensibilizacin del individuo es una ayuda,
individual or group interventions, for a better and more
cuando est correctamente unida a un encuadre no-
directed interaction with the patient.
verbal, para valorar y orientar las intervenciones, a nivel
808
tanto individual como grupal, para una mejor y ms T H R O U G H AU D I T I O N T O L I ST EN I N G .
directa interaccin con el paciente. T H R O U G H L I ST EN I N G T O C O M M U N I C AT I O N /
PO R L A AU D I C I N A L A ESC U C H A. PO R L A
Este test puede ser til para una averiguacin en el
ESC U C H A A L A C O M U N I C AC I N
tempo (follow-up) de las modificaciones que se hayan
determinado en el individuo y en el grupo, porque M I SABEL S ALINAS A LONSO & L ORENZO C ARBAJO
puede documentar, de una manera no exhaustiva sin E STEBAN
eficaz, los niveles de implicacin en la comunicacin
tanto en el campo afectivo como en el campo motor y
The ear is the essential organ for Listening-Hearing,
en aquellos cuyo fin es la capacidad de activacin
and its correct functioning will result in a better quality of
sonora. Es ste un feedback que puede dar elementos
both .
tiles para un mejor enfoque al interior del setting.
We can define the Audio-Psycho-Phonology as an
opening through listening-hearing to the universe of
language-communication, approa-ched from a psycho-
emotional angle.

It can be understood as a true Pedagogy of Listening,

relating the basic aspects in which this methodology is

809
based, such as: Applications: specific auditive pathologies, problems
with postures, learning of languages, prophylaxis and
- audio Power of listening
preparation to childbirth, problems of communication,
- psych life of relation
autistic children, depressions and necessity of
- phonology language dynamism, early stimulation, learning difficulties, work
with the voice, musical and instrumental learning,
Diagnosis in Audio-Psycho-Phonology is made from a
epilepsy.
Listening Test. This proof give us an assessment of the
use a person does or does not make of his/her auditive
capacity. From this test we analyze the elements of
El odo es el rgano fundamental de la Escucha-
distortion, confussion and auditive spacing, and also the
Audicin, y es cierto que en la medida en que funcione
relations between the aerial and osseous curves of both
correctamente, mejor calidad tendr la audicin y la
ears.
escucha.
The Listening Test is complemented with indicators of
Podemos definir la Audio-Psico-Fonologa, como una
lateral reception and any other necessary proofs.
apertura a travs de la audicin-escucha al universo del
In the re-education sessions we use an electronic piece lenguaje-comunicacin, abordado desde un ngulo
of equipment, and the sonorous material can be either psico-emocional.
music or voice.
810
As entendida se puede considerar como una necesarias.
verdadera Pedagoga de la Escucha, que ponen en
La sesiones de reeducacin se hacen utilizando un
relacin los aspectos bsicos en los que se asienta esta
aparato electrnico y el material sonoro puede ser tanto
metodologa:
msica como voz.
- audio: facultad de escucha
Aplicaciones: problemas de comunicacin, autismo,
- psico: vida de relacin determinadas patologas auditivas, problemas
posturales, aprendizaje de idiomas, profilaxis y
- fonologa: lenguaje
preparacin al parto, depresiones y necesidad de
El diagnstico en Audio-psico-fonologa se realiza a dinamizacin, estimulacin precoz, dificultad de
partir del Test de Escucha. Esta prueba permite valorar aprendizaje, trabajo con la voz, aprendizaje musical e
la utilizacin que una persona hace o no hace de su instrumental y epilepsia.
capacidad de audicin. A partir del Test de Escucha se
analizan los elementos de distorsin, confusin,
espacializacin auditiva, as como las relaciones entre
las curvas areas y seas de ambos odos.

El Test de Escucha se complementa con indicadores de

la lateralidad y otras pruebas que se consideren

811
 SO U N D S, C O L O U R S AN D PYR AM I D AS introspection of third eye). Once we stimulate this
D I F F ER EN T EN ER G ET I C SO U R C ES T O H EAL / chakra we become aware of everything that happens
L O S SO N I D O S, L O S C O L O R ES Y L A PI R M I D E inside and outside the self, and we can direct this
C O M O F U EN T ES EN ER G T I C AS PAR A C U R AR energy to the painful spots. The results are faster if we
combine music with colors on the same frequency (the
F ELICIANA S CURTULESCU
musical note DO and the color red are an the same
frequency, and both influence the first chakra which is
Music is a beneficial influence; it helps the selfdiscovery connected with the sexual activity; the note MI and the
and the selfrealization of the person at a subliminal color yellow influence the second chakra, which is
level-deeply physiological. This means that it affects connected with the digestion of food etc.)
everyone: healthy and sick people. If we make an effort We have tried this method at the Sadahana Health
to convince the sick person of the healing possiblities of Center (Valencia), and we have obtained great
music, we will help him or her to recover his or her own improvements on the mental and physical levels of the
health. parients clinically proven.
Music helps the energy to freely circulate in our body We use this method only in the right frame, with a quiet
through its specific channels. When this energy is and intimate atmosphere and without distracting
deposited is when we get sick. The free circulation of elements. The patient has to be placed northward, and
energy stimulates especially the sixth chakra (center of
812
sometimes we add to the musical stimulation a enfermedades. La circulacin libre de la energa
massage to the energetic spots corresponding to the estimula especialmente la actividad del sexto chakra
sick organ. (centro de la introspeccin o el tercer ojo). Una vez
estimulado este chakra devenimos conscientes de todo
lo que pasa dentro de nosotros y en torno de nosotros y
La msica nos influye de manera benfica, en el podemos dirigir esta energa hacia el lugar en
sentido de los posibles autodescubrimiento y sufrimiento. Los resultados son mucho ms rpidos si
autoconstruccin del S, al nivel del subconsciente, por se combina el sonido con el color que tiene la misma
una va subliminar, por tanto profundamente fisiolgica. frecuencia (por ejemplo la nota DO tiene la misma
Es decir, acta sobre todos: personas normales o frecuencia con el color rojo y pueden influir el primer
enfermas. Si nos esforzamos en captar y canalizar la chakra que responde de la actividad sexual; MI tiene la
atencin del enfermo sobre el efecto regenerador de la misma frecuencia con el color amarillo y pueden influir
msica que le ofrecemos, le ayudaremos y le el segundo chakra que responde de la actividad
aceleraremos la curacin. digestiva etc.)
El efecto esencial de la msica sobre nuestro cuerpo Hemos probado estos efectos en el Centro de Salud
consiste en el hecho que favorece la circulacin libre de Sadahana de Valencia donde estoy colaborando como
la energa por sus propios canales, evitndose su investigadora y hemos obtenido un notable
depositacin. Esta depositacin da lugar a las mejoramiento del estado psquico y fsico del paciente,
813
los ltimos siendo probados a travs de investigaciones T H E R O L E O F M U SI C I N M U SI C T H ER APY / L A
clnicas. F U N C I N D E L A M SI C A EN M U SI C O T ER API A

Debemos especificar que nuestro mtodo se aplica H EIDI A HONEN

solamente en el marco adecuado, con una atmsfera
ntima y tranquila, sin presencias que pueden perturbar
The goal of this round table discussion is to analyze the
la atencin, teniendo en cuenta la orientacin del
music therapy processes, specially the different roles,
paciente hacia el Norte y combinando si es posible, la
tasks and goals of music in relation to the theoretical
audicin con la estimulacin por presopuntura de los
frame of the music therapist.
diversos puntos energticos sobre cuales sabemos que
corresponden al rgano enfermo. The tasks of music in music therapy process can be
several and the roles of it can be called by different
terms depending the music therapist's behavioristic,
III. MUSIC AND MUSIC THERAPY - MUSICA Y humanistic - eksistentialistic, psychodynamic,
MUSICOTERAPIA psychoanalytic, bio-medical or etc. theoretical
background.

The participants of the round table are asked to analyze

their own music therapy practise in relation to their own

814
theoretical frame. M U SI C T H ER APY F O R PEAC E: A G L O BAL
I M PER AT I VE / M U SI C O T ER API A PAR A L A
PAZ : U N I M PER AT I VO G L O BAL
El objetivo de esta mesa redonda es analizar los
procesos de la musicoterapia, especialmente las E DITH H ILLMAN B OXILL & JOSEPH M ORENO

diferentes funciones, tareas y objetivos de la msica en

relacin con el marco terico del musicoterapeuta.
Music Therapists For Peace, Inc. is a worldwide network
Las tareas de la msica en el proceso de la of music therapists who are dedicated to making a
musicoterapia pueden ser variadas y sus funciones major contribution to peace in the world. With skills
pueden ser denominadas con trminos diferentes unique to the profession of music therapy, these like-
dependiendo de si la base terica del musicoterapeuta minded music therapists are effecting peaceful relations
es behaviorstica, humanstico-existencialista, on all societal levels -- expanding the scope of our field
psicodinmica, psicoanaltica, bio-mdica, etc. by reaching out to all people, especially the children.
A los participantes de la mesa redonda se les pide que PROPOSAL
analicen su propia prctica musicoteraputica en
Music Therapists For Peace proposes a Plenary
relacin con su propio marco terico.
Session at the VII World Congress of Music Therapy
which will present music therapy in the context of World

815
Peace and the worldwide role of music therapists as la paz en el mundo. Estos musicoterapeutas, con las
ambassadors of peace through music. This Plenary habilidades propias de la profesin de la Musicoterapia,
Session will be conducted by world renowned tratan de promover relaciones pacficas a todos los
representatives of Music Therapists For Peace. niveles de la sociedad, ampliando el objetivo de nuestro
campo y alcanzando a todo el mundo, especialmente
The session will open with the ringing of a Peace Bell
los nios.
crafted from weapons of war. This ceremony will be
followed by a musical meditation for peace. Each of the PROPUESTA
participating panel members will then offer a statement
La asociacin "Music Therapists For Peace" propone
about the significance and far-reaching effects of
una Sesin Plenaria en el VII Congreso Mundial de
peacemaking through music therapy/music from their
Musicoterapia en la que se presentar la musicoterapia
perspective and experience.
en el contexto de la paz mundial y el papel a nivel
A 10-minute period will be scheduled for general mundial de los musicoterapeutas como embajadores
duscussion concerning the possibilities for our work and de la paz a travs de la msica. Esta sesin plenaria
its expansion locally and globally. ser conducida por los representantes mundiales de
mayor reputacin de los Musicoterapeutas Por La Paz.

La sesin se abrir con el repique de una Campana de

Music Therapists For Peace, Inc. es una red a nivel
la Paz fundida con armas de guerra. A esta ceremonia
mundial de musicoterapeutas dedicados a contribuir a
816
seguir una meditacin musical por la paz. Cada uno de I N VEST I G AC I N EN L A F R O N T ER A C O M N D E
los miembros participantes presentar entonces un L A T ER API A, L A ED U C AC I N Y L A M ED I C I N A
informe acerca de la importancia y los efectos a largo
N ORMAN A. GOLDBERG
alcance de la realizacin de la paz a travs de la
musicoterapia/msica, partiendo de su propia
perspectiva y experiencia. Publications, resources, trends and organizations since
Se dispondr de 10 minutos para un debate general the previous Congress in Ro de Janeiro will be
acerca de las posibilidades de nuestro trabajo y su presented. The world wide momentum bringing music in
difusin a nivel local y global. particular and the arts in general closer to the medical
world is gaining.

There is more and more evidence pointing to the

R EC EN T PU BL I C AT I O N S, R ESO U R C ES, greater acceptance by the medical profession of the
D I R EC T I O N S AN D N EW R ESEAR C H arts therapies in general and music therapy in
PR O PO SAL S I N T H E I N T ER F AC E O F particular.
T H ER APY, ED U C AT I O N AN D M ED I C I N E /
Publications such as MusicMedicine, edited by Drs.
PU BL I C AC I O N ES, R EC U R SO S, I N D I C AC I O N ES
Ralph Spintge and Roland Droh, are having a strong
R EC I EN T ES Y N U EVAS PR O PU EST AS D E
international impact. The International Journal of Arts

817
Medicine (IJAM) has taken its place beside long- that team which will meet again several times including
established journals in the field, being included in many a few days prior to the Conference of the International
hospital, university and public libraries, as well as Society for Music in Medicine to be held in San Antonio
information networks such as CAIRSS which is now on in March, 1994.
line and being accessed from several continents.

A recent entire North Carolina Medical Journal was

Publicaciones, recursos, tendencias y organizaciones
entitled Special Issue-Turning Points:
desde el Congreso previo en Ro de Janeiro sern
Arts Medicine. Guest editor for this edition was Patrick presentados. El mpetu mundial que est acercando la
Kenan, M.D. msica en particular y las artes en general al mundo de
la medicina es cada vez ms fuerte.
Rhythm For Life, which came into being in February of
1992, is conducting research in a number of hospitals Hay cada vez ms y ms puntos de evidencia de la
and senior citizen centers, with varied populations, mayor aceptacin por parte de la profesin mdica de
including dementia up to advance Alzheimers patients. las terapias relacionadas con las artes en general y la
In January, 1993 a research team was assembled at the Musicoterapia en particular.
University of Texas San Antonio to address "Setting an
Publicaciones como "MusicMedicine", editada por los
Agenda for Neuromusical Research". Dr. Karl Pribram,
doctores Ralph Spintge y Roland Droh, estn teniendo
Keynote Speaker for this Congress, and I was part of
un gran impacto internacional. El "International Journal
818
of Arts Medicine" (IJAM) ha ocupado su puesto al lado Neuromusical". El Dr. Karl Pribram, uno de los
de publicaciones veteranas en este campo, y ha sido principales conferenciantes en este Congreso, y yo
incluida en muchos hospitales, universidades y fuimos parte de ese equipo que se reunir de nuevo
bibliotecas pblicas, as como en redes de varias veces incluyendo la que tendr lugar unos das
comunicacin como el CAIRSS al que actualmente se antes de la Conferencia de la Sociedad Internacional
puede acceder desde varios continentes. para la Msica en la Medicina a celebrar en San
Antonio, en Marzo de 1994.
Un ejemplar reciente del North Carolina Medical Journal
fue titulado: Puntos de Cambio: las Artes en Medicina. El
editor invitado para este nmero fue el Dr. Patrick
T H E M U SI C AL D I C T AT I O N O F T O T I L A AL BER T
Kenan.
AS A WI N D O W T O WAR D S T H E VI VEN C I AL
Ritmo Para La Vida, fundada en Febrero de 1992, est
WO R L D O F BR AH M S / EL D I C T AD O M U SI C AL
llevando a cabo investigaciones en hospitales y
D E T O T I L A AL BER T C O M O U N A VEN T AN A AL
residencias de ancianos, con poblaciones variadas
M U N D O VI VEN C I AL D E BR AH M S
incluyendo dementes y enfermos de Alzheimer. En
Enero de 1993 un equipo de investigacin fue reunido C LAUDIO N ARANJO
en la Universidad de Texas - San Antonio para tratar el
tema: "Organizacin de una agenda para Investigacin
I will speak about Totila Albert, a Chilean sculptor and
819
poet, who in the course of his spiritual development had internal world.
an experience which he called a "musical dictation".
I will show slides of his work to be read simultaneously
Although its essence could be described as a spiritual
with the audition of fragments from the four symphonies
communion with musicians from the past, its formal
and the three quartets of the masterful composer.
aspect meant the audition of German words
corresponding syllable-to-note with works of several
German romantic composers. Dar noticia acerca de Totila Albert, escultor y poeta

Although some other artists were mediums who felt like

chileno quien, en el curso de su desarrollo espiritual,

channels for artists of the past, I think Totila Albert's

conoci una experiencia a la que hubo de referirse

work is the only case in which the artistic merit can be

como "dictado musical". Aunque la esencia de ella

compared to the work of his classical predecessors. For

pudiera describirse como una comunin espiritual con

this reason his case means an important contribution to

los msicos del pasado, en su aspecto formal

the arguments about the significance of music and

entraaba este fenmeno la audicin de palabras (en

about the existance of music with an objetive content.

alemn) en correspondencia de slaba-a-nota con
obras de varios romnticos alemanes.
These reflections will be part of my lecture, which will be
focused in what Totila Albert - an expert explorer of
Aunque se ha dado el caso de mediums artistas que se

musical contents - perceived as contents of Brahms'

sintieron canales de artistas del pasado, la obra de
Totila Albert me parece el nico caso en que el mrito
820
artstico pueda equipararse al de sus antecesores H AR M O N I C T H ER APY / T ER API A AR M N I C A
clsicos. Por ello puede constituir un aporte notable a
W ERNER S CHULZE
las disquisiciones sobre el significado de la msica y
acerca de la existencia de msica con un contenido
objetivo. There are many harmonic laws in nature. For instance:

Reflecciones de esta ndole tambin sern parte de mi man's rhythmic physiology rests on simple proportions

charla, que se centrar principalmente sobre lo que that can be expressed almost only with the numbers

Totila Albert - experto explorador de contenidos from one to four, so this is a matter -with no exceptions-

musicales - percibi como contenidos del mundo of consonances, as it has been proved by Dr. Gunther

interno de Brahms. Hildebrant. Heartbeats and breathing, for example,

have a proportion of four to one. Many bodily rhythms
Expondr ilustraciones de su obra en forma de
are coordinated to this proportion, especially while
diapositivas que leeremos en sincrona con la audicin
sleeping -so they do not run without coordination,
de pasajes entresacados de las cuatro sinfonas y tres
arbitrarely. (Besides this, the German physician, Hans
cuartetos del magistral compositor.
Weiers, experimented with success in the field of high
frequency radiations, and built a bio-oscillator which
applies radiations with two frequencies, forming a
quint). The harmonic bases are also very important in
821
music therapy, discipline which has been developed in cuatro a uno. Muchos ritmos del cuerpo estn
the last decades with great success. The Pythagorean coordinados a esta proporcin, especialmente durante
tradition already reported about the meaning of music el sueo - de modo que no corren sin coordinacin
for the healing process. To summarize these arbitrariamente. (Aparte de eso, el mdico alemn
discoveries, we can see that the same proportional laws Hans Weiers experiment con xito en el campo de las
or other very similar appear in all these sciences. The radiaciones de alta frecuencia y construy un
harmonic research shows analogies between different bioscillator, el cual aplica radiaciones con dos
sectors, connections which cannot be seen in the frecuencias - que forman una quinta). Muy importante
isolated sciences. tambin son las bases armnicas en la terapia musical,
que se ha extendido en las ltimas dcadas con cada
vez mayor xito. Ya la tradicin pitagrica reporta sobre
Son muchas las leyes armnicas en la naturaleza. Por
el significado de la msica para la curacin.
ejemplo: la fisiologa rtmica del hombre descansa
Resumiendo estos descubrimientos se ve que las
sobre proporciones sencillas que se pueden expresar
mismas leyes proporcionales u otras muy similares
casi solamente con los nmeros del uno al cuatro, de
aparecen en todas estas ciencias. La investigacin
manera que se trata sin excepciones de consonancias,
armnica muestra, analogas entre distintos sectores,
como lo ha demostrado ampliamente el mdico
conexiones que no pueden ser vistas en las ciencias
Gunther Hildebrant. Los latidos del corazn y la
aisladas.
respiracin, por ejemplo, tienen una proporcin de
822
 The Mobile Service was made possible because of the
3.1.- TECHNICAL AND MUSICAL ASPECTS -
ASPECTOS TECNICO-MUSICALE developments in modern electronic digital technology.
( CONFERENCE HANDOUTS)
We were able to plan a self-contained studio complete
with a great variety of musical instruments, of excellent

T EC H N O L O G Y I N T H E SER VI C E O F M U SI C quality, which could be driven to various locations.

T H ER APY WI T H PAR T I C U L AR R EF ER EN C E T O
"M I D I G R I D "
Already interested in the developments of colleagues in
M ARY E. ABBOTSON , RAYMOND A BBOTSON , ANDY H UNT Y the Music Technology Group at the University of York,
R OSS K IRK we decided that the options of the MidiGrid Program
offered the greatest scope, and should therefore be
included in the facilities to be used.
The North Yorkshire Music Therapy Centre was
established in 1987 with the two aims of establishing
Music Therapy in a largely rural area and to offer a new MidiGrid
concept of doing so by means of a self-contained
MidiGrid is a software system which allows composition,
Mobile Unit.
performance and improvisation. Its name originates
823
from the GRID of boxes on a computer screen and the consists of many boxes each containing a single note,
sound-source which is controlled via the standard MIDI the user may be considered a player-performer in the
interface. MIDI is an acronym for the 'Musical conventional sense. He or she moves the mouse and
Instrument Digital Interface' and is an internationally the notes are played in accordance with the layout on
accepted standard for connecting together electronic the screen. However, as the proportion of chords and
musical nstruments and computers. sequences on the grid increases, the player begins
more and more to take on the role of a conductor. The
The number of boxes on the screen can be altered and
MidiGrid boxes therefore offer an infinitely configurable
each one configured to contain notes, chords
palette of musical structures.
(comprising many notes and possibly many timbres),
and recorded musical sequences. The boxes are
primarily triggered by passing a cursor over them using
MidiGrid includes a real-time recording function which
a computer mouse and pressing and holding the mouse
allows whatever is played on the grid (or indeed from
buttons.
any external MIDI device such as an electronic piano) to
be recorded and the resulting sequence played into a
new grid box. This is now a separate musical entity
A MidiGrid user is able to merge the traditionally
which may be played, edited, replicated, and even
independent roles of the performer and the conductor
played in canon with itself. It can also be played
by controlling an electronic orchestra. When the grid
824
simultaneously with any number of other sequences, performer ever having to touch the computer.
chords and notes and the entire resulting musical piece
stored as a new sequence in another grid box.
The sensitivity of the mouse control can be adjusted for
the individual. This enables those with even the most
This allows complex timbral and temporal musical limited range of movement to operate the computer.
structures to be added to the palette. Because the
player triggers these events and hears the result
immediately, there is constant aural feedback thus Music Therapists have to serve the needs of a wide

making improvisation an integral part of the composition variety of human conditions and there are those who

and performance process. are best served by the simplest means. Midigrid
incorporates a facility for making up individual grids
The grid, in addition to being played by the mouse, can
which opens up the possibility for original creative work.
be controlled by the process of "keyboard mapping".
At the simplest extreme a grid could consist of only one
Any grid box can be 'mapped' to a note on an external
tone, to be incorporated into a musical texture as and
electronic instrument. This concept opens up a huge
when required.
range of possibilities as each note played by the
performer can now explicitly control or trigger a chord,
or a sequence or even an entire composition without the The North Yorkshire Music Therapy Centre already
825
possessed an electronic digital piano, which was
capable of receiving and sending MIDI, and was
The headmaster requested that when the Mobile Unit
equipped with its own amplifying speakers. Therefore to
became available, the service should be resumed and
complete the amount of equipment necessary we
we have now been working there for two years. The
added a computer and a sound module capable of
boys at this school are generally of exceptionally high
giving a great many different sounds and timbres; and,
intelligence. One of the boys we treat is already
of course, the MidiGrid program supplied in disc form.
achieving marks of over 60% in 'O' Level mathematics'
papers at the age of eleven.

Application

Our most immediate consideration was to discover if They are often gifted and idiosyncratic, their common
MidiGrid could help us in our work at a Residential features being a lack of self confidence and/or sense of
Special School for emotionally disturbed adolescent self worth. Some have been or are under Care Orders,
boys. Originally the boys were brought to the Centre, possibly resulting from abuse, and normal schools have
but the problem of bringing the boys a distance of over been unable to contain their often disruptive, violent or
50 miles each week proved too difficult for the school to anti-social behaviour. The use of word processors and
sustain. computers helps them produce their school work well,
as their presentation of work can otherwise be very
826
poor. It seemed reasonable to expect that our Music modification.
Computer might form a link with the boys' normal
As it is in the nature of music to discover solutions, the
educational tools.
positive experiences begin to usurp the negative ones
and in our joint musical explorations a rapport is formed
between the therapist and the boys, of trust and mutual
In treating such boys we always hope to involve them
respect. One boy entitled an improvisation "On the
sooner or later in free improvised music so as to give
horns of a dilemma!", which seemed to mirror his inner
them opportunity to release into it, if necessary, any
state.
build-up of emotional pressure and possibly trigger any
latent creative gifts. For the purposes of this short paper, our references will
be related to two boys who have opted to work on a
series of experiments in Music Technology.
MidiGrid, containing as it does, an enormously wide
range of melodic, rhythmic and chordal possibilities
combined with the tone colours provided by the sound The older boy, John, is just 13 years of age and we have
module, allows for the boys an infinite variety of musical been working with him for two years. Initially John was
invention. The capacity for recording and playback is so acutely withdrawn that we could hardly get a word
also an invaluable asset as the work is immediately out of him beyond a barely audible 'Hello'. He tended to
available for appraisal, discussion and possible isolate himself by experimenting with the Computer and
827
avoided verbal interchanges with the therapists. It was a each subsequent stage.
great step forward when we managed to get him to
make an announcement of the title and date of his work
into the microphone of our tape recorder for the In the final stage of "Factory, a piece consisting of

purpose of storing his work on audio tape. multi-layered sound effects improvised on the
computer, he felt that some unifying element was called
for and so he added a violin sound throughout the piece
At the beginning of the current academic year, we and a flute tune at the end.
asked John if he would like to embark on a series of
experiments in Music Technology which might be of
interest to our colleagues in the Electronics Department Gradually John became more relaxed and he is now

of the University of York. John agreed to do so, and with much more communicative. There is also a history of

the help of his Science teachers we arrived at a format violence, but as far as we are concerned we are dealing

for writing up the experiments, supported by an audio with a polite and well mannered boy. John's great

tape recording. interest is in science and his music has reflected this in
his naming an improvised piece 'Sky Lab'.

He has built up his music in stages and we have

discussed with him what he felt the music needed in John's growth in self-confidence is such that not only is
828
he self-assured in front of the video camera, but he will
also agree to talk to visitors about his use of the
The younger boy, Richard, has also been with us for two
computer. Recently he gave a demonstration to, and
years and we knew him first as a delightful but scattered
guided a visiting musician through the stages of making
nine year old.
an individual grid of sound patterns; John then
improvised at the piano, with the visitor using the grid.
Richard had been under a Care Order, and is also from
a broken home. His approach to the use of the
In the words of the Headmaster:
Computer was to use it as a game. He has led us
through many musical adventures. We have slain
dragons, cast spells and attempted a work of epic
"John has made quite marked progress in his
proportions in which we sank the Titanic. Not content
ability to relate 'peacefully' to his peers, and in his
with adding overtures to his music, Richard included an
general air of calm and growing happiness. There is a
"Underture" on one occasion.
real change at home also, where John, once the
'outsider', is now very much a part of the family unit, and
demonstrates the humour which he is now at last daring
Then one day last year, in a quieter mood when fetched
to show to the world."
for his session, Richard said that he would like to make

829
up a piece of music about the sadness of his early life.
The result was a haunting and evocative piece.
"Richard is much more relaxed generally. His
enuresis is less frequent and he no longer wets himself
during the day because of his high level of anxiety. I am
Richard's illustration on video shows him inventing
quite sure that his experiences with the North Yorkshire
another 'Fantasy' in his series of these improvisations.
Music Therapy Centre have played a considerable part
In the first stage of his work he uses voice and electronic
in bringing about this welcome change."
sound played from the piano and in the second, after
some consideration of the pitches, he chooses the four
hand chimes: B 4; C5; D 5 and F5 as additional tone
CARPETGRID
colours.
The MIDIGRID computer music instrument was
described above. In normal use, the musical content of
In a later version of the piece Richard makes use of a a cell is played by passing a cursor over the cell on the
visiting musician as an extra musical resource. screen using a computer mouse. So long as clients are
able to use this device adequately, they can participate
Richard's enthusiasm for Music Therapy does a great
in solo or ensemble performance using relatively simple
deal for the therapists and his report from the
movement patterns. Since the size and content of the
Headmaster is:
grid are entirely determined by the performer, these
830
patterns may be adjusted by a music therapist to allow various kinds of transducer to trigger cells, and so
support therapy programmes. to perform musical material. CarpetGrid is an example
of the extension of this type of system where pressure
This part of the paper describes further work which has
sensitive switches are hidden in carpet tiles which may
been carried out to make the MIDIGRID system less
be arranged in various ways by the therapist. A carpet of
dependent on the use of the mouse, in such a way that it
these tiles may be laid out on the floor so that
enables other kinds of movement to be linked to the
movement at a particular place will result in the
performance of music by the client: Examples of this
performance of a musical fragment linked to that
include dance, percussive gestures or simple rolling
position. The tiles could of course be placed in any
activities.
configuration to suit a therapist's requirements: under
As mentioned earlier in the paper, MIDIGRID has a
particular toys for instance, or on climbing apparatus, or
'keyboard mapping' function built into it which allows the
at different places in the room, including placements on
content of a cell to be played from a MIDI instrument
the walls. For example, transducers can be placed
such as a keyboard or windcontroller. The performer
inside a toy, where a squeezing, rolling or tilting action
nominates a particular MIDI note which will be used to
would activate the musical material in a cell.
trigger a specified cell and this can be done for all cells
on the screen.
Work is also in hand to allow transducers of other types
The work described here has extended this concept to
831
(pressure sensors, strain gauges etc.) which, it is experiences for those, who, but for our Mobile Studio
hoped, will extend the way in which therapists may link could not otherwise receive treatment, through the
musical expression with performance gestures. This application of this wonderful commodity we call "Music".
may then be tailored to the specific requirements of
By the time of the Conference we shall have carried out
individual clients.
further research into the use of the prototype model and
are particularly interested in the benefits to grossly
handicapped children such as are contained within
MidiGrid certainly challenges our musicianship and we
Special Care Units or who need permanent Hospital
are excited by the possibilities contained therein. It has
care.
increased the versatility and scope of the therapy
through the immediacy of access to an alternative world
of sound. What the therapists have enjoyed most is
combining the use of MidiGrid and the Sound Module I N F O R M AT I O N T EC H N O L O G Y AN D

with conventional instruments and we have had a lot of EXPR ESSI VE T H ER APY

fun converting our piano into, say, a pipe organ or even C LAUDIO C AVALLINI , BRIGITTE F LUCHER F EDERICO
an aviary full of bird song. We are continuing to find T USBERTI , FRANCO V ECCHI Y D ANIELE V ESCOVINI -
more ways of opening up musical possibilities which
may provide liberating and perhaps self-healing

832
INTRODUCTION AND BRIEF HISTORY instruments, but more for the opportunity that these
solutions would offer for reflection using new conceptual
The development of information technology in Italy was
instruments on old and new phenomena. From this they
first felt, (in terms of the spread of technology, the
would derive a greater richness of thought, action and
corresponding halo of technical-formal thought
motivation in a positive, (in our opinion), process of self-
necessary to use it and the cultural reflections that go
generating vitality. So, for the first time we were moving
hand in hand with every novelty), between the late 70's
towards terms, concepts and themes such as
and early 80's. In those days, our work, conducted
programming, flow-chart, electronic archive, simulation,
mainly in schools, allowed us to witness the wave of
telematic communication and others which after a while
contrasting emotional reactions aroused by the
became fixed areas of reference and applicative work.
unstoppable advance of technological equipment in the
The first personal data archives useful for daily work
face of which a state of unreadiness divided operators
were created.
into the three traditional categories: those who were
enthusiastic over the new, the demonists, and the The idea of constructing a databank devised in the form
"cautious" (we're waiting to see how it all ends). Our of a service open to the public took shape in 1988 and
work group sided with the enthusiasts, not so much the project was developed when the series of resources
and reflections accumulated during the previous period
through the desire to compete in colonizing (hence
were brought together.
violating) society with new and more sophisticated

833
- Among the resources we believe we have are: institutional planning as an efficient response to the
need to develop logical-formal instruments that could
* the development of an ideology aimed at
be wellmatched with the use of activities requiring clear
gleaning from technological solutions not so much the
relationship of the creative dimension. This guiding idea
aspect of practical and "local" use as the
remained a constant inclination in our work, even today
communicational-social dimension
as regards the attempt to "transversely" read the
* the development of tried and tested
diversities which characterize the theoretical and
hardware and software equipment slowly accumulated
applicative approaches of the various forms of recourse
over the years since the 80's
to non-verbal languages such as instruments used in
* contacts and acquaintances made within the rehabilitation, therapy and social integration, which
sector with experts who believed it to be of interest and characterize the panorama of experiences that may be
use to assist in the realization of what was previously listed in our country. We would not want to give in to
expressed in the form of an idea, then became a formal easy, superficial generalizations, but all too often it
project and finally developed into something concrete seems to us as though the predominant dimension in
resorting to different languages (music, theatre,
By information technology "material" we mean above all
painting, dance, etc.,) is something more like being in
"discipline of thought", (applicable in fields such as:
love with the chosen language combined with a
programming, simulation, modelling, data filing,
destinee who has some kind of difficulty, and a need for
communication), initially usable within the field of
834
self-expression, - where perhaps the weakness of the most people.
interlocutor allows greater ease of affirmation - than a
balanced application to verify behaviour on the basis of
meta-procedural reflections. In other words, research The technical beginning of the initial project required no

and motivation at the base of a what-how-why particular effort: electronic technology as a sector

component methodology. offered sophisticated solutions on the market, which

went far beyond all our imaginations, and indeed still
- With regard however to the reflections developed, we
does. The greatest problem lies in the fact that we are
list as follows:
not culturally motivated to interest ourselves in this,
* attention to the process of development (namely the given the special nature of the work carried out (which
territorial and institutional propagation) of art-therapy in tends to end with the operator-user, and, especially, in
Italy (courses, projects, operators, experiences,...) view of the particular type of scholastic and professional
training received: because cultural integration is felt in
* the dimensions, forms and structural aspects of the
the formation of operators, perhaps it is necessary to
phenomenon (projects to bring people together)
wait for the effects of the introduction in schools since
* the progressive overtaking of the restrictive concept of
the aforementioned 80's. The question with regard to
personal data archive or of local group to reach a wider
the economic side of project commencement is
field of vision which may be the concept of "service", of
different, in that it grieved us and still does limit us
informative communication "networks" accessible to
835
greatly in spite of the generosity of collaborators (and Mario Piatti, Prof. Gino Stefani, who, interested in our
suppliers). This difficulty has only been slightly project, encouraged our presence at training courses to
overcome thanks (for want of a better word) to illustrate the aim and the characteristics to those who
contributions from a few public organizations. These attended from all over Italy (25th July, 1990)
contributions were paid out for services carried out. We
have also recently appreciated a donation in the form of
a collection of obsolete cars which were no longer CRITERIA FOR PROJECT PLANNING

useful to the donating company.

Overcoming the concept of "electronic archive", and of

As time has gone by we have been encouraged to "registry" of data concerning art therapy was possible by

continue by several directors of services from Local bearing in mind two factors:

Authorities (Towns, Councils, Regions), from heads of 1. on one hand the theoretical assumption of making the
public services covering the schools, national health most of the cultural dimension of the technological
and social services sectors. instruments as a way of understanding them and

We must mention especially the directors of the courses conceiving their use and the overall plan aimed at

of Musicotherapy of the ProCivitate di Assisi (the exploiting those among the possible technical

director Dr. Nora Cervi, Dr. Pierluigi Postacchini, Dr. conditions and solutions that were most suited to the

836
production and maintenance of cultural situations. attention (and customers) was, and still is, that of
creating information technology stations aimed at
In other words, it is not the data itself which creates
collecting programmes for public perusal to which those
culture, but the project of managing the data and the
who were able to make a phone link using special
technical and technical-cultural operations that can be
electronic cards (modem cards) could gain access to be
carried out with the data.
able to exchange the said programmes and personal
2. on the other hand, research on any similar presences
messages in a sort of electronic post box. These
on the territory and comparison with their
solutions are called BBS (Bulletin Board System).
characteristics. Therefore we opted for something that
Information systems stations of this type rapidly diffused
was not just an archive for easy external reference, but
from then onwards, so much so that a few years ago an
which proved to be an instrument of communication
Italian magazine conducted a census to find that there
through which it was possible to talk to, question,
were 227 of these stations scattered all over Italy.
answer one or more interlocutors, leave specifically
addressed messages (according to the criterion: from To be more precise, the following distribution was given:
one person to another, from one person to lots of
(regions are listed in alphabetical order)
people and from lots of people to lots of other people.
Abruzzi = 5 Lombardia= 59
One solution adopted by many companies dealing in
Basilicata= 1 Marche = 4
hardware and software products to get people's
837
Calabria = 1 Piemonte = 22 These could have been, for example, didactic actions,
teledebates, and the like. Something like that is going on
Campania = 6 Sicilia = 3
right now (May 1993): it's a competition of which we will
Emilia = 24 Toscana= 20
talk a little more further on (see "Concorso Albero Amico
Friuli = 4 Trentino = 4 Mio": further details will be available in July.

Lazio = 37 Umbria = 2 The projectual concept developed showed an

interesting aspect which in part, and very slowly, we are
Liguria = 8 Veneto = 27
checking in practice now: it is again another relationship
TOTAL = 227 between data and data elaboration. A circular
Such rapid diffusion along with frenetic linking activity relationship of a recurring and generative nature.
encouraged us to adopt its model supposing it to be
extendable to our sector of interest. What we had in
Starting off with a certain amount of basic data (this
mind then was not just the agility of the means, which
certain amount is to be interpreted as being in a state of
promoted the collection of culture through the
constant, dynamic evolution, at least in a quantitative
possibilities of communicating in an informal manner
sense) which may be for example the result of a census
but also the opportunity of planning, with time, formal,
of the projects found in a given area - territory "A" -
organically-structured communication projects.
during the course of a given segment of time "T", a
838
census that obviously takes into consideration the forth other new data of the first type, or even new
themes discussed, the active experts, the institutions products constituted by new projects triggered from the
containing the projects censussed, and yet more processes we have described. Data and process thus
elements which we will not list here (the attached survey come to constitute a tightly bound material for which the
cards can be consulted), at the moment in which this definition can only be,
data is placed at the disposal of the applicants and
at times, according to the type of reading made. This is
constitute a typological space-time map, this data
not a new problem in information technology especially
makes up material for reflection and elaboration not
in information handling organizations geared towards
only in the technical-statistical sense but also in the
Artificial Intelligence.
"ideological" sense in that it is interpretive, as it may
prove to be the construction of a situational image and, For information completeness let's say that besides

starting from this, the decision and choice of those specific data (that most strictly inherent to the projects

attitudes or positions (this is an element of cultural of Art Therapy) is may be connected, in our opinion, to

participation), to be assumed and which/like other the data relative to other presences on a given territory

projects to be undertaken. (which-how many public and private institutions,

population and characteristics, number and type of
This process, currently more deducible than directly
services, and anything else may be considered as a
verifiable, constitutes another form of interesting data,
useful element to classify the phenomena in the best
in that it constitutes the living material from which burst
839
way, glean the intrinsic and extrinsic characteristics and
have the greatest possible number of indicators of
A. disciplines, artistic-expressive languages and
process and state.
activities (music, gesture, image - traditional and
electronic speech, theatre, dance, etc.,)

WHAT IS "ARTERMAP" ? B. categories of citizens in conditions of hardship,

suffering and/or who are social outcasts (those with
ARTERMAP (= Art-Therapy Map) is an electronic
mental disorders, handicapped persons, the aged, non-
archive installed on a personal computer (actual
Europeans, convicts, bed-ridden people, drug addicts,
memory capacity 90 MB - this is to be increased by the
and other specific categories to be defined each time)
end of the year). It may be consulted technically by
anyone who has at least three items (a computer, a C. criteria for intended use, effects of use, interpretation
modem card, a telephone) and accessed by authorized aspects in therapeutic and rehabilitative perspective,
persons (also by applying directly to the databank) who and in any case to promote the contents of paragraph
abide by the rules of use and have not already been A, and prove effective for the categories listed in
penalized or banned for misuse or misconduct. The paragraph B.
area of competence of the ARTERMAP service is
D. metadisciplinary and metacultural aspects
determined by the intersection of sets of keywords
defining: E. pertaining integrative, supplementary and

840
complementary components (in this sense interest is AIMS
focussed, for example, on environmental sound
ARTERMAP is a computerized centre whose main
pollution - the negative effect of the wild use of sound)
aims are summed up as follows: A. to track down, keep,
elaborate and to make available for reference and
diffusion quantitative and typological data on all that
ARTERMAP is for all those who need to collect
concerns resorting to expressive activities aimed at the
background information in the field of art-therapy and
general social promotion of categories of citizens in
similar, related sectors, and to communicate with
conditions of hardship and/or who are social outcasts,
qualified experts or those with institutional competence
with special attention to aspects of therapy and
regarding the subjects in question. ARTERMAP has
rehabilitation (declared such through projectual choice
been developed with the specific aim of promoting the
or simply because they were interpreted in this way,
exchange of physically and conceptually remote and
independently of the original intention).
isolated experiences to increase useful opportunities,
and exploit their intervention potential through effective B. to predispose a network of relationships and
social communication which thus far has been limited, communications with the range of institutional and other
latent and rather correlated. public and private interlocutors which can be
recognized and defined as being part of the competent
territorial resource system and/or pertaining to the

841
subject. ARTERMAP is complex and articulated as a result of the
variety of disciplinary sets concerning the use of art-
C. to take part in cultural promotion and
therapy.
production beginning with all published data and vice
versa, to produce data beginning with the current This is one of the reasons why we have preferred to
cultural context. include connecting collateral content rather than sever
the link circuits defined by contiguous but pertinent
subjects.
LIST OF INFORMATORY CONTENTS
Here is a list of titles of the areas of subjects which are
accessible for reference:
Firstly, we would like to explain that the term
01 Publications (biographies, articles, unpublished
"ARTTHERAPY" is a short, convenient title of a
works, theses)
summary nature used to define the entire range of
02 Picture library (list)
expressive languages (none omitted) aimed at
achieving rehabilitative and/or therapeutic objectives 03 Operators within the sector (register office and
according to the aforementioned dual perspective of the curriculums)
explicit declaration and/or later legibility.
04 Institutions (register office and description)
The field of competence and pertinence determined by
842
05 Projects (list and calendar) specified each time)

06 Advice for research work (applications for...) 08 Foreign affairs (a general, informative overview)

07 Recipient categories of assistance (set-up

procedures by draw) 09 Didactic page (experimental project on telematic
updating)
. 1. Handicapped persons (puberty, adult)
10 Information technology (specialist area of technical
.2. Mentally disturbed patients
support subdivided into:)
.3. Senior citizens
.1. Library of pertinent programmes
.4. Non-Europeans
.2. Library utility
.5. Preparation for natural childbirth
.3. Facts on the information technology sector
.6. Odontostomatology
.4. Simulation programmes
.7. Drug addiction
.5. Various (integrative category to be defined and
.8. Imprisonment specified each time)
.9. Hospitalized persons 11. Exchange of messages (electronic post: "from one
.10. Various (integrative category to be defined and person to everyone else", "from one person to several
843
people", "from one person to another")

12. Service messages (office information on public It is possible to link-up every day 24 hours a day,
and/or individual use) (except on Saturdays (from 8 a.m. to 2 p.m.) for routine
maintenance purposes).
13. Information on overall service (description and
instructions)

14. Request for the sending of printed matter (for PROTECTION

those who cannot use the telematic link-up)

15. Statistics (internal elaboration and extraction

The service is governed by the current laws on
of data from external sources)
telecommunications.
16. Legislation (regional and national regulations
Public use involves the observance of the principles of
pertaining to competent sectors) 17. Ecology (sound
behaviour which are not detrimental to persons,
and colour environment of architectural shapes).
institutions or the to service itself.
TECHNICAL AND ORGANIZATIONAL
ARTERMAP is not responsible for the observance of
CHARACTERISTICS OF THE SERVICE USING
these principles and regulations as far as its users are
TIMES
concerned, but it reserves the right to take legal action
against those responsible for any damage.
844
Access to data by individuals is subject to a recognition
process by means of a password reserved for and
COLLABORATION PROPOSALS
chosen by the authorized user. There are three
For fast, efficient territorial mapping of projects,
hierarchical access levels.
experiences, technical operators and institutions which
Promotion from one level to a higher level is decided by
are active/interested in art-therapy, ARTERMAP's
ARTERMAP taking into consideration a series of
research department has elaborated a few
valuative factors on correct use of the service.
collaboration proposals, some of which are advanced in
Subscription commences from the first Monday after
public and private organizations.
notice of payment has been received and IF THE
One of these concerns self-documentation: those who
APPLICATION FOR ENROLMENT IN THE SERVICE IS
wish to may enrol in the ARTERMAP archives
CORRECT AND COMPLETE.
(enrolment is free), by sending a curriculum on the ruled
Applications to join the list and for access to make
paper of the attached sheet "SELF-DOCUMENTATION
withdrawals should be addressed to:
FORM" (for individuals, or, if necessary, for
"ARTERMAP", BANCA DATI/BBS SULL'ARTE- organizations, or by completing the questionnaire on
TERAPIA, VIA FERRARA 99, 41100 MODENA the computer screen.

Payment is by postal order or non-negotiable bank draft In all cases, any requests for discretion made by the
to the order of the above. senders as to what data they wish to pass on to the
845
service without its being given public access will be projects: in this sense ARTERMAP is willing to receive
respected. and assess any ideas and proposals as well as to take
into consideration general declarations of availability
Obviously the service does not hold itself in any way
whilst waiting for the perfection of particulars.
responsible for the declarations made out by the
senders, in that it has neither the power nor the A project launched recently by ARTERMAP regards the
intention, nor the role to investigate the statements creation of an "Art-Therapy Historical Study Centre".
made. Those who are interested in taking part in this project
should submit a written application to the address
Should it be proved that written communication results
below.
in damaging or disturbing effects on the normal, correct
use of the functions of the service and/or users, the it is Any telephone requests for further information should
provided - except the public duty of resorting penal be made on Saturday mornings only between 9.30 a.m.
action - that the perpetrator be denied right of access and 12 noon. Written requests should be sent to:
and expelled from the service. Maximum severity is also
"ARTERMAP", banca-dati sull'arte-terapia, via Ferrara
placed on checking the particulars of subjects and on
99, 41100 Modena.
the correctness of use of the service.

Further peripheral collaboration procedures are

planned on the basis of occasional and permanent BETWEEN NEEDS AND INDICATIONS

846
There are sound underlying reasons for believing that on the existing systems with opportune means of
information systems able to register and presumably identification and description (questionnaires, circular
elaborate the relative local data should work, for charts, etc., whose standard headings (name, holding,
different reasons, with different technical and position, address, short background history, technical
organizational aims and modalities, within numerous features, volume of information, costs, objectives,
public and private associations and groups, operating in fields, developments, organization, requisites and
the various sectors. access procedures, etc., may be completed using a
series of projectable secondary entries handled by this
In consideration of world development with regard to
special work group.
"ArtTherapy", we ask ourselves what is actually the
current state of information technology and, if they exist, We ask ourselves which of these might be possible with
instruments for critical assessment and organic, unitary regard to the realization of a first computer-printed
publicizing of these means. document, and why not, computerized, subject to
updating once or twice a year?
If yes, we would like the existing documentation.
We ask ourselves what type of problems the realization
If not, the attention of interested, competent experts is
of international network links might create (after
focussed upon a census of existing specific information
interview checks) of the various procedures individually
systems currently in the world, which is feasible by using
adopted and studied on reciprocal compatibility).
forms of research with the aim of carrying out a census
847
The thought of creating a unitary network involves the individual local needs.
possibility of linking up with every part of the world to
It means thinking of an instrument which, besides
meet the needs for thorough research and, more
having the function of increasing therapeutic aspects,
importantly, if one believes the criterion of electronic
can effectively have, in the long term, the function of
post to be valid, it involves the possibility of being able to
contributing to prevention. In an age in which unease is
"chat" in real time.
recognized as an international constant the instruments
It involves an evaluation of projects (local, national, ready to face it must also consider these characteristics
international) and an evaluation and a re-planning of and consequently adapt themselves to them.
the didactic and cultural potential regarding themes of
the greatest social importance such as health eduction
or the role to assume during emergencies caused by "CONCORSO ALBERO AMICO MIO"

nature or conflict. Considering the fact that information technology

It means laying down the ideological and technological instruments were put at the disposal of disabled

bases promoting a passage from single, unrelated local subjects by the USLs in Italy to promote the

projects to a single, organic, yet articulated, authorized development of communicational possibilities, on the

system such as an international service, but which is at occasion of a competition on trees organized by a

the same time autonomous and respectful towards district of Modena (S. Agnese), our association offered
to be the go-between to allow disabled people to enter
848
and take part by means of a personal computer along BIBLIOGRAPHICAL. NOTES
with a modem card to send works (letters, drawings,
Luciano Galliani, Il processo e il messagio, Cappelli,
music, etc.,) elaborated using this instrument, without
Bologna, 1979
having to move from their homes to do so. An attempt
has been made to promote intrapersonal Giovanni Lariccia, Le radici dell'informatica, Sansoni,

communication and the Firenze, 1981 interview with Dr. Benenzon on "Il
Giornale della Musica", April 1993
participation of the cultural group via a form of "telematic
animation". One may ask how far this is pertinent to a
concept traditionally understood as Art-Therapy. We
M U SI C AN D SO F T WAR E
believe that many forms of communication and
relationships that can be created through these means A NDREW C LEATON , ROSS K IRK , ADELE D RAKE
are still to be analyzed as far as the potential, the new
characteristics and the new contexts they develop, are
The computer should no fonger be viewed as an
concerned.
'unfeeling' piece of machinery, but a powerful
sophisticated musical instrument capable of meeting
virtually any requirement in order to improve qualty of
life. (Fitzwilliam A. 1988 Journal of British Music

849
Therapy Vol 2 No1) resources. MIDI (Musical Instrument Digital Interface) is
a universal industry standard communication protocol
which enables electronic musical instruments to be
"Music and Software"
connected together and linked with computers. The
benefits of this type of technology may be summarised
as follows:
This workshop will enable participants to spend time
with experienced practitioners in the field of music
technology and gain "hands-on" experience of different
Sound
systems as well as learning more about, and
Advances In synthesis and sampling technology have
responding to, some of the issues raised in this abstract.
provided us with instruments
There will be a short film of the compositional process
within our workshops which will demonstrate the which come with many varied, exciting and dynamic
creative involvement in music-making by children and sounds. From instrumental simulations (such as flutes
adults who are physically disabled. and pianos) to strange new textures, the player is
encouraged to explore and manipulate the medium of
Music Technology offers the therapist or educator a
sound. By using the technology of microphones,
vast selection of powerful tools
samplers and, signal processors one is not restricted to
which may be adopted as an expansion of current
those sounds programmed by the manufacturers but
850
may involve everyday sounds from the world around us from the constraints of "real time" by the typing in of
in the process of music making. Indeed, the stimulus of instructions or even graphic "drawing" of musical events
having the sound space (apparently) transformed into on the screen.
the interior of a vast cavern has proved to be highly
motivating to even the most timid of vocalists.
Interfaces

Having established the usefulness of the computer in

Control
managing musical situations the problem which
Computers excel at controlling complexity and are remains is whether or not the user can control the
therefore highly suited to the task of managing the computer. This problem can be regarded as twofold -
subtleties and nuances of music. Linked to a musical the accessibility of the software (ie how the liser
instrument the computer can, by using appropriate MIDI instructs the system) and the feedback which the user
software, capture all the shades of expression in a receives from the system. The usual methods of
pefformance. More importantly, the software gives the controlling a computer are via a QWERTY keyboard
musician the ability to edit and manipulate his music in and a desktop mouse. There are, however, many
the same way that a writer uses a word processor. For different interfaces which enable even the most
those lacking in performance skills, the computer severely physically disabled to access and control every
affords the opportunity to create a piece of music away aspect of the cornputers operation, Trackerballs,
851
suck/blow mechanisms, touch screens, switches and need no longer "start from scratch" at the beginning of
ultrasonic controllers all have their place in the each session. In this respect the computer is an
therapist's tool kit. assistant with endless patience. This ability to archive
material has implications for record keeping

and assessment.
However the apparent complexity of many software
packayes can be somewhat daunting to the
professional musician let alone the novice. It is the
Teaching and Resource Materials
responsibility of software developers to devise systems
which present the user with relevant information in the Perhaps one of the reasons why music technology is

most understandable form. not more widely used in educational and therapeutic
situations is that having been introduced to the potential
of such systems many people react by saying "That's all
Storage and Retrieval very well. Now I know what

One facet of microtechnology which proves to be the technology can do, but what do I actually do with it in
extremely valuable s that of data storage. Work may be my sessions?" In order to address this problem, the
saved to disk and recalled at a later date allowing the Drake Rescarch Project is concerned that the spread of
user a real sense of progress and development. One music technology is supported by a cornprehensive

852
programme of training and resource material - in the where previously simplepercussion, vocal, or listening
form of videos, work-cards, handbooks and computer work would have been the only available musical
files which may be applied to particular needs. experience. Moreover, by blurring the distinction
between music and dance, the creative and therapeutic
potential of the system is further widened.
U N L O C KI N G M U SI C AL I T Y: U SI N G
SO U N D BEAM AS A N EW KEY T O EL O Q U EN C E.
Within the western musical tradition, it is often the case
T IM S WINGLER that only those who have acquired a prescribed set of
technical and expressive skills are deemed to be
'musicians'. Those (the majority of people) who fall
The development of ultrasonic Soundbeams to play
outside this category are disempowered by this
electronic musical instruments at a distance and without
tradition, becoming consumers rather than creators of
physical contact has historically been undertaken with
music.
professional dancers in mind. However, for children
(and adults) with a range of physical, behavioural or
learning disabilities this technology has proved to have This is the first of two important barriers to
an unexpected and dramatic significance. Genuine, selfexpression through music, and is principally
creative music-making possibilities are now possible concerned with perception - our perceptions about our
853
own musical potential, about the extent to which we may creative and interpretative role is increasingly shifted
feel we are 'allowed' to be musical; and others' away from the client with more profound levels of
(teachers', therapists') perceptions about musical disability.
validity and 'correctness'.

There is a second obstacle to musicality which may

This allocation of creative 'power' may have no clinical
often have a particular relevance where there are
or therapeutic rationale, it may simply result from what
explicitly therapeutic objectives. This second barrier
is physically possible.
goes up where there is a physical disability which
prevents manipulation of, and articulation through, But can ways be found to make the tools of musical

musical instruments. expression through active performance more

accessible? Does technology have any answers?

These factors have important ramifications in therapy,

because the less the client is able to 'say something' Experience with the SOUNDBEAM midi-controller in the

with sound, the heavier becomes the therapist's UK and elsewhere, principally in special schools and

responsibility for empathy and interpretation. The main hospitals, suggests that the ability to control sound and

focus and engine for the mood and meaning of the music by moring in space creates a new expressive

music which is happening is on the therapist, and this medium with massive potential as an empowerer and

854
as a motivator. Cascades of sounds and notes and relatively simple and inexpensive home keyboards to
musical flights of fantasy which under normal professional studio-quality synthesisers, samplers and
circumstances could only be realised by accomplished expanders.
musicians can be triggered and controlled with minimal
movement.
The system incorporates three principal control
Improvisation, what Christopher Small (1) describes as
parameters. Variations in RANGE settings allow the
a "journey of exploration (where) we obtain glimpses of
length of the beam to be varied between 0.25 and
glittering new lands", is central to this work.
metres. Shorter beams concentrate note information
into a relatively small space, a setup which has proved
to be of significant value where players' ability to move
SOUNDBEAM works by emitting an invisible beam of
expansively may be limited by disability (2). Longer
high frequency sound (ultrasound) inaudible to human
beams allow a complete performance space to be 'live'
ears. The ultrasonic pulses are reflected back into the
with sounds (3).
device's sensor by interruptions of and movements
within the beam. Information about the speed and
direction of this movement is translated into a digital
MODE settings govern the realisation of note
code (MIDI) which is understood by a growing
information contained in the beam. Each of the ten
proliferation of electronic musical instruments, from
Mode presets comprises four variables: the number of
855
notes potentiated (between one and sixty-four), the
relationship of those notes to one another (scales and
In a sense, Soundbeam is a highly sophisticated
arpeggios), the articulation required to activate the note
development of the selected-scale musical activity
(the dynamics of the movement in relation to the
which is commonplace in many junior and special
sensor), and secondary information such as pitchbend
educational contexts (4), but it does so in a way which
and modulation depth.
introduces a radical element of compositional and
improvisational freedom, whilst at the same time
encouraging expressive movement.
TRANSPOSE settings allow semitonal modulation of the
scales contained within the beam, useful where the
beam is played alongside other electronic or acoustic
In addition to the ten resident Soundbeam 'memories' it
instruments.
is also possible to load a user-defined sequence of
notes into the beam. This has the benefit of enabling a
considerable degree of compositional exploration
Up to three add-on 'Slave' units can be attached to the
without the necessity for a commensurate level of
basic system. Thus it is possible to have four beams,
keyboard skill: an idea can be programmed in at the
each of different length, each angled in a different
user's pace and then performed in real time with dance
plane, and each with its own sound or 'voice'.
or simple movement.
856
For many children using Soundbeam is likely to against traditional music curricula or existing
introduce fresh vistas of aural texture, shape and therapeutic approaches. Technology should not evolve
colour. This will mark a significant point of departure to replace what has gone before, but rather to
from their previous experience of playing and listening, compliment it. The temporal experience of music which
because Soundbeam (used on its own and without any happens in percussion work is enriched by the spatial
live or electronic percussion accompaniment) has no experience of music, the symbiosis of movement and
memory of rhythm, phrasing or tempo. Much of our sound, which happens with Soundbeam.
early musical experience has a very strong rhythmic
dimension, and whilst it is clear that this is something
which is both accessible to and enjoyed by children, this This workshop will include an introduction to the

focus on rhythm may also be a reflection of the musical operation and performance on the system and some

resources which permit fairly immediate participation, examples on video of Soundbeam's use in the field of

and which have traditionally been available to teachers special needs as well as in dance and performance.

and therapists. There will also be opportunity for 'hands-on' experience.

This notion of 'what has been available' compared with References

'what is available now' is not intended as an argument 1. SMALL, CHRISTOPHER: Music, Society, Education.

857
John Calder 1977. p. 176. M U SI C AN D T R AG ED Y / M SI C A Y T R AG ED I A

2. WILSON-HINDS, ROGER: An objective appreciation D ENIS A NDR C ASAGRANDE

of Soundbeam. Unpublished field trial.

3. LEE, PATRICK: Ten More Minutes. Dance

Tragedy was born from the "spirit" of music by the
performance at the Fourth International Computer
double effect that is offered by the music phenomenon:
Music Conference, Keele University, 26.1.91.
in the other words, music produces a plot (originated
4. WYATT, JAN: Music as a Language in 'The Creative from the musical insinuation) and at the same time
Tree' ed. Levete, G. Michael Russell 1987. Pp.105-106. surrounds it trhough its plastic capacity, giving to the
plot its complete essence.

Looking on tragedy as integral part of the universal man

3.2.- CULTURE, MUSIC AND MUSIC THERAPY
- CULTURA, MUSICA Y MUSICOTERAPIA and, therefore, inseparable from the human nature, a
( ABSTRACTS) very closely harmony is found between music and our
inner world (emotions) that is then represented by an
object (music).

Our proposal consists of making possible the

experiments of the tragic world of man (his existencial

858
problems) and of the concerning group through a
musical sonorous situation.
La Tragedia naci del "espritu" de la msica por el
Then the theme to be perfomed arises and begins to doble efecto que el fenmeno musical proporciona: que
embody between the music therapist and the group. es simultneamente criar una trama (nacida de la
sugestin musical) y la capacidad plstica de la msica
The favorable tragic situation is only possible when
en adornar tal trama y conferir a sta toda su esencia.
there is harmony between the dramatic story and the
musical sonorous integrant parts. Considerando el trgico como categora del humano
universal y por eso indisociable a la propia condicin
As shown, a favorable environment is created so that
humana, se establece de esta forma un estrecho
each nember of the group during the experi-ments
vnculo entre la msica y nuestro mundo interior
begins to take part in the plot, incorporating and
(emociones) dando a este una representacin, un
recreating it.
objeto (msica).
At first, this exercise begins with a kind of entertaining
La propuesta del trabajo consiste en posibilitar que el
game; changing in words what is suggested by sound
contenido trgico del individuo o grupo en cuestin sea
and music, and also practices the listening of silence by
vivenciado en un contexto sonoro-musical. La temtica
changing into music and sounds what has not been
a ser desarrollada emerge y toma forma cuando hay el
said.
encuentro entre el musicoterapeuta y el grupo.
859
La esfera trgica propicia al trabajo solo es posible AN AL YSI S O F M O T I O N I N T H E T H ER APEU T I C
cuando hay adecuacin perfecta entre el texto N O N - VER BAL C O M M U N I C AT I O N PR O C ESS /
dramtico y el componente sonoro-musical. As se cra AN L I SI S D EL M O VI M I EN T O EN EL PR O C ESO
una ambiente favorable para que los participantes, en D E C O M U N I C AC I N T ER APU T I C O N O -
el desarrollo del trabajo, intervengan, asuman toda la VER BAL
trama, apropindola y recriminndola.
A LICIA C OPPO
Eso es ejercitado por el juego ldico de verbalizar lo
que el sonido y la msica sugiere, as como ejercita la
escucha del silencio transformando en msica y The body is in constant motion. Through it, the
sonidos lo que no ha sido dicho. individual relates with the internal and external worlds.
Each individual has, at the same time, a functional and
expressive content with which communicates through
its postures and movements. This communication is
changing permanently according to the receptor.

These changes of articulation are read by means of

signs, traces, and bodily symbols.

We call sings to the movements that have a cultural

860
origin, and their reading answers to a psychosocial and
ethnic language.
El cuerpo est en constante movimiento. A travs de l,
Traces have an emotional and affective meaning el individuo se relaciona con su mundo interno y el
(uncouncious), Their primary purpose is not to mundo exterior. Cada individuo posee a la vez un
communicate, but to serve us aa a psychophysiological contenido funcional y expresivo, con el cual se
reading. comunica a travs de sus posturas y movimientos. Esta
comunicacin est en permanentes cambios de
Symbols: to distinguish them allows us to separate the
acuerdo al receptor.
intentional symbolizations from the involuntary with a
symptomatic value. Estos cambios de articulacin son ledos mediante los
signos, indicios y smbolos corporales.
From all the above the non-verbal communication is
enriched, and it is possible to observe how these three Llamamos signos a los movimientos que revisten un
elements share a daily life inside the body language. We origen cultural y su lectura responde a un lenguaje
will be able to observe and to sharpen the attention to psicosocial y tnico.
the different changes within the tonic range of the body,
Indicios poseen un significado emocional y afectivo
and to facilitate the resources to be used in a Music
(inconscientes). Su finalidad primaria no es la de
Therapy treatment.
comunicacin pero sirven de lectura psicofisiolgica.

861
Smbolos: distinguir stos nos permite descubrir las The author analyzes the importance that music therapy
simbolizaciones intencionales de las involuntarias con will have as an indispensable therapeutical procedure in
valor de sntoma. the third millennium.

De lo expuesto se llegar a enriquecer la comunicacin This work is based on historical data which prove the
no-verbal y observar cmo estos tres elementos intrinsical relationship between sound which vibrates in
conviven a diario dentro del lenguaje corporal. Esto nos all the Universe and its reflection on the microcosms of
permitir observar y agudizar la atencin en los mankind and the growing collective awareness which
distintos cambios dentro de la gama tnica del cuerpo y tends to consider symbolic language, that is, the
facilitar los recursos a utilizar dentro de un tratamiento language of the world, as a language of angels in which
musicoteraputico. music, as sound, rhythm and vibration, is inserted.

In the age of Aquarius, the roads of evolution and

philosophical search will be part of the area of Art, and
M U SI C T H ER APY I N T H E T H I R D M I L L EN N I U M /
the ways of healing will have returned to their roots in
L A M U SI C O T ER API A EN EL T ER C ER M I L EN I O the past, to their origins which technological

E LISABETH D OS S ANTOS F ELICIO development have condemned to oblivion. The idea is

to determine the angle at which music and therapy unite
in order to assist a society which is opening up to holistic

862
understanding. Basndose en datos histricos, que atestiguan la
relacin intrnseca del sonido que vibra en todo el
The conclusion is that, in order to be able to fill this
universo y el reflejo de todo ello en el microcosmo
space adequately, the music therapists of today must
representado por el hombre y con la creciente
feel the need to become aware of the fact that we are
expansin de la consciencia colectiva que se inclina a
the instruments of a huge orchestra whose creative and
considerar el lenguaje simblico, o sea el lenguaje del
boosting force was a vibration that expanded towards
mundo, como el lenguaje de los ngeles en el cual la
us and beyond.
msica como sonido, ritmo y vibracin est introducida.
Sound and light are one unique vibration, and that
En la era de Acuario los caminos de la evolucin y las
vibration is the origin of the Universe. Between those
bsquedas filosficas estarn a cargo del Arte y los
two points, there is a path on which we stand, and
caminos de la curacin volvern a las races del
where we have the privilege of using this vibration as a
pasado, a los orgenes, lo que el desarrollo tecnolgico
working tool.
haba hecho olvidar. Se trata de ver el ngulo en el cual
la msica y la terapia se unen para atender a una
La autora analiza la importancia que la musicoterapia sociedad que se abre a la comprensin holstica.
podr asumir como indispensable forma de
Se concluye que, para este espacio se llene
procedimiento teraputico en el tercer milenio.
adecuadamente, es necesario que los

863
musicoterapeutas de hoy sientan la necesidad de The object of research of the work is the analysis of the
concienciarse de que somos instrumentos de una gran different components of the individual of the urban
orquesta cuya fuerza creadora y propulsora fue una society. We mean to consider the different aspects of
vibracin que se expandi hasta nosotros y as this acoustic product, the inclusion of mass media in the
sucesivamente. relation between use and production, creativity
orientated towards consuming, the way we listen to
Sonido y luz forman una nica vibracin y la misma es
sound messages, the technological "dopings", the
el origen y el destino del universo. Entre estos dos
stereotyped musical codes.
puntos hay un camino en el que nos encontramos, con
el privilegio de utilizar estas vibraciones como The attention is concentrated above all upon the
herramienta de trabajo. "passive" listener, the most exposed to the breaking
effects of non "consumed" emotions. The aim of this
report is to underline how we should expect to find in
M ASS M ED I A AN D SO U N D I D EN T I T Y / M ASS music therapy work a pathologies (strees, noise,
M ED I A E I D EN T I D AD SO N O R A marginating, exasperated individualism). The new
pathology is marked by an adaptation to the acoustic
R ENATO D E M ICHELE
peak, a difficulty in concentrating on the sound event, a
refractoriness in working out sound-emotional lived
experiences, a denial of the possibility of
864
communicating with one's own self and the others experimentadas.
through sounds.
La finalidad del trabajo es la de poner en evidencia
como en la prctica musicoteraputica tendremos que
esperar encontrarnos cada vez ms, aadidas a las
Objeto de la investigacin de este trabajo es el anlisis
patologas urbanas (estrs, ruidos, marginacin,
de los distintos componentes del condicionamiento del
individualismo exasperado), la patologa musical
individuo en la sociedad urbana.
"mass-mediatizada" caracterizada por la dependencia
Tienden a considerarse los distintos aspectos de este de la contaminacin acstica, la dificultad de
bombardeo acstico y entre ellos la funcin de concentracin respecto al hecho sonoro, el rechazo
"vendibilidad" del producto acstico, as como la para con la elaboracin de vivencias emotivo-sonoras y
insercin de los medios de masa en la relacin entre la negacin de la posibilidad de comunicar consigo
uso y produccin, la creatividad dirigida al consumo, el mismo y con los dems a travs de los sonidos.
modo de escuchar el mensaje sonoro, los mensajes
tecnolgicos subliminales, los cdigos musicales
estereotipados.
T O WAR D S A U N I VER SAL T H EO R Y O F M U SI C
El foco esta encendido sobre todo hacia el oyente T H ER APY: A M U L T I C U L T U R AL APPR O AC H /
pasivo, ms expuesto a los efectos H AC I A U N A T EO R I A U N I VER SAL D E T ER API A
desestructuralizantes de las emociones no
865
 M U SI C AL : U N AC ER C AM I EN T O cultural settings.
M U L T I C U L T U R AL

J OSEPH M ORENO La ponencia estudiar la msica como terapia desde

las perspectivas de la prctica de la musicoterapia, la
teora y la investigacin modernas, en comparacin con
The presentation will consider music as therapy from
las prcticas y la teora implcita en la utilizacin de la
the perspectives of both modern music therapy
msica en las prcticas tradicionales de curacin de las
practice, theory and research, in comparison with the
culturas indgenas de todo el mundo. Al comparar estos
practices and theory implicit in the use of music in
dos paradigmas -como contextos convergentes o
traditional healing practices in indigenous cultures
divergentes pero igualmente vlidos- es posible aislar
throughout the world. By comparing these two
los elementos comunes y universales de la msica
paradigms, as reflective of differing by equally valid
como terapia que transciende los prejuicios culturales
cultural contexts, it becomes possible to isolate those
que conforman los mundos asumibles de cada sistema.
common and universal elements of music as therapy
Esto nos lleva al desarrollo de una teora universal de la
that transcend the cultural biases that inform the
musicoterapia, que puede ser aplicable y pertinente a
assumptive worlds of each system. This leads us to the
toda persona en cualquier entorno cultural.
development of a universal theory of music therapy that
can be applicable and relevant to all persons in all
866
 T H E SI N G I N G T H AT O PEN S T H E H EAR T : integral approach- not frequently used in the field of
T R AN SPER SO N AL SI N G I N G / EL C AN T O Q U E musical education.
ABR E EL C O R AZ N : EL C AN T O
We will experiment with the diversity in the use of the
T R AN SPER SO N AL
voice in millenary cultures such as India, Africa, Tibet,

S ILVIA N AKKACH and also the harmonic subtleties of Gregorian chants,

Afro-Brazilian jazz, native and Eskimo songs, and the
tonal purity of Norwegian and Armenian songs. The
"The heart is a pearl that looks to God". combination of rhythm and the ease of the voice during
Ibn Arab the sonorous trip propitiates the collective intuition,
expanding the borders of the personal creativity.
The Healing and Liberating Energy of the Voice
A goal of this workshop is to revitalize a more positive
A focus integrating the expression and the listening with
concept about the possibility of singing and creating
the conscience and the self-help; towards a universal
music, understanding the spontaneous composition
vocal music as a way to obtain the genuine
and the improvisation as a liberating art, a form of
consciousness of the Human Being.
personal transformation.
In this workshop we will be able to develop our capacity
"to realize" through different techniques of musical
participation which emphasize a multi-ethnic and an
867
"El corazn es una perla que mira a Dios". Ibn Arab voz en el viaje sonoro, propicia la intuicin colectiva
expandiendo las fronteras de la creatividad personal.
La Energa Curativa y Liberadora de la Voz.
Un propsito de este taller es re-vitalizar un concepto
Un enfoque integrador de la expresin y la escucha con
ms positivo acerca de la posibilidad de cantar y crear
la conciencia y la auto-asistencia. Hacia una msica
msica, entendiendo la composicin espontnea y la
vocal universal como va al conocimiento genuino del
improvisacin como un arte liberador, una forma de
Ser.
transformacin personal.
En el Taller podremos trabajar nuestra capacidad de
darnos cuenta a travs de diversas formas de
participacin musical que enfatizan un abordaje
EXPR ESSI O N AN D I M PR ESSI O N I N BAR O Q U E
holstico y multi-ethnico - poco usado en el campo de la
M U SI C / EXPR ESI N E I M PR ESI N D E L A
educacin musical.
M SI C A BAR R O C A
Se experimentar la diversidad en el uso de la voz en
J OS L UIS P ALACIOS G A R O Z
culturas milenarias como India, frica, Tibet, as como
la sutileza armnica del canto gregoriano, el jazz afro-
brazilero, los cantares indgenas y esquimales, con The problem of semantics in music - an abstract and
pasajes por la pureza tonal de los cantos Noruegos y universal language of feelings - oscillates, as every
armenios. La combinacin del ritmo y la soltura de la other language, between two mutually implied poles:
868
expression and impression.

Traditionally, music therapy has been working on this El problema de la semanticidad de la msica -lenguaje
latter aspect, ignoring the complementary pole universal, abstracto, del sentimiento- oscila, como todo
altogether. lenguaje, entre dos polos implicados mutuamente: la
expresin y la impresin.
However, in baroque music, so used nowadays by
music therapists, expression was an integrated part of Tradicionalmente, la musicoterapia ha venido
the musician's craft. trabajando esta ltima, descuidando su
complementaria.
In this report, it is my intention to show, in its general
lines at least, the baroque musical vocabulary: the Sin embargo, en la msica barroca -hoy tan utilizada
attempt by the composer to concrete the abstract in por los musicoterapeutas- la expresin era parte
musical language by means of several clearly integrante del "oficio" de msico.
delimitated "effects", through melodic, harmonic,
A travs de esta comunicacin, me propongo dar a
dynamic, rhythmic, colour and theatrical resources.
conocer, al menos en sus lneas generales, el
Perhaps we will discover in this way how baroque music vocabulario musical barroco: el intento del compositor
expresses and impresses on us certain sensations and por concretar lo abstracto del lenguaje musical en
feelings. diferentes "efectos", a travs de recursos meldicos,
armnicos, dinmicos, rtmicos, tmbricos y teatrales
869
perfectamente delimitados. The concept of sound identity (ISO) formulated by
professor Benenzon radically and satisfactorily
Quizs entonces sabremos las razones secretas por
describes the individual's phenomenological sound
las que la msica barroca expresa e imprime en
identity during his/her philogenetic and ontogenetic
nosotros determinadas sensaciones y sentimientos.
development.

