Book Review: A play Leslie Bunt,Sarah Hoskyns and Sangeeta Swamy (eds),The Handbook of Music Therapy 2nd Edition

Hi Regina!

Hi Suzannah!

You’ve been working in the field for a year now, is that right, Regina?

Yes, nearly! I still can’t quite believe it’s been a year. I qualified in the summer of 2023, and at the moment, I work with older adults living with dementia in a hospital setting, and I also work with children at an SEMH school. I’d love to know more about your work and experience in the field as well, Suzannah?

Well, I started my masters degree back when the first edition of this book was published, in 2002. When I came into the profession, in New York City, I worked mainly with children and their families – first in an after-school programme for children whose parents were in addiction recovery, and then in a paediatric oncology setting. Over a number of years, I did advanced training in the Continuum Model of Guided Imagery and Music, Analytical Music Therapy, integrative trauma work, and other psychotherapy methods. It was my music and imagery training, though, that really opened the door for me to do private practice work with adults with trauma histories and other experiences of mental distress. And that’s what I do now. Training in the USA, I’m not sure I came across the first edition of this book. Did you read it?

Yes, and I remember that when we read a few chapters while I was training, part of it was so that we could have an understanding of the context of how music therapy became an established profession in the UK. And the field has grown and changed and is continuing to change . . . And gaining an understanding of how we got to where we are now is so helpful to me as someone who’s just entering the profession. So I think one of the most important differences between the two editions is in the context and how this then shapes the content of the book. I feel like a second edition of anything should be in dialogue with the first in some way. It was interesting to note that the editors had asked the contributing authors to update the literature they used and to add as much sociocultural context as possible. What I think would have been great is if the authors had also been asked to look back at their work of 20 years ago and reflect on what they would do differently now.

Yeah, that’s nice to think about. I realise that there are things I wrote early in my career that would be so valuable to review and dialogue with myself around.

Right, and I think the idea of continuous questioning and dialogue with ourselves and with each other is important. What this edition does is ask the sorts of questions that I wish had been asked while I was training, questions that I had wanted to ask and reflect on.

And I think having a book like this would have really helped to guide the conversations that were just beginning to happen and should have been happening for a long time. So that as a trainee, I wouldn’t have felt as burdened with having to ask those questions. I know that others in my cohort, and those that trained before and after us, shared that experience too.

I wonder if you’re talking about how Sangeeta Swamy’s voice comes through in the text? The injection of those questions and prompts to think about power, privilege and culture – that’s Sangeeta, right? She’s the new editorial addition to this version. And her voice feels very important.

Yeah, I think so. This edition has a real, continued emphasis of integrating sociocultural reflexivity and sensitivity into our thinking as music therapists. And yes, these were conversations that we were able to have in our training, and there were definitely spaces for them – but I think that we weren’t in the place yet where that kind of thinking could be fully integrated into our learning, across all aspects of our work. Having this book would have helped to support and guide that – almost like an active participant in the conversation.

I know that you love working with older adults but also took the job working with children to get a wide range of experience. I’m really struck by, in this first part of the book and in your experience, how complex the work of a music therapist is. For me, straight away, this book suggests the possibility of being able to do it all; work with all the people, play all the music, develop competency around all the cultures and integrate all the techniques and theories. My favourite part so far, and the part that felt like a true ‘handbook’ for beginners, was when the authors focused on the kinds of qualities a music therapist needs. I think this was the first moment in reading that I breathed because it was about qualities of being, not necessarily all the things you need to do.

It’s an ambitious undertaking, isn’t it? To tackle the scope of the profession in one book? The editors bring in a range of different perspectives. And what I appreciated about this book was how the different authorial voices of the editors were presented – highlighting that each author is different, making it clear that what’s written on the page is someone’s voice, someone’s perspective. It’s not like one authoritative voice that you usually get in a text like this. When the text is shared, it’s a conversation. And it’s an ongoing conversation which I think is something that is important to make explicit because that sort of feels like this is what editions of something are: conversations with themselves.

Hello? Suzannah? Can you hear me?

I can hear you. Can you hear me?

Yes, sorry I’m late. I just finished my working day at the school and thought I’d do our meeting from here rather than travel home first.

Are you okay there? I’m just aware that I’m sitting in the comfort of my own home, and I’ve had all this time before our meeting to relax and listen to music and process what I’ve read. I just want to name that and appreciate how we’re coming at this from different places today. Is there anything we need to do before getting started?

It would be good to have . . . some space, I think. To transition from the busy work day to this.

