INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer. ‘The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning tke cziginal, beginning at the upper left-hand corner and continuing from left to right in equal sections with small overlaps. Each original is also photographed in one exposure and is included in reduced form at the back of the book. Photographs included in the original manuscript have been reproduced xerographically in this copy. Higher quality 6" x 9° black and white photographic prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order. University Microfims International Bell & Howell information Company 300 North Zeeb Road, Ann Arbor, Mi 48106-1346 USA 313/761-8700 800/621.0600Order Number 9287730 Awakening and expanding the self: Meaningful moments in the music therapy process as experienced and descrited by music therapists and music therapy clients Amir, Dorit, D.A. New York University, 1992 Copyright ©1992 by Amir, Dorit. All rights reserved. 300 N. Zeeb Ra. ‘Ann Arbor, MI 48106Sponsoring Committee: Professor Barbara Hesser, Chairperson Professor John V. Gilbert Professor Margot Ely AWAKENING AND EXPANDING THE SELF: MEANINGFUL MOMENTS IN THE MUSIC THERAPY PROCESS AS EXPERIENCED AND DESCRIBED BY MUSIC THERAPISTS AND MUSIC THERAPY CLIENTS Dorit Amir Submitted in partial fulfillment of the requirements for the degree of Doctor of Arts in the School of Education, Health, Nursing, and Arts Professions New York University 1992© Dorit amir 1992Aug. 15th, 1991 I hereby garantee that no part of the dissertation which I have submitted for publication has been heretofore published and copyrighted in the United States of America, except in the case of passages quoted from other published sources; that I am the sole author and proprietor of said dissertation; thet the dissertation contains no matter which, if published, will be libelous or otherwise injurious, or infringe in any way the copyright of any other party; and that I will defend, indemnity and hold harmless New York University against all suits and proceedings which may be brought and against all claims which made be made against New York University by reason of the publication of said dissertation. Dood daw Dorit Amir 3add ACKNOWLEDGMENTS I would like to thank my committee members: I wish to thank Barbara Hesser in particular. What she gave me goes far beyond words, but I will try: For sharing her vast knowledge and vision of music therapy so openly. For her encouragement, support, dedication and interest in my work, For all the time and energy she so generously devoted to reading my work and discussing it with me. These wonderful dialogues over the last three years have been a tremendous source of inspiration to me. I deeply valued her insights and will always treasure her friendship. I am very grateful to Margot Ely for generously offering her expertise. She taught me the value of qualitative research and helped me to effectively employ it in this study. Her insights were very valuable and contributed a lot to this study. Also, I am indebted to John Gilbert for helping me see what I was unable to see and for sharing his wisdom. His feedback, ideas and suggestions were very valuable to me and contributed to my understanding of the research. A special note of appreciation goes to Carolyn Kenny from whom I have learned much about the beauty ofmusic therapy. Her help in forming my ideas, her interest, encouragement and support are gratefully acknowledged. Michele Forinash shared the entire process and was there for the joyous, painful and frustrating moments. Her empathy, support and understanding made the process easier. I appreciate her help in editing my document and value her feedback. Judi Rubin tirelessly listened to my ideas, dilemmas, frustrations and conflicts, and shared my enthusiasm and glee. I am very grateful for the time and energy she spent in helping me with last minute technical problems. I value her friendship and thank her for all the help and support she gave me. I want to thank Ken Aigen for his support and caring. I value his comments and ideas. I also thank a wonderful group of music therapists who inspired and supported me in many of our gatherings: Alan Turry, Michele Forinash, Judi Rubin, Ken Aigen, Noah Shapiro, Frank Bosco, and David Ramsey. I also would like to acknowledge people in the music therapy community of New York University who inspired me, supported my work, and helped me create this document: Lisa Sokolov, Susan Feiner, Concetta