Starting from studies and research carried out on the

T H E O N T O PSYC H O L O G I C AL C O N C EPT O F field of sound identity, this paper poses the following
SO N O R O U S I D EN T I T Y: EXPR ESSI O N O F T H E questions:
I N D I V I D U A L `S O R I G I N A L I N W A R D N E S S O R 1) Is there a universal rhythm, characteristic of human
M U SI C AL SEM AN T I C S / EL C O N C EPT O
cells, which may be used as a measuring unit of health?
O N T O PSI C O L G I C O D E L A I D EN T I D AD
2) Is it possible to get to know such rhythm scientifically
SO N O R A: EXPR ESI N D E L A
and to reproduce it so as to be able to apply it in music
I N T ER I O R I Z AC I N O R I G I N AL D EL I N D I VI D U O
therapy?
O SEM N T I C A M U SI C AL
Ontopsychological Theory applied to music therapy
M ARA P ICCOLO
praxis, to which the author refers by means of her own
professional experience, leads to an affirmative answer.

870
Inside the most advanced music therapy El concepto de la identidad sonora (ISO) formulado por
methodologies, the concept of sound identity in el Prof. Benenzon, describe radical y satisfactoriamente
ontopsychological terms is an original and innovative la identidad sonora fenomenolgica del individuo, en el
result for two reasons: curso de su desarrollo filogentico y ontogentico.

1) it is based on the criterium of biological health Partiendo de los estudios e investigaciones efectuados
according to nature; en el campo del ISO, el presente trabajo plantea
algunos interrogantes:
2) it contacts and involves the subject beyond any sign
phenomenology, that is, in the universal aspect of the 1) Existe un ritmo universal caracterstico de las
being. clulas humanas, que pueda ser utilizado como medida
de la salud?
Ontopsychological methodology considers the music
therapist's conscious health as an indispensable 2) Es posible conocerlo cientficamente y reproducirlo,
assumption. The music therapist opens him/herself to para aplicarlo a la musicoterapia?
standard sound identity readings, and becomes the
La Teora Ontopsicolgica aplicada a la praxis de la
provoker, stimulator and warranter of his patients'
musicoterapia, que la autora relata a travs de su
health.
propia experiencia profesional, conduce a una
respuesta afirmativa.

871
Dentro de las ms avanzadas metodologas de la O N T O PSYC H O L O G I C M U SI C T H ER APY /
musicoterapia, el concepto de ISO en clave M U SI C O T ER API A O N T O PSI C O L G I C A
ontopsicolgica es un resultado original e innovador por
M ARA P ICCOLO
dos motivos:

1) se basa en el criterio de la salud biolgica segn la

naturaleza; The workshop is divided into two parts.

2) se permite el contacto e implica al sujeto ms a la de Part I: The music therapist plays several rhythmic
cualquier fenomenologa de signos, o sea en el aspecto sequences so as to sensitize the participants to the
universal del Ser. internal echo of sounds in the various organs of the
body. The objective is to tune everybody's organism to a
La metodologa ontopsicolgica tiene como supuesto
healthy rhythmic-biological musicality, or health ISO.
imprescindible la salud consciente del
musicoterapeuta, que se abre a la lectura del ISO, Part II: Now "sound communication" may start from a
llegando a ser provocador, estimulador y garante de la universal informatic-type basis which has been
salud de sus pacientes. constituted in part I.

The music therapist plays several rhythms following a

natural intention as if he sensed the "here and now" of
the music therapeutical moment in the bodies and
872
emotions of the participants. The participants, who are comunicacin sonora".
constantly tuning and homologating their own sound
El musicoterapeuta toca diversos ritmos siguiendo la
identity, or subjective ISO, to the rhythm proposed by
intencionalidad natural como si presenciara en los
the music therapist as a response to his intrinsic
cuerpos y en las emociones de los participantes el "aqu
demands, act out the perception and action unit which
y ahora" del momento musicoterpico. Estos,
constitutes the basis of health for a social operative
sintonizando y homologando continuamente su propia
creativity.
identidad sonora, o ISO subjetivo, al ritmo propuesto
por el musicoterapeuta como respuesta a su exigencia
intrnseca, actan la unidad de percepcin y accin que
El taller se divide en dos partes.
constituye la base de sanidad para una creatividad
I Parte. El musicoterapeuta toca diversas cadencias operativa social.
rtmicas en modo que sensibiliza a los participantes a la
resonancia interna de los sonidos en los diversos
rganos del cuerpo. El fin es sintonizar el organismo de
cada uno en la musicalidad rtmico biolgica sana, o
ISO de sanidad.

II Parte. De la base universal de aspecto informtico,

constituida en la primera parte, puede iniciar ahora "la
873
 M U SI C T H ER APY I N A C O N T EXT O F PO L Y- Let us analyze what space would be granted to music
EXPR ESSI O N / M U SI C O T ER API A EN U N therapy in the other associated techniques and how it
C O N T EXT O PO L I - EXPR ESI VO could be used to profit within the groups. In other words,
how could sound be conjugated in conjunction with
L IANNA P OLYCHRONIADOU - PRINOU
other means of expression, for example:

- Music therapy and corporal expression

The goal is to improve quality of life and inter and
- Music therapy and drawing,
intrapersonal relationships.
- Music therapy and plastic expression
Such objectives have made me:
- Music therapy and therapeutical work with masks
1) exploit the wealth of resources of poly-expression
(both reference to their making and to their use),
methods, among which music therapy occupies a place
of privilege. - Music therapy and literary expression - Music
therapy and stage expression.
2) realize how important it is that the therapist may
always be available, and that he may be adaptable to * The importance and complexity of affective life and
the group's external demands and preferred means of that of the environment, the role played by conflictive
expression. (these are qualities which it will be situations in the genesis of disturbances impose the
necessary to enumerate). search and use of all possible verbal and non verbal
874
means of expression and communication directed terapeuta y de su adaptabilidad a las demandas
towards helping those who need us. internas del grupo as como a las modalidades de
expresin preferidas. (Cualidades necesarias a
* Musical expression, a language which, in principle, is
enumerar).
not verbal, has its origin in affective life and can be
transformed into a source of motivation for any other Analicemos cul sera el espacio otorgado a la
means of expression. musicoterapia dentro de las dems tcnicas asociadas
y cmo podra ser aprovechada en los grupos. Dicho de
otra forma, cmo podra articularse lo sonoro con las
El objetivo que me he fijado tiene dos caras distintas: dems modalidades de expresin, por ejemplo:
una teraputica y otra pedaggica. En cualquier caso,
- Musicoterapia y expresin corporal
la meta es mejorar la calidad de vida y las relaciones
inter e intra-personales. - Musicoterapia y expresin pictrica

Estos objetivos me han llevado a: - Musicoterapia y expresin plstica

1) Explotar la riqueza de los recursos de los mtodos - Musicoterapia y trabajo teraputico con mscaras
poli-expresionales entre los que la musicoterapia ocupa (tanto en su fase de elaboracin como de utilizacin)
un lugar privilegiado.
- Musicoterapia y expresin literaria
2) Darme cuenta de la imprescindible disponibilidad del
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- Musicoterapia y expresin escnica. 3.2. CULTURE, MUSIC AND MUSIC THERAPY -
CULTURA, MUSICA Y MUSICOTERAPIA
* La importancia y la complejidad de la vida afectiva, la ( CONFERENCE HANDOUTS)
trascendencia del medio-ambiente, el papel de las L A EXPR ESI O N C O R PO R AL EN I A F O R M AC I O N
situaciones conflictivas en la gnesis de las D EL M U SI C O T ER APEU T A
turbaciones, imponen la bsqueda y la utilizacin de
todos los posibles medios de expresin y comunicacin G REGORIO T ISERA

verbales y no verbales destinados a ayudar a los que

nos lo piden.

* La expresin musical, lenguaje en principio no verbal,

1. INTRODUCCION
tiene su origen en la vida afectiva y puede
transformarse en una fuente de motivacin para Ante todo debemos tener perfectamente claro de qu

cualquier otra forma de expresin. manera funciona y reacciona nuestro cuerpo desde el
punto de vista psico-biolgico (psiquico, fisiolgico,
neurolgico). Slo comprendiendo la biologia (fisiologia
y psicofisiologia) del cuerpo tendremos la posibilidad de
lograr una visin profunda y global de la multiplicidad de
la expresin corporal.

876
 nervioso vegetativo funciona segn el principio de
prioridades, cuyo orden est determinado en cada
2. PERCEPCION
situacin por las necesidades biolgicas primarias. Slo
Nosotros percibimos nuestro medio ambiente y a
a travs de tcnicas como las descriptas bajo el rubro
nosotros mismos slo a travs de nuestro cuerpo.
Ejercicios (5.1.) es posible ejercer una cierta influencia
Las sensaciones son el resultado de estimulos, tanto conciente sobre los procesos vegetativos.
provenientes del propio cuerpo como del medio
ambiente, que llegan a los rganos sensoriales
2.1. FORMAS DE LA PERCEPCION
(viscero, propio o exteroceptores), los cuales
transforman a los estimulos en impulsos que son Algunos de estos impulsos son llevados hasta centros
trasmitidos por el sistema nervioso hasta distintos nerviosos superiores o hasta la corteza cerebral, donde
niveles del mismo. No todos estos impulsos llegan a son registrados de dos formas:
nivel conciente, sino que forman parte de diversos
mecanismos de funciones vegetativas (las que
mantienen al cuerpo vivo y funcionando). El sistema 2.1.1. Registro neuro-fisiolgico, es decir como

vegetativo de regulacin no es dirigido ni influido percepcin conciente de un acontecimiento.

concientemente. Pareciera como si la "naturaleza" no

confiara en el raciocinio del hombre. El sistema
877
2.1.2. Registro psico-f isiolgicos como vivencia las ordenes motoras, nos referimos al sistema nervioso
agradable o desagradable. de la vida de relacin, pues este representa para
nosotros la nica relacin posible con el mundo exterior
y con nuestro propio cuerpo.
2.2 EL ROL DEL SISTEMA NERVIOSO

Nosotros no disponemos de otra forma de percepcin

3. INTERACCION ENTRE EMOCIONES Y CUERPO
que sta. El sistema nervioso desempea aqu el rol
ms importante, pues es el que recibe las A principios de siglo Wilhelm Reich comenz a observar
informaciones, tanto del mundo interior como del que todos sus pacientes con trastornos emocionales
exterior,las transmite a centros nerviosos (por las vias presentaban tambin graves estados de tension
sensoriales o aferentes) para su evaluacin, muscular. Sus observaciones pusieron de manifiesto
elaboracin y coordinacin y finalmente envia las an otras relaciones entre el cuerpo y la psiquis y sobre
rdenes a los rganos efectores correspondientes (por esta base desarroll su concepto de la "coraza
las vias motoras o eferentes). Cuando todo esto sucede muscular".
sin haber llegado a la conciencia hablamos del sistema
Otro pionero en este campo fue Moshe Feldenkrais
nervioso vegetativo, es decir de la parte regulativa,
quin se bas en la suposicin que el organismo
automtica, inconciente. Si la informacin sensorial se
humano nace con el "miedo a caerse" y asi inicia el
registra concientemente y se envian voluntariamente
proceso de crecimiento y de aprendizaje. El nio
878
aprende a funcionar corporalmente y aprende al mismo travs de trastornos psquicos y psicosomticos
tiempo a conocer todos los efectos emotivos que
acompaan al aprendizaje corporal. Para desarrollar la
totalidad del potencial somato-psiquico es necesaria, 4. NIVELES DE COMUNICACIN

segn Feldenkrais, una reeducacin del sentido En los seres humanos existen siempre dos niveles de
cinestsico y de la regulacin muscular. comunicacin. Uno es el verbal; el otro es el no-verbal,

Los afectos son estados reactivos intensos y de corta la expresin corporo-sonoromusical.

duracin (por ejemplo: alegra, ira, odio, miedo). Esto lo podemos constatar en casos de graves
Generalmente van acompaados de reacciones discapacidades, en las que frecuentemente el lenguaje
psicomotoras y vegetativas. crporo-sonoro-musical representa la nica posibilidad

Los estados emocionales producen efectos en el de comunicacin con el medio.

cuerpo. Las emociones slo pueden reprimirse durante Lo primario es el cuerpo, no la palabra.
un cierto tiempo sin que se manifiesten de alguna
Nuestro cuerpo reacciona siempre de manera
manera, pues esta represin engendra una tensin que
espontnea, no puede engaarse no puede mentir
trata de descargarse hacia afuera. Si intentamos
como lo hacen nuestras palabras.
bloquear esta tensin, se produce una sobrecarga de
los distintos rganos del cuerpo que se expresa a Los sentimientos, emociones, deseos, se expresan as
a travs de nuestro cuerpo. Lo que nosotros llamamos
879
lenguaje crporo-sonoromusical es la expresin visible solamente con estructuras ritmicas y espaciales, sino
y audible de nuestra vida o mundo interior. con estados de nimo y estados afectivos. La
fundamentacin de la expresin corporal en esta
carrera se basa en la premisa que la msicoterapia se
5. FORMACION DEL MUSICOTERAPEUTA EN
mueve en un contexto predominantemente no-verbal.
EXPRESION CORPORAL
La interaccin entre pacientes y msicoterapeutas se
Dentro de la formacin de msicoterapeutas, la realiza sobre todo a travs del lenguaie crporosonoro-
capacitacin a travs de la asignatura "Expresin musical.
Corporal" tiene como objetivo, intensificar y entrenar la
capacidad perceptiva y expresiva, a fin de poder recibir,
5.1. EJERCICI0S
interpretar y utilizar dentro del contexto de la
msicoterapia, las seales crporo-sonoro-musicales Los ejercicios prcticos tiene la finalidad de desarrollar
de los pacientes tanto como las suyas propias. la conciencia y percepcin del propio cuerpo, la
capacidad de observacion critica y autocritica, la
La expresin corporal en la formacin del
capacidad creadora y expresiva:
msicoterapeuta utiliza el recurso de iniciar a los
estudiantes en determinados ejercicios que tienden a
transformar al propio cuerpo en un instrumento de
5.1.1. Ejercicios de concentracin mental en los que la
expresin y percepcin. No se trata aqu de trabajar
880
vivencia concentrativa del propio cuerpo conduce a una
experiencia global del esquema y la dinmica
5.1.3. Ejercicios de relajacion por medio de tcnicas
corporales. El provocar voluntariamente cuadros en la
concentrativas para lograr una intensificacin de las
imaginacin implica una gran cantidad de contenidos
vivencias sensoriales de la funcin muscular;
que no son directamente voluntarios.

5.1.4. Eiercicios sensoperceptivos, que consisten,

5.1.2. Eiercicios respiratorios en los que se pueden
desde el punto de vista psico-fisiolgico, en un
utilizar trminos sugestivos como por ejemplo: la
entrenamiento prctico que permite introducirse
inspiracin nos da energia, vitalidad, alegria a travs de
sugestivamente en un estado mental y concentrarse
la absorcin de oxigeno; la espiracin representa una
concientemente en las percepciones endosensoriales
reduccin de la energia, pasividad, prdida de vitalidad,
en estado de inmovilidad, de relajacin y de inhibicin
pero tambin liberacion del aire acumulado, de
de estimulos externos;
contenidos estancados; contener la respiracin
coadyuva a la concentracin; a travs de esta
detencin el cuerpo trata de bloquear todo tipo de 5.1.5. Ejercicios expresivos para desarrollar la
estimulo y flujo de informacin para tomar una capacidad creativa y expresiva del cuerpo humano a
determinacin en un estado de calma total; travs de la improvisacin de juegos individuales y/o de

881
relacin con los dems.El cuerpo humano se desarrolla E1 dominio de este lenguaje nos da informaciones
asi en todas sus capacidades como instrumento importantes sobre los estados interiores, orientaciones
comunicativo basndose en la sensibilidad, en el y enfoques, tanto propios como de nuestros pacientes.
pensamiento y en la reflexion.
E1 conocimiento de la expresin corporal, de ese
lenguaje mudo de sensaciones, sentimientos y
emociones expresado a travs del comportamiento de
6. LENGUAJE Y LENGUAJE CORPORAL
nuestro cuerpo, abre vias ms directas para la
Nosotros dedicamos tiempo y energa para aprender
comunicacin y en la relacin mutua entre las
muchas cosas que consideramos tiles. Adems de
personas. Asi, una mirada, un giro de la cabeza, un
nuestra lengua materna queremos aprender otros
gesto de acercamiento, un ademn de rechazo, dicen
idiomas. Asi el lenguaje corporal se va convirtiendo
mucho ms que mil palabras. Tambin podemos decir
poco a poco en un idioma extranjero. Dado que no
que a travs de las experiencias y reacciones del propio
podemos prescindir de, ni reprimir este medio de
cuerpo las informaciones sobre los matices del
comunicacin crporo-sonoro-musical (y mucho
comportamiento humano nos llegan con ms nfasis y
menos an el msicoterapeuta),es de fundamental
ms exactitud que a travs de las observaciones del
importancia aprender a utilizarlo.
mundo exterior. No existe prcticamente un ser
humano que pueda sustraerse a las posibilidades
expresivas de su propio cuerpo o a la percepcin de los
882
mensajes que envan en gran escala otros cuerpos. sentimientos y emociones del paciente, casi como si
fueran los propios.

7. EXPRESION CORPORAL EN LA CLINICA

8. ORIGENES DE LA EXPRESION CORPORAL
Nosotros observamos un paciente, sus reacciones y la
situacin (el "aqui y ahora"), lo cotejamos con nuestros Nuestra expresin corporal representa el origen
conocimientos adquiridos y con las observaciones que biolgico y cultural de la comunicacin no verbal. Se
hemos realizado, es decir, con toda nuestra manifiesta a travs de dos tipos de reacciones:
experiencia previa. Verificamos de qu manera
corresponden a este paciente y a esta situacin.
Intentamos interpretar estas sensaciones y, en ciertos 8.1. Reacciones primarias o congnitas (tambin

casos, traducirlas en una expresin corporal. En esto llamadas instintivas).

nos ayuda nuestra formacin, pues a diferencia del Algunas de las seales que emite el cuerpo son
paciente, ella nos permite conocer el flujo incesante de congnitas, como ciertas expresiones faciales de los
contraccin y relajacin de nuestros msculos y su sentimientos. Se ha observado:
accin coordinada, y poder dirigirla concientemente. Asi
no slo surgen gestos y ademanes, sino que podemos
reproducir en nosotros mismos los pensamientos, 8.1.1. que estas expresiones son muy similares en

883
todos los pueblos y culturas, flirtear. Este tipo de expresiones corporales son
primariamente resultado de la evolucin

8.1.2. que se manifiestan ya en nios de corta edad (se

encuentran presentes incluso en bebs ciegos y sordos 8.2. Reacciones adquiridas o reflejos condicionados,
de nacimiento que no podrian haberlas aprendido por que forman la mayor parte de la mimica, gestos y
imitacin) y, ademanes que hemos incorporado a travs de la
imitacin y la educacin.
8.1.3. que ciertas expresiones faciales humanas son
muy similares a las de los primates. Se ha podido seguir
la pista de algunas de ellas a lo largo de la escala
En las seales correspondientes a ciertos gestos
evolutiva. Estas caracteristicas son vlidas para las
existen diferencias marcadas entre los distintos
expresiones faciales ms importantes y para la risa y el
pueblos. Aqui se trata de componentes de la
llanto.
comunicacin adquiridos culturalmente, es decir que
Irenus Eibl-Eibesfeldt (1972) ha encontrado una son el resultado del desarrollo historico del individuo
difusin universal de la llamada "elevacin de cejas". En dentro del medio que lo rodea.
este gesto, comn a la especie humana y a los monos,
la cejas suben bruscamente durante una fraccion de
segundo (aproximadamente 1/6 seg) al saludar o 8.3. En otros casos, como por ejemplo en las
884
formalidades de saludo entre los humanos, ambos seales del cuerpo y del comportamiento. Comunicarse
factores el biologico y el cultural, o sea el congnito y el quiere decir interpretarlas correctamente y responder
adquirido, desempean una funcin importante. en forma inteligible (verbal o no-verbal). En este
proceso se produce siempre una real imentacin (
feedback) . Por esta razn debemos prestar atencin a
9. EL CODIGO DE LA EXPRESION CORPORAL
las seales que nosotros emitimos corporalmente.
Estas reacciones muestran nuestras sensaciones,
sentimientos, emociones y, a pesar de toda la
10. EL ESQUEMA CORPORAL
subjetividad e individualidad que involucran,
representan un cdigo generalmente aceptado. Pero El esquema corporal es la imagen subjetiva externa
esto significa tambin, que inversamente, los patrones conocimiento y la vivencia del propio cuerpo. Schilder
de movimientos que hemos incorporado condicionan a fu uno de los precursores en el estudio del esquema
su vez los sentimientos, sensaciones y emociones, corporal . En su trabajo " Ilusin y Conocimiento" (1918)
tanto nuestros como de las personas con quienes nos public los resultados de sus estudios sobre la
relacionamos. fenomenologa de la conciencia del yo corporal,
llegando a la conclusin que en su constitucion, la
imagen del propio cuerpo es un fenmeno psicolgico.
En el lenguaje corporal, percibir significa reconocer las
Es una diferenciacin gradual de una impresin
885
primero vaga e indefinida, a la que se agrega material corporal. Las investigaciones de Schilder y
de experiencias visuales y cinestsicas. Cada colaboradores representan el primer intento
impresin recibida implica una respuesta motora, pero sistemtico de describir los complejos fenmenos de la
cuenta ms la impresin que la respuesta motora. En percepcin y conciencia del cuerpo. Herta Lange-
un extenso estudio realizado en colaboracin con Hoff, Cosack (1952) public un trabajo sobre sus
Schilder (1927) demuestra el rol preponderante del investigaciones en nios discapacitados fIsicamente.
tono muscular en la representacin del esquema Mientras estos nios modelaban plastilina, observo que
corporal. En otro trabajo se estudian las percepciones a menudo reproducian inconcientemente la forma de
del interior del cuerpo, que se vivencia como una masa su propio esquema corporal. Los investigadores K.
pesada, entremezclada con imgenes visuales y Poeck y B. Orgass (1964), a travs de sus
acompaada de una sensacin global de vitalidad. La observaciones de nios normales y ciegos, llegaron a la
percepcin de los rganos se localiz conclusin que el esquema corporal debe madurar de
aproximadamente a 2 cm de la superficie externa del forma autnoma como funcin cerrada. Recordemos el
cuerpo; la vivencia de la piel era difusa, sin limites informe personal de la MT 0felia Herrendorf (1991)
precisos y estaba debajo de la superficie conciente o sobre su trabajo con jovenes drogadictos en el
imaginaria del cuerpo. Es de hacer notar que ciertas CENARES0, Buenos Aires. Al pedir a los pacientes que
enfermedades orgnicas del encfalo y tambin ciertas modelaran en plastilina su propio cuerpo con ojos
lesiones medulares, perturban o destruyen el esquema cerrados, observ que habia una correlacin muy

886
estrecha entre las formas realizadas y la vivencia agrupamiento bien definido. Lo ms prximo a este Yo
interior de cada uno sobre su cuerpo. ficticio es la musculatura esqueltica, pues su funcin
habitual nos da la falsa impresin de movimiento
10.1. REPRESENTACION GRAFICA DEL ESQUEMA
voluntario. Un poco ms alejado del punto terico del
CORPORAL
Yo, vemos al sistema cardio-circulatorio que an est
en relacin permanente y directa con la vivencia del yo.
Dib. pg 7 De acuerdo a las observaciones cotidianas, clinicas y
experimentales, la relacin del Yo con los procesos
vegetativos generales es menos directa.
Visualizamos mejor este escalonamiento ordenando al Comparativamente el esqueleto de sostn se
Yo ficticio y los diversos sistemas orgnicos en una encontraria en la zona ms alejada.
serie de circulos concntricos. Podemos intentar,
siguiendo a J.H.Schultz (1931) representar
grficamente el esquema corporal desde un punto de 11. ESPACIO Y EXPRESION CORPORAL
vista psicofisiolgico. Imaginemos un esquema grosero
Los limites entre expresin corporal y comunicacin
del cuerpo con la conciencia del Yo y sus sistemas
tactil no estn claramente definidos. a primera vista
funcionales, y cuales de estos sistemas se encuentran
puede parecer dificil establecer la relacin exacta entre
ms prximos a este Yo esquemtico. Esto nos da un
el espacio personal o individual, las zonas individuales
887
o territorio por una parte y la expresin corporal por de espacio. " El Homo sapiens obedece siempre
otra. Sin comprender los principios bsicos (frecuentemente sin saberlo) instintos milenarios que
involucrados en estos conceptos no es posible prever estn incorporados a su herencia biolgica."
qu sucederia cuando estos espacios son usurpados.
Nuestras reacciones ante una intromisin en nuestro
territorio estn en relacin directa con la expresin 11.2 PROXEMIA

corporal. El etlogo austriaco Konrad Lorenz dice en "Das

sogenannte Bose" (1963), su libro ms difundido,
(traducido al castellano baio el titulo "Sobre la agresin:
11.1. TERRITORIALIDAD
el pretendido mal") que "el comportamiento del ser
El ornitlogo ingles Eliot Howard (1920) fu un humano, sobre todo su comportamiento social, est
precursor en este campo y sento las bases tericas del suieto an a leyes dominantes del instinto que se han
concepto de territorialidad. Poco tiempo despus el desarrollado en el largo proceso de la historia de las
noruego Schielderup-Ebbe (1922) public "La especies de los seres vivos".
psicologia social del gallinero", seguido por Desmond
Otro investigador en este campo fu Edward Hall, que
Morris con "El mono desnudo" y "El zoolgico humano",
public "El lenguaje del espacio" (1963) y acun el
obras que fundamentan detalladamente el
termino "proxemia" (el estudio del comportamiento
comportamiento animal y humano referido al concepto
humano en determinadas zonas espaciales). El autor
888
sostiene que " todo lo viviente tiene un limite fisico que espacio corporal. Las categorias de distancia
lo separa de su medio exterior. Cada organismo tiene representan la forma de codificar la magnitud de la
una delimitacin perceptible que marca su comienzo y distancia que separa un objeto o un acontecimiento del
su fin. Sin embargo existe en cada punto de la escala ncleo central del cuerpo. Magnitud en este contexto
evolutiva una especie de limite no fisico que es denota una definicin de distancia vivenciada o
independiente del limite fisico. A pesar que este lmite concebida comportamentalmente ms que
es ms dificil de definir, no por eso es menos real. Lo cuantitativamente.
que encierra este limite es llamado el territorio de un
organismo. E1 hecho de reclamar y defender un
espacio determinado es lo que se conoce como 11.4. DELIMITACION DE LOS ESPACIOS

territoriali dad" . El espacio interno o personal (del propio cuerpo)

denota el espacio entre el ncleo interior del cuerpo y la
piel (ver esquema corporal). Las caracteristicas
11.3 LIMITES Y ESPACIOS
cuantitativas del espacio interno tienen alguna
En un estudio publicado en Estados Unidos sobre importancia sobre todo para los muy gordos o muy
lmites y espacios que stos definen, Spiegel y flacos; pero la existencia de cualquier obieto o
Machotka (1974) encuentran que su significado se movimiento dentro de este espacio es de importancia
hace evidente en el caso de los radios de distancia del primordial para el individuo en cuestin,
889
independientemente de sus dimensiones corporales. El por medio de dispositivos o instrumentos (prismticos,
espacio interno es la ms ntima y personal de todas las radio, televisin).
zonas distribuidas concntricamente alrededor del
El espacio perimetral o limbico no es accesible a la
ncleo interior.
percepcin o a los procesos sensoriales y debe ser
E1 espacio proximal o parcial se define como el que completado por medio de fantasias.
existe entre el cuerpo y sus coberturas de ropa, pelo,
vello u ornamentos, o como el brea fisicamente
indeterminada pero psicolgicamente muy restringida 11.5. REPRESENTACION GRAFICA DE LOS

adyacente en forma directa a la piel. A este espacio ESPACIOS

pueden ingresar las secreciones del espacio interior o Dib. Pg 10

puede ser invadido desde el espacio axial o total.

El espacio axial o total es el rea controlada por brazos

12. CONSIDERACION FINAL
y piernas extendidos, es decir el espacio abarcado por
el desplazamiento corporal. Por esta razn es un La expresin corporal en la msicoterapia es un

espacio mvil y de forma irregular. proceso psicobiolgico con tecnicas propias aplicadas
al cuerpo o que deben ser aprendidas por el cuerpo.
E1 espacio distal abarca el mundo que se puede
conocer y percibir. Es posible ampliar su radio de accin
890
BIBLIOGRAFIA IBID - The case of Nora, Harper & Row, New York, 1977

ALEXANDER, Gerda - Eutonie, Copenhagen, 1945 GUIRAUD, Pierre - Le langage du corps, Presses Univ.
de France, Paris, 1980
ARGYLE, Michael - Bodily communication, Methuen &
Co., London, 1975 HALL, Edward - Proxemics: A study of man s spatial
relationship, Intl.Univ.Press, 1963
BIRDWHISTLE, Ray - Kinesics and context, essays on
body motion communication, Univ. Pennsylvania Press, HERRENDORF, Ofelia - Trabajo con jovenes
Philadelphia, 1970 drogadictos en el CENARESO, Buenos Aires,
comunicacin personal, Rosario, 1991
BONNAFONT, Claude - Les silencieux messages du
corps, Editions Buchet/Chastel, Paris, 1977 HOWARD, Eliot - (citado por Bonnafont, C.),1920

EIBL-EIBESFELDT, Irenaus - Hombre preprogramado: LABAN, Rudolf von - Kunst der Bewequna, Florian
lo hereditario como factor determinante en el Noetzel Verlag, Wilhelmshafen, 1988
comportamiento humano, Alianza, Madrid, 1972
LANGE-COSACK, Herta - Untersuchunqen an
FELDENKRAIS, Moshe - Body and mature behaviour, krperbehinderten Kindern, Dtsch. Ver.
Intl.Universities Press, New York, 1949 Jugendpsychiatrie, Marburg, 1952

IBID - Awareness through movement, Harper & Row, LEONHARD, K. - Ausdruckssprache der Seele, Karl F.
New York, 1972 Haug Verlag, Berlin, 1949
891
LORENZ, Konrad - Das soaenannte Bose, Deutscher 1918
Taschenbuchverlag, 1963
SCHJELDERUP-EBBE - Sozialpsychologie des
LOWEN, Alexander - The language of the body, Collier, Huhnerstalls, Hans Huber Verlag, Bern, 1922
New York, 1958
SCHULTZ, J.H. - Das autogene Training: Konzentrative
IBID - The betrayal of the body, Collier, New York, 1969 Selbstspannuna, Thieme Verlag, Stuttgart, 1931

MOLCHO, SAMY - Krpersprache, Mosaik Verlag, SPIEGEL, J., MICHOTKA, P. - Body language, The Free
Munchen, 1983 Press, New York, 1974

MORRIS, Desmond - Der nackte Affe, Droemersche ___________________________

Verlagsanstalt Th. Knaur, Munchen, (sin fecha)

IBID - Der Menschenzoo, Ebenda, (sin fecha) L A T R AN SI C I O N EST ET I C A: I N D I C I O S D E U N

POECK, K., ORGASS, B. - (citado por Schultz, PEN SAR EST ET I C O EN M U SI C O T ER API A

J.H.),1964
G USTAVO R ODRIGUEZ E SPADA
REICH, Wilhelm - Character analysis, Orgone Institute
Press, New York, 1949
De la existencia del discurso no-verbal: el arte
SCHILDER - Wahn und Erkenntnis, Springer, Berlin,

892
La postulacin de algn caracter, alguna descripcin, Vamos ahora con lo dicho por Eliseo Veron (La
alguna palabra, algn gesto, acerca de cierta entidad Semiosis Social 1987): "Configuracin espacio-
nos sita, en una especie de reaccin, en un punto temporal de sentido".
definido del universo. Este movimiento, convierte de la
Por otra parte, Heinz von Foerster dice sobre el tema
cosa en objeto. Este objeto, ahora, es un decir. Un
que es una descripcin a partir de la eleccin de un
discurso.(Def. de discurso en 'De Popper a Coltrane..."
lenguaje, que hacemos del orden-complejidad del
jornadas A.MU.R.A. 1991). Tomemos a ttulo de ejemplo
universo. ("Desorden-Orden, descubrimiento o
algunas definiciones de Discurso y algunas
invencin? "Stanford International Symposium 1981 no
observaciones sobre el tema, desde ngulos diversos:
edit.).
La primera es de Oscar Massota (introduccin a la
lectura de J.Lacan 1970) dice: "Un discurso es una Ernst von Glaser-sferd, hablando del conocimiento nos

concurrencia de mensajes enlazados por una relacin dice "El saber es construdo por el organismo viviente

pluridimensional y bidireccional constituyendo una para ordenar lo ms posible el flujo, de por s constante,

secuencia articulada donde, a la altura de uno o de la experiencia, en hechos repetibles y relaciones

cualquiera de sus estados, siempre es posible realizar, relativamente seguras" (Introduccin al

o se halla ya realizado, la conmutacin (sustitucin) del Constructivismo radical" en La realidad inventada P.

significante". Watzlavick 1988).

Agregaria aqu el apoyo de una definicin de msica de

893
Pierre Schaeffer: "La msica es la organizacin de la En el caso de material no-verbal sonoro corporal, el
materia sonora en el tiempo". Acotemos que al hablar problema se plantea dada la imposibilidad de descifrar
de materia sonora, hablamos de material significante. este qu.

Parece entonces razonable pensar que la materia Por mucho tiempo hemos intentado esta traduccin, y
significante, fuere la que fuere, de constituirse an hoy insistimos en esto, por cierto, y gracias a Dios
apropiadamente, quiero decir formalmente, se puede sin xito.
pensar como discurso. Cualquiera que fuere.
Si el problema para considerar esta organizacin de
Pero ocurre que estas formas, estos discursos, cuando material significante no-verbal o diferente de la palabra,
se constituyen con materia significante diferente de la sonoro corporal, como discurso, radica en que no
palabra, e inclusive cuando son palabra pero con puede contestarse satisfactoriamente a la cuestin de
peculiaridades especiales, tal es cierta poesia, parecen Qu es lo que dice, como se planteara en trminos
no decir nada, nos plantean un problema intelectivo verbales, el conflicto puede allanarse con relativa
que no podemos salvar, aparentemente. facilidad considerando que la pregunta es
improcedente. No se puede jugar al ajedrez con las
Suponemos que cierto relato verbal de lo que ocurre
reglas del tenis, porque reglas y juego son lo mismo. O
dice que ocurre, o por lo menos parte de ello. Alude a
para mejor decir: se co-pertenecen.
un sujeto sintctico, con cierta identidad, del que se
predican determinados accidentes. E1 lenguaje verbal que contestara esta pregunta es
894
quien la crea, de tal suerte que constituye un sistema fundamentales enunciaciones lgico-sintcticas a las
cerrado pues solamente se puede contestar a una que no se puede evadir sin entrar en territorios del Arte
pregunta verbalmente formulada con sus mismas o la locura. (Identidad, causalidad, linealidad temporal,
reglas sntcticas. etc.)

Estas reglas implican algunos principios, axiomticos De aqu derivan otras cuestiones en las que
en tanto las constituyen, (necesitan de ellos pues la intentaremos abrir sentidos durante el trancurso del
sintaxis y la gramtica dependen de ellos), de cierta trabajo, por ejemplo: Cmo responder a los
linealidad temporal, de cierto respeto por el principio de requerimientos del mtodo cientfico con el discurso del
causalidad, de una identidad, es decir de sustantivos. Arte? Como saber cuando es la verdad, puesto que
las certidumbres cientficas son lgicas y verbalizables?
E1 nombre de la cosa34. Todo nombre es un recorte del
Cmo dar cuenta de lo que hacemos en funcin de
todo, una especie de eleccin.
algn saber mas abarcativo, una teoria general, o un
En el contexto del discurso no-verbal, vemos
conjunto articulado de ellas?
suspendidas, no negadas ni afirmadas, ciertas
Lo que no es posible decir: otra vez el arte
34
Si bien existe un intento de anlisis del D.S. derivado del lenguaje,
respetando o analogando el analisis de las, oraciones lingusticas a la
msica, resulta en extremo dificil sostener comparaciones de este orden,
aunque parezcan, en algunos anliss agregar algn grado mas de Hasta aqu intentamos acordar en la existencia de un
inteleccin al discurso sonoro.
De todas maneras el intento de "sustantivar" fragmentos del discurso discurso no verbal, tal vez sonoro corporal. Hemos
sonoro es el punto en que se traban todos los esfuerzos "traductivos"
895
dicho que el material significante diferente de la palabra tienen equivalentes en discurso del Arte. No hay razn
puede constituirse en discurso, como en el Arte, y para endilgarle al discurso del Arte los mismos
diremos que no es posible sostener como nica presupuestos axiomticos sobre los que se construye
descripcin de la cosa al discurso verbal. Ni como nico la sintaxis de un idioma.
objeto discursivo posible.
Esto es, "hablemos lo que hablemos...la experiencia de
Los dichos de un artista sobre su obra, sus la msica seguir lejana. Vedada a la palabra de los
explicaciones, o las de los crticos, o la de los hombres."(cit "De Popper a Coltrane..."199l). E1 peso de
musicoterapeutas, no son un "...espejo del mundo, sino la existencia del Arte es lo que hace tan contundente
una cosa ms agregada al mundo." (Jorge Luis Borges esta posicin, y tal vez sea el lugar ms slido desde el
"Una Rosa Amarilla". El Hacedor ). cual observamos. Es una epistemologa 35.

Constituido como objeto discursivo, como metfora, el Este es un punto nodular en esta ponencia. Hablamos
objeto de la Musicoterapia, y definido como discurso de un salto de tipo lgco en el pensar
no-verbal, tal vez sonoro corporal, vemos que es
imposible responder a una peticin tal como la 35
La evidencia del Arte es el argumento mas contundente para pensar
nuestro hacer como discurso diferente de la palabra y sin perjuicio de
traduccin a trminos verbales, a un discurso verbal. que la incluya por cierto, como el Arte.
Tratar de explicar una obra artistica, un cuadro de Picasso, un solo de
Charlie Parker, es otra cosa, no la obra, pues ella no necesita de esa
Esta traduccin no es posible en tanto La estructura explicacin para tener existencia, tiene dignidad ontolgica mas all de -
todo la que se pueda decir de ella.
sintctica de la palabra (y ni hablar de la gramtica) no Lo mismo ocurre con este objeto discursivo del que intentamos hacernos
cargo.
896
musicoterapeutico. hablamos de realidades que no son posibles de ser
descriptas con la palabra, de conocimiento que no es
No estamos postulando una "verdad" que reemplace a
palabra. Y 2) La "cosa", el enigma, la "Ding und sich"
otra, ni hay ruptura alguna con algn determinado
kantiana, a la que solo se accede por los relatos que
sistema, sino que hablamos de elecciones de lenguaje
dicen aludir a ella, por el trazado de diferencias que son
(discursos), de generacin de sentido, al intentar
lazos entre enigmas.
explicaciones de un discurso no-verbal.
En este ltimo punto se torna evidente la imposibilidad
Esto es: ya no seremos inocentes al otorgar sentido a
de la traduccin, de la verbalizacion del discurso no-
estos discursos. No podremos negar las alternativas
verbal. No se puede decir lo que dice, solo se puede
que abra o clausure para siempre nuestro obrar.
hablar de l. Pero no es l. Hablar de l otra cosa.
E1 hecho de postular nuestro objeto de estudio como
discursivo, implica postular una circulacin de este
discurso en el terreno de la Esttica, en tanto no es
verbalizable, esto es, una construccin realizada con
Las ceremonias del conocimiento
material significante diferente de la palabra, (y en
ocasiones incluyndola, pero tratada esteticamente) Postulados estos argumentos, en principio y

que realiza un supuesto sujeto y que es , a la vez: la Fragmentariamente, por supuesto, estamos en

descripcin de realidades posibles, en tanto discurso, y condiciones de preguntar sobre ellos.

897
Dijimos hasta aqu 1) Que existe un discurso realizado constitutivos, tales como la lgica, fracasan en sus mas
con material significante diferente de la palabra, caros fundamentos.
aunque en ocasiones la incluya pero con un tratamiento
Como se puede investigar aquello que es indecible?,
esttico. Un discurso no-verbal.
lo que no es ni falso ni verdadero, con un modelo
2) Que este discurso es intraducible a lo verbal, en pensado filosfica, epistemolgica y
tanto constitutivamente diferentes. Y 3) que entonces el metodolgicamente para encontrar la verdad.
objeto de nuestro hacer teraputico es un objeto
En las lneas que seguirn trataremos de construir
discursivo.
algn modelo para pensar nuestro hacer, y cuyo
Ahora bien, planteada la imposibilidad de abordarlo paradgma ser el discurso del Arte.
verbalmente, salvo como auxiliar util en muchos casos,
Sealaremos, si nos es posible, las limitaciones del
la pregunta es: Como conocerlo?, en su doble
pensamiento positivista, o mas generalmente del
dimensin de objeto y cosa, de descripcin y realidad,
mtodo cientifico para conocer este territorio. Y
de diciendo y siendo.
estaremos hablando de una concepcin estetica de
Como penetrar donde la herramienta mas preciada y nuestro hacer.
poderosa de construccin de conocimiento que
En el contexto-universo del discurso no-verbal, o
pareciesemos tener, el lenguaje verbal, no puede
discurso del Arte decamos hace un momento, vemos
cortar, no puede trazar disticiones. Y sus sistemas
suspendidas, no negadas ni afirmadas, ciertas
898
fundamentales enunciaciones de la lgica, sobre las feo36.
cuales se sustenta (y a la vez sustenta a) el lenguaje
Los sistemas cientficos positivistas, o derivados
hablado.
"suavizados", siguen el camino de la verdad, buscan "la
No se pueden evadir estas cuestiones sin entrar, verdad", lo que es realmente.
decamos, en el territorio del Arte o la locura. Hablamos
Los sistemas de enseanza artstica, en muchsimos
del principio de identidad, A no puede ser y no ser A en
casos, se constituyen en reglas o leyes que sealan
la misma circunstancia, la relacin causal de los
hacia lo "bello".
acontecimientos, la linealidad progresiva del tiempo, la
Es que considerar al objeto de nuestro hacer como
existencia de lo "verdadero", lo "bello", lo "bueno", como
discursivo y esttico, es efectuar algunas renuncias y
absoluto, y ciertos principios econmicos que incluyen,
limpiar el,campo percept:ivo para poder "ubicarse en el
por ejemplo, la generalizacin para un gran nmero de
mejor lugar para observar".
casos, etc.

Se trata de postular algo as como un corrimiento de la

lnea conceptual aristotlico - cartesiano - hegueliana,
para sostener algo que no es ni mejor ni peor, ni falso ni
36
Este hilo Aristteles - Descartes - Hegel es un sistema conceptual,
verdadero, ni bueno ni malo, y por cierto, ni bello ni una superficie sobre la cual "mapeamos" lo real.
Cualquier relevamiento cartogrfico es un extraer pautas, diferencias, e
imprimirlas sobre cierta superficie. Esta superficie condiciona la utilidad y
posibilidades del mapa. No es lo mismo hacer un mapa de un territorio
sobre un papel, un queso, o una vaca.
899
Es importante hacer un pequeo parntesis para definir a una posicin.
los trminos epistemologia y esttica.
La esttica es una marca epistemolgica porque segn
En cuanto al primero, proviene del verbo griego la rigidez o amplitud de movimientos que me permita
"epistemai", que en la acepcin mas adecuada a para situarme en el lugar mas ventajoso para observar,
nuestro pensar podra definirse como ponerse en (epistemologa) ser lo que perciba - formalice
posicin ventajosa para observar. (esttica).

En cuanto a Esttica, deriva del griego "astetos", o E1 desplazamiento de la superficie conceptual de la

"aistetiks" o "astesis", segn se lo sustantive o ciencia a la de la de la esttica implica un
adjetive, que es perceptible, sensible, o sensacin. desplazamiento epistemolgico: Primero porque
Como no es posible percibir nada sin formalizar, y pensamos al discurso cientifico ya no como camino a la
circularmente no es posible formalizar nada que no se verdad, sino como mtodo de percepcin, citando a G.
perciba, hablamos de esttica como una interaccin Bateson, o tal vez mejor, mtodo para otorgar sentido a
mutua entre percepcin y formalizacin, y de las cosas.Y segundo porque abandonamos este
epistemologia, como la posicin desde la que vemos mtodo por otro: La Esttica, cuyo caracter paradojal,
acontecer - acontece el evento esttico, y circularmente (se niega a s misma como verdad) abre el campo a la
otra vez, la estetica determina, "atornilla" al observador alternativa metodolgica, al pensar objeto y mtodo
900
como un par en co-pertenencia y mutuamente E1 tiempo dertruy estos penosos pensares y los
determinados. O dicho de otra manera una releg al olvido, o tal vez, los dej disponibles para que
construccin de mundos de sentido. hoy podamos observarnos en posiciones similares.

Suponer que un D. no-V. puede ser ledo desde alguna

teoria que marque ciertos principios como verdaderos,
Tal vez se marque una diferencia al observar que la
que "revele" que "detras" o "debajo" del discurso en si
esttica se nombra a si misma como eso: Construccin
hay otra cosa, es una visn desde la antigua estetica.
de sentido y no verdad.
E1 Arte, los discursos del Arte, no tienen leyes que los
superen tipolgicamente hablando. cada esttica dicta
Indicios de una transicin posible
sus propias leyes. Cada esttica se sostiene a s misma
Para ensayar una transicin al paradigma esttico, en su ser constante. Citando a F. Nietzsche: "E1 mundo
comencemos limpiando el sentido de la palabra puede considerarse como una obra de Arte que se
"esttica". engendra a s misma" (La voluntad de poder).

La esttica tradicional entendia que habia ciertas E1 D. no-V. es esto, un ente esttico que se sostiene a
normas que rega el Arte. Que las obras de Arte, para s mismo, escribe sus propias leyes y Es, en tanto brota.
ser tales, debian cumplir con ciertas leyes "estticas".
Es el agua de la fuente que es forma en tanto brota, en
tanto acontece. Como lo es la
901
msica. posbilidad de expresin sintctica. Esto es una
explicacin.
Puede, claro est, ser asociado a otros discursos,
puede, en su caracter polismico, abierto al sentido, Pero "explicar" los fenmenos estticos, y tal vez todos
estar dispuesto a las ms osadas observaciones. Pero lo sean, implica en principio un "cartografiado" de los
sern ni mas ni menos que otro evento esttico. mismos mediante una descripcin, lo cual ya nos pone
en serias dificultades pues se trata de dibujar un mapa
Y el hacer musicoterapetico es esto: Un evento
en la superficie del agua. La superficie (el lenguaje)
esttico.
sobre la que se hace el relevamiento cartogrfico
Durante largo tiempo los musicoterapeutas intentamos,
(descripcin) condiciona dicho relevamiento.
y tal vez sigamos haciendolo, explicar ciertos
Por otra parte en la explicacin no se encuentra
fenmenos de nuestro hacer mediante una
informacin que no estuviese ya presente en la
verbalizacin que extraiga de la descripcin del evento,
descripcin. (En realidad se descarta gran cantidad de
o de mas de uno, pautas generalizables que permitan
ella).
una mayor inteleccin, en el sentido de verdad de
dichos asuntos. Por supuesto en el plano verbal. En la explicacin se cartografa la descripcin sobre
sobre un sistema auxiliar que conecta causalmente los
Esto es, de una descripcin de fenmenos dada,
eventos.
"extraer" informacin que conecte causalmente los
acontecimientos, dandole estructura lgica y
902
E1 sistema auxiliar es lgico. Es el lenguaje en tanto
emparentado con la lgica por su sintxis, y es los
Nuevas consideraciones sobre el poder, la tica
principios de causalidad, identidad, linealidad temporal,
y la esttica
etc. a los que aludiamos.
Entre las tantas construcciones posibles que definen lo
En trminos de ciertas concepciones pedaggicas
que es el Poder, en el mbito de las disciplinas
aplicadas a la musicoterapia, ocurre estructuralmente
cientficas existe cierta manera de pensarlo que es
lo mismo, porque se observa el fenmeno esttico
interesante observar a la luz de lo antes dicho.
(discurso) desde una Disciplina esttica a la que se
Hablamos de Poder en tanto capacidad de dominar los
supone debe respetar y adaptarse Y si as no lo hiciere
acontecimientos imprevisibles: Preverlos. Predecirlos.
se lo considerar equivocado, falso o feo.
Si bien no es la nica postulacin sobre el Poder, nos
En ambos casos, la disciplina cientfica y la pedaggica
interesa en particular por su influencia en nuestra
intentan hacer depender la validez de los eventos
prctica.
estticos de una red conceptual que les sera
tipolgicamente superior. De estas construcciones de discursos previsibles, que
necesariamente recurren a una instancia superior a
Se sustantiva el discurso esttico y se lo "atornilla" a un
quien construye, una teora cientfica, un modelo de
sentido rigido y nico. El verdadero, el bello.
belleza, o de verdad, o de salud, de estas rigidizaciones

903
estticas es de donde podemos movernos a partir de esttico-epistemolgica de un modelo "nico y
considerar que el D. no-V. es un evento esttico al cual verdadero", desde el que no se entablan relaciones,
nos acercamos desde una Adisciplina Esttica que nos sino que se imponen, no se co-construyen discursos y
permite situarnos en el mejor- lugar para observar: sentidos, se instruyen, no se investiga, se controla, no
Epistemologa. se responsabiliza el observador de sus descripciones,
de sus discursos, sino que en tanto respondan a la
Hablar de Adisciplina Esttica es pensar este
entidad superior, son objetivos, y en especial se
acercamiento al D. no-V., y a la clnica en general, sin
destruye el nacimiento de estticas alternativas.
un molde, un marco o modelo de salud, de belleza o
verdad donde 'introducir este D. no-V., o donde Decamos en "Etica y Esttica en Musicoterapia",
disciplinar a un paciente. Se trata de una mencin tica, (Cong. mundial 1990 Ro de Janeiro), como definicin
de postular una actitud de abordaje al evento esttico, posible de tica: "Es un hacer tendiente a aumentar el
como lo es la relacin con el paciente, de manera de nmero de estticas posibles".
dejar que sea el mismo evento quien dicte sus leyes, y
en todo caso, nos "discipline" e "introduzca" a nosotros
musicoterapeutas. Fragmentos de un pensamiento esttico

Claro est, no siempre se est dispuesto a abandonar Tal vez aqu pueda aclararse mas an la diferencia

la seguridad y el poder que pacece otorgar la rigidez entre el pensamiento positivista, o mas generalmente
cientificista, y una posicin esttica: E1 primero valora a
904
la explicacin como una interpretacin o elaboracin Por eso una esttica rgida deja afuera conecciones,
progresiva, que va hacia algo, hacia la verdad. vnculos, contactos, porque los condiciona a existir o
no. Disciplina.
En el pensar esttico lo que hay es una modificacin del
sentido, en tanto el discurso es un discurso polismico, Cuando nos acercamos a nuestro objeto discursivo
abierto al sentido. desde una Adis- ciplina Esttica, nos ponemos en "el
mejor lugar para observar", esto es, dejamos que la
Y el hacer musicoteraputico consiste, precisamente,
esttica del discurso sea quien modele nuestra
en abrir al sentido aquello que est cerrado. No en
percepcin, formalice. Dejamos que las cosas nos
revelar verdades.
hablen y dicten sus reglas.
Es un hacer tendiente a aumentar el nmero de
Una esttica es tambin un contexto en el que lo que
estticas posibles: Etica.
acontece adquiere sentido en tanto es percibido y
La esttica es una metfora de la nada, dibujos en el
formalizado, o no. Salvo como error37. (4)
caos. Una . esttica no es un conjunto de cosas, sino de
Una esttica es una tautologia. Una esttica Es. No es ni
relaciones, pautas, diferencias cuya validez o verdad
faIsa ni verdadera, no es bella, no es fea. No hay
no es posible probar fuera de s, fuera del sistema. Es
orgen, no hay razon, no hay objetivo, no tiene ayer ni
arbitrariamente verdadera. Tautolgicamente
verdadera. 37
Aqui aparece lo aleatorio como -fuente de informacin que permite la
movilidad de las estticas. Las estticas son, como lo es el Arte,
asuntos de lo imprevisible. Lo que muta.
905
maana, se alimenta de si misma y se engendra a s que conecta, traza y percibe diferencias y relaciones, y
misma. Y habitamos en ella a veces como prisioneros, a describe mundos posibles.
veces como testigos del Arte, a veces sutiles, a veces
Una esttica es esto, un modo de conectar, unir, tejer al
desesperados.
mundo. lo religioso, lo sagrado, tambin, ambos, por
Tanto es que a veces creemos ser ella y se nos acerca cierto, arbitrarios y metafricos. Ambos entraan
la muerte con su ausencia o su ruptura. ceremonias inexplicables, no sujetas a validacin o
invalidacin. Como toda metfora.
Involucra la duda del Sujeto sobre s mismo y su
experiencia. Estas ceremonias son complejidades que relacionan
mundos. Tanto es que perderlas, verlas cuestionadas,
Es el riesgo, el miedo, el placer, lo aleatorio y lo ertico.
es hablar de la muerte. Tal vez el Sujeto no sea ni mas
Lo esttico es pariente de lo sagrado. Tal vez esto
ni menos que una metfora esttica, y al reconocer
explique las vinculaciones y apariciones de la
este discurso no-verhal, el mismo que el del Arte,
musicoterapia en contextos esotricos.
reconocemos lo que creemos ser. No cosas, no
Lo esttico y lo sagrado son sistemas metafricos de objetos, no sustantivos. Solo relaciones.
construir mundo y relacionarse con l. Son una
Trazos sobre el todo. Nudos en la nada.
ligadura, como toda metfora, entre dos proposiciones,
(o sea otra vez entre dos metforas). Un modo de ser

906
Un eplogo sonreimos creyendo secretamente habernos visto
pasar.
Concebimos estticamente es aceptar un ser que
somos, transitado por mareas de mundos posibles, de Fugazmente.
esas mareas emerge, a veces, una conciencia, que no
es mas que una metfora de un discurso esttico mas
(Este trabajo es una elaboracin basada en "Sonidos y
amplio an.
Ceremonias", presentado en las Jornadas A.MU.R.A.
Esto que creemos saber, que creemos haber
1992, en Buenos Aires)
descifrado del mundo de las cosas es, lo que nos ha
descifrado a nosotros.

Hemos, somos sabidos, conocidos por lo Otro, lo BIBLIOGRAFIA

indecible, lo que creemos percibir y organizar. AA VV Diccionario Filosficas Espasa Calpe, 1952, Bs.

Es aceptar que somos formas. Somos, sin razon. As.

Sentidos que mutan y existen en tanto brotan, en tanto Bateson, G. Pasos hacia una ecologia de la mente.
suenan. Y para existir no necesitan de justificaciones Planeta-Lohl 1991 Bs. As. 1 Ed. 1972
mas all de s mismos.
Idem ant. Espiritu y Naturaleza Amorrortu Ed. 1990 Bs.
Como las obras de Arte frente a las que a veces As. l Ed. 1979 Dutton N.Y.

907
Bateson, G. Bateson, Mary C. E1. temor de los angeles Popper, K. El Universo Abrto: Un argumento en favor
Gedisa 1989 Barcelona, 1 Ed. 1987. del indeterminismo Tecnos 1984 1Ed.. 1956 Madrid.

Borges, J. L. El Hacedor Emec 1960 Bs. As. Rodriguez Espada., G. "Etica y Esttica" VI Congreso
Mundial de Musicoterapia 1990 Ro de Janeiro
Bruner, J. Realidad mental y mundos posibles. Gedsa
1988 Barcelona, 1 Ed. 1986 Idem ant. "De Popper a Coltrane: Construyendo objetos
en musicoterapia" Jornadas A.Mu.R.A. 1991 Bs. As.
Bunge, M. Seudociencia e Ideologa. Alianza
Universidad 1985 Madrid. Veron, E. La Semiosis Social Gedisa 1987 Barcelona .

Ferrater Mora Diccionario de Filosofia Alianza. Edit.

1990 Madrid. 1 Ed. l.979
A R C H E T Y P I C A L A S P E C T S O F "P O P U L A R "
Ferrero, G. Rodrguez Espada, G. "Comunicacin no-
M U SI C I N M U SI C T H ER APY
verbal y Musicoterapia. Seminario." VI Congreso
Mundial de Musicoterapia 1990 Ro de Janeiro E LENA D E R OSA Y D IANA F ACCHINI

Gaeta Robles Nociones de Epistemologia Eudeba.

1988 Bs. As. 3 Ed. These remarks derive from the syntesis of a research
Nachmanoxitch, S. Free Play Planeta 1991 Bs. As. 1. Ed. work about the Archetypes in traditional "popular" music
1990 St Martin Press N.Y.
908
carried out by the authors38. Such remarks can be especially used with regard to
certain clients, namely those in most regressive
We want to stress here the archaic, nuclear aspects of
conditions (autistics, severe psychotics, etc.).
comunication, that is, real symbols which replace
something coming from primary universal feelings and The hypothesis is that traditional "popular" music can be
emotions. used in music therapy, as it bears archaic comunication
ways and as it represents an approach to the client's
In this thesis we are using the term "popolare" in the
evolutive communicative level.
italian sense.
The music therapy setting represents a protected
It refers to "del popolo", that is, "of the people".Thus
territory, which stimulates and holds tne client's activity
"popular music" does not refer to modern mevements in
of daydreaming.
the music scene, but rather to the "traditional or folkloric"
music with universal roots. A process of releasing takes place: disentangles
psycologically "blocked" conditions and lets abreactions
The sound-expressive manifestations, particularly the
and visible accomplishements of the client's
traditional ones, represent prototypical behaviours,
unconscious, imaginative production be possible.
which match the respective primary emotions linked to
survival.(S.1) The client retraces the stages of his existential process.

38
DE ROSA E., FACCHINI D. "Aspetti archetipici della musica
popolare in musicoterapia" ...Napoli (in via di pubblicazione)
909
The regression, produced through sounds, leads to a hallucinations and in certain artistic, works.
pre-verbal phase of the experience when the emotion
Likewise, symbolic images of voyages, routes to follow,
was lived in the totality of the body and its primary
rites, festivals, sacrifices, birth, death, wars, forces of
sensations.(3. 2)
nature, often appear in music therapy group sessions.
In our approach, we have referred to the concept of
The group and the individuals get in touch with their own
"Archetypes" in the psychology of Carl Jung and
interior figures in the unconscious, and experiment with
especially to the "collective memory" where primary
them actively, dramatizing with sounds this experience,
images, belonging to humankind, settle.
which is not possible to express through words.
The ancient and traditional evolution of music is strictly
connected with the one of the archetypes which expects
to be lived by the individual and embodied In symbolic "IL POPOLARE"

shapes. All the music is traditional and folk, that is, it cannot be

There are archetypal beings, shapes and characters conveyed or have a meaning out of social relationship,

which are drawn by Jung from mythology and fairy tales, thus supporting the thesis of a "sound presence" on

like the SHADOW, the Self, the OLD WISEMAN, the which all the sound experiences are based.

GREAT MOTHER, the MANDALA, the CROSS, the As a consequence, there is a common musical
WHEEL, the WAY which appear even in ravings and competence lying at the base of man's musical practice.
910
It has its roots in universal experiences. Traditional purification, rest and renewal.
music offers him the past living experiences belonging
Why do we consider traditional and popular music more
to a virtual time of his existence. We can refer to an area
appropriate than any other to get in touch with man?
which precedes the so called traditional manifestation: a
"pre-traditional" area placed at a level of a pre- Because it can be varied in a creative way, adjusted to

conscious phase. circumstances and it can even support a rhytmic or

melodic unchanged production, quite an obsessive one.
Popular music continuously interacts with nature, earth
These traditional instruments are created by man
and the human body. The sound key elements, on
which traditional music is based, are particularly according to the image and expressiveness which
animates them. They are born out of the earth.
symbols, represent certain perceptive values stand for
special realities and denote the experience of an ethnic It is useful to stress the imitative value of traditional
group. They are the ethnic group itself. music with regard to its functions; it is based on the

Certain sounds can evoke archetypal symbols. We will principles of "the like by means of its like". The sounds,

give just one example: the sound of water, which is the the rhythms and the melodies are strongly orientated to

element at the origin of life, has the most wonderful reproposing the reality in an analogical way.

symbology. ln fact the rain, the river, the source, the sea Let's think of processional music, ritual songs and
have a symbolic content in common. Theyall refer to dances in addition, of their way of being straightly

911
representative and of their descriptive function which Lets' look at 11 points of similarity.(S.3)
makes relation and interpretation easier.
1) Both of them are orally, quite instinctively,
We can find all the archetypes of man in traditional transmitted. This happens quite magically; they are
music. For example, let's consider the following: the handed down from one generation to the other, while
magic song of love and the one for birth and the song of the origin of the process comes to be almost forgotten.
the resurrection of the dead, singing as evocation of
2) Both of them have a link with the earth, nature, its
shadows, and spells, as expression of the wonderful,
forces, its annual times and cylces. The contact with
the supernatural and even the terrifying music of the
earth gives man the possibility of identifying himself with
devil. These are all archetypes which can be found
natural phenomena and to confer to them a liveliness:
again in the traditional practice and have their roots in
the thunder similar to the voice of an angry God; the
ancient times when tradition mixed with magic, and
river similar to the ghosts' dwelling place; the tree seen
sound also identified itself with magic.
as a vital principle; the cave seen as the devil's hiding-
This ancient and traditional evoluting music is strictly place.
connected with the one of the archetypes.
3) Both of them are subject to certain changes on the
Both aim at producing the repetition and the working out side of the individuals, who live again some experience
of the same emotional experiences. or reproduce some musical forms. Even though there-
are steady elements which seem to be handed down,
912
man always intervenes in the with his creativity. directly linked to the "moment" of the rising of the sun
and it has a propitiatory aim.
4) Both of them are common; they refer to humankind.
9) Both of them have long periods of existence which
5) Both of them are anonymous in a certain way, they
permit them to establish themselves in a common
regard everything and belong to everybody.
memory.
6) Both of them are "spontaneous" and "immediate" just
10) Both of them snow a strong relationship between
like the emotion we feel towards some natural
significant and significance and are symbolic. The
phenomena which repeat, alternate and recur.
sound act of popular music summarizes thoughts,
7) Both for popular music and archtypal images we can
memories, sensations, emotions and movements in
talk of enjoyment and of easy way of the enjoyment
one form.
itself. The archetypes, just like traditional music, exert a
The archetypes in the extreme synthesis of human
strong power of attraction.
experiences; it lies at the basis of the symbols which
8) The function with regard to a goal is important for
exist in dreams, art, symptoms and children's
both of them. For instance, the ritual action produces a
daydreams.
magical effect.
11) Both of them are linked to emotions.
Some African populations breathe and spit in their
Lullabies, rhymes and children's games, together with
hands and then raise them to the sky: it is a gesture
913
magic formulas, recall rhytmic work songs and ritual (S.4) The creative repetition and variation are two
songs, a very important element of the so-called basic essential aspects for man. One example could be the
traditional popular music. behaviour chosen by the child during his anal phase
and his Oedipus period. He often tries to control his
Such material witnesses the passage from the word to
anguish through rituals and repetitive behaviours linked
singing, which is fundamental in popular communication
to particular moments of the day, just like the rites which
and is able to sublimate and turn in instinctual energies
are linked to time and periods for primitive populations.
into socially accepted expressions and behaviours in
acreative way. These processes are based on archaic psycological
mechanisms, such as, isolation, control; retroactive
This is what actually happens in music therapy.
magic annulment.
The improvisation, the variation, the repetition and the
In psychopathology the obsessive behaviours seem to
creativity peculiar to popular music allow a free use of
be the only means to assure the persistence of the
the sound material, a part from a specific
object and the sense of individuality. Conversely, the
musical competence.
variaton represents a disillusion about the constancy of
the object.

REPETITION AND VARIATION During this "creative" phases the client substitutes the
primitive illusion of fusion with an intermediary area, the
914
one of primary creativity (Winnicott's transitional area). Lullabies are the prototypes of man's existence, of his
desires, frustrations, fears, shadow which come to be
The music therapy setting is meant as a space of "free
exorcized through a repetitive ritual. Such a "ritual" is
game" based on repetition, resonance, imitation,
developed through generally brief intervals and
variation, opposition, projection, holding, starting from
acquires the value of a magic potion, with its sound
the client's evolutive level.
games, fragments of words, rhymes and
In popular music repetition becomes an element used
onomatopoeia. The binary time gives the idea of reality,
to formulates idea, to let them be shared, to create a
the
stability; it is a starting point for variation and invention
link with the mother earth; the mainly minor tone gives
produced by instruments, body and voice.
the idea of anguish, the melancholy of life. (Piece n.l
This last one really unites sounds with basic emotions;
"Lullaby", Pisticci-Matera feminine voices).(S.5)
thus, expressing an even sensorial strong tension,
Moreover, lullabies show a series of contradiction:
especially when singing is a closed throat singing.
- on the one hand their function is to calm down the
We will give just two examples of popular music
child, on the other hand, their contents refer to death
production as reference points.
and other frightening signs;

- apparently singing is useful for the baby though its

First example: deepest function is to let the mother release her
915
feelings, a vent otherwise impossible for her in a represents a sort of orgasm stressed through the voice,
traditional rustic society as the one of Southern Italy; the screams, the melismatic procedure; a sound effect
which cannot be traslated or repeated. The expressive
- if the music causes a feeling of sweetness, conversely
force becomes the means to convey strong emotions.
the meaning of the words, which is sometimes terrifying,
(Piece n.2: "Serenata" Carpino-Foggia, male voice,
causes opposite emotions: Playing with this
striker guitar, incitements and screams).(3.6)
ambivalence allows to live the problem and overcome it.

FROM THE WORD TO SINGING

Second example:
(3.7)There are some constants in the verbal expression
The "Serenata" show a recognizable degree of
which can let us think of a common "archaic recitation
functionality. It has the function of communicating
intonation".
feelings and desires which wouldn't be accepted in a
different communicative form. The erotic content of A series of elements of human communication exists
many texts; the sexual invitation, the declaration of love between the word and the singing. Such elements are
desire, are conveyed at a level which is different from present even in natural sounds. That is the reason why
the daily one and beyond any moral convention. these elements acquire certain meanings that are easily
decoded even in different cultural realities as they imply
In the example we discuss here, the sound effect
emotions which can be shared; a deep language
916
without words. always directed towards high-pitched sounds, following
a precise scansion.
The example we are going to propose reveals the
extraordinary range of vocal expressions, easily Such a musical piece seems to propose the archetypal
recognizable for their sound strength and related to theme of the Hero, the Preacher, the Power, the Devil
some archetypes. and the one of the Energy of the mob. (Piece n.4
"Lutze's political speech" Norimberga 1894).
- The whistle stands for the most primitive form of
communication linked to vital aspects, to breathing - The "Rythmic work song to incite the workers at the
(archetypes birth-rebirth) (Piece n.3 "Calls, signals and stoneboat" (Alpi Apuane - male voices) underlines the
communication through whistling"). strong harmony existing between gestures and voices.
Here the function of singing is to recover some "energy".
- In the second piece the pauses make the
The group takes a unique shape thanks to the time
communication rhetoricai.
scansion given by the leader.
This kind of communication provokes an answer on the
- "The eternal voice" (Buddhist ritual- metallic
side of an "audience" so structuring a perfect alternation
instruments- male voice) follows a path of searching for
from the point of view of sound. The sequence "Ich-
the Self. Here comes again the image of the cave where
acclamation of the audience" underlines the energic
the recesss resounded with the voice of the "God of the
aspect of this communication, the high level of
mountain". The "spiral" sound effect (the "sound
involvement it produces, and shows an intonation
917
mandala") gives an image of unity-entirety-centrality: down" (symbology of the water, the earth).
the Self.
Some clients, particularly those in the most regressive
How do we recover these aspects for a more suitable conditiones seem to be fixed in those stages where
therapy for the individual? Which means do we use to imagination and myths overwhelm the reality of
disclose his unconscious characters? In our clinical everyday life. The meeting point with the pathology is,
work we made the hypothesis of a non-verbal framing maybe, the possibility of coming back to the Ages of
before the therapy; a framing directed towards singing Gods and Heroes, to dreams, to symbols, to a "popular
out the archetypal aspects of the personality.(S.8) way" of communicating and of being with the other.

The acquired elements will come back during the Therefore, popular music gives the possibility of
therapy under different forms. recovering the path of humans in history through its
universal language.
In the group even the way of placing the participants
and instruments can refer to primordial images found in
the popular usage (dances and rites): the arrangement
Bibliografia
in circle, the "square" which propose again the cardinal
points of existence, the "cross", all symbols of a whole. Benenzon R.O., Manuale di musicoterapia, Borla, Roma

Or the use of a vertical space which allows the "climbing Blacking J., Come e musicale l'uomo?, Ricordi Unicopli,
up" (symbology of the tree, the fire) and the "getting Milano,
918
1986 Boringhieri, Torino,

Carotenuto A., Seliso e contenuto della psicologia 1984

analitica, Bollati
Imberty M., Suoni, emozioni, significati, CLUEB,
Boringhieri, Torino, 1990 Bologna, 1986

Cassirer E., Simbolo, mito e cultura, Laterza, Bari, 1985 Jaff A., Ricordi, sogni, riflessioni, Il Saggiatore, Milano,
1960
Cassirer E., Filosofia delle forme simboliche, Laterza,
Bari, 1985 Janklvitch V., La musique et l'ineffable, Colin, Paris,
1961
Cirese A.M., Cultura egemonica e culture subalterne,
Palumbo, Jung C.G., L'uomo e i suoi simboli, Longanesi, Milano,
1980 .
Palermo, 1982
Jung C.G., Simboli della trasfomazione, Boringhieri,
Combarieu J., La musica e la magia Mondadori, Milano,
Torino, 1984 . Laplanche J. e Pontalis J.D.,
1982
Enciclopedia della psicoanalisi, Laterza, Bari, 1968 .
Freud S., Introduzione alla Psicoanalisi, Boringhieri,
Leydi R., I canti popolari italiani, Mondadori, Milano,
Torino, 1978
1973
Hall C.S., Lindsey G., Teorie della personalita,
919
Piaget J., La nascita dell'intelligenza nel bambino, La U N M O D EL O PAR A EL AN AL I SI S D EL D I C U R SO
Nuova Italia, Firenze, 1974 EN M U SI C O T ER API A

Schafer R.M., Il paesaggio sonoro, Ricordi, Milano, P ATRICIA L EONOR S ABATELLA

1977 .

Spaccazocchi M., Suono segno gioco, Suvini Zerboni,

PRESENTACION
Milano
Una sesion de musicoterapia supone una preocupacion
Stefani G., Il segno della musica, Sellerio, Palermo,
por tratar de establecer o reestablecer la
1987
comunicacion,lograr la expresion de sentimientos,la
Stefani G., La competenza musicale e cultura della relacion entre los integrantes del grupo...ocuparse mas
pace, CLUEB, Bologna Vitali M., Verso por el HACER, que por QUE VAMOS A HACER o
un'operativit musicale di base, Cappelli, Bologna, COMO VAMOS A ORGANIZAR todo el material
1991 corporosonoro-musical que se produce.
Winnicott D.W., Jeu et ralit, Gallimard, Paris, 1975

Para poder poner en palabras lo sucedido en las

sesiones se pueden utilizar "modelos prestados" de
otras areas cientificas,que en principio ayudan a
920
ordenar el material,pero que el producto final no refleja cilias del oido interno hasta el tamborillear de los dedos
lo que realmente ocurre en el proceso sobre la mesa o el golpe de la mano sobre un tambor).
musicoteraputico.Creo que un "modelo ideal" debe
permitir realizar una lectura ordenada de las
producciones sonoras ubicandolas siempre dentro del Este circulo interminable SONIDO - MOVIMIENTO se

contexto en el que se producen, la sesion de convierte en MENSAJE.Una serie de mensajes

musicoterapia. relacionados constituyen un DISCURSO,que es una

organizacion observable.

Dentro de una sesion de musicoterapia,encontraremos

Buscando el modelo ideal regresamos a los origenes
una organizacion observable de movimientos - sonidos
de la MUSICO - TERAPIA, del SONIDO, del
dentro de un contexto no verbal.
HOMBRE,de las PRODUCCIONES SONORAS y las
relaciones que se establecen entre ellos.
E1 discurso musicoterapetico o corporo-sonoro-
musical es una realidad,de la que se desprende
E1 sonido es energia que se desplaza en un medio,que
informacion que nos permite conocer a la persona y/o
el hombre convertira en sonido,en quien,a su
al grupo que lo produce.
vez,provocara una modificacion,causandole un
desequilibrio que se traducira en movimiento (desde las
921
A continuacion describir la mejor forma en la que he * B. AREA DEL LENGUAJE SONORO
podido organizar el material producido en las sesiones
* C. AREA DEL LENGUAJE VERBAL
de musicoterapia.Como modelo de analisis no es
cerrado,abarca un amplio espectro de posibilidades, * D. AREA DE LAS RELACIONES INTERPERSONALES

basicas segn mi criterio, a tener en cuenta en el * E. APARTADO FINAL DE OBSERVACIONES

momento de analizar un discurso pudiendo ser
ampliado o modificado en relacion a las necesidades
del profesional que lo utilize. Estas areas a su vez se subdividen en secciones para
un analisis mas detallado , que a continuacion explico .
La explicacion teorica se completa con el analisis
practico de un caso.
* A. AREA DEL LENGUAJE CORPORAL

MODELO TEORICO

E1 modelo lo divido en cuatro areas de analisis en las Si el brazo no se mueve y la mano golpea un pandero,el

que se manifesta el discurso musicoteraputico: sonido no se produce,si el hombre no abre la boca y

deja que el aire resuene en su cuerpo,la voz no
aparece;si el oido no es capaz de decodificar las
* A. AREA DEL LENGUAJE CORPORAL seales acusticas que percibe y transformarlas,el
922
sonido no existe.Una manifestacion sonora sin ambas formas de expresion.
movimiento,sin un cuerpo,es impensable.
E1 area se subdivide en tres secciones:

E1 cuerpo es el principal instrumento de relacion que

* A.a. MOVIMIENTOS INMOTIVADOS Se
tenemos con el sonido,ya sea de una manera activa (la
describen todos los movimientos no controlados o
produccion de sonidos) o de una manera pasiva desde
asociados a los movimientos naturales que implican un
el movimiento corporal (la escucha).
gasto de energia innecesario.
La relacion que mantiene una persona con su cuerpo
* A. b. COORDINACION EN LA EJECUCION
nos habla de su modo de relacion con el mundo,que se
INSTRUMENTAL Se describe la existencia de-
traduce en la forma de acercarse,relacionarse y
anomalias que impidan la ejecucion instrumental.
ejecutar los instrumentos,los cambios de tension,las
posturas,los gestos,la intencionalidad que se asocia a * A.c. RELACION SONIDO MOVIMIENTO Se

los movimientos naturales. describen las variaciones en el tono corporal que

acompaan las producciones sonoras,analizando si la
energia corporal utilizada se halla en relacion con la
Conjuntamente con el analisis sonoro,el analisis intensidad del sonido que se produce y si se observa
corporal permite corroborar la coherencia o no entre una expresion unificada entre el mensaje sonoro y el

923
corporal.