Perhaps we can listen to a piece of music first, to get settled?

Yeah. Yeah, let’s do that.

It just reminded me of how we are in bodies, you know? We are in bodies that need to be felt, and feel, and to express themselves through movement. I have that image of Tessa Watson’s case study chapter, where she so sensitively plays music that reflects the body movements of her client. And the diagrams of her client’s body, and the way it moved. Sometimes when I’m reading this book, I get so disconnected from this flesh and blood and bone body and I really need to dance and draw and make music.

Something else is coming up for me as I read the book – apart from Swamy’s voice, there is an absence of talking about power. And I wanted to name that there may be power imbalances here between us that are important to state, explicitly. First of all, I’ve been in this profession for 20 years, and so that means that there are a lot of things that are no longer a risk for me – I don’t need a job with an institution because I work for myself. I am beholden to no one, nor need to make a good impression. I was just thinking that there is a privilege of ease around this process for me.

And I am someone at the beginning of her career, who might have, or need to forge, relationships with the authors in this book, for example. This process might be a riskier endeavour.

Also, there are the issues of power in relation to me being a woman in a white body, with a name that some might recognise. We are approaching the reading of this book, as well as this reviewing process from very different places.

Yeah, thanks for that. It actually helps me to verbalise what I’d been sitting with – different thoughts and anxieties around this process. In some ways, I’m so excited to be doing this book review with you. It feels like this is a chance to prove myself in some way, or that it will open up doors for me that will be really helpful for my development as a music therapist. But in other ways – I’m so new to the profession, so what could I possibly have to offer? What could I possibly have to say which would be useful or meaningful? Those anxieties and feelings can also be located in those power structures. So I really appreciate you addressing the fact that our own relationship as co-authors is embedded in patterns of power. And I also appreciate that you’re bringing attention to the lack of discussion in Part II (Music Therapy Practice) regarding power. There are more considerations around self-reflexivity and self-awareness, especially around culture. So why isn’t power addressed?

What is new in this edition is the careful attention to positioning of author, therapist and client. But the positionality statements kind of miss the point for me – they are not necessarily in service to the client, nor do they contribute to understanding the work more deeply. I think this might be, in some part, due to the re-writing of old case studies where the authors were not thinking about issues of identity and power at the time. Swamy’s new chapter on ‘Music therapy with immigrants’ is the exception to this, but as a person of colour, Swamy is more identified with the client, thus not getting to explore the kind of issues of power that show up between individuals with differing identities.

The point of positioning yourself is to make visible how that informs the way that you’re thinking, the way that you’re writing, the choices you make and your understanding of the client. Instead of it being taken for granted, it situates knowledge from your particular perspective.

Yeah, yeah, exactly. And positionality is only the start of a deeper reflexive process.

Like shaping your thinking – how does it change your relationship to your client?

I liked how Tessa Watson carefully considered who she was 15 years ago and the kinds of values that she held but that she took for granted and wasn’t explicit about until this version. I really appreciated that. What did you think of her chapter?

One of the things that struck me about that chapter was this processual aspect – she’s also looking forward, recognising that things are still happening, still changing, like passing the baton in some form. I really appreciated how she outlined the changes she had undergone in a really thoughtful way. It gave the justification for why we’ve got this second edition in the first place, as opposed to putting together an entirely new book. ‘This is how I’ve changed. This is what I’ve learned’. A dialogue with your past self.

Right, and her updates to the literature were especially thorough, which I appreciated and learned a lot from. It reads to me like she responded well to the editorial challenge. I’m not sure the other case study authors did this as well as her, if they were able to. I think adding Swamy to the editorial team was a significant decision. As we said in our first meeting, her voice is loud and clear – whether it’s in the main body of text or even in a footnote, there are parts when it feels apparent that it’s Swamy’s voice. And it’s also significant that, of all the contributors to the handbook, besides Carolyn Kenny who was an Indigenous person, she is the only person of colour. And it feels like the task has fallen on her to illuminate those dynamics and questions of power. I wonder whether this is a burden?

I did some creative processing after reading these first two parts of the book, you know, some music, a bit of art and writing. I wonder if you also had a creative response?

I did, yes. I drew something. One of the visual things that stood out to me after I read Part I (Foundations and context) of the book was that a lot of the diagrams were made up of circles – a very containing shape – but what was also coming into my imagination was this field. There was this quote by Carolyn Kenny that the editors used – I think it’s on page 69 – and Kenny describes the therapeutic relationship as a field, consisting of human beings who move like flowers. I ended up drawing this riot of flowers and vines, crossing and intersecting and growing through this circle, this field. And afterwards, I looked at my drawing and thought – this feels a bit overwhelming. There was so much going on in that image, in that field. And maybe that’s actually speaking a lot to how I felt. How it can feel, as someone new to music therapy, to enter this field with so much going on, so much changing and growing.