Tomaino, David Gonzalez, Clive and Carol Robbins, Shirley Berenstein and Susan Gorman. I am very grateful for the help from my supportv group members: Iris Kaplan and Nancy Biederman. Their feedback and support throughout writing this dissertation were invaluable. Benny Baumohl helped me with the tables and Danny Krieger helped me with technical problems. I thank them both. I thank Bingo Wyer who read the document for editorial input. I am especially grateful to all the participants in this study: Beth, Martha, Lucy, Adam, Kathy, Ben, Karen and Lyn. I thank them for their willingness to devote time and energy and, above all, for sharing with me the beauty of their work. Without them--there would be no document! My clients and my students taught me much about humanity, about love and about the beauty of music therapy for which I am deeply grateful. And last but not least, my son, Ari, who had to tolerate a great deal throughout this research. Thank you for your patience and impatience and the times when you were supportive and understanding. I am especially grateful for your sense of humor that made life easier. Above all, I thank you for your love and presence in my life.vi TABLE OF CONTENTS ACKNOWLEDGMENTS LIST OF TABLES CHAPTER I IZ IIE Iv INTRODUCTION The Source of the study The Unfolding Essence of the Study Need for the Study Research Questions THE RELATED LITERATURE Meaningful Moments in Psychology Meaningful Moments in a Person's Life Meaningful Moments in Therapy Meaningful Moments in Education Music Therapy The Concept of Time Meaningful Moments in Music Therapy Critique of Quantitative Research Towards a New Language Qualitative Research Conclusion METHOD Introduction and Rationale Research Participants Research Instrument: The Intensive Interview Data Analysis The Process of the Data Analysis Trustworthiness of the Study INTRODUCTION TO THE FINDINGS Organization of the Findings ener 10 10 10 13 16 17 17 20 23 28 32 35 37 37 39 43 46 a7 52 55 59vii Vv PROFILES OF MUSIC THERAPISTS Beth ‘Vignette One: Sue Vignette Two: Mary Martha Vignette One: Fredie Vignette Two: Helen Lucy Vignette One: "I listened and trusted my impulse" vignette Two: Denise Vignette Three: "Light came through and illuminated something for me" Adam Vignette One: Gabriella Vignette Two: Joseph VI PROFILES OF MUSIC THERAPY CLIENTS kathy Vignette One: "Sara is the sea for me" Vignette Two: "I sort of slipped into the glove of my soul" Vignette Three: "The Music called for all of my emotions" Ben Vignette One: "We all were in the same spirit” Vignette Two: "How soon you forget" Vignette Three: "We start with nothing and come up with a good song" Karen Vignette One: "The golden light" Vignette Two: "All of a sudden, the dread was over" vignette Three: "What a relief!" Lyn Vignette One: "I have become me" Vignette Two:"Playing the piano, I felt like a playful chila” Vignette Three: "It was a very spiritual experience for me" VII MEANINGFUL MOMENTS IN THE MUSIC THERAPY PROCESS Context of these Moments General Characteristics of Meaningful Moments Meaningful Moments that Occurred on an Intrapersonal Level 99 100 101 101 104 105 106 107 109 110 ua 115 115 116 121viii Moments of Awareness and Insight Therapists’ Moments Therapists’ Perceptions of Their Clients’ Moments Clients’ Moments Moments of Acceptance ‘Therapists’ Perception of Their Clients’ Moments Clients’ Moments Moments of Freedom Therapists’ Moments Therapists’ Perceptic: Clients’ Moments Clients’ Moments of Their Moments of Wholeness and Integration Clients’ Moments Moments of Completion and Accomplishment ‘Therapists’ Moments Clients’ Moments Moments of Beauty and Inspiration Therapists’ Moments Clients’ Moments Moments of Spirituality Therapists’ Moments Clients’ Moments Moments of Intimacy With Self Therapists’ Moments Therapists’ Parception of Their Clients’ Moments Clients’ Moments Moments of Joy and Ecstacy Therapists’ Moments Therapists’ Perception of Their Clients’ Moments Clients’ Moments Moments of Anger, Fear and Pain Therapists’ Moments Therapists’ Perception of Their Clients’ Moments Clients’ Moments Moments of Surprise ‘Therapists’ Moments Therapists’ Perception of Their Clients’ Moments Clients’ Moments Moments of Inner Transformation ‘Therapists’ Perception of Their Clients’ Moments Clients’ Moments Meaningful Moments That Occurred on an Interpersonal Level Moments of Physical Closeness 121 121 123 124 127 127 127 128 128 129 130 132 132 133 133 134 135 136 337 139 139 140 14t 141 14r 142 142 142 144 145 