Para realizar un analisis diferenciado se toman en

cuenta los aspectos formales del sonido como portador
* B. AREA DEL LENGUAJE SONORO
de significantes dentro de un contexto de
comunicacion.
Este pareciera ser el area que mas nos interesa,pero
es una manifestacion mas a tener en cuenta para
Las secciones del area son:
entender la realidad del paciente.

* B.a, MATERIAL SONORO UTILIZADO Se

En este area se incluyen todas las manifestaciones
describen los materiales utilizados para las
sonoras capaces de ser emitidas,desde las mas
producciones sonoras: el propio cuerpo,la voz,los
primarias (gritos, llanto,sonidos guturales) pasando por
instrumentos musicales (formales o informales).
las primeras manifestaciones del lenguaje pre-
locutivo(chasquidos,laleos,gorgogeos, expresiones * B.b. TIPO DE SONIDO Se describen los sonidos
fonematicas vocales) hasta las expresiones sonoras utilizados por el paciente resaltando la cualidad
musicales convencionales (sonidos de instrumentos material que caracteriza al sonido
musicales y vocales). (lisos,rugosos,cortos,cortos con resonancia,largos).
924
* B.c. MODOS DE EJECUCION Se describien los * B.f. INTENSIDAD Se describen las variaciones del
diferentes modos de accion sobre un mismo grado de fuerza de las producciones sonoras.
material.Los modos basicos a
* B.g. CONTINUIDAD DISCONTINUIDAD Se
tener en cuenta son describen las interrupciones en el aspecto temporal del
golpear,percutir,entrechocar,sacudir,puntear y discurso,analizandose su relacion con el contenido del
soplar.Este aspecto nos permite observar el grado de mensaje.
condicionamiento cultural que pueda tener el paciente
* B.h. ORGANIZACION FORMAL Se describe la
al ejecutar los instrumentos.
organizacion de las manifestaciones sonoras en un
* B.d. DISEOS RITMICOS Se describe la evolucion producto final. Se tiene en cuenta la direccionalidad del
mtrica del discurso,asi como la presencia de un ritmo discurso (el propio paciente, el grupo,el
personal que pueda ser utilizado como modo de musicoterapeuta) y la intencionalidad y utilizacion que
relacion. se le d al mismo (dirigir el grupo,perturbar la
comunicacion,o agredir a otro).
* B. e DISEOS MELODICOS Se describe la
evolucion de las alturas del discurso en el tiempo
haciendo referencia tambin al registro de alturas
* C. AREA DEL LENGUAJE VERBAL
predominante.

925
En el hombre,el lenguaje verbal ademas de ser un De la misma forma,en sesiones de musicoterapia nos
medio de comunicacion es un instrumento de relacionamos con los otros a travs y con el sonido.
pensamiento.Para hablar y comunicar un sonido debe
En este rea se describe el tipo de vinculo que
salir de nuestro cuerpo.Trabajar los modos de
establece el paciente con el grupo,el musicoterapeuta y
comunicacion no verbal es una forma de incentivar y
el instrumental,rescatando la relacion afectiva que se
promover las expresiones verbales.
produce entre los mismos,que ser en definitiva la que
En ste area se describe el uso que se hace del posibilite un buen rapport entre los
lenguaje operativo en el sentido de si es capaz de integrantes,analizandose ademas los roles ocupados
nombrarse y nombrar a los integrantes del grupo y de por los integrantes dentro de la dinamica grupal.
relatar lo ocurrido en las sesiones y los sentimientos
E1 area abarca las siguientes secciones:
vivenciados.
* D.a. MODO DE RELACION CON EL INSTRUMENTAL

* D.b. MODO DE RELACION CON LOS COMPAEROS

* D. AREA DE LAS INTERRELACIONES
* D.c. MODO DE RELACION CON EL
GRUPALES
MUSICOTERAPEUTA
E1 sonido aislado no existe,siempre se encuentra en
relacion,ya sea con el propio productor o con el
receptor.
926
* E. APARTADO FINAL DE OBSERVACIONES EDAD: 10 aos.

NIVEL: PRE-INSTRUMENTAL

Se describen todas las apreciaciones personales e

indicaciones que no puedan reflejarse en otros
DIAGNOSTICO: DEFICIENCIA MENTAL MEDIA.
apartados.
TRASTORNO ASOCIADO DE
PERSONALIDAD.
MODELO PRACTICO

A.C. asiste a sesiones de M.T. desde el mes de Octubre

Aplicacion practica del modelo sobre el caso de un nio de 1990.Esta integrado en un grupo de 7 nios de su
de 10 aos que recibio tratamiento de musicoterapia en mismo Nivel,que presentan trastornos en la
el Centro Pblico de Educacion Especial al cual asistio personalidad y problemas en la comunicacion.
durante el curso escolar 1990-1991.

INFORME MUSICOTERAPEUTICO
ANALISIS DEL DISCURSO CORPORO-
NOMBRE DEL ALUMNO: A, C. SONORO-MUSICAL

FECHA DE NACIMIENTO: 1980.

927
* A. AREA DEL LENGUAJE CORPORAL la ejecucion.

* A.a. MOVIMIENTOS INMOTIVADOS Realiza * B. AREA DEL LENGUAJE SONORO

movimientos con los ojos, descarga tension apretando
* B.a. MATERIAL SONORO UTILIZADO
las manos en situaciones de excitacin emocional.
* B.a'. VOZ Presenta multiplicacion de voces,tanto a
nivel timbrico,de registro,altura,intensidad y de
* A.b. COORDINACION EN LA EJECUCION contenido tematico.Se reconocen tres voces
INSTRUMENTAL No presenta problemas de diferentes,las que corresponden a tres aspectos de su
coordinacion que le impidan ejecutar los instrumentos y personalidad.
realizar ejecuciones simultaneas.

Una es su voz normal con la que se nombra,interacta

* A.c. RELACION SONIDO-MOVIMIENTO La y se comunica con el entorno;es modulada,la tesitura
descarga motriz que acompaa la ejecucion abarca el registro medio.La segunda aparece en
instrumental no siempre esta en relacion a la intensidad momentos excitacion psicomotriz,coincide con la
producida por la misma,en algunas ocasiones se ejecucion de tambores a intensidad muy fuerte y con un
observa mayor energia corporal que la necesaria para gesto motriz rigido.Esta voz es grave,no
928
modulada,timbricamente aspera,puede definirse como * B.b. TIPO DE SONIDO Con los instrumentos
una voz "dura".Con sta nombra mujeres,refirindose a realiza sonidos cortos.Con la voz reproduce las
aspectos sexuales.La tercera es una voz de nio canciones cantadas en sesion recordando las letras de
pequeo,la tesitura es mas aguda que la de su voz las mismas.
normal,con la que habla como si fuese un nio de 4 o 5
* B.c. MODO DE EJECUCION Ejecuta los
aos,nombrandose en diminutivo. Aparece seguida a
instrumentos de forma tradicional.Realiza ejecuciones
la voz anterior.Estas voces desdobladas aparecen de
simultaneas,coordinando dos modos de accion
manera aislada y aparentemente para l,carecen de
diferentes (golpear y soplar).
conexion,ya que al preguntarle sobre ellas luego de su
aparicion,no es capaz de responder,se rie y realiza * B.d. DISEOS RITMICOS Presenta una pulsacion

gestos de verguenza. regular espontanea,producto de una descarga

corporal.Las producciones ritmicas espontaneas son
combinaciones binarias simples.El esquema mas
* B.a''. PERCUSION Ha explorado de forma caracteristico INSERTAR Figura 1 que funciona
espontanea todo el instrumental,generalmente prefiere como ritmo grupal,aunque tambin realiza otras
tocar los parches combinados junto con el metalofono combinaciones.
cantando simultaneamente.

929
* B.e. DISEOS MELODICOS Es capaz de entonar * B.g. CONTINUIDAD-DISCONTINUIDAD Realiza
correctamente las canciones.Recuerda sus interrupciones intencionadas en su discurso
letras.Puede inventar melodlas sencillas sobre una sonoro.Luego de seis meses de tratamiento comienza
base armonica tarareando o inventando letras tomando a manifestar intencionalidad de dialogo sonoro.
como base el contenido tematico de mis
* B.h. ORGANIZACION FORMAL A1 finalizar el
improvisaciones,que estan en relacion a aspectos de
tratamiento no presentaba an un discurso sonoro
su personalidad,de su relacion conmigo,con el grupo o
organizado,pero se encontraba en una primera etapa
con algn acontecimiento producido durante la sesion.
de organizacion,ya que manifestaba intencionalidad en
su comunicacion sonora,reconociendo sus
producciones.
* B.f. INTENSIDAD Es capaz de variar
intencionalmente la intensidad.Puede imitar contrastes
de intensidad.Cuando toca los instrumentos la
* C. AREA DEL LENGUAJE VERBAL
intensidad se mantiene forte,cuando canta
improvisando varia en relacion al contenido tematico de
las letras,cuando se trata de l lo hace piano,cuando se Responde a su nombre.Es capaz de nombrarse
refiere a los otros lo hace forte. aunque en ocasiones manifiesta episodios de tension
cuando lo hace. Nombra a sus compaeros.

930
* D. AREA DE LAS RELACIONES * D.c. MODO DE RELACION CON LA
INTERPERSONALES MUSICOTERAPEUTA Desde el inicio del tratamiento
ha mantenido una buena relacion conmigo, aceptando
y contestando a mis propuestas sonoro-corporales.
* D.a. MODO DE RELACION CON LOS
Siempre ha tratado de incluirme en la tarea
COMPAEROS En un principio se aisla y toca
ofrecindome instrumentos o acercandose a mi para
solo.Luego comienza a asociarse para tocar con D.
interactuar de forma no verbal.
R.Actualmente participa, trata de relacionarse con
* E. OBSERVACIONES FINALES
todos sus compaeros del grupo,incluso haciendo
propuestas a M. B. y a L. que son dos nias que no se
relacionan.
Considero favorable la evolucion de A.C.,ademas creo
que puede ser beneficioso un tratamiento individual,sin
interrumpir el grupal,que permita trabajar de forma mas
* D.b. MODO DE RELACION CON EL
profunda sobre la multiplicacion de voces que presenta
INSTRUMENTAL Se relaciona espontaneamente con
y asl organizar y afianzar aspectos de su personalidad.
el material desde un primer momento. Puede
manifestar sus emociones e intenciones sonoramente.

931
 T H E O R I G I N S O F M U SI C T ER APY I N T H E and which distinguish between Healer, Witch-Doctor,
H EAL I N G R I T U AL S O F N O N - L I T ER AT E Herbalist, etc. and Shamanism as it is known in Siberia
SO C I ET I ES and Central Asia, Eliade acknowledges that such
phenomena occur in other regions of the world,
DR. CHAVA SEKELES (PHD, R.M.T., O.T.R.)*
provided they conform to the following three principles:

Firstly the use of techniques by which the Shaman falls

Traditional healing rituals serve as the most ancient into a trance (an Altered State of Consciousness ).
origins of Music Therapy archeological and
Secondly that when n this state of trance the Shaman's
anthropological evidence has revealed that such rituals
spirit is capable of leaving his body and making magic
existed as far back as the Paleolithic culture of Ur of the
journeys, ascending to the heavens or descending to
Chaldese, In 1970 La Barre wrote about Shamanite
the depths of the sea and the bowels of the earth.
rituals in which to the best of our knowledge music was
a major and permanent element. Thirdly: that the Shaman's studies include: a knowledge
of Dreams, Trance, Ecstatic Flifhts, Gods and Spirits,
In Ethno-Musicological literature, as well as in recent
the Myths and Genealogies of the fincestors, Secret
writings concerning Music Therapy, "Shamanism" is
Languages, as well as drumming, songs and ritual
employed as a general term for almost all forms of
dances.
Ethnic Healing, In this study I chose to include those
Healing Rituals which match Eliade's definitions (1972)
932
I have chosen to discuss this subject with examples symptoms of imbalance (fever or chill), whereas in the
from these societies which even today do not posess a second there is a deliberate intervention of various
written culture (such as certain groups to be found in agents which he further subdivides into Human
remote regions of Africa, South America, and Asia) as (Witches and Sorcerers), Extra-human (Demons, Evil
well as in societies which exist on the fringes of the Spirits, Ancestors), and Super-human (the Gods and
literate world (such as certain groups of Morrocan their emissaries).
Berbers).
Whereas Naturalistic healing perceives only the disease
In such societies it is the Oral Tradition which and its symptoms and treats them as best it can,
dominates, and it is music as a therapeutic agent which Personalistic healing is rooted in the overall perception
precedes the written word (such as amulets, inscribed of the human being and therefore touches also on
blessings and so on), religion and magic.

Traditional medicine is known by a number of The healer or Shaman engaged in Personalistic healing
diminutives ranging from Primitive Ethnic and Rural, to is first and foremost concerned with such questions as
Folk, Shamanite and so on. "Who caused this afflication, and to what purpose ?",
For many the diagnosis is of graver ioportance than the
Foster (1976 , 1978) chose two categories: Naturalistic
actual treatment.
and Personalistic: the first takes into account the
objective factors such as natural forces, or obvious It is held that disease attacks Man because he has
933
infringed certain taboos and thus exposed himself to the in music therapy, the music in healing ritual makes it
invasion of evil spirits which are capable of stealing his easier for us to explore the degree to which both the
soul (as Eskimos believe), to rule over it (the North physiological organism and the emotional mood of the
African belief in being "Posessed by the Devil"), or to patient can be influenced, This is due to the
torment it by means of visions and dreams (as held by comparative simplicity of a musical texture based only
the North American Salish Indians), and so on. on a few components, Even in the Voodoo rites in Haiti,
in which the drumers make use of highly complex
According to Foster's definitions it would seem that
rhythms, a basic beat is mantained to serve as a
music plays the dominant role in Personalistic healing,
framework ("Holder") for both music and participants, It
However there is evidence that music is not the only art-
should also be noted that apart from drunming and
form utilised in healing rituals: there is an integration of
stickbeating there are almost no additional musical
movement, costume, headdress, dramatic action, the
elements.
ritual decoration of musical instruments (in Asia and
Africa for example), painted bodies and faces (among In Ecstatic rituals in Asia, Africa and Australia for
North American Indian tribes) as well as more unique example, drumming is the major component, In certain
phenomena (such as the sand-drawings of the Navajo rites, such as those of the Hamadsha in the Morroccan
Indians in the South- West of the United States). Atlas Mountains, oboes are added; on the other hand in
the Hypnotic rituals of the North American Indians it is
As opposed to Art Music which is sometimes enployed
singing which is dominant, accompanied by rattles and
934
now and then by a monotonous, repetetive drum- MM thus from a moderate tempo the music and the
rhythm. locomotion of the participants reach the equivalent of
Presto-Prestissimo. Along with this acceleration comes
In a cowparative study of the components and typical
an increase in volume, and at the climax of the ritual we
developments of such Ecstatic rituals as opposed to the
can hear a multi-rhythmic texture in which the melody (if
Hypnotic, I found a remarkable similarity of basic
there was one) shatters apart as do the words (if there
processes, despite vast geographical, cultural and
were any).
other differences between the groups examined,
(Sekeles, 1979, 1981). An excellent example of this is the Ahouache ritual from
the Morroccan Atlas Mountains which moves from 76 to
In all such Ecstatic rituals whether they last a few
200 MM, resulting in an inability to either reproduce or
hours, a full day, or even several days), the rhythmic
understand the words, particularly if we take into
and dynamic development is extremely similar the ritual
consideration that the participants are in continual
begins with a drum (or other rhythmic means such as
motion, which increases in tempo all the time .
foot-stomping, hand-clapping or stick-beating) in a
repetetive metronomic tempo of 60 to 80 MM (between
Largo and Andante) In other words a tempo which
* RECORDED EXAMPLE = 1
matches the normal human heart-beat. Gradually there
is an acceleration which can advance to more than 200 As far as hypnotic healing rituals are concerned, the
musical aspects are different: the beat begins in a
935
moderate tempo suited to a relaxed heart-beat, and beyond-reality situations (according to traditional
mantains this throughout Now and then stimuli may be perceptions)and intra-personal experience in terms of
inserted, by means of a single drum, and often by rattles accepted therapeutic dogma in the Western World).
whose sound is more ambiguous.
We shall now discuss in further detail the Physiological
Frances Densmore (1954), finds that in North American and Psychological aspects of Healing Rituals.
Indian rituals of such nature the rattles and drums
In our examination of traditional healing rituals, we
mantain a steady rhythm whilst the melodic line is
encounter two opposing rhythmical processes: one of
irregular, characterised by a shift of both accent and
which steadily intensifies by means of a systematic
duration, Densmore stresses that this is an unusual
acceleration of tempo and an increase in dynamics, with
phenomenon for a Western musician and concludes
the participants responding with energetic movements
that it is the maintenance of a steady beat which permits
as dictated by the musical development; and the
melodic freedom.*
second, which preserves a constant rhythmic beat,
* RECORDED EXAMPLE = 2 generally with no change of tempo or dynamics, and in
which the participant remains in a state of quiet
We should add here that in both Ecstatic and hypnotic
receptiveness In both cases, stimulus and reaction can
healing rituals, the patient enters into an Altered State of
lead to a state of trance, typified by an Altered State of
Consciousness (Due either to an Ecstatic or Hypnotic
Consciousness.
trance), and by way of this undergoes the experience of
936
This is defined by Tart ( 1969) as a situation in which the Moroccan Hamadsha, and the performance of the
The person experiences a clear sensation of qualitative ritual in the open market-square under the blazing sun;
shift in the structure of his mental processes".This massaging the body with glowing coals as is done by
phenomenon, well known to Music Therapists as a the kung in the Kalahari Desert; the inducement of fever
result of Guided Imagery in Music has been described by means of powerful metaphors describing the sun in
in detail by Ludwig (1968) who observed it in various, various parts of the body and a sun-kissed world, which
sometimes contradictory situations: is a part of the technique of the Tibetan Shaman the
extensive and continuous dancing which can continue
A decrease or an increase in exteroceptive stimulation,
for hours, and even days) resulting in the symptoms
A decrease in the alertness of critical human faculties,
already mentioned - all these are characteristic of
Selective and focussed alertness, Ecstatic healing ritual.

Various Psycho-Physiological conditions connected On the other hand the experiencing of states of extreme
with Hyperventilation, such as Hypoxemia, cold is also a part of many healing rituals: The Dance of
Hypoglycemia, Dehydration, Sleeplessness, and the Spirits of the Salish Indians on the North-West coast
exposure to extreme temperatures. of the United States, opens with the patient situated in a
darkened tent watched over by "Nursemaids", Here he
This last is a phenomenon to be found in many healing
undergoes a womb-like experience whilst the Shaman
rituals the drinking of boiling-hot tea and water amongst
and his assistant seek the most suitable Demon Song.
937
The Demon Song represents the healing process, and due to the magic thinking associated with it, The
the Dance of the Spirit its intensity and power. instruments are constructed from special materials,
they have specific shapes and forms, bear special and
At a certain point the patient enters into a trance and
symbolic decorations (Iconography) and there are strict
experiences dreams and visions which symbolise re-
Taboos regarding their use and how they must be
incarnation and a new birth, after four days of fasting
played.
and total isolation, the "Newborn" chants his new song,
accompanied by the drums and voices of his Apart from occasional Eskimo rites, the drum figures in
companions, He then rushes into the forest to undergo all Ecstatic rituals as an essential instrument for the
the agonies of bathing in an icy stream, The Shaman inducement of trance, The magic properties with which
breathes upon him the "Breath of Life" which symbolises it has been endowed make of it a multi-purpose tool: its
re-birth. All participants in this rite are called upon to shape enables it to be employed as a vehicle, and as a
repeat it each winter. receptacle, as well as serving its purpose as a musical
instrument, The Asian Shaman can use it as a boat in
This ritual decreases sensory stimulation and enables a
order to reach the Spirits Under the Sea, as a bird in
"Return to the Womb" simulation, as well as a symbolic
order to reach the Heavenly Spirits, or as a stag, a
purification in the icy waters - a parallel to purification by
gazelle or a horse if he seeks Spirits on Earth (in which
fire.
case he makes use of the drumstick as a whip), Once
Percussion posesses a tremendous ritual significance,
the Spirits are captured, they can be trapped within the
938
drum and brought back to Earth. a spirit of life.

Because of its special qualities the drum is often made In addition to these spiritual attitudes, there are
from rare species of timber: for example the "Tree of the however various physiological aspects connected with
Universe" which the Ostiak-Samoyed tribe believe to drumming and its influence on the participants in such
sprout from the centre of the world with its trunk linking rites which also merit discussion.
Humanity to the Upper Spheres, Other examples of the
In a pioneering work, Neher ( 1961) exposed a group of
sanctity of this instrument can be seen as the result of
normally healthy people to low-frequency, high
dreams and visions:
amplitude drumming under controlled laboratory
Crapanzano and Garrison ( 1977), describe a conditions and recorded their EEG results, in an attempt
Moroccan Shaman who was commanded in a dream to to discover whether such percussion can lead to the
find a tree struck by lightning, and construct his drum reaction known as Auditory Driving (an expanding
from such wood. reaction firing frequencies to surrounding systems).

The Shaman believes that the drum has a soul, which This research project (and additional research in 1962)
must be awakened before the instrument is played, The led him to a number of conclusions:
Altai Shaman anoints his drum with beer, whereas the
One single drum-beat contains many frequencies each
Moroccan Healer will expose his drum to fire, thus both
of which is transmitted to the brain by a different nerve-
stretching the skin and at the same time breathing into it
pathway hence the drums stimulate a wider range of
939
brain-areas than that done by a single frequency. When the rhythmic stimuli are variegated in terms of
sensory modalities (Sound, Sight, Touch,
A drumbeat contains mainly low -frequencies
Proprioception, Kinesthetics),response becomes even
(particularly the oversized drums usually employed in
stronger: hence in Ecstatic rituals we find such visual
healing rituals), and the low-frequency receptors of the
stimuli as the flickering of candle-light (as with the Zar,
human ear are more resilient than those designed to
in Ethiopia) and of course the kinesthetic stimuli of
receive high-frequencies.
frenzied rhythmic movement to be found in all societies
Therefore the drum is capable of transmisting more
which practise Ecstatic healing ritual.
energy to the brain than high-frequency stimuli (such as
Since it is this insistent stimulus which leads to a steadily
that provided by flutes): and indeed in Ecstatic
growing physical reaction, which in itself leads to the
ceremonies we find a combination of low frecuencies,
Physiological symptons already described, one can say
intense volume, and an acceleration in the tempo of the
that in this chain of events music can be defined as the
druming.
initial link whose task is to ignite and activate all the
The reinforcment of the basic rhythm by additional
others.
rhythms increases participatory response In Ecstatic
Field researches by Jilek ( 1982) serve to authenticate
ritual use is made of additional rhythmic structures such
Neher's conclusions, since they were conducted in the
as hand-clapping, idiophones and various percussion
natural settings of such rituals, and tend to support a
instruments.
940
certain hypothesis which claims that: developing research into Endorphines.

The auditory tracts enter the reticular systex of the Endorphines are Endogenous Healing Mechanisms
brain-stem, this massive nerve-net arts as the co- similar to morphine and other opiates which act upon
ordinator between sensory input and muscular tone, the brain as anaelgesics to relieve pain, to create
alerting the brain to incoming information. euphoria, as well as leading to an Altered State of
Consciousness.
Sounds transported through these channels are
capable of activating the entire brain. Strong and Their greatest concentration is to be found in the Extra
repetitive neuronal firing, as would be experienced from Pyramidal system of the brain which controls muscle
the drums, can theoretically create a state of cognitive and the integration of movement, Other concentrations
awareness. are to be found in the Lymbic system (connected with
conditions of Amnesia, Euphoria and Altered States of
This hypothesis contradicts the Western belief which
Consciousness) as well in those areas responsible for
perceives trance as an illusory state similar to that of the
transmitting pain-impulses and the perception of pain,
dreamer and reinforces the theory that at least the
Pain has always been a major research-subject for all
Shaman who conducts the ritual is in fact capable of
those concerned with opiates, Prince ( 1982)
clear control of his thoughts and actions.
differentiates between the Hypnotic Analgesia of
A significant contribution to the understanding of the
Shamanite ritual (the lessening of stress, anxiety or
Shamanite phenomenon comes fron the ongong and
941
pain), and what he terms Endorphine Suggestion or as well as other agonising situations involving extremes
Endorphine-Related Phenomenon. of temperature, self-mutilation with knives and needles,
in addition to the state of extreme anxiety experienced
In the first case (the Hypnotic, there exists a
by the patient which is reinforced (consciously or
psychological mechanism based on belief (Faith
unconsciously) by the Healer and the entire process of
Analgesia), unblocked by Naloxone which neutralises
the ritual.
Morphine, The second case is a natural result of the
interaction between various Endorphines (opiates) and This is an anxiety which can be fed by actual causes
their receptors: it is this which allows of changes in the and events but also by inner fears and imaginings.
sensation of pain, of movement, of Food, and of the
The Organism experiences anxiety without any
reactions of the autonomic nervous system.
reference to its origins, and activates a hormonal
Inter-action between an opiate and its receptor reaction (and according So recent researches, an
depends on pressures, or on deep-tactile stimulation Endorphine reaction as well), Incidentally, the
(such as Acupuncture), Such stimulation can also be realisation of nightmare and horrific fantasies triggers
originated by intensive rhythm and movement (as in an intensive hormonal reaction to stress-situations: this
Ecstatic ritual). is something practised by various tribes as part of their
maintenace of mental-health (Such as the Iroquois
We should bear in mind that Ecstatic rituals involve
lndians in Canada's St, Lawrence River region) and
extreme states of fatigue and certainly muscular pain,
942
serves as an integral part of music therapy in which the We have already noted that the singing, acconpanied
patient is encouraged to express by way of music, sony, by rattling or rhythmic drumming, is characterised by
or any other artistic means, his own fearfu1 fantasies. repetition, by a very limited dynamic, by a steady and
moderate tempo, and by a general atmosphere of
Prince stresses that Endorphine is especially active
soothing and limited movement.
under extreme stress-situations this is also true of
hormonal activity, such as an increase of the adrenalin From the point of view of a music therapist such musical
level in the bloodstream. characteristics, movement and surroundings, provide
the ideal setting for the total relaxation of the patient and
In conclusion is can be stated that the above-mentioned
his or her descent into slumber.
studies propose an added dimension (widely
researched over the last ten years) to the possible Both in the Ecstatic ritual, as in the hypnotic, the
function of the Endorphines in Ecstatic rituals already rhythmic opening is characterised by repetition and
described. monotony, thus focussing the personal consciousness
inwards.
So far the Neurophysiological descriptions match the
events of the Ecstatic ritual, We shall now examine the This is not simply a mental process:
Physiological effects of the Hypnotic ritual on its
affected by one's physical posture and the effort
participants.
needed to counteract the force of gravity During a
hypnotic ritual, the Healer (mostly seated), and the
943
Patient (mostly seated or lying down) invest no physical sensory and ideo-motor activity, acording to the
energy in movement or posturing: as a result (and also autonomic and endocrine systems, and as far as we
due to the repetetive melodic-rhythmic stimulation) they know, the immunological as well.
can restrain and slow-down their breathing-process.
The more suggestion matches the psycho-physiological
As a result: blood-pressure is reduced, as is muscle- structure and social characteristics of the patient, the
tone and other physiological parameters, Stage by easier it will be for the therapist to make use of such
stage the Healer brings both himself and the Patient to a suggestion, This is a feature of Hypnotic ritual, in which
state of relaxation from which it is possible to reach a both healer and patient share an identical social and
hypnotic trance and an altered State of Consciousness. ideological background.

Whilst it is true that some of the rituals include the use of Since traditional societies regard the majority of
hallucinogenic substances, it would seem that pure illnesses (even if they display physical synptoms) as
relaxation without their use can also lead to a state of spiritual melodies, it is hard to differentiate between the
hypnotic trance and to the emergence from it with no processes of physical and psychological relaxation,
harmful after-effects (according to Bonny & Savary, in This is equally true of music therapy in our day and age.
1973).
Above and beyond the psycho-physiological relaxation
The patient is exposed to music and suggestive words and the imagery of Hypnotic rituals which employ music
when in a totally passive state/ reacts with an inner ideo- and other elements, there remains the question (as in
944
Ecstatic ritual) of the influences which create the ability Theory" of Melsack and Wall (1965) in which they claim
to overcone pain and stress. that since pain-sensations are transmitted by very
sluggish fibres which can be blocked, or limited, by rapid
One explanation is provided by Prince (as already
and powerful counter-stimuli, This could be
mentioned) who differentiates between the easing of
acupuncture, mild transcutaneous electrical stimulation,
pain due to Endorphine Activity, and that due to hipnotic
massage, and even repetetive percussion.
Suggestion, Another explanation can be found in one of
Achterberg's researches ( 1982) concerning severely- The anaesthetising of infants, children and even adults,
burned infants. by means of bonotonous and repetetive pulses is
recognised and accepted as effective in a variety of
As an anaesthetic she made use of heart-beats
schools of relaxation therapy, This is generally
recorded in utero, very similar to drum-beats, These
attributed to psychological causes, or to physiological
rhythms (which probably match Delta brainwaves: 4-5
causes associated with a loss of alertness due to the
cycles per second) created an effective sensory block
continuous and monotonous stimulus which holds no
against pain, which facilitated even extremely painful
changes and no surprises.
treat ents, Once the infants got used to the presence of
the tape-recorder in their cots, they would fall asleep Achterberg (as we have already mentioned) presents
within a minute or two after hearing the sound. another viewpoint in which she claims that rhythmic
stimulation can be employed not only as an anaesthetic
Achterberg bases this clinical research on the "Gate
945
but also in order to block, or delay, the sensation of pain. which serve as the rock-solid basis of traditional
healing, Alongside these there exists a clear social code
An additional hypothesis regarding relaxation concerns
of the Forbiden and the Permissible, any transgression
the Reticular Formation (or system) of the Brain Sten
of which can lead to Inbalance and hence to illness.
which serves as a modulator between sensory input
and motor output, When stimulus (such as sound) is The Healer is acknowledged by his patient as being
extensive, it can excite, and when linited it may relax, In posessed of an expert knowledge of traditional law and
particular it is the Ascending Reticular Formation (more an ability to restore equilibrium due his inherent powers
commonly known as the Reticular Activating System), and his ability to make contact wth the forces of
which influences the state of alertness; reduced activity affliction.
of this portion can lead to a state of hypnosis, trance or
It should be stressed that whilst such magic thinking
sleep
(which embraces the concept of supernatural powers)
And now to the psychological aspects Traditional may be regarded by western psychology as a form of
Healing is aimed at those individuals who sprang fron pathological regression, within traditional societies the
the self-same cultural and societal roots as did the supernatural remains a concrete part of reality Spirits,
Healer or Shaman, and who share his own philosophy Demons, Ancestors, Gods and Demi-tods all inhabit
and beliefs It is these shared faiths and the confidence their surroundings and watch over them all the time.
of the patient in the abilities and powers of the Healer
Within this web of beliefs, music is also considered to
946
posess magical powers due to the merits perceived in it for adolescence in which sublimation serves as the
over the centuries and the manner in which it influences most effective defence-mechanism (Sport, Music, Rock
mankind Accordingly, music makes its own specal and so on), Statistics reveal that in most Ecstatic rituals
contribution in a variety of functions, for example: the Healer is generally a male father-figure, whereas in
Hypnotic rituals we can often find a woman mother-
As a means of return to primal object-relation during
figure as Healer.
Hypnotic healing rituals, it is vague, soothing and sleep-
enducing. In all the rituals so far discussed, the group plays an
essential support-role as regards the individual
In this way the patient returns to infancy, the healer
spontaneaus action, legitimation of transgressing
takes on a motherly role, and the Music serves as a
accepted taboos (sexually explicit movement, shrieking
lullaby .In other words a regression to the Oral stage of
and yelling, and so forth), and by a tolerant and
life.
absorbant participation.
And on the other hand as a release of sexual and
The first, or active, category, resembles the dynamics of
aggressive energy during Ecstatic healing rituals, by
"Doing" in Music Therapy, Here the patient initiates
means of strong rhythms which develop in an orgastic
activity and takes part in creating the music, The second
manner and elicit energetic, catharthic movement.
category is similar to that of "Being" in which the patient
If we compare the hypnotic ritual to the symbiotic-oral
is passive and receptive.
stage, then the Ecstatic ritual can serve as a metaphor
947
Both can be traced back to ancient times as part of the possibility of eliciting threateningly-laden personal
history of healing and music as a meeting- point. matters.

In all the rituals so far described the major therapeutical Collective symbols appear both in Hypnotic ritual and in
factor is imagination (generally guided by the Healer), Guided leagery however the music therapist
Imaging, visions, and dreams, transport the patient encourages the awakening of personal issues, whereas
through experiences which differ from his day-to-day the traditional Healer stresses the collective material.
existence and release him, monentarily, from routine
Traditional healing deals with the body, mind and soul
struggles, awarding him the chance to experience
as if they were one single entity This is in fact a
something out-of-the-ordinary.
comprehensive therapy: suggestive stimuli provided by
In some cases this could be described as "Rebirth" (as music, song and the word, affect body and mind
in the Salish tribe), or as a journey of spiritual together, Energetic movements exert their influence on
purification and catharsis. both internal and external systems.

Very similar phenomena can be observed when Traditional healing rituals serve as the historic roots of
employing the technique of Guided Imagery in music music therapy. Despite the differences of concept, and
which in some ways resembles that of the hypnotic ritual in the therapeutic Rationale which exist between the
Guided lmagery also involves collective symbolism Shaman and the Music Therapist, their basic
(such as animals, structures, water, etc ), as well as the therapeutic activity appears to be remarkably similar.
948
Not only that: all possible explanations of those physical 3. Bonney,H. & Savary,L. Music and Your Mind:
and psychological phenomena which typify patients Listening with a New Consciousness, Harper & Row,
under treatment, and whigh are based on New York, 1973.
neurophysiological researches and on a psycho-
4. Crapanzano,V. The Hamadasha: A Study in
dynamic concept, hold good in the main both for
Moroccan Ethnopsychiatry, University of California
Traditional Healing Ritual and for Music Therapy as we
Press, Berkeley, CA., 1973.
know it today.
5. Crapanzano,V. & Garrison,L. Case Studies in
Spirit Possession, John Wiley & Sons, New York, 1977.
Bibliography
6. Densmore,F. "Importance of Rhythm in Songs
1. Achterberg,J., Kenner,C. & Lawlis,G.F. for the Treatment of the Sick by the American Indians",
"Biofeedback, Imagery and Relaxation: Pain & Stress Scientific Monthly, 79:109-112, 1954.
Intervention for Severely Burned Patients", Presented at
7. Eliade,M. Samanism, Archaic Techniques of
The Biofeedback Society of America, Chicago, March
Ecstasy, Bollington, Princeton University Press,
1982.
Princeton, 1972.
2. Achterberg,J. Imagery in Healing: Shamanism &
8. Foster,G.M. "Disease Etiologies in Non-Western
Modern Medicine, New Science Library, Boston, 1985.
Medical Systems", American Anthropologist, 78:773-

949
781, 1976. 14. Neher,A. "Auditory Driving Observed with
Scalp Electrodes in Normal Subjects", EEG and Clinical
9. Foster,G.M. & Anderson,B.G. Medical
Neurophysiology, 131:449-451, 1961.
Anthropology, John Wiley & Sons, New York, 1978.
15. Neher, A. "A Physiological Explanation of
10. Jilek,W.G. Salish Indian Mental Health &
Unusual Behaviour in Ceremonies Involving Drums",
Culture Chanae: Psycho Hygienic & Therapeutic
Human Biology, 34:151-160, 1962.
Aspects of the Guardian Spirit Ceremonies, Holt,
Rinehart & Winston, New York, 1982. 16. Prince,R. "Shamans and Endorphins:
Hypotheses for a Synthesis", Ethos, 10:4, 1982.
11. La Barre,W. The Ghost Dance: The Origin of
Religion, Delta, New York, 1970. 17. Sekeles,C. Music in Healing Rituals of Non-
Literate Societies, Hebrew University, Jerusalem, 1979.
12. Ludwig,A.M. "Altered States of
Consciousness", Trance and Possession States: 69-95, 18. Sekeles,C. "The Effect of Specific Musical
(Prince ed.), Buck Memorial Society, Montreal, 1968. Components in Healing Rituals of Non-Literate
Societies", (A Comparative Analysis), Presented at The
13. Melzak,R. Wall, P.D."Pain Mechanism. A New
AAMT Conference, Imaculata, PA., 21 March, 1981.
Theory", Science,
19. Tart,C.T. "Introduction", Altered States of
150:971-979, 1965.
Consciousness, (Tart ed.), John Wiley & Sons, New

950
York, 1969. individuals) is increasing, and the technological
development has become a threat to the ecological
balance of the nature.

M U SI C T H ER APY AS C U L T U R AL
There are also some other, maybe less dramatic, but
EN G AG EM EN T - O R : H O W T O C H AN G E T H E
still very important, dark sides of the road: stress-
WO R L D - I F O N L Y A BI T
problems, urbanization and flight from the countryside

B RYNJULF S TIGE and a splitting of areas of life which used to belong

together. In this situation many persons experience
their feeling of identity as threatened. The social
Introduction networks are changed, and often weakened. Quite a
After the Second World War technology and economy few people experience loneliness and isolation. This
have gone through a fast development in many situation is bound to have concequences on these
countries. The individual's possibility to choose individuals health and quality of life (Dalgard &
education, job and place to live is much larger than Sorensen, 1988), (Kleive, 1990). It is said that the
before. But, there are some dark sides of the road. The development of the society produce new clients much
gap between the rich and poor (both countries and faster than what could be treatened by a (growing)

951
health system (B0, 1989). with action. To move from an institution to a flat or house
in an ordinary living-quarter, does not create a new
social network. Every fellow-citizen must take his
In Norway, this situation is met by different reforms of
responsibility to make integration possible, and
the health system. As we can see of MTIR, volume 8
professional help is in some cases necessary (Kleive &
(Summer & Smeijsters, 1992), this seems to be the
Stige, 1988). We are now speaking of individuals that
case in very many European countries. More
experience a two-fold problem: they must (as all of us)
decentralized and democratic communities are stated
walk on the "dark sides of the modern road" and they
as goals for these reforms, and they focus on a process
have a startingpoint as segregated individuals. The task
of integration: persons with handicaps or mental
to create a positive social network indeed then must be
problems shall be a part of the local community.
very demanding.
Institutions are build down, and the local community
must take responsibility for providing education, work, a
place to live and cultural and leisure-time activities. Profylactic Health Work, Culture Life and Music
Therapy

Political and bureaucratic descisions, though, never can

make a human beeing become an integrated member The World Health Organisation (WHO) has stressed the
of a community. These descisions must be combined connection between health and quality of life, and put
952
focus on profylactic health work. Health is certainly more for the growing interest for music therapy in Norway in
than just "not beeing sick". Important criteria of quality of the 70-ies. In the same decade, there was an important
life is the individuals ability to be active, his self-esteem, cultural discussion. Main issues were how to make the
his relationships to other people and his experience of cultural life in the society more decentralized and
life as meaningfull (Rustoen, 1991). Thus health is a democratic. The culture of the people was given more
process, it is not a state or condition. attention, and cultural activity was given more priority
than before. Thus, the concept of quality no longer
should be attached only to the cultural products, but
An important way to strengthen and improve the social
also to the cultural process. The discussion of the 70-ies
networks is engagement in cultural activities (Bo, 1989).
opened up for a broader understanding of the concept
These activities will give possibilities for a development
of cultural life (Stortingsmelding nr. 52, 1973-74).
of contact and relationships, social learning and the
experience of self-esteem and self-realization. In other
words, engagement in such activities may be important Some Words on Theory, Goals and Method
for a persons quality of life and thus his health.
Music Therapy as Cultural Engagement therefore is an
important area for the music therapist. Even Ruud's
definition of music therapy (1981) (1990) is connected
These connections between health, quality of life and
to a concept of sickness/health that focus on profylactic
cultural activities seem to be an important background
953
health work. He underlines that healthproblems must be anthropology, is a useful tool for understanding and
regarded as "limited options for action", and that these working with many clients. An ecological and
often are created by the society. The development of systemtheoretical orientation will be necessary to meet
the area of Music Therapy as Cultural Engagement has the new challenges (Skarderud, 1984), (Dalgard &
"put this definition into action". In this paper I will give an Sorensen, 1988.)
example of work with mentally handicapped persons.
This kind of work is just as important for other groups in
the society: the elderly, people with psychiatric Knowledge and theory of individual treatment therefore

problems a.s.o.. Here I want to present some thoughts must be combined with socialeducational,

on theory, goals and method that I find essential for all socialpsychological and socialpsychiatric approaches.

these "client populations": Theories focusing on the individual and theories

focusing on the social level may here be seen as thesis
and antithesis. The challenge must be to develop an
It seems clear that the health system and the useful synthesis (B0, 1989).
professions of therapy no longer can work as if the
Communication is a very important aspect of this. The
problem(s) only existed inside the client. A family and
growth and development of every person depends on
community perspective seems essential in many cases.
communication, and so does the development of the
The concept of social network, borrowed from
community. The Norwegian philosopher Nina Karin
954
Monsen (1987) states that only when we see and hear the community, the public institutions that are involved,
the others and are seen and heard by them - that is, the clients neighbourhood etc.. Of course these goals
only when we communicate - are we able to be will be on very different levels. The point is that it is not
ourselves and learn who we are. Community is possible to work with the client as an isolated individual.
communication (as the words themselves tell us). Only
when we are able to communicate do the social
networks achieve positive values in our lives (Schjodt & In his practice the music therapist will have to be flexible

Egeland, 1989). and use a broad approach. Music therapy models must
be combined with flexible instructional techniques. It is
also essential to take departure in the musical codes
Ruud (199O) state that the music therapist must that are known and preferred by the client (Ruud, 1990).
consider man as both an organism, an individual/a
person and a member of a community. This point of
view I find relevant also in Music Therapy as Cultural The work of the music therapist will be more open and

Engagement, but it is of specific importance to see the wider than he may be used to. On one side he must

client as a cultural individual in the community. In fact, work with the individual/group, on the other side he

goals should be defined both for the individual, the must work with attitudes and traditions in the

music group (if the format is group), the organisations in community. Very often also there are economic
limitations (or priorities) in the community that limit the
955
clients possibility for growth and development. The work "Upbeat" - an example
of the music therapist therefore gets a political
My own first meeting with Music Therapy as Cultural
dimension. The music therapist can not be indifferent
Engagement was the "Sandane-project" (1983-86).
about the political discussion of education, health and
From the book about the project (Kleive & Stige, 1988) I
culture.
will translate some passages that tell about the process
of "Upbeat", one of the many groups in this project. The
members of the group were mentally handicapped, age
A very important aspect is the therapist's work before
30-40. They lived in an institution where my colleague
and after the lession. The music therapist must be given
Ingunn Byrkjedal worked as a part of her combined
opportunity to work in close collaboration with other
post. When the project started in 1983, the members of
professions working with the client. In Sandane this
"Upbeat" was taken on as students in the Community
process has been strengthened by conscious use of
Music School in Sandane. They were the first
combined posts for the music therapists. They work in
handicapped students at this school.
different systems, and in this way establish contact and
communication between the systems (Kleive & Stige,
1988). Slowly, with their eyes and ears open, they come into the music
room. They know nothing about beeing pioneers, but they know
that this is new - and exiting! They have come here after a long

956
walk from Nordfjordheimen, the institution for mentally Day), he had heard and seen the local brass band. And
handicapped were they all live. he had liked it!
Besides Reidar and Gunnar, the group consists of Solveig, Jon,
Knut and Solbj0rg. Reidar was able to play a little on a recorder.
The others had very little or none experience of making music. When we started to play together, we realised that there
But they have an interest of music, and the pictures on the wall was a big gap between this dream and earlier
soon awaken their interest further. They see pictures of the local experience. The members of the group had never
brass band, with uniforms and horns. After a few minutes we sit played together before, and it was not possible to
down and talk together. establish a beat together. Many members of the group
The atmosphere changes and becomes more relaxed and did not have contact with their own beating or the
confident. Knut asks: May we too play in the brass band? beating of the others. We therefore changed activity. To
play structured activities together was not possible.
Individual improvisation seemed to be the way to
These few notes from the first lession show that just to achieve contact and better communication. We used
move the lession from the institution to the Community the model af Creative Music Therapy (Nordoff &
Music School made an important difference. The Robbins, 1977), (Bruscia, 1987) as a startingpoint, but
pictures at the wall helped Knut to put to words an old accomodated it to the groupsituation. This
dream: to play in the brass band. On different improvisational way of work we carried on for months.
occasions, like the 17th of May (the Norwegian National
957
After some time we also worked with group- community? We contacted the local council for music
improvisations and bodycommunication: organisations. Could any of these organisations be
interested in contact and collaboration with the
members of "Upbeat"? The response was positive. A
Gradually signs meaning "fast", "slow" and "hard" and "soft"
choir wanted to work together with "Upbeat". Maybe we
were introduced and mastered. The groupmembers are
should sing and play together on the 17th of May (the
becoming more coordinated and collaborative. The musicians
National Day)? Could this be the start of a new process?
become more aware and in contact with themselves, each
other, the instruments and the music therapists. We now start to
try activities with a clear and simple structure. At a sign given by
In planning the 17th of May we worked out a lot of
the leader (one of the music therapists) each musician plays his
written musical arrangements, but realised that these
(often rather free) part. We are able to do such activities after
some months. But is this music that others would like to hear? had to be just sketches of musical ideas. Accomodation
was allways necessary, and improvisation was still an
important part of our work:
This last question became important. Three of the
members of the group were now to move out of the
The musicians were asked to improvise different atmospheres
institution and into a house in an ordinary living-quarter.
on their instruments, like "sad", "happy" or "strong". They did this
Was it possible for us as music therapists to contribute
with great interest. We found out that we wanted to improvise
to a process which could enable them to take part in the
958
together with the choir. Two traditional Norwegian songs were the community. In this process the social interaction
taken as a point of departure... One of these songs - a between the musicians is seen as very important.
springsong - was arranged with a long impovisational
introduction. The atmosphere of spring was created by
birdflutes, percussion instruments and voices. In this music- The musical products that evolve will be a synthesis of
making the members of "Upbeat" were the skilledones. They the musical competence of the two "partners". The
now had more experience in improvisation than the members of
musical organisations of the community therefore may
the choir. Instead of being"handicapped and unskilled" they
have to change their concepts of quality. In "Upbeat's"
could experience themselves as skilled musicians!
collaboration with the choir, the quality of improvisation
and spontanity was made visible (and audible). The
The (out-door) concert of the 17th of May was a members of "Upbeat" were here the skilled ones. This
success. "Upbeat" and the choir played and sang, was stimulating for "Upbeat".
improvised and smiled together. It was springtime! We
were satisfied, and we had done our first experience
How then, could we realise their first dream, to play with
with a way of work we chose to call period-collaboration.
the brass band? After two years with practice in
In a period-collaboration a group of handicapped
improvisation and structured activities, after quite a few
musicians work out musical products together with a
concerts and periodcollaborations we found that the
choir, a brass band or another musical organisation in
time was there. The headmaster of the Community
959
Music School also was conductor of the brass band. through for "Upbeat". Reidar played "Kum ba yah" on the
This was our connection: recorder. Together with him the top-administrator of the town-
hall, one of the members of the brass band, played his clarinet.
The contact between the two of them was not to be doubted.
He (the headmaster) suggested a period-collaboration between This we could see; they poked and teased each other, and
"Upbeat" and the brass band. "Kum ba yah, My Lord" and "Go smiled the whole time. When playing "Go Down Moses"
Down Moses" were now dressed in some new musical clothes. Solbjorg played a tremolo on the drum. She did this with such
"The People's Voice", a concert where the audience was asked enthusiasm that the audience applauded and she herself stood
to sing along, was on the brass band's schedule later that up and shouted in triumph, her arms up in the air!
winter. "Upbeat" could play together with the brass band on that
occasion! We couldn't quite believe it......
A dream was transformed to reality. Contacts were
The exercises began. With quite some proudness we saw how
established, and: these were contacts that could be kept
six mentally handicapped musicians had "climbed mountains".
alive after the period-collaboration. We knew that the
The pictures on the wall in the music room had now became a
natural part of their lifes, in more than one way. Under these members of "Upbeat" would meet the players of the
exercises - and in the intervals, filled with talking and brass band everywhere in the small community of
coffeedrinking - these musicians became a part of the musical Sandane: in a shop, in the library, in the tall-hown, at the
and social community. And, the uniforms, the uniforms.... filling station etc.. These were places the members of
The concert at "The People's Voice" was a kind of final break- "Upbeat" were to use more than before now, since they

960
were moving out of the institution. a) In assessing health and quality of life, the individuals
own experience and description of his lifesituation is
very important. The phenomenological perspective
Some consequences for research and ethics
should therefore be included in the research.
Research in this area is needed. We need to know more
about what kind of problems that exist, who have them
b) Many clients experience their alternatives for choice
a.s.o. And the contribution of music therapy
and action as reduced because of attitudes or practical
interventions should be evaluated. To do research in an
and economical limitations in the community. Research
area like this will require a varied and flexible approach.
should have as one objective to contribute to changes in
Both quantitative and qualitative methods for collecting
these conditions. Research that carry on the best from
and understanding data will be relevant (Hammersley &
the "action-research" tradition, therefore will be to the
Atkinson, 1987), as will be the combination of these
benefit of the clients.
(Triangulation).

It will not be a good idea to try to give very specific

norms for research in the area, but I will underline three c) Research on man can not be separated from ethics
points of view that I find important: (Fjelland & Gjengedal, 1990). In Music Therapy as
Cultural Engagement this is of outmost importance.
Much of the time we will move in a borderland between
961
cultural activities, profylactic health work and therapy. 1991).
How clear is this for the client? How clear should it be?
What about those clients that have no language and
thus cannot discuss this in words? In this area we not only need action researchers, but in
fact also "action therapists". The music therapist should
help the client to clarify his identity in the community
Conclusion through musical identification. This then, may be done
in many different ways: In working with "Upbeat" it was
A critical question is near: Can it be right to meet a
important to communicate to the community that this
"client-producing" development in the society just with
was not primary a "group of handicapped people". The
more professional help? There are no simple answers
members of the group were individuals and persons,
to this. For many clients the help is needed now, and not
with the same dreams as you and I. They were
after a long political process to change the society. Still,
musicians that wanted to take part in the community.
in Music Therapy as Cultural Engagement the music
Other times the content of the communication may go
therapist should try to change the world, if only a bit. The
further, or be more specific. Working with for instance
changes may be small, and the part of the world where
music and words in songs, the client/group may tell us
he is working may be very small. But we get a therapist-
all more about how they experience their participation,
role which is broader and more political than a
their contacts and their responsibilities in the
traditional therapist-role, see (Broch & Enerstvedt,
962
community. Dalgaard, O.S. & S0rensen, T. (red.) (1988): Sosialt
nettverk og psykisk helse. Tano, Oslo.

Fjelland, R. & Gjengedal, E. (199O): Sykepleie som

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Sogn og Fjordane. Samlaget, 1988.

963
Monsen, Nina Karin (1987): Det elskende menneske. - Summer, L. & Smeijsters, H. (1992): Music Therapy
Om person og etikk - . Cappelen, Oslo. International Report. Volume 8. Ammerican Association
for Music Therapy.
Nordoff, P. & Robbins, C. (1977): Creative Music
Therapy. Individual Treatment for the Handicapped Stige, Brynjulf (1991 a): Musiske born. Ein tekst om
Child. John Day, New York. improvisatorisk musikkterapi. H0gskuleutdanninga pa
Sandane.
Rust0ent Tone (1991): Livskvalitet. En
sykepleieutfordring. Gyldendal Norsk Forlag, Oslo. Stige, Brynjulf (1991 b): "Musiske born. - kjenneteikn pa
ein improvisatorisk musikkterapimetode". i: Stige, B. &
Ruud, Even (1981): Hva er musikkterapi? Gyldendal,
0stergaard (red.): Levande musikk. Foredrag og referat
Oslo.
fra Nordisk Musikkterapikonferanse, 1991.
Ruud, Even (199O a): Musikk som kommunikasion og
Stige, Brynjulf (1992): "Har musikkskolen behov for
samhandling. Teoretiske perspektiv pa musikkterapien.
musikkterapi?" i: Toner med variationer. Aarhus
Solum, Oslo.
Folkemusikskole.
Schj0dt, B. & Egeland, T. Aa. (1989): Fra systemteori til
Stortingsmelding nr. 52 (1973-74): Ny kulturpolitikk.
familieterapi. Tano, Oslo.
Stortingsmelding nr.37 (1992-93): Utfordrinqer i
Skarderud, Finn (1984): Farvel til institusionen.
helsefremmende og forebyggende arbeid.
Gyldendal, Oslo.
964
 indiscutible que el espritu no enferma, pero tampoco
enferma el cuerpo lo que enferma es el hombre ".
I M PO R T AN C I A D E L A R EL AC I O N M ED I C O
Y el Profesor Doctor Francisco Alonso Fernndez con
PAC I EN T E Y EL R ESC AT E D E L O S VAL O R ES
quin tambin nos perfeccionaramos afirma. Un ser
PER SO N AL ES M ED I AN T E L A M U SI C O T ER API A
psiquicamente enfermo, en el sentido a la vez doctrinal
D RA . AGUSTINA I SABEL V ERGES Y R UBEN A CUA y clinico, es aqul que ha perdido la libertad de elegir y
conducirse ". Y el catedrtico francs Renry Ey aade, "
E1 enfermar tiene que ver con la libertad ms que con
La psiquiatria mdico - antropolgica pretende captar
la verdad ", definiendo a la psiquiatria como La
en forma de sintesis unitaria lo somatolgico y lo
patologia de la libertad ".
psicopatolgico acogiendo en su seno aquellas
corrientes que apelan al estudio del hombre completo. El concepto de norma nos hace distinguir -uncontenido
La realidad clinica demuestra que lo psiquico y lo y una forma funcin.. E1 contenido de la norma
somtico no se yuxtaponen, sino que se integran, equiparable al trmino medio tiene una base estadistica
reafirmando esto nuestro maestro espaol el Doctor y, como seala la teoria del relativismo cultural, no
Juan Jos Lpez Ibor, con quien trabajaramos en constituye un estado absoluto, ni tiene un fundamento
Madrid en ocasin de haber obtenido una beca del ontolgico, sino que est subordinado al tiempo
Instituto Platense de Cultura .Hispanica,. decia " Es histrico, al lugar y a las peculiaridades de una cultura.

965
No existe una norma estable de validez general. Lo que antes que ahondar en puras disquisiciones cientificas,
en una forma de comunidad es normal, puede aparecer resumir lo que hace a estos conceptos antropolgico -
en otro tipo como una manifestacin de anormalidad. espirituales.

Una definicin que preferimos es " La psiquiatria es la En la relacin mdico - paciente es recomendable
rama humanistica por excelencia de la medicina que conocer el nimo habitual del enfermo, valorar la
trata del estudio, la prevencin y el tratamiento de los incidencia de su cultura intelectual y/ o psiquica
modos psiquicos de enfermar ". entender qu grado de confiabilidad merecida
inspiramos ponderar en cada caso qu grado de real
Antes, el enfermo psiquico no era visto como tal. Para el
persona le concedemos. Entonces para cada crisis de
profano era algo que inspiraba temor y para el mdico
salud (clinica o quirrgica) debemos observar el valor
un ente vilizacin, y viceversa, ogao nos resultan
tico espiritual de tal relacin, an a riesgo de otorgar
extemporneas o raras algunas cualidades o valores,
algo ms de lo que son o admiten nuestras
de pocas pasadas. No nos desafiar un
convicciones personales, teniendo en cuenta su
interrogante? No ser preciso incrementar o retomar,
creencia o fe, en lo que no dae, aunque para nosotros
la concepcin de algunos nobles cerebros ya clsicos,
tenga menos valor.
de que el paciente o quien demanda ayuda no es nunca
un mero " caso ms " sino una persona ? El mdico debe infundir paz y equilibrio, lo que es ms
fcil si se los tiene.
Expresado el sentido de estas reflexiones preferimos
966
Sin duda concordaremos en que la misma dedicacin cientifico natural capitaneados por Griesinger no
demanda y debe otorgarse al necesitado " medio desconocian que el enfermo como individualidad
normal ", y al disminuido leve, moderado o severo y al permanecia inaccesible a sus mtodos.
psictico.
Luego la vertiente psicolgica o cientifico - espiritual
Jams deberiamos rehuir a la. solicitud de informacin trat de llevar a cabo una descripcin comprensiva de
del interesado. Adems manejarnos con la verdad. Si, los fenmenos psiquicos (captacin del sentido de las
recordando el "primum non nocere" pero sin recurrir al vivencias), dejando al hombre como simple receptculo
engao. La verdad tiene un particular poder en si de las mismas.
misma, y siempre habr para el profesional lcido una
Por lo tanto la estructura originaria de la psiquiatria es
forma de presentarla con provecho y no deprimiendo.
bifronte generalizadora en cuanto a ciencia natural e
Por eso dijo Cristo. "La verdad os har libres".
individualizadora como ciencia espiritual. Ambas
A1 enfrentar la ansiedad, casi siempre presente cosifican al enfermo.
tenerlos en cuenta lo que afirma Goodman y Gilmant:"
Binswanger dice que la relacin mdico - paciente,
Es sintoma cardinal de muchos trastornos psiquitricos
hombre al lado del hombre, resume su concepcin de
es una de las emociones humanas estrechamente
la psiquiatria y para el filsofo alemn Martin Buber es
relacionadas con el temor que a menudo tie
justamente este encuentro interhumano la base de la
a estudiar y clasificar. Los adeptos a la psiquiatria terapia. Lo aclara asi " Si yo soy yo y TU eres TU
967
entonces ni Y0 soy Y0 ni TU eres TU, porque el modo de relacin humana con el mundo, invade y
verdadero acto de amor al prjimo es aqul en que el deglute las estructuras antropolgicas y
Y0 y el Tu se transforma en NOSOTROS ". socioculturales. As el " homo sapiens " se ha convertido
en el " homo faber " y ciertos estados psiquicos se
La entrega antropolgica exige ante el paciente, no
transforman en un estilo de vida.
slo una relacin profesional sino tambin un darse
existencialmente. E1 ser del psiquiatra reclama la Finalmente creemos que hay dos terapeuticas
existencia del psiquiatra. E1 mdico tiene que universales, que si no curan, siempre mejoran el amor y
comprometerse humanamente en su cotidiano el arte.
quehacer. tiene que esgrimir su libertad para
Segn el Doctor Rolando Benenzn, a quin tenemos
trascender al enfermo.
el honor de conocer personalmente, " Musicoterapia es
La desespiritualizacin del hombre occidental moderno la especializacin cientfica que se ocupa del estudio e
y la liberacin de sus fuerzas instintivas son datos investigacin del complejo sonido - ser humano, sea
particulares, que a su vez estn condicionados por la este musical o no, tendiente a buscar los mtodos
moderna transformacin de las estructuras diagnsticos y 1os efectos terapeuticos de los mismos ".
antropolgicas, donde impera como dispositivo de
A su vez, el sonido no tiene porque ser eminentemente
defensa personal, la racionalizacin en lugar de la
musical. tambin podr tener otras caracteristicas
represin con avances de la tcnica surgidos como un
ejerciendo iguales efectos, la cuestin es que con un
968
simple elemento logremos el estimulo correcto y Cuando el enfermo no habla o demuestra -tener - de
adecuado a la sensopercepcin que abra canales de mltiples formas - tener cortado el cordn -umbilical
comunicacin. que le une al medio circundante, algunas terapias no
clsicas emparentadas justamente con lo esttico han
En el trabajo de Terapia Musical en el Hospital
contrituido con su eficacia. Tal la musicoterapia.
Neuropsiquitrico: Alejandro Korn de melchor Romero,
institucin dependiente del Ministerio de Salud de la E1 conjunto hospitalario con el que trabajamos es
provincia de Bs As ( Argenti.na ), la msica constituye el heterogneo en cuanto a los diagnsticos, pero en e1
factor creador e integrador del grupo. Mediante ella, se ocurren cosas similares a un grupo llamado " normal "
liberan ansiedades y temores establecindose una se establecen lideraz
comunicacin no verbal o pre - verbal.
gos, competiciones, conflictos, etc. En cambio, lo que
No hay dilogo sin interlocutor vlido, asi que cuando el en realidad diferenciaria un conjunto de otro serian las
paciente no puede asumir integralmente sus vivencias maneras de satisfacer las necesidades. Los enfermos
y no se coloque a la altura de las circunstancias, el utilizan caminos regresivos que son normales en los
terapeuta deber procurar que recobre los atributos de nios pero que se presentan reidos con las actitudes
ser razonante y razonable que le son propias a su de los adultos. E1 supuestamente sano controla sus
condicin humana. Slo asi el encuentro entre paciente regresiones y descarta ciertas tensiones, equilibrando
y mdico perder el estado de fria relacin tcnica. el conflicto entre sus deseos infantiles y lo que le pide la

969
realidad. con el resto de la sociedad. Los pacientes se cosifican y
paulatinamente van perdiendo ciertos atributos Se
Una de las necesidades ms imperiosas de nuestras
debilitan y an desaparecen las coordenadas temporo
pacientes es el deseo de comunicarse y la msica
espaciales, el esquema corporal se derrumba y a
ocupa un lugar muy importante en las relaciones
fuerza de vivir " su propio mundo " disminuyen los
humanas. En las etapas primitivas, la madre mece y
estitmulos que provenientes del exterior agudizan la
mima a su hijo, casi siempre cantando una cancin de
sensopercepcin. La afectividad, aunque presentes se
cuna relacin estrecha entre msica y afecto. De all la
opaca. La realidad se ve an ms distorsionada. En
importancia de ciertos items que apuntan a ello en las
otras palabras los humanos se petrifican.'Entonces
llamadas Fichas Musicoteraputicas
surge la pregunta- Cmo lograr establecer
En nuestro hospital neuropsiquitrico, como en casi
nuevamente los sistemas de comunicacin cuando el
todas las internaciones de esta patologia, las estadas
ms importante, el lenguaje, casi se ha desvanecido ?
suelen ser de muy larga duracin y a veces las familias
Utilizando los elementos de la msica justa y
dejan a los enfermos definitivamente. Estas
adecuadamente trataremos de restaurar estas
instituciones, al decir de nuestro maestro en Paris
prdidas llegando al horizonte de la remisin, no asi de
(Francia) el Doctor Henry Baruk presentan como claro
la curacin.
simbolismo paredones o jardines rodeados de alambre
tejido, cual si sealaran una "separacin o marginacin" Pero hay algo ms. Despus de unos 7 aos de

970
sesiones de musicoterapia propiamente dichas, nos humana como la fragmentacin y el derrumbe de la
lanzamos a brindar a la sociedad, su emergente el coro. mente en la locura Rota en mltiples partes, volcada la
La Agrupacin se llama "In Musica Salus" Y damos fascinacin de un mundo y un escenario propios, la
conciertos fuera del hospital. Los propios familiares asis personalidad psictica no es sinrazn pura.

asisten. Estn uniformadas en cuanto a vestuario y son La materia dialoga con la creacin artistica y apela a la
acompaadas por instrumentistas de reconocida razn, a la afectividad, a lo imaginario; y en una lucha
trayectoria en flauta traversa y guitarra. Quin os habla casi cuerpo a cuerpo, de las entraas del hombre y de
las dirije y acompaa desde el rgano. Nuestro la substancia, nace la forma concreta o abstracta en
repertorio va desde lo popular, pasando por lo que se plasma lo humano del Arte,alquimia de la
folklrico de distintos paises, hasta lo clsico. Ellas sinrazn de la razn, en los lindes del desequilibrio y de
mismas manejan los instrumentos de percusin. la locura, pero proceso al fin donde cuaja lo humano del
hombre.
Adems de los resultados del punto de vista de la
recuperacin de las pautas sociales de cada integrante, Pero todo estmulo, an el sonoro - musical no ejerce
hemos logrado disminuir la medicacin, un mayor ninguna accin teraputica ni sn tan slo una
nmero de altas peridicas y definitivas, asi como las motivacin que inicie un proceso de cualquier tipo, si no
visitas continuas de los allegados en el propio hospital. va acompaado por el afecto del terapeuta. Se
movilizarn entonces en el paciente deseos escondidos
Jada desnuda tan al vivo, dolorosamente, la condicin
971
tras una patologia mental que encierran todo ese T H E C R O SS- AR T I ST I C APPR O AC H T O M U SI C
caudal de sentimientos que llevan al camino de la T H ER APY: T H E I M AG I N AT I O N AN D H ER E- AN D -
comunicacin. Recin aqui la relacin mdico - N O W L I F E / APR O XI M AC I N AR T ST I C A
paciente se habr establecido con fluidez, fruto de una M L T I PL E A L A M U SI C O T ER API A: L A
corriente afectiva que envuelve a ambos. I M AG I N AC I N Y L A VI D A C O T I D I AN A

Quizs para concluir este pequeo aporte el trozo ms H EIDI A HONEN

inspirado resulte aqul del Apstol San Pablo que se
registra en las Sagradas Escrituras " Las profecias se
acabarn y la ciencia tornar a su fin pero el Amor Brief description: Imagery, music and art will be used to
nunca dejar de ser " evoke better self-knowledge.

An experience-oriented workshop engaging

participants in the use of their imagery, creativity, music
3.3.- MUSIC AND MUSICAL DEVELOPMENT - and visual art aimed at broadening their ability to
MUSICA Y DESARROLLO MUSICAL
( ABSTRACTS) understand themselves and their identity and their life-
situation and resources through the use of their
imagination, guided music-listening, water-color
painting and improvisation.

972
Cross-artistic approach to music therapy: music, for many reason.

1. Music * Being clear with oneself opens the way for being
more clear with others about how one feels and thinks.
2. Painting

3. Story-telling
Breve descripcin: Se utilizarn las imgenes, la msica
4. Improvisation.
y el arte para evocar mejor el auto-conocimiento.
4.1 "My Piece of Music"
Se trata de un taller orientado hacia la experiencia, en
* When composing the piece of music that
el cual los participantes se comprometen en la
describes the feeling and the attitude of the painting, the
utilizacin de su imaginacin, creatividad con la msica
outer feeling turns into the inner feeling. When playing
y las artes visuales, con el fin de ampliar su habilidad
the music to the others the inner feeling turns back to
para comprenderse mejor a s mismos y su vida
the outer.
cotidiana. Los participantes deben explorar su
* Better understanding of oneself is gained. identidad, sus recursos y su situacin vital utilizando su
imaginacin, la escucha guiada de msica, la acuarela
4.2 "Improvisation-making contact"
y la improvisacin.
* People tend to choose a partner who had similar
Aproximacin artstica mltiple a la Musicoterapia:
kind or opposite feeling state in his painting or in his
973
1. Msica * Ser claro consigo mismo conduce a ser ms claro
con los dems acerca de lo que se piensa y se siente.
2. Pintura

3. Contar historias

4. Improvisacin M AN AN D M U SI C : O N T O PH I L O G EN ET I C
D EVEL O PM EN T / EL H O M BR E Y L A M SI C A:
4.1 "Mi propia msica"
SU D ESAR R O L L O O N T O F I L O G EN T I C O
* Cuando se compone la msica que describe la
sensacin y la actitud de la pintura, la sensacin L EONOR F. DE A LEMANN
exterior se transforma en sensacin interior. Al
interpretar la msica a los dems, la sensacin interior
Now we know that nothing in our make-up, or in the
vuelve a salir al exterior.
make-up of animals, is incidental. The evolution of the
* Se alcanza una mejor comprensin de s mismo. nervous system in a wide range of living beings proves
4.2 "Improvisacin-contacto" this. Our brain is not only formed of the cortex, which
distinguishes us from all else, but it also maintains the
* Por muchas razones, a la hora de pintar o hacer
thalamous, rachidial bulb, the mesencephalus that we
msica, la gente tiende a elegir un compaero que
already find in inferior animals and that still fulfill their
tena un estado de sensibilidad anlogo u opuesto.
functions both in animals and in the human being. I am
974
not able to go into further detail here, because my porque s: tanto en el animal como en el hombre, la
theme is "man and music" and where is the music ? evolucin del sistema neuronal, a travs de toda la
gama de seres vivientes, es un claro ejemplo. Nuestro
As music therapists, it is annoying to hear the power of
cerebro est formado no slo por la masa cortical que
music referred to as "magical", especially when it has
nos distingue, sino que mantiene el tlamo, el bulbo
been explained scientifically. We know that it is
raqudeo, el mesencfalo que ya encontramos en
associated with a particular part of the central brain; and
animales inferiores y que hoy siguen cumpliendo con
further, that it is connected to our vital behaviour,
sus funciones tanto en el animal como en el hombre.
behaviour essential to our being. Undoubtedly, the
passing on of customs from generation to generation En esta exposicin, no es posible entrar en detalles.
plays a vital role in the lives of each of us. Who can Por qu el tema es el hombre y la msica?; y dnde
remain unmoved on hearing a particular lullaby, a est la msica?
march, a trumpet fanfare or a hymn ? Paying particular
A los musicoterapeutas, no nos gusta que el poder de la
reference to our heartbeat, who can remain unaffected
msica sea denominado mgico, porque hoy podemos
by the melodies of a nursery rhyme, or the folk dance of
explicar su especificidad y sabemos que mucho ms
our ancestors.
profundamente est arraigado en nuestro ser, en los
centros que rigen nuestros comportamientos vitales.
Indudablemente, la transmisin generacional de las
Podemos afirmar que nada se cre, creci o form
975
costumbres y tradiciones tambin juega un rol individual to discover his/her creative and expressive
importante en cada uno de nosotros: quin no possiblities, using them to communicate with the others.
reacciona frente a una cancin de cuna, una trompeta o
Our way to understand art and the standards of beauty
fanfarria, una ronda, una marcha o un himno y ms
consider, first of all, everyone's interior life, and the
especficamente a los ritmos cardacos, de caminar, a
necessity of bringing out and retaking the production as
las melodas maternas, melodas y danzas folklricas
a starting point for communication.
de nuestros ancestros?
Visual Plastic and Music are complimentary, and in the
limits between both artistic areas is where an
assemblage takes place. Joined together, they multiply
VI SU AL PL AST I C AN D M U SI C / PL ST I C A
their influences in the development of the Human Being,
VI SU AL Y M SI C A
like Kandinsky thought speaking about the monumental
A NA M B ALLESTA & M A NGELES M ARTI art.

As we analyze the progression of musical and plastic

We are trying to research the possibility of a joined work elements, we find multiple connections and
using Visual Plastic and Music. interrelations. To contemplate the contrasts between
those elements makes enormously rich their
Departing form the conception of the Human Being and
experimentation and assimilation.
his multiple experiences, we are trying to help each
976
Finally, we contribute with a vision of the different La complementariedad entre Plstica Visual y Msica
materials that can be used in the proposed activities, respeta los lmites de ambas reas artsticas y en estos
and its adaptation to them. Always using a personal and puntos donde se produce el ensamblaje. Se unen y as
stimulating perspective to awaken the curiosity of the multiplican sus influencias en el desarrollo del Ser
child we all bring inside. Humano, como pensaba Kandinsky al hablar del arte
monumental.

A medida que analizamos la progresin de los

Tratamos de investigar la posibilidad de un trabajo
elementos plsticos y musicales encontramos mltiples
conjunto de Plstica Visual y Msica.
conexiones e interrelaciones. Contemplar los
Partiendo de la concepcin del Ser Humano y de sus contrastes entre los elementos enunciados enriquece
mltiples experiencias, pretendemos que cada enormemente la experimentacin y asimilacin de los
individuo descubra sus posibilidades creativas y mismos.
expresivas y las pueda utilizar con un fin comunicativo.
Por ltimo aportamos una visin de los diferentes
Nuestra forma de entender el arte y los patrones de materiales que se pueden utilizar en las actividades que
belleza considera ante todo la vida interior de cada uno, planteamos y su adecuacin a los mismos. Aunque
la necesidad de sacar fuera y retomar la produccin siempre desde una perspectiva personal y motivadora
como punto de partida de la comunicacin. que despierte la curiosidad de ese nio que todos

977
llevamos dentro. setting and objectives of the task to be undertaken.