Carolyn’s voice is all over this book, isn’t it? The editors not only integrate her voice as one of the three elders they interview, but she is quoted everywhere.

One of the main disciplines that Kenny drew from in her academic work was anthropology. And my own academic background is in anthropology. So I was thinking maybe there is some kinship there. Someone who has already pulled out the possibility of interconnections between anthropology and music therapy. And maybe that’s important to me because I also hold both fields in my body, in my feeling-thinking. And the image of the field, its multitudes of metaphorical meaning. I always look to nature when I think about interconnectedness. Our environment, our earth, is the most important example of how we are connected to everything and how we’re connected to each other, how we shape and are shaped by each other.

I’m so glad you’re naming our wider connections with earth, the human and the more-than-human. I almost feel like Part II (Music Therapy Practice) might have been named ‘A Handbook for Music Therapy in a Climate Crisis’. We need to think, as a profession, about what our world will look like in 2034 and beyond. There is some estimation that by 2050, there will be one billion people on the move, in part due to the effects of global heating. So, Swamy’s scholarship regarding working with immigrants and issues of acculturation is, I’d say, of critical importance. Watson’s chapter thoughtfully centres issues of disability justice, which speaks to the kind of present and future that we need in this crisis – all the bodies and minds valued and valuable. And Odell-Miller’s chapter on dementia care is another hugely important area for consideration, given our rapidly ageing population and the fact that one in three of us will develop dementia in our lifetime.

I feel a lot of grief thinking about what the generations after us will experience, or not experience. I feel the same thinking about a publication like this, wondering what kind of world it might or might not serve. And that leads me to wonder what is not in this book. What is backgrounded? Or invisible? Did you read ‘Unruly Therapeutic’ by Foluke Taylor? Our mutual friend, Michaela de Cruz, introduced it to me. Taylor writes about being influenced by Toni Morrison’s way of reading a text. Can I read a quote?

Yes, please.

Here it is! Taylor writes ‘I read for the nothing, the not enough, and the incomplete. I encourage other therapists to do likewise . . . Trying to live and learn and survive the dazzling foreground is always also a process of recovery. There is always undoing to be done. And backgrounds and blackgrounds always exist in relation to foregrounds and whitegrounds. They are interdependent. They will always have something for each other’ (Taylor, 2023: 70).

So, what’s in the background/blackground here? What’s been invisibilised? Or taken for granted? How do we engage in that process of undoing and recovery?

The sensuous.

The magical.

That which can’t be spoken or written in words.

Colour. Riot.

I kept coming back to the reprinting of Carolyn Kenny’s words from her ‘Field of Play’ on page 9. What does it say?

‘The music therapist is one of the keepers of the gate, one of the technicians of the sacred, one who sees the vision and hears the song of the one and many, the one who dances on the edge of time, one who can guard the threshold of being, one who waits for sound.’

Sandra Brown’s chapter, with an introduction by Pauline Etkin, about working with a school-aged child felt really relevant to what I’m doing in this school. Since qualifying, I haven’t been able to make space for grounding my work in literature. I hoped that reading this book would help me get back to that. So Brown’s chapter was so helpful for me – just to have some of my challenging clinical experiences reflected back to me and to play with other ways of thinking about them.

This is so important – the handbook should support a new professional like you’re describing. I’m so glad that you felt its relevance to where you are right now. They write a tribute to Sandra Brown’s life as an introduction, and it’s touching to me that the way she thinks about the work is relevant to you in this space and time.

When I read chapters from the first edition of this book while I was training, I found it really helpful that it offered a range of case studies. Sort of like having different examples or possibilities of who we might work with or how we might work as music therapists. And then having wider literature to refer to so that you can follow those threads and signposts. I think this is true of the second edition as well, but with the literature being more up to date and with a greater consideration for sociocultural context.

As a relatively new music therapist, is there something in here that you wish you were reading that you haven’t yet read?

I wish that there was more of an in-depth exploration of power structures. How our work shapes and is shaped by the patterns of power relating that are deeply embedded and reinforced by the institutions we work in. Ourselves as music therapists and our clients – their needs, their experiences – are all part of this. I think this was best exemplified in Watson’s and Swamy’s chapters, in their real thought and consideration for history and our situatedness in patterns of power.

