Abstract
In a qualitative case study design the connection between a music therapist and a female client with severe frontotemporal dementia in music therapy with singing is examined.
The first object of the study is to investigate whether there is any coherence in the music therapeutic techniques and the client's behaviour. A second purpose is to examine which communicative techniques the therapist uses. This is in order to seek answers to the question and third purpose: finding the relational impact of the music therapist's techniques. The fourth object is to provide a theoretical understanding of the connection between the therapist and the client. These objects are presented in a list of four problems.
The investigation is mainly carried out through inductive empirical analyses. It involves an ethnographically informed research and I bring in thoughts and beliefs from a phenomenological and hermeneutic position too.
Through four empirically founded analyses I systematically examine
1) the video material from the 21st music therapy session in its full extent;
2) an audio file from the same music therapy session in its full extent;
3) a selected video sequence from the 21st music therapy session;
4) the music therapist's log book concerning all the music therapy sessions
in order to seek answers to the first, second and third presented problem of the thesis. All four analyses are based on ethnographically informed research. The first and fourth analysis are also concerned with a phenomenological philosophy due to my epoché. The second and third analysis contain interpretation parts and have by this elements of hermeneutics where I seek to find meaning in my empirical findings.
In the end I discuss and interpret my empirical findings with several theoretical perspectives. This deductive and hermeneutic procedure makes a final solution to my problems of investigation.
My overall empirical findings show that a systematically attained focus concerning interactions at a micro perspective level can reveal coherence between the music therapist's techniques and the actions and reactions of the client.
It is documented that the therapist is singing and humming composed songs; humming in a improvisational way and singing call motives with use of the client's name. All along with the musical techniques the therapist is using a nonverbal communication: smiles, gestures and nods. When the therapist isn't singing, but expressing herself verbally, she uses an airy tone of voice with a descending pitch and she mainly uses monosyllable. This is to communicate empathy and reflection on the clients position. The aim of the music therapy is to show the client a. o. an openness and respect.
The results concerning the relational impact of the music therapist's communicative techniques show that there is created a space of proximity and the client is attentive and motivated especially by the music therapist singing call motives with her name. Her motivation involves an initiative to receive caress and this initiative develop into her taking control in the interactions. The therapist maintains the intimate space by mirroring e.g. the client's emotions.
By putting my empirical findings into a theoretical understanding the overall findings are, that the music therapist's techniques break the client's 'bubble' of isolation resulting in the client being able to make use of the cognitive executive functions.
The therapist makes use of a communication consisting elements of Communicative Musicality, Emotional atunement and Forms of Vitality. The therapist's techniques are regulating the client's arousal in a both stimulating and calming way. This involves a connection between the polyvagal theory and the vocal and respiratory responses from the client so that she is becoming safe and able to take part in a social interaction.
Based on Reisberg’s theory of retrogenesis the client's level of function is comparable with the function of an infant. Due to this there are some counter transferences in the connection between the therapist and client where the therapist undertake a. o. a motherly role. This is however a relational necessity as the client respond positively. The call motives could be understood as a cue where the client get in touch with some emotional memories about her identity and a nearness with her mother.
The theoretical perspective gives an understanding of the necessity of a long repeating process in the music therapy based on terms of the client.