This conference is meant to present a reflection on

some forms of musical games within a music therapy
R ESO N AN C E L ABO R AT O R Y: C O O R D I N AT ED
context, based on experience acquired with children,
U SE O F VO I C E, G EST U R E, M O VEM EN T AN D
adults and the elderly. Theoretical principles will be
PO L YPH O N I C I N ST R U M EN T AL
related to the clinical experiments shown.
I M PR O VI SAT I O N I N M U SI C T H ER APY /
L ABO R AT O R I O D E R ESO N AN C I AS: EL U SO
C O O R D I N AD O D E L A VO Z , D EL G EST O , Tocar msica y el carcter de los diferentes tipos de
M O VI M I EN T O Y D E L A I M PR O VI SAC I N comunicacin en musicoterapia, toman formas
M U SI C AL PO L I F N I C A EN M U SI C O T ER API A diversas en funcin a las dificultades y potenciales del
paciente, terapeuta, marco ("cadre" en francs, "setting"
M ICHAEL D WYER
en ingls) y de los objetivos de trabajo.

Basndose en la experiencia adquirida con nios,

The playing of music and the character of other adultos y personas de la tercera edad, esta
methods of music therapy communication adopts comunicacin se propone presentar una reflexin
several forms in relation to the difficulties and sobre algunas formas de juego musical en la
possibilities of the patient and the therapist and also the musicoterapia. Aprovechar esta oportunidad para
978
comentar unos principios tericos con las experiencias view. It is a level of sound involvement which starts and
clnicas presentadas. develops exclusively from the voice as it belongs
entirely to the person who produces the sound.
Moreover this experience aims at letting the participants
VO I C E AS A M EAN S O F EXPR ESSI N G become aware of what a sound relation with a patient
EM O T I O N S / L A VO Z C O M O M ED I O D E can indicatively mean.
EXPR ESAR L AS EM O C I O N ES The workshop is set up in a "pre-logic" dimension: the

G IANLUIGI D I F RANCO first phase gives the possibility of learning how to

express oneself using directly one's own voice; then, the
second one the possibility of using the voice as an
This workshop means to offer suggestions, directions instrument to convey emotions.
and practical exercises for the use of voice in its
broadest sense.
Este taller quiere dar sugerencias, indicaciones y
Voice is the first channel through which we become
ejercicios prcticos entorno al uso de la voz,
aware of the possibility of expressing deep emotions. A
considerada como el ms amplio concepto de
training in this field could be interesting for those
vocalidad.
operators who approach music therapy in order to
analyze their being involved from an emotional point of
979
La voz es el primer canal que toma conciencia de la T H E M EN T AL R ET AR D AT I O N L ABEL AN D
posibilidad de expresar emociones profundas: este M U SI C T EAC H ER S` AN D PR O SPEC T I VE
entrenamiento puede resultar interesante para los T EAC H ER S` EXPEC T AT I O N S F O R C H I L D R EN ' S
profesionales que se acercan a la musicoterapia para SO C I AL AN D M U SI C BEH AVI O R S / EL
experimentar su posibilidad de compromisin referida T R M I N O R ET R ASO M EN T AL Y L AS
al aspecto emotivo; un nivel de implicacin sonora que EXPEC T AT I VAS D E PR O F ESO R ES Y F U T U R O S
parte y se desarrolla nicamente desde la vocalidad PR O F ESO R ES D E M SI C A PAR A C O N L O S
como aspecto completamente perteneciente a la C O M PO R T AM I EN T O S SO C I AL ES Y
persona que lo produce. Adems esta experiencia M U SI C AL ES D E L O S N I O S
tiende a hacer conocer lo que puede indicativamente
JUDITH A. JELLISON & ROBERT A. DUKE
significar una relacin sonora con un paciente.

El taller est colocado en una dimensin "prelgica": en

una fase inicial hay la posibilidad de aprender a The purpose of the present study was to examine the
expresarse directamente usando la voz y effect of the label "mental retardation" on teachers' and
sucesivamente emplear la voz como instrumento para prospective teachers' expectations for children entering
comunicar emociones. their music classrooms. Subjects (N=336) were
university music education majors (n = 95) and public
school elementary music teachers (n = 139). Subjects
980
were presented with a hypothetical scenario in which Subsequent factor analyses revealed a four-factor
they, as teachers, were permitted to admit students or structure within the set of 25 social behaviors. The four
not admit students to their music class based on factors encompassed classroom routines, emotion and
students' indicating the degree to which they communication, responses to verbal and nonverbal
considered each behavior "essential" for a potential new cues and directions, and eagerness and involvement in
student to have demostrated prior to being admitted to activities.
class.

Across all respondents, music and social behaviors

El propsito del presente estudio era examinar el efecto
were considered more essential for the new nonlabeled
del trmino "retraso mental" en las expectaciones de
student than for the new student with retardation.
profesores y futuros profesores para con los nios, en
Teachers and pre-service teachers expressed a
sus clases de msica. Los sujetos (N = 336) eran
greater willingness to teach music and social behaviors
estudiantes univer-sitarios de educacin primaria (n =
to a student labeled as having retardation than to teach
95) y profesores de msica en escuelas pblicas de
the same behaviors to a nonlabeled student. In addition,
primaria (n = 139). Los sujetos fueron presentados con
teachers expressed a greater willngness overall to
una situacin hipottica en la que ellos, como
teach music behaviors to a new student entering their
profesores, fueron permitidos a admitir o no
classrooms than was expressed by either of the
estudiantes en sus clases de msica basndose en su
prospective teacher groups.
981
habilidad social y musical. Los sujetos evaluaron listas cualquiera de los grupos de futuros profesores.
de 25 comportamientos musicales y 25
El subsiguiente anlisis de factores revel una
comportamientos sociales, indicando el grado de
estructura de cuatro factores en el grupo de 25
comportamiento que ellos consideraban "esencial" en
comportamientos sociales. Los cuatro factores
un estudiante potencial, habiendo sido demostrado
incluyeron rutinas de clase, emocin y comunicacin,
antes de ser admitido en la clase.
respuestas a indicaciones e instrucciones verbales y
Todos los que respondieron consideraron que los no-verbales, y ahnco y compromiso en las actividades.
comportamientos musical y social eran ms esenciales
para los nuevos estudiantes no clasificados que para
los nuevos estudiantes retrasados. Los profesores SO N G SEN SI T AT I O N : T H E T H ER APEU T I C U SE
reales y los profesores en prcticas expresaron una O F SO N G AN D I T S EF F EC T U PO N G R O U P
mayor inclinacin a ensear comportamientos PR O C ESS / SO N G SEN SI T AT I O N : L A
musicales y sociales a un estudiante clasificado como U T I L I Z AC I N T ER APU T I C A D E L A C AN C I N
retardado que ensear los mismos comportamientos a Y SU S EF EC T O S SO BR E EL PR O C ESO
un estudiante no clasificado. Adems, los profesores G R U PAL
expresaron una mayor inclinacin general para
J OANNE L OEWY
ensear comportamientos musicales a un estudiante
nuevo integrndose en sus clases que lo expresado por
982
Song Sensitation@ is a method of music therapy that enhances intra as well as inter consciousness
created by the presentor. It was developed for the small within groups. Song Sensitation@ invites group
(2-6 member) emotionally handicapped, adolescent members to share their nost relevant issues through the
music therapy group. This presentation will view Song use of song. Song becomes an accessible framework
Sensitation@ in terms of psychodynamic theory and for the group, allowing each member the structure and
group process before providing practical and safety to explore his authentic self through symbolism
experiential applications within the (video and live) while enhancing the group domain through the sharing
presentation of several actual group experiences. and taking in of others.

What is your favorite song? Where and when did you Song Sensitation@ is a four step method of music
first hear it? What is its message? Does your selection therapy derived from two processes: sensation and
of a favorite song change through time or has it citation. It utilizes the act of citing the sensations of song
remained the same? through the use of: 1.Selecting, 2.Listening,
3.Reflecting, 4.Actualizing. Psychotherapy principles,
Song Sensitation@ is founded on two basic principles of
group process as well as Bonny's induction techniques
thought: the symbolic transformation of perceptions
are all included in the Song Sensitation@ process
(Langer, 1953) and the Gestalt concept of commanding
form; the reshaping yet maintaining notion of the self @Copyright Loewy 1991
(Perls, 1975). It suggests a method of music therapy

983
Song Sensitation@ es un mtodo de musicoterapia sin embargo mantenida nocin del yo (Pearls, 1975).
creado por la presentadora que lo desarroll para Sugiere un mtodo de musicoterapia que destaca la
grupos reducidos de musicoterapia (2-6 miembros) de intra-conciencia as como la inter-conciencia dentro de
adolescentes con disminuciones emocionales. Esta los grupos. Song Sensitation@ invita a los miembros del
presentacin estudiar Song Sensitation@ en trminos grupo a compartir sus temas ms importantes a travs
de teora psicodinmica y proceso de grupo antes de de la utilizacin de la cancin. La misma se transforma
mostrar las aplicaciones prcticas y de experiencia con en el marco accesible al grupo proporcionando a cada
la presentacin (en vdeo y en directo) de varias miembro la estructura y seguridad para explorar su
experiencias de grupo reales. autntico yo a travs del simbolismo y aumentando el
dominio del grupo por medio del intercambio con los
Cul es su cancin favorita? Dnde y cundo la
dems.
escuch por primera vez? Cul es su mensaje? Su
eleccin de cancin favorita cambi con el tiempo o Song Sensitation@ es un mtodo de musicoterapia que
sigue siendo la misma? consta de cuatro fases, derivndose de dos procesos:
sensacin y citacin. Utiliza el acto de citar las
Song Sensitation@ se basa en dos principios
sensaciones suscitadas por la cancin a travs de la
fundamentales del pensamiento: la transformacin
utilizacin de: 1. Seleccin 2. Escucha 3. Reflexin 4.
simblica de las percepciones (Langer, 1953) y el
Actualizacin. En el proceso de Song Sensitation@ se
concepto Gestalt de forma de comando; la reformada y
incluyen principios de psicoterapia, procesos de grupo
984
as como las tcnicas de induccin de Bonny. The time.

The rhythm.

WO R KSH O P ABO U T R YT H M / T AL L ER SO BR E
RIT M O La intencin del taller es, ser lo ms elemental y
esencial posible y se iniciar las experiencias en el
A TTILA R ICHARD M ISSURA
punto donde se origina el ritmo: En la vivencia del
tiempo mismo. En este sentido hay tambin un
The aim of the workshop is to be as elemental and basic pensamiento central del taller: redefinir el ritmo como
as possible, and experiments will start from the point "cdigo que indica, como experimentar el tiempo por
where the rhythm is generated; in living a moment in medio del movimiento".
time. The workshop has an underlying thought in this
sense: to redefine rhythm as a "code which indicates
Contenido
how to experience time through movement".
El pulso

El comps
Contents:
El Ritmo
The beat
985
 presentation will also focus on Klein's concept of
reparation as a motivating force for the creative
T R AN SF ER EN C E I N T H E M U SI C T H ER APY
process. Case examples which demonstrate reparation
R EL AT I O N SH I P / T R AN SF ER EN C I A EN L A
through music, the awakening of the "music child", and
R EL AC I N M U SI C O T ER APU T I C A the unique transference issues that arise during this

L OUISE M ONTELLO process will be shared, along with a live demonstration

of music's reparative role within the psychodynamic
music therapy context.
In this lecture/demonstration the concept of
transference in the patient-therapist relationship will be
explored in the light of the object relational theories of En esta conferencia, se estudia el concepto de la
D.W. Winnicott and Melanie Klein. Special attention will transferencia en la relacin paciente-terapeuta, a la luz
be given to transference issues related to Klein's theory de las teoras relacionales de D.W. Winnicott y Melanie
of the paranoid-schizoid and depressive positions. Klein. Se prestar especial atencin a los temas de la
Specific musical case examples will be offered to help transferencia relacionados con la teora de Klein de las
participants to discriminate, both in the music and posiciones paranoico-esquizoides y depresivas. Se
verbally, where the client may or may not be ofrecern ejemplos musicales especficos para que los
developmentally fixated, and what specific kinds of participantes puedan determinar, tanto con msica
music therapy interventions are indicated. The como verbalmente, cundo el cliente puede ser fijado a
986
nivel de desarrollo y qu tipo especfico de EL T EM A D E L A C O N T R AT R AN SF ER EN C I A
intervenciones de musicoterapia es el ms adecuado. D EN T R O Y F U ER A D E L A M SI C A
La ponencia se centrar tambin en el concepto de la
L OUISE M ONTELLO
reparacin de Klein como fuerza de motivacin para el
proceso creativo. Se presentarn ejemplos de casos
que demuestran la reparacin a travs de la msica, el This workshop is offered to music therapists, who want
despertar del "nio msico" y los temas propios de la to experience a music therapy supervision--on work
transferencia que surgieron durante el proceso, junto with clients with whom they have problems--that
con una demostracin en vivo del papel reparador de la incorporates music therapy techniques in the
msica en el contexto de la musicoterapia supervision process. Participants can come from a
psicodinmica. variety of backgrounds-they do not have to be analytical
music therapists. The participants are expected to
either speak about their work or to have audio or video
AD VAN C ED M U SI C T H ER APY SU PER VI SI N tapes with them to present. This material will be used as
WI T H F O C U S O N I SSU ES O F a starting point for the experiential work. The
C O U N T ER T R AN SF ER EN C E I N SI D E AN D experiential work will be videotaped and used as
O U T SI D E T H E M U SI C / SU PER VI SI N D E L A teaching material in the workshop.
M U SI C O T ER API A AVAN Z AD A, D EST AC AN D O
987
 SAB A. T AL L ER D E C R EAT I VI D AD M U SI C AL A
PAR T I R D E L A VO Z Y D I VER SO S M AT ER I AL ES
Este taller se ofrece a los musicoterapeutas que
deseen experimentar una supervisin de musicoterapia N LIDA H IROKO N AKAMURA
que incorpore tcnicas de musicoterapia en el proceso
de supervisin, sobre el trabajo que realizan con
clientes con los cuales tienen problemas. Los The aims of this workshop are:
participantes pueden proceder de campos distintos, no * to work wit the "uncertain" elements of music
es necesario que sean musicoterapeutas analticos.
using an expressive perspective.
Los participantes debern hablar de su trabajo o
presentar cintas o videos. Este material se utilizar * to recycle knowledge in order to come up with
como punto de partida para el trabajo de experiencia. an original product.
Dicho trabajo se grabar en vdeo y se utilizar como
* to use the context as a means of getting more
material de enseanza en el taller.
out of musical practice.

I H AD I T , BU T I D I D N O T R EAL I Z E I T . M U SI C AL
Los objetivos de este taller son:
C R EAT I VI T Y WO R KSH O P U SI N G T H E VO I C E
AN D O T H ER M AT ER I AL S / L O T EN A Y N O L O * Trabajar los elementos aleatorios
988
 de la msica desde and inter-personal processes within a group through
vocal, sound, instrumental, role-playing and drama
propuestas expresivas.
activities. Music is a (non-verbal) language in a primitive
* Reciclar el conocimiento para state of development, prior to verbal language. It is
elaborar un producto propio. capable of transmitting semi-conscious feelings and
sensations with ease, without having to use intellectual
* Apropiarse del contexto para
processes. It uses all levels of thought, culture, and
enriquecer la prctica. especially feelings. It acquires meaning through the
association of representing affection, and belongs to
the world of expression of feelings.
M U SI C AL PSYC H O - D R AM A / PSI C O D R AM A
Using sounds and voices we look for meaningful
M U SI C AL
images, experiences and memories of the different
M ONICA P ETRUCH DE T ANNY & ARIELA N IR stages in a person's life. The dynamics of interpersonal
relationships are investigated through musical
improvisation.
Musical psycho-drama is the meeting point of psycho-
drama and music therapy, offering the possibility of Psycho-drama uses the stage and the group
living, expressing, investigating and analyzing personal participants as a mirror of the soul. It enables you to

989
experience moments of your life, memories, dreams, instrumentales, interpretativas y dramticas. La msica
desires and fantasies through drama. It allows you to go es un lenguaje no verbal en un estado primitivo de
deeper and analyze personal and inter-personal desarrollo, previo al lenguaje verbal. Es capaz de
conflicts and to propose spontaneous and creative transmitir con facilidad sentimientos y sensaciones
alternatives to face up the different situations that life semi-conscientes, sin tener que utilizar los procesos
confronts us with. Sometimes, in that space where there intelectuales. Utiliza todos los niveles de pensamientos,
are no words or where words cannot enter, that is cultura y especialmente sentimientos. Adquiere sentido
where voices and sounds can suggest a new level of a travs de la asociacin de los afectos y pertenece al
contact. Sometimes, behind the sounds and music, mundo de la expresin de los sentimientos.
words and phrases are hidden which are difficult to utter
Utilizando los sonidos y las voces, buscamos imgenes
and face up to.
llenas de sentido, experiencias y recuerdos de las
diferentes etapas de la vida de una persona. La
dinmica de las relaciones interpersonales se investiga
El psico-drama musical es el punto de encuentro del
a travs de la improvisacin musical.
psico-drama con la musicoterapia, ofreciendo la
posibilidad de vivir, expresar, investigar y analizar los El psico-drama utiliza el escenario y los participantes
procesos personales e interpersonales dentro de un del grupo como espejo del alma. Permite a cada uno
grupo, a travs de las actividades vocales, sonoras, experimentar momentos de la propia vida, recuerdos,

990
sueos, deseos y fantasas a travs del drama. Permite T H E F R EE I M PR O VI SAT I O N G R O U P: SO U N D S
ahondar y analizar los conflictos personales e AN D C ER EM O N I ES O F KN O WL ED G E / G R U PO
interpersonales y proponer alternativas espontneas y D E I M PR O VI SAC I N L I BR E: SO N I D O S Y
creativas para enfrentarse a las diferentes situaciones C ER EM O N I AS D EL C O N O C I M I EN T O
que la vida nos presenta. A veces, en el espacio en que
G USTAVO R ODRIGUEZ E SPADA
no hay palabras o donde las palabras no pueden
entrar, es el lugar donde las voces y los sonidos pueden
sugerir un nuevo nivel de contacto. A veces, detrs de This workshop is the experiential side to the talk
la msica y los sonidos, se esconden las palabras y las "Aesthetic Transition". It is a practical / theoretical
frases difciles de pronunciar y tratar. exploration in group context, where via improvised
sound/body discussions we consider knowledge from
an aesthetic perspective.

The aim is to think about what we know or construe from

a non-verbal discussion. How do we establish
ceremonies and greeting rituals, and how do we
construe and change the feelings in these encounters?
How do we make communication an aesthetic
phenomenon?
991
We will work on the concept of syntax, the construction encuentros, cmo se construye la comunicacin como
of speech and other knowledge. fenmeno esttico.

Also if Jorge Luis Borges was correct in saying "music, Intentaremos trabajar sobre el concepto de sintaxis, del
mysterious form of time", then we will also touch the discurso como construccin de Otro conocimiento.
topic of time.
Si es cierto el decir de D. Jorge Luis Borges de que "la
msica, misteriosa forma del tiempo", tal vez

El taller constituye la faceta de la experiencia de la indaguemos en el tiempo.

ponencia titulada: "La Transicin esttica". Se trata de

un trabajo terico-prctico, en el contexto de un grupo
de improvisacin libre en el que, mediante la
generacin de discursos sonoro-corporales EVO L U T I O N AL D EVEL O PM EN T /

improvisados, abordaremos el problema del D ESAR R O L L O EVO L U T I VO

conocimiento desde una perspectiva esttica.
S ARA R OMANO
El objetivo ser pensar qu es lo que se conoce-
construye en un discurso no verbal, cmo se
The objective of this present work is to show the
establecen ceremonias y ritos de encuentro y se
different sonorous-bodily approaches to the areas of
construyen y modifican los sentidos de estos
992
detention of the development, according to Anna M U S I C T H E R A P Y `E X P E R I E N C E S I N I T A L I A N
Freud's concept in her book:"Normality and Pathology SC H O O L S / EXPER I EN C I AS D E
of Childhood". It unifies psychoanalytical concepts with M U SI C O T ER API A EN L AS ESC U EL AS
Music Therapy techniques, and allows us to work with I T AL I AN AS
extremely regressive pathologies such as autistic
L ILIANA R OSSI P RITONI
children and simbiotic phenomena.

Since ten years ago, Italian special schools and

El presente trabajo tiene como objetivo mostrar las
Institutes for mental disabilities have been eliminated,
diferentes formas de acercamiento sonoro-corporal a
and all children with psyco-phisic or social problems are
las reas de detencin del desarrollo de acuerdo al
included in educative communities.
concepto de Anna Freud vertido en su libro "Normalidad
y Patologa en la niez". Unifica conceptos Our research starts from a constitutional concept: to
psicoanalticos con tcnicas propias de la offer to every Italian citizen the opportunity of
Musicoterapia y nos permite trabajar con patologas en development on the ground of his own ability. We have
extremo regresivas tales como el autismo y los resolved to allow every expression of communication,
fenmenos simbiticos. starting from the easiest for the child.

Music is for the child one of the first ways of

993
communication (for exemple the "lallazioni" are comunidades educativas todos los nios en dificultad
expressed in third minor). por causas psico-fsicas o sociales.

Our methodology, including music and sound as Naturalmente lo que ha mayormente estimulado
important elements, is adressiong to children nuestra investigacin ha sido lo que nuestros papeles
handicapped and it is applied in schools. constitucionales nos han dictado, o sea, que cada
ciudadano italiano tiene iguales oportunidades de
I like to finish my report with a statement that you can
desarrollo, segn sus propias capacidades.
find in the introduction of our first European meeting: "If
we are able to transform by means of our music therapy Puesto que la motivacin social es prevalente, antes de
interventions the potentiality of a handicapped child in todo nos hemos propuesto combatir todas las formas
operative capacities, in social integration, in pleasure to de marginacin y de privilegiar la comunicacin en
life, we should accomplish the dictates of the Italian todas sus formas, partiendo desde las que el nio
Constitution, that is the greatest pupil's development. percibe y expresa ms fcilmente.

La msica, que es un lenguaje pre-verbal y es uno de

los primeros modos de expresin del infante
Las escuelas italianas, desde ms de diez aos, han
(recordamos las primeras pronunciaciones
casi completamente eliminado las escuelas especiales
defectuosas en un tercer grado menor), y el sonido,
y los institutos de asilo para menorados mentales
que llega en las partes ms escondidas de nuestro ser,
destinados a la infancia y, han inserido en las
994
han sido utilizados por nuestros educadores desde la M U SI C AN D ED U C AT I O N / M SI C A Y
edad ms tierna. ED U C AC I N

En nuestras metodologas de encuentro con el nio con M L OURDES S EKEFF Z AMPRONHA

handicap, la msica y el sonido han ya entrado en las
escuelas con resultados muy buenos.
This paper deals with the subject of "Music and
Deseo terminar mi informe con una afirmacin
Education" and in it we will try to show that:
expresada en la introduccin de los actos de nuestro
primer convenio europeo: "Si logramos transformar, Music is a way of behaviour which makes people think,
mediante nuestras intervenciones de musicoterapia, and which plays a considerable role in a person's
las potencialidades existentes en el nio con handicap development, in a society, in a country and in any group
en capacidades operativas, en interacciones sociales, in the sense that the arts give us hope for the future
en la alegra de vivir, habremos cumplido con los over and above class differences, and it is in the world
dictmenes de la constitucin italiana que quiere el of arts that key elements for a liberating practice are
mximo desarrollo de los alumnos que nos han developed.
confiado. As a phenomenological and triadic experience, with an
analogy in the categories of thought and the nature of
Peirce, music is a language which can be seen in

995
different lights, benefitting both the educator and process which includes creativity, where doing and
especially the therapist. If as a text, it is alteration experimenting generate a scheme of meanings which
(Proust's theory) and autonomy (Valry's theory), then form a part of human behaviour and thought.
the creation and experience of this sensitive language
contribute to the expression of our ego, ever
discovering some subconscious element which both
Esta Comunicacin gira en torno al tema "Msica y

reveals and hides. This is precisely due to the fact that

Educacin", y en ella tratamos de demostrar que:

music always has a gap which is filled by the La Msica es una forma de comportamiento, que
imagination of a person and where the specific stamp of produce cabezas pensantes y que desempea un
the subject is left (such as with one's voice). papel considerable en la formacin del individuo, de la

Talking directly to our body, to our mind or to our

sociedad, del pueblo, de la colectividad, en el sentido

emotions, evoking, associating and integrating

de que en las artes se cifra la esperanza de un futuro

experiences, this spiritual activity "obtained through

por encima de clases, y de que en ellas se generan los

fantasy directed by calculation" (Juan Carlos Paz, 1977)

elementos claves de una prctica liberadora. Como

shows similarities to dynamism and the productions of

experiencia fenomenolgica y tridica, con analoga en

the subconscience: condensation techniques, using the

las categoras del pensamiento y de la naturaleza de

same materials for two different meanings, the three

Peirce, la msica es un lenguaje que permite realizar

large groups catalogued by Freud within the funny

diferentes lecturas, beneficiando al educador y
996
especialmente al terapeuta. Si como texto es alteridad creatividad, en donde el hacer y el experimentar
(leccin de Proust) y autonoma (leccin de Valry), la generan un esquema de significados partcipes del
creacin y experiencia de ese lenguaje de lo sensible comportamiento y del pensamiento humanos.
contribuyen a la expresin de nuestro yo, descubriendo
siempre algn elemento del subconsciente que ella
revela y oculta. Debido, exactamente, a que la msica M U SI C - PSYC H O T H ER APEU T I C EXPER I EN C I ES
muestra siempre una laguna que es completada por la / EXPER I EN C I AS M U SI C O -
imaginacin del otro, y en la que se encuentra impresa PSI C O T ER APU T I C AS
la marca particular del sujeto (como en la voz).
M ARISTELA P IRES D A C RUZ S MITH
Hablando directamente a nuestro cuerpo, a nuestra
mente y a nuestras emociones, evocando, asociando e
integrando experiencias, esa actividad espiritual This study reports a music-psychotherapeutic process,
"obtenida a travs de la fantasa dirigida por el clculo" developed during eighteen months, making up a total of
(Juan Carlos Paz, 1977), presenta semejanzas con el 56 encounters. During this procedure a group of five
dinamismo y las producciones del subconsciente: women - under the supervision of a music-therapist and
tcnicas de condensacin, empleo del mismo material y a psychologist - went through sonorous-rhytmic
doble sentido, los 3 grandes grupos catalogados por experiences, which were later analysed by the group,
Freud en el proceso chistoso, y que envuelven a la following pedagogical and therapeutical guidelines.
997
The link between Musictherapy and Psychotherapy has and its conclusion could be carried out.
enabled new possibilites of scientifical exploration, as
The music therapy reading, done after the first stage of
this experience has been developed based on research
each session, was based in direct observations,
method, experimentation, search, analysis,
recording and objective notes.
generalization, comparison and conclusion.
Our conclussion is that Didactic Music Therapy has to
All the instrumentation - sonorous, environmental,
be available to professionals and students of Music
neural, physical, vocal and electronic - presented
Therapy and other related disciplines in the medical
relevant correlation and also a relation with previous
area, which reflect the necessity of
and current elements of each individual life.
personal/professional complementation of those who
The reaction to the stimulated sounds or to the are willing to work with people carrying various
improvised ones not only depended on the external compromises.
sonorous objects, but it was also related to the
characteristic mosaic inherent to each one, their own
atmosphere. To make a constant, periodical evolution,
En este trabajo se narra un proceso musico-

the sonorous-rhythmic musical history was written in

psicoteraputico que se llev a cabo durante un ao y

individual cards during the whole process. This way, the

medio y en el que tuvieron lugar 56 encuentros. A

comparative analysis between the begining of the work

travs de dichos encuentros, un grupo formado por
cinco personas del sexo femenino, bajo la orientacin
998
de una psicloga y una musicoterapeuta, tuvo la comparativo entre el comienzo del trabajo y su
oportunidad de experimentar vivencias sonoro-rtmicas conclusin.
y de analizarlas, siguiendo la orientacin didctico-
La lectura musicoteraputica, hecha tras la primera
teraputica.
etapa de cada sesin, se bas en observaciones
Toda la instrumentacin sonora ambiental, natural, directas, grabaciones y anotaciones seriogrficas
corprea, vocal y electrnica mantuvo relaciones objetivas.
significativas entre s, respecto a las funciones ligadas a
Se concluye que la Musicoterapia Didctica debe estar
las historias anteriores y al momento por el que pasaba
a disposicin de profesionales y estudiantes, tanto de
cada elemento en el grupo.
musicoterapia como de otras disciplinas,
La reaccin a los sonidos estimulados o emitidos pertenecientes al rea de la paramedicina, pues refleja
improvisadamente no dependi solamente de los la necesidad de un complemento personal/profesional
objetos sonoros externos, sino sobre todo del mosaico en todo el que se propone lidiar con seres portadores
caracterstico inherente a cada una en su medio de los ms variados compromisos.
ambiente. Para que la evolucin peridica fuera
constante, se redact durante todo el proceso la
historia sonoro-rtmico-musical por escrito, en fichas
individuales. De esta forma, se puede realizar el anlisis

999
WH ER E T H ER APY AN D ED U C AT I O N M EET AN D la autora como musicoterapeuta que ha trabajado en
D I VI D E / D O N D E L A T ER API A Y L A escuelas para nios con diferentes exigencias
ED U C AC I N SE EN C U EN T R AN Y SE SEPAR AN especiales en Inglaterra. Se presenta tambin un
panorama de cmo el cambio de actitud, tanto en la
A URIEL W ARWICK
educacin general como en la musical, ha afectado el
papel del terapeuta: desde la sospecha a la aceptacin,
The paper will outline the author's 20 years of los problemas y los logros, junto con algunas
experience as a music therapist working in schools for reflexiones acerca del futuro de la musicoterapia en el
children with a variety of special needs in Britain. It will campo de la educacin. Se utilizarn ejemplos
present a view of how changing attitudes in both grabados en vdeo.
general and music education have affected the role of
the therapist; from suspicion to acceptance; the
problems and achievements, together with some IV. TRAINING AND "ROLE" OF THE MUSIC
THERAPIST - FORMACION Y "ROL " DEL
thoughts about the future of music therapy in the MUSICOTERAPEUTA
educational field. Video illustrations will be used.

M U SI C T H ER APY: C R EAT I VE PR O C ESS,

La ponencia perfilar los veinte aos de experiencia de T H ER APEU T I C PR O C ESS / M U SI C O T ER API A:
1000
 PR O C ESO C R EAT I VO , PR O C ESO relation, communication and creativity, individually as
T ER APU T I C O well as in the group.

P ATXI D EL C AMPO S AN V ICENTE 2. To discover and experiment with forms to sharpen

the sonorous world, and with instruments and musical
notions in a very playful, creative, globalising and
In fact education and therapy can be conceived as levelling way.
processes in which the human existence shows itself in
3. To make possible creative, construc-tive and
its sensory amplitude. The paper is oriented to
enrichening experiences.
experience attitudes which make possible creativity and
sensory awareness, and to learn the emotional
processes by starting with the associative work of En la actualidad se concibe la educacin y la terapia
movement and sound which make possible the como procesos en los cuales el ser humano se
awareness of creative living beings. desarrolle con amplitud sensorial. La ponencia esta
orientada a la vivencia de actitudes que potencien la
Objectives:
creatividad y el desarrollo sensorial, y al aprendizaje de
1. To sharpen the musical-therapeutical concept as procesos emocionales a partir del trabajo de asociacin
a technique in which music, sound and movement are de movimiento y sonido que posibilite el desarrollo de
used as elements which bring about awareness, las vivencias creativas.
1001
Objetivos: IV. CONFERENCE HANDOUTS

1. Acercamiento al concepto de musicoterapia como T R AI N I N G O F M U SI C T H ER APEU T I ST S

tcnica que utiliza la msica, el cuerpo y el movimiento BET WEEN M U SI C AN D T H ER APY
como elementos favorecedores del desarrollo, relacin,
G IUSEPPA P ISTORIO , G. GASTALDI Y G. SERAZZI -N ICODANO
comunicacin y creatividad individual y grupal.

2. Descubrir y experimentar formas de

acercamiento al mundo sonoro, los instrumentos y las During the Fifties, the initially general and superficial

nociones musicales de una manera ms ldica, finding that music has a positive influence on living

creativa, globalizante y diferencial. beings by inducing relaxation and an overall feeling of

physical anda psychological well-being led to its initial
3. Posibilitar experiencias creativas, constructivas y
application for therapeutical purposes, supported by
enriquecedoras.
scientific experiments on the changes music induces on
the physiological and psychological behaviour of
animals and human beings.

Music therapy started to be considered as such when it

was realized that sounds could be a valid therapeutical
1002
instrument in neurological, neuromotory and
psychiatrical pathology, as it could favour the recovery
Music therapetist or music therapist?
of a patients healthy constituents by harmoniously
enhancing them, and with the support of aesthetic and
aesthetizing gratification of the patients psycho- Musician or therapeutist of the psyche?
corporeal unit.

These are the questions that have come up more

A further step forward in music therapu came with the commonly and continue to do so today, thereby
discovery of the importance of a therapeutical underscoring the confusion and misunderstandings that
relationship on rehabilitation enhancement and the still exist as to this profession, especially as to the
ensuing entry of psychoanalysis into music therapy. expectations of those who intend embarking upon it.
Some believe that those who use music for
therapeutical purposes must be good musicians first
At the same time, and perhaps even more after these
and foremost; others hold that a therapeutists main trait
steps forward, the need to classify the role and
should be training and the capability to entertain a
professional training of those who use music as a
transfer relationship, manage it and turn it into a
therapeutical tool for subjets with some disabledness
therapeutical rapport.
was felt more and more.
1003
 As the interesti for this discipline grows, the definition of
the professional role and training of those who use
These two extreme and diametrally opposite positions
music for therapy and rehabilitation as well as the
can certainly not be satisfactory nor thrash out the issue
creation of a theory upstream the practical application
to the full.
of music becomes more and more urgent.

An article by Nora Cervi published in Quaderni di

They could in fact define a music therapeutist as a
Musica Applicata offers an overview of some of the
person who uses music skillfully to improve socil
leading training schools for music therapists in Europe
relationships; in this case, musical animator might be a
and America.
better definition. The other position in that the danger
exists of limiting the use of music therapy to a few
persons with in-depth knowledge and experience in Even a hasty glance at study subject matters reveals a
medicine and/or psychology, analytical trainig and a common view on the need to couple musical and
good knowledge of music. This would mean that music medica-psychological knowiedge as a guarantee of a
therapy would only be used for few pathologies and in positive therapeutical approach with music.
limited or even lite conditions.

Rolando Benezon, ono of South Americs outstanding

1004
figures in music therapy, states that the training of a For Benezon, experience therefore seems to be the
music therapeutist requires a certain length of time, that privileged field of research for the music therapeutist;
is mandatory to acquire a know-how that needs to be paralley developping musical and medical-
incorporated by the learner as a lived experience. Use psychological knowledge seems to be the background,
and knowledge of the non-verbal context are regardies of the would-be music therapeutist baseline
mandatory. So, personal experiences have to be faced, culture.
sach as to allow experimentation and recognition of
ones own skills and the blocks to ones non-verbal
experiences. Training courses are prost-graduate in Great Britain;
though internally articulated between the psichological
Benezon goes on to say that the therapeutical
and the musical, they appear to privilege the latter, so
relationship must be based on the possibility of
that only students with a very high level of musical
communicating hic et nunc in a non-verbal context:
education (such as a conservatory diploma for
this therefore presupposes the need to develop the
instance) are admitted.
capability of passing without difficulties the path of entry
into and exit from the progressive to the regressive and
viceversa. Leslie Bunt says De facto, all course in Grat Britain
continue to be directed above all at training professional
musicians who also show personal traits such as to be
1005
able to became therapists - the ability to listen in work mainly in psychopathology and psychiatry and
particular. who also have musical practice. The music therapeutist
is warmly advised to take part in psychotherapeutical
training.
The theorical matrix of British music therapists in
psychodynamic, tied in particular to psycholanalysis, as
Mary Kinstley does, above all. Two schools inspired by two diferent programme lines
exist in Belgium: one based on the line of Gestalt or
generally phenomenologial directions and the other
Unlike Benezonian practice, the therapeutical rapport
more psychosomatically oriented that used the the
mainly stresses the therapeutical project that passes
techniques of musical improvisation above all. Both
through change, whereas Beneson speaks of an
converge in considering the music therapeutics as a
experience of interpersonal relationship in the first
person who acts on human behaviour, with
place.
restructuring at the cognitive leve.

In her book Music Therapy, Edith Lecourt states that

In Italy, interest in music therepy has grown steadily
in France, music therapy is considered as a specialty
over the past 25 years and has led to the creation of
reserved to professionals of the health care world who
various regional courses and some training poles, the
1006
more significant being Genoa and Assisi. The music therapeutist has had no legal recognition in
Italy so far. Several legally established regional
The Gestalt approach based theoretical matrix is
associations have ben created now, however, with the
directed at considering the individual in his or her unity
objetive of forming a natinal confederation.
of body and mind, that is also enhanced when
personlized through integration of the symptom into This overview of the status of music therapy in the world
the subjects golbal personality and integration of clearly show tahat the misunderstanding as to the role
therapy into a dynamic and funtional conception that and training of those who use music for therapeutical
respectos the individual and his or her need (L.M. pusposes are still prominent.
Lorenzetti).

This is also probably why much debate still goes on as

The importance of the therapeutical rapport in to the persons Music Therapeutist or Music Therapist.
undersored in this case too, especially vis--vis a
patient-to-therapeutist dialogue, cosisting of proposals
and counterproposals in a dynamically changing and We believe taht the professional figure and music

continually evolving exchange. therapy disciplines must use both musical and medical-
psychological knowledge and research, to the same
extent.

1007
 themselves as musicians during their training period.
They must of course have already matured in-depth
Interest in the training of music therapeutists has alsa
knowledge, from the physics of acoustics to musical
continued to widen and grow over the past decade
grammar but above all the must have experimented the
however, so as to have to include pluralistic specialties
semantic and semiological aspects that can be drawn
such as the prenatal, neonatal and day-to-day life.
from music.
During his or her training period, the musica
therapeutist shall have to research, investigate and
implement learning processes leading processes
These are the essentian features without which no real
leading to the conscious use of the perception of sound
music therapy training can be achieved.
and its subsequents sensory connections for
advantageous proposals to be made to patients. They must be overcome however, as a music
therapeuticst must learn how to acept any kind of
Training must also be directed at being ready to use
trasngression.
the world of sound for therapeutical purposes, nothing
excluded.
From this stanpoint, training will also mean accepting
the patients full and independent freedom of musical
The Author are convinced that music therapeutists have
expression.
already gone beyond the idea of considering
1008
 The conscious use of these non-verbal communications
techniques will allow more satisfactory results tahat
We believe that a trained music therapeutist never
could not be reached with sound and music alone.
imposes his or her estylo or musical professionality but
is deed capable of using musical sound in a equal and
dialoguing rapport with the patient.
We believe these techniques must always be used in
interconnection, alternation and compenetration with
music and sounds. This means that music therapeutist
Even technological research must not be neglected
courses must include this type of training : study
nowawadays as it permits instrumental applications
meetings, practical training periodos, publications and
unthinkable in the past.
international professional trainers are easy to access
nowawadays and must be part of a complete music
The direct consequence of using music and sounds in a therapy education cycle.
therapeutical setting will be acchieved in rhythm an
If a music therapeutist intende going through the whole
movemente; we believe the trainee music therapetist
gamu t of his or her training, connection with Art
will have to devote a lor of attention to body expression,
therapy must not ve neglected for adaptation to a more
psychodancing and psychodramas.
complete view of integration of a patients personality.

1009
 must be experienced and interpreted globally, aware
that the signs of a language cover symbols to be
The music therapeutist must the refore know how to
retrieved by enhancing personal creativity.
master methodologies that can enhance global body
experience plastic movements, vocal sounds and
writtrn-colour and form traces in a concept of language
During their training, music therapeutist must come to
globality so deeply experimented by Guerra Lisi.
realize that their voice can exert a function capable of
favouring a communications relationship.

Passage from psicho-corporeal experiences (with

unavoidable synesthesias) to movement, action and the
The tool or instrument voice must therefore be stadied
desire to leave ones trace to arrive at communicating
and looked after with great care, not only to master
must be well matured and lived personally by the music
intonation from speecha to song and allow creativity to
therapeutist for effective application in music therapy to
take on a psycho.symbolic form but above all to learn
achieve in-depth self-awareness and the asserion of
how to make professional use of its immense
freedom.
communications potencial.

The various languages of expression in Art therapy

Our view is that the objetive to be reached is one
1010
independent character as free as possible form The purpose of music therapy as a non-verbal
extremely technically based both medical-psychological technique is to use sound as a pre-, analogic language
and musical constraints. When techniques are needed, born from aensoriality and translated into feelings
music therapeutists require music therapy ones stricto communicated through sound.
sensu, enabling them to travel together with their
patients along a path starting from non-verbal registers
to the formal argumentations of emotional contents. To conclude, the Author believe that music
therapeutists must have an identity of their own, know
and manage their own emotional world through
Music therapeutist must therefore know their body and personal training and interact competently with sounds
mind in great depth to help patientes make contacto and music. All these traits will allow them to pass from
with parts unknown to the patiens themselves; they analogic to verbal language in full awareness.
must have imagination and creativity and be able to
improvise; they must also be able to make contact with
their own deeper selves and have a formal and
technical though not techicistic knowledge of music.

1011
SABER O N O SABER AC ER C A D EL PR O BL EM A escasez de teora especfica de musicoterapia Son
D E L A T EO R I A EN M U SI C O T ER API A muchas ms las expresiones de deseo acerca de la
posibilidad de que algn colega haga algn
D IEGO S CHAPIRA
desenvolvimiento en este campo o que en las librerias
aparezca "ese texto anhelado", que los intentos de
"cualquier teoria es principalmente insegura" escribir, o al menos de compartir los desarrollos
tericos que pudieran existir.
Karl Popper.

Lejos de intentar dar respuestas a esta situacin, mi

"supreender a todos nao por ser extico mas
intencin es plantear interrogantes acerca de sus
pelo fato de poder ter sempre estado oculto quanto ter
posibles causas. Hay o no teorias
sido o bvio"
musicoteraputicas? Cmo se construye una teoria de
Caetano Veloso musicoterapia? Qu habra que tomar y de qu habra
que desprenderse para consolidarla?.

Uno de los reclamos que los musicoterapeutas nos Supongo que algunos de los anhelos de ms teora
hacemos frecuentemente es acerca de la supuesta propia pueden ser satisfechos si cada uno extiende su
1012
horizonte ms all de las fronteras del territorio en que las teorias.
se desenvuelve. De este modo podremos ver que
existe una gran cantidad de literatura especfica en
algunos paises que por diversos motivos no se conoce Hacia un universo de discurso propio

en otros. Pero an pudiendo superar esta barrera, nos Es sabido que gran parte de las teoras, o de los
encontrarnos con la sensacin de que el desarrollo emprendmientos tericos surgen como un intento de
terico de nuestra profesin esta lejos de satisfacernos explicacin de determinados hechos, o de respuesta a
a los musicoterapeutas. interrogantes especificos. Como seffala Popper,
"cualquier teoria es una modificacin de una teoria
precedente. La modificacin tiene conexiones con la
Tal vez nos estemos sometiendo a un grado de
observacin o con otros sucesos, habitualmente est
exigencia tal que nada, o muy poco de lo escrito nos
en relacin con esperanzas defraudadas o no
conforma Quizs estemos comprando la idea de que
defraudadas. una esperanza, esto es, una teoria se ve
cada vez que uno escribe algo debe decir algo original,
frustrada y es modificada por ello" Entonces, si nos
o al menos "inteligente" cuando lo original e inteligente
corremos de la urgencia de satisfacer esas inquietudes
podria ser darnos ms espacios para poder plantear y
y acontecimientos de manera inmediata es posible
compartir dudas, y que de los intercambios en esos
entrar en un plano de mayor abstraccin que nos
espacios surjan las posibles respuestas que constuyen
perrnita discurrir en un terreno epistemolgico, y
1013
abocarnos al intento de refutacin de las hiptesis Por ejemplo, el principio de iso, la nocin de esquema
planteadas. Esta opcin se contrapone y a la vez se sonoro, de imagen sonora, el valor simblico de
aleja de la bsqueda de soluciones pautadas, "pildoras" algunos instrumentos musicales, la importancia de la
musicoteraputicas o mtodos supuestamente posibilidad de induccin de estados regresivos a travs
generalizables en su eficacia. Tal vez, en estas de estimulos sonoros o el uso de la improvisacin como
ocasiones se olvide que el estudio de casos promotora de cambios en el self .
particulares es una de las herramientas mas
Estas seis hiptesis musicoterapeuticas, tomadas a
importantes paragenerar hiptesis, pero no para
modo de ejemplo, poseen diversas dimensiones, esto
comprobarlas.
es, diversos rangos de generalidad o complejidad,
especificidad, comprobabilidad, reproducibilidad, (etc.).
Tomando las falencias de cada hiptesis en alguna de
Si aceptamos que una hiptesis es un conjunto de
estas dimensiones es que solemos argumentar su
variables interrelacionadas, o sea que "una hiptesis
falsedad, o al menos su poca seriedad. Tal vez
presupone un conjunto de unidades y un conjunto de
tengamos que especificar el "campo propussto de
variables y, a continuacin, dice algo acerca de cmo
grado de confirmacin", o sea las condiciones con las
se distribuyen las unidades en las variables" (Galtung),
cuales se supone que las hiptesis son vlidas,
entonces podemos reconocer que manejarnos una
considerando que en la ralz de toda actividad cientlfica
cierta cantidad de hiptesis referidas a nuestra materia
hay un ajuste continuo entre las hiptesis y su contexto
1014
de justificacin, sin que esto implique, en modo alguno, son pasos posteriores.
el abandono de su contrastacin.

Willer, quien define la teoria como "un conjunto

Tomando la definicin de teoria de Galtung, como inte8rado de relaciones con cierto nivel de validez"
conjunto de hiptesis estruct~do por la relacin de sostiene que, hasta tanto no estn validadas, es
implicacin o deducibilidad, tal vez tengamos que comeniente hablar de "conjunto de hiptesis" en vez de
indagar 8i en el conjunto de hiptesis que manejamos, teoras, pero aclara que "no debemos inferir que para
o que podemos elaborar, se da esa estructuracin a que dichas hiptesis se conviertan en teoria se exige
travs de la relacibn de implicacin (relacion binaria una validacin perfecta, sino simplemente que es
que vincula el antecedente con el consecuente). De ser necesario alcanzar cierto nivel determinable y til de
asi, estaremos hablando de teoria de la musicoterapia validez antes de que corresponda aplicar dicho rtulo".
Luego habria que hacer las evaluaciones Dicho de una manera ms llanas toda hipotesis o
metodolgicas y epistemolgicas correspondientes con conjunto de hipotesis deberia acreditar un grado de
respecto a la estructura, a las hipotesis, a su relacibn de autenticicidad permanencia, vigencia y eficiencia tal
deducibilidad y a la relacin entre la teorizacin y los que lo aleje del polo de la charlatanera (v.g. "Mozart
investigadores para determinar el tipo y las sirve para curar la melancolia"), pero sin llegar a
dimensiones de la teorizacin en cuestin. Pero esos extremar estas condiciones al punto de colocar a la

1015
teorizacin en el exigente camino de la bsqueda de la presupone la repetibilidad de los fenmenos de que se
perfeccin e irrefutabilidad. que slo conduce a la trata.
parlisis, al desgano, o la frustacin y que,
paradogicamente, transita por un camino divergente
del del campo de la ciencia. La respuesta a esto es que todo suceso individual es
nico, tanto para las ciencias fsicas como sociales, en
el sentido de que no se repite con sus caractersticas
Con referencia a la transitoria validez o no de las peculiares. "No obstante, los sucesos individuales
teorizaciones en musicoterapia, creo que nos pesan los pueden acomodarse a leyes generales de tipo causal y
criterios que suelen hacerse a las ciencias sociales en ser explicados, por ende, mediante ellas pues todo lo
cuanto a su estructura cientfica y por ende la que afirma la ley causal es que todo hecho que reune
estructuracin de su teoria Hempel menciona cuatro certas caracteristicas determinadas va acompaado
argumentos recurrentes en este sentido, y su de otro suceso, que a su vez tiene caracteristicas
refutacin correspondiente. Veamos: especficas".

1) Los sucesos que involucran actividades de seres

humanos tienen la peculiaridad de ser nicos e
A modo de ilustracion la improvisacin con un
irrepetibles y por lo tanto inaccesibles a la explicacin
instrumento que realice un paciente,es nica e
causal porque sta, el apoyarse sobre unifrmidades.
irrepetible. Sin embargo su lectura es posible si la
1016
supeditamos, por ejemplo a i) los parrnetros puedan logarse generalizaciones que tomen en cuenta
establecidos en el codigo musical, ii) la historia personal esta subordinacion del comportamiento al pasado del
del paciente, iii) la historia del proceso sujeto (como ocurre en fisica, por ejemplo, con
musicoteraputico del paciente y iiii) el anlisis de sus fenomenos como la fatiga elstica).
diferentes improvisaciones.

3) La explicacin de cualquier fenmeno que implique

Este ejemplo es vlido para el segundo argumento, que un comportamiento finalista (como podrian ser, por
dice: ejemplo la rehabilitacin o el alta) exige hacer
referencia a motivaciones, y en consecuencia, requiere
2) Es imposible establecer generalizaciones cientficas
ms bien un analisis teleolgico que causal.
- y por ende principios explicativos - para el
comportamiento humano porque las reacciones del
individuo en una situacin dada, dependen no slo de
Hempel sostiene que es evidente que, cuando la accin
esa situacin sino tambien de la historia anterior del
de una persona est motivada por el deseo de lograr un
individuo.
objetivo, no puede decirse que es el acontecimiento
futuro todavia no realizado, de obtener esa meta lo que
determina su comportamiento presente. Lo que lo
Sin embargo, no hay razon a priori por la cual no
determina es a) su deseo, presente antes de la accin,
1017
de alcanzar ese objetivo particular y b) su creencia proceso musicoteraputico no sean accesibles a la
tambien presente antes de la accin, de que tal o cual observacin directa exterior, como ocurre tambin
procedimiento tenga ms probablemente el efecto frecuentemente en las explicaciones de las ciencias
deseado. Con esto quiero decir que los motivos y las fisicas inaccesibles a este tipo de observacin. pero
creencias determinantes forman parte de las determinables mediante mtodos indirectos (por ej. el
condiciones antecedentes de una explicacin comportamiento de algunas particulas subatmicas, o
motivacional. la compocisin de las estrellas). En musicoterapia, la
observacin diferida estaria contemplada, por ejemplo
en la instancia de supervisin.
4) Es importante que los fenmenos sean accesibles a
la observacin de un observador exterior, lo que no
ocurre en musicoterapia (salvo las observaciones, Teorias y teorizacin en musicoterapia
excepcionales, en cmara gessell; o las
Cuando hablamos de teoras musicoteraputicas, nos
videofilmaciones, que implican, de todos modos, una
referimos a la estructura del sistema conceptual
observacin diferida).
denominado musicoterapia Tanto las teorias de accin
como las teorias cientificas son, en realidad, una parte
fundamental de su armazn.
Para responder a esto hay que remarcar que no es
sustancial el hecho de que los acontecimientos de un
1018
 claves fundamentales si queremos compartir nuestros
pensamientos e interrogantes con respecto a nuestra
En la accin de construccin de las mismas, es
profesin y a nuestro trabajo. "El discurso cientifico y
importante contemplar los conocimientos presupuestos
filosfico - dice Althuser - tiene exigencias propias:
en que se basan las condiciones de produccin y las
Utilizan
condiciones de reconocimiento.
palabras del lenguje cotidiano, pero que funcionan
siempre de un modo distinto a como lo hacen en el
De los conocimientos presupuestos me voy a referir
mismo(...)el sentido de las palabras no est fijado por su
ms adelante, si bien tienen relacion directa con las
uso concreto sino por las relaciones existentes entre los
condiciones de produccin y de reconocimiento. Pero
conceptos en el interior de su sistema".
cuando hablamos de estas es ineludible hacer
referencia a la estructura de las teorias, que tienen un
sistema formal de proposiciones, y un sistema Entonces necesitaramos precisar ms claramente a
operacional. qu nos referimos cuando hablamos de lo que
hacemos. Por ejemplo podemos decir que hay un
consenso generalizado cuando hablamos de msica,
El sistema formal se refiere no a las definiciones o
de cuerpo, de materia sonora, musicoterapia, sistema
explicaciones, sino al lenguaje. Aqui radica una de las
sonido-ser humano, lo crporo-sonoro?, nos estamos
1019
refiriendo a lo mismo cuando hablamos de manejar el sistema operacional de la teora
improvisacion, de proceso musicoteraputico, del uso musicoteraputica, formado por la suma de
de los instrumentos, de la lectura de una sesin? "La definiciones y explicaciones y asi, habiendo transitado
dificultad propia de la terminologia terica -dice este camino, llegamos al problema del contenido de las
Althuser- consiste en discernir ms all del sentido definiciones en las proposiciones tericas en
usual de la palabra, su sentido conceptual, que siempre musicoterapia.
es diferente a su sentido usual".

Aqu nos encontramos en el punto de la necesarias

Entonces, para aspirar a un entendimiento acerca de lo divergencias en los pasos a seguir ya que, a mi
que expresamos dentro de nuestra comunidad de parecer, la construccin de las proposiciones tericas
profesionales, tal vez tengamos que hacer una revisin tienen que ver con la concepcin de ser humano del
de nuestra terminologia y reconocer las posibles teorizador, con los conocimientos presupuestos que
convenciones ya establecidas. De este modo podremos desde alli rescata, y ms an, con las corrientes
darnos lugar, entonces, para visualizar los conceptos tericas o de pensamiento a las que adscribe dentro de
que necesitamos determinarnos como convenciones esas disciplinas.
las que, por definicin. son transitorias pero vlidas
mientras rigen como tales. De este modo seria mas fcil

1020
De todos modos, a pesar y a consecuencia del rigor que debemos establecer su naturaleza
metodolgico que se implemente, es oportuno recordar interdisciplinaria.El campo de la musicoterapia deberia
que la investigacin en nuestro campo no nos permitir tomar el concepto del hombre en el cual todos los
decir con certeza cmo es la musicoterapia o deberia factores, biolgicos, sociolgicos y psicolgicos son
decir la sonologia?-, pero si cmo no lo es. considerados como necesarios para nuestra
comprension con relacin a la msica, y a como esta
relacin debe formar parte de una estrategia
Algunos posibles errores en la teorizacin
teraputica. Esto significaria un cambio en el paradigma
El Musicoterapeuta noruego Even Ruud seala que de la unidad en direccion a un paradigma de la
"una caracteristica de la construccin de teorias es la complejidad, en el cual el homnbre est considerado
existencia de una cierta tendencia a la reduccin. como la suma de varias dimensiones"
Frecuentemente relacionado al ideal positivista de la
ciencia? el hombre busca explicar lo complicado por lo
la musicoterapia, como disciplina, reconoce como
simple. Es el llamado "paradigma de la unidad" -y
disciplinas que forman parte de sus conocimientos
agrega-"en vez de reducirnos en nuestros conceptos
presupuestos a la msica, la filosofa, la biologia, la
musicales o humansticos a una dimension de nuestra
medicina, la fsica y la psicologa Estos conocimientos
existencia (v.g la biologa o la fsica) me parece
presupuestos son los extraidos de otros campos de
razonable? no solamente tratandose de musicoterapia,
1021
investigacin, donde ya han sido contrastados, educacin musical del campo de la musicoterapia -
probados o categorizados, constituyendose en discusin que todava tiene remezones en Amrica
herramientas indispensables para enfrentar y abordar latina- y plantea como tendencias en cuanto al
la problemtica de la musicoterapia con mejores desarrollo nssicoteraputico al alineamiento segun el
perspectivas. modelo mdico, la teoria psicoanalitica, las teorias
behavioristas y la tendencia humanista-existencialista.

La diversidad en el acercamiento preponderante hacia

alguna o algunas de estas disciplinas en detrimento de Considero que de acuerdo a la linea que se escoja
las otras y el nfasis puesto en la eleccin de los seguir ser la manera de pensar un tratamiento, de
campos internos de estos conocimientos presupuestos concebir al paciente y al musicoterapeutas y de leer el
elegidos es lo que ha dado origen a las distintas proceso musicoteraputico. Sin embargo, suele ser
escuelas de musicoterapia Even Ruud, en su libro muy comn olvidar en la toma de los elementos
Caminhos da Musicoterapia, reconoce distintas lineas tericos de nuestros conocimientos presupuestos -
musicoteraputicas, vinculadas a las tendencias cuando es necesario adaptarlos a nuestro discurso-, y
usuales de los conceptos de tratamiento, y a como esas de las tcnicas y procedimientos que estas proponen,
tendencias se ajustan con las diversas orientaciones su necesaria transformacion en posibles terminos,
filosoficas. El seala la necesidad de excluir a la tcnicas y procedimientos propios de la musicoterapia.

1022
 conceptos propios ya que la musicoterapia puede
adaptarlas como propias sin que medie ese paso.
Es habitual, por ejemplo, que los musicoterapeutas
Simplemente quiero sealar que la aplicacin
estudiemos psicodrama, y luego hagamos psicodrama
automtica de estas ejemplificaciones, y otras tantas
en musicoterapia; que aprendamos las tcnicas de
que podriamos agregar, cuando no son recursos
ensueo dirigido y las apliquemos intactas en nuestras
excepcionales sino que constituyen la prctica habitual,
sesiones; que estudiemos cursos de improvisacin
desvirtuaria o al menos desdibujaria a la prctica propia
musical y analicemos las improvisaciones de nuestros
de la musicoterapia Seguramente nuestra profesin, y
pacientes tal cual lo aprendimos con los msicos que
nosotros como profesionales, nos enriqueceramos en
nos ensearon; o que propongamos ejercicios
gran medida si continuamos expandiendo el carnpo de
guestalticos que, o bien practicamos como alumnos o
la musicoterapia a partir de estos nutrientes, ya que
pacientes, o bien tomamos de la frondosa literatura
esto es una de las vas principales en la construccin
existente al respecto.
del conocimiento musicoteraputico, y la consolidacin
del universo del discurso de la musicoterapia
Destacando esto no quiero hacer ningn juicio de valor.
No digo que est mal, ni que este bien. Tampoco digo
Por ejemplo, partiendo de las tcnicas psicodramticas
que siempre haya que transpolar o adaptar la
la musicoterapia ha construdo una herramienta propia,
terminologa de las disciplinas presupuestas a
1023
como son las dramatizaciones sonoras; de las tcnicas cuestionando su validez; o la revisin que de este tema
de ensueo dirigido surgi el mtodo de visualizacin estaria haciendo la mta. brasilea Lia Rejane Mendes
de imagenes a partir de estimulaciones sonoras Barcellos cuando distingue el uso de la msica en
(mtodo elaborado por los mtas. norteamericanos); de terapia -que podra ser un territorio compartido por
la confluencia de la msica y la psicologia surgen la varias disciplinas- del uso de la msica como terapia,
concepcin del uso de los instrumentos musicales que seria patrimonio exclusivo de nuestra profesion.
como funcin del yo, de las improvisaciones clinicas, de
su lectura como posible lectura de los sintomas, o la
creacin de test proyectivos a partir de elementos Otro de los problemas que pueden estar incidiendo en

musicales. nuestro desarrollo terico podria estar en cierta

recurrencia al pensamiento mgico, o a explicaciones
algo alejadas del rigor cientifico para argumentar los
Slo a partir de estos, y otros ejemplos, es que pueden procedimientos utilizados.
surgir problemas bricos propios de la musicoterapias
como el de la imagen sonora y esquema sonoro; la
discusin que se viene dando en otros paises entre lo Lejos de mi est el pretender que se pueda dar cuenta

que se denomina musicoterapia activa y musicoterapia de todo lo que sucede en las sesiones pues, ms all

pasiva; la que se superpone a esta discusin de la omnipotencia que presupone, implicaria una
postura acientfica Lo que quiero marcar es que tal vez
1024
sea conveniente aceptar que muchas veces debemos Volviendo a Popper, "un buen sistema debe
hacer lecturas incompletas de una sesin o de un permanecer constantemente despierto frente a las
proceso, y que el reconocimiento de esa carencia faltas que comete, porque siempre sabemos muy poco
puede llevarnos a incrementar nuestro y por ello siempre cometemos faltas. Debe, por una
herramentorium, mientras su desconocimiento puede parte. trabajar con cierta audacia, pero, por
llevarnos a adoptar respuestas a la manera de
otra parte, saber que tambin esta audacia introduce
creencias, retrotrayendo y reduciendo a la
riesgos De ah que deba descubrir tan rapidamente
musicoterapia a una suerte de cosmologia precientifica.
como sea posible las faltas para aprender de ellas y
corregirlas, en vez de encubrirlas o declararlas no-
faltas". En este sentido, algo que tal vez nos conviene
Sealo esto sin dejar de considerar a. epistemlogos
no pasar por alto es que la musicoterapia, en tanto
como Kuhn, quien destaca que la naturaleza de las
campo de conocimiento, no es un campo de creencias
teoras que se proponen, o de los criterios por los
sino un campo de investigacin. Como tal, las teorias
cuales estas son aceptadas o rechazadas, estn
deberian ser concebidas nada ms que como
firmemente influidas por creencias o convicciones
instrumentos, evitando incurrir en su generalizacin
extracientificas vigentes en determinado momento
como filtro para leer la explicacion de otros campos de
histrico.
la realidad, o como un dogma.

1025
 personas se resumian las tareas de investigacin y la
asistencial, pero nuestro contexto social favorece que
La teoria es tranquilizadora porque implica una
resulte sumamente dificil establecer las categorias de
estructuracin, la adquisicin a priori de un cuerpo de
investigador y de tecnlogo en musicoterapia o
hipotesis, que despues pueden confrontarse con la
sonologa.
realidad de la praxis. El problema sera en el caso de
esta confrontacin, tanto ideolgico como
metodolgico en tanto: i) las hiptesis se afirman
Esto implicara que los Estados,en los llamados pases
temporariamente o se derrumban en la contrastacin, y
perifricos, vuelvan la vista hacia las politicas de salud
en consecuencia se modifican las proposiciones; o ii)
que implementan y, ms especificamente en el campo
uno encaja la lectura de la prctica o la prctica misma
de la salud mental, reconsiderando a las erogaciones
en una teoria dogmatizada.
en este rubro como inversiones. y no como gastos.
En Amrica latina no existe, o al menos desconocemos, Como sealan las Dres. Daniel Bes y Martin Bes "la
un desarrollo terico que se condiga con el desarrollo inseguridad asociada a los procesos de mercado se
de la prctica clnica de la musicoterapia en estas, casi combina con la inherente a los procesos de
tres dcadas de ejercicio profesional acadmico. La investigacin. Si esta incertidumbre se suma a la
historia de las ciencias de la salud muestra que todas dificultad para lograr la apropiacin de los
han pasado por un perodo en que en las mismas conocimientos cientficos, resulta dificil imaginar a la

1026
actividad cientfica alejada del financiamiento pblico". slo vienen provocando que los musicoterapeutas
acusemos una marcada falencia en nuestra produccin
teorica, o al menos en su intercambio. Es probable que
Concluyendo
si nos damos ms permiso para equivocarnos, para
proponer semi-respuestas, para contestar y para
preguntar, procurando mantenernos en el marco de los
A modo de conclusin, quiero decir que mi intencin
conceptos bsicos que hacen de la musicoterapia un
con este trabajo es sealar que las teorizaciones en
campo de conocimiento, podamos ir dndonos esas
muscoterapia, exsten. Estn ah para ser estudiadas,
respuestas que posibiliten el planteo de nuevos
discutidas, adoptadas, recreadas o refutadas.
problemas.
Obviamente, no podemos sentirnos satisfechos con lo
mas conocido por nosotros ni con las demas
teorizaciones existentes que dan otros argumentos, o
Por otra parte, incrementar y consolidar el cuerpo
plantean otros problemas en musicoterapia.
terico propio de la musicoterapia, tal vez sea una de
las herramientas fundamentales para instituir a nuestra
profesin como una disciplina autnoma del campo de
Tal vez este sea el incentivo para seguir compartiendo
la salud.
nuestras dudas y nuestras posibles rplicas. La
autolamentacin o la auto y heteroexigencia extrema
1027
Bibliografa INVESTIGACION SOCIAL Edic. Nueva
Vision.Cuadernos de Invest Social.
ALTHUSSER, Louis. SOBRE EL TRABAJO
TEORICO:DIFICULTADES Y RECURSOS. Cuadernos MENDES BARCELLOS, Lia Rejane.CUADERNOS DE
Anagrama Barcelona, Espaa MUSICOTERAPIA 1. Enelivros Brasil.1992.

BES, Daniel y BES, Martin CIENCIA Y DESARROLLO. POPPER, Karl. SOCIEDAD ABIERTA, UNIVERSO
Revista Ciencia Hoy, vol. 4 No 20. Septiembre-octubre ABIERTO. Conversacin con Franz Kreuzer. Edit. REI
1992. Argentina Cuadernos de Filosofa y Ensayo.Diciembre
1990. RUUD, Even.CAMINHOS DA MUSICOTERAPIA.
FESTINGER, L y KATZ, D.LOS METODOS DE
Simunus Editorial.Brasil. 1990
lNVESTIGACION EN LAS CENCIAS SOCIALES. Edit.
Paidos, Biblioteca de Psicologia Social y Sociologia RUUD, Even.O CONCElTO DO HOMEN EN
MUSICOTERAPIA Confierencia dictada en el II
GALTUNG Johan. TEORIA Y METODOS EN LA
Simposio Internacional Multidisciplinar de
INVESTIGACION SOCIAL. Tomo II Eudeba
Musicoterapia Sao Paulo, Brasil.Septiembre de 1991.
HEMPEL, Carl y OPPEN M, Paul. LA LOGICA DE LA
RUIZ, Mauricio. ALGUNOS CAMINOS PARA PENSAR
EXPLlCACION. Cuadernos de Epistemologia 4.
LO PROPIO. Trabajo publicado en el Anuario AMURA.
UBAFac. de Filosofa y Letras. 1965
1991-1992, de la Asociacion de Musicoterapeutas de la
KORN,F. y otros. CONCEPTOS Y VARIABLES EN LA
Repblica Argentina
1028
SCHAPIRA, Diego.ENCUADRE LIMITANTE O METODOLOGIA, PROGRAMACION,
OBJETIVOS (ABSTRACTS)
PERMISOR?. Trabajo publicado en el Anuario
A.MU.RA.1991-1992.

SCHAPIRA, Diego. LA MUSICOTERAPIA EN D I D AC T I C M U SI C T H ER APY /

ARGENTINA.Charla ofrecida en el VI Simposio M U SI C O T ER API A D I D C T I C A
Brasilero de Musicoterapia Belo Horizonte, Brasil.
R OLANDO O. BENENZON
Marzo 1992.

SERRONI COPELLO, Raul.HACIA UNA

EPISTEMOLOGIA REALISTA DE LA MUSICOTERAPIA What is Didactic Music Therapy? It is the learning of the
use of movement, sound, music, and the objects used
VELOSO, Caetano. CIRCULADO AO VIVO. Um indio.
as intermediaries and integrators (Complex sound-
Polygram Brasil.1992.
human being) so the professional:
WILLER, David LA SOCIOLOGIA CIENTIFICA. Teoria y
a) Will discover and recognize in him or herself the
Mtodo. Amorrortu Editores.
characteristics of his-her own gestaltic ISO, cultural,
complementary and groupal.

4.1.- SCHOOLS, METHODOLOGY, b) Thus, the therapists will be able to discriminate

PROGRAMMING, AIMS - ESCUELAS. between their own ISO and the ISOS of their patients,
1029
who will receive the non-verbal or pre-verbal
techniques.
Qu es la Musicoterapia Didctica?: es el aprendizaje
c) They will rationalize the conflicts and difficulties of de la utilizacin del movimiento, el sonido, la msica, los
the communication process with the other and with the objetos intermediarios e integradores (Complejo
group, in all the attached levels of the non-verbal and sonido-ser humano) para que el profesional:
pre-verbal processes.
a) Descubra y reconozca en s mismo las propias
d) They will acquire the capacity to handle the caractersticas de su ISO gestltico, cultural,
elements of production, and non-verbal and pre-verbal complementario y grupal.
expression for their application in the respective areas
b) De esa manera podr discriminar entre su propio
of mental health.
ISO y el de los ISOS de los pacientes en quienes
e) They will strengthen the possibility of going, with aplicar las tcnicas no-verbales o pre-verbales.
no difficulty, over the route of entrance and exit from the
c) Justificar los conflictos y dificultades propias de
prospective to the regressive and vice versa.
comunicacin para con el otro y para con el grupo, en
There are three feasible places to develop the todos los niveles vinculares del proceso no-verbal y
application of music therapy. At the music therapy pre-verbal.
practice, in nature or in an aquatic medium (for instance
d) Adquirir la capacidad del manejo de los elementos
a swimming pool).
1030
de produccin y expresin no-verbal y pre-verbal para A .I .S .M T .: C E N T R O D E R E H A B I L I T A C I N D E
su aplicacin en las respectivas reas de la salud M U SI C O T ER API A Y ESC U EL A D E F O R M AC I N
mental. PR O F ESI O N AL PAR A M U SI C O T ER APEU T AS

e) Fortalecer la posibilidad de recorrer sin dificultad G IOVANNA M UTTI & ALESSIA M ARTINELLI
el camino de entrada y salida de lo prospectivo a lo
regresivo y viceversa.
Este trabajo presenta estudios, investigaciones y
Hay tres lugares factibles para desarrollar la aplicacin
metodologa cientfica sobre la Formacin Profesional
de la musicoterapia. En el gabinete de Musicoterapia,
de Musicoterapeutas en el desarrollo y experiencias de
en la naturaleza o en un medio acutico como puede
este campo, siguiendo el camino de las tres principales
ser la piscina.
tendencias de la musicoterapia en la realidad italiana.

La Asociacin Italiana para el Estudio de la

AC T I VI T I ES O F T H E I T AL I AN AXXO C I AT I O N Musicoterapia (A.I.S.M.) contribuy a la realizacin de la
F O R T H E ST U D Y O F M U SI C T H ER APY: M U SI C primera Escuela Italiana de Formacin Profesional de
T H ER APY R EH ABI L I T AT I O N C EN T R E AN D T H E Musicoterapeutas.
SC H O O L O F PR O F ESSI O N AL T R AI N I N G F O R
M U SI C T H ER API ST S / AC T I VI D AD ES D E
This paper presents studies, researches and scientific
1031
methodology about professional training for music M U SI C O T ER API A EN L A U N I VER SI D AD D E
therapists in the development and experiences of the AAL BO R G .
area, following the way of the three principal trends of
I NGE N YGAARD P EDERSEN
music therapy in the italian reality.

The Italian Association for the Study of Music Therapy

(A.I.S.M.) contributed to the realization of the first Italian As a pre-experience for clinical work, the students in
School of Professional Training for Music Therapists. Aalborg University, Danemark, are placed in the role of
"student-clients", over the three years before they are
allowed to work from a psychotherapeutic base with

"S E L F E X P E R I E N C E F O R S T U D E N T S " A S A clients. The aims of the training are as follows:

M ET H O D O L O G Y. A C O M PU L SO R Y PAR T O F - to increase the sensitivity and flexibility of the

T H E M U SI C T H ER APY PR O G R AM M AT students ability for establishing contact and
A A L B O R G U N I V E R S I T Y . / "L A P R O P I A communication.
EXPER I EN C I A D E L O S AL U M N O S D E L A
- to work through traumatic blockings to develop
C AR R ER A D E M U SI C O T ER API A" C O M O PAR T E
more resources.
D E U N A M ET O D O L O G A. U N A I M PO R T AN T E
PAR T E D EL PR O G R AM A D E L A C AR R ER A D E - to develop techniques to confront transference
and countertransference.
1032
- to develop techniques to analyze and recognize "inner child" part with other parts of the clients
the therapist/client relationship within body, feeling and personality.
consciousness.

- to develop musical techniques to establish and

Los alumnos de la Universidad de Aalborg, Dinamarca,
develop contact with clients at different levels.
toman como el rol de "alumnos-pacientes", como una
As an example of training design, the work includes experiencia previa al trabajo clnico. El entrenamiento
confrontating phenomena such as "inner child", "parent acontece durante los primeros 3 aos de la carrera,
representations" in the psyche and pictures of self- antes de que el alumno pueda comenzar a trabajar
identification and identification from others. desde una base psicoteraputica con clientes.

The work also includes training in analyzing Los objetivos del entrenamiento son:
relationships in terms of phases in mother/infant
- incrementar la sensibilidad y flexibilidad de las
relationship (in normal development). For exemple,
posibilidades de los alumnos para lograr un mejor
phases which include the "Healing" process, the
contacto y comunicacin.
containing process or the frustration process.
- trabajar con bloqueos traumticos y de esta
As a whole the phases are defined from the
manera desarrollar mayores recursos en el alumno.
developement of the "inner child" of the client, and are
defined from the progression of the integration of the
- desarrollar tcnicas que puedan confrontar la
1033
transferencia y contratransferencia. frustracin.

- desarrollar tcnicas para analizar y reconocer la Estas fases son definidas a travs del desarrollo del
relacin terapeuta-paciente en lo corporal, sentimental "nio interno" del cliente, teniendo en cuenta los
y consciente. procesos de integracin en el cliente, tanto de su "nio
interno" como el resto de su personalidad.
- desarrollar tcnicas musicales que permitan
establecer y desarrollar el contacto con los pacientes
en diferentes niveles.
ST AN D AR D S, C U R R I C U L AR ST R U C T U R ES,
Este modelo de entrenamiento tiene por objetivo lograr
AN D C O M PET EN C ES F O R M U SI C T H ER APY
que el alumno pueda confrontar, en lo psquico,
ED U C AT I O N AN D T R AI N I N G / ST AN D AR S,
fenmenos como el "nio interno", o, "la representacin
EST R U C T U R AS C U R R I C U L AR ES Y
de los padres" y las imgenes de autoidentificacin e
C O M PET EN C I AS PAR A L A ED U C AC I N
identificacin con los otros.
M U SI C O T ER APU T I C A Y SU F O R M AC I N
El trabajo incluye tambin el entrenamiento en analizar
M ARILYN I. SANDNESS
las relaciones interpersonales o partir de las diferentes
fases de la relacin madre-hijo (en su normal
desarrollo). Por ejemplo, fases que incluyen el proceso Objetives: To promote discussion on
de "Healing", el proceso de contencin o el de
1034
A.