145 145 145 146 146 146 147 147 148 148 150 152ix Between Therapist and Client Therapists’ Moments Moments of Musical Intimacy Between Therapist and Client Therapists’ Moments Moments of Close Contact Between Client and a Significant Person In his/ner Lite Therapists’ Perception of Their Clients’ Moments Clients’ Moments VvIIL FACTORS THAT ALLOWED THESE MOMENTS TO COMB TO BIRTH Environmental Factors Music Being a Part of a Music Therapy Group Therapist’s Intrapersonal Factors ‘Therapist’s Knowledge and Experience Therapist‘s Listening to Inner Impulse, Instinct and Intuition Therapist’s Listening and Exploration of the Client's Needs Therapist’s Trust Therapist’s Perception of Therapist-Client Relationship Therapist’s Set of Beliefs that Influenced the Work Client's Intrapersonal Factors Client's Meaning of Music Client's View of Self Client's Readiness, Motivation and Commitment to the Work Client's Courage in Taking Risks Client's Perception of Music Therapy Client's Perception of his/her Music Therapist and the Relationship Between Them Client's Trust The Process Ix CONTRIBUTION OF THESE MOMENTS TO THE PARTICIPANTS’ LIVES Contribution of these Moments to the Client’s Life Improved Self-Esteem 152 152 153 153 155 155 155 187 187 157 158 159 159 160 162 163 164 165 167 167 167 168 170 a7. 172 173 175 177 177 177x Improved Emotional and Physical Health Improved Interpersonal Relationships No Improvement Outside Therapy Contribution to the Therapist’s Work and Life Improved Therapeutic skills Personal Growth x DISCUSSION OF THE FINDINGS Methodological Considerations XI RECOMMENDATIONS Implications for Educating Music Therapists Recommendations for Further Research BIBLIOGRAPHY APPENDIXES APPENDIX A. HUMAN SUBJECTS STATEMENT APPENDIX B STATEMENT TO THE SUBJECTS APPENDIX C CONSENT FORM APPENDIX D AN EXAMPLE OF INTERVIEW QUESTIONS APPENDIX E AN EXAMPLE OF A FIRST LEVEL ANALYSIS IN THE PROFILE OF LYN: A MUSIC THERAPY CLIENT APPENDIX F LIST OF CATEGORIES 179 180 182 181 181 182 184 197 202 212 214 21s 216 218 236xi TABLE All Participants’ Meaningful Moments 114CHAPTER I INTRODUCTION The Source of the Study It all started with Shir. Shir was four years old when she was referred to me by her psychologist for music therapy sessions. The reason for referral was elective mutism syndrome: The only place Shir spoke was at home, with her parents and her dolls. she did not speak outside of home. She was mute. Shir went to kindergarten, participated in all indoor activities, but she did not talk. When she first came in, I saw a beautiful little girl who clung to her mother and would not come into the music therapy room. I took the autoharp out of my room to the hallway and strummed it very softly. shir left her mother’s hand and hesitantly followed me into the room. I went to the far corner of the small room, playing the autoharp while Shir stood nex: to the door, looking down at the floor. Occasionally she would lift her head up and make eye contact with me for a few seconds. She looked very sad and I still remember how every time she would make eye contact I would feel joy and a moment of connection with her.2 During her third session, she sat next to the door, as usual, looking at the autoharp which was on my lap in a far corner of the room. I improvised on the autoharp and she started crawling toward me until she finally sat next to my lap. Something within me told me to stop playing. After a few seconds of silence, she put her hand on the autoharp and strummed it once. She looked at me and smiled. I smiled, too. What a precious moment it was. In the following sessions, she became more active, Giscovered the drum, and experimented with it. It was during her tenth session that she started beating the drum, softly and slowly, gradually increasing the speed and the volume. The sound grew louder and faster. She was using both hands and it looked as though she was fully involved. The drumming became very intense until it reached a peak. Shir screamed, started to cry and came to me. Automatically, I opened my arms, hugged her and held her very close. This was a very intimate moment for me. The beauty of this moment moved me. Another client, 25-year-old Edna, heard about me from a friend and wanted to come for one session to experience misic and imagery. After talking to her and getting to know her somewhat, I selected music that I thought would be suitable and guided her through her inner journey. In her imagination, she traveled to various places and met and talked