At no point in Sloboda and Compton Dickinson’s chapter on music therapy in forensic psychiatry did they discuss the trauma of incarceration itself, or indeed, anti-carceral thinking. I was glad they updated their chapter with the mention of restorative justice approaches to violence. But, to me, this chapter was an example of Foluke Taylor’s ‘dazzling foreground’. In this case, an institution and larger society that doesn’t hesitate to question carceral methods to treat so-called mental illness – and a backgrounding of how institutions and the music therapists that work within them – can be complicit in ignoring the effect of detention itself on the mental health patients.

Yes, that’s it, it’s the backgrounding of power dynamics. And we are always entangled in those. It’s all there in the text already – in the subtext – in what the authors say and don’t say. And I think we have to be able to say it outright: I am part of this. I think that’s how we begin to explore how to engage in that process of recovery that Taylor writes about. ‘There is always undoing to be done’.

I know we didn’t really do this, Regina, but I’d like to think that we might have done this, and enjoyed the summer sunshine and the scent of flowers and this delightful breeze, while we talked.

I’m so glad to be sitting in the park with you. I’ve actually struggled this week with the balance of work and finishing the book. I feel like I haven’t really had the space for this review as much as I would have liked. So I like that we can re-imagine our conversation like this, where there’s so much space – so much green space and open air.

I’m really appreciating your honesty about struggling. Yes, we are humans in bodies, with work and all kinds of responsibilities. And, as book reviewers, our task is not simply to digest and spit out a summary of this text. It’s our responsibility to live with this text in some way, to let it affect us, as we are and where we are. It’s an opportunity, not to be some authoritative voice about the text, but to say something about how this book affected us in this moment and time in our lives. Even in a tired and unbalanced body. You are representative of a whole lot of future readers of this book. I remember what it was like to have to say ‘yes’ to all the opportunities – like Sarah Hoskyns describes in reflecting on her own professional journey.

The process of reading the book and undertaking this review – there’s this pressure or expectation that I have to remember everything about the book, experience it ‘properly’ and ‘fully’. To take all of it in. Which is the same as saying ‘yes’ to all the opportunities.

I know that feeling all too well; although in recent years, I can be a lot kinder to myself as I detox from perfectionism – what I now understand as a vestige of colonialism and capitalism. We can feel like we just have to do it all and do it ‘right’ because that’s how we grow, or that’s how we progress, or that’s how we become a leader in the field.

Exactly. So I’m glad this book talks about the potential for burnout. I mean. I still don’t know how to progress – how to stop myself from burning out while trying to build experience and grow as a music therapist. How do I become the music therapist I want to be – the music therapist my clients need me to be – without exhausting myself in the process?

I think there’s something to be said about space and stillness. The joy of being in a growing profession, and a changing profession, is that there will still be more things in the future. We don’t have to do all of it now. It doesn’t have to be now.

And will there? Will there be more in the future?

If we give space for it in the now. We say this all the time – it’s all part of the process. And we are the process. What’s taking up all that space? Where are you in all this? Where are the people that we work with?

There’s a quote from Nachmanovitch in Chapter 12, page 261, that Hoskyns and Bunt use to draw attention to silence and sound, how sounds emerge when stillness is found. He says that art does not need to ‘imitate’ nature but to represent it ‘in the way nature functions, the organic process by which patterns accumulate, interconnect, and grow into relationships’. And that’s sort of where I’m getting at, I think. Grounded in space, in earthen stillness, we grow into relationships.

That’s it. Give the space a chance to surprise you.

And let’s not forget, space for the music. The book does something special in this regard, with the reflective listening and music-making exercises in Chapters 12 and 13.

Yes! Those exercises were what I really wanted to make time for but didn’t get a chance. I really appreciated these chapters.

Me too. Swamy’s and Hoskyn’s chapter on listening was especially important as it gave some clear instructions for how to listen to or play the music, and what to pay attention to. I don’t think I’ve read this kind of culturally-sensitive, reflexive instruction anywhere in music therapy literature. This is something I’m deeply invested in as a GIM practitioner and trainer and interrogator of the GIM method – decolonising our listening.

Decolonising our relationship to music. That’s exactly why I was so excited to see the space that was made for music in this book through the downloadable student materials.

We could listen now together, if you like?

The Blues piece is so strange – it doesn’t have soul or spirit.

It doesn’t sound like the Blues. It’s so sanitised – like the Blues is just a chord sequence.

It doesn’t sound like it’s played by someone who is rooted in the culture and carries the history that the Blues emerged from. It’s missing that intangible quality, that history, which makes it the Blues.