1. Establishing and maintaining standards for music C. Exploring future working relations and possible
therapy education an training. affiliations with music therapy training programs in other
countries over the world.
2. Integrating competencies within a curriculum for
music therapy education and training.

3. Developing liaisons and working relations with Objetivos: promover una discusin en:
music therapy training programs in other countries over
A.
the world.
1. El establecimiento y mantenimiento de normas
para la formacin y educacin de la musicoterapia.
B. Integrating competencies within a curriculum for
2. La integracin de competencias en un plan de
music therapy education and clinical training
estudios para la formacin y educacin de la
1. The process of implementing a curriculum based musicoterapia.
in the capacity of a course system.
3. El desarrollo de conexiones y relaciones de
2. Competencies (knowledge, skills, ability) in the trabajo con programas de formacin en otros pases
following areas: Music foundations, Clinical foundations, del mundo.
Music Therapy.
1035
 METODOLOGIA, PROGRAMACION,
OBJETIVOS (CONFERENCE HANDOUTS)
B. Integracin de competencias en un plan de
T H E ESSEN T I AL R O L E O F
estudios para la educacin de la musicoterapia y la
O N T O PSYC H O L O G I C AL PSYC H O T H ER APY AS
formacin clnica.
PR ESU PPO SI T I O N F O R M U SI C T H ER API C
1. El proceso de fomentar un plan de estudios T R AI N I N G
basado en la capacidad de un sistema de cursos.
M ARCELLO B RUOGNOLO
2. Competencias (conocimiento, talentos, habilidad)
en las siguientes reas: Fundamentos musicales,
Fundamentos clnicos, Musicoterapia In musictherapy however the methodology approachlis,
it exists a psychotherapeutic relationship. The
psychotherapist is in interaction with the client; the
C. Explorar futuras relaciones de trabajo y posibles
components of this interaction are peculiar to the
afiliaciones con programas de formacin de
relationship thera pist-client. The musictherapist cannot
musicoterapia de otros pases del mundo.
only be a mediator or user of musical standards
employed to improve the unsettled psychic soundness.
He cannot only be a musical pharmacologist, that
4.1. - SCHOOLS, METHODOLOGY,
PROGRAMMING, AIMS - ESCUELAS. means the one that settles the different kind of music as
1036
if they were calmatives (drug) suitable to different kind as operative as possible, which means that it is aimed to
of pathologies or psychophysical alterations. the improvement of the client: knowledge of the other
through dreams, proxemic and mnagement of the
He cannot only be a musical hypersensitive person that
semantic field, all scientific means typical of the
dialogues with the schizophrenia of the other through
Ontopsychology school.
musical and rhythmic organizzations.
Semantic field stands for: network of base information in
He must be an expert of human psyche, of its structures
the environment , the primary movement of energy that
and of its operativity in every relationship.
shows itself through emotional and logi cal alterations. It
In order to help understanding we can mention C.
is the more precise instrument that the human
Rogers that has well clarified the specification of the
conscience can have; it is the conscience of the base
relationship in six points: 1) contact 2) con gruency 3)
language of life that is acti ve and continuously
incongruity 4) unconditioned regard 5) empathy 6)
operative inside the relationships among humans
empathy and unconditioned positive regard
structures. The semantic field allows the vision in the
communication of the therapist for the client These
inner individual subjectivity, giving the reality occurring
conditions specify in a specific way the characteristic
in an environment, the reality in its primary cause, not in
relationship in the professional setting.
the phenomenology of its effects. Obviously the person
Moreover there are other specifications that are must be conscient about how his subjectivity is
necessary to make the psychotherapeutic relationship operative, since the less the person is unconscious to
1037
itself, the more is able to experience the reality of the relationship professionally defective that we can easily
semantic field. Through the semantic field it is possible find in whatever relation: doctor-patient, priest-believer,
to:1) know how the past psychic action is acting now 2) mother-son, in friend ships or love affairs, employer-
reason by induction on the characterial personality 3) employee and so on. If psychotherapy wants to become
knowledge of the natural psychic action as subjective an exact and operative relationship,it must enter the
evolution 4) knowledge of the programme inserted in scientific means that are necessary qualifications--to
the mental structure that will be realized in the next adapt itself to basic technical parameters. The
future. The dream analysis is understood according to musictherapy is a psychotherapy that has a
the ontopsychological methodology and not methodology centered on the musical instrument
psychoanalytical since the second one does not give instead of the verbal instrument or dialogue. The
the exact relation between symbol and reality, as, on psychotherapis * sictherapist must be aware of the
the contrary, the ontopsychological interpretation does. psychic intentionality, the movement of the psychic
The proxemic is concerned with all the sensitivity of dynamic. Why? Because: 1) in order to avoid groping
listening, perception, evaluation and interaction of the one's way in using whatever musical instrument and
subverbal communication, of the expressivity, of the consequently suf fer from the empathic and
semiotic, of posture, smells, of kinetic movements, of psychosomatic effects that this involves; 2) the effect
physiognomy. Every psychotheapeutic relationship may be sedative for the mind but not yet therapeutic or
must foresee these knowledges,otherwise it is a also because it may be a flattening to social rules and

1038
introduction in a standard la tent pathology; 3) to avoid activity occurs. In this empty space the psychic activity
projection of personal instances on the relationship: the of the pathological structure of the client becomes part
conscious and unconscious structures of the therapist of the therapist.
filtrate the way of evolution of the client and condition
Each of us should perfectly know the removal, the
the technical choices of help, deviating the appraisal of
resistance, the negative psychology that are peculiar to
the effects that may be checked.
neurosis and schizophrenia. Removal and resi stance
If all this is not in the discretional, rational and operative are well-known defense mechanisms; the first one
power of the therapist, we cannot have a valid helpful occurs when the psychic activity, hidden to conscious
relationship. ego, go on operating according to an unconscious
determinism that guides thesubject's behaviour,
There will be a loss of time, a casualness in the
decisions, emotions. The second one, the resistance, is
intervention and no positive operativity in the
a mechanism that obliges the subject to be diabolically
soundness of the patient.
against everybody and everything could change the
There also another important aspect which is that the ill
pathology condition in general and in particular it is the
patient may, through a tranference necessity, run the
defense of the secondary advantage of the disease.
inner relationship in psychotherapy. If the therapist is
The patient doesn't want the responsability of his life; he
unconscious the psychic intentionality leaves an empty
is ready to defense also pathology because has no
space; he doesn't manage that part where the psychic
inten tion to change and above all he is not free to
1039
decide about his own life, since his subjectivity is and strong. The ill patient may externally be defined
managed by a psychic master inside his cerebral ducts. psychically weak, but inside of him he is strongly
The negative psychology is a peculiar discovery of the structured in a fixed and obstinate way that makes him
Ontopsycholo gical school. It is the mental, destructive, be the negative leader of the whole environment. Every
tanatic aspect of the monitor of deflection inside the ill person has a reference environment where he/she is
human mind. It is a not-human mechanism induced by the absolute despot, unfortunately in a disparted way
the family and absorbed by the neuro-physiologic from his original and functional leadership.
schemes of the subject which find himself in a self-
This means that pathology is a dynamic may impose
contraddiction; the monitor of deflection cause the ego
itself in a negative way , above all to who decides to
and organismic scission and induces the loss of the
help.
subjective capability of reality so that the subject is
compelled to live only for the outside, the duty, the In musictherapy the therapist open himself to the

coercion slnce he has lost the reference with his inner client's needs: he must love him if he wants to help him.

self . It is an aspect of the monitor of the conscience that During this outbreak the client automatically in sert his

doesn't refer reality but deviates the reflection on tanatic pathology highly structured.

aspects of existential loss. The ingenuous, unconscious therapist which is

The musictherapist must know and overcome these therefore not professional, may experiment during the

problems. These psychic struc tures are highly active relationship (musictherapy is often physical, there is a
1040
contact, a tranference emotion, the attempt of insertion consequencies or ruinous for both members of the
in himself the client's pathology, in an unconscious way. relationship. The first important effect can be observed
on the patient that will be rein forced in his disease, go
Once he has been informed by the patient's
on depending from the cure and will pretend for his
pathological structure, the therapist will behave, choose
whole life to be served by the society.
and find it right to provide to the therapeutic rela tionship
according to the needs of the client pathology. This The effect on the therapist will be also negative. After
pathology becomes the inspirer of the therapeutic having absorbed the pathogenous information he will
action. This is the paradox that happens more often find himself ill: tiredness, psychosomatic diseases,
than one could imagine. ideological hardening, obsessions, phobia, delirium,
fears, uncertainty, loss of vision of reality.
The contact with the psychic pathology is an information
contact that structu res the inner reference patterns of If we want to build true musictherapists, we must
the persons involved in the relationship. We cannot, premise, to whatever ideological current, the bases
therefore, be superficial in the use of musictherapeutic examinated till now. A good musictherapist must know
technics. the psychoanalitical technic and dynamic, but must also
know the scientific results that come out from authors
If the pathological contact happens the effects will not
like C. Rogers, L. Binswanger, C. Jaspers and the
be useful for the client's soundness but simply reinforce
existential psychology in general, and must know
his psychopathology with useless intervention
1041
Ontopsychology and its fundamental and innovating It is clear now that the musictherapist must have a
concepts of negative psychology, monitor of deflection, clinical attitude and therefore need praxic and
semantic field and in s of man. The in s of man is the theoretic;psychotherapeutic bases. He needs a
positive base where the Being establishes his own a psychology of the depth that allows him to achieve a
priori sense that universalizes to self-realization and to real moditication of the pathology, a power on the
which usictherapy attends. psychic action, otherwise he will simply do charitable
nursing but not therapy.
The in s is the evidence of the etymon of the base
action of life. Knowing this reality means for the
musictherapist-ontopsychologast being connected with
the potentiality of this marvellous nature through the M U SI C T H ER APY I N PO R T U G AL

rhythmic-musical fact, reorganizing the man according G RACIELA C INTRA G OMES , JACQUELINE V ERDEAU -P AILLES ,
to this natural order in a psychic, cellular way. E LEUTERIO G OMES D E A QUILAR Y T ERESA P AULA L EITE

It is impossible to learn all this as if it was only an

external technic; the natural practise comes after and
In the International Congress of Music Therapy help in
through a deep knowledge of one's own in nerty. Our
Paris ein 1977 Y presented a paper on music and
own innerty to guarantee being exact and vital
cerebrla palsy children, report of my own experience
instrument of psy chotherapy.
with handicapped children. In July 1983 Dr. Edith
1042
Lecourt invited me as being member of the Board os Already in the 60s there was an attempt to establish a
ISME -International Society for Music Education, to music therapy association which was no successful
participate en another World Congress in Music being its members integrated in a Group of studies on
Therapy also held in Paris, to talk about the role of ISME psychopedagogy of the Portuguese Society of
and its Commission for Music Therapy and Music in Psychology (1967).
Special Education in this specific field.
During several years the Research Pedagogical Center
It is a great honour for me to participe this week in the of the calouste Gulbenkian Foundation developed a
VII World Congress of Music Therapy and describe the project of expressive reeducacin, a
present status of music therapy in Portugal, its past psychoeducacional child therapy method which
and future trens. involved the use of music with children having specific
learning problems. A childpsychiatrist and psycologist
Y Believe that the presence of Dr. Jacqueline Verdeau-
supervised the research which had positive results and
Paills, pedagogical responsible for the Music Therapy
could be used as a model for future research.
Training program in Madeira Island and of Dr. Teresa
Leite, psichologist, first Portuguese Masters Degree in The support given by the Gulbenkian Foundation in the
Music Therapy at the New York University will help to divulgament of music therapy in the country should not
clarify the situation and prove that something is going be forgotten, sponsoring the coming of foreign music
on in this area in Portugal. therapy experts to lecture in Portugal, providing funds

1043
for music educators to work in centers for handicapped sound therapist, thus receiving consequent influences
chisdren and offering scholarships to teachers and of American, Argentinian, English and French currents
student to attend seminars, conferences and courses of music therapy.
abroad. Juliette Alvin, Rolando Benenzon, Maria Fux,
APEM became a gathering point and information
Sue Jennings were some of the specialists who came in
source for professionals and students interested in the
the 70s, stimulated knowledge and awareness of the
subject. A quarterly Bullein delivered to 900 membres,
need of a formal therapeutic training.
includes regularly music therapy articles and world wide
APEM, the Portuguese Association of Music Education information, exchanged with several M. T. associations
which represents ISME en Portugal soon recognise the bulletins. The Document Center contain up-to-date
high value of the discipline including it in its annual specialised books, magazicens and a bibliography and
programs (1974). offers councelling for those who intend to conduct
research for their degree requirements or for pursuing
Introductory seminars and workshops with well-known
postgraduate studies.
therapists and teachers Moresno, Claus Bang, V.
Hemsy de Gainza, A. Fenwick, A. Warwick, H. Moog, R. Thar was the case of Teresa Leite that now w have the
Benenzon, E. Lecourt and J. Verdeau-Paills were pleasure of introducing to you as a Master in Music
organised in the following years and attend by hundreds Therapy.
of individuals, eager to acquire skills in expressive
An International ISME Seminar on Music Education -
1044
Music in Sapecil Education was held in Lisbon in 1985,
its proceedings being published in the referred APEMs
I - How it began
bulletins. Dr. Verdeay-Paills, one of the speakers of
this International Meeting, came back to Portugal and
following a first information seminar given in Lisbon she Like other guest mosictherapists; I was invited to give
was invited to Funchal, Madeira where the first lectures and conduct seminars and workshops in
Postuguese music therapy training progam was Lisbon, in 1886 and 1887 - In 1988 I was asked by
implemented (1989-92). Madeira Island Reginal departament of Special

APEM has been instrumental in this training progam as Education to provide a 40 Hours seminar in Funchal.

a pedagogical adviser, member of the juris of admission The fisrt portuguese three years training progam was
interviews and final examinations besides supplying subsequently implementede between 1989 and 1992. A
assistance to the students formn the continent. diploma for clinical or psycho-pedagogical practice was

Fromo the structure and contents of the progam we will awarded for the 8 students, teachers in special

next hear Dr. Verdeau-Paills. education and therapists who successfully completed
the training progam, final examination and writted
THE MUSICTHERAPY TRAINING PROGAM IN
monograph.
MADEIRA ISLAND

1045
II The training program as it is now reeducators, etc...) other methods based on
pschological approachh for music in educaion, re-
The training program, developped according to
education, rehabilition and social and family integration
European models, began in September 1992.
of the handicapped.
Begin a Neurologist, Pychiatrist and Musictherapist, a
- to introduce psychotherapeutics appraches based on
member of the board of French Musictherapy
sound and music, recptive and active music-therapy to
Association, and a menber of the pedagogic team of
physicians, not only psichiatrists but all medical doctors,
training course for Art Therapy and Music-Therapy
to nurses, psychologists and therapists.
in Paris V - Ren Descartes University, Y thought that a
cooperation between the french University and THE CONDITIONS OF ADMITION TO THE TRAINING
Regional Departament of Special Education of Madeira COURSE:
Government would be of a grat interest.
To be admitted to the program, students must have a
A recognition and cooperative arrangement was B.A. degree, musical training, and psychological or
effective and a convention signed in Marcha 1992. pedagogical training.

THE OBJETIVES OF THE TRAINING PROGAM ARE: THE STRUCTURE OF THE TRAINING COURSE:

- to offer special education and music education it includes 2000 hours distribubed between:
teachers and other techincians (orthophonists, psycho-
- 6 weeks of intensive coursework
1046
 - additional training during the 3 years In presentation.
Psychiatry Semiology, Psychology, Pedagogy, Music
Concurrently 24 students from PORTUGAL, the
History, Music Analysis, Vocal and Instrumental
AZORES, and MADEIRA ISTLAND are enrolled in the
Training, Theory and Work in Art-Therapy
course
-The 2000 Hours are:
Jacqueline Verdeau-Paills
- 240 hours of theoritical Lessons
Present and Future Trends
- 560 hours of additional training
The field of Music Therapy in currently taking form in
- 600 hours of practical work in institutions Portugal. We can identify two different approaches
which correspond roughly to the work being done with
- 600 hours presonal research with supervisin
two types of population - handicapped children and
The final exam include: psychiatric adults. There is a resiprocal influence
- written tasks between these two trends due to the role of the music
therapy training program which introduces education
- practical examination
professionals to the work in clinical settings and on the
- presentation and discussion of a monograph other hand, it sends music therapists with Psichology
All precisions concerning the contents of the background to work in educational facilities.
musictherapy progam will be given during the
1047
In the field of special education (education of health profeccionals who are musically trained. Musical
handicapped children), music therapy evolved out of activities were progressively included in their
the work of music teachers and educators who were therapeutic work chich is evolving from therapeutic
progressively trained to de therapeutic work cith recreational activities into a forma of supportive
children with special needs. This kind of practice mainly psychotherapy. This kind of work includes both music-
includes recreational music activities with therapeutic listening and musical improvisation work in day
implications such as handicap-rehabilitation and treamente agencies with multidisciplinary teams and
emotional support. These activities are organized and are supevised by psychoanalytically oriented
carried throught in accordance to the functioning level psichologists and psychiatrists.
and the psychoeducational goals that are established
Even though this trend was initiated in the work with
for each child.
adults, it also takes form, at the current moment, in
Some music educations methods (Orff, Willems, some intervention project with emotionally disturbed
Kodaly) are applied by educator/therapist who directs childrem and adolescents.
the musical activities towards the achievement of non-
In the near future, the field of music therapy in Portugal
musical goals. Folk music and musical games are often
will greatly benefit from the establishment of an official
used as a source of material for the sessions.
association that will join the efforts of all the techinicians
The second trend evolved from the work of mental incolved and create a professional community that is

1048
responsive to the growing interest of special education M U SI C T H ER API E : AR T - T H ER API E O U
and mental health agencies. The growing number of PSYC H O T H ER API E
music therapy projects being initiated throughout the
R. FORESTIER
country requires the establishment of basic princiaples,
prectice standards and training requirements for the
best of an organized growth of the field. Introduction
The expanding of the training progam that is being put S'il est vrai que l'Art et le soin sont associs depuis les
in effect will certainly have a strong impact in tah field, temps les plus anciens de l'humanit, il faut bien
through the production of more qualified music admettre que c'est avec le XXeme siecle qu'un interet
therapists and their future work initiatives throughout purement mdical apparait, et qu'enfin, la
the country. musicothrapie retrouve ses fondements thoriques et
Teresa Laite pratiques comme activit d'art, et comme dpartement
de l'art-Thrapie.

Alors que le modble initial d'analyse se rfre aux

techniques psychothrapeutiques, c'est dans les
annes 1970, avec le centre de recherches de
l'Association Franaise de Recherches et Applications

1049
des Techniques Artistiques en Pdagogie et Mdecine nature meme des modeles choisis tant pour aborder le
(AFRATAPEM), qu'un intret est port a l'activit processus mis en oeuvre, que les modalits d'actions et
artistique comme modalit singuliere d'intervention et d'observation thrapeutiques.
d'analyse dans le processus thrapeutique. C'est au
Afin de prserver l'originalit et la spcificit de l'Art-
Congres de Limoges en 1986 que simpose, en Europe,
Thrapie, c'est tout naturellement aupres de la rflexion
le clivage entre la psycho-thrapie a support artistique
artistique que nous trouvons les modeles adapts a ce
et l'art-thrapie. L'ide d'art opratoire trouve enfin sa
type de pratique. Ainsi, l'Art-Thrapie trouve-t-elle ses
place en art-thrapie.
lettres de noblesse comme activit originale et
De faon cavaliere, et en reprenant les ides complmentaire dans l'qulpe pluri-disciplinaire de
traditionnelles, nous pourrions rsumer l'Art-Thrapie soins.
avec la psychagogie platonicienne : l'art de mener les
ames, et la catharsis aristotlicienne : "a fait du bien".
Cependant, et en nous rfrant aux pouvoirs et effets Gnralits

de l'Art dj voqus dans l'antiquit, nous rappellerons Les thories artistiques, issues de l'antiquit, donnent a
la dfinition actuelle de l'arttherapie : Exploitation du l'artiste une place ambigue de mdiateur entre le divin
potentiel artistique dans une vise humanitaire. et le citoyen. Cela met l'oeuvre d'art en exergue et lui

Cela nous amene a nous poser la question relative a la donne une place priviligie comme rvlation d'une
pulssance surnaturelle. L'aspect contemplatif s'impose
1050
aux dpends de l'action. l'idalisation du bonheur. L'activit s'impose comme
manifestation mdlatrlce, d'ou se dgage un principe
L'approche thorique qui s'en dgage donne l'art une
de rajustement et d'quilibrage entre l'intention et la
nature signifiante qui, de la signification divine propre a
production. Cela donne toute leur valeur aux techniques
la tradition aux thories psycho-analytiques
comme modalits expressives adaptes. Elles
contemporaines, donnent des modeles d'action et de
reprsentent dans la production artistique, une limite
rflexions thrapeutiques. Le sens s'impose comme
entre l'homme et l'universel ainsi qu'un clat rel d'un
dtermination de l'oeuvre d'Art et donne son originalite
bonheur idal. Avec cette proposition, le phnomene
la psycho-thrapie support artistique.
artistique rvele le bon comme attenant a l'homme, le
Avec la thorie de l'art opratoire, vont s'attacher au
bien attenant a l'activit et le beau comme attenant a
concept d'Art, et de faon dterminante, les ides de
l'oeuvre. Le principe de causalit qui s'impose, donne a
phnomene et d'opration artistique.
chaque lment du phnomene un dterminisme et
L'oeuvre trouve une place essentielle dans le une singularit qui, paradoxalement, cautionnent
processus artistique, et s'inscrit dans un principe de l'entit du phnomene. C'est parce que l'art opratoire
causalit comme fruit d'une laboration. Elle renvoie donne place a la fonction existentielle que le sens s' en
tant a l'activit de l'artiste qu'a l'artiste lui-meme. Alnsi, trouve relativis. Cela ouvre 1A potentialit oprante de
sont poss les fondements d'une opration singuliere, l'Art, qui, au-dela de la signification trouve dans la
qul trouve dans l'homme la tension essentielle a fonctlon voque une modalit active singuliere.

1051
L'Art qui favorise l'expression bnficie du sens comme d'quilibre et d'harmonie.
support de la communication. Cependant, et au-dela du
b) dans le domaine de la communication, ou l'change
sens, l'art peut provoquer une relation intime, sorte de
et le sens s'imposent, au moyen du verbal, du
coalescence, qui tout en chappant a la communication
comportemental ou bien des formes signifiantes.(Nous
entendue comme change de sens, gnere une
rappelons notre ide du sens qui est "une orientation de
modalit relationnelle singuliere, sorte d'empathie au
la fonction").
sens classique du terme, ou l'intgrit du sujet est
prserve par la fonction limite et rflchissante de c) dans le domaine de la relation, rapport entre les

l'oeuvre elle-meme. C'est parce qu'il sait "prendre la individus qui chappe au sens, ou la connivence, sorte

distance" d'avec son oeuvre que l'artiste n'est pas fou. de principe sympathique cher aux anciens, permet
d'etre, de faire, de ressentir spontanment ensemble.

Le phnomene artistique
Fort de ses trois effets dterminants dans le
Avec les ides traditionnelles de pouvoir et d'effets de
phnomene artistique, un champ opratoire se dgage
l'art, nous retenons le role priviligi qu'il tient :
qui concerne l'activlt de l'homme, et peut des lors,
a) dans le domaine de l'expression, qui par le jeu subtil prendre place dans l'arsenal ducatif et thrapeutique.
entre impression et expression, sollicite la justesse d'un En lui et par lui, le phnomene artistique peut aider au
rapport psycho-moteur, et dtermine les concepts bonheur des hommes et permettre a chacun d'assurer
1052
et d'assumer sa dignit. communication entre lui et le patient.

Si l'Art peut redonner le gott a une qualit de vie, l'Art Nous retenons, de l'ensemble des techniques de l'art,
n'a pas vertu de gurison. I1 peut, dans certains cas, comme la musique, la peinture, la danse, etc... qu'elles
favoriser l'autonomie du sujet dficient ou bien mergent d'un tronc commun, dtermin par le concept
permettre de traditionnel de l'Art.

comprendre et accepter un traitement medical. Cependant, s'il est vrai que l'Art s'entend conmunment
comme technique sophistique , la grande leon que
Le pouvoir de l'Art en ce qu'il touche au plus profond de
nous apporte le travail artistique aupres d'handicaps
l'homme, implique une raction qui dtermine un
profonds est une reconsidration du processus.
accident spacio-temporel rvlateur. Le pouvoir de
dcision relatif la rceptivit cre un lien, rudimentaire Avant de se prsenter comme sophistique, la
peut-etre, mais un lien quand meme entre l'artiste et le technique est une gesticulation, qui, dans la mesure ou
sujet. C'est le travail sur ce lien qui va donner la nature elle rpond a la volont et aux possibilits du sujet
de la comptence en art-thrapie. trouve sa place dans le phnomene de l'art. Si l'art
s'entend avec les oeuvres magistrales des Giotto,
Spcialis en art-thrapie, l'artiste sait exploiter tant le
Moliere, Beethoven ou Bjart, il est redevable, aussi,
contenu que la forme de l'activit artistique, afin
des activits plus modestes. Si Lonard de Vinci est
d'exhumer, de l'expression du sujet, une potentialit et
Lonard de Vinci, c'est bien parce que d'autres ne sont
activit relationnelle afin d'tablir une relle
1053
pas Lonard de Vinci. C'est l'ide de complmentarit
qui va retenir notre attention. N'est-ce pas, d'une
Aspect thrapeutique
certaine maniere, la leon que nous pouvons retenir
des maltres italiens de la Renaissance, qui avec les Cette approche du phnomene artistique tend a

"non-finito" laissent volontairement des oeuvres non dgager l'Art du carcan psychologique qui trop souvent

termines : c'est certainement, en cela, que des gnies l'enserre et dnature son action essentielle. Cela

comme Michel-Ange nous incitent d'une certaine Justifie d'autant plus cette complmentarit entre la

maniere a considrer le travail artistique du dbile psychothrapie a support artistique domaine du

profond. Ce n'est pas le beau qui nous intresse mais thrapeute et l'art-thrapie domaine de l'artiste.

l'idal de beaut, sorte de tension qui nous pousse au- Si tout art-thrapeute est d'abord un artiste, tout artiste
dela de nous meme pour aspirer a une qualit n'est pas art-thrapeute. Un complment thrapeutique
suprieure de vie par "l'lvation de l'ame", c'est a dire indispensable doit complter la formation initiale afin de
une jouissance profonde de la conscience d'etre , et par permettre le controle et l'exploitation des prises en
la reconnaissance, non pas comme "artiste" pour un charges thrapeutiques.
dbile profond qui n'en a pas les moyens, mais reconnu
L'artiste, que nous voquons ici, est une personne qui a
comme homme et femme a part entiere. C'est bien de
plaisir a la pratique artistique, fort d'une comptence
l'Art au service des hommes dont il s'agit en Art-
technique ou invention et reproduction vont de pair cet
Thrapie.
artiste spcialis saura mettre son art au service de
1054
l'homme malade et bnficier du pouvoir et effets de que la qualit de l'opration artistique. I1 ne s'agit en
celui-ci. La grille d'observation, en ce qu'elle synthtise aucune faon de porter un jugement de valeur. L'art-
l'action de l'artthrapeute, permet d'envisager une thrapie n'a pas pour vocation de "faire" des artistes,
exploitation, observation, et valuation judicieuses et mais de permettre aux hommes d'enrichir et d'exploiter
spcialises. leur potentiel expressif et relationnel, de meme que leur
facult critique. C'est pourquoi l'observation s'attache a
De l'ensemble des rubriques de la grille d'observation,
l'ide de "prsence" du sujet, notion qui chappe a la
nous retenons, aujourd'hui, les registres esthtiques et
quantification, et qui s'apprcie en terme de
relationnels. Comme l'artiste qui ne fait pas "du beau"
rayonnement du sujet. Cela se prsente
lorsqu'il cre, le processus relationnel qui s'instaure
esthtiquement par la facult de "nuancement", c'est a
peut chapper aux phnomenes transfrentiels en ce
dire outrepasser les regles et limites communes pour
qu'une simultanit expressive commune et spontane
imposer son style. Ainsi, tel mouvement est saccad, tel
peut apparaitre et imposer un moment artistique
dessin estomp, ou bien tel son est "vibr". Entre
intense et absolu. L'observation doit considrer ces
mimesis et heuristique, la production montre un ventail
moments essentiels ou l'homme se rvele tel qu'en lui-
de nuances qui rvelent le dpassement de l'homme
meme, de la meme faon que la configuration ou la
par lui-meme. Ce nuancement impregne la globalit du
signification des productions.
processus, qui du comportement initial a la ralisation,
I1 s'agit d'apprcier la manibre et le savoir faire ainsi
rvele la singularit du sujet. L'apprciation de cette

1055
nuance trouve sa matiere dans la comparaison des Le phnomene artistique s'entend donc comme entit
situations, afin de reprer la situation basale et dgager oprante attache a la fonction existentielle et au sens.
le nuancement C'est dans la rallsation et la conscience I1 se prsente initialement sous une forme archasque
de ce nuancement que l'opration artistique s'est et globale inhrente a la tension fondamentale, pour se
impose comme humanitaire. concentrer dans l'intention, et trouver dans l'idal de
bonheur une orientation de son activit. Tant l'intention,
le principe de causalit qui associe les diffrentes
Conclusion
lments, la "justesse" de l'activit, (c'est a dire un
Je conclueral ce bref aperu des travaux du centre de rapport harmonieux entre fins et moyens), que la nature
recherches AFRATAPEM-Facult de Mdecine de et qualit de la production, dterminent l'activit et
Tours, en rappelant d'abord, l'ide qui s'attache au mot l'observation. Autant d'lments qui donnent a l'art-
thrapie. I1 s'agit bien du sens premier du terme thrapie une place originale et complmentaire dans
Soigner, entendu comme "s'occuper de". l'quipe de soins.

Ensuite, l'ide d'art. Entendu comme phnomene A la diffrence des ateliers d'art, les prises en charge en
artistique. I1 s'agit d'animer le pouvoir expressif et les art-thrapie n'ont pas pour objet l'art, mais l'homme
effets communautaires qui s'attachent a l'art. L'Art ne sensible. Elles permettent de rinvestir dans la vie et de
gurit pas, mais il revigore l'aspect existentiel du patient tendre vers une qualit de celle-ci
qui retrouve son statut de sujet.
1056
L'Art-Thrapeute par sa comptence d'artiste sait 1 - L'ART OU LE DROIT D' ETRE - R. FORESTIER
animer le phnomene artistique pour le rendre
73 pages - Ed.Cantigas - 1979
opratoire, et par sa spcialisation en art-thrapie, il
sait mener et exploiter une prise en charge.

L'Art n'a pas l'exclusivit de l'expression, mais ses 2 - DESPERTAR AL ARTE Introduccin al mundo

moyens semblent particulierement bien adapts. C'est sonoro - R.

de la confrontatlon entre le plaisir essentiel, source FORESTIER - Editorial mdica i tecnica, S.A. Barcelona
d'isolement et d'absolu et le plaisir existentiel, source -141
communautaire et de relativit qu'une activit d'art va
pages - 1980
s'imposer et exhumer de l'homme un principe vital
d'quilibre, ou l'essence devra s'accorder avec
l'existence, l'intention avec l'action, l'un avec l'autre. 3 - ART-THERAPIE: DES CONCEPTS A LA PRATIQUE
L'ide qui s'attache a l'harmonie dpasse, alors, - R. FORESTIER,
l'activit artistique, pour concerner la vie de l'homme,
J.P CHEVROLLIER - 106 pages - Ed.Jam Cantigas -
pour concerner la vie des hommes.
1982

PUBLICATION
1057
4 - ART ET THERAPIE AU-JOURD'HUI - CONGRES I N SEAR C H O F T H E G O O D EAR : SO M E
INTERNATIONAL - Dr J. T H O U G H T S O N PO ST - G R AD U AT E M U SI C
T H ER APY T R AI N I N G
DELANEAU, Pr.J.M LEGER, etc...- 142 pages -
AFRATAPEM-FACULTE S ARAH H OSKYNS
DE MEDECINE DE TOURS - 1986

INTRODUCTION

5 - LES BASES DE L'ENSEIGNEMENT EN ART- British music therapy training has traditionally used the
THERAPIE - Dr. J.P model of a one-year full-time course usually following 3

CHEVROLLIER, Pr.J. THOUVENOT, etc ... - 153 pages - years of undergraduate music (or related) studies at a

AFRATAPEM university, conservatoire or school of education. The

Guildhall School of Music and Drama's music therapy
FACULTE DE MEDECINE DE TOURS - 1990
course pioneered this model in Britain under the
direction of Juliette Alvin and continues in this way in the
199Os. However, preparing music therapy students for
professional work in one short year is a challenging
task. Colleagues in Europe, USA, Australia and
elsewhere who have established longer training periods
1058
are undoubtedly wise. The trainee music therapist has Guildhall School, England showing some of our
quickly to become an a, complished juggler, developing solutions to the problem of helping students to find their
and polishing a complex mixture of skills. As educators own good ear.
how ,can we focus and balance the teaching of these
skills ? How can we assist students to find a clear path
through what might seem to be bewildering new areas I would like to begin with two reflections on work with

of knowledge? clients in music therapy. In each case I believe the idea

of listening in the sessions to be crucial to the way the
work developed, although the clients and therapeutic
This paper will examine a central point of connection approach seem initially to be quite dissimilar. The first
between the training of the musician and the training of reflection concerns some work described and shown by
the therapist. That is the development of a finely tuned Clive Robbins at the European music therapy
and sensitive ear. For the musician this is essential in conference held in Cambridge, England in April 1992.
ensemble playing at all levels and also for concentration For part of the presentation, Clive described the first five
on quality of sound production in solo performance. For sessions of music therapy with a four year old child
the therapist, the ability to listen attentively to your called Nicole. (Robbins, 1993) He was co-therapist and
slients is pre-requisite. The paper will then discuss his wife, Carol the primary therapist working at the
some aspects of the music therapy syllabus at the piano. In watching the video presentation, I was riveted

1059
by the quality of Carol Robbins listening attention to regularly commit petty have spent long periods in
Nicole, writing the following in my notes: "Such accurate prison. The group I had as music a rehabilitation
timing by the therapist, such sensitivity and clarity about offences and who had met for their enthusiastic and
the way the music proceeds. The therapist keeps an session was their second of twelve and felt of us. The
overall stability in the music but is ready to respond to improvised music was loud and first session the
any subtle nuance." previous week in quite an lively way. This difficult for all
of us. The improvised music was loud and chaotic and
It was a thrilling moment to witness this fusion of musical
seemed to just disintegrate rather than come to any
and therapeutic skill particularly as first Carol then
clear endings. It was very hard for anybody to hear their
Nicole slipped into "dancey" 6/8 rhythm in the last
own or others' input. After the second improvisation
session shown. Pamela Steele suggests that this
people began to shout out their frustrations. The
willingness and ability to listen is "perhaps the most
following is an outline of the main parts of their
primary servi,~e" offered by the therapist (Steele,1988)
discussion. (The taped example gives an idea of the
though indicates that we are "often limited in our
level of noise which led up to and accompanied the
capacity for it".
conversation.)

The second reflection is on an experience therapist with

Taped example 1
a group of clients attending centre for adults who
1060
 everyone else, if I pick the right time. But, if I don't really
k.now what I'm doing and I just play loud...... (banging)
Extract of dialogue from music therapy session
then no-one else can (demonstrates loud solo) ... hear
Client 1: I decided to bash away at them (drums) anything.
Client 2: Thats allright if you're in a room by yourself.... Therapist : One of the difficult things about getting music
SHUT UP! ( to everyone else) together is being sensitive to each other. It's a hard
Client 1: We're not musicians - we're just, sort of ....... business.

Client 2: But all of us here, we can get a little thing going. Client 1 : Yes ... that's why a lot of musicians don't get on
break up and all that. They can't agree. They can't get
Client 3: Yes ! but drums are supposed to be hit loud
together as a group, they just bust up.
man! Not just "tap, tap, tap"

Client 4: Is there any such thing as a quiet drum? Client

1 : No,loud ,drum! This discussion interests me on many levels, not least in
the way it demonstrates this group's struggle to work
Client 2 : Yes but for someone who can't play, like me,
together. However, with reference to the subject of "the
I'm just feeling my way (playing drums with natural
good ear" and the way we listen, it seems that this group
ease) until I can get something. Then when I'm a bit
of people were getting a very strong idea of the
more confidents I can hit it loud without drowning
importance of aural skills in music and in therapy. (A
1061
trainee therapist might well learn from their clients' need to be heard and understood and in the way
conclusionst) The group won't survive if people are not we evolve music for them. One might say - and
sensitive to each other. Some people need to play loud particularly to students beginning their training - it is not
to be heard and as a release, but that may mean that so much what you play that is important but how you
others can't hear or have any impact. You've got to show that you are listening to what is communicated.
listen and feel your way. Timing is important. So is
confidence.
Identifying and practising the listening skills of
musician and therapist in training (Overhead
Within this sort of group, relationship with and projector - slide 1 )
responses to the peer group are often as significant as
1. Some examples of listening skills of the musician
they are with the therapist. Everyone has a
responsibility to make the group work. However,in
music therapy, whether one is working indivi,iually with - Critical awareness of own sound
young non-verbal children, or in groups with highly
(e.g. tone quality, evenness, rhythmic accuracy contrast
articulate and disruptive adults, the therapist does have
etc.)
a common purpose. That is, to model an attentive,
listening attitude both in our general reponse to the - Pitch recognition

1062
(single notes, intervals, melodic patterns) - Noticing tone o f vo ice ani breathing

- Timing and phrasing - Reflecting, repeating

- Rhythmic awareness and memory - Summarising

(tempo, pulse, patterns)

- Timbre and orchestration How are such skills identified here explored in the music
therapy syllabus at the Guildhall Schcool?
- Balancing sound in silence

Firstly it seems important to emphasise that the idea of

Some examples of listening skills of the therapist
the finely tuned and sensitive ear is primarily one of
attitude and philosophy. It is not something easily
The innocent ear packaged and handed over to students as a set of skills
to be straightforwardly mastered and used. In many
(i.e. listening and wondering - not prejudging)
ways, at audition we are looking for potential trainees
- Waiting (not interrupting silences) who already have the ability to wait, to use silence, to
- Attending to patient's not own concerns recognise intervals and harmonies, and who have a
sophisticated sense of timing and phrasing and so on.
1063
 listening. They raised some interesting points which I
shall summarise briefly as follows:
However, the course of training aims to help students to
focus their listening in different ways, to incorporate 1. The aspect they emphasised most was the fact that
senses and feeling more and intellect less simply and they had spent a lot of time practising improvisation in a
with more detail; to be freer and less preoccupied with variety of contexts : large grzoup improvisation, music
their own performance but able to concentrate fully on therapy group, small group clinical improvisation and
patterns to help communicate perceiving form, and yet general musioianship, an.i in work with clients and
still to listen. (Steele 1988) supervisors on placements. They felt they nee,ie,i a lot
of time to tune in to different instrumental sounds an,i to
-. We want people to listen more to be freer and less
be,-ome less self-conscious
preoccupied more aware of its effect. to be freer and
less preocupied with 2. They all valued spen,iing concentrated time on their
own performance instrument. They felt that
their clients sounds, finding meaning and "to tolerate
concentrating on their own soun,i was valuable an,i
non-perceiving form, and yet still to listen." (Steele,
vital, nourishing their musical resources. One student
1988).
thought that the concentration on first study playing had
I recently asked this year's group of students to reflect
really improved the quality of listening as her teacher
on where within the course they had felt they had
had worked specifically on this. felt, however that they
gained particular insight into the issue of attentive
1064
had too little time to practice. about other people's playing.

3. Several students particularly valued having a regular

movement session. One person described being able to
Three other areas of the training syllabus to which I
listen more accurately with her body echoing patient's
would draw attention in regard to the development of
rocking movements and postures.
integrated and sensitive listening are :
4. All valued making particular connections with their
student colleagues in sensitive moments of listening
and playing in improvisation groups. These were high 1. Students' work. in keyboard musicianship and

points of their student experience. They also felt that at contemporary improvisation without using your eyes.

times staff had role-modelled a concentrated way of This would involve either having eyes shut or playing

listening which had been very helpful to copy and use in back musical patterns without being able to see the

their work. teacher's hands at the keyboard. Although visual cues

are often vital to our clinical observation, working
5. Finally, though many students had found their
without vision concentrates attention on and awareness
experiential musictherapy group a very demanding and
of the aural messages.
tough experience , all felt it had contributed greatly to
their ability to listen and be heard effectively.It had 2. Doing exercises in group dynamics on preparing

helped to identify personal blocks and preocupations chamber music in small groups. The students do the

1065
task and then reflect with the group leader (who is a I would like to play some brief examples of listening and
counsellor and professional chamber musician) on the playing with students on this year's course in their
dymamics brought up in their musical collaborations. clinical improvisation sessions. Depending on timing I
This process draws attention to attending and feeling will play 3 examples:
within a purelymusical setting, stretching their
understanding of the relationship between music and
therapy. - A music therapy student on her principal study flute,
acting as music al accompanist to fellow students on
3. A lecture course initiated by Juliette Alvin, the
percussion
course's founder, and developed by Leslie Bunt, on
paring down individual sounds into the constituent
elements of timbre, pitch, duration intensity and - An exploration of a child's musical game on violin
loudness. This happens early on in training and I think
really helps students to isolate their listening attention to
simple and vital detail in clinical work.. It also - A music therapy student on piano developing a client

encourages them to ask questions about how the theme in her own individual improvisation

clients listen to and perceive their offered music. In conclusion, I am a new head of music therapy training
in an old debate. In a chapter describing issues of
professional identity in music therapy edueation, Ken
1066
Bruscia observes that educators have battled for (timbre, tone of voice, silence, pattern) can give the
decades about the problem of emphasis on and focus musician new ways to listen to his or her own playing
between musicianship and therapy skills. He links the and living.
debate to the philosophy of whether trainees are
considered to be primarily musicians or therapists -
musis as therapy, or music in therapy (Bruscia, 1987). Perhaps as a faithful reader of Winnicott, I should be

However in this paper, I hope I may have taken a looking only for the "good enough ear". However, I think

sideways step in the ,debate by concentrating on a point it is worth aiming high and expecting excellent attentive

of integration and connection in our subject. Perhaps listening from our trainees, as was demonstrated to me

the qualities of music and therapy can enhance and last year in Carol Robbin's beautiful musical dance with

enlighten each other in their mutual focus on listening her 4 year old partner. For as Carolyn Kenny concludes

and timing. The supreme attention and listening of in her last prose passage in The Mythic Artery

musical accompanists such as Gerald Moore who "The music heals, if we will only hear."
support, nourish and stimulate their instrumentalist
partners could prove an inspiring model to therapists
anywhere - music or otherwise. Also the consummate and given that attentive waiting state, the combined

artistic skill of the experienced personal therapist who listening talents of the musician-therapist should be

gives attention to musical features of verbal dialogue dynamite !

1067
 L A M U SI C O T ER API A D EN T R O D E U N C U R SO
D E F O R M AC I N PER M AN EN T E D EL
References
PR O F ESO R AD O , Y C O M O ASI G N AT U R A EN EL
Bruscia, K. (1987) Professional identity issues in music
N U EVO PL AN D E EST U D I O S D E
therapy education. In Maranto, C and Bruscia, K. (eds).
PSI C O PED AG O G A, C O N M ET O D O L O G A A
Perspectives on music therapy education and training.
D I ST AN C I A
Philadelphia : Temple University Esther Boyer College
of Music P ILAR L AGO C ASTRO

Kenny, C. (1982). The Mythic Artery. Atascadero:

Ridgeview Publishing Company. 1. Introduccin
Robbins, C. (1993). The creative processes are La Msica en sus diferentes manifestaciones a lo largo
universal. In Heal, M. and Wigram, T. Music Therapy in de la Historia, ha formado parte importante en la cultura
Health and Education. London: Jessica Kingsley y el desarrollo de los pueblos.
Publishers.
Hablar aqu y ahora de ese tema, sera repetir
Steele, P. (1988). Foreword. Journal of British Music innecesariamente hechos que como el mejor de los
Therapy. Vol 2, No. 2 pp 3-4. axiomas, no necesita demostracin.

Por esta razn nuestra Comunicacin no se centrar en

1068
este punto, sino en aquel otro que mediante la el momento, nos ha parecido oportuno utilizar el marco
observacin nos ha hecho reconocer en la Msica una de este VII Congreso Mundial de Musicoterapia para
de las mejores herramientas de trabajo para llegar al presentar las nuevas ofertas que la UNED har a lo
hombre y a todos los elementos que configuran la largo de los prximos meses dentro de sus Nuevos
sociedad en la que nace, crece y desarrolla sus Proyectos y Planes de Estudio.
saberes.
En el primero de los casos, es decir, los Nuevos
Hoy la sociedad est en cambios permanentes que le Proyectos, la UNED presentar un Curso Monogrfico
hacen buscar "desesperadamente" un bienestar difcil de "Musicoterapia enmarcado dentro del Programa de
de alcanzar. Nuestro actual Sistema Educativo tambin Formacin Permanente del Profesorado, y en los
forma parte de ese cambio y bsqueda de mejoras, Nuevos Planes de Estudio, por primera vez aparecer
abriendo vas de comunicacin ms prometedoras que una asignatura optativa de Musicoterapia dentro de la
las pasadas, ya que parece que una vez ms se ha nueva carrera de Psicopedagoga. Lgicamente,
pensado en la implantacin del rea de Msica en los ambas propuestas se desarrollarn mediante la
diferentes niveles educativos por considerarla uno de metodologa a distancia, ya que es esta forma de hacer
los mejores recursos para alcanzar un desarrollo y aprender la que caracteriza a la Universidad que
personal ms global y completo. representamos.

Por estas razones y teniendo en cuenta lo dicho hasta

1069
2. Programas de Formacin Permanente del Por lo expuesto en estas lneas, la UNED elabora en el
Profesorado ao 1974 una experiencia-piloto de Actualizacin y
Especializacin a distancia dentro del Programa
La UNED desde su fundacin en 1973, ha prestado una
Nacional de Especializacin del Profesorado de
particular atencin a la Educacin Permanente, y
Educacin General Bsica llamado en lo sucesivo
dentro de ella, a la actualizacin profesional del
PRONEP/E.G.B., que el Ministerio de Educacin y
Profesorado. En el Decreto de fundacin se pueden
Ciencia a travs del I.N.C.I.E. encomienda a la UNED.
leer objetivos fundamentales sobre este tema,
reflejados de la forma siguiente: Lgicamente a partir del acuerdo del Convenio
realizado por ambas instituciones, el PRONEP/E.G.B.
"El Programa de Actualizacin profesional tratar de
debia actualizar y ampliar los conocimientos de los
poner al da los conocimientos y la capacitacin
profesores en ejercicio, ofertando una formacin que
Tcnica de los distintos profesionales del pas mediante
capacitase a los profesoresalumnos a desarrollar los
Cursos y Programas especficos de adiestramiento".
nuevos programas de la Ley General de Educacin del
(Decreto 3113/1974, art. 19).
ao 1970 (Villar Palas).
Adems, aade: "Establecer y desarrollar Programas
La Educacin Musical formaba parte de este ambicioso
de Educacin Permanente, promocin Cultural y
programa con un Curso que se denomin "Msica y
perfeccionamiento profesional". (Ttulo preliminar. art.
Dramatizacin", y el que tuvimos la inmensa
3).
1070
satisfaccin de dirigir desde el ao 1981 hasta su reajustes en la plantilla del profesorado que formamos
desaparicin en el ao 1985. el antiguo PRONEP/E.G.B., comienza una nueva etapa
con caractersticas bastante diferentes.
Este Curso de "Msica y Dramatizacin" dentro del
programa general del PRONEP/E.G.B., desarrollaba un En primer lugar, ya no hay un Ministerio que impone un
modelo con Metodologia a distancia utilizando para la Curriculum cerrado, ni unos alumnos seleccionados por
misma todo un Material Didctico elaborado el MEC que tienen la obligacin de hacer determinadas
expresamente para el desarrollo del mencionado especialidades, sino que se crea un Programa de
Curso. Unidades Didcticas, Guias de Curso, Formacin Permanente (P.F.P.) dependiente
Programas Radiofnicos y un perodo de prcticas en nicamente de nuestra propia Universidad, la UNED.
modalidad presencial, completaban este Curso
Los Programas o Cursos que se ofertan en el P.F.P. son
intensivo de una duracin de 12 meses.
amplios y variados, y permiten a los alumnos elegir
Creemos que el hacer demasiado hincapi en explicar entre todos los presentados en cada convocatoria. El
cmo se realiz el material, cules eran las funciones Programa de Formacin Permanente se configura con
del Profesor-Tutor, etc., se tocar ms ampliamente en un equipo de profesores multidisciplinar que
el momento de citar el desarrollo de los proyectos diseamos, elaboramos y desarrollamos el proceso
futuros. enseanza-aprendizaje a travs de Materiales
Multimedia (Texto, Audio, Video, etc.) e Inteqrado (Guia
A partir del ao 1985, y despus de una serie de
1071
Didctica, Orientaciones Pedaggicas, etc.) con una Pues bien, ya es momento de que la Msicoterapia
doble va de Comunicacin, a Distancia tenga su Curso especfico y ser dentro del marco del
(correspondencia, telfono, Programas de Radio) y P.F.P. desde donde se desarrolle este proyecto que nos
presencial (Seminarios de Trabajo, etc.). tiene cargados de ilusin.

Los profesores que formamos el P.F.P. estamos Como nunca podemos olvidar el modelo metodolgico
perfectamente integrados dentro de la estructura que define o postula nuestra Universidad; de nuevo
universitaria de la UNED, ya que todos estamos ser el Materia trabajo fundamental de nuestra labor
adscritos a un Departamento de esta Universidad. docente mientras el Curso no se ponga en marcha.

Dentro de esta nueva andadura, la Educacin Musical Las personas que libremente decidan matricularse en
ha estado presente desde una doble vertiente, El Curso l, tendrn un Boletn Informativo en donde podrn
de "Didctica de la Educacin Musical - Lo que sea revisar de forma pormenorizada, los diferentes
sonar" como Curso de Iniciacin, y otro interdisciplinar Objetivos y Bloques de Contendido, adems del nuevo
sobre "Didctica de la Plstica y la Msica" en donde se Material que se habr elaborado expresamente para su
aunaban ambos lenguajes utilizando una metodologa realizacin. En cualquier caso, es bueno aadir 120
muy especfica, en donde de nuevo los Materiales horas reconocidas por el Ministerio de Educacin y
fueron elaborados por cada una de las profesores Ciencia y las Comunidades Autnomas que tienen
expertas que dirigamos los Cursos mencionados. transferencias en Educacin, y por otro lado, que est

1072
en nuestra voluntad el que este Curso tenga dos desarrolladas por los "Grandes elefantes sagrados" de
niveles ms de profundizacin consiguiendo as 360 la distintas Facultades en el momento de hacer las
horas. reparticiones de asignaturas Troncales, Obligatorias,
etc., pero lo que s hemos conseguido despus de esas
"grandes luchas", es que la Msica aparezca reflejada
3 Programas de Formacin Permanente del
dentro del Curriculum de las nuevas Licenciaturas de
Profesorado
Psicopedagoga como asignatura optativa con
En estos momentos toda la Universidad espaola vive denominacin siguiente "La Msicoterapia en la
cambios importantes en las carreras regladas ya intervencin educativa".
existentes, y aparecen nuevas titulaciones como es el
Creemos que tanto para quien les habla, como para la
caso concreto de la Licenciatura de Psicopedagoga.
propia Universidad, ste ha sido un gran logro.
La U.N.E.D. ha apostado por esta nueva titulacin con
Una vez ms nos encontramos con el gran reto de
gran cario, y ha previsto una serie de asignaturas
elaborar aquel material que puede ayudar a los
tambin nuevas, que ayudarn en la creacin de un
alumnos a que el mayor nmero de dudas pueda ser
nuevo perfil profesional que seguramente tendr
resuelto mediante la utilizacin del material oportuno
mucho futuro en la sociedad que nos ha tocado vivir.
para cada momento y cuestin. Sabemos que es
Creemos innecesario precisar aqu, las duras batallas importante para todos aquellos que, como quien les

1073
habla, han visto en la Msica un recurso inmejorable en comunicacin entre profesor y alumno que aseguren el
el trabajo teraputico de distintas deficiencias. Ahora desarrollo de una verdadera relacin educativa". As
nos queda lo ms importante, saber que dar en cada pues, uno de los esfuerzos primordiales de toda
momento, y buscar la manera de hacerlo lo ms institucin de educacin a distancia debe consistir en la
asequible y cercano posible. adopcin de unos criterios metodolgicos ordenados
para el logro de unos objetivos docentes.

Adems debemos mencionar, que la UNED preve en

4. Metodologa a distancia
sus Estatutos varios artculos en relacin a la necesidad
E1 modelo educativo de la UNED, precisa de Tcnicas
de aplicar una metodologa didctica especfica.
y recursos especficos que fundamentan su
En funcin de lo dicho hasta el momento, y teniendo en
metodologa, y en los planteamientos generales que
cuenta que estamos hablando de una doble propuesta
esta Universidad tiene se dice: "La educacin a
de enseanza, es decir, el desarrollo de la asignatura
distancia supone la aplicacin de una metodologa
de Msicoterapia dentro de una carrera reglada como
didctica especfica, muy diferente a la que rige los
es la Psicopedagoga, y como Curso Monogrfico
procesos de enseanza-aprendizaje en una relacin
dentro del Programa de Formacin Permanente del
educativa directa". Anade adems que: "el fundamento
Profesorado, veamos los medios con los que cuenta la
ltimo de la existencia de una metodologa propia se
UNED para que ambos proyectos tengan un futuro
encuentra en la necesidad de establecer canales de
1074
prspero. . Video-Interactivo

. Ordenador-Interactivo

1 - Medios Impresos: . T.V.-Interactivo

. Gua del Curso . T.V.-Interactiva

. Unidades Didcticas . Otros

. Pruebas de Evaluacin a Distancia

. Programa de la Asignatura o Curso 3 - Tutorizacin

obligatoria
. Servicio Telefnico directo
. Abundante Bibliografa sugerida
. Contestador Automtico

. Correo
2 - Material Didctico Audiovisual:
. Medios Presenciales: Centros Asociados
. Programas Radiofnicos (semanales, por toda la red nacional.
quincenales, etc.).
. Encuentros - Seminarios - Jornadas de
. Audio-Cassette trabajo, etc.

1075
 y se les sugiere pautas que ayuden a superar la
dificultad. Adems, entendemos que la Guia debe ser
Como podemos observar, el abanico de medios que la
un Manual de lectura inicial en donde el alumno
UNED pone a disposicin del alumno es variado, y que
encuentre toda la informacin necesaria, y
cualquier de los recursos mencionados seran motivo
secuenciada, como por ejemplo: Fechas importantes
de un anlisis profundo y exhaustivo. Pero aunque sea
para que el alumno recuerde como son, el envio de
brevemente, indicaremos algunas de las cualidades de
Pruebas Presenciales, Encuentros y Seminarios,
cada medio.
Exmenes Presenciales (slo en el caso de las carreras
- Guia del Curso
regladas, etc.), dias, lugar y horas donde el alumno
podr localizar al profesor, etc.

Este documento les aporta las pautas, que deben - Unidades Didcticas
seguir a lo largo del Curso, la distribucin temporal en el
trabajo, y orientaciones sobre la metodologia ms
Llamamos Unidades Didcticas al material impreso que
recomendada segn los temas.
constituye el instrumento fundamental de los alumnos
En la Guia, que muchas veces denominamos Guia
de la UNED.
Didctica, aparecen aquellas partes en donde la
A pesar de los avances tecnolgicos, el libro continua
dificultad de estudio en determinados temas es mayor,
siendo uno de los recursos preferidos por el alumno, ya
1076
que adems stos renen unas caracteristicas muy
especiales al ser redactados.

Los autores-profesores de estos documentos deben

Se trata de una serie de propuestas que sintetizan los
tener en cuenta varios aspectos como son: el hacer de
Contendidos de los que consta la Asignatura en el caso
la Unidad Didctica un manual sencillo y cercano para
de las carreras regladas, o el Curso en el caso de
que el alumnolector pueda aprender sin grandes
Programa de Formacin Permanente.
dificultades. Estos documentos disponen de
En ambos casos presentan una doble finalidad, son un
Esquemas-Resumen, Contenidos cognoscitivos,
medio didctico y a la vez un medio de evaluacin,
Actividades recomendadas, Bibliografia que ample la
destacando sobre todo el principio ya que poseen un
informacin, etc. E1 Instituto de Ciencias de la
valor orientador que ayuda al alumno en su
Educacin de la UNED ha elaborado unas
aprendizaje. Por otro lado, podemos "medir" los
"Instrucciones para la realizacin de Unidades
resultados obtenidos mediante su realizacin.
Didcticas", en las que se explica con todo detalle el
modelo pedaggico a seguir.

La UNED tiene un modelo concreto para la elaboracin

1. Pruebas de Evaluacin a Distancia de estas Pruebas de Evaluacin que no discutimos en

absoluto, s610 que la experiencia realizada en la

1077
enseanza a distancia, y dadas las caracteristicas En las carreras regladas, las Pruebas de Evaluacin no
peculiares del lenguaje musical, hemos elaborado son definitivas en la calificacin final del alumno, ya que
nuestras propias Pruebas de Evaluacin. estos cuentan con unos exmenes realizados en tres
ocasiones a lo largo del Curso (Febrero.Junio y
Septiembre) que decide su calificacin final, no
No obstante coincidimos con la filosofia que acompaa
obstante nuestro planteamiento es distinto, ya que
las diseadas para lo que se conoce como Carreras
pensamos en el esfuerzo que el alumno debe realizar
Regladas, y encontramos en ellas unas funciones muy
para hacer una Prueba de Evaluacin digna, ms an si
positivas como son: Facilitar el estudio alumno,
tenemos en cuenta el aspecto prctico-presencial que
estimular el aprendizaje, ya que el alumno recibe
nosotros encontramos en esta prueba.
corregido el "cuadernillo de evaluacin" y conoce
Estas Pruebas de Evaluacin a distancia el profesor de
exactamente cules han sido sus fallos. Adems,
la Sede Central las prepara cada ao, y su nmero
puede realizar de forma prctica, la experiencia o
varia segn cada asignatura, pero suelen ser tres o
ejercicios propuestos por el profesor.
cuatro.

E1 alumno recibe una calificacin, sobre todo una

Programa de la Asignatura o Curso
orientacin especfica y valiosa sobre la marcha de sus
estudios.
1078
E1 Programa propiamente dicho es el resultado una relacin de entidades o Centros en donde podrn
concreto de todo un Diseo Curricular, en donde los hacer con el libro o artculo de revista, etc.
objetivos, los contenidos, los mtodos y las tcnicas
aparecen para que sirva de orientacin general para el
2. Material Didctico Audiovisual:
alumno. Permite adems conocer y comprobar el
contenido que abarca la asignatura o Curso, segn los En este apartado presentamos los Medios Didcticos
casos. Audiovisuales que en estos ltimos aos han ido
ocupando un lugar cada da ms importante entre los
recursos propios de la enseanza a distancia. Como
Bibliografia
indicaba el profesor Gmez y R. de Castro: "la conquista
A lo largo de ao, el alumno va recibiendo una tecnolgica del medio audiovisual ha supuesto un salto
Bibliografa suplementaria actualizada segn los cualitativo en el desarrollo de concepto de enseanza a
temas, el inters del alumno, y el trabajo que ste tenga distancia" y el papel que se le atribuye es de tal
intencin de desarrollar posteriormente. magnitud que le induce a formular siguiente conclusin:
"el porvenir de la enseanza a distancia corre paralelo
Las Unidades Didcticas disponen de una Bibliografa
al ritmo de difusin de los medios audiovisuales en la
de consulta o necesaria para ampliar y conocer mejor
sociedad informatizada del futuro".
los temas, pero adems, se les envan las ltimas
publicaciones aparecidas en el mercado o se les enva
1079
Como se puede entender, los Medios Audiovisuales La elaboracin de los guiones y grabaciones
ofrecen una variada seleccin de formas de llegar al radiofnicas las realiza el profesor de la asignatura,
alumno, y permiten adems atender a los distintos enfocando cada programa de forma que interese a
objetivos didcticos de la asignatura. todos.

La Radio: Este medio generalmente se utiliza para

hacer posible que la relacin de profesor y alumno sea
Audio.Casete. En contraste ofrece la posibilidad de
ms directa. Por otra parte, este medio permite la
repetir el mensaje, en detrimento de la actualidad; es un
permanente actualizacin de los contenidos de la
medio muy valioso para la prctica del lenguaje
asignatura, y en el caso concreto de la enseanza
musical, ya que puede presentar el ejemplo concreto
musical se podra pensar en un medio de aprendizaje
de manera clara y concisa, adems de contar con la
sonoro-musical mejor que aquel que fundamenta todo
participacin de personalidades relevantes del mundo
su expresin en este hecho?.
musical, educativo, en el caso de nuestras asignaturas.
"La Radio se caracteriza por su fugacidad, valor de
Muchos temas del Currculum, se desarrollan con
actualidad y capacidad de sugerencia; a cambio,
facilidad en este medio.
demanda concentracin y actitud activa cuando se
utiliza con fines educativos", as la entiende Garcia
Matilla al hacer una valoracin del medio. E1 Video aporta en este caso la referencia visual y el

1080
movimiento tan importante en asignaturas como las error negarse a conocer los lenguajes que la tcnica
nuestras. Puede utilizarse como material bsico o pone a nuestro alcance ya que no podemos olvidar la
complementario de algn Tema especfico. Temas metodologa que caracteriza nuestra enseanza.
globales o analiticos de la asignatura pueden ser
La msica ha comenzado a formar parte importante de
visionados, realizando con posterioridad un uso
la Informtica, y seguramente en muchas ocasiones
didctico de las aportaciones realizadas en este medio.
pueda llegar a suplir la labor minuciosa y sacrificada de
E1 profesor de la asignatura junto a los tcnicos las transcripciones de miles de pginas musicales
especializados del C.E.M.A.V. son los encargados de escritas de forma manual. Encontramos en este medio,
realizar la Escaleta, Guin de Video y 1gicamente, su una poderosa herramienta que aportar cualidades
posterior realizacin. innegables en el campo de la enseanza musical.

T.V. Interactiva. Como en el caso anterior, la rapidez

y permanente contacto con el alumno, puede ser y de
E1 Video-Interactivo. Hoy en total actualidad, facilita
hecho cada da lo es ms, un medio rpido y cercano
por su rapidez el que alumnos y profesor puedan
para los aprendizajes.
mantener una comunicacin casi directa y permanente.
Como hemos podido comprobar, la UNED permite
utilizar diferentes recursos didcticos que ayudan a
E1 Ordenador, hoy ms que nunca puede ser un
realizar mejor nuestra labor docente. Seguramente, la
1081
utilizacin de uno u otro medio depender de la eficacia E1 alumno recibe al comienzo de Curso una Gua de la
que queramos alcanzar en el aprendizaje de los que ya hemos hablado, y conoce por ella los das y
contenidos de nuestra materia. horarios en los que podr comunicar directamente con
el profesor de su asignatura, dando ocasin a que
De cualquier modo, encontramos que una asignatura
comenten y opinen acerca de las dudas o problemas
como la nuestra Musicoterapia aplicada dentro de la
surgidos en relacin con la materia. el profesor orienta
carrera Reglada o dentro del P.F.P. debe recurrir a los
adecuadamente al alumno, realizando una funcin de
medios audiovisuales de los que dispone la UNED, ya
feed-back que consideramos altamente positiva.
que as lo hemos venido haciendo durante nuestros
aos de docencia con la metodologa a distancia.

Contestador Automtico. E1 alumno deja reflejada

su duda o pregunta, y nosotros le llamamos
3. Tutorizacin
inmediatamente de recibir la informacin.
En una enseanza a distancia, debe existir un sistema
Correos, el alumno puede enviarte por este sistema
que nos ponga en relacin con el alumno, y la UNED
cualquier tipo de consulta o sugerencia respecto a las
cuenta entre otros con los siguientes.
cuestiones que debe de realizar lo largo del Curso. En
concreto, en nuestra asignatura, hemos utilizado un
Servicio Telefnico: sistema dadas las caractersticas de la misma, en la
1082
que el profesor o el alumno enva una cinta-casete en la E1 cometido de los Centros Asociados, ya que es as
que puede manifestar sus dudas con ejemplos en el como se les denomina, es doble, por una parte hacen
caso del alumno, o la revisin o ampliacin de temas posible que los alumnos de todo el territorio nacional
distintos en el caso del profesor, de cualquier modo, los dispongan de un lugar de encuentro que les rena y
envos de cartas, circulares informativas de cuestiones organice, y por otra, proporcionarles un apoyo tutorial
de inters por parte del profesor, es permanente. dentro de su formacin. En nuestro caso concreto,
sera un nuevo planteamiento a desarrollar ya que la
disponibilidad de profesionales cualificados en una
Pero la Universidad Nacional de Educacin a Distancia,
asignatura como la nuestra no es demasiado comn, y
tambin cuenta con unos Medios Presenciales que
sobre todo, por el concepto personal que tenemos de la
apoyan y refuerzan su enseanza.
filosofia de la enseanza a distancia, no obstante,
Los Centros Asociados: La UNED como muchas de vivimos momentos de cambio que pueden hacer
las Universidades con un sistema abierto cuenta dentro replantearnos algunos aspectos, entre otros el referido
de su organigrama, adems de con la Sede Central, a la labor tutorial en la que por supuesto creemos
con una serie de Centros distribuidos prcticamente profundamente.
por toda nuestra geografia. Su modelo organizativo
E1 Profesor de la Sede Central, realiza encuentros con
hace compatible dentro de su estructura estos dos tipos
los alumnos que pueden realizarse en los Centros
de organismos.
Asociados, adems disponen de un material de
1083
consulta importante, ya que casi todos ellos cuentan ya que depender mucho de la situacin en la que se
con un amplio fondo de publicaciones en sus encuentren nuestros alumnos. Por ejemplo, si la
Bibliotecas, Videotecas, etc. E1 alumno de la UNED, Convivencia se realiza pasada la primera Prueba de
puede acudir al Centro Asociado ms cercano para Evaluacin, seguramente estarn interesados en
escuchar una cinta-casete de un Programa de Radio analizar con el profesor cules han sido los fallos
interesante, o visionar unas imgenes de un video, o producidos en la misma, y seguramente nos sugerirn
sencillamente buscar la Unidad Didctica que por nuevos ejemplos que les hagan entender mejor una
mltiples razones an no tiene en su poder. determina cuestin. En cualquier caso, entendemos
que los Seminarios o Convivencias nos ayudan ha
Seminarios-Convivencias: a lo largo del Curso, el
conocernos los unos a los otros y enriquecer
profesor organiza al menos un encuentro presencial,
seguramente entre todos el tema que nos ha reunido,
con sus alumnos, bien en la Sede Central o como
en nuestro, la Educacin o Expresin Musical.(
hemos citado anteriormente, en un Centro Asociado.
musicoterapia )
Existe una amplia relacin bibliogrfica que nos indica
en lo que deben consistir estos Seminarios o En cualquier caso y dadas las peculiaridades de la
Convivencias, pero nuestra experiencia nos ha ido nueva materia o asignatura, la UNED tendr que hacer
demostrando a lo largo de los aos cul es la demanda Convenios con Centros Asistenciales y/u Hospitales,
real que nuestros alumnos necesitan, por esta razn en etc., donde los alumnos matriculados en el Curso del
estos encuentros los temas pueden concretarse o no P.F.P. o Carrera de Psicopedagoga, puedan hacer su
1084
perodo de prcticas, pero de este y otros temas habr 5. Conclusiones
que hablar ms adelante cuando nos encontramos
Por todo lo expuesto con anterioridad, encontramos
redactando los Diseos Curriculares que formarn
que ste es un momento histrico importante, tanto a
nuestro Proyecto Docente.
nivel personal, como institucional, ya que hemos
Finalmente, quiz hemos despertado muchas conseguido por primera vez que la Msica se
expectativas con lo dicho hasta el momento esperando contempl en unos programas universitarios desde la
que al menos los Descriptores de la Asignatura o del doble vertiente educativa de un Programa de
Curso de Musicoterapia aparecieran ya como primicia, Formacin Permanente del Profesorado y desde una
pero nos encontramos en los pasos previos a este carrera reglada en la U.N.E.D.
punto, en donde emisiones acadmicas, firmas de
En ambos proyectos hemos puesto toda nuestra ilusin
permisos, y presentacin de Documentos, nos han
y energa ya que siempre hemos encontrado muy
impedido compartir con todos ustedes nuestros
necesaria la formacin, tanto inicial como permanente,
proyectos de futuro de forma escrita, en cualquier caso,
de todas aquellas personas que opten en su vida por la
estamos en ello tanto como en la formacin de un
enseanza o el trabajo en Educacin Especial en
equipo de expertos que podamos desarrollar todos
diferentes instituciones como: Hospitales, Centros de
este amplio proyecto.
Marginados, Centros de Tercera Edad, etc., como en
los nuevos Curricula de la nueva carrera de

1085
Psicopedagogia. Chadwick, C. (1981): "Perfeccionamiento de Docentes
via educacin a distancia". Madrid. Edit. M.A.V. n 108
El momento se nos presenta lleno de ilusin y trabajo,
Junio. Pg. 9-11.
ya que como hemos visto a lo largo de esta
comunicacin,. el desarrollo y creacin del Material Decaigny, T. (1974): "El perfeccionamiento y la
necesario para ambas propuestas llevar gran parte de actualizacin de los docentes a travs de la Radio y la
nuestra dedicacin docente en la Universidad. T.V.". Estudio realizado por CIME, bajo contrato con la
UNESCO.
Al mismo tiempo que la realizacin de los materiales ya
mencionados, la Universidad deber ir pensando en la Hoyo, A. del (1982): "Sobre la Educacin Permanente".
ampliacin de la dotacin de expertos colaboradores Rev. Escuela Espanola. ns 2607. Enero, 252.
tanto en el campo educativo, mdico,psicolgico, etc.,
Lago Castro, P. (1987): "Lo que sea sonar" (libros y
para de este modo poder responder con la mayor
casetes de Contenidos y Actividades). Cuadernos de la
seriedad cientifica.
UNED. Madrid.
A todos ellos y a ustedes por su paciencia al
Lago Castro, P. y Garcia Sipido, A. (1990): "Didctica de
acompaarnos en esta exposicin, gracias.
la Expresin Plstica y Musical". Edit. Real Musical.
Madrid.

6. Biblioqrafa Lago Castro, P. (1992): "Iniciacin a la Musicoterapia.

1086
Educacin Vocal". Cuadernos de Logopedia n 8, Edit. PR O F ESSI O N AL PR O F I L E O F T H E M U SI C
Instituto Ciencias del Hombre. Madrid. T H ER API ST I N I T AL Y: T H O U G H T S AN D
PR O PO SAL S
Labrada, F. (1981): "Panormica de la T.V. Educativa en
el Mundo". Madrid. Edit. M.A.V. n 103. Enero. pg. 17. P IER L UIGI P OSTACHINI Y M ARZIA M ANCINI
Marin Ibez, R. (1986): "El sistema Tecnolgico de la
Enseanza Superior a Distancia". Edit. Rev. Terica de
Introduction
la Educacin. n 1, Dic./Enero., pg. 45-65.
Before embarking on an argument which attempts a
O.C.D.E- (1985): "La Formacin de los Profesores en
contribution to the definition of the professional profile of
ejercicio". Edit. Narcea. Madrid.
the music therapist in Italy, it must be pointed out that
Popa Lisseanu, D. (1986): "Reto Mundial: la educacin a the term "music therapist" today in our country is
distancia". Edit. UNED. Madrid. indicative of a diversity of practices, techniques,
U.N.E.D. (1982): "PRONEP/E.G.B. - Programa de methods and theories whose common denomintor is
Formacin del Profesorado". Edit. UNED. Madrid. the intent of helping those in difficult situations either
psychological or physical For this reason, we can no
longer speak in general ter-ms of a music therapist, but
rather we should define every time the context in which
this activity takes place, otherwise it is difficult to
1087
understand people responsible for the services and structures?

Our own approach to this difficulty has been to ask a c) Which are the social spheres and the institutional
series of cuestions (the maiority still remain structures in which the professionalism of the MTA can
unanswered) which have been raised on various and must function?
occasions by those who operate in the music therapy
d) In order to practise this profession is the setting up
field:
and the registration in a "professional list" necessary
a) Does the music therapist (henceforth MTA) carry out and indispensable?
a specific autonomous profession with its own specific
It is therefore necessary to consider two kinds of
characteristics, or is this only a "specialization"
questions when describing the professional profile of
connected to and completins an existing profession (for
the MTA:
example: logopedics, rehabilitation therapist,
psychomotorist, teacher etc")? 1. the juridical aspects of the profession according to the
regulations in force;
b) Does the MTA manage the activities on his own (as
regards therapeutic, sociosanitary, educative and 2. the specific operative tasks such as can be identified

welfare responsibilities) or must his work "perforce" re according to a practice which has now become

carried out inside projects which are developed and widespread.

manased by a team and therefore controlled by those The answer to these questions will allow a more precise
1088
definition of the formative curriculum of the MTA. N.Dal Cero, G.Furlani, ed. Rirola publisher Milano 1990.
From such a text fruit of research as laborious as it is
The present article intends to offer some points in order
indispensable, there results a notable source of
to find the most effective solution to the above listed
consultation for those working with the handicapped,
questions, It comprises four parts:
since it covers all the complex legislation regarding this
I. references to the regulations in force;
matter. Naturally, since such laws are subiect to very
II. spheres of the MTA intervention; quick changes, this text would require continual and
constant revision - to be carried out at least three or four
III. Professional Profile of the MTA;
times 3 year - which is clearly impossible for such a
IV. Principles for a formative curriculum of the MTAF publication. Despite this, the "Code" represents the most
valid and complete source of consultation available
today in Italy and also the first real attempt to collect all
I References to the regulations in force
the exiting legislation.
We considered it useful, having to outline the situation
We have limited ourselves on this occasion to present a
relative to a "profession" to see what the Italian
summary of the research carried out by quoting the
legislation says regarding the matter.
laws which regulate the organization of the public
The researchs in this first Phases has been conducted administration concerning social and health services
using the "Code of civil invalidities" edited by M.Tavassi, and professional and artisan education:
1089
- D P R 24 July 1977 n 616, which defines the state and yers have operated in an autonomous way qualifying
regional responsibilities concerning social services; their work as "music therapy", we have to rely on our
partial knowledge, which we consider however
- L 21 December 1978 n 845, which regulates the
indicative enough of the general situation in Italy.
Professional Instruction Courses with regional
recognition; It is Possible to highlight three categories which indicate
moth the operative spheres and the types of structures
- D.P.R. 20 December 1979 n.761, regarding the
in which one operates, and the methods mostly used.
iuridical state of the local health authorities, a particular
important law as it define, in article 1 ("Roles of the
personnel" , regulatiQns that will have to be kept in mind
These three categories are:
if one wants to place the Profession of the MTA inside
the USSL (operative organisms within the Italian health 1. HEALTH SPHERE

service)" 2. SOCIO-WELFARE SPHERE

3. SCHOLASTIC SPHERE.

II. Spheres of intervention of the music therapist It seems important to underline also how the current
legislation relative to invalids and the handicapped
Not being able, as yet, to complete a statistical inquiry
refers to these three specific areas
into the spheres of intervention of those who in recent

1090
 regional regulations regarding the matter, Presenting it
thus a HEALTH SERVICE and therefore qualifying the
1. Health sphere
MTA as HEALTH OPERATOR. What role will the MTA
The health sphere is strictly the competence of the
have to cover: a health professionale technical or
USSL, according to what the Law 23 December 1978
administrative one (see DPR 761, article 1, paragraph
n.833 ( INSTITUTION OF THE NATIONAL HEALTH
1)?
SERVICE, article 19) has foreseen : "The local health
On the basis of practice widely used the types of
units organize prevention, treatment, rehabilitation and
interventions which have been carried out in different
legal medicine, ensuring health care to all the
setting during the last few years, it seems to us that the
population established according to article 3". It must
prevalent characteristics of a "health" type are
therefore be highlighted how every activity aimed at
emerging, with particular attention on the preventive-
treatment, rehabilitation and prevention should be
rehabilitative sector.
carried out in the sphere and under the control of the
USSL services or of the connected structures (Law 833 The music therapy practices have in fact been centred
and following). on projects orientated towards overcoming sensorial
deficiencies (in particular hearing and vision), motory
If the music therapy activities come within this operative
deficiencies (hypotones, hypertones, dystonias),
category, it is obvious that this activity, and therefore
psychic deficiencies (autism and psychoses,
also the MTA7 will have to conform to the state and
1091
psychomotory retardment and learning problems) etc.. It must be remembered however how the Italian political
and economic situation has greatly changed during this
We must not forget what the laws themselves indicate
last yearw In particular the very serious economic crisis
as necessary, the connection and co-ordination operant
which has hit the Country and which, while it reflects a
within the different spheres, with regard to the specific
more general world recession, has its own specific
areas of competence. The same article 1 of Law 883, ln
repercussions of particular gravity in Italy and is
fact, states: "The National Health Service is constructed
changing considerably the existing laws, questioning
of the totality of functions, of the structures, of the
the very survival of the National Health Service, at least
services and activities aimed at the promotion,
as it has been hitherto conceived and financed. We can
maintenance and the gaining of physical and mental
expect to see considerable reductions in the state
health of all the population without distinction of
assistance sector, and the whole of the health service
individual or social conditions and according to methods
will work much more in the private sector, thus limiting
which ensure the equality of the citizens as regards the
many of the existing services, and in particular the
Service. (...) The National Health Service ensures the
handicapped sector where the government's financial
linking and the co-ordination with the activities and with
cuts will be greatly felt
the practices of all the others organizations, centers,
institutes and services, which are active in the social
sector operatins on the state of the health of the
2. Social-welfare sphere
individuals and of the community""
1092
In this sPhere it is maintained that on the normative personality within family and social relationships, to the
level continuous reference must be made to the D.P.R. satisfaction of essential needs of life, to a promotion
616 as a reference point for regional laws. maintenance or regaining of physical and mental
wellbeing, the system of social-welfare services nas the
What are the characteristics of this sphere?
following general objectives
On this theme, article 2 of the Regional Law 7 JanuarY
a) together with the partecipating co-operation of family
1986 n1 of the Lombardy region sheds light twe must
members, the interested community and in
remember that in Italy the National Health Service looks
collaboration with other welfare, education and
to the State for defining the broad outlines of
employment services, to prevent and remove the
interventions, formulating the laws and promoting
economic, psychological, cultural, environmental and
finances, but on the operative level how to use the
social causes which can results in situations of need or
resourcess and therefore the general responsibility for
alienating conditions of life, study and work;
health and assistance, is delegated to the Regions
which are autonomous organisms on the financial level b] to ensure the availability of the structures, of the
and in some cases political, for example the Val d'Aosta, services and of the social services according to terms
Trentino Alto Adige and Sardinia): which guarantee personal freedom and dignity,
establish equality of treatment, respect specific
"In order to participate and make more effective
requirements and allow adequate rights of choice for
everyone's right to a complete development of the
1093
the users; those whom the law has assigned to this task are
unavailable or are ineffectual"
c) to promote and safeguard the health of the individual
and of the community, by developing maximum We can say that in this sphere are included all those
autonomy and self-sufficiency, also through the interventions not classifiable as "welfare" and
integration of the socio-welfare services; "rehabilitative" (strictly within the USSL competence)
and which are characterized as preventive,
d) to act in support of tne family, guaranteeing
interventions of social improvement through socio-
particularly to individuals with difficulties, where
educative structures, educative-welfare interventions
possible, to stay or rejoin their own family and social
as for example residential centres, old age homes, etc..
environment and their positive insertion into it,
As can be noted the social-welfare environment offers
e) to protect the non self-sufficient individuals without a
countless possibilities for the MTA (excluding as already
family or whose family is unable or unfit to provide for
stated the health and rehabilitative services - unless
them, by promoting the forms of juridical guardianship
they are run by the USSL). For these services the MTA
foreseen by the law and carrying out or favouring their
is required to have not a "Professionalism of a health
insertion into families, family-type units or suitable
kind but a socio-welfare type. As we have seen, this
community environments, freely chosen;
Professionalism could be achieved through special
f) to promote the protection and juridical defence of the
regional courses.
individual who is unable to provide for himself when
1094
 the professional formation courses promoted by the
same Education Board or by private institutions which
3. Scholastic sphere
have been recognized by the state.
In Italy, as opposed to all other European Countries, the
As far as the school environment is concerned, the MTA
law says that handicapped children should be
services come under two aspects:
integrated in normal schools. Thus, the special schools
have been eliminated along with the relative specialized a) as a specialistic service in relation to the interaction
courses provided by the teaching personnel with the health and/or socio-welfare services; in this
case the professional image of the MTA must be
Scholastic insertion is carried out by a specific
developed keeping in mind the previous considerations.
professional figure (called a "support teacher"),
In the primary school New Programme we read: "In the
designated to each child on the basis of a health
sphere of the activities for sound and music education
certificate and depending on the provincial Education
one must bear in mind the value that Possible specialist
Board, a local institution that governs state schools (the
musical therapy services can assume aimed at the
few existing private schools have no bearing on the
handicapped" (D.P.R. 12 February 1985 n.104, G.U.
purpose of this discourse, and do not in fact keep any
n.76 of the 29.03.1985, s.o.)
handicapped children)" The support teachers are
chosen from a list compiled by the Education Board, b) as a characterizing element in the teacher activities,
according to the qualifications acquired after following and therefore as a service managed by the teaching
1095
staff itself. The teachers, in this case, should hold a title - such duties are carried out within projects of
of specialization similar to the one obtained in the intervention and are co-ordinated by the heads of
specialization courses. It is evident that the intervention services of the respective spheres;
of music therapy run by the support teachers would
- the projects are undertaken in teams, as is foreseen
seem a specific educational intervention according to
by the regulations
the specific aims of the school institution.
2. The MTA operates in a functional area that consists
of services requiring Professional Preparation and
III. Professional profile of the music therapist ability, suited to the realization of Programmes within a
team work context;
According to the points of the regulation in force, stated
in part one, and according to observations regarding - this area also involves educational functions aimed at
the spheres of intervention of the MTA, stated in part the recovery and the insertion of individuals with
two, we can at this point outline the characteristic profile Psycho-Physical impairments.
of the MTA in Italy in the following way:
3. The MTA is required to have a knowledge of sound
1. the MTA may be considered a professional operator and musical techniques aimed at establishing a music-
who carries out both rehabilitative and social-welfare therapeutic relationship;
duties;
- these techniques require the use of a specific

1096
apparatus and of instruments while carrying out the In our opinion, the Professional profile outlined in this
activity: way may be part of the roles of health operators
(HEALTH SPHERE).
4. The functions of the MTA imply likewise deontological
responsibilities in the realization of the work The MTA will be able to carry out his own duties in the
Programmes: sphere of the regional social-welfare Projects,
according to what is foreseen by the regional
- Professional competency will have to be acquired
regulations (SOCIAL-WELFARE SPHERE).
through the actualization of a formative staff training
under supervision; Finally concerning the SCHOLASTIC SPHERE, the
Professional Profile of the MTA is to be identified with
- the training is aimed at supplying the operator with an
the figure of the support teacher, for whom a
indispensable technical competency and allowing him
specialization in the field of music therapy may be
to attain a desree of psycho-Physical equilibrium
foreseen durins the specific specialization courses.
suitable for obtaining a correct therapeutic relationship.
At the moment in Italy, the responsibility for educative
5. For such professionalism and, therefore, to accede to
interventions in state schools is the exclusive
the relative role, a post secondary diploma is needed
competence of the teaching personnel and in particular
providins access to the practice of the Profession itself.
of the support teacher.

1097
IV. Principles for a formative curriculum of the The Pin-Pointing of evaluation criteria for the
music therapist candidates for the admission to the course of music
therapy must bear the following in mind:
We Propose some general principles, inherent to the
formative curriculum of the MTA, developed having - level of musical competence
considered in depth the decade of experience of the
- Psycho-physical equilibrium of the candidate
Four-Years Music Therapy Course held at the
- an aptitude to carry out work of a therapeutic nature.
"Permanent Education Centre", music section, of the
Pro Civitate Christiana of Assisi. It is necessary to bear in mind that the evaluation of
musical competence involves a double inconvenience:
The formative curriculum makes provision for:
a) it excludes persons, who even though not adequately
1. Admissions criteriea
musically cultured, have an instinctive capability to
2. Course contents
utilize the language of sound-music;
3. Methodology aspects
b) it admits candidates who even though greatly
talented in sound-musical competence, are not suited
to communicating with said language in a therapeutic
1. Admissions criteria
relationship context.
1098
As far as the level of Psycho-Physical equilibrium is - in the HEALTH SPHERE the constitution, in psycho-
concerned, the evaluation of the same is equally pathological terms, of a therapeutic relationship based
important, as it sets the base for a correct application of on competences of nonverbal communication;
Professional operativeness
- in the SOCIAL-WELFARE SPHEREX the integration of
Lastly the capability of using the musical competence each individual within the community;
must be evaluated, in the context of an integrated
- in the SCHOLASTIC SPHERE, the overcoming of the
personal identity, in a work of therapeutic nature,
instructioneducation of important and significant
building stable and differential relationships .
learning contexts.

2. Contents of the course

3. methodology aspects

The pin-pointing of the contents of a music therapy

The methodology of a music therapy course requires, in
course, with regards to sound and musical and
our opinion, experiences of formation characterized by:
psychological knowledge and competence, will have to
allow for the anthropological context of its own - a first level, centred on experiences of personal music

operativeness, setting the following goals: therapy aimed at the acquisition of the instruments of
work through a formative training obtained with a music
1099
therapist. This work will allow the candidate to learn to From what has been stated, it should be clear how we
differentiate his personal conflicts from the ones of the think a course for the formation of music therapists
patients to know his own sound-musical identity, should be set out But we know an ideal can not always
distinguishing it from that of the patient, to know how to be reached in a short time, and there may be
approach the sphere of regression and be able to exit intermediate stages that help to better outline the
from it, to learn from experience the non-verbal and objectives and content
musical bases of the therapeutic relationship;
We maintain that the four-year Music Therapy Course
- a second level, characterized by work of supervision in Assisi is contributing greatly in clarifying and attaining
on specific cases undertaken by the candidate himself an ideal formative structure. At the moment the Course
once he has completed his personal formative training. is Presented more perhaps as a course of studies in
music therapy (which in fact was the intention when it
Within these two levels, it is necessary to make
regan in 1981) than as a formative training course for a
provision for placements to be carried out, the duration
"new" profession.
of which, the method and location will have to be
outlined. Following on from this last consideration, a new
organization has recently been proposed for the four-
years course (Piatti, Postacchini, 1993) which redefines
Conclusion
aims, contents and guide lines for the actual Course,

1100
and contains revised regulations with new criteria for
admission, giving more importance to the music
formation. L A EXPR ESI O N C O R PO R AL EN I A F O R M AC I O N
D EL M U SI C O T ER APEU T A
Such a new organization has been formulated on the
basis of the present laws, the present working Italian G REGORIO T ISERA
reality, and in accordance with the formative and
deontological principles as interpreted by the
1. INTRODUCCION
Association of Professional Italian Music TheraPists
(A.P.I.M.), an association which includes those with a
professional diploma from Assisi and other similar Ante todo debemos tener perfectamente claro de qu
institutes. manera funciona y reacciona nuestro cuerpo desde el
In conclusion, while awaiting directives from the public punto de vista psico-biolgico (psiquico, fisiolgico,
Institutions, the Assisi initiative along with its new neurolgico). Slo comprendiendo la biologia (fisiologia
dispositions, is to be seen as a private formation course y psicofisiologia) del cuerpo tendremos la posibilidad de
of an experimental nature, at the end of which a lograr una visin profunda y global de la multiplicidad de
"Diploma in Music Therapy" is granted only valid for the la expresin corporal.
uses consented by the law.

1101
2. PERCEPCION prioridades, cuyo orden est determinado en cada
situacin por las necesidades biolgicas primarias. Slo
Nosotros percibimos nuestro medio ambiente y a
a travs de tcnicas como las descriptas bajo el rubro
nosotros mismos slo a travs de nuestro cuerpo.
Ejercicios (5.1.) es posible ejercer una cierta influencia
Las sensaciones son el resultado de estimulos, tanto
conciente sobre los procesos vegetativos.
provenientes del propio cuerpo como del medio
ambiente, que llegan a los rganos sensoriales
(viscero, propio o exteroceptores), los cuales 2.1. FORMAS DE LA PERCEPCION
transforman a los estimulos en impulsos que son
Algunos de estos impulsos son llevados hasta centros
trasmitidos por el sistema nervioso hasta distintos
nerviosos superiores o hasta la corteza cerebral, donde
niveles del mismo. No todos estos impulsos llegan a
son registrados de dos formas:
nivel conciente, sino que forman parte de diversos
mecanismos de funciones vegetativas (las que
mantienen al cuerpo vivo y funcionando). El sistema 2.1.1. Registro neuro-fisiolgico, es decir como
vegetativo de regulacin no es dirigido ni influido percepcin conciente de un acontecimiento.
concientemente. Pareciera como si la "naturaleza" no
confiara en el raciocinio del hombre. El sistema
nervioso vegetativo funciona segn el principio de 2.1.2. Registro psico-f isiolgicos como vivencia
agradable o desagradable.
1102
 nosotros la nica relacin posible con el mundo exterior
y con nuestro propio cuerpo.
2.2 EL ROL DEL SISTEMA NERVIOSO
3. INTERACCION ENTRE EMOCIONES Y CUERPO
Nosotros no disponemos de otra forma de percepcin
que sta. El sistema nervioso desempea aqu el rol A principios de siglo Wilhelm Reich comenz a observar
ms importante, pues es el que recibe las que todos sus pacientes con trastornos emocionales
informaciones, tanto del mundo interior como del presentaban tambin graves estados de tension
exterior,las transmite a centros nerviosos (por las vias muscular. Sus observaciones pusieron de manifiesto
sensoriales o aferentes) para su evaluacin, an otras relaciones entre el cuerpo y la psiquis y sobre
elaboracin y coordinacin y finalmente envia las esta base desarroll su concepto de la "coraza
rdenes a los rganos efectores correspondientes (por muscular".
las vias motoras o eferentes). Cuando todo esto sucede
Otro pionero en este campo fue Moshe Feldenkrais
sin haber llegado a la conciencia hablamos del sistema
quin se bas en la suposicin que el organismo
nervioso vegetativo, es decir de la parte regulativa,
humano nace con el "miedo a caerse" y asi inicia el
automtica, inconciente. Si la informacin sensorial se
proceso de crecimiento y de aprendizaje. El nio
registra concientemente y se envian voluntariamente
aprende a funcionar corporalmente y aprende al mismo
las ordenes motoras, nos referimos al sistema nervioso
tiempo a conocer todos los efectos emotivos que
de la vida de relacin, pues este representa para
acompaan al aprendizaje corporal. Para desarrollar la
1103
totalidad del potencial somato-psiquico es necesaria, 4. NIVELES DE COMUNICACIN
segn Feldenkrais, una reeducacin del sentido
En los seres humanos existen siempre dos niveles de
cinestsico y de la regulacin muscular.
comunicacin. Uno es el verbal; el otro es el no-verbal,
Los afectos son estados reactivos intensos y de corta la expresin corporo-sonoromusical.
duracin (por ejemplo: alegra, ira, odio, miedo).
Esto lo podemos constatar en casos de graves
Generalmente van acompaados de reacciones
discapacidades, en las que frecuentemente el lenguaje
psicomotoras y vegetativas.
crporo-sonoro-musical representa la nica posibilidad
Los estados emocionales producen efectos en el de comunicacin con el medio.
cuerpo. Las emociones slo pueden reprimirse durante
Lo primario es el cuerpo, no la palabra.
un cierto tiempo sin que se manifiesten de alguna
manera, pues esta represin engendra una tensin que Nuestro cuerpo reacciona siempre de manera

trata de descargarse hacia afuera. Si intentamos espontnea, no puede engaarse no puede mentir

bloquear esta tensin, se produce una sobrecarga de como lo hacen nuestras palabras.

los distintos rganos del cuerpo que se expresa a Los sentimientos, emociones, deseos, se expresan as
travs de trastornos psquicos y psicosomticos a travs de nuestro cuerpo. Lo que nosotros llamamos
lenguaje crporo-sonoromusical es la expresin visible
y audible de nuestra vida o mundo interior.

1104
 fundamentacin de la expresin corporal en esta
carrera se basa en la premisa que la msicoterapia se
5. FORMACION DEL MUSICOTERAPEUTA EN
mueve en un contexto predominantemente no-verbal.
EXPRESION CORPORAL
La interaccin entre pacientes y msicoterapeutas se
Dentro de la formacin de msicoterapeutas, la
realiza sobre todo a travs del lenguaie crporosonoro-
capacitacin a travs de la asignatura "Expresin
musical.
Corporal" tiene como objetivo, intensificar y entrenar la
capacidad perceptiva y expresiva, a fin de poder recibir,
interpretar y utilizar dentro del contexto de la 5.1. EJERCICI0S
msicoterapia, las seales crporo-sonoro-musicales
Los ejercicios prcticos tiene la finalidad de desarrollar
de los pacientes tanto como las suyas propias.
la conciencia y percepcin del propio cuerpo, la
La expresin corporal en la formacin del capacidad de observacion critica y autocritica, la
msicoterapeuta utiliza el recurso de iniciar a los capacidad creadora y expresiva:
estudiantes en determinados ejercicios que tienden a
transformar al propio cuerpo en un instrumento de
expresin y percepcin. No se trata aqu de trabajar 5.1.1. Ejercicios de concentracin mental en los que la

solamente con estructuras ritmicas y espaciales, sino vivencia concentrativa del propio cuerpo conduce a una

con estados de nimo y estados afectivos. La experiencia global del esquema y la dinmica

1105
corporales. El provocar voluntariamente cuadros en la 5.1.3. Ejercicios de relajacion por medio de tcnicas
imaginacin implica una gran cantidad de contenidos concentrativas para lograr una intensificacin de las
que no son directamente voluntarios. vivencias sensoriales de la funcin muscular;

5.1.2. Eiercicios respiratorios en los que se pueden 5.1.4. Eiercicios sensoperceptivos, que consisten,
utilizar trminos sugestivos como por ejemplo: la desde el punto de vista psico-fisiolgico, en un
inspiracin nos da energia, vitalidad, alegria a travs de entrenamiento prctico que permite introducirse
la absorcin de oxigeno; la espiracin representa una sugestivamente en un estado mental y concentrarse
reduccin de la energia, pasividad, prdida de vitalidad, concientemente en las percepciones endosensoriales
pero tambin liberacion del aire acumulado, de en estado de inmovilidad, de relajacin y de inhibicin
contenidos estancados; contener la respiracin de estimulos externos;
coadyuva a la concentracin; a travs de esta
detencin el cuerpo trata de bloquear todo tipo de
estimulo y flujo de informacin para tomar una 5.1.5. Ejercicios expresivos para desarrollar la

determinacin en un estado de calma total; capacidad creativa y expresiva del cuerpo humano a
travs de la improvisacin de juegos individuales y/o de
relacin con los dems.El cuerpo humano se desarrolla
asi en todas sus capacidades como instrumento
1106
comunicativo basndose en la sensibilidad, en el y enfoques, tanto propios como de nuestros pacientes.
pensamiento y en la reflexion.
E1 conocimiento de la expresin corporal, de ese
lenguaje mudo de sensaciones, sentimientos y
emociones expresado a travs del comportamiento de
6. LENGUAJE Y LENGUAJE CORPORAL
nuestro cuerpo, abre vias ms directas para la
Nosotros dedicamos tiempo y energa para aprender
comunicacin y en la relacin mutua entre las
muchas cosas que consideramos tiles. Adems de
personas. Asi, una mirada, un giro de la cabeza, un
nuestra lengua materna queremos aprender otros
gesto de acercamiento, un ademn de rechazo, dicen
idiomas. Asi el lenguaje corporal se va convirtiendo
mucho ms que mil palabras. Tambin podemos decir
poco a poco en un idioma extranjero. Dado que no
que a travs de las experiencias y reacciones del propio
podemos prescindir de, ni reprimir este medio de
cuerpo las informaciones sobre los matices del
comunicacin crporo-sonoro-musical (y mucho
comportamiento humano nos llegan con ms nfasis y
menos an el msicoterapeuta),es de fundamental
ms exactitud que a travs de las observaciones del
importancia aprender a utilizarlo.
mundo exterior. No existe prcticamente un ser
humano que pueda sustraerse a las posibilidades
expresivas de su propio cuerpo o a la percepcin de los
E1 dominio de este lenguaje nos da informaciones
mensajes que envan en gran escala otros cuerpos.
importantes sobre los estados interiores, orientaciones

1107
 fueran los propios.

7. EXPRESION CORPORAL EN LA CLINICA

Nosotros observamos un paciente, sus reacciones y la 8. ORIGENES DE LA EXPRESION CORPORAL

situacin (el "aqui y ahora"), lo cotejamos con nuestros
Nuestra expresin corporal representa el origen
conocimientos adquiridos y con las observaciones que
biolgico y cultural de la comunicacin no verbal. Se
hemos realizado, es decir, con toda nuestra
manifiesta a travs de dos tipos de reacciones:
experiencia previa. Verificamos de qu manera
corresponden a este paciente y a esta situacin.
Intentamos interpretar estas sensaciones y, en ciertos 8.1. Reacciones primarias o congnitas (tambin
casos, traducirlas en una expresin corporal. En esto llamadas instintivas).
nos ayuda nuestra formacin, pues a diferencia del
Algunas de las seales que emite el cuerpo son
paciente, ella nos permite conocer el flujo incesante de
congnitas, como ciertas expresiones faciales de los
contraccin y relajacin de nuestros msculos y su
sentimientos. Se ha observado:
accin coordinada, y poder dirigirla concientemente. Asi
no slo surgen gestos y ademanes, sino que podemos
reproducir en nosotros mismos los pensamientos, 8.1.1. que estas expresiones son muy similares en
sentimientos y emociones del paciente, casi como si todos los pueblos y culturas,

1108
 primariamente resultado de la evolucin

8.1.2. que se manifiestan ya en nios de corta edad (se

encuentran presentes incluso en bebs ciegos y sordos
8.2. Reacciones adquiridas o reflejos condicionados,
de nacimiento que no podrian haberlas aprendido por
que forman la mayor parte de la mimica, gestos y
imitacin) y,
ademanes que hemos incorporado a travs de la
8.1.3. que ciertas expresiones faciales humanas son imitacin y la educacin.
muy similares a las de los primates. Se ha podido seguir
la pista de algunas de ellas a lo largo de la escala
evolutiva. Estas caracteristicas son vlidas para las En las seales correspondientes a ciertos gestos

expresiones faciales ms importantes y para la risa y el existen diferencias marcadas entre los distintos

llanto. pueblos. Aqui se trata de componentes de la

comunicacin adquiridos culturalmente, es decir que
Irenus Eibl-Eibesfeldt (1972) ha encontrado una
son el resultado del desarrollo historico del individuo
difusin universal de la llamada "elevacin de cejas". En
dentro del medio que lo rodea.
este gesto, comn a la especie humana y a los monos,
la cejas suben bruscamente durante una fraccion de
segundo (aproximadamente 1/6 seg) al saludar o 8.3. En otros casos, como por ejemplo en las
flirtear. Este tipo de expresiones corporales son formalidades de saludo entre los humanos, ambos
1109
factores el biologico y el cultural, o sea el congnito y el proceso se produce siempre una real imentacin (
adquirido, desempean una funcin importante. feedback) . Por esta razn debemos prestar atencin a
las seales que nosotros emitimos corporalmente.

9. EL CODIGO DE LA EXPRESION CORPORAL

10. EL ESQUEMA CORPORAL
Estas reacciones muestran nuestras sensaciones,
sentimientos, emociones y, a pesar de toda la El esquema corporal es la imagen subjetiva externa
subjetividad e individualidad que involucran, conocimiento y la vivencia del propio cuerpo. Schilder
representan un cdigo generalmente aceptado. Pero fu uno de los precursores en el estudio del esquema
esto significa tambin, que inversamente, los patrones corporal . En su trabajo " Ilusin y Conocimiento" (1918)
de movimientos que hemos incorporado condicionan a public los resultados de sus estudios sobre la
su vez los sentimientos, sensaciones y emociones, fenomenologa de la conciencia del yo corporal,
tanto nuestros como de las personas con quienes nos llegando a la conclusin que en su constitucion, la
relacionamos. imagen del propio cuerpo es un fenmeno psicolgico.
Es una diferenciacin gradual de una impresin
En el lenguaje corporal, percibir significa reconocer las
primero vaga e indefinida, a la que se agrega material
seales del cuerpo y del comportamiento. Comunicarse
de experiencias visuales y cinestsicas. Cada
quiere decir interpretarlas correctamente y responder
impresin recibida implica una respuesta motora, pero
en forma inteligible (verbal o no-verbal). En este
1110
cuenta ms la impresin que la respuesta motora. En percepcin y conciencia del cuerpo. Herta Lange-
un extenso estudio realizado en colaboracin con Hoff, Cosack (1952) public un trabajo sobre sus
Schilder (1927) demuestra el rol preponderante del investigaciones en nios discapacitados fIsicamente.
tono muscular en la representacin del esquema Mientras estos nios modelaban plastilina, observo que
corporal. En otro trabajo se estudian las percepciones a menudo reproducian inconcientemente la forma de
del interior del cuerpo, que se vivencia como una masa su propio esquema corporal. Los investigadores K.
pesada, entremezclada con imgenes visuales y Poeck y B. Orgass (1964), a travs de sus
acompaada de una sensacin global de vitalidad. La observaciones de nios normales y ciegos, llegaron a la
percepcin de los rganos se localiz conclusin que el esquema corporal debe madurar de
aproximadamente a 2 cm de la superficie externa del forma autnoma como funcin cerrada. Recordemos el
cuerpo; la vivencia de la piel era difusa, sin limites informe personal de la MT 0felia Herrendorf (1991)
precisos y estaba debajo de la superficie conciente o sobre su trabajo con jovenes drogadictos en el
imaginaria del cuerpo. Es de hacer notar que ciertas CENARES0, Buenos Aires. Al pedir a los pacientes que
enfermedades orgnicas del encfalo y tambin ciertas modelaran en plastilina su propio cuerpo con ojos
lesiones medulares, perturban o destruyen el esquema cerrados, observ que habia una correlacin muy
corporal. Las investigaciones de Schilder y estrecha entre las formas realizadas y la vivencia
colaboradores representan el primer intento interior de cada uno sobre su cuerpo.
sistemtico de describir los complejos fenmenos de la

1111
10.1. REPRESENTACION GRAFICA DEL ESQUEMA voluntario. Un poco ms alejado del punto terico del
CORPORAL Yo, vemos al sistema cardio-circulatorio que an est
en relacin permanente y directa con la vivencia del yo.
De acuerdo a las observaciones cotidianas, clinicas y
Dib. pg 7
experimentales, la relacin del Yo con los procesos
vegetativos generales es menos directa.
Comparativamente el esqueleto de sostn se
Visualizamos mejor este escalonamiento ordenando al
encontraria en la zona ms alejada.
Yo ficticio y los diversos sistemas orgnicos en una
serie de circulos concntricos. Podemos intentar,
siguiendo a J.H.Schultz (1931) representar
11. ESPACIO Y EXPRESION CORPORAL
grficamente el esquema corporal desde un punto de
Los limites entre expresin corporal y comunicacin
vista psicofisiolgico. Imaginemos un esquema grosero
tactil no estn claramente definidos. a primera vista
del cuerpo con la conciencia del Yo y sus sistemas
puede parecer dificil establecer la relacin exacta entre
funcionales, y cuales de estos sistemas se encuentran
el espacio personal o individual, las zonas individuales
ms prximos a este Yo esquemtico. Esto nos da un
o territorio por una parte y la expresin corporal por
agrupamiento bien definido. Lo ms prximo a este Yo
otra. Sin comprender los principios bsicos
ficticio es la musculatura esqueltica, pues su funcin
involucrados en estos conceptos no es posible prever
habitual nos da la falsa impresin de movimiento
1112
qu sucederia cuando estos espacios son usurpados. estn incorporados a su herencia biolgica."
Nuestras reacciones ante una intromisin en nuestro
territorio estn en relacin directa con la expresin
corporal. 11.2 PROXEMIA

11.1. TERRITORIALIDAD El etlogo austriaco Konrad Lorenz dice en "Das

sogenannte Bose" (1963), su libro ms difundido,
(traducido al castellano baio el titulo "Sobre la agresin:
El ornitlogo ingles Eliot Howard (1920) fu un el pretendido mal") que "el comportamiento del ser
precursor en este campo y sento las bases tericas del humano, sobre todo su comportamiento social, est
concepto de territorialidad. Poco tiempo despus el suieto an a leyes dominantes del instinto que se han
noruego Schielderup-Ebbe (1922) public "La desarrollado en el largo proceso de la historia de las
psicologia social del gallinero", seguido por Desmond especies de los seres vivos".
Morris con "El mono desnudo" y "El zoolgico humano",
Otro investigador en este campo fu Edward Hall, que
obras que fundamentan detalladamente el
public "El lenguaje del espacio" (1963) y acun el
comportamiento animal y humano referido al concepto
termino "proxemia" (el estudio del comportamiento
de espacio. " El Homo sapiens obedece siempre
humano en determinadas zonas espaciales). El autor
(frecuentemente sin saberlo) instintos milenarios que
1113
sostiene que " todo lo viviente tiene un limite fisico que hace evidente en el caso de los radios de distancia del
lo separa de su medio exterior. Cada organismo tiene espacio corporal. Las categorias de distancia
una delimitacin perceptible que marca su comienzo y representan la forma de codificar la magnitud de la
su fin. Sin embargo existe en cada punto de la escala distancia que separa un objeto o un acontecimiento del
evolutiva una especie de limite no fisico que es ncleo central del cuerpo. Magnitud en este contexto
independiente del limite fisico. A pesar que este lmite denota una definicin de distancia vivenciada o
es ms dificil de definir, no por eso es menos real. Lo concebida comportamentalmente ms que
que encierra este limite es llamado el territorio de un cuantitativamente.
organismo. E1 hecho de reclamar y defender un
espacio determinado es lo que se conoce como
territoriali dad" . 11.4. DELIMITACION DE LOS ESPACIOS

11.3 LIMITES Y ESPACIOS El espacio interno o personal (del propio cuerpo)

denota el espacio entre el ncleo interior del cuerpo y la
piel (ver esquema corporal). Las caracteristicas
En un estudio publicado en Estados Unidos sobre cuantitativas del espacio interno tienen alguna
lmites y espacios que stos definen, Spiegel y importancia sobre todo para los muy gordos o muy
Machotka (1974) encuentran que su significado se flacos; pero la existencia de cualquier obieto o
1114
movimiento dentro de este espacio es de importancia E1 espacio distal abarca el mundo que se puede
primordial para el individuo en cuestin, conocer y percibir. Es posible ampliar su radio de accin
independientemente de sus dimensiones corporales. El por medio de dispositivos o instrumentos (prismticos,
espacio interno es la ms ntima y personal de todas las radio, televisin).
zonas distribuidas concntricamente alrededor del
El espacio perimetral o limbico no es accesible a la
ncleo interior.
percepcin o a los procesos sensoriales y debe ser
E1 espacio proximal o parcial se define como el que completado por medio de fantasias.
existe entre el cuerpo y sus coberturas de ropa, pelo,
vello u ornamentos, o como el brea fisicamente
indeterminada pero psicolgicamente muy restringida 11.5. REPRESENTACION GRAFICA DE LOS

adyacente en forma directa a la piel. A este espacio ESPACIOS

pueden ingresar las secreciones del espacio interior o

puede ser invadido desde el espacio axial o total.
Dib. Pg 10
El espacio axial o total es el rea controlada por brazos
y piernas extendidos, es decir el espacio abarcado por
el desplazamiento corporal. Por esta razn es un 12. CONSIDERACION FINAL

espacio mvil y de forma irregular. La expresin corporal en la msicoterapia es un

1115
proceso psicobiolgico con tecnicas propias aplicadas FELDENKRAIS, Moshe - Body and mature behaviour,
al cuerpo o que deben ser aprendidas por el cuerpo. Intl.Universities Press, New York, 1949

IBID - Awareness through movement, Harper & Row,

New York, 1972
BIBLIOGRAFIA
IBID - The case of Nora, Harper & Row, New York, 1977
ALEXANDER, Gerda - Eutonie, Copenhagen, 1945
GUIRAUD, Pierre - Le langage du corps, Presses Univ.
ARGYLE, Michael - Bodily communication, Methuen &
de France, Paris, 1980
Co., London, 1975
HALL, Edward - Proxemics: A study of man s spatial
BIRDWHISTLE, Ray - Kinesics and context, essays on
relationship, Intl.Univ.Press, 1963
body motion communication, Univ. Pennsylvania Press,
Philadelphia, 1970 HERRENDORF, Ofelia - Trabajo con jovenes
drogadictos en el CENARESO, Buenos Aires,
BONNAFONT, Claude - Les silencieux messages du
comunicacin personal, Rosario, 1991
corps, Editions Buchet/Chastel, Paris, 1977
HOWARD, Eliot - (citado por Bonnafont, C.),1920
EIBL-EIBESFELDT, Irenaus - Hombre preprogramado:
lo hereditario como factor determinante en el LABAN, Rudolf von - Kunst der Bewequna, Florian
comportamiento humano, Alianza, Madrid, 1972 Noetzel Verlag, Wilhelmshafen, 1988

1116
LANGE-COSACK, Herta - Untersuchunqen an POECK, K., ORGASS, B. - (citado por Schultz,
krperbehinderten Kindern, Dtsch. Ver. J.H.),1964
Jugendpsychiatrie, Marburg, 1952
REICH, Wilhelm - Character analysis, Orgone Institute
LEONHARD, K. - Ausdruckssprache der Seele, Karl F. Press, New York, 1949
Haug Verlag, Berlin, 1949
SCHILDER - Wahn und Erkenntnis, Springer, Berlin,
LORENZ, Konrad - Das soaenannte Bose, Deutscher 1918
Taschenbuchverlag, 1963
SCHJELDERUP-EBBE - Sozialpsychologie des
LOWEN, Alexander - The language of the body, Collier, Huhnerstalls, Hans Huber Verlag, Bern, 1922
New York, 1958
SCHULTZ, J.H. - Das autogene Training: Konzentrative
IBID - The betrayal of the body, Collier, New York, 1969 Selbstspannuna, Thieme Verlag, Stuttgart, 1931

MOLCHO, SAMY - Krpersprache, Mosaik Verlag, SPIEGEL, J., MICHOTKA, P. - Body language, The Free
Munchen, 1983 Press, New York, 1974

MORRIS, Desmond - Der nackte Affe, Droemersche

Verlagsanstalt Th. Knaur, Munchen, (sin fecha)

IBID - Der Menschenzoo, Ebenda, (sin fecha)

1117
L A AC T I VI D AD D E M U SI C O T ER API A EN C R EI - durante este perodo. Todo ello nos llev a plantearnos
SAN T S: U N M O D EL O D E F O R M AC I O N E la necesidad de crear un nuevo modelo educativo que
I N T ER VEN C I O N contemplara, al mismo tiempo, las necesidades del
mundo de la infancia, de los futuros maestros y de los
F ELICIANO C ASTILLO A NDRS Y M. DOLORES T ORRES
formadores de maestros.
J ORDI

Este planteamiento slo poda llevarse a cabo, a

Presentacin del Modelo
nuestro entender, dentro de un modelo contextual-
En el ao 1978, la Escuela Universitaria del
ecolgico que coordinara la teora y la prctica, por un
Profesorado de la Universidad de Barcelona inici el
lado, y los intereses de los distintos componentes del
primer curso de la especialidad de Educacin Especial.
hecho educativo -el nio, el maestro (y, por lo tanto,
El grupo de profesores que, junto con los alumnos
tambin el futuro maestro), el formador de maestros-
interesados en el tema, impuls aquella experiencia ha
as como de sus respectivas famlias y grupos sociales.
ido reflexionando a lo largo de estos aos, sobre los
Fruto de estas reflexiones, naci la idea del
problemas que conlleva un trabajo de tal envergadura.
modelo CREI-Sants. Para poder realizarlo con
Ilusiones, frustraciones, incomprensin, necesidad de
posibilidades de xito, valoramos la necesidad de
dar respuesta a los problemas reales del entorno
actuar en un marco muy concreto que permitiera
educativo... son algunos de los elementos recurrentes
1118
contextualizar nuestro trabajo para limitar el riesgo de conjuntamente con otras universidades y centros
caer en teoricismos estriles. Dentro de nuestras europeos.
posibilidades, elegimos el barrio barcelons de Sants -
El rasgo fundamental del modelo CREI-Sants, el
donde est ubicada la Escuela Universitaria-para
que le confiere una mayor originalidad, es el hecho de
desarrollar nuestra experiencia.
combinar la teora y la prctica, la docencia y la
investigacin, la formacin inicial y la formacin
permanente.
Se crea pues, CREI-Sants, en 1985. Su emblema,
un caballo azul inspirado en la historia de Marco
Cavallo (vid. Scabia, G. 1976 Marco Cavallo. Torino,
Para hacer posible este planteamiento,
Enaudi), puede dar una idea de la filosofa que inspira
trabajamos, no solo con el nio, sino tambin con su
el Centro.
famlia -a travs de los grupos de padres-, con la
CREI-Sants se plantea, desde sus inicios, la escuela -a travs del trabajo directo con los maestros-,
necesidad de la investigacin como uno de sus con los estudiantes en prcticas y, finalmente en el
objetivos bsicos. La investigacin que se lleva a cabo barrio, gracias a la integracin del centro en la dinmica
es dinmica, ya que enriquece directamente el trabajo de las entidades cvicas y culturales de Sants.
educativo y teraputico con los nios implicados.
Algunas de estas investigaciones se realizan
1119
 Los nios que acuden a CREI-SANTS presentan, mediante una metodologa cientfica es el reto de CREI-
en su mayora necesidades educativas especiales. Se Sants.
les somete, entonces a un proceso de diagnstico para
conocer sus posibilidades de aprendizaje y desarrollo.
El proceso no se limita al contacto y a las sesiones INSERTAR Figura n1

teraputicas, individuales o en grupo, sino que conlleva

la intervencin activa del maestro tutor de la clase
CREI-Sants parte de la aceptacin de todas las
donde est integrado, a fin de ayudarle a potenciar una
formas creativas que signifiquen la relacin del
interaccin positiva con sus compaeros y una
individuo con su entorno, con otros individuos y consigo
adaptacin de los programas de trabajo a sus
mismo a la vez que lucha tambin por intentar refundir
necesidades reales. Para ello, la intervencin directa
las facetas artsticas que caracterizan a todo individuo,
del estudiante en prcticas es fundamental, ya que
errneamente separadas por un concepto
trabaja con el nio tanto en el aula como en el Centro.
excesivamente simple, y tal vez maniqueo, de la
persona humana.

Activar estas diferentes intervenciones en un solo La educacin del individuo precisa de todos los
modelo que contemple a la vez todos estos mbitos recursos que la sociedad puede ofrecerle, inclusive
comentados y constatar las posibilidades y limitaciones aquellos que son inherentes al propio individuo y que

1120
forman parte de su realidad ms biolgica. Este
abanico de recursos constituye el marco en el cual la
Entender el ser humano como una entidad
educacin y la formacin del nio se producen de forma
psicosomtica, valorando las interacciones entre las
natural.
funciones psquicas y motoras
Durante las ltimas dcadas hemos asistido a una
Concebir el proceso de percepcin como plurisensorial
gran proliferacin de formas de trabajo teraputico y
ello nos ha llevado a llegar al acuerdo de que la La plasticidad del SNC y las modificaciones funcionales

educacin es la mejor terapia y que sta no puede que se pueden producir a travs del diferente

entenderse fuera del objetivo de ensear-aprender, tratamiento en edades precoces

siempre buscando mejorar la vida del individuo en su La valoracin del contexto social y ambiental como
grupo social. Nos referimos a la educacin globalizada, parte intrnseca e implicada en la educacin de la
atendiendo tanto a los aprendizajes instrumentales persona, con mltiples interacciones
como al desarrollo de la personalidad, y entendiendo al
Evaluacin del modelo
sujeto como un todo.
CREI-Sants, como modelo terico-prctico de
formacin de profesores caracterizado cada vez ms
Entre otros factores, la globalidad de la que hablamos como diseo, parti de un conjunto de hiptesis y de
se fundamentara en los siguientes puntos: criterios que exigan, desde una dinmica temporal, el
1121
establecimiento de una etapa pre-experimental de dos especfico (42 nios) y la accin interventora en cada
aos como mnimo (1986-1988). Ello se justificaba por uno de los espacios -famlia, escuela, CREI-Sants...-por
la necesidad que nos habamos planteado de organizar medio de diferentes tcnicas.
los diferentes equipos de trabajo, de crear un lenguaje
La horizontal evala los grupos en los diferentes
cientfico comn, de advertir las caractersticas que la
contextos -todos los nios, todos, los padres, todos los
adaptacin del modelo podra tener en la prctica y en
maestros,...-. La confluencia evaluativa llevar a un
el contexto.
replanteamiento del perfil que habra de tener un buen
Si nuestro modelo resulta complejo, ms maestro. Hay pues una evaluacin individual, a travs
compleja y difcil result la evaluacin de la etapa pre- de tcnicas cualitativas y observacionales, y una grupal
experimental. (realizada a travs de una entrevista-cuestionario), que
posibilita un tratamiento cuantitativo de las muestras.
La evaluacin se realiz en dos direcciones: una
Esta ltima ha permitido, por un lado, la realizacin de
vertical y otra horizontal
contrastes de correlaciones entre los grupos de
maestros titulados que haban pasado por CREI-Sants
INSERTAR Figura n2 y los que no lo haban hecho, as como entre los grupos
de los alumnos que practicaban en CREI-Sants (40
alumnos) y los que realizaban otras modalidades de
La vertical representa la evaluacin de cada caso prcticas.
1122
El anlisis de los datos obtenidos por la entrevista- mejor conocimiento tcnico en la elaboracin de
cuestionario fueron estadsticamente muy significativos programas individuales y colectivos
y esperanzadores, destacndose una serie de
mejor actitud ante los equipos de zona y otros
aspectos positivos en los alumnos de prcticas:
profesionales

mejor actitud ante la problemtica del nio

Actividades que ofrece CREI-Sants
mejor capacidad de utilizacin de los recursos
didcticos
Actividades en las escuelas del barrio
mejor capacidad crtica

mejor aceptacin y superacin de la frustracin

Asesoramiento y orientacin a los maestros
mayor creatividad
Seguimiento directo de casos a travs de los alumnos
mejores relaciones con los profesores
de prcticas y de las visitas que hacen los profesores
mejor conocimiento tcnico y sistematizacin de los miembros de CREISANTS encargados de cada caso
procesos de observacin, evaluacin y diagnstico
escolar

1123
Actividades en CREISANTS danza y movimiento

diseo, volmen y construccin

Diagnstico y tratamientos especficos,individuales o dramatizacin

en grupo: estimulacin del lenguaje

logopedia
Durante los ltimos cursos CREISANTS ha
soporte psicoteraputico incrementado las actividades teraputicas a travs del
arte y la creatividad, llevndonos a poner en prctica
psicomotricidad
alternativas teraputicas basadas en las ltimas
terapia de juego tendencias del arte. Fruto de este aspecto es el trabajo
lgica y abstraccin realizado en el rea de la dramatizacin y la creacin
de una compaa de teatro que nos ayuda a difundir
expresin sonora: msica y musicoterapia
nuestra metodologa y los resultados obtenidos a
travs de ella.
Talleres globalizadores de integracin a travs de Trabajo concreto con los padres de los nios que son
diferentes tcnicas: atendidos en el Centro. Este trabajo se realiza
partiendo de dos pretensiones bsicas: una cultural y la

1124
otra , teraputica. entorno natural organizando exposiciones,
conferencias, representaciones y otras actividades en
las que participamos activamente en la dinmica
Actividades de reciclaje y formacin en diversas
cultural de Sants.
tcnicas de Educacin Especial

A continuacin pasamos a explicar ms detalladamente

Investigacin en el campo de la Educacin Especial
nuestro modelo de formacin e intervencin en
Musicoterapia en CREISANTS.

Reciclaje y formacin contnua de los miembros del

Centro ACTIVIDAD DE MUSICOTERAPIA EN
CREISANTS: UN MODELO DE FORMACION E
INTERVENCION
CREISANTS participa tambin en varios programas de
investigacin de universidades estatales y estranjeras La actividad de MUSICOTERAPIA es uno de los
servicios que ofrece CREISANTS que pretende dar
respuesta a tres de las expectativas principales que
Actividades didcticosociales abiertas al barrio y a la dieron orgen al modelo del centro:
ciudad. Pretendemos abrir la Universidad hacia su
1125
 hecho de que el fenmeno sonoro ofrece al
individuo una serie de elementos referenciales
Ofrecer otras alternativas teraputicas y pedaggicas
que le ayudan a estructurarse y resituarse e n
en la formacin de los futuros profesionales y en la
un espacio y un tiempo. Asimismo consideramos
formacin permanente
necesario valorar la expresin sonora como uno
Responder, a travs de una actividad sonora, a la falta
de los medios de que dispone el ser humano
de atencin educativa y teraputica de nios con
para expresarse, relacionarse y comunicarse
necesidades educativas especiales de un barrio de
con los dems . Reconocemos esta modalidad
Barcelona (Sants)
de expresin como una forma de produccin
Investigar y reflexionar sobre las implicaciones del humana que se elabora gracias a la identidad
fenmeno sonoro en las diferentes tcnicas de sonora que construye el nio a partir de sus
expresin humana para proponer nuevas expectativas relaciones con el espacio sonoro, sus figuras
de trabajo en este mbito parentales, la cultura y la educacin.

De las diferentes posibilidades que nos puede ofrecer Fundamentamos nuestro trabajo en tres principios que
el trabajo con el material sonoro, en CREISANTS justifican por qu es posible realizar una intervencin
hemos basado el tratamiento de Musicoterapia en el teraputica a partir de la utilizacin del material sonoro:

1126
A. Principio de identidad sonora 2. el sonido como objeto de identificacin ya que
el receptor puede sentirse interpelado por el mensaje
Todo individuo configura a partir de su
sonoro
experiencia sonora y sus vivencias personales una
particular identidad sonora

C. Principio de la capacidad intermediaria d e

los objetos

Los objetos sonoros pueden ser instrumentos de

B. Principio de la d oble dimensin del fenmeno
comunicacin capaces de actuar teraputicamente
sonoro
sobre el sujeto mediante la relacin. Siguiendo a
El fenmeno sonoro se presenta en una doble
Benenzon, la capacidad intermediaria de los objetos
dimensin:
(sonoros) permite al sujeto pasar de un estado
indiferenciado, donde el mundo exterior y el yo se
confunden, a un estado de ser diferenciado.
1. el sonido como objeto de proyeccin ya que
gracias a la expresin sonora el hombre puede
proyectar sus sentimientos
Desde el curso 1988/89 en CREISANTS hemos
podido ir diseando un modelo de formacin e

1127
intervencin en musicoterapia que incluye 3 mbitos de
trabajo esenciales:
1. Explorar las reacciones emocionales y afectivas
del nio a partir de la expresin sonora

1.INTERVENCION MUSICOTERAPEUTICA C O N
LOS NIOS
2. Ayudar al nio a explorarse y
Cuando se solicita la admisin de un nio al centro es el descubrirse facilitando su reestructuracin y
equipo de diagnstico y evaluacin quien valora los revalorizacin
talleres o espacios teraputicos a los que se puede
3. Potenciar la expresin libre de las emociones y
integrar.
deseos del nio

En relacin al espacio teraputico que nos ocupa y

4. Reforzar los potenciales creativos de la expresin
teniendo en cuenta que vamos a trabajar
sonora, corporal, plstica y verbal del nio
fundamentalmente a partir de la expresin
sonora,junto con la corporal, plstica y verbal, los
objetivos principales que nos planteamos a partir de la 5. Permitir el establecimiento de relaciones
musicoterapia son: interpersonales para fortalecer y estructurar las

1128
relaciones con el entorno respuestas ante la interaccin con los objetos sonoros

relaciones con los compaeros y el terapeuta

A partir del momento en que el nio llega al espacio de actitud de escucha

Musicoterapia se definen 2 fases de trabajo:
actitud corporal

etc...
1. Fase de observacin

A lo largo de las 34 primeras sesiones se

2. Fase de tratamiento
observan las demandas y necesidades del nio y se
En el caso de que sea valorada positivamente una
valora si se le puede dar respuesta a partir de la
intervencin musicoteraputica se establece un
Musicoterapia. La valoracin se hace
proyecto teraputico en el que se especifican los
fundamentalmente en base a la observacin de los
objetivos generales y especficos.
siguientes aspectos:

La intervencin se estructura fundamentalmente

tipos de producciones y expresiones y caractersticas
permitiendo el acceso a la comunicacin, a la relacin
de las mismas (instrumentales, vocales, plsticas,
con el entorno mediante los elementos sonoro,
verbales, corporales...)
1129
corporal, plstico y verbal, ste ltimo en el caso de que PERMANENTE
sea posible.
El poder disponer de alumnos en prcticas de la
Escuela de Formacin del Profesorado de EGB, de la
Facultad de Pedagoga y de la de Psicologa de la
Tendiendo en cuenta la interdisciplinaridad de
Universidad de Barcelona, nos ha permitido reflexionar
nuestro modelo de Centro, es a travs de las sesiones
y proponer un modelo de formacin, que combina la
clnicas que todos los responsables de talleres y
formacin inicial con la permanente, no exclusivo a la
espacios teraputicos, profesores de la Universidad y
musicoterapia sin tambin abierto a otras tcnicas de
estudiantes de prcticas nos encontramos para discutir
expresin.
y comentar la evolucin de cada nio.
Desde el momento en que un/unos alumno/s de
prcticas llega al espacio de Musicoterapia, ya sea por
Asimismo, las reuniones que peridicamente se
sus intereses personales o por las necesidades del
realizan con los padres y las que se realizan con los
Centro, iniciamos un perodo de formacin inicial en
maestros permiten ampliar la valoracin del
esta tcnica. Paralelamente y gracias a que el modelo
tratamiento.
de CREISANTS contempla las relaciones con las
escuelas a travs de las prcticas que hacen estos
alumnos en los colegios de los nios, podemos llevar a
2. FORMACION INICIAL TEORICO/PRACTICA Y
1130
cabo una formacin permanente con profesionales que antes de empezar las actividades con los nios los
ya llevan unos aos en ejercicio. El hecho de que el alumnos reciben una primera informacin introductoria
alumno asista durante unas horas a la semana a la sobre Musicoterapia. Al mismo tiempo se les explica el
escuela de uno de los nios que viene a Musicoterapia funcionamiento y desarrollo de la formacin y se
permite, de forma indirecta, no slo transmitir un nuevo especifican detalles prcticos.
mensaje, una nueva percepcin del nio, sin tambin
enriquecer la formacin del profesional al ponerle en
2 PERIODO
contacto con otras tcnicas alternativas.
Esta segunda fase empieza ms o menos al mismo
tiempo que iniciamos las actividades con los nios. Est
La formacin inicial en Musicoterapia con los alumnos
constituida por 4 momentos:
de prcticas se realiza 1 tarde a la semana y
fundamentalmente desde la prctica para llegar a la
teora, distribuyndola en dos perodos: 1. De 16 a 17'30h. Utilizando el video como observador,
todas las sesiones se graban con la finalidad de
conseguir la mxima validez y fiabilidad en nuestras
1er PERIODO
observaciones a travs del anlisis y del acuerdo
Durante el mes de Septiembre o inicios de Octubre, interprofesional. Por este motivo, durante esta primera

1131
hora y media de encuentro visualizamos todos juntos la
grabacin filmada. A partir de los comentarios que
4. 19 a 20h. Una vez finalizada la sesin despedimos a
surgen y de las observaciones hechas por los alumnos
los nios y recogemos la sala. A continuacin
a nivel particular, elaboramos una ficha de observacin
comentamos como ha ido y cmo hemos vivido la
de la sesin lo ms objetiva posible, a la vez que se van
sesin desde dentro y desde fuera. Es tal vez uno de los
introduciendo aquellos aspectos tericos necesarios
momentos ms ricos durante los que surgen muchas
para la formacin.
cuestiones y se debaten interesantes temas. Se hacen
las sugerencias para prepara la siguiente sesin.

2. 17'30 a 18h. Durante esta media hora

acondicionamos y preparamos la sala para recibir a los
Durante este segundo perodo de formacin los
nios
alumnos colaboran en la elaboracin de los informes
trimestrales y en la preparacin del material para las
sesiones clnicas.
3. 18 a 19h. La sesin se desarrolla con los nios y
dentro de la sala un alumno participa activamente .
Fuera, en la cabina de observacin el/los otro/s
Pretendemos ir ms all de los contenidos y de la teora
alumnos observan cmo se va desarrollando la sesin .
para llevar al alumno a la reflexin y a la participacin

1132
trabajando las actitudes. investigando, elaborando y perfeccionando una ficha
de observacin con el fin de poder establecer de forma
cada vez ms definida aquellos aspectos que
3.INVESTIGACION Y DIVULGACION
permitirn valorar mejor la evolucin del nio en el
La prctica musicoteraputica, al igual que el resto de tratamiento en musicoterapia.
actividades, se evala partiendo de 3 tipos de
observadores, lo que nos da una validez y fiabilidad
Al mismo tiempo, el contacto permanente entre los
muy altas:
diferentes artistas y profesionales que llevan a cabo su
actividad en CREISANTS, nos ha permitido iniciar la
observador directo, dentro de la sala elaboracin de un proyecto de investigacin colectivo
con el fin de conseguir una forma de trabajo peculiar
observador en cabina
que mejore las actuales terapias y que represente
video nuestra personalidad profesional en el conjunto social
que se dedica a las mismas tareas.

Teniendo en cuenta la dificultad que supone llevar a

cabo una observacin lo ms sistemtica y rigurosa En el mbito de la divulgacin y teniendo en cuenta que
posible en Musicoterapia, llevamos ya 4 aos CREISANTS es un centro que surge en el seno de la
1133
comunidad universitaria, nos es posible difundir y dar a polticos, personas e instituciones sensibles al tema y
conocer esta disciplina desde los estudios iniciales a que adjuntamos en documento annexo.
los futuros profesionales de las ciencias de la salud y de
la educacin.
4.2.- TRAINING DESIGNS IN EVERY SUBJECT -
DISEFIOS INTERDISCIPLINARIOS DE
FORMATION ( ABSTRACTS)
Asimismo y gracias a las relaciones que CREISANTS
tiene con otros centros y universidades a nivel
internacional tenemos la posibilidad de dar a conocer
las investigaciones y el trabajo que estamos llevando a
cabo en este campo.

De esta forma esperamos que a travs de nuestro

modelo de formacin e intervencin podamos contribuir
un poco ms a la difusin de esta disciplina en nuestro
pas. Con la intencin de influir en una mejora de la
situacin de las personas por medio del arte y la
creatividad elaboramos un Manifiesto sobre Arte y
Creatividad para llamar la atencin de artistas,
1134
 C R EAT I N G T H E R O L E O F T H E M U SI C C. Interaction with the audience
T H ER API ST O N T H E BASI S O F T H EO R ET I C AL -
Th following areas will be explored:
PR AC T I C AL - L EAR N I N G I N T H E I N T ER AC T I O N
A. 1. Theoretical background (lecture given by
BET WEEN O BSER VAT I O N - SU PER VI SI O N -
the lecturer)
APPL I C AT I O N I N M EN T AL D I SABI L I T Y /
F O R M AC I N D EL M U SI C O T ER APEU T A A 2. Clinical observations of students (from
P A R T I R D E L P R O C E S O D E A P R E N D I Z A JE subjective to objective)
T E R I C O - PR C T I C O EN L A I N T ER AC C I N -
3. Practical exercises and clinical
O BSER VAC I N - SU PER VI SI N . APL I C AC I N
supervision
EN L A D I SC APAC I D AD M EN T AL
4. Evaluation techniques
IRIS M ARIANA C OCHIA & RICARDO R ODRIGUEZ
B. Bases and objectives for music therapy training

C. Exchange of opinions with the audience

Points to be developed:

The conference will be divided into three parts:

Puntos a desarrollar:
A. Video presentation
La conferencia tendr tres momentos:
B. Theoretical aspects
1135
A. Presentacin de video PSYC H O D YN AM I C , I N T EG R AT I VE WO R K WI T H
T H E PH EN O M EN O N O F T H E I N N ER C H I L D
B. Articulacin terica
EXPR ESSED AN D R EF L EC T ED T H R O U G H
C. Interaccin con el auditorio BO D Y, VO I C E AN D M U SI C I N ST R U M EN T S /
Se desarrollarn los siguientes tems: T R A B A JO P S I C O D I N M I C O E I N T E G R A T I V O
D EL F EN M EN O D EL N I O I N T ER N O
A. 1. Encuadre terico a cargo de la ctedra
E X P R E S A D O Y R E F L E JA D O A T R A V S D E L
2. Observaciones clnicas de los alumnos C U ER PO , L A VO Z E I N ST R U M EN T O S
(de lo subjetivo a lo objetivo). M U SI C AL ES
3. Prcticas y supervisin clnica
IN GE N YGAARD P EDERSEN
4. Modalidades de evaluacin

B. Fundamentos y objetivos de la formacin

Some of the themes for the workshop will be:
musicoterapeuta
chaos, structure dynamics, and child / parent / grown up
C. Intercambio de opiniones con el auditorio
representations. We will work with different
improvisation techniques within a psychotherapeutic
approach. The work will focus the dynamic of each
person more than the dynamics of the group, but both
1136
qualities will be considered. 4.2. - TRAINING DESIGNS IN EVERY SUBJECT
- DISEFIOS INTERDISCIPLINARIOS DE
FORMATION (CONFERENCE HANDOUTS)
Los temas a tratar en el taller sern: U N M O D EL O D E M U SI C O T ER API A PAR A L A
Caos, estructura, representaciones de la imagen del SAL U D . U N ESPAC I O D I F ER EN T E PAR A
nio / padre / adulto. PEN SAR L A R EAL I D AD

Se trabajar con distintas tcnicas de improvisacin A IZENWASER , MARCELO B IANCHEDI , JULIO F AINGUERSCH
con un abordaje psico-teraputico. El trabajo enfocar Y ROBERTO SEVILLA
la dinmica de cada paciente, ms que la dinmica
grupal, pero ambas cualidades sern tomadas en
A pedido de las autoridades de la Facultad de
cuenta.
Psicologia de la Universidad de Buenos Aires se
constituy en 1989 el equipo integrado por los autores
del trabajo que tendra el encargo de crear la Carrera
de Musicoterapia dentro del mbito de esa Facultad.

La Facultad de Psicologia a travs de sus directivos, le

encomend al equipo introducir nuevas modalidades
terico tcnicas que incluyeran en la Carrera

1137
aprendizajes especificos en el rea de la prevencin y
la promocin de la salud comunitaria.
Es de destacar que durante el perodo de
E1 proyecto presentado y aprobado por el Consejo tramitaciones, primero con el Consejo Directivo de la
Superior Universitario de la lJniversidad de Buenos Facultad y luego con el Consejo Superior Universitario,
Aires conforma un perfil de musicoterapeuta que toma el equipo tambin se encarg de dar un Curso de
en cuenta el marco social del pais, y se sensibiliza Extensin Universitaria en el mbito de la Facultad de
frente a las demandas ms urgentes de la comunidad. Psicologia de Buenos Aires al que hemos denominado:
LA MUSICOTERAPIA., un Espacio diferente para
El eje fundamental que gui nuestro proyecto fue
pensar la realidad.
considerar a la Msica en funcin del Ser Humano y en
un Espaclo diferente para pensar la relidad. .

E1 plan de estudio ha sido concebido en seis La experiencia recogida en los 5 seminarios

cuatrimestres de aprendizajes terico-prcticos cuatrimestrales del Curso, ha mostrado una amplia
distribudos equitativamente en reas especficas de respuesta nmerica y cualitativa Durante estos casi 3
prestaciones universitarias que proporciona un 66% en aos de duracin sus participantes tanto alumnos como
enseanzas para el conocimiento y uso teraputico de docentes lo han hecho con compromiso y entusiasmo.
la Msica y un 34% para el aprendizaje en lo atinente al
Mas de un centenar de personas de diferentes
area de la salud.
disciplinas se han interesado activamente en estudiar
1138
teoras y prcticas vinculadas con la MUSICOTERAPIA comprensin e implementacin de la conjuncin ser
Muchas de ellas ingresarn a la carrera que se iniciara humano-msica-salud-perturbacin-comunidad
en el prximo ao lectivo.
Testimonia el haber respondido a la necesidad y
Lcs asistentes, profesores, estudiantes avanzados y demanda del medio algunos documentos que
alumnos, msicos, psiclogos, docentes del Instituto transcribimos a continuacin y reflejan en forma
Superior del Teatro Colon, compositores, ingenieros, espontanea lo oportuno de nuestra propuesta.
actores y estudiantes de Arte Dramtico, alumnos
A tal efecto hemos seleccionado dos trabajos
avanzados de los diferentes Conservatorios y
(monografa y evaluacion) cuya elocuencia avala lo
Facultades de Msica (musicos populares, cantantes,
antedicho,
instrumentistas), educadores especiales, educadores
preescolares, musicoterpeutas, mdicos, kinesilogos, Carlos E. C.

fonoaudilogos, psicopedagogos, etc , manifestaron su "Personalmente, este seminario me resulto ,muy

necesidad de un mbito en el cual intercambiar sus interesante Me posibilito hacer algunas sintesis y
especialidades en las distintas reas (interdisciplinas) comprobar la coincidencia de enfoques y actitudes en

Se pudo comprobar a travs de esta prctica que el disciplinas distintas

modelo desarrollado en los Seminarios fue Nuevamente me encontr, sin proponermelo, con mis
instrumentalmente til y altamente promisorio por su amigos, con los cuales vengo trabajando en los ltimos

1139
aos: El Cuerpo, La Cmunicacin, La Creatividad, E1 diferencia est en que cuando toco el piano no soy
Juego, La educacin y la Enseanza. En este caso responsable por el dolor, el sufrimiento, o a veces, la
vinculados con La MUSICA vida o la muerte de otro ser humano Para mi al menos,
ser msico fue siempre mucho mas "livianito" que ser
Yo vena pensando y estudiando estas cosas mas que
mdico Pero en los ltimos 10 aos vengo haciendo
nada vinculandolos con la medicina el psicoanlisis y la
una transformacin y ampliando mis posibilidades
psicoterapia quizs ahora este en condiciones de poder
tcnicas teraputicas incluyendo el cuerpo (el gran
hacer una sintesis personal entre Msica y Terapia.
olvidado de la tecnica psicoanaltica clasica y las
Hasta ahora, deliberadamente las mantuve separadas
deformaciones lacanianas tan en boga), las
La msica era algo para jugar, divertirme y crear y las
dramatizaciones y el trabajo en equipo con talleres de
enfermedades y los sufrimientos. No es que mi
Arte la Bioenergetica
profesin de mdico y psiquiatra no me guste; todo lo
Esto fu as porque los cuadros clinicos de los
contrario Para m, comenzar una sesin de
pacientes que consultaban eran cada vez mas graves o
psicoterapia puede ser una aventura como tocar un
complicados y me di cuenta que la palabra sola no
tema de jazz: se cual es el tema y como empiezo el
alcanzaba y en algunos casos hasta era ineficaz Es
resto va a ocurrir de ah en adelante y lo ignoro
lgico que asi sea el lenguaje hablado -es la ltima
totalmente. A veces me divierto mucho y me regocija la
adquisicin que evolutivamente hacen los seres
forma en que pude resolver las dificultades Pero la
humanos. Sirve para tratar neurticos pero con los
1140
psicticos o psicosomticos, caracterpatas, etc Hipotesis de los Niveles de Integracin de la Energa,
ademas del lenguaje hablado, la palabra, hay que usar hubiera podido plasmar mejor sus ideas.
otros medios de comunicacin En esto me resulto
Respecto del cuerpo, podemos agregar que no solo es
esclarecedor el punto de vista de Edgar Willems, que
un olvidado del psicoanlisis sino de la cultura
relaciona distintos aspectos de la msica con distintas
occidental toda, que lo toma utilitariamente: es algo que
estructuras del sistema nervioso y por ende con
sirve para producir y consumir. No lo considera como la
distintas funciones Aqui aparece nuevamente que la
base de la expresin de la persona.
ontogenia reproduce la filogenia y que lo patolgico es
un trastorno en la evolucin de lo normal. Y lo bueno es Me alegr mucho encontrar en los trabajos sobre

que se puede usar la musica aplicando estos Eutonia, Feldenkrais y Ritmica Dalcroze una

conceptos. concepcin de totalidad y de respeto por el ser

humano.
Me resulto precursora la concepcin de Willems, su
intento de integrar, de totalizar Ignoro en qu ao Claro!, todo esto me hace pensar que la Musicoterapia

escribi sus trabajos ledos en el Seminario Hoy se va en contra de la corriente o que se dedica a arreglar

podria explicar ms detalladamente y en forma ms lo que todo un sistema socio-econmico-cultural se

actualizada sus ideas Pero la intencion, el espiritu con dedica a romper alegremente.

que fueron escritos son totalmente actuales y de Y aqu no puedo menos que pensar en el sistema
avanzada Quizs si Willems hubiera conocido la educativo, tan vinculado a estas cosas y que ensea "a
1141
repetir y no a crear'' y que no tiene en cuenta para nada Habra mucho mas para escribir, pero me llevara
las particularidades individuales Que ensea a ser mucho tiempo. Por mis actividades no dispongo de
Personaje y no Personare Que ensea a Plan en lugar mucho tiempo libres por lo cual trat de reflejar las
de Playng (en trminos de Winnicot) cosas que ms me impactaron de la manera ms
sintetica"
No hay tiempo para perder en experimentaciones y
errores! iHay que salir a competir cuanto antes! E1 Segundo documento responde la item "El juego
musical en Musicotarapia" y fue realizado por una de
No es de extraar que los musicos no puedan jugar con
las alumnas de la ctedra de Didctica I de la Carrera
sus instrumentos.
de Educacin Musical del Corservatorio Nacional
Para poder hacerlo, tienen que "desaprender" primro
Superior de Msica de Buenos Aires.
lo aprendido Volver a juntar lo que separaron ya en la
Marcela L.
antigua Grecia, es decir: juntar la msica con el
movimiento, con el cuerpo; volver a juntar la " Nuestra Profesora nos propuso participar de una de
matemtica con la acusmtica. las jornadas del Seminario de Extensin Universitaria
de Musicoterapia que se estaba desarrollando en la
En lo personal, este Seminario me ha servido para
Facultad de Psicologia de la UBA Nuestra participacin
desarrollar y armonizar ms an mis aspectos artsticos
se bas en mostrar un trabajo hecho en clase sobre un
y cientficos, es decir mis aspectos afectivos e
cuento musical, que an no haba sido concluido.
intelectuales
1142
1) Como surgi el cuento musical Tcnica utilizada, Por las caractersticas propias del cuento cremos que
mtodo taller sera conveniente sonorizarlo con instrumentos acorde
al folklore Colla Utilizamos: Charango, SiKus, Quena,
La consigna primera de trabajos fue que realizara
Pincullo, piano y Voz El trabajo fue hecho en forma
improvisaciones con su instrumento: el piano, la
conjunta en horas de clase.
guitarra, la flauta traversa, la voz, sobre canciones
infantiles. Como resultado se obtuvo un Cuento Musical con
partes instrumentales y partes narradas y sonorizado
De todas las improvisaciones, optamos por la de
con instrumentos acordes al ambiente en donde
Adriana quien tom la cancion "Soy un Colla Chiquitito"
suceda la historia.
de Esther Shneider, al piano.
2) Cmo fue la Experiencia en el Seminario de
Ella nos explico, luego de tocarla y armonizarla
Extensidn Universitaria:
libremente, la historia que haba imaginado mientras
improvisaba su composicin . Primero nos presentamos ante las personas que
asistieron y luego presentamos los instrumentos y
Entonces, la siguiente consigna fue que cada una
enseguida nuestro cuento musical.
redactara esa historia.
A continuacin hubo una charla interdisciplinaria sobre
De todas las narraciones tomamos la que realiz
el juego musical y despus, con la participacin libre de
Karina .
todos (nosotros y los asistentes al Curso) volvimos a
1143
tocar y narrar el cuento. musicoterapeutas) que surgi despus de haber
terminado nosotras con nuestra exposicin.
3) Mi vivencia:
Al comienzo particip desde mi perspectiva que es la
Me pareci una linda experiencia porque compart con
Educacin Musical, sin pensar que las personas que
otras personas algo en lo cual particip en la creacin.
estaban adelante lo hacian recibiendo desde su
Al principio estaba un poco tensa . No sabia bien qu
formacin e intereses.
lugar estaba ocupando Me senti ms distendida
Por eso actuando comenz la charla integradora recibi
cuando nos mezclamos entre la gente y ellos tambin
una gran sorpresa, puesto que escuch lecturas
participaron.
diferentes sobre lo que hicimos y de nuestra actitud
Me gust mucho tambin la actitud de algunos de tratar
frente al juego.
de ver desde la educacin qu est pasando con la
Tambin percib que no todas las personas podan
msica. Desde la demostracin de desinteres frente a
entendernos: me refiero en propuesta ldico musical.
las materias especiales hasta los cambios que surgen
en nuestro Conservatorio para poder salir adelante. Comenzo a escaparse el sentido propio del juego
musical entre la gente; trataban de verlo aisladamente
Lo sobresaliente de esta experiencia fue el enfoque
como juego pero no como musica.
interdisciplinario ( con educadores musicales,
compositores, psicoanalistas, psiclogos, mdicos, Otros sintieron que esta herramienta era muy dificil de

1144
aplicar (dentro de su profesin) casi inalcanzable y para Enfatizamos ahora, que dadas las caractersticas de
otros resultaba ms que sencillo. esta Carrera, conformada por dos reas de
Capacitacion, si bien interrelacionadas pero
Sobre todo, lo que ms me llam la atencin, fueron los
manifiestamente diferenciadas (Area de Formacin en
diferentes aspectos, las diferentes visiones que
Ciencias de la Salud y Area de Formacin Musical),los
surgieron ante la propuesta debido a que se trataba de
grupos docentes se reunirn en Seminarios Talleres
un grupo de profesionales de distintas areas.
Vivenciales de conceptualizacin y compenetracin con
Hasta por un momento me senti paciente, frente a las
el Rol del Musicoterapeuta y de la Musicoterapia previo
exposiciones-interpretaciones de los psiclogos. Me
a la iniciacin del ao lectivo y con el criterio de
sirvi para comprender que tanto el juego musical
integracin interdisciplinaria.
como muchas otras cosas pueden ser vistas y vividas
de diferentes maneras por diferentes personas" .
Traemos el susurro de este viento latinoamericano
Creemos que el curso de extensin universitaria es una
desde la Argentina con la idea que a pesar del
iniciativa sumamente acertada que le ha permitido al
dramatismo que comparten nuestros pueblos, nos
equipo autor de la carrera consolidarse tanto en sus
alberga la esperanza de mezclarnos en la brisa
funciones docentes como en confirmar la necesidad de
unificadora que nos una en la pasin que nos
la realizacin del proyecto generador de la misma.
identifica: LA MUSICA.
1145
 3. "Self experience in practice"

Prof. Vida B. de Aizenwaser, Lic. Marina I. Ajsenwaser,

Dr. Marcelo Bianchedi, Prof. Julio Fainguersch, Prof.
To build in Self experience as a compulsory part of a
Marta Marucco, Prof. Luisa Penovi, Lic. Roberto Sevilla.
registered university Masters program in Music
Therapy raises problems and gives possibilities. Here I
want to draw up highlights from 10 years experience of
SEL F EXPER I EN C E F O R ST U D EN T S AS A
training Music Therapy students and having them as
M ET O D O L O G Y - A C O M PU L SO R Y PAR T O F
student clients in the program within the same
T H E M U SI C T H ER APY PR O G R AM AT AAL BO R G
framework and environment.
U N I VER SI T Y.