Which misses the point of this exercise, I think.

I’m also wondering why the example from the Māori tradition is a contemporary pop song sung by a Filipino music therapy student. I think, as someone who is also Filipino, I felt a lot of resonance with the fact that the song is so important to Māori communities in its reference to intergenerational trauma and the longlasting, continuing damage of colonisation. And there are definitely significant historical and social connections and exchanges between the Filipino and Polynesian cultures. But then it feels a bit misleading to call it an example from Māori tradition. I feel like if you’re trying to give an example that’s rooted in a particular culture and its history, there are other ways of finding musical extracts from musicians who are of those cultures.

Or music therapists of those cultures who play that music. Like they do with the extracts from Indian and Madagascan cultural traditions.

Yes, those felt like they were more representative, and I guess that’s because the music was being played by people who hold those histories in their bodies – who have that relationship with the music. That intangible quality. And I think that’s the most important thing when we’re trying to think about how to share and experience music that’s not our own. Listening to the history and relationship behind it.

And at the same time, I think we’re both agreeing that these chapters feel like a handbook. They’re saying – this is how to prepare yourself, musically. And I really like that a lot.

I’m thinking about another quote from Carolyn Kenny that the editors use to talk about the power of music, on page 287. They talk about music’s capacity to ‘contain our diverse realities’. And I’m also imagining – in terms of preparing ourselves – if there had been a module in my training that was solely dedicated to teaching students about decolonising our music, about sociocultural reflexivity and addressing power in music therapy; I think that’s what I felt was really missing. It would have felt safer.

White educators need to make it safer. To me, Chapter 13 is for people in white bodies especially, but for all folks who have a sense of entitlement to all music. Maybe it would have been safer for you in your training program if teachers in white bodies had explicitly engaged in this kind of musical-cultural reflexivity?

There were a lot of challenges in the process of trying to have these discussions. And if we’re talking about culture, identity and power, it can’t just be brought into the space without laying the groundwork beforehand, without that reflexivity. This sort of chapter will help to lay the groundwork so that the burden doesn’t fall on minoritised trainees.

Yeah, it’s not only that there is the need for a sensitive understanding around how our own relationship to music is shaped by colonial histories and white supremacy – it goes beyond that. As an educator myself, I’ve worked to centre previously minoritised voices in scholarship and music. But without the interrogation and making conscious my own complicity in not centring these voices in the past, I risk unnecessarily burdening my students with unconscious enactments of white supremacy. The questions on pages 297 and 298 go some way toward helping music therapists, and music therapy educators, to do the deeper, more painful but ultimately radically life-changing work. For example, we are asked:

My experience of this chapter was really difficult in the sense that I identified with it in many ways, which made it really emotionally heavy. I came to the UK as a child. I grew up in a migrant family. And to read about the stress and trauma of acculturation just hit really close to home. So it was difficult. But it was important. And I’m so glad that chapter is in this second edition because it’s so relevant to all of us. It provides practical and useful information and different frameworks to help prepare ourselves to think about working in a culturally reflexive way. On page 201, when Mia the client says, ‘It’s like I finally exist’ – that was beautiful, profound and really really hard to read. There are parts of me, as I read this book, that are opening up, realising exactly how much was missing, how much wasn’t being seen and addressed and foregrounded. And that has always been the case for my own sense of self.

I’m so touched by your experience and how Swamy’s work captured something of the complexity of culture and identity that’s often missing from our discourse. Like if my music therapist played a piece of Scottish folk music, it would connect me with what I love about my culture, but also the ways I’m disconnected from my culture, or the loss of my culture and language due to historic forced assimilation. In other words, the good, the bad and the ugly.

Like identity – it’s not just one thing. It’s not, ‘let me bring the music from your culture’ – it’s so much more complex.

Fluid identities is how she puts it I think – our identities are never fixed.

. . . Are we not at once, in-between

Don’t we already hold the contradictory

In our origins? In our becoming?

. . . To know ourselves is to know our

histories

And these are our origins: music is

human.

. . . We tell stories because we must

Because stories are questions

And to question is to wonder

. . . And to wonder is to play,

Energy joyously expelled

. . . And music is wonder, full of surprises:

Through our eyes, ears, and feelings

The magic unfolds

. . . These are our origins: music is more

than human

And we are a riot of colour

. . . Like a homecoming. Like an odyssey

And our odyssey shows us: we exist, now

. . . our origins tell us: we are the

process

And our histories will point us to our

undoing

Our becoming. And everything in between.