I NGE N YGAARD P EDERSEN

Why Self experience?

The aim of Self experience training is to prepare the

My focus for this lecture will be: students for therapy work. This work is unique in the
1. "Why I think Self experience should be a compulsory way, that it involves a conscious contact - and work with
part of music therapy training programmes" the present psychic ressources and readiness - for the
client and for the therapist.
2. "Self experience in a progressive program frame"
1146
 matter of time and experience to be prepared to reflect
possible parts of those psychical processes in a way,
The Self experience work with students is very complex,
where they can be examined respectfully.
as it has to be done with a clear understanding of the
double character characterizing the psychical
ressources and readyness. These are on one hand a
The vulnerability of this way of learning owes much to
result of a person's life story and actual social
the way western culture has put weight on rationality in
circumstances - on the other hand they are the
learning processes in general. The emotional side is -
cognitive and emotional fundamentals, with which a
whether you reflect it or not - present as an important
person influences his/her circumstances.
guide for acknowledgement in the psychical potential,
Even though it may be obvious that it is necessary to but most often recognised as "irrational" in this culture -
draw this psychical readyness into the training and regarded as an area of very little meaning or even
processes as a tool to be worked with, it is or can be a embarrassmentl This creates an atmosphere where it is
very difficult area. The vulnerability has primarily even more difficult and painful to reflect and get
something to do with the vital nature of these processes. personal insight through emotional work. In western
Exploring f.i. your life strategies - some of which you culture emotional work is most often separated from
might find not practical or limiting - can be experienced rational work and is practised in subgroups, where it -
as threatening and anxiety provoking. It is mostly a reversely - is totally separated from rationality.

1147
Therefore I think it is important for therapists - especially developmental proces. Developing means a widening of
music therapists to focus on the emotional side of the potential space.
development, acknowledgement and learning,
The playground of the potential space changes with the
integrated with the rational side of learning in their own
client group. For groups of 'student-clients' it is both the
training in the formal education process - as basic tools
group of students, they belong to, and the individual
for their future profession work.
music therapist who becomes a very important person
An important aspect of the work is to focus on the in the exploring and widening of the students'potential
students ablity to interchange between emotionality and space. The individual music therapist in a paradoxical
rationality. way becomes both

- a kind of partner at the student's disposition; a person

the student can relate to,
The potential space
- a part of a teacher group in a program where the
In the training we among other theories use Winnicott's
student has to be evaluated and advised concerning
concept of "the potential space" (or "transitional area").
personal development for the future professional work.
In the Teaching music therapy it is understood as the
range of individual and interrelational possibilities of The student's overall 'potential space' also includes
action, which the 'student clients' are able to use and be doing process work with psychical possibilities and
in contact with in playing situations during a readyness parallel with the exercise of many musical
1148
skills and digestion of theories and metatheories 4. Learning to deal with projections, introjections and
through reading, discussions and writings. self containment in practice.

5. learning to develop a high level of sensitivity

The basic tools (diagram 1) 6. Lerning how to be involved and at the same time
survive as a music therapist.
This kind of traing where the student's self exploration
becomes basic tools for the future professional work
also prevents the students from becoming copies of the
For me there are two important points concerning the
senior music therapists within the program.
last area: The students must learn to protect
The basic tools can be lined up in the following areas: themselves and build up their own energy in and
between the process work. And they have to learn to
1. Learning to be familiar with their personal
have their own needs fulfilled in a proper way, so that
improvisational language - especially in music,
the clients won't be placed in a situation where they
2. Experiencing the power of music as a tool for
must fulfil the needs of the therapist.
reflections of psychical possibilities and readyness.

3. Learning to be part of ongoing processes in an active

The Framework around the Self experience
and consciously reflected way.
work - The MA Music Therapy Prowram a t
1149
Aalborq Universitv (DK). in the treatment of a client or group of clients). The last
statement are quoted from the Curriculum. The
The Master Program in Music Therapy at Aalborg
psychodynamic and/or psychoanalytical understanding
University (Kandidatuddannelsen i musikterapi) is a four
of musical communication and the therapeutic
year fulltime training program. I now quote from the text
relationship forms the basis of training. Students, as
edited in Cheryl Maranto "Music Therapy - International
part of their training are required to participate in group
Perspectives" Jeffrey Books 1993. Pennsylvania, USA.:
and individual therapy for three years. They are
The program is: "within the Faculty of Human Science,
exposed to a wide variety of techniques and methods,
Institute for Music and Music Therapy at this University.
and an emphasis is placed on active music therapy and
From 1982 - 89 the program was established on an
improvisation. In addition, receptive methods e.g.
experimental base. In 1989 this experiment was
Guided Imagery and Music are presented.
evaluated and recognized; The same curriculum is
The theoretical basis for the music therapy program are
currently used. Because the program is run by the state,
dynamic psychiatry, psychoanalysis, developmental
the program is automatically recognized and its
psychology, object relations theory, metatheory, and
graduates are awarded the title, "Kandidat i
theories of science. The program prepares the students
musikterapi". They are allowed to practice music
for practice and research in music psychotherapy. This
therapy either independently or as part of a treatment or
means that there is an emphasis on the client's
teaching team (where the team represents a joint effort
psychological problems, irrespective of other
1150
problematic conditions. Students are introduced to work
with various client populations,e.g., mental handicaps,
The Entrance Examination
physical handicaps, and adult and child psychiatry
patients. Students may specialize with a smaller number The entrance examination consist of tests in

of client groups during the training. The dialectic piano/voiceskills prepared and improvised eartraining

philosophy of the program reflects the general attitude musictherapy dialogues on xylophones with a trained

towards training in denmark, and the dialectic music therapist,voice improvisation inspired by a picture

possibilities are limited by the definition of music therapy or a poem and an interview. During the interview the

as a psychotherapy. student is asked to state their motivations for starting

this program and are told about which processes they
To be admitted into the program, students must have a
can expect themselves to go through and which role
Danish High School degree or its equivalent. In addition,
they can expect themselves to become concerning the
music therapy students must have played music for at
studentgroup (a kind of network). This talk is very
least 3 years and must pass a comprehensive
important. Even if we can never tell about real
examination; relevant work experienced is also
experiences, the students do choose this kind of
required. A large percentage of students already
training seriously before they start this program.
possess a degree before they start and the average
age of students is in the middle 20's. A maximum of 10-
12 students are accepted per year.
1151
The first three years the students are trained in three In order to explain the musical framework around the
areas of equal importance. Self experience training I want to present the different
ways in which the students are trained and in which they
1. Music therapy performance, self experience and
cope with music as their tool. The diagram shows how
didactics.
music is taught both as formalized knowledge, as skills,
2. Musical skills - improvisational skills.
as a symbolic product and in different improvisation
3. Academic skills - theoretical and research training. models. The diagrams shows also how music is taught
both as a product and as a tool for symbolic processes.
(See next page)
These three areas are integrated particularly within the
compulsory report worked out in groups or individually
at the end of each semester. In the fourth year the The improvisational models can overall be divided into:
students leave the university for half a year of practice
1. Improvisation within specific musical styles - musical
at an institution, and the last semester is dedicated to
"Gestalts".
the master's thesis.
2. Improvisation inspired by musical guidelines from the
students' experiences of a given task.
The musical framework around the Self experience
3. Improvisation expresing interrelational identity in
traininq Part.
1152
music "here-and-now-relations" and "in-the-past- Formalized Knowledge
relationships".
Skills

The piano- and voice traning contains techniques,

Music as a symbolic product
interpretation of scores and the first two improvisational
models shown on the diagram model 1 and 2. Improvisation I

The third improvisational model is only trained in the

Self experience training parts of the program. here it is Improvisation II
used together with model 1 and 2 - dependent on the
aim of the therapeutical work.
Improvisation III
THE MUSICAL FRAMEWORK AROUND THE SELF
EXPERIENCE TRAINING PART.
Music Therapy diciplines Auditory training Science of
Music
Music Therapy Student
Playing tecniques Voice tecniques Interpretaion of
music Prima Vista Accompagnement

1153
Composition and arragement tecniques "I/Clients-" and "I/Institution"-problems and ressources.

Formalized improvisation (with musical gestalts) 3. Individual Music Theraps for one year (the second
year of the program). This discipline mostly deals with
Music guidelines from therapists experience to a given
"I/Self"- and "I/You"-problems and ressources.
task
4. Psychodynamic Group Leadinq. (a student therapist
Expressing interrelational identity in music; hers and
leads a group of students under direct supervision) for
now and in the past
half a year. (First half of the thrid year) - deals with
"I/Group"- and didactic problems and ressources.
Structures of Self experience traininq parts,
5. Therapy-related Ensemble Playing (A student
performance and didactics in music theraps. (Diagram
therapist leads a group of students in a roleplay, where
5)
the students play the roles of a specific client group
given as a problem beforehand under direct
supervision) for one year (the third year of the
1. Group Music Therapy (group process) during three
program). Deals with performance problems and
years.
didactic training.
2. Observation Practice for 6 weeks at institutions with a
6. Intertherapy. (Two students takes turns in being a
trained music therapist. The discipline deals with with
client and a therapist for each other under direct
1154
supervision, followed by individual supervision for both have chosen for their work. This examination is -
students by a trained music therapist) for half a year together with the masters thesis - the most important
(second half of the third year). Deals with "I/Self"-, examination of the program.
"I/You"- and "I/Didactic"problems and ressources.

7. Clinical practice. The students work with clients at in

As you may have noticed the students during the four
institution for half a year (fourth year of the program)
years go through a process, where they play a
under supervision (direct and non-direct). From
student/client role during the first two years of the
unversity they get individual and group supervision in
program. They begin to take turns in student/client- and
the same period.
student/therapist roles in the third year (in situations
This half year deals with all the earlier mentioned more like roleplay). Nevertheless the first two years of
processes ("I/You" etc.). - In this period the students are training and process work influence the third year in a
building up an identity as music therapist. The practice way, that the students still work with deep personal
time ends up with an examination where each student processes when they start to work with each other
must present a case study and state their way of under direct supervision.
understanding music, human beings, music therapy
didactics and make an account of the methods they
have found relevant and the theoretical framework they I will now present a music example from my former
individual work with a student client.
1155
 In the music I play the part of a birth helper, but at the
end I do press the student through my drum playing and
Example 1 + 2)
keep the student in high energy untill the climax.
These two pieces of music is from the beginning and the
end of an 18 minutes long improvisation with the title "I
try to play my own birth in a smooth way". This student Music example 1.
formulated as a main topic for the self experience work
The student plays piano (including the strings inside the
to focus on a nonbalanced use of energy: the student
piano). - After the improvsation the student lay down on
felt either too paralysed for action or too active. Here like
the floor and said nothing. I placed myself nearby and
in most individual and group work we take turns in
was just present. After a couple of minutes the student
playing music together and reflect verbally on the music
told that it was the first time this student had had such a
in between. After having explored the topic with different
kind of body feeling. This kind of body feeling became a
methods we one day decided to go back and work with
guideline next time the student felt unbalanced - it was a
the student's birth as the theme. The student was told
tool for focusing the search for more balanced energy.
by the mother that the birth had lasted for a very long
time, and then suddenly the child came out like in an Special circumstances and ethical rules around

explosion. This life rhytm seemed somehow to follow Self experience in practice.

the student also as an adult. This kind of compulsory training built into a recognised

1156
program of course requires a high standard of ethical - Supervision is compulsory for the Teaching music
rules. (Diagram 6) therapist who do Self experience training with the
students.
The most important of these are:

- The work takes place behind a locked door

In continuation of the ethical rules I'll mention some
- There is a "Don't disturb" note on the door, which must
special circumstances connected with this "Teaching
be respected.
music therapy", which differ form a pure personal,
- There is no telephone in the room
individual music therapy training:
- All teachers who work in the field of Self experience,
- you cannot choose your own therapist. You can
performance and didactics are subjects to Professional
express your wish about the sex of the therapist - and
Secrecy according to the ethical code for professional
this will be accepted when possible.
music therapists.
- there is a precise number of hours available - no
- All sessions are recorded or videotaped.
matter where you are in your process. (If you want or
- Before they start the program all students are need to go deeper into the proces, you must add a
prepared for taking responsability for group members personal, individual therapy outside the teaching
as a compulsory element of the training. training).

1157
- your development will be evaluated for future choice a responsible one - for the clients as well for the
professional work. students.

Of course this training must be based on a certain level

of trust between student and therapist, and the students
Which possibilitiesdo we have for evaluation.
are encouraged to raise 'trust problems' during the
work. In cases of difficult problems the student has the
The examination after the clinical practice period in the possibility to change over to another therapist. This will
fourth year is externally evaluated, and so is the therapy only take place under the supervision of a third person
related ensemble playing training. The Self experience and in dialogues with the student and the therapist
training parts (individual and group training) cannot be together. - This is not an indication of bad development -
evaluated that easily! What we do is the following: The on the contrary. The trained music therapists have their
trained music therapists are as attentive as possible limits too - of course. Untill now we have trained 50
with each student and sum up the process work students and have had very few 'trust problems'.
continuously, and at least every half year they go into a
discussion with the students on their experience of their
own process. All Teaching music therapists are asked
for their statements concerning the students' choice of Paradoxes (Diagram 7).
client group for clinical practice. The question is: Is the
1158
In order to avoid 'trust problems' the Training music transference and countertransference. This means f.i.
therapist (TMT) has to be conscious of and to deal with that the TMT often must accept to play a specific role to
paradoxes like: be able to clear up the meaning of the role, he/she is put
into. In these situations you may compare some of the
1. Remember/forget
work of the TMT with the job of an actor or actress on
The Training music therapist is the one, who is
the stage - the role must be so convincingly played that
supposed to remember the important information the
it moves the audience. But as a therapist you must at
student brings into the process work and the one who in
the same time be as authentic as possible in the
a later situation can refer to former information (verbal
therapist role - in order to keep the basic trust of the
or musical), which the TMT imagines has something to
client. Another paradox concerning this work:
do with the present situation. On the other hand the
TMT must enter at least the individual therapy sessions
with students knowing exactly nothing - thus letting the 3. Knowledqe/no knowledqe.
student present the knowledge of the present situation.
In a program where Self experience training is a
compulsory and integrated part of the program you
cannot avoid mixing roles as a TMT. We can avoid it to a
2. A disciplined way of beiinq present/authentic.
certain extention, f.i. will an individual therapist never be
The TMT has to be able to deal consciously with
your later examinator or internal censorship. On the
1159
other hand the individual therapist will be asked for his guideline for selecting TMT's. They must of course have
opinion on the student's client group choice for the a lot of Self experience themselves. But they are not
clinical practice - compared with the developmental allowed to or supposed to make love with any of the
stage of the student. student clientsl As a TMT you cannot help being the
target of many and often strong positive projections and
If a TMT has to be a course teacher within another
often the student will fall in love with you. It can be a very
discipline for the same students the TNT has the
important part of the developmental process if you as a
responsibiblity of 'forgetting' all inside information from
TMT can contain and handle this in a respectful way.
the therapy sesssions and to be clear about the
We always as have a minimum one male and one
professional secrecy. The same responsibility is applied
female TMT, so that special wishes concerning the sex
to the student therapist's work with other students
of the TMT may be obliged in most cases.
during the training. The work is based on a deep respect
for all kinds of problems and expressions in the process
work.
Learning processes and steps of progression in
Self experience training with Improvisational
Model II and III. (Diagram 8)
4. Love/not make love.

Last but not least : The TMT must be able to love the
students as human beings - this is a very important
1160
Even if no examination can take place in disciplines 3. Learning to recognize yourself in "your own eyes"
concerning Self experience training within a program, instead of in the eyes of other people.
certain common learning processes and steps of
4. Learning to handle what you feel is right for you -
progressions can be lined up especially from the
independent of parent censorship and your own
individual music therapy training work with students.
defiance reactions in a responsible way for yourself and
These learning processes and steps of progression can others.
of course be analyzed in different ways. I have
- In these two learning processes Consciousness of
developed the following way of analyzing them on the
Introsections is trained.
basis of a psychoanalytical approach:
5. Learning how to develop important tools for the
1) Learning to see/experience intimate
practical work when you contain feelings at the same
relations/parents the way they are and the way you
time as you allow feelings to appear.
intend them to be (distinguishing ideal from reality).
- This last learning process train Self containment as a
2. Learning to contain and accept pain, disappointment,
music therapeutical tool.
aggression, joy and other feelings related to intimate
relationships. - In these two learning processes
Consciousness of Proiections is trained. This is only one way of analyzing steps of progression in
the training of the students' ability to interchange in a
1161
balanced way between rationality and emotionality. I to mix up roles like being director of the training and
have experienced developments within these steps as individual TMT at the same time. I still train performance
very important tools for the professional music therapy and didactics and supervision for practice with the
work. It gives the student a better grounding and a good students in the third and fourth year.
basis for the integration of spiritual elements in their
practice.
Example 2.
In the beginning of this lecture I mentioned that many
other skills are taught parallel to Self experience training These two pieces of music show a student's struggle

- like developing a personal musical improvisational with different personality parts. Two main parts were

language, sensitivity and - most improtant - that the chosen and given the names of

students experience the power of music as a tool for - the innocent and polite child
focused work with psychical ressources and readyness.
- the demon

Finally I want to play another example from my former

In the first piece of music the student plays in a
individual work with students. I don't do individual work
wellknown way, where the "child part" is expressed in
any more other music therapists specially trained for
the upper part of the piano and 'the demon' in the lower
this work have taken over. It is too hard and complicated
part. This special day the student goes further, inspired
1162
by the title of the improvisation: "I allow myself to be Music example 3.
abnormal". The student continued the music on a
metallophone ending up using a gong and the voice. - I
tried to follow the student with my music as a kind of List of litterature:

assistant, reinforcing the student musical expressions. Books:

During the gong/voice part the student suddenly got in
contact with yet another power in the voice expression -
which gave both of us associations to Tibetan monks Braaten, L. J.: "Psykoterapeutisk laering i grupper"

singing. In the following session the student wanted to Universitetsforlaget, Oslo, 1974
try out this voice quality again, and this time alone so
that the student could identify the power in the self and
do integrative work as a soloist. This experience Brinkner,K, Villumsen, H.: "Terapi og filosofi". En

balanced the two personality parts of the student in a artikelsamling om filosofiske problemer i forbindelse
more useful way. The demon part - which was based on med
defiance reactions against parents and other authorities
vejledning, radgivning og terapi. Forlaget Philosophia
were transformed into a powerful tool of personal
1985
confidence.

1163
Casement, P.: "Lyt til patienten". Hans Reitzels Forlag
1987. ("On learning from the Patient" 1985)
Pedersen, I. N., Scheiby, B.B.: "Musikterapeut, musik,
klient" Musikterapeut - musik - klient", Aalborg
Universitetsforlag,1981.
Haley, J. "Psykoterapi - strategi og teknik". Natur og
Kultur 1975

Cohn, R. C.: "Von der Psychoanalyse zur Pedersen, I. N.: "Musikterapi - et fag under udvikling. Et
themenzentrierten Interaktion" Klett - Cotta. Stuttgart nyt skud pa stammen inden for
1980 universitetspisdagogikken. Aalborg
universietetscenter.Institut f. musik og musikterapi.
1986
Jorgensen P.S., Almstrup.O.: "Brn og Terapi.
Universitetets b0rnepsykologiske Klinik. 40 ar. Dansk
Psykologisk Forlag 1990 Priestley, M.: "Analytische Musiktherapie"
KlettCotta,Stuttgart 1983

Pahuus, M.: "Fornuft og fflelse". Den fflende fornuft og

den vellykkede identitet. Forlaget Philosophia. Aarhus Schmiedbauer, W.: "De professionelle hjeelpere" -
1986 nestekerlighed som vare. Hans Reitzels Forlag. 1986
1164
("Helfen als Beruf, Rowohlt Verlag GmbH.1983) Musiktherapie Herdecke". Musiktherapeutische
Umschau", nr 3 1982

Skov, V.: "Det skabende menneske" - udvikling gennem Pedersen, I.N., Scheiby, B.B.: "Intermusiktherapie
myter og innerhalb der Musiktherapieausbildung.
Selbsterfahrung als Interaktionsmethode."
kunstterapi. Munksgaard. 1991
Musiktherapeutische Umschau. Band 9,Heft 2. Gustav
Fischer verlag 1988
Articels:

Pedersen,I.N.: "Kandidatuddannelsen i musikterapi v.

Eschen,J.T.: "Zur Praxis der Einzel - Musiktherapie". Aalborg universitetscenter. Et historisk og nutidigt
perspektiv." Dansk Akademisk tidsskrift for musikterapi.
Musiktherapeutische Umschau 1. 1980.
1 argang nr 1.. MTF 1990

Eschen,J, Hass,W., Purdon,C., Ostertag, J.:

"Mentorenkurs 4.3.- THE MUSIC THERAPIST ROLE IN THE
INSTITUTION - EL "ROL " DEL
1165
MUSICOTERAPEUTA EN LAS INSTITUCIONES trmino ATENCION FLUCTUANTE MUSICAL para
( CONFERENCE HANDOUTS)
designar la postura receptiva del musicoterapeuta, a
AT EN C I N F L U C T U AN T E M U SI C AL : U N A partir de la hiptesis de que este, en la relacin con su
R EF L EXI N R ESPEC T O AL PAPEL D EL paciente, ejerce musicalmente la atencin fluctuante,
M U SI C O T ER APEU T A propuesta por Freud en su obra.

M ARCIA M ARIA DE S ILVA C IRIGLIANO Esta exposicin dar continuidad al tema improvisacin
Musical Libre, Asociacin Libre y Atencin Fluctuante:
entre Musicoterapia y Psicoanlisis, presentado en el IV
"Si algn dia usted fuera escribir a mi respecto... sea Simpsio Brasilero de Musicoterapia (Cirigliano, 1988).
bastante sensato - como nadie lo fu hasta hoy para La idea de continuar escribiendo y refleccionando en
caracterizarme, describirme, pero no evaluarme" esta linea es el resultado del camino que,
(Nietzsche a Carl Fuchs) personalmente, recorro en mi formacin de terapeuta.
Desde el inicio hasta su conclusin, mi curso de
Musicoterapia coexisti paralelamente a una prctica
I-INTRODUCCION
psicoterpica, de fundamentos psicoanalticos. Creo
E1 presente trabajo pretende contribuir al cuerpo que, lejos de ser opuestos, el Psicoanlisis y la
terico de la practica musicoterpica, a travs de una Musicoterapia, a pesar de proponer enfoques
refleccin respecto al papel de aqul que la ejerce. Es el diferentes en la lectura del ser humano, revelan puntos
1166
de interseccin en sus fundamentos. La investigacin Para que pueda sugerir un trmino que particularize la
de tales puntos puede favorecer, no apenas el estudio situacin musicoterpica, por considerase que, dentro
del comportamiento, sino una mejor comprensin de lo de sus parmetros, la atencin del terapeuta est a
que ocurre en la relacin terapeutica. semejanza de lo que ocurre en el contexto
psicoanaltico, es importante retomar el concepto
No hay como detallar exhaustivamente este tema en
hecho por Freud, y lo que a partir de 1 fu
las prximas pginas, en la medida en que se hace
acrecentado en ese sentido. Se tiene, por lo tanto, a
necesaria una colocacin sucinta, teniendo en vista su
seguir, un retorno sobretodo al articulo en el que Freud
presentacin en Congreso. Lo que aqu se pretende
pormenoriza el trmino , seguido de una alusin a la
es estar en consonancia con lo que se configura como
utilizacin de este en otros abordajes terapeuticos. Se
mayor objetivo del evento: un encuentro de
considera tal digresin imprescindible, para que se
profesionales para refleccionar y dialogar sobre la
proceda al desarrollo de la hiptesis que busca
actividad musicoterpica y su papel en el mbito de la
fundamentar la utilizacin del trmino en el campo
Salud Mental.
terico de la Musicoterapia.

II - EL CONCEPTO DE ATENCION
II. 1 - E1 surgimiento del trmino en el
FLUCTUANTE
Psicoanlisis

1167
Sigmund Freud, creador del psicoanlisis, expone y Esta actitud, segn Freud, es ms productiva al
comenta en su articulo Recomendaciones a los analisar que cualquier otra medida como, por ejemplo,
Mdicos que ejercen el Psicoanlisis (1912), el modo la de tomar notas. Pues, como afirma, "aquellos
como el analista debe escuchar el analisado, su actitud elementos del material que ya forman un texto
subjetiva que, en verdad, corresponde a la regla de coherente quedarn a disposicin conciente del
asociacin libre, propuesta al analisado: "se ver que la mdico; el resto, an sin nexo y en desorden catico,
regla de prestar igual reparo a todo constituye la parece al principio estar sumergido, pero viene
contrapartida necesaria de la exigencia hecha al rpidamente al recuerdo cuando el paciente trae algo
paciente, de que comunique todo lo que le ocurre, sin nuevo, que se puede relacionar y por el cual puede ser
crtica o seleccin (...). La regla para el mdico pueda continuado" (p. 150-1). Tal actitud denominada
ser expresada as: "E1 debe contener todas las atencin fluctuante o equifluctuante, permite, por lo
influencias concientes de su capacidad de prestar tanto al analista descubrir las conecciones discurso del
atencin y abandonarse enteramente a la "memoria paciente. Freud ilustra su pensamiento con la siguiente
inconciente". O para decirlo en trminos propiamente comparacin: el analista "debe mudar su propio
tcnicos: "E1 debe simplemente escuchar y no inconciente, como un rgano receptor, en direccin del
preocuparse si est recordando de alguna cosa" (p. transmisor inconciente del paciente. As como el
150). receptor trasforma de nuevo en ondas sonoras las
oscilaciones electricas en linea telefnica, que fueron

1168
creadas por ondas sonoras, de la misma manera el en su mayora, son cosas cuyo significado slo es
inconciente del mdico es capaz, a partir de los identificado posteriormente' (p. 150).
derivados del inconciente que le son comunicados, de
Freud busca, al proponer esta atencin
reconstruir ese inconciente, que determin las
"imparcialmente suspensa" (5-p.291), alcanzar la
asociaciones libres del paciente" (p. 154). Sobre este
verdadera comunicacin de inconciente a inconciente.
ejemplo Theodor Reik se reporta para preconizar la
Para esto, cabe al analista una tarea compleja que
expresin metafrica "oir con el tercer oido".(8)
Lagache resume as: observar, escuchar, comprender,
Si el analista se comporta de otro modo estar saber esperar y callar, y cuando llega el momento
perdiendo material precioso del proceso, fuera de estar oportuno, dar la interpretacin conveniente.
posicionandose de forma incoherente a la que solicita
el paciente (o sea, que este le hable o que quiera que
este si su atencin prioriza algn contenido, fatalmente II. 2 - La utilizacin del trmino en otros

podr perder otros tantos, talvs mucho ms abordajes terapeuticos

elucidantes en relacin a las preguntas del paciente. La atencin fluctuante, enunciada por Freud, siempre
Como resalta Freud "al efectuar la seleccin, si seguir mereci relevancia por constituirse en uno de los
sus expectativas, estar arriesgando a nunca descubrir preceptos bsicos a todo aquel que pretenda ser
nada fuera de lo que ya sabe (...)" (p. 150). En efecto, el analista. Para ms all de este campo, trminos
analista no debe olvidarse de que 'lo que se escucha, psicoanalticos son prestados a abordajes terapeuticos,
1169
que los utilizan, en la tentativa de fundamentar Parece comprensible que Carlos Fregtman atente para
aspectos de su estructura terica y les confieren el lenguaje corporal en su profesin. E1 instrumento de
significados especificos, a veces diferentes del original. trabajo, para el musicoterapeuta es, evidentemente, la
Tal ocurrencia es usual en el medio cientifico y msica pero, como recuerda Benezon'2' no es solo
necesaria para que nuevos caminos sean abiertos y no msica lo que se utiliza como parte del proceso de
se agote el potencial de la creacin humana. aplicacin terapeutica, pero tambin se utiliza el sonido
en el aspecto mas amplio de su concepcin y el
E1 musicoterapeuta Carlos Fregtman (3) hablando
movimiento(...)" (p.12).
sobre su experiencia con grupos, describe el
profesional de musicoterapia trabajando como "una Es precisamente dotado de esa comprensin
antena receptiva y amplificadora de las melodias y denominada por Fregtman, atencin fluctuante
ritmos latentes" (p. 59). Para que alcance esa actitud de corporal, que el musicoterapeuta puede percibir el
receptividad el musicoterapeuta debe, segn grupo musicalmente: "As como debemos estar atentos
Fregtman, conocerse desde sus reacciones a nivel a los datos de nuestro cuerpo (movimientos,
corporal: "(...) una forma de crecer como terapeutas emociones, tensiones, etc.) para una comprensin ms
consiste en estar en contacto con nuestro cuerpo y totalizadora de la realidad grupal (atencin fluctuante
entender su lenguaje, con esta premisa, intentaremos, corporal), deberiamos tambin centrar nuestra
paso a paso, construir nuestra atencin fluctuante atencin en la propia produccin musical en el
corporal" (p.79). transcurso de la sesin configurando una atencin
1170
fluctuante musical" (p.59).

Cabe observar que Carlos Fregtman cita el trmino III-ATENCION FLUCTUANTE MUSICAL
atencin fluctuante musical pero no llega a
La hiptesis de que es posible hablar de una atencin
sistematizarlo como concepto terico pasible de
fluctuante en el setting musicoterpico surgi a partir de
insercin en la Musicoterapia. Mientras que de la
la observacin clnica personal, que delimita no solo
atencin fluctuante corporal, a la que se refiere ms
una clientela como una tcnica especifica. Se trata de
extensamente, seala que su empleo difiere del
un trabajo intividual en el que predominantemente es
concepto freudiano. En esta descansa el concepto de
utilizada la tcnica de improvisacin musical libre (la
inconciente como condicin bsica del escuchar
cual, para ser empleada, no implica necesariamente en
analtico. Ya en la situacin de Fregtman, la atencin
el musicoterapeuta adoptar una filosofia freudiana) con
del terapeuta parece ser una actitud de
pacientes de comportamiento autista (en su mayoria
concientizacin, orientada para una situacin mas
nios) aliado a alguna deficiencia sensorial (visual, en
concreta e inmediata: el "aqu y ahora" grupal. A pesar
la mayor parte de los casos), fsica o mental.
de escencialmente importante ser llevado en
consideracin, se hace necesario destacar que, hasta Con el fin de fundamentar el concepto de atencin

donde se puede comprender, una formulacin fluctuante musical, cabe, inicialmente, recordar dos

conceptual es expresada en moldes distintos de la otra, colocaciones importantes. Lia Rejane Barcellos(1)

as sea con igual terminologa. retrata en la relacin musicoterapeuta-paciente, el

1171
establecimiento de una "reaccin sonora espiral". En y que atravieza el atendimiento musicoterpico, se
otras palabras, hay la presencia de alguna torna fundamental que el escuchar del
manifestacin sonora que, aceptada por el musicoterapeuta funcione lo ms libremente posible,
musicoterapeuta, es devuelta, ya modificada, para que pueda ser facilitada la emergencia de
enriquecida por la improvisacin de este. E1 paciente, contenidos alternos del paciente. La atencin del
entonces, responde al nuevo estimulo sonoro y as musicoterapeuta, a nivel musical, debe pues, estar lo
sucesivamente. ms lejos posible de todo aquello que la focaliza
habitualmente: preferencias, preconceptos, en fin
Un segundo aspecto define la improvisacin musical
cualquier procedimiento selectivo. Actuando as se cree
como la utilizacin del cuerpo, voz e instrumentos
que el musicoterapeuta contribuya para tornar
musicales, tanto a nivel rtmico como meldico,
productivo el camino "en espiral"(1) del proceso
tomandose siempre por punto de partida, las
musicoterpico, el cual siempre se hace impotante que
necesidades e intereses del paciente, sujeto del
cualquier producto esttico a nivel sonoro.
proceso terapeutico. A este respecto, Violeta de
Gainza(6) recuerda que "toda improvisacin supone un
acto expresivo de comunicacin, asi no conduzca
La atencin fluctuante musical contituye una actitud
necesariamente a un producto sonoro estructurado".
significativa cuando se piensa en pacientes con
Ahora, en esta relacin que se establece a nivel musical dificultad y/o imposibilidad de expresin verbal. Siendo

1172
msica, para el musicoterapeuta, cualquier La formulacin de esta hiptesis tropez con las
manifestacin ritmico-sonora, desde la ms dificultades que, posiblemente, sern superadas a lo
rudimentaria hasta la ms elaborada, lo que largo del tiempo. La primera de ellas es la poca
"escuchado" por el musicoterapeuta, si ste tiene su bibliografa, en este sentido en musicoterapia, por
escuchar musical regido por una atencin tratarse de una prctica an reciente, si se compara
"imparcialmente suspensa"(5). E1 resultado de eso es, con otras ramas de las disciplinas paramdicas. Otro
no raro, durante la improvisacin, respuestas aspecto dice respecto a las posibles preguntas que
musicales inconcientes del musicoterapeuta (letras de surgen a partir de la colocacin de que la atencin
msica, ritmos, etc., aparentemente repentinas, pero fluctuante musical presupone una actividad
impregnadas de sentido) que posteriormente pueden inconciente, cuyo discurso es investigado en la
ser comprendidas y contextualizadas. literatura psicoanaltica. Siendo as, se retoma una
antigua discusin; ser la msica un lenguaje?, los
En resumen, la atencin fluctuante musical, aqu
ritmos, fragmentos meldicos y armnicos revelan
expuesta, presupone la existencia de dos inconcientes,
mecanismos inconcientes?.
que pueden comunicarse musicalmente, en una sesin
de musicoterapia. Adems de estas, hay todavia una cuestin respecto a
la atencin fluctuante: se trata desde su concepcin de
una regla ideal, a primera vista, ya que en la prctica al
IV - CONCLUSION
producirse una intervencin al que se escucha, sea
1173
verbal o musical, va a priorizarse un recorte del especulacin en ese universo inconmesurable del
discurso. Sin embargo, la recomendacin freudiana, estudio del comportamiento, universo se que solo se
tiene como objetivo apenas eliminar la seleccin puede comparar en dimensin y complejidad al propio
voluntaria y conciente en el escuchar, de modo que enigma del ser humano.
posibilita expresiones involuntarias y por eso mismo
reveladoras del inconciente.
V - BIBLIOGRAFIA
En sintesis, esta refleccin en lo referente al papel del
musicoterapeuta no se limita a un concepto terico. Ella 1. BARCELLOS, Lia Rejane Mendes. A msica utilizada

existe para darle prioridad a otras preguntas y a la como elemento Terapeutico. Trabalho apresentado no

creacin de nuevas producciones. La prctica II Encontro de Pesquisa em Msica, So Jao Del Rei,

terapeutica es algo complejo, que exige como ya MG, 1985

alertaba Freud un perfeccionamiento constante del 2. BENENZON, Rolando O. Manual de Musicoterapia,

escuchar obtenido a travs de estudios, supervisiones Enelibros Rio de Janeiro, 1985.
y en el propio analisis personal. En trminos de
3. FREGTMAN, Carlos Daniel.Cuerpo, msica y terapia.
musicoterapia se suma a esto la importancia de una
Ediciones Bsqueda, Buenos Aires, 1982.
formacin musical slida y lo ms completa posible.
4. FREUD, Sigmund (1912).Recomendaces aos
Por lo tanto, cada trabajo que se escribe es ms una
mdicos que exercem a psicanalise in o caso de
1174
Schereber, Artigos sobre Tcnica e outros trabalhos. E N C U A D R E : L I M I T A N T E O P E R M I S O R ?
Imago Ed., Rio de Janeiro, 1969, vol. XII, p.149 - 159.
D IEGO S CHAPIRA
5. FREUD, Sigmund (1922) Dois Verbetes de
Enciclopdia in Alem do Principio de Prazer, Psicologa
de Grupo e outros trabalhos. Imago Ed., Rio de Janeiro, "El nico modo de huir de la condicin de prisioneros
1969, vol.XVIII, p287-312. es el entender cmo es la prisin" (Italo
Calvino)
6. GAINZA, Violeta Hemsy de. La improvisacin
musical, Ricordi, Buenos Aires, 1983.

7. LAGACHE, Daniel. A Psicanlise, Difel, Rio de Janeiro "La humanidad ha sufrido siempre la misma
1978 maldicin: Creer que lo que ya se sabe es cierto, y
todo lo distinto, un error" (Theodore
8. LAPLANCHE, J y PONTALIS, J. B. Vocabulario da
Sturgeon)
Psicoanalise, p. 74 - 76, Martins Fontes Ed., So Paulo.

Es mi intencin con este trabajo presentar algunas

cavilaciones y tambin algunas dudas acerca de lo que
denominamos encuadre. Luego de algunos aos en el
ejercicio de la profesin mi concepto de encuadre es el
1175
mismo que aprendi en la facultad?; cmo funcion El encuadre deberia ser un tema lateral cuando la
este en las diferentes instituciones en las que trabaj?, actividad transcurre entre la intencin de comprensin
para qu sirve el encuadre?; es un concepto ligado al y las posibilidades de implementacin de la tarea Sin
de tica?; para quin sirve el encuadre?; mi criterio embargo, muchas veces ni lo uno ni lo otro pueden
puede ser similar en una institucion o en mi plantear sus propios dilemas o cuestiones. Algunas de
consultorio?; se puede hablar de un encuadre estas tienen que ver con el no haber tomado al
musicoteraputico? . encuadre como el tema central en las instancias
previas o iniciales del tratamiento, con una modificacin
del mismo o con una superposicin de otro u otros
No pretendo dar una respuesta a cada pregunta, ni a
encuadres sobre el propio.
los que no menciono relacionados con este tema El
propsito en todo caso es presentarlos con el fin de
interrogar a quien le interese y darnos algunas Recordemos que el encuadre es el conjunto de
respuestas que nos sirvan en este momento, y nos elementos que permanecen estables, y permiten
permita profundizarlas posteriormente. visualizar el proceso teraputico. Estas componentes
que idealmente se establecen antes, y son acordadas
en el contrato inicial, aluden a constantes temporales
El encuadre como herramienta
(como periodicidad de las sesiones y duracin de las

1176
mismas); espaciales (como el lugar de atencion, los puede parecerles obvios pero sin embargo no es poco
elementos que integran el consultorio y disposicion de habitual no contemplar la especificacin del campo de
los mismos) y econmicas (modalidad y regulacin de trabajo en el que el profesional se desempea con las
los honorarios). No son el juego sino las reglas del condiciones particulares que esto requiere. Suele
juego, como dice Emilio Rodrigu, quien define al olvidarse o desconocerse, en estos casos, que la
encuadre como "el conjunto de las actividades no eficiencia en la tarea tiene uno de sus apoyos
interpretativas que tienen por finalidad mantener la fundamentales en la especializacin, o sea en la
marcha ordenada del proceso analitico". Pero si circunscripcin y profundizacin de un rea
tomamos a Winnicott, que lo define como "la suma de determinada
todos los procedimientos que organizan el anlisis",
podemos pensar que hay otros elementos que
formaran parte del encuadre y que, si bien no son Dentro de los otros elementos no necesariamente

acordadas explicitamente en el contrato, forman parte explcitos pueden inscribirse, por ejemplo el lugar en el

de los considerandos del mismo y suelen estar que se sita el terapeuta con respecto al proceso -

convenidos como supuestos precarios. Esto tiene que dentro o fuera del mismo-; y tambin el modo en que se

ver, por ejemplo, con el marco terico del terapeutas y establecen las constantes desde cada terapeuta (por

con el recorte que el mismo hace en cuanto al tipo de ejemplo, fijar si el tiempo de la sesin empieza a la hora

demanda que se propone atender. A muchos esto previamente convenida; cuando el paciente traspasa la

1177
puerta del consultorio, cuando llega el ltimo de los laboral, bien podran estos cambios quedar
miembros de un grupo o cuando finaliza la pre-tarea y inadvertidos.
comienza la denominada "tarea" en si misma)

Me parece importante aclarar que si bien estoy de

Podramos llamarlas semiconstantes, o constantes alguna manera aludiendo a la ubicacin filosfica y
idealmente en movimiento ya que, salvo en terica del terapeuta, y a su contacto prctico con el
oportunidades drsticas, no tienen una rigidez objeto que estudia, no me refiero especificamente a
inconmovible o un devenir que no sea vivido como una estos en algn sentido valorativo, sino que los ubico
evolucin sin bruscas alteraciones durante sus situacionalmente como posibles integrantes del
mutaciones. Es ms, muchas veces estas encuadre, como sumatoria de ingredientes que en su
modificaciones se van produciendo de manera tan conjunto hacen factible la construccin de un clima de
paulatina que el percatarse de ellas cobre en el espacio trabajo consecuente, cmodo y tendiente a la eficacia.
de supervisin, o en alguna otra instancia en la que se
realiza una mirada retrospectiva del aprendizaje y de
los puntos de vista que se han podido ir tomando con En trminos de Bleger, podra decir que

respecto a estos temas. Y si acaso el profesional no fenomenologicamente el encuadre teraputico es

supervisara, o no acostumbrase a revisar su historia situacional en lo temporal, y dialecticamente dinmico y

dramtico en el acontecer.Dinmico en cuanto se
1178
constituye en el marco dentro del cual se registran pero el hecho de encuadrar es inherente a la fotografia
hechos y actos concatenados como proceso; y en si, ms all de la herramienta que se utilice. En el
posibilitador de inducciones o disparador de conductas campo teraputico ocurre algo similar, ya que los
cuando se modifica Dramtico en cuanto permite la resultados tendrn que ver con las teorias utilizadas y el
observacin y el estudio de ese proceso en trminos de modo de instrumentarlas. Pues es dificil que un
experiencia, de conocimiento aplicable en esa y otras terapeuta, utilizando una teoria de probada utilidad
instancias, y mantenerlo en un nivel terapeutico. pueda lograr resultado positivo alguno si no se
predeterminan los lmites del campo perceptivo entre
los que discurre el proceso, las fronteras de ese
De todos modos, an teniendo ms o menos clara la
espacio intersubjetivo que hacen posible la tarea, que
conceptualizacin del encuadre, es importante no
permiten algn tipo de desarrollos y cuestionamientos
perder el norte de lo que se puede observar y/o
sin temores, heridas, interrupciones o acechanzas
estudiar desde el mismo.En fotografia, encuadrar
adicionales a los que ya de por si son caractersticos de
significa hacer un recorte de un universo visual utilizar
los mismos.
una herramienta (la cmara) para poder seleccionar y
prestar atencin a una parcialidad de un campo de otra
manera inabarcable. La calidad de la imagen depende Encuadre Para quien?
de la calidad de la camara y de la pericia del operador,
En este punto viene bien preguntarse a quin le sirve
1179
el encuadre?. Si hablamos de un espacio intersubjetivo, nico lugar en el que sabe que todo lo que se
ha de ser de utilidad a ambas partes implicadas. Esto manifieste no trascender a otras personas a menos
me parece importante de destacar, ya que inclinar el fiel que l lo haga
hacia el paciente o hacia el terapeuta provoca un
desbalance que inevitablemente repercute en la tarea
Y supongo que esta repercusin no ha de ser Al terapeuta, el sostenimiento del encuadre le permite

conveniente, porque o el paciente o bien el profesional brindar continencia al paciente, le da la oportunidad de

desaparece o al menos se descentra del foco de situarse dentro y fuera para, de alguna manera, aspirar

atencin durante el proceso. a la objetivacin del proceso; y tambin le sirve como un

continente propio, en la medida en que, tanto desde las
constantes como desde las semiconstantes que l se
Al paciente, el encuadre ha de servirle como construye, apunta a poder trabajar de la manera ms
continente, como marco de seguridad que de lugar a la til, cmoda, eficaz y placentera posible.
aparicin de las propias inseguridades. E1 tambin
Menciono estas cuatro cualidades premeditadamente,
acuerda que, cada tanto tiempo, har un recorte de su
ya que tengo la sensacin de que tanto la idea de
universo y desde esa porcin que comparte con su
utilidad como la de eficacia estn presentes como
terapeuta trabaja con lo que le ocurre, ocurri y puede
posibilidades o aspiraciones casi permanentes. Pero en
pasar tanto en el afuera como ah. Es muchas veces el
mis conversaciones con muchos colegas,
1180
musicoterapeutas y de otras profesiones, me parece parte, me parece que implica, ms que la "necesaria
que son menos las menciones a la comodidad, la ligera deprivacin sensorial" de la habla el psicoanlisis,
gratificacin o el placer, salvo cuando aparecen en una brusca eliminacin de estimulos que puede
momentos criticos, o en rupturas o amenazas de perturbar ms que colaborar.Tal vez el error haya
quiebra de los procesos o del encuadre, como ideales radicado en haber generalizado una idea de encuadre
lejanos e inaccesibles. pensada en un momento para la atencin de nios
autistas. Y bien sabemos que, sin cuestionar si en esos
casos las constantes espaciales mencionadas sean las
Muchos musicoterapeutas compramos alguna vez la
adecuadas o no, las generalizaciones suelen constituir
idea de un consultorio de paredes pintadas de blanco o
errores. Cuando recuerdo esta imagen me divierte
algn color claro, un armario empotrado y la menor
pensar qu habria hecho Freud, de haber sido
cantidad posible de elementos a la vista (instrumentos,
musicoterapeuta, con sus libros y la coleccin de
equipo ds sonido, almohadones, etc). Todo esto en
cientos de estatuillas que poblaban su consultorio; o
funcin de no provocar perturbaciones al paciente.
Jung con los cuadros que l pintaba y su biblioteca.
Imaginemos ahora a un terapeuta trabajando durante
horas en un sitio as.Y durante das y meses.
Personalmente la sola idea me resulta lindera con lo A veces habra una idea que considero deformada de lo
alienante, con lo abrumador y con lo aburrido. Por otra que es la vocacion de servicio, que se trastocara en

1181
una "vocacin de sacrificio" en haras del beneficio del individual, no es imposible que otra personalidad
paciente y la desestimacin o autodesestimacin del rol mdica, distintamente constituda. se vea impulsada a
del terapeuta, o quizs en haras de algn beneficio adoptar una actitud diferente ante los enfermos y ante
secundario. Podriamos preguntarnos entonces si la la labor que los mismos plantean". El ya habia
tarea que realizamos no nos brinda gratificaciones y contemplado esta situacin, pero ochenta aos ms
placer, al servicio de qu lo hacemos. Las respuestas, tarde an son muchos los sostienen que el encuadre
de todos modos, son individuales y slo han de servirle una vez que el terapeuta lo ha establecido o aceptado,
a quien se interroga. debe permanecer invariante. Como si la tcnica no
fuera algo posible de evolucin; las reglas del juego no
Discurriendo en torno al concepto de utilidad del
pudieran cambiarse cuando cuando los participantes
encuadre me aparecen las ideas de rigidez y
varian; y como si la persona misma que acta como
flexibilidad. Si hablo de constantes pueden sufrir
terapeuta no fuera alguien que (es de esperar) vaya
modificaciones?. Y sin pensar en la magnitud de una
modificando sus puntos de vista o sus pensamientos
modificacin pueden tener oscilaciones tales que
durante el tiempo.
permitan variaciones en determinadas circustancias?.
En sus "Consejos al mdico en el tratamiento
psicoanalitico" de 1912, Freud sealaba; "quiero hacer
En estos casos, me parece que lo que se hace es
constar que si la tcnica aqu aconsejada ha
someterse a un estamento terico en lugar de
demostrado ser la nica adecuada a mi personalidad
1182
acomodarlo a la propia personalidad manteniendo pequeas variaciones". Y en otro parrafo seala:
obviamente un nivel operativo adecuado. Seria "sospecho adems, que, cuando se extrema la
practicar una teora, mas que teorizar una prctica El correccin del encuadre, ms all del sobrio sentido
no cambio o rigidez en el encuadre como postulado, tal comn, se produce un acto paradojal: que el paciente
vez hablen del no cambio o rigidez del terapeuta, y en responda en forma excesiva a estmulos minimos".Leo
consecuencia del desfavorecimiento del cambio en los estos prrafos y vuevo a pensar en las cuatro
pacientes. Me pregunto nuevamente si en esta cualidades que mencion anteriormente: utilidad,
preservacin de la invariabilidad no podra estar comodidad, eficacia, placer.
cobijada una falsa idea de seguridad, que puede
tornarse en un lugar de poder desde el cual se opera.
Hay otro encuadre en mi encuadre

Quiero destinar ahora un espacio para referirme a

Rodrigu sostiene que "un encuadre razonablemente
algunas situaciones partculares que se presentan con
correcto es un requisito indispensable de todo
respecto al encuadre en la practica institucional. Son
analisis.Un indice de que un tratamiento marcha
situaciones habituales tanto en Argentina como en los
adecuadamente est dado por la reaccin que tiene un
dems paises de Amrica latina, que ilustran una parte
paciente ante los cambios que se producen en el
de la realidad de la musicoterapia como disciplina, y de
encuadre, reaccionando con gran sensibilidad a
los musicoterapeutas como profesionales.
1183
 patio cerrado con ventanas rotas y piso de baldozas, un
comedor por donde transitan mucamas, un pasillo o
Suele ocurrir -al menos en los llamados paises
una sala de estar de la que entran y salen enfermeras y
perifericos- que al desempearnos en instituciones,
otros pacientes ajenos a la actividad, en lugar de un
existe una disarmona entre la idea de encuadre del
consultorio destinado exclusivamente para
terapeuta y la de la institucin. Esto es algo que tambin
musicoterapia Habra aqu un choque entre el deseo
puede observarse en la supervisin, pero a los efectos
del terapeuta y el deseo de la institucin, en una diada
de abreviar me voy a centrar en lo institucional. Este
vertical.
desfasaje casi siempre se da no en los postulados sino
en los hechos, provocando un efecto de doble vnculo
paralizante o inoperante. Parece dificil pensar en
En una oficina comercial, o incluso en las oficinas
trminos de objeto sonoro, de discurso sonorocorporal,
administrativas de las clnicas privadas, a nadie se le
de imagen corporal o de imagen sonora cuando el
ocurrira pedirle a los empleados que lleven sus
mbito pre-determinado para intentar realizar la tarea
maquinas de escribir, sus cintas y sus resmas de papel.
no es el adecuado. No es algo alejado de lo cotidiano
Como a nadie se le ocurrira pedirle al radilogo que
que las instituciones asistenciales, por diversificacin
costee las placas a utilizar o al psiquiatra que pague el
de intereses o por desconocimiento de los
importe de los psicofrmacos que receta El
requerimientos de la prctica musicoteraputica,
musicoterapeuta, sin embargo, pone sus cintas, a
destinen como mbito para la misma un garaje, un
1184
veces su grabador y otras tambin sus instrumentos. partes implicadas tienen algo que ver, considero
No hay algo desvirtuado en esta actitud? Me refiero a prudente revisar la parte que puede tocarnos a los
la de una gran cantidad de instituciones privadas que musicoterapeutas en esto. Tal vez una carencia puede
lucran a costa de malos servicios; o que privilegian la estribar en la no formalizacin a nivel reglamentario del
hotelera en desmedro de los honorarios profesionales mbito, condiciones y equipamiento mnimo de trabajo
y del equipamiento necesario.En estos lugares se del profesional musicoterapeuta Cada pais tiene una
puede observar a los musicoterapeutas invirtiendo a realidad diferente en este temas pero sabemos que en
veces ms tiempo en negociar, defender o construir un la mayorla esta carencia an persiste.
encuadre que en ocuparse de los contenidos del
trabajo. Las propias ideas que se pueden tener acerca
del encuadre estn atravesadas por las de la Rescato otro prrafo de Rodrigu: 'El consultorio es un

institucin, que en lo referente a la relacin paciente- mbito con su espacio y su tiempo propios. Es un

profesional suelen no estar al servicio ni de uno ni de microcosmos donde se desarrolla un proceso y es un

otro. retablo donde se generan "movimientos " y "ruidos". (...)

El encuadre viene a ser la pantalla del retablo analitico
que tiene que tener el suficiente grado de constancia y
Como toda crtica sin propuesta es paralizante, y como consecuencia para que la trama de fantasias que en
en toda relacin ambas ella se proyectan puedan ser discriminadas".

1185
Si pensamos en un encuadre en musicoterapia en una FREUD, Sigmund. Obras Completas. Tomo II. Edit.
institucin, deberamos pensar en la construccin de Biblioteca Nueva Madrid Espaa
ese espacio y tiempo propios dentro del espacio-tiempo
RODRIGUE, Emilio. El Contexto del Proceso Analitico.
flsico y virtual de la misma. Construir un espacio y un
Edit Paidos
tiempo, constante y consecuente. Creo que es algo
STURGEON, Theodore. Los Cristales Soadores.Edit.
ligado con la tica, en la medida en que nos aliemos o
Minotauro
no a un mensaje contradictorio que est ms al servicio
de la alienacin que de la cura Creo, tambin, que es
algo ligado a la dignidad profesional.
L AS PR I N C I PAL ES I D EAS Q U E SU ST EN T AN EL
E JE R C I C I O P R O F E S I O N A L D E L
M U SI C O T ER APEU T A EN L A AR G EN T I N A.

Bibliografa G ABRIELA W AGNER Y M C ELIA P REZ

BLEGER, Jose. Psicologia de la Conducta Edit. PAIDOS.

CALVlNO, Italo. Tiempo Cero.Edit. Minotauro. I. INTRODUCCION

ELKAYM, Mony. Formaciones y Prcticas en Terapia La inclusin del movimiento, del sonido y del silencio,
Familiar.Edit. Nueva Visin. de la danza y de la msica con intencin teraputica se
1186
remonta en America al perodo precolombino. modificaciones. que no se reducen solamente al campo
del aprendizaje musical sino que involucran otras
Algunas de las, creencias as cmo los rituales que de
capacidades humanas dando lugar a cambios
ellas resultan subsisten aun hoy con pequenas
profundos y significativos en diferentes areas de la
variantes en diferentes comunidades tribales (1982,
personalidad.
Depalma))
2 Desde el campo mdico el psiquiatra y el neurlogo
El advenimiento de la cultura occidental y cristiana vara
formados musicalmente, son los que ven en la
el concepto de hombre y su interrelacin con la
interaccin sonoro-musical las posibilidades nuevas:
naturaleza dando lugar a un nuevo sistema de ideas
para sostener los criterios de salud y enfermedad asi
como su etiologa y teraputica.
2.1. Acceder a aspectos inconscientes de la dinmica
La Musicoterapia argentina del siglo XX surge a partir intrapsiquica flanqueando mecanismos de defensa
de dos pilares fundamentales. (Benenzon).

2.2. Posibilidades de aprendizaje no verbales,

paraverbales sustentadas por las capacidades
1. Desde el campo de la msica es el msico que
involucradas en el hacer musical y del movimiento.
reconoce que su trabajo pedaggico asi como su
(Quirs)
experiencia personal de interpretacin promueve

1187
 curriculares de la Ex-Direccion Nacional de enseanza
Diferenciada y de la Universidad del Salvador, Carrera
El objetivo del presente trabajo es el estudio de las que
de Musicoterapia para intentar a responder las
dieron lugar y sostienen el ejercicio musicoteraputa en
siguientes preguntas:
la Argentina.
Cual es el sistema de ideas que sostuvo y sostiene la
Antes de proseguir, ambas autoras de este trabajo
formacin y la prctica de la Musicoterapia en la
debemos una disculpa a ustedes publico y a nuestros
Argentina?
posibles lectores por pretender en un espacio de media
hora introducirles en un tema tan vasto. Tengamos
presente que hay ms looo graduados argentinos.
Podemos hablar de un modelo terico
lntentaremos, eso s abrir una ventana Hemos
musicoterapeutico?
seleccionado trabajos, artculos, libros y hemos includo
trabajos realizados por alumnos de la Carrera de
Musicoterapia de la Universidad del Salvador, Facultad Qu relacin hay entre el discurso cientfico utilizado
de Medicina. (Ver bibliografa adjunta). por un autor y su lugar de desempeno profesional? Ej.

Hemos procesado y vuelto a procesar 189 encuestas a Si en Salud Mental predomina el discurso psicoanaltico

profesionales musicoterapeutas, seleccionando 88 y como base para la comprensin psicodinmica del

por ltimo hemos estudiado las modificaciones sntoma podemos generalizar diciendo que todos los

1188
musicoterapeutas argentinos comparten esta postura?

1. Estudio e investigacin de:

Qu ideas comparten? Qu paradigmas? Cul es el

lugar de la improvisacin clnica? Cuales son las
l.l.Las areas de desempeo profesional
hiptesis de base para la comprensin de aspectos de
nuestro mundo interno expresados a travs del .institucional.

lenguaje corporo-sonoro-musical? Sin duda, cada .privado

marco terico lo entender de otra forma, y formular
1.2.Las areas de formacin post-grado.
hiptesis de trabajo teraputicos diferentes.

2 La seleccin y lectura de artculos y libros publicados

II. METODOLOGIA Y DATOS PRELIMINARES
en. idioma castellano en el perodo 1965--1.992 segn
II a RECOPILACION DE DATOS los siguientes criterios:

Para la elaboracin del presente estudio hemos partido 2.1.De autores musicoteraputas profesionales
de los siguientes datos. (Slide).
2.2 De autores musicoteraputas idneos o formadores

1189
de musicoterapeutas. 2.5 Se incluyeron 25 trabajos elaborados por alumnos
de la Carrera de Musicoterapia de la U.S.

2.3.De autores especializados en el estudio del hombre

y su relacin con la msica y el movimiento en sus 3. Estudio analtico de programas de:
aspectos:

. De percepcin y expresin corporo-sonoro-musical

3.1 Congresos, jornadas y seminarios realizados en la
. Psicodinmicos Argentina

. De coordinacin psicomotriz

. Cognitivos que sustentan el pensamiento musical y del 3.2 Trabajos presentados por musicoteraputas
movimiento argentinos en congresos mundiales

4. Observacin y estudio de:

2.4 Otros de autores incluidos con una frecuencia no

menor de 3 en 10 en el material bibliogrfico
4.1 Sesiones de musicoterapia:
musicoteraputico seleccionado
. En vivo

1190
. En grabacin 5.1 Universidad del Salvador.

. En videos 5.2 Ex-Direccin Nacional de Enseanza Diferencial

. Coordinados por una de las autores

6. Entrevistas a autores cuando posible
. Coordinados por otros profesionales

11 b EVALUACION DE LOS DATOS

4.2 Clases en la Carrera de Musicoterapia

. Idem
Referente a los criterios de evaluacin de la
mencionada informacin centramos nuestra atencin
4 3 Grupos de Musicoterapia Didctica.
en los siguientes datos:
. Idem
. Area de desempeo profesional

. Area de indagacin cientfica

5. La experiencia profesional de reuniones peridicas . Definicin de trminos y conceptos.
en:
. Vocabulario general.

1191
. Referencias bibliogrficas. . Area de Musicoterapia en Salud Mental (Mt Gabriela
Wagner)
. Procesos de evaluacion previos y/o realizados durante
el tratamiento musicoteraputico

. Niveles de interaccin teraputica y de intervencin . Area de Musicoterapia en Medicina (Mt Gabriela

Wagner)

La elaboracin de los datos de la encuesta se hizo

teniendo en cuenta tres areas de insercin profesional. II.1. EL DESEMPEO PROFESIONAL
MUSICOTERAPEUTICO EN ARGENTINA

Antes de pasar al tema de referencia recordamos que

. Area de Musicoterapia en Educacin Especial
aproximadamente el 95% de los mil musicoteraputas
(Discapacitados mentales, hipoacsicos y nios con
argentinos se formaron en una facultad catlica, la
transtornos de la conexin, de la comunicacin y de la
Universidad del Salvador La concesin original de esta
motricidad insertos en el mbito de las escuelas de
carrera , insertada en la Facultad de Medicina, es la
recuperacin y de educacin especial municipales y
que publica Benezon (1971) en su libro "Musicoterapia
privadas (MT Mara Celia Prez)
y educacin": "La musicoterapia es un auxiliar de la
medicina y, por lo tanto es fundamental para el

1192
musicoterapeuta su integracin en un equipo En la Argentina, el proceso musicoteraputico se
interdisciplinario." caracteriza por privilegiar la interaccin corporo-
sonoro-musical, sin excluir otras sensibilidades con el
A los 33 aos de la primera camada de egresados,
objeto de implementar acciones, teraputicas en
nuestra visin como profesionales se ha modificado.
diversos campos de la salud. A1 revisar publicaciones,
Estamos luchando por el reconocimiento profesional
crnicas y videos de sesiones, material de supervisin y
autnomo.
de musico-terapia didctica se evidencia claralmente
una constante detectable a primera vista: "el hacer"
Como constante resultante de la formacin musicoteraputico E1 musicoteraputa canta, se
mencionamos los fundamentos mdicos, tericos de la mueve, habla, ejecuta instrumentos de percusin
prctica, una comprensin psicodinmica de la elemental y folklricos, sabe tocar flauta dulce y
conducta, una actualizacin importante en la teoras del guitarra, toca otros instrumentos, usa grabadores.
aprendizaje del siglo XX y el. reconocimiento de la trabaja con nios, adultos , adolescentes y personas de
religiosidad, o no, de uno mismo y del otro lo que nos la tercera edad.
lleva a un axioma bsico: el hombre es una unidad bio-
En un segundo nivel encontraremos que las
psico-social y espiritual.
consideraciones preliminares, as como los resultados
previsibles y/o posibles son variables que dependen de
los siguientes factores entre otros:
1193
1.1. Area de desempeo profesional. alumnos del primer ao de la Carrera de Musicoterapia
de la U S. durante 1986-1992. Las preguntas surgieron
desde las inquietudes de los mismos alumnos en
1 2 Concepto etiologa y patologa en la especialidad.
relacin a su futuro profesional

1.3 Diagnstico y pronstico de la problematica y su

De las encuestas se consideraron los siguientes puntos
relacin con un marco terico referencial.
ao de promocin, lugar de desempeo profesional,
insercion institucional y area de especializacin: (Slide)

1.4. Formacin del musicoteraputa a nivel de pre-

grado, ao de graduacin y post-grado Marco
DATOS OBTENIDOS.
institucional en que se desarrolla el tratamiento
musicoterapeutico
.Area de la Educacin Especial: 37% .

Area de la Salud Mental: 68% .Area de la Rehabilitacin

1.1. AREA DE DESEMPEO PROFESIONAL
de Trastornos de la Motricidad, de la conexin y de la
Para evaluarlo se han tomado en cuenta los datos
comunicacion: 43% .Area de la Educacin
obtenidos a travs de una encuesta realizada por los
Musical: 35% . Prctica privada (no institucional, sin
1194
especificar el area):53% corporales:18%

OBSERVACIONES: .Area de musicoterapia: 34%

.Area de cuidados intensivos (terapia intensiva,

enfermedades terminales): 9%
E1 0,08% se desempea en una sla area.
A1 comparar los datos correspondientes a 1988 con los
E1 99,02 de los musicoteraputas encuestados se
de 1992 podemos observar un aumento en: ( Slide )
desempena en diversos mbitos a la vez.

. Psicologia
E1 desempeo profesional se relaciona con la
formacin post-grado del musicoteraputa. Los . Terapias corporales
siguientes datos ilustran los campos de inters.
. Musico terapia

. Afasiologa Neuropsicologa
.Area del desarrollo musical: 46%

.Area de psicologia: 65%

Se incluyen adems dos nuevos campos de actividad y
.Area de la educacin especial:17% .Area de
formacin:
neurosicologa: 14% .Area de las terapias
1195
 este sector tiene directa relacion con la disposicin
humana y la excelente formacin de la Prof. Nardelli
. Terapia intensiva
En 1949, dicha docente organiz el primer curso de
. Pacientes terminales
capacitacin docente para maestros de musica
especializados en pedagaoga diferencial .
II.2. CONCLUSIONES ACERCA DE LA BIBLIOGRAFIA
Durante este mismo perodo, msicos, profesionales
SELECCIONADA.
independiente se interesaron por el uso teraputico de
CONSIDERACIONES PRELIMINARES. la msica y por demostrar el calor formativo de la
educacin musical Muchos de estos profesionales
pertenecieron al Collegium Musicum de Buenos Aires
Histricamente la actividad musicoteraputica institucin de gran influencia en la modernizacin de la
institucional argentina comienza en 1948, ao en que la educacin musical en la Argentina. Llegados durante y
educadora musical Prof. Mara Laura Nardelli, despus de la 2 Guerra Mundia] difundieron los
profesora nacional de msica, fue invitada por la grandes cambios ocurridos en este campo entre las
reconocida mdica psiguiatra Dra . Carolina Tobar dos, guerras .Entre ellos , G. Graetzer , E. Epstein, E
Garca como colaboradora especializada en la Leuchter , H Weil, H.H. de Epstein, F.Wolf, L. Spiller.
enseanza de nios llamados entonces anormales e (Ver bibliografa adjunta. ) Ms tarde M Nardelli, A.O. de
inadaptados El reconocimiento de la musicoterapia en
1196
Larrocha, G E de Wagner ,A Yepes,E.Bovone,P Simultaneamente se inicia en Buenos Aires un
Stockoe,A.Gallo,V. H.de Gainza, V.Aizenwaser. Sus movimiento profundo tendiente a modificar
trabajos y publicaciones difundieron la prctica y el globalmente los conceptos pedaggicos imperantes. El
aprendizaje musical propuestos por, Dalcroze, primer resultado visible, es que se comienza a
Martenot, Orff, Kodaly, Willems, Susuki, Bentley, etc. privilegiar al nio como sujeto de la enseanza y el
Ms tarde vinculados con la ISME, mantuvieron una aprendizaje cmo consecuencia de distintas variables
intensa actividad nacional e internacional como dependientes no exclusivamente de la capacidad del
precursores en la especialidad . alumno.

Ideologicamente, alrededor de 1953, el cambio E1 cambio surge con fuerza Cursos seminarios; se
producido llega al mbito de las llamadas escuelas, de estudian se publica y se correlacionan discursos
educacin diferenciada. Hasta este momento, salvo
excepciones, la msica en las escuelas diferenciales se
trabajaba , con un criterio recreativo y de esparcimiento La psicologia evolutiva entra en la biblioteca de msicos

sin analizar los efecto que producia esa experiencia en bailarines y maestros en general Primero en frances

el comportamiento de los nios. ingles y alemn Ms tarde en castellano 1950-1960 Los

aspectos psicomeneticos del pensamiento se mezclan
con el desarrollo del aparato psiquico Piaget, Spitz,
1197
Stone y Church, Freud, M. Klein Gesell, T Reca, Filloux adj.)Los autores ms relevantes son E Willems,
y muchos ms enriquecen la biblioteca de W.Howard, J.Alvin, Thayer Gastn y otros. La palabra
profesionales y buenos lectores musico-terapia adquiere contenido.

Evidentemente este movimiento revoluciona desde lo Por otro lado dos medicos de renombre Rolando
ms, profundo; desde el concepto de hombre que lleva O.Benenzon y Julio B Quirs crean en 1965 la Comisin
implcito Entonces se generaliza la idea de que en el ser de Estudios de la Musicoterapia invitando participar
humano confluye lo biolgico con los, afectos, lo diferentes personalidades que sin saberlo hacian
psicologico con lo social, la inteligencia con la musicoterapia . (Benenzon, 1971) . En 1966 Se anunci
sensibilidad y la creatividad as como la expresividad en la facultad de Medicina de la Universidad de Buenos
son exponentes de su interioridad Aires, la fundacin de la Asociacin Argentina de
Musicoterapia Este grupo de profesionales ligados a la
medicina y a la educacin musical organiza en la
En lo estrictamente musical, el objeto de estudio es el
Universidad del Salvador , la Carrera de Musicoterapia,
producto musical en un contexto (Leuchter 1946,
ingresando el primer grupo de alumnos en 1967.
Salazar 1955 )

Para evaluar el material bibliogrfico de referencia, lo

Nuevas publicaciones se suceden.(Ver bibliografa
hemos dividido en tres periodos:
1198
2.1. ler PERIODO APERTURA DE NUEVOS CANALES Esta dcada nos presenta un saber en musicoterapia
DE COMUNICACION. 1965-1975 que se define por no musicoteraputas. Hay una
bsqueda de campo especfico, de accionar
2.2 2do PERIODO EL MUSICOTERAPEUTA COMO
teraputico por un lado e intentos de definicin del perfil
AUXILIAR DE LA MEDICINA. 1976-1982.
profesional por el otro. " La musicoterapia es .. "E1
musicoteraputa debera. . ." "
2.3 3er PERIODO; LA BUSQUEDA DE UNA IDENTIDAD
PROFESIONAL. 1983-1992.
Los puntos ms criticos de discusin (an hoy
subsisten) fueron:
II.2.1 ler PERIODO; APERTURA DE NUEVOS CANALES
DE COMUNICACION
. el nivel y las caracteristicas generales que debe tener
la formacin musical de musicoteraputa antes de
Las publicaciones de este perodo se caracterizan por ingresar a la carrera durante y al recibirse.
una decidida intencin de jerarquizar la actividad
musical y su posible uso con intencin teraputica

1199
. Las caractersticas y el nivel de formacion psicolgica sonido". La Psicologa se caracteriza o se define por
estudiar la conducta en su mas alto nivel de integracin
Las caractersticas y el nivel de formacin mdica.
.. ."(Bleger 1963).

Es interesantte destacar que la necesidad de tener

.Los pedaggos musicales reformulan su lugar de
entrevistas personales de evaluacin-seleccin del
docentes as como su proceso de informacin. El
alumno nunca se cuestion.
estudio gentico de la conducta musical despierta cada
vez ms inters. Los pilares de este enfoque son por un
En lo referente al sistema de ideas en musicoterapia lado Freud y el psicoanlisis, y por el otro Piaget y su
durante el periodo de referencia se sucedieron los psicologa de la inteligencia. Se habla de encuadre
siguientes cambios evolutivo en el estudio de la conducta musical y se
reconoce que los fenmenos complejos se desarrollan
La actividad musical del hombre es reconocido como
a partir de fenmenos extremadamente simples,
una conducta. Como tal. es, el fenmeno central de la
pasando progresivamente por niveles.Se habla de
psicologa, este caso de la actividad musical. La
niveles de integracin, de ontognesis y de filognesis
conducta sonora, musical y del movimiento puede ser
de la actividad musical .
objeto de estudio cientfico de distintas disciplinas. Ej .
Benenzon( 1971 ) 'Biologa del sonido" "Psicologa del
1200
. En esta dcada se afirma el enfoque psicodinmico en profesin.
salud mental. La actividad musical es estudiada
teniendo como marco de referencia el aparato psquico
comprendido desde el psicoanlisis . La psiquiatra . La musicoterapia es definida por Benenzon como

psicodinmica y la insercin de la musicoterapia como "especializacin cientfica que se ocupa del estudio e

recurso teraputico no verbal es estudiado por investigacin del complejo sonido-ser humano sea el

Benenzon.Proverbio, Rojas Bermudez y otros que ms sonido musical o no tendiente a buscar los metodos

tarde fundan la Asociacin Mdica Argentina de diagnsticos y los efectos teraputicos de los mismos"

Musicoterapia. Esta definicin cientfica marca una actitud que de ahi

en ms caracterizara esta disciplina en la Argentina
Las bases neurofisiolgicas de la conducta musical,
como parte de las tantas, actividades, que el hombre es
capaz de aprender es estudiado por Quirs, Tormach, . La musicoterapia es definida como una tcnica. Se
Schrager y otros que ms tarde colaboran en la recalca su valor como canal de comunicacin no verbal
organizacin de la Carrera de Musicoterapia en la que puede establecerse a niveles regresivos
Universidad del Museo Social Argentino. (Benenzon)

Nota: An cuando estas instituciones han desaparecido Se reformula el lugar del instrumento musical
como tales colaboraron en el crecimiento de la recalcando sus posibilidades expresivas, como

1201
prolongacin del cuerpo y de objeto intermediario . . La aceptacin y valorizacin del mundo sonoro del
(Rojas Bermdez, Alvin, Benenzon). nio como punto de partida para un interaccionar
positivo

La realizacin de las 'Primeras Jornadas

Latinoamericanas de Musicoterapia' son el comienzo . La necesidad de la especializacin en las diferentes
de un intercambio que dara sus frutos ms adelante patologias. (Quiros, 1968)
sus actas llegan a ser editadas y an hoy son
bibliografa de consulta
. E1 reconocimiento y la aceptacin del profesor de
En 1969 se gradan los primeros musicoteraputas.
msica y/o del musicoteraputa como profesional del
Comienzan a trabajar como tales y ya en 1970
equipo interdisciplinario.
aparecen sus primeros trabajos publicados

. Se definen areas de trabajo y surge la necesidad de

En el area de la EDUCACION ESPECIAL las
discriminar el trabajo pedaggico musical especializado
consecuencias imnediatas de esta nueva concepcin
de lo terapeutico en el contexto del tratamiento
del complejo sonido-ser humano (Benenzon 1971) son:
musicoteraputico como coadyuvante de la
psicoterapia (Benenzon--Yepes 1972, M.C Perez 1973)
1202
La difusion de las tcnicas corporales as como una . Se perfilan los primeros mtodos de diagnstico y la
revalorizacin del cuerpo como posibilidad de abordaje problemtica de la testificacin del encuadre no verbal (
de diversificacin de transtornos (Quirs, Penovi. Benenzon )
Stockoe, Kamen, Fux, Aberastury, ver bibliografia
adjunta )
. Con referencia a las interverciones teraputicas slo
se mencionan sus objetivos y no sus medios.
E1 area de la SALUD MENTAL y de lo que hemos
En esta dcada se fundamenta el trabajo
denominado rehabilitacin en MEDICINA van tomados
interdisciplinario como lugar imprescindible para un
de la mano durante estos comienzos.
trabajo efectivo.
. La prctica da lugar a nuevas formulaciones tericas.
Benenzon (1971) exiplicita su teora del ISO partir del
anlisis de sesiones de musicoterapia. Se abre un II.2.2 2do PERIODO:EL MUSICOTERAPEUTA COMO

camino nuevo relacionado con el factor sonido como AUXILIAR DE LA

elemento constitutivo de la organizacin de la MEDICINA. 1976-1982

personalidad.

El contexto histrico as como el terico se moviliza al

1203
realizarse el II Congreso Mundial de Musicoterapia en Musicoterapia en un Hospital Hogar Geritrico" sera
nuestro pas 1976 es un ao de organizacin, replanteo algo as como el primer libro de la especialidad
y reestructuracin profesional. preparado por musicoteraputas graduados editado en
el pas.
Se seleccionan 23 trabajos elaborados por
musicoteraputas para su presentacin Se organiza la
Asociacin de Musicoteraputas Graduados de la
Mordkowsky interrelaciona, para el entendimiento de
Repblica Argentina lo que aumenta la conciencia de
su quehacer profesional aspectos de la teora de la
indentidad profesional El proceso comienza en 1969,
comunicacin de Watzlawick,Helmick Beavin y Don
ao de graduacin de la primera camada de
(Teora de la comunicacin humana, 1967) con los
musicoterapeutas.
aspectos analgicos de la interaccin no verbal
Consideramos que el trabajo musicoteraputico ms instrumental y musical en la sesin de musicoterapia.
relevante fue presentada por la MT Susana En lo referente a la comprensin de las sintomatologa
Mordkowski, "Aspectos tcnicos y especficos de la psiquitrica se adhiere al psicoanlisis, marco terico
Musicoterapia en Psiquiatra de adultos" Publicado en referencial del equipo al que perteneca.
1977 juntamerlte con otro presentado por un

grupo de alumnos del ltimo ao de la carrera

Los puntos ms interesantes de su trabajo son:
(Wagner,Puntel y Testa)"Experiencias de
1204
Integrar la expresin no verbal sonoro-musical a la como objeto intermediario,(Benenzon) y su experiencia
conducta como totalidad fenomenolgica. profesional esboza tcnicas de dramatizacin en
musicoterapia.

. Ampliar las hipotesis diagnsticas del encuadre no

verbal desde la observacin de la interaccin sujeto- . Aborda la problemtica del lenguaje en la transmisin
instrumento musical.Ej actitud corporal del fbico al de la informacin para el paciente y para el resto del
ejecutar un instrumento musical equipo.

. Conceptualizar las posibilidades de intervencin Es el comienzo de la bsqueda de una epistemologa

teraputicas agrupndolas en verbales y no verbales. musicoteraputica Del otro trabajo mencionado (
Instrumentar estrategias teraputicas en funcin de Wagner, Puntel, Testa) citamos:
focos de trabajo, teniendo en cuenta la semiologia
"En nuestra experiencia como musicoteraputas
psiquitrica.
hemos podido observar que los elementos sonoro-
musicales que surgen a lo largo de un proceso
musicoteraputico estaran relacionados unos con
. Desde el psicodrama (Rojas Bermudez) y desde la
aquellos aspectos que nos permitiran tomar en cuenta
teora del concepto de ISO y el instrmento musical
1205
la hiptesis de la existencia de constantes sonoras incluyndolo (1981)
debidas a la evolucin ontogentica y filogentica del
Durante el perodo anterior las crnicas de sesiones, en
ser humano y otros que surgen de la variables de
especial en salud mental , se refieren a tratamientos
expresin sonoras resultantes de los distintos grupos
individuales en musicoterapia Este nuevo perodo se
socio-culturales "(1976) Esta referencia sintetiza la
caracterza por una mayor cantidad de propuestas
necesidad del estudio y anlisis del discurso musical
grupales y familiares de tratamiento en musicoterapia
propiamente dicho que surge de la necesidad de
Los aportes tericos para ello vienen de la escuela de
"sonorizar" desde la prctica la conceptua lizaci terica
de Benenzon. psicologa social de Pitchn Rivire.

E1 trabajo corporal en musicoterapia adquiere cada

vez mayor importancia Se hace necesaria la formacin
La musicloga chilena, Mara Ester Grebe presenta su
terica ademas de la experiencial (Fregtman,
trabajo "Aspectos culturales de la musicoterapia.
Ballestrin, Jnic 1976 II Congreso Mundial de
Algunas relaciones entre la antropologa, la
Musicoterapia )
etnomusicologa y la musicoterapia."La transculturacin
comienza tener un lugar en la conceptualizacin terica
de la musicoterapia en la prctica clnica Benezon Si bien la escuela de la gestalt, en su versin post-
completa su formulacin del concepto de ISO psicoanaltica planteada por F Perls llega a la Argentina

1206
en la dcada del 70, solamente despus de 1980 el desarrollo progresivo de la estructura de cada campo
encontramos artculos donde se lo explicita como a partir de la anterior
referencia (Fregtman 1982) E1 anlisis de las
Se toma en cuenta la informacin necesaria para una
publicaciones de este perido nos lleva a las siguientes
comprensin psicodinmica del sintoma desde las
consideraciones:
areas complementarias de Freud.

METODOS DE EVALUACION Y DIAGNOSTICO.

. En cuanto al manejo del encuadre no verbal con finea
diagnsticos se proponen diferentes testificaciones que
comprenden aspectos perceptivos y expresivos
Dado que el musicoteraputa desde su perfil es
(Benenzon, Mordkowsky, Zerkowsky,
preparado para integra un equipo interdisciplinario, sus
Fregtman,Wagner-Puntel-Teata, Bonano, etc.)
mtodos de diagnstico se centran en los relacionado
con la sincrnico y lo diacrnico en lo sonoro y lo
corporal
LA PROBLEMATICA DE LA TESTIFICACION DEL
ENCUADRE NO VERBAL.

. Las "fichas musicoterapeuticas" utilizadas en eate

periodo, respetan la idea de continuidad gentica o sea
1207
En el periodo que denominaremos "Apertura de otro, pero ninguno de las dos resulta adecuada para
canales de comunicacin"(1965/1975) los autores no obtener informacin especifica.
hacen referencia a la estructura musical de las formas
Los aspectos perceptivos se testificaron teniendo como
aleatorias que surgen de la improvisacin clinica.
referencia la agrupacin de los elementos constitutivos
En 1977, el msico C Saitta se incorpora como profesor de la msica presentada por Benenzon (1971) y
de la Carrera de Musicoterapia de la U.S. En 1978 edita eatudiadaa por Willems (1975)deade una hiptesis de
su libro "Creacin e iniciacin musical" que lleva una efectoa psicolgicos Ej fragmentos musicales de
propuesta util para en musicoterapeuta, de anlisis duracin especifica predominantemente ritmicos,
musical de las estructuras aleatorias de la meldicos, armnicos y de msica concreta con
improvisacin libre El grabador se incorpora connotacin regresiva o no Qu se evalua a travs de
definitvamente al encuadre musicoterapeutico. los ejemplos mencionados? Asociacin libre de ideas,
actitudes corporales, proyeccin de elementos
E1 primer intento de analisis estructural del discurso
inconcientes del paciente o del terapeuta?
sonoro-musical presentado por la Mt E Belloc, (19?8)
abre una nueva posibilidad para el analisis del discurso
sonoro.
Sin embargo la propuestas no dejaron de ser tiles en
En las primeras testificaciones predomina el modelo su momento y se fueron perfeccionando. Desde lo
psicolgico por un lado y el pedaggico-musical por el terico la consecuencia inmediata de esta
1208
aproximacin es la sonorizacin de las teorias mis estados de su estructuracin.(Quirs,1963,1973) Se
reconocidas de la personalidad dando lugar valoriza la expresin corporal como tcnica
definifivamente a la via auditiva y a la interaccin no favorecedora de la estructuracin del esquema
verbal, paraverbal, corporo-sonoro-musical como corporal.
organizadores de la personalidad (Benenzon,Gainza,
Durante el 2do Perodo (1976-1982), los trabajos
Wagner 1992).
publicados tienden a clarificar el encuadre en que se
desarrollan E1 encuadre musicoteraputico se define
frecuentemente desde el marco terico referencial del
INTERVENCIONES TERAPEUTICAS EN
equipo interdisciplinario en el cual el profesional se
MUSICOTERAPIA.
desempena.

En la dcada transcurrida entre 1965-1975 los trabajos

Se reconoce el valor del trabajo musicoteraputico
elaborados hablan de acciones pedaggicas
integrndolo como auxiliar de la medicina, desde los
favorecedoras de la actividad
resultados logrados
musical.(Aizenwaser,1968).
La inclusin de musicoteraputas en el area de la
Esta propuesta se enriquece con la comprensin
SALUD MENTAL le coloca en el lugar de coadyuvante"
nuerofisiolgica de la comunicacin verbal y los

1209
 Las llamadas intervenciones musicoteraputicas se
agrupan en verbales y no verbales:
Los trabajos presentados o publicados hablan de
"experiencias musicoteraputicas E1 encuadre
teraputico se separa del encuadre recreacional.
VERBALES

E1 encuadre no verbal puro de la sesin de

. Consignas verbales con objetivos teraputicos.
musicoterapia propuesto por Benenzon (mdico
psiquiatra) es cuestionado por los musicoterapeutas. . Senalamientos.

La predominancia de la llamada musicoterapia activa' NO VERBALES.

es abrumadora La improvisacin espontnea se

convierte poco a poco en tcnica La sesin de
. La interaccin sonoro-musical y del movimiento es el
musicoterapia lleva implcito el pasaje por tres etapas
punto de partida para la comprensin del encuadre no
no siempre especficamente regulables: caldeamiento y
verbal. La bsqueda de canales de comunicacin es el
catrsis,de percepcin y observacin del encuadre no
objetivo teraputico.
verbal y el dilogo sonoro (climax) (Benenzon, 1981).

1210
. Tenindo como base terica la teora de la . Se permite el acceso a los legajos y/o histrias clincas
comunicacin se plantea las intervenciones al profesional musicoteraputa o al profesor de msica
terapeutias en diferentes niveles. Ej. Mordkowsky
diferencia tres tipos de intervencin no verbal a
acompanante, b complementaario, c latente y tres tipos .Se lo incluye en las reuniones d equipo.

de intervencin no verbal.

. E1 gabinete psicopedaggico se interesa por las

LOGROS Y CAMBIOS. observaciones de clases de educacin musical con

objetivos teraputicos.

En el campo de la EDUCACION ESPECIAL los logros y

los cambios se suceden: . Se comienza la coordinacin de diferentes actividades
en forma conjunta donde la msica no es el
acompanamiento sino la motivacion.
. Se replantean los procesos de aprendizaje musical y
se modifican las pautas de accionar dentro de las
escuelas especializadas. . Si en el perodo anterior, la referencia a los mtodos
1211
de enseanza era explicitada por los autores, a partir En el rea de la EDUCACION ESPECIAL los
de 1976 aproximadamente los mismos comienzan a musicoteraputas hablan y escriben del tratamiento en
formar parte de los recursos propios del musicoterapia como una propuesta de actividades
musicoteraputa o del maestro de musica destinados a lograr objetivos claramente expresados,
especializados quien se maneja en la integracin de relacionados con la organizacin simblica,con la
acuerdo a los principios psicogenticos y estructuracin del lenguaje y las estructuras del
psicodinmicos que los originaron pero en el aqu y pensamiento gue lo acompaan as como otros
ahora'. aspectos cognitivos y de socializacin.Ej:Se recalca la
importancia de las actividades ligadas a la msica y al
movimiento (Reccia, 1976). Se propone trabajar con
La voz cantada y el entrenamiento rtmico es un
elementos sonoros seleccionados de acuerdo a la
coadyuvante fundamental para el logro de una mejor
audiometra modificando trabajos anteriores en donde
expresin verbal (Reccia, Ferragina, Perez,Rens,) Se
el juego y la imitacin permita solamente la
comienza hablar de educacin psicomotriz, dilogo
estructuracin de posibilidades de expresin
corporal, (Vayer, Reccia) y se subraya la importancia
automtica.
del proceso vivencial

Alrededor de 1982 se consigue inclur en el Anexo de

1212
ttulos el de musicoteraputa, pero con carcter En el prximo perodo (1982-1992) se cristaliza la
supletorio. necesidad de trabar la idea del contexto y la demanda
de ayuda como elementos importantsimos en la
formulacin del encuadre.
E1 musicoteraputa como auxiliar de la medicina,
En el-area de la SALUD MENTAL surgen dos nuevas
comienza ocupar lugares en el sistema de educacin
especialidades:
especial. Se enfrenta con la problemtica de que su
perfil de formacin no lo prepara para ello. Sin embargo
supera el desafo. Es el comienzo de una
. Musicoterapia en Geriatra.
conceptualizacin basada en la experiencia y desde la
especialidad.
. Musicoterapia en Adicciones.

En este perodo se separan definitivamente los

caminos de la educacin musical teraputica y la Los musicoteraputas que se desempean en este
musicoterapia como propuesta con objetivos area (salud mental) comienzan a buscar espacios de
terapeuticos. E1 acto del trmino queda cada vez ms supervisin y de formacin didctica
delimitado.

1213
La musicoterapia en el area predominantemente En 1982 AMURA edita su primera revista,
MEDICA se incluye formalmente en el tratamiento del Desafortunadamente no pudo convertirse en una
paciente afsico.(Wagner 1980) publicacin regular por la falta de recursos.

Se abre un nuevo campo en la investigacin del En 1982 aparece el libro "Msica, movimiento y
complejo sonido-ser humano: la neurosonologa terapia",del MT.
musical como rama de la especialidad de
Carlos Fregtman Este libro surge como resultado de su
neuropsicologa.
experiencia de trabajo en una comunidad de da para
adolescentes. En lo terico utiliza el trmino "sonsfera"
como equivalente a la atmsfera sonora. A partir de
II.2.3. 3er PERIODO. LA BUSQUEDA DE UNA
este momento el concepto de elemento sonoro se
IDENTIDAD PROFESIONAL. 1982-1992.
tiende a reconocer imprescindible para el desarrollo de
E1 contexto histrico en que comienza este perodo es
su personalidad. Su formacin con Fedora Aberastury,
complejo.
creadora de la llamada "sistema consciente para la
En 1983 accede a la direccin de la Carrera de tcnica del movimiento" lo remite a la energia humana
Musicoterapia de la U S. la MT Elcira Belloq. como complejo energtico vital. Incorpora a su
conceptualizacin las formulaciones de Wilheim Reich.
La alternativa de la formacin en bioenerga o en

1214
biosntesis como especialidad post-grado comienza a
ser tenida en cuenta.
En lo musical se tiende a considerar
Benenzon publica su "Manual de Musicoterapia" (1985). indiscriminadamente la produccin de msica
estructurada como el resutado de mecanismos de
Comienzan formarse grupos de musicoterapia
defensa No se tema en cuenta en lugar de estos
didactica como espacios de crecimiento profesional.
mecarismos en la estructuracin de la personalidad
interpretndolo como sntoma patolgico.
Se produce una reorganizacin de contenidos de las
materias de la Carrera de Musicoterapia de la U.S. Este
En enero de 1984, visita a Bs.As. Andr Lapierre de
perfil musicoteraputico prvilegia el uso de las formas
Francia. La psicomotricidad relacional replantea y/o
pre-musicales y musicales como estructurantes del
complementa los enfoques ms difundidos en
proceso de simbolizacin. Las materias psicolgicas se
musicoterapia.
organizaron teniendo en cuenta los estudios de Lacan
(1983) Por otro lado la formacin musical focaliz sus E1 encuadre no verbal propuesto por Benenzon (1985)
objetivos en perfeccionar las posibilidades de estudiar se entremezcla con la de Lapierre. Los conceptos de
la improvisacin espontnea del paciente como "regresin", "fusin","separatidad"," objeto
equivalente a la asociacin libre de ideas, tcnica intermediario","objeto mediador" y " objeto transicional"
escencial en psicoanlisis. son utilizados con frecuencia.
1215
Ej. el trmino "objeto intermediario" es propuesto por los como diagnstico y tratamiento en musicoterapia"
siguientes autores: Robas Bermudez, Juliette Alvin, (Wagner 1985, Benenzon-Wagner "Musicoterapia
Rolando O Benenzon Este ltimo lo complementa con didctica" presentada en el V Congreso Mundial de
la del "objeto integrador" al referirse a las posibilidades Musicoterapia, Gnova, Italia ).
de los instrumentos musicales de ser, adems de
prolongacin del cuerpooi,instrumento de conunicacin
capaz de actuar teraputicamente sobre el paciente Despus de varios intentos, finalmente se organiza la

mediante la relacin, sin desencadenar estados de atencin pautada de la persona afsica en

alarma (1985). musicoterapia A1 incorporarme en 1980, (Wagner) el

Centro de Investigacin y Rehabilitacin del Afsico
(CIRA) del Centro de Educacin Mdica e
La concepcin de Winnicott, es expresada en su Investigaciones Clnicas "Dr Norberto Quirno", se abren
"Realidad y Juego". (Introducida como bibliografa dos puertas al mismo tiempo: para los pacientes,
obligator en la U.S , 1976) A partir de ah, podemos tcnicas sonoro-musicales y de movimiento que
encontrar frecuentemente el uso del trmino "objeto ayudan a su recuperacin y para la investigacin, y la
transicional" y de "espacio transicional" Ambos llevan comprensin de nuestra actividad como teraputas la
implcitos una concepcin psicogentica y posibilidad de la formacin en Neuropsicologa y en
psicodinmica del lugar de la improvisacin clnica Metodologa de la Investigacin en Medicina. Nombres

1216
para tener en cuenta: Prof S Rubio, Dr. R. Cacuri, Dr. R. democratizacin del pais incidieron favorablemente en
Allegri, Dr. L.Tamarof, MT. L. D'Asero MT. C. Fontana, su desenvolvimiento. Seminarios, jornadas, cursos,
MT. V. Snchez, MT.G.Alcoba y otros. publicaciones regulares - no tantas como quisieramos-
y muchas otras actividades nos hacen sentir que
E1 estudio de las capacidades musicales involucradas
estamos creciendo en este camino de
en la organizacin simblica y la comunicacin humana
autoreconocimiento profesional as como en el del
se enriquece con el estudio fenomenolgico de las
logro del reconocimiento de nuestra identidad como
mismas y con un posible aporte a los estudios
musicoterapeutas por la comunidad En este caso sin
relacionados con la localizacin de funciones de la
duda me refiero a la delimitacin de las incumbencias
actividad musical
asi como a la reglamentacin de la profesin.
Desde mi punto de vista personal (Wagner) estos
estudios pueden ser base para la eventual elaboracin
de mtodos teraputicos de rehabilitacin del lenguaje Los musicoteraputas tenemos cada vez ms
tomando en cuenta las funciones musicales. ingerencia en la estructuracin de los espacios de
formacin. Cada vez ms, pero no lo suficiente. No
fumos consultados al disenar las nuevas carreras de
La actividad de las asociaciones de musicoterapia de la
musicoterapia (Instituto Superior del Paran y
Argentina fue creciendo y afirmndose en este perodo.
Universidad de Buenos Aires.)
Los cambios polticos ocurridos durante el proceso de
1217
En 1986, una de las autoras asumi como directora de E1 sistema de ideas que di lugar al diseno del perfil
la Carrera de Musicoterapia, (Wagner) y en 1989 la otra profesional del musicoteraputa argentino fue, sin duda
(Prez) como Jefa de Prcticas Clnicas La directora alguna, muy original y pionero Como espacio de
actual es la Lic Leonor Alemann. formacin la U S. sigue siendo el de mejor nivel
acadmico. Sin embargo se hace necesario el
reconocimiento de los cambios a nivel de los marcos
Hara falta mucho espacio para nombrar uno por uno a
tericos referenciales para formular nuestas
todos los musicoterapeutas que trabajan, ensenan,
propuestas teraputicas.
escriben y publican como tales. An, la bibliografa
. A partir de 1982 se hace clara la intencin del
adjunta es slo parte. A1 no haber tiempo y espacio
musicoteraputa de construir un marco referencial
para ello, slo podemos recordarlos
terico propio.
Nosotros somos la comunidad de profesionales,
Autores como Ruiz, Rodroguez Espada,
nosotros todos
Ferrero,Schapira, Siccardi, Pellizari, D'Asero, Vigil,
Rodriguez P. entre otros, son testimonio de ello. Sin
LOGROS Y CAMBIOS. embargo, an hoy es frecuente encontrar entre
nuestros colegas una ferviente
1218
adhesin a diferentes corrientes psicolgicas y reservas y recibe derivaciones especialmente como
filosficas como marco de referencia para la alternativa teraputica en la atencin problemticas de
comprensin de los procesos musicoteraputicos. Esta diferente etiologa donde la sintomatologa
sonorizacin de las diferentes teoras de la predominante es el aislamiento muy severo en algunos
personalidad es sin duda enriquecedora pero NO casos, y en donde la idoneidad profesional del
SUFICIENTE PARA UNA COMPRENSION PROFUNDA musicoterputa esta ampliamente demostrada por la
DEL EFECTO TERAPEUTICO DE LOS PROCESOS realidad y la bibliografa consultada.
MUSICOTERAPEUTICOS.
. E1 musicoteraputa es includo en el sistema de
LOS MUSICOTERAPEUTAS DEBEMOS LLAMAR LA educacin diferencial an cuando, al menos la
ATENCION SOBRE LOS FENOMENOS CORPORO- propuesta de formacin de la U S no brinde una
SONORO-MUSICALES QUE PERMITEN LOS formacin pedaggica especfica sino que forma al
CAMBIOS POSITIVOS OBTENIDOS Y QUE NO SON alumno en los principios psicolgicos que sustentan un
OBJETO DE ESTUDIO, POR EL MOMENTO, DE proceso de apredizaje como actitud y posibilidad
NINGUNA DE LAS LINEAS PSICOTERAPEUTICAS humana, as como propone prcticas supervisadas en
MAS DIFUNDIDAS. la especialidad (Coccia, Rodriguez R.1992)

. E1 musicoteraputa es consultado es incluido sin . E1 musicoteraputa es solicitado y apoyado por la U S.

1219
como abordaje teraputico en la atencin de pacientes en el abordaje sonoro-musical del nio autista
de cuidados intensivos (terapia intensiva de adultos y (Benezon, Gainza, Wagner 1992), sus limites se dan
enfermedades terminales) . desde la realidad humana de cada uno de nosotros. Es
un conocimiento que se basa en la accin
E1 musicoteraputa est includo en el sistema de
rehabilitacin de diferentes deficiencias relacionadas Como recurso teraputico, la musicoterapia se basa en
con la percepcin sensorial, de la motricidad , de la capacidades inherentes al hombre pero no estimuladas
comunicacin, y del sistema nervioso central. en forma sistemtica por nuestra cultura occidental.

NOTA: nuestra hiptesis de base para este "xito" son III. CONCLUSIONES.
fundamentalmente dos,

Los musicoteraputas argentinos coincidimos en

. Nace de un "hacer" que poco a poco se convirti en considerar la improvisacin clnica como tecnica
tcnica.Su sustento terico nacio de la obra de escencial en musicoterapia.
personas que partieron de sus propias vivencias
relacionadas con una actividad sonoro-musical
inherente al hombre. Si su orgen en la Argentina est Podemos hablar de una clara tendencia de elegir como
especializacin el campo de la salud mental.( 68% de
1220
103 encuestados.) Dado que el discurso ms difundido
para la comprensin de la problemtica psiquitrica es
a. La inclusin de recursos teraputicos desde el
la psicodinmica psicoanalitica y post-psicoanalitica,
lenguaje premusical y musical.
LAS INTERVENCIONES MUSICOTERAPEUTICAS en
esta area se basan sobre las siguientes hiptesis:
b. La inclusin de recursos teraputicos desde el
lenguaje predanza y de la danza
Una comprensin psicodinmica del material de
improvisacin clnica
c La posible inclusin de objetos intermediarios

. Un hacerse cargo del material transferencial y contra- sonoro-musicales.

transferencial como material de base para un posible

trabajo teraputico (Teora del vinculo, ISO
Nota : personalmente considero que la tcnica
complementario.) Desde esta ptica la musicoterapia
escencial en musicoterapia es la asociacin corporo-
es considerada como rama de la psicoterapia La
sonoro-musical en interaccin.
interaccin de la transferencia y la interpretacin de lo
latente desde la interaccin no verbal son recursos y/o Se toma como punto de partida la expresin individual

tcnicas que presuponen : y/o grupal privilegiando el lenguaje no verbal corporo--

1221
sonoro-musical de la danza a partir de una consigna implica hablar de asociacin libre de ideas corporo-
verbal o no verbal. (Se aclara que desde este punto de sonoro-musical en interaccin: presupone sin duda la
vista el encuadre no verbal lleva como consigna la existencia de una sintaxis mental, un cdigo, una
inhibicin temporaria de la- palabra para dar lugar a estructuracin de la realidad interna y externa desde
otras capacidades.(Wagner 1992). estas posibildades humanas.

Dado gue nuestra vida interactuamos constantemente

utilizando nuestras posibilidades verbales y no verbales
Se considera fundamental perfeccionar nuestros
estas situacin sin duda es artificial y los lmites que ello
recursos para un anlisis de las estructuras sonoro-
implica pueden ser trabajados como parte del proceso
corporales de asociacin libre de movimientos danza,
de crecimiento personal del paciente.
sonido y msica.
E1 punto c. es a su vez fundamento terico para incluir
la construccin de instrumentos musicales como
recurso y/o tcnica en musicoterapia en la Argentina. E1 encuadre neuropsicolgico de la evaluacin sonoro

Debemos reconocer la obra de Benenzon como un musical considera la expresin libre sonoro-musical

aporte fundamental para la comprensin terica de los como un testimonio de las capacidades no estimuladas

fenmenos observables y descriptos. en forma sistematica desde la cultura. Por otro lado
recordemos que filogenticamente y
Se considera importante reflexionar acerca de lo que
ontogenticamente la danza y la msica surgen como
1222
una unidad. efectividad como teraputas.

Este enfoque nos acerca al "sustento biolgico de la BIBLIOGRAFIA SELECCIONADA.

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1237
4.4.- PROFESSIONAL PROFILE OF THE MUSIC 4. Music therapy societies in Belgium
THERAPIST - PERFILPROFESIONAL DEL
MUSICOTERAPEUTA (ABSTRACTS) The possibilities and the future of music therapy in
Belgium will be illustrated at the same time.

M U SI C T H ER APY I N BEL G I U M / L A This document will also attempt to give a picture of the

M U SI C O T ER API A EN BL G I C A search for identity of the Belgian music therapist. At the

same time, it hopes to present the possibility for an
J OS D E B ACKER exchange of experiences between music therapists
form several countries, expanding the training and
trying to find the right definition of the music therapist.
This document contains a short historical sketch of the
development of music therapy in Flanders. The
following existing music therapy situations are being Este documento contiene un breve esbozo histrico del
examined more closely: desarrollo de la musicoterapia en Flandes.

1. Psychiatric field (examination of methods) Se estudian de forma ms profundizada las siguientes

situaciones de la musicoterapia:
2. Field of orthoagogic music practice
1. Campo psiquitrico (estudio de los mtodos)
3. The actual state of the old 5 year music therapy
training plan which is presently being developed 2. Campo de la prctica de la msica ortoaggica
1238
3. El estado actual de los primeros 5 aos del plan MUSICOTERAPEUTA (CONFERENCE
HANDOUTS)
de formacin de musicoterapia que se est
desarrollando actualmente. T H E R ESPO N SI BI L I T I ES O F T H E M U SI C
T H ER API ST
4. Asociaciones de musicoterapia en Blgica.

Al mismo tiempo se ilustran las posibilidades y el futuro R UTH B RIGHT.

de la musicoterapia en Blgica.

Esta ponencia intentar tambin dar una idea de la If we are to be Music Therapists and not simply
bsqueda de identidad de los musicoterapeutas belgas. musicians who happen to work with those who are
As mismo, espera poder presentar la posibilidad de disadvantaged, and not simply psychotherapists who
intercambio de experiencias entre musicoterapeutas treat psychological problems, we have a wide range of
procedentes de varios pases ampliando la formacin y professional responsibilities.
tratando de encontrar la justa definicin del
musicoterapeuta.
The details will in part depend on the population with
whom we work, so that a music therapist who

4.4. - PROFESSIONAL PROFILE OF THE MUSIC specialises in autism will have somewhat different tasks
THERAPIST - PERFILPROFESIONAL DEL compared with a therapist who specialises in palliative

1239
care. But despite these differences there are four base and skills outlined above.
fundamental directions of responsibility which are -
* The Therapist's own self-knowledge and ethical
common to all populations, obligations which we must
obligations
fulfil if we are to meet the deepest level of need in our
clients.
How do we achieve fulfilment of these
responsibilities?
These four are:
Clearly there is some overlapping between my topic and
* Music Knowledge and Skills: The development,
the therapists, but we cannot consider our
maintenance
responsibilities without at the same time asking
and improvement of our music skills in a wide ourselves we need certain skills and what these skills
competencies. should be.

* Therapy Knowledge and Skills. The development,

maintenance and imprqvement of our knowledge base
1. Music Sikills.
as it relates to the disabilities and/or diseases of the
people we are likely to meet in our work as therapists. We must achieve a high level of competence in our
music skills, and although most therapists specialise
* The applications of music in therapy to the knowledge
after completing their training, we need to start with
1240
level of achievement. As we specialise, we develop
further in whatever the requeriments may be for the
In some schools of therapy, the only important music
particular population we serve.
skill is that of improvisation on the piano, to express
emotional states, life-experience etc, and possibly at
the same time facilitating the use of tuned and untuned
Although the use of recorded music can be important in
percussion instruments by clients.
clinical situations, its use as the only resource and the
only musical capability of the music therapist is open to
question. If we are to justify the title of Music Therapist,
Undoubtedly this is a skill which most therapists will
"playing" a cassette player or a pianola is not enough!
need to develop for their clinical work, but there are
others which the therapist with an eclectic approach
needs as well. These would, in my view, include some or
What more do we need and why?
all of the following:
We require a means of musical expression which is
* the development of appropriate repertoire for a
flexible enough to respond to the need of the moment,
particular population;
the changes in feeling as a session progresses from
minute to minute as more material emerges. Only "live" * skills in composition as a planned, not spontaneous
music can do this. activity;

1241
* informal, spontaneous "composition" of songs etc to interaction.
meet the needs of the moment.
Different therapists will wish to add to this list, and may
* keyboard skills such as transposition, sight-reading, wish to change the emphasis of different aspects of
playing spontaneously an accompaniment for a client's music skills, but this list encompasses general
own composition; requirements for any music therapist who is competent
to work with a variety of populations.
* playing a portable instrument in order to reach bed-
fast clients or others for whom a piano is inaccessible;

* vocal improvisation, and facilitating vocal ensemble. 2. Therapy Topics.

* ability to facilitate instrumental ensemble of all kinds We have an professional responsibility to know what
from group percussion improvisation to chamber music! any particular disease, disadvantage or disability
means to the client, how he feels within himself
* care of instruments (but not including piano-tuning!);
emotionally, physically, psycho-logically and socially.
* knowledge of music history and aesthetics, to reach
If we are to know how the client feels, we must
clients for whom "serious" music is an important means
necessarily learn about the condition itself
of interaction;

Also in order to select appropriate items from the

standard repertoire to sustain and support a particular
1242
For example, we must consider what it means and how
it feels to have, following a stroke or other brain-
We also need to know what the outlook is - do we
damage, a loss of visual fields so that one sees only
comfort the person by saying "It may get better in time"
half of whatever is presented. How does this affect the
or do we have to help the person and the family accept
person's playing of musical instruments, their behaviour
that the damage is permanent?
towards others, both inside and outside music therapy
sessions? Does the family understand why the person
may seem "different" in their family relationships? Can We need to know whether the person will Jeteriorate,
we help them understand what has happened and then e.g. in Upper Motor Neurone Disease, Huntington's
go on to use music in an attempt to bring them together disease, arthritis, Parkinson's disease, the Dementias.
again? Or it may be that the person will improve gradually, as in
Guilliame Barre syndrome, that terrifying viral-caused
paralysis. Or it may be known that the illness will soon
Such understanding is not gained through music alone
terminate in death. or it may be relatively static, as in
but by reading about the effects of hemianopia, learning
many completed strokes.
about family dynamics following disability, learning
about grief following the loss of a part of one's sensory
"equipment", and so on. The decision as to who speaks to the client and family

1243
about such things will depend on the ethos of the All these matters affect their attitudes towards
hospital concerned, but we ourselves need the therapists, their relationships with their child, and - by a
background information in order to relate apropriately in follow-on effect - also affect that child's perception of
the music therapy sessions, empathising with grief, fear; himself, probably for the rest of his life. The feelings of
relief or disappointment. the parents thus affect our work in music therapy, since
we are dealing with the whole child (or adult).
Our work, whatever form it takes, must be on the basis
of knowledge and not of wishful thinking !

Here too we have a professional responsibility to try to

understand, as far as we can, what has gone before.
Another example: how do the parents of a child with a
congenital disability feel about this tragedy? Do they
blame themselves for it, do they blame the medical
These are just two examples from an endless range of
profession for failing to avert it, do they wish the child
clinical situations which music therapists meet in their
was dead? Do they cling unrealistically to a hope of total
daily work, depending upon their area of specialisation.
reversal of the disability or can they accept the child for
We cannot learn all about everything but we need to
the unique individual he is without making their
learn about the problems of client and family, problems
acceptance of him dependent upon his changing into
encountered by the particular population with whom we
something totally different?
work.
1244
This will necessarily involve much study, e.g. of the participation in music therapy and so on.
neurological basis of the disabilities we meet in our work
Following on from this we have a sphere of the client's
the effects of spasm in cerebral palsy, the different
relationships; we must never see him as an isolated
types of aphasia in stroke victims, the varying stages of
individual with whom we work in total separation from
dementing processes in older clients, the difference
his social milieu. Today's philosophy of socio-medical
between intention end resting tremors in Multiple
care demands that music therapists, like other
Sclerosis and Parkinson's disease and how these
professionals, have a responsibility to the social unit in
tremors affect musical performance as well as
which the client is placed or from which he has come.
emotional adjustment, and so on.
Although for practical reasons we may have to work with
the client alone, we must never lose sight of the fact that
he is part of a social unit, whether this is a family or the
If we work in psychiatry, we must learn about the
social unit of a ward or nursing home, and indeed many
differences between schizophrenia and psychotic
clients belong to both groups and in such cases the
depression, obsessive and how this may affect
music therapist may be in a unique position to help
someone's behaviour in a music therapy session, how
bring the two worlds together!
to assess suicide risk in depressed persons, how post-
traumatic stress disorder affects people and what effect 3. Responsibilities application of music to therapy.
their terrifying flash-backs may have on their

1245
Bringing music and therapy together, conjoint skills. must, nevertheless, have some idea at the beginning of
what we hope to achieve, otherwise our music may be
As music therapists we can never separate the skills in
mere recreation or self-indulgence!
music and the skills in therapy, even though our study of
these may the place at different times!

Music Therapy goals are often reached best after

consultation with other therapists; we do not necessarily
The art of music therapy lies in bringing together our
accept their goals as our own, we work in a different
music competency with our understanding of and for
medium and our hopes may be different, but only the
the needs of the client and family, which needs arise
most arrogant of therapists rejects opportunities for
from a particular illness or disability.
inter-disciplinary teamwork, since it is in the best
interests of the client if the different professions work in
Assessment co-operation and not opposition.

Part of our professional responsibility lies in assessment This assessment is followed by on-going evaluation,
(before we start or in the early stages of our work) so using whatever methods are appropriate, so that we
that we can set reasonable goals. Such goals must not can adapt and adjust music therapy work to meet the
be rigid or unimaginative, but must be modified - needs of the client on a progressive and not-a
reduced, extended - as the relationship develops We stationery basis.
1246
 that we can have some idea of whether or not there is
generalisation or whether the outcome is restricted to
We observe for ourselves how behaviour changes in
the music therapy room. of course both are valuable to
the music therapy session itself, and take careful notes
the isolated individual but it is helpful to know, as part of
of these: better eye-contact? Less agitated? Change in
our accountability for public funding, whether there is
style of singing or playing? participating with the group
generalisation.
or better alone?

Planning our work.

But it is wise also to ask ward staff to assess whether the
client behaves differently (worse? better?) after a music In making assessments so that we can plan our work,
therapy session. We may need to ask the family much of our preparation consists of answering (or trying
whether the child's levels of communication are to answer) our own questions!
different (better? worse?) after a music therapy
e.g. (a) asking ourselves whether this person reacts
session. Is the child happier? Sadder?
better to individual than to group work? If so, do we
need to encourage group work now or is the client not
yet ready, does she have a need for individual attention
And it is on the basis of this total assessment, through
to deal with some difficulty in life? Will she do better if
the answers to these and other questions or check-lists
the attention is "diluted" in group situation?
1247
 nystagmus prevents him from using eye-movements as
a signal I have recently faced.)
Does this client respond best to vocal or pianistic
improvisation or to song-writing on topics of her own
choosing? Does she respond best to male or female
Do we provide music with which he is familiar in order to
therapists and (if there is a difference) why? Would she
build a trust relationship before moving to other types of
do better with a colleague of the opposite sex from
music or will this elicit a grief reaction which -because of
herself or a same-sex music therapist?
his brain damage - he cannot deal with?

Asking ourselves about a client suffering from brain

These and similar questions sometimes have to be
damage (paralysed, aphonic, perhaps the result of an
faced by music therapists in making initial assessment
accident: has he passed the stage of hypersensitivity to
and on-going evaluation, unless we opt out by saying
sound so that we an use music at a moderate volum?
"That is too hard for me!"
He has only previously enjoyed noisy pop music - what
music do we present to him when he cannot indicate
any choice or decision? How can we assess enjoyment On the basis of this self-questioning we shall plan
or dislike in such a person (described as being in coma whatever is appropriate for music therapy for the
vigil) whose only movement is in his eyes, but for whom person's particular disease or disability, his personal
1248
emotional needs as far as we can know these, his 6- 8 months, still seeing progress yet avoiding
musical taste and preference at present, although dependency issues by careful monitoring and
perhaps with the aim of widening this, and so on. supervision of one's own work.

The on-going evaluation is also part of our Appropriate separation from the client is also part of our
responsibility, and this leads to accepting a ethical responsibility towards him, we do not simply
responsibility to cease therapy when evaluation shows send a message to say "No more Music Therapy!"
that no further benefit can be gained from our continued
work.
4. The Music Therapint's Self-knowledge.

"Physician, know thyself!" is wise advice not only for

Different schools of therapy have different ideas on this,
physicians but for music therapists too, and we have a
so that the psycho-dynamic approach, whether in music
professional responsibility to try to reach that goal!
or other therapies, may accept a long-term commitment
lasting perhaps years. Other therapists prefer to keep to
a relatively short involvement, say 6 weeks or so, in We must have clear comprehension of why we
order to avoid dependency becoming a problem. In ourselves behave as we do. How do we feel when a
other situations, one can work with a client for perhaps client rejects therapy? Does this seem to confirm
1249
attitudes built into us in childhood, that nothing we do essential if we are avoid burn-out or other difficulties.
will ever be right and lead to a feeling of failure?

Different people approach the matter differently; some

Or were we given the belief that everyone has undergo their own psycho-analysis; others attend
successes and failures, nobody can reach all his goals unstructured groupwork in order to be challenged by
and that it is O.K to fail sometimes? their peers; some attend music therapy workshops for
therapists. There is no end to the ideas, but the basic
need remains the same - to understand oneself and the
If our own self-esteem cannot take failure or rejection,
extent to which one's own problems (from which none of
then the patient who does not get better, who rejects us
us is free) affect our work and relationships with both
and our offers of music therapy, or who commits
clients and staff. One needs to recognise, for example,
suicide, engenders in us such feelings of failure that we
that not only transference occurs between client and
may over-react by becoming "rescuers", or by blaming
therapist but also counter-transference. The music
the patient, or by accepting too much of the blame
therapist who denies or ignores this issue will find
ourselves.
difficulties in working with a number of his or her clients.

Self-knowledge and honesty about ourselves is

1250
For long-term work in music therapy with a client, information may well be of crucial importance in
supervision is important and it is part of our professional successful overall treatment!
responsibilities to make appropriate arrangements for
this.
If we find, for example, that a client has difficulty with
male staff because she was incestuously sexually
In all this, our aim is to work to best effect with people, abused as a child and any staff member who reminds
both clients and colleagues, avoiding harmful effects her of her father is avoided, it is, I believe, our duty to
due to At our own personal, unrecognised "hang-ups". pass this information on in very general terms because
this behaviour may not be recognised for what it is by
Ethical consideration.
other staff.
The idea of sharing information with our colleagues is,
for some, a thorny problem! We must maintain
confidentiality, but this must not be an excuse or a Music provides an almost unique opportunity for
reason for ignoring our ethical obligation to share with building relationships, and (so long as the client is
our colleagues any information which has a bearing on aware that we work as part of the clinical team and that
treatment planning, and prognosis. It is nice to feel that we shall be sharing important information in general
"We are special" but the total welfare must take terms, even if not in detail,) then there is nothing to be
precedence over our professional pride, and passing on lost and much to be gained for the client's own well-
1251
being by such sharing. discussion in recent years as it relates to the "Duty of
Care", i.e. the ethical and legal obligation to pass on to
the appropriate person(s) information as to risks (a) that
It is also important to recognise the risks of the
the client may commit suicide or (b) may harm another
manipulative patient splitting the team "I will tell you
person. It is now included in the code of ethics of
because you are the only one who understands but you
psychiatrists that confidentiality must not over-ride the
must not tell anyone else!"
duty of care, to prevent harm to the patient or to
others.Thus one is legally and ethically obliged to pass
on immediately information about a patient who says he
This is commonly heard, and it is flattering to feel that
plans to commit suicide. Similarly if he says he is going
we alone are trusted, keep secrets entrusted to us, and
to murder someone or otherwise harm another person,
so on. But the probability is that everyone else in the
ethical responsibility demands that this information is
team has been told the same thing and there is an
passed on and not kept as secret. [varassof reference]
intention of splitting. (I find it useful when I am warned of
this in the referrals I receive, it save a great deal of Music Therapists may see themselves as outside such
heart-searching and decision making !) dilemmas, but they can arise and we need to know
beforehand what to do if such a situation occurs in the
context of a music therapy session.
Confidentiality is an ethical issue which has been under
1252
Music Therapists (who so often receive people's most Any research planned must be submitted to a research
intimate confidences) need to be aware of other ethical committee of the establishment or the ethics committee
implications of their work as such. Although we have an of the Music Therapy professional association to ensure
obligation to pass on information to fellow-clinicians, we that it complies with requirements of the United Nations
must never pass on information, however interesting, to on research in human subjects. But this is only part of
those whose do not need to know, especially friends or our general professional responsibility to do good and
relatives of the client. not harm.

When arranging for publication of our work, case We must maintain the highest possible standards of
reports must be adequately disguised to ensure the professional excellence and professional ethics, for the
privacy of those involved. benefit of the client and also of our profession.

It is also our responsibility to ensure that our students

who have access to confidential files are fully informed
SUMMARY
as to the ethical requirement to keep to themselves any
information they gather in the course of a placement,
both at the time and in the future.
1253
Music Therapists must see themselves as therapists
and not simply as musicians We have responsibilities
towards our clients, responsibilities to maintain our own T H E U SE O F VI D EO BY T H E M U SI C

standards of work in music, in therapy matters and in T H ER API ST - T O WAR D S A C L EAR ER

the bringing together of these. We also have ethical and PR O F ESSI O N AL I D EN T I T Y.

moral responsibilities towards our clients but also AMELIA OLDFIELD, M.PHIL. RMTH
towards society.

SUMMARY:
We are accountable to the society in which we live and
This presentation will begin with a paper which will
work to do that work in terms of the needs of both clients
explore all the different uses a music therapist might
and society.
make of video-equipment. These as well as for
reference and teaching purposes. The advantages and
Responsibilities should not, however, be seen as disadvantages of videos will be examined.
restrictive but as challenges to extend our professional
work for the benefits of clients and their families. and for
The author will then look at the role of the music
the community as a whole.
therapist within the and discuss what kind of

1254
professional identity music therapists have or would like
to have. Ways of creating different types of professional
Introduction
images will be looked at and in particular how the use of
videotapes of clinical material can influence this However intense a musical experience is, once it is over

procedure. one has to rely on memory to recreate or remember the

event; Unlike a painting which provides tangible
evidence of an artistic creation, a musical performance
A thirty eight minute music therapy training videotape of or improvisation can not be handled or visually
the author's Development Centre will then be shown. examined. For the music therapist, this ephemeral
The author will explain how and why this video was nature of music can be an advantage as it may allow a
made with particular reference to two previous client to express him or herself without feeling that he or
unsuccessful attempts to make training videotapes. she is committing themselves in any way. The
disadvantage is that the therapist has to rely entirely on
memory to analyse the work that has been done.
After the viewing the author will encourage participants
to ask questions and make comments. The different
types of professional identity a video of this type will Over the past few years, music therapists have been
create for the music therapist will be discussed. videotaping music therapy sessions in order to review
their work more effectively. Videorecordings have
1255
helped music therapists improve their work with identity will be threatened.
individual and groups of clients and have also been
extensively used for training purposes. Extracts of
music therapy sessions are often showed during This paper will examine the advantages and

teaching sessions or workshops by individual music disadvantages of videos and the different uses that

therapists and several training videos have been made music therapists make of videoequipment. The focus

for more general use. Various music therapy sessions will then be on the use of video for training purposes

have also been televised. and on the effects music therapy on the screen may
have on the identity of the music therapist.

Advantages and disadvantages of video

Music therapists in Great Britain have often reacted
strongly to therapy programmes or music therapy Many music therapists record some or all of their

videotapes. Although it is generally accepted that music sessions on audiotape. Audio recordings can help the

therapists should inform other people about their work music therapist and in some cases the clients to

and that videotaped examples of music therapy recapture, remember and analyse musical moments

sessions greatly aid this process, music therapists together. But there are various disadvantages.

seem to fear that assumptions will be made about their Analysing and understanding audiotapes, is very time

own style of work and that their own professional consuming and difficult for anyone who is not used to
analysing music. Clients will often loose interest in
1256
listening to their own recordings and be disappointed by doing what. When viewing the video tape it is
the chaotic sound of their improvisations. It may be immediately evident that the little girl is communicating
difficult to distinguish who is playing each instrument actively and enthusiastically with me. Our body
and background noises and talking will interfere. language and actions are an important part of the
therapeutic process. Although the music is essential, on
Videorecordings of music therapy sessions are much
it's own it does not convey the purpose or the creativity
easier to follow. For the music therapist,
of this session.
videorecordings provide the enormous advantage of
following the process involved in the music making
rather than focusing purely on the sounds involved in
There are also some disadvantages to videorecordings.
this process.
Clients (and/or parents) will always have to be informed
I once recorded a music therapy session on audiotape. that they are being videod and some people may
as well as having the session videotaped, and then choose not to be on camera. Unobtrusive cameras and
analysed both the audio tape and the videotape s microphones may not always be available and the client
and the therapist may be influenced by the camera or
From the audio tape it is possible to hear the little girl I
the person holding the camera.
am working with, request a familiar nursery rhyme. One
can then hear a variation of this nursery rhyme played However, people are getting more and more used to
on the piano by the two of us but it is unclear who is being on "video" and children in particular often tend to
1257
think that this is nothing out of the ordinary. Even self technical difficulties with the machines. Editing tapes for
conscious parents will gradually forget about the teaching purposes can be a very lengthy process which
videocamera as they become accustomed to it. requires special equipment and usually the help of a
Occasionally the use of a videocamera will spur a client video specialist. However, as equipment improves, and
(or a therapist) on to make a greater effort and provide music therapists become more used to using video,
a stepping stone for further treatment. more and more music therapists are making use of
video for a variety of purposes.

It must be remembered that videorecordings can

sometimes miss crucial moments and may not give us The use of video for assessment and treatment
all the information we need. The camera may be purposes
pointing at the wrong person for example, and it is very
Videotapes are particularly valuable in the initial
difficult to videocamera.
assessment period with a client. In the early stages the
music therapist has to establish a relationship with the
client, assess the needs of the client and introduce new
It must also be remembered that viewing and analysing
instruments and new ways of interacting. As the music
videotapes is very time consuming. It may take time to
therapist is doing so much at the same time, much can
find the particular moment a music therapist is looking
be gained from observing the session again on a
for in a session and time will often be wasted by
1258
videorecording. Other professionals could also be
asked to observe the recordings, particularly if the
One of the great advantages of videotaping music
music therapist has questions regarding the diagnoses
therapy sessions is that when examining the videotapes
of certain problems. It may also be easier to observe the
a music therapist will be able not only to look again at
clients "purely" musical reactions at this stage, before
the way a client is behaving but also to examine how he
client and therapist are emmeshed in a close
or she is interacting with a client. This can be very
relationship. For example, one might be able to
helpful it is not always easy to evaluate one's own ways
determine whether a child is repeating a characteristic
of interacting, particularly when one is focusing entirely
rhythm such as or responding to the tone colour of a
on the client. When analysing videotapes of music
particular instrument.
therapy sessions a music therapist may, for example,
Early videorecordings are also very useful as a point of feel that he or she is being to directive or that a client
comparison at a later stage of treatment. Although it is needs more continuous musical support. The music
tempting to wait until a good relationship is established therapist may also discover subtle movements or
with a client before videotaping a session, early sounds that had not been noticed before.
videotapes will shed light on how the relationship has
progressed. Videotapes taken at different stages of
treatment can be compared and will influence the way in Videotapes of music therapy sessions can usefully be

which treatment progresses. shown to parents or

1259
other professionals involved with a particular client, in their children were presenting that they needed
order to discuss progress or pass on suggestions. reminding that at times they were able to have fun
Parents might be surprised to find how well a child is together as a family. Videotapes of family sessions will
concentrating when engaged in a musical often help parents and the music therapist to identify
improvisatidn, for example, or a physiotherapist might and focus on particular communication difficulties.
pick up a song that a child particularly likes to Families may also be agreeably surprised by the
encourage walking. amount of cogress they have made when comparing
videotapes taken at different stages of treatment.

Videotapes of music therapy sessions can be viewed by

the music therapist and the family to discuss the ways in Videotapes that can remind a client of a positive or
which different people are interacting. One mother was exciting moment can be of great value to depressed
surprised to see how little she was looking at her son in clients or difficulties believing that anything they do is of
a musical conducting game, for example. Some other value. One of the most moving therapeutic uses of video
parents couldn't believe how well behaved the two tapes that I have come across was that of the music
children they perceived as naughty and disruptive were therapist Barbara Griessmeier working on a children s
when they were all singing an action song together. cancer ward in Germany. The therapist videotaped
These parents were so concerned by the difficulties some music therapy sessions of a little girl who was

1260
actively and happily involved in an energetic action means that observers can "practice" viewing video
song. Later on when this same child was very ill and tapes until they reach a high enough percentage of
rable to move she requested that this videotape be agreement for their findings to be considered as reliable
shown to her parents. The child was obviously greatly data for research purposes. It also enables findings to
relieved to be able to help her parents focus on her be revised at a later stage or to be re-used for other
former energetic self rather than on her present state. types of investigations. For example, in 1986 I
Barbara Griessmeier also made use of videotape to try completed a research project where we used video
to reassure children about some forms of frightening recordings to compare the effectiveness of music
medical interventions such as epidural injections. She therapy to that of play activities with a group of adults
showed a video of a child breaking out into song during with severe learning difficulties. (Oldfield 1990). Later
this procedure which greatly reassured other children on, I re-used the same videotapes to analyse staff
who needed these injections. (Griessmeier 1991). behaviours in the sessions and to evaluate a music
therapy assessment procedure. (Oldfield 1993).

Music therapists have also made use of videotapes for

research purposes. Sessions can be viewed again and Finally, it must be mentioned how useful it is to use
again by any number of people which allows the videotapes for students on clinical placements.
analysis of the data to be relatively objective. This Students' interventions with clients can be analysed in

1261
great detail not only by the supervisor but also by other other uses of music and relate these to music therapy.
tutors and students. In particular, it may be possible to One taxi driver I once talked to, for example, was
encourage students who lack confidence by focusing on convinced that music therapy was related to playing
moments of successful interaction in a particular music to cows to promote milk production. Having an
session. It is often well worth while videoing the student unusual job that hardly anybody knows about gives the
in action at the beginning of the placement and music therapist " carte blanche" to describe his or her
comparing this with the students' work at the end of the work as accurately as possible without having to
placement. Students will often progress so fast that they overcome previous misconceptions. The music
will forget how uneasy they initially felt. therapist therefore has an advantage over an
"engineer" or a "computer programmer", for example,
who will only rarely be questioned about his or her
The use of video for training purposes
occupation even though many people may have no real
Music therapists are used to having to explain what they idea of what being an "engineer" or a "computer
do to other people. The combination of the two words programmer" involves.
"music" and "therapy" excite curiosity and interest. Most
people will have never heard of the profession although
Nevertheless, this situation also gives the music
some will have listened to a program about the subject
therapist an added responsibility and, at times, most
on television or radio and others may have heard of
1262
music therapists will wish that they could answer the therapists find that quite a substantial amount of their
question "what do you do?" without having to go into time has to be spent on in-service training.
lengthy explanations. Several music therapists I have
When planning in-service training most music therapists
talked to, have admitted that they have occasionally
find that a combination of talks, workshops and showing
avoided answering questions about their profession or
videotapes of music therapy sessions work best. When
simply invented another job spur of the moment. While
talking to people about music therapy for the first time I
this is possible when talking to strangers one is unlikely
think it is important to emphasise the straightforward
to meet again this is obviously not possible in the
and simple aspects of my work. Music therapy is often
working situation.
surrounded by a mysterious aura. People hear sounds
coming from the music therapy room and wonder
vaguely how it all works. I, therefore, often start a
Although music therapists who work in small centres or
presentation off by explaining that I use music as a
schools may not have to exolain what they do to fellow
means to an end and that my work is sometimes very
professionals all the time, they will have to inform new
simple even if the processes involved are quite
members of staff, visitors and students on placement,
complex. I might use the example of helping a very
and possibly also clients or parents. The larger the
withdrawn child to look up at me when singing a song
centre in which the music therapist works the more
and encouraging him or her to clap my hands. The
explaining will need to be done and some music
activity itself is very simple but the way I am doing it may
1263
not be. The child might look away and I might change member of the have. This is different from speech
the tempo of my song to get his or her attention back. I therapists, occupational therapists and physiotherapists
might also change the volume or the tone colour of my who each specialise in particular types of problems a
singing to match the childs' changes of mood or energy. child might be having.
I also try to get across the idea that while some of the
music I use is quite basic, at other times I might be
playing more complex improvisations. This makes it One of the quickest and easiest way of getting these

clear that while some techniques or ideas can be points across is by showing carefully selected examples

passed on, others remain in the domain of the music of clinical work on videotape. Over the past twenty years

therapist. people have become used to absorbing information

from television. Unlike talks or audiotapes which leave a
lot to the listeners imagination, videotapes speak for
By mentioning musical parameters early on in my themselves and will therefore have a strong impact on
presentation I remind the listeners that my special area the viewer.
of expertise lies in the medium I am using (the music)
The music therapists identity
rather than in the particular difficulty of the child. Musical
expertise and the ability to make use of music in a The impact of the screen is perhaps best illustrated by

clinical setting are two uncontested skills that no other the strong reaction shown by music therapists to music
therapy programmes on television or music therapy
1264
training videos. In January 1989 the Association of therapists the presenter is no longer unique and often
Professional Music Therapists Newsletter published faced with a highly critical audience. This is rather like
numerous letters written by music therapists in an expatriate who returns home to find he is no longer
response to a television programme entitled "The an interesting foreigner but merely one of many like him.
Power of Music". There have never been as many
letters on any one subject in the Newsletter before or
since. Even in music therapy conferences those talks The two most common comments made by music

using videotapes tend to draw more criticism or praise therapists in Great Britain about their colleagues work

and lead to more fervent debates. This can be quite on video tape seem to be: "I don't work like that" and

daunting for the person presenting videotapes "that is not what I would call music therapy". (Ritchie

particularly if they are used to positive feedback from 1989). Both these remarks indicate that the viewers as

other colleagues (non music therapists) or from the well as the presenters are struggling to maintain the

general public. unique and special status that they have become
accustomed to. Thus, although music therapy sessions
on video clearly illustrate what a music therapist does,
When talking to non music therapists, the presenting this very clarity can be threatening to other music
music therapist is used to being viewed as a rather therapists because it may not fit in with the image they
interesting "artistic oddity". When talking to music are used to projecting of themselves. (Brittain 1989).

1265
 acceptable to music therapists.

As the number of music therapists in Great Britain

increases, so the music therapists will gr-adually
Conclusion .
become less unusual and less used to being seen as
"different". The number of music therapy training videos This paper has shown that inspite of some

and music therapy programmes will also increase and disadvantages, videotapes can be used in a number of

the reactions to such productions will probably become different ways to aid and improve the clinical work of the

less strong. At present, however, it is interesting that music therapist.

whereas books, articles or radio programmes on Videotapes are also very useful to the music threrapist
specific styles of music therapy are acceptable, music for training and teaching purposes. Videotapes of music
therapy on the screen is still likely to be criticised therapy sessions can help the non-music therapist to
strongly. understand how music can be used in both simple and
complex ways to aid the client.

There has been much talk of producing an Association Music therapy videos will, however, strongly reflect the

of Professional Music Therapists (APMT) video over the personal style of work of individual music therapists.

past few year end it may be that a document of this type This means that many music therapists fear that

showing different styles of music therapy would be more incorrect assumptions about music therapy will be

1266
made unless the presenter makes it very clear that Griessmeier, B. (1991). Unpublished workshop
other music therapists may work in different ways. given in London in May 1991. B. Griessmeier works as a
music therapist in Frankfurt, Germany, in a children's
This situation will almost certainly change as the
cancer ward.
profesion grows in years to come and a series of
different videos on music therapy become available. At Oldfield, A. and Adams, M. (1990). The effects of
present, however, there seems to be a slight music therapy on a group of profoundly handicapped
contradiction between the fact that on the one hand adults. Journal of Mental Deficiency Research. 34: 107-
music therapists want a high profile and a clear 125.
professional identity and on the other hand they want to
Oldfield, A. (1993). A study of the way music
be completely free to develop their own personal style
thaerapists analyse their work. Journal of British Music
of work.
Therapy. Vol 7 no 1: 14-22.

Ritchie, F. (1989). Letter to the editor. Association

References of Professional Music Therapists Newsletter. January
1989. 22.
Brittain, N. (1989). Letter to the editor. Association
of Professional Music Therapists Newsletter. April 1989.
16-17.

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PR O F ESSI O N AL I SAT I O N O F M U SI C T H ER APY

M ARTYN P ARKER -E AMES The King's edict gave the herbalists a secure and
valued position in society and the market place of that
tine, It is the creation of such positions in the modern
King Henry VIII of England had six wives, five of which world, with reference to Music Therapy, that is the
were either beheaded, divorced or died of 'natural subject of this paper.
causes' leaving the sixth to outlive him. Although not a
great believer in marital counselling, he was an
enthusiastic ant vocal supporter of herbalism. His In order to look at the occupational status of music
opinions of surgeons, with whom he must have had therapy, it is necessary to understand the sociological
plenty of contact given his state of health, was quite the concept of a profession. Although more specific that the
reverse. He condemned them for their ineffectiveness, lay use of the word, the term profession has almost as
high fess and legal harassment of the herbalists and by many definitions and perspectives as writers on the
decree granted the herbalists royal protection "all time subject, To amalgamate some of the less criticised
from henceforth". The surgeons, enviously eyeing the definitions, a professon can be described as
King's ulcerated legs, withdrew quietly waiting until 1923 occupational group which professes a unique form of
for their revenge (Larkin 1983). expertse based in higher education, which is used to
monopolise and dominate a defined market, and to
1268
demand high status and rewards for service. This and medicine, These professions held high status social
monopoly ls protected by legislation, and entry to the positions without any challenge until well into the
profession is restricted by the social boundaries of nineteenth century. At this time in Great Britain and the
entrance qualifications and an extended training Its USA, the new middle class occupations began to realise
autonomy within this market is justified by its philosophy the status, tradition and financial benefits of the three
of public service and altruism, and its self-policing professions. Aided by the laissez-faire style of
mechanisms ( Friedson 1983, Turner 1985, Abbot and government and small civil service, certain occupations
Wallace 1991). Although most I commonly seen as a seeking secure and privileged positions sought and
position to be achieved, more recent study has focused achieved state support for an exclusiory shelter in open
on professionalisation, the process by which market. These occupations also mimicked the existing
occupations attain and retain professional status professions by organising their own training and
(Friedson 1983, Turner 1987). A good example of the crediting institutions and attempted to legitimise their
process of professionalisation can be found in the efforts by assuring disinterested dedication and a
history of the Medical profession in Britain. specialised learning (Freidson 1983),

In Europe there were originally only three professional Apart from the Medical profession, healthcare in Brtain
arising out of the medieval universities; law, the clergy at this time consisted mostly of locally based and

1269
travelling healers. Many of which were incompetent and Medical Council . This eliminated medical
dangerous, but many of whom were on a par with the apprenticeship and the use of unqualified assistants. It
doctors. The Apothocaries, who to date had been also gave the medical profession the ability to
content to manufacture and dispense tho medicines determine who could practice medicine. Initially this
prescribed by the doctors, were also beginning to resulted in the acceptance or mostly rejection of
diagnose and great clients on their own. Many were different groups of healers. In effect this established for
becoming very skilled and were reapected in their own the Medics an occupational monopoly; a heirachy of
right (Donnison 1977 cited in Larkin 1983). This healthcare with medicine firmly in control at the top
represented quite a threat for British medicine not only (Larkin 1989).
was their privileged position in the healing profession
being eroded, but they were rapidly loosing a market in
the form of the new expanding middle classes. In The efficiency with which the Medics achieved such a

reaction to this situation representatives of the medical powerful and enviable position appears to have greatly

profession petitioned the government and exerted their impressed the other healthcare occupations. Many,

class based political power to promote legal seeking to solve status insecurities (Green 1991a) or

intervention. In 1885 parliament passed the , Medicine wishing to achieve more autonomy and better

Act. This legislation established a system of medical renumeration (Bruscia 1989), appear see it as a goal of

registration controlled by a medical body, the General grail like proportions. Yet the importance attached to

1270
achieving such status may be overstated if not unsuccessful. Their bill of registration was described by
erroneous. the Ministry of Health as, unusually good as Private Bills
go, but in substance most; mischievous (Ministry of
Health cited in Larkin 1983). Despite reference to their
For Music Therapy, and the Arts Therapies in general,
protection by Henry VIII, the bill was rejected on the
in Brtain and the USA, there appears to be a great deal
grounds that if the herbalists were given recognition, it
of importance attached to achieving independence
would have to be given to any other type of practice
through practice legislature (Bruscia 1989). The widely
(Larkin 1983). The surgeons had their revenge and the
held assumption that putting music therapy practice on
King no doubt rolled in his grave.
a legal footing would achieve independence, status and
Partial success was gained by the Physiotherapists,
finacial security of the other professional may not be
Occupational Therapists, Radiographers and other
true in practice. At the beginning of the century in Britain
paramedical occupations through the 1963 Profession
groups of healthcare workers, together with some of the
Supplimentary to Medicine Act. Although gaining legal
traditional healers, sought to improve their position in
recognition they were still under medical domination in
the marketplace and to achieve recognition
that they could not reskill themselves and that medical
independent from the medical profession. The Dentists
practitioners legally held the majority on the various
alone were fully successful, becoming fully autonomous
governing boards. Defined working practices are still
through new legislation. The Herbalists were
very clearly under medical supervision. Not only did
1271
legislation not free these occupations from medical by an incremental process (Green 1991a). This
dominance but did not allow exclusivity from each other, approach is criticised in that it ignores the influence of
hence the intense debate over role boundaries that still outside governmental agencies and the overlooks the
persist thirty years on. In this example legislature did not existence of other valuable and secure occupations that
ensure independence and only came part way to do not posses all the traits. As a movement in itself
ensuring better renumeration and employment professionalisation in healthcare can be criticised in that
prospects the other professed reasons for promoting any profession achieving this status is most likely to ally
legslature, In sociological terms these ocoupations itself with the medical profession and subsequently
arguably do not qualify as professionals but have been away from the clientele. Health occupations that
termed semi-professions (Ezzioni 1963) perceive themselves as being an agency for
empowering their clientele, as music therapy does, may
find themselves severely compromised in this process.
While full professional status in healthcare can be seen
to be difficult to achieve, the desirability of the
achievement should be questioned. The overall Part of being a full profession is to demonstrate having
perception of professionalisation by the health an exclusive knowledge base. In healthcare the direct
occupations seems to have been allied to the Weber ' s reference point for determining what is valuable
"trait" approach, in which professional status is achieved knowledge is that of medical science, and in mental

1272
healthcare psychiatry and psychotherapy, which may largely one of self preservation and parity of steem with
not be the theoretical framework of an aspring competing groups (Green 1991b). It needs to be asked
occupation. Yet to adopt the scientific net might be to whether this is,the best motive and best way to develop
loose or severely compromise the occupations primary good practice for clients. For security most occupations
skillys and inhibit the development of valuable develop exclusory practices especially so if they wish to
alternative models of working (Lee 1992). Bennet and professionalise. Yet the extent to which is this beneficial
Hokenstad (cited in Green 1991a) assert that the use of to clients is open to debate. For example, all available
knowledge by the professions is substantielly different music therapy literature emphasises that music
to that of the semi-professions. A doctor will use her therapists must be extremely accomplished musicians
knowledge to treat but will not share the process of (eg Paulicevic 1992, Bruscia 1989), this is mirrored in
using tho knowledge with the client. A semi-professional the formal entry requirements for post-graduate training
works more as a catalyst, using her knowledge to help in Britain. Perhaps it needs to be asked to what extent
the client help herself. To become professional would this s a real prerequisite of good practice It could be
arguably necessitate a change in the use of knowledge seen as an exclusory device to separate music
from giving to withholding. therapists from other clinicians of differing musical
ability or to restrict entry into the profession hence
hightening its professonal profile There are parts of a
The health occupations desire to be professionals is
formal music education that do not appear to have

1273
much relevence to music therapy practice yet as part of It may well be the case that with current developments
a degee qualification do permit entry into a music in healthcare, professionalisation may not continue to
therapy training. Conversly there are informal be a major issue for any health occupation including the
musicians, notably jazz musicians, who are very skilled medical profession. The strength of the occepational
in improvisational musicianship yet through having no monopoly held by the medics has waned considerably
formal musical qualification would find it very difficult if in the last decade with the rise and increasing power of
not impossible to gain entry into music therapy training. corperate involvement in healthcare (Elston 1991). This
is most noticeable in the USA where a mixture of
increasing bureaucratisation of work organisation,
The drive for professionalisation as self preservation;
oversupply, decreasing public confidence, and changes
also inhibits the merger with other occupations (Green 1
in the health market all bring less autonomy and
991a) . Such a merger may to provide an improved
influence in doctors. In this situation the medics can be
service and give music therapist more flexibilty in their
seen to be incorporated into a factory like system and
work. On a practical note, the influence of health
becoming like any other worker, hence th sociological
conglomerates wanting value for money way result in
theory of proletarianisation which describes;this
the employers shying away from a tightly defined
phenomena (Haug in Elston 1991). In the the UK a
profession in favour of a more cost effective and pliable
similar process may be happening in that the medics
occupation .
economic and political influence can be management of

1274
the NHS. Abbot P Wallace C (199l) Sociology of the Caring
Professiont London Tavistok

Bruscia K (1989):Defining Music Therapy Pheonixville

Regardless of the feasibility of the becoming a
Sprinthouse Books
profession in the full sense of the word, the issues
relating to the occupational place of music therapy are Elston M (1991) in Gabe J Calnan M Bury H (eds) The
still pertinent. Is it possible or desirable to try to achieve Sociolgy of the Health Service London Routledge
a secure and influential position n healthcare? What
Etzioni A (1969) The Smi-Professions and their
compromises would have to be made to achieve this?
Organlsatiot New York Free Press ,
Are the necessary compromises worth it for the
clinicians and for the clients? As the healthcare world Friedson E (1983) The Theory of Professions: State of

becomes more complix and more corperate, and the the z Art. in Dingwall R Lewis P (1983) The Sociology of

financial aspects more crucial, these are questions that the Professions London MacHillan

have to asked and answered by all the health Green S (1991a) Shaklng our Foundations Part 1:
occupations. Occupational Therapy - Its Path to Professionalisation
Brit J Occ Therapy 54:1

Green S (1991b) Shaking our Foundations Part 2: Into

References:
the Future Brita J Occ Therapy 54:1
1275
Larkin G (1983) Occupational Monopoly and Modern R O U N D T ABL E O N ET H I C S / M ESA R ED O N D A
Medicine London Tavistok Press SO BR E T I C A

Lee C (1992) The Relationship Between Music Therapy C HERYL D. MARANTO

and Psycoterapy J Brit Music Therapy 6:1

Paulicevic M (1992) Forward: Music in Therapy -

The discussion in this round table will focus on the draft
Revisiting the Muses. J.brit Music Therapy 6:2
from of the "Guidelines for Ethical Conduct" developed
Turner B (1987) Medical Power and Social Knowledge by the Commission on Ethics of the World Federation of
London Sage Publication Music Therapy.

In addition, specific ethical concerns for music therapy

practitioners in varlous countries and the role of the
4.5.- ETHICAL CODE OF THE MUSIC
THERAPIST / CODIGO ETICO DEL World Feredarion in assisting professional associations
MUSICOTERAPEUTA (ABSTRACTS) to develop and implement codes of ethics will be
addressed. Finally, any questions from participants and
observers will be considered and discussed.

El debate de esta mesa redonda estar centrada en

1276
torno al borrador de "Guas de tica" desarrollando por The object of this work group is to get together
la Comisin de tica de la Federacin Mundial de members from associations, schools, and delegates
Musicoterapia. from different Latin American countries and discuss the
situation of music therapy in the region. It is hoped that
Adems, se versar sobre las inquietudes ticas
better means of communicating and cooperating will
especficas de musicoterapeutas practicantes en varios
grow out of this discussion.
pases y la funcin de la Federacin Mundial asistiendo
a asociaciones profesionales desarrollando e Given the particular socio-economic situation in Latin
implementando cdigos de tica. Finalmente se America, and considering the peculiarities of music
escuchar y discutir cualquier pregunta de los therapy's insertion as a discipline integrating the
participantes y observadores. ensemble of health sciences and technologies, it is
convenient to inquire the following points:

* Where do the music therapists get their training?

M U SI C T H ER APY I N L AT I N AM ER I C A / L A
* What is the professional profile that Training
M U SI C O T ER API A EN AM R I C A L AT I N A
Schools propose for music therapists?
C LAUDIA M ENDOZA
* Which are their interests?

* The relationships between music therapists and

1277
other professionals Federation

* The situation of music therapists associations and

music therapy
El objeto de esta propuesta es convocar a
* The relation between Associations and Training representantes de Asociaciones, Escuelas de
Schools Formacin y Delegados de los diferentes pases de
Latinoamrica para intercambiar opiniones y debatir la
* The acknowledgement and the social insertion of
realidad de la musicoterapia en la Regin y la manera
music therapy in each country
de buscar formas ms fluidas de mutua cooperacin e
* The legal situation of the discipline
intercambio.
* The socio-structural difficulties in the actual work
Dada la particular situacin socio-econmica
* The objectives of music therapy communities in latinoamericana, y considerando las peculiaridades de
each country la insercin de la musicoterapia como disciplina
integrante del conjunto de ciencias y tecnologas de la
* The possible objectives of a music therapy Latin-
salud, resulta oportuno indagar, entre otros puntos;
American Committee
* Dnde se forman los musicoterapeutas?
* The possible constitution of this committee as a
Latin American Secretary of the Music Therapy World * Cul es el perfil profesional que las escuelas de

1278
Formacin proponen para los musicoterapeutas? * Objetivos de las comunidades de
musicoterapeutas de cada pas
* Cul es el perfil profesional que la comunidad de
musicoterapeutas postula para s misma? * Posibles objetivos de un comit latinoamericano
de musicoterapia
* Cules son sus intereses?
* Posible funcionamiento de un comit
* La relacin de los musicoterapeutas con otros
latinoamericano de musicoterapia
profesionales
* Posible constitucin de este comit como
* La situacin de las Asociaciones de
Secretariado Latinoamericano de la Federacin
musicoterapeutas y de musicoterapia
Mundial de Musicoterapia
* La relacin entre las Asociaciones y las Escuelas
de Formacin.

* El reconocimiento y la insercin social de la

musicoterapia en cada pas

* La situacin legal de la disciplina

* Dificultades socioestructurales en la prctica

laboral

1279