to some people who3 were important to her. Toward the end of her fantasy trip, she had one big tear in her right eye. She let it run down her face and said to me: "This moment is very special to me. I never cry. This tear is precious, because it is the first time I let myself cry. It is a new beginning for me." Then I met Rina, a 50-year-old woman artist. She participated in one of my music therapy groups and wanted to get in touch with her inner music and to expand and heal herself. During one session we experimented with our voices. Rina was improvising with vocal sounds together with three other women in her subgroup. With their eyes closed, they started making different sounds, which gradually turned into a beautiful harmonious melody with long ooh-aah-eeh sounds in soprano voices. At this time, I sat close to this group, and when I closed my eyes for a few seconds, I had an image of being in a sacred, spiritual temple. When I opened my eyes and looked at Rina, she looked to me as if she were in a trance. Her whole body was moving. She clapped her hands from time to time like she was in ecstasy. I felt that she was ina different place completely. The following week, at the beginning of the session, Rina said that this was the most incredible experience she had had in her life. "I was transcended. I was at one with everything. It was a moment of awe.”4 It is because of these experiences that I am doing this research. These particular moments stood out for me as they occurred and are still riveting for me to recall. I was struck by the number of descriptors that popped into my mind to describe these moments: beauty, love, intuition, insight, peak experience, intimacy, spiritual, Aha!, transpersonal, transcendent, aesthetic, creativity, flow of energy, contact, healing, transformation, change, growth, expansion, turning point, breakthrough, inspiration, catharsis, spontaneity, immediacy, liberation, openness, oneness. ‘The Unfolding of the Essence of these Moments At the initial stage of my study, since I perceived these kinds of moments as beautiful, I decided at first to call them beautiful moments. But it was questionable whether the term beautiful carried with it a web of popular implications that might be understood only as positive, happy moments. Because it did not represent my intentions, nor did it represent the findings, I considered several different terms that might be more suitable and I tried out the term “healing moments." This was a more general term which somewhat captured what I wanted to investigate: moments which are major, powerful and transformative. But some of my colleagues found it difficule to comprehend exactly what I meant. At this point I decided to see5 what terms are used by music therapists in describing their experience. In a preliminary study, I interviewed two music therapists. One of the terms used was peak experience which contained the vitality, richness and importance of the experiences that I was trying to uncover. However, I did not want to lose the word moments and take it out of my title, and therefore decided to use the term peak moments. At this point, my committee members felt that if I used this term, I would have to take Maslow’s definition of peak experience (1968) because he coined this term. However, studying Maslow’s definition made it clear that he is referring to moments of bliss, ecstasy, great happiness, and joy. To adopt this term, I would have to exclude another range of difficult and painful moments. Therefore, I decided to try the term "meaningful moments" which can be used as an umbrella term for all sorts of experiences. The term meaningful implies importance, impact, significance and possible transformation. These were some of the dimensions of the phenomenon that I was interested in studying. It was a descriptive term that included all that came to mind when I was trying to describe my own experiences as a music therapist. It also seemed to best fit my thoughts and feelings. However, the term did not seem to agree with my intuitive self. I was aware of the fact that the term "meaningful" might imply mainly a6 cognitive meaning, and it was not my intention at all. I decided to use this term as a working title until I had my findings and then to look at it again. When I had all the findings that encompassed fifteen moments, I studied each moment. I realized that all of the moments were meaningful moments for both clients and therapists. These were moments when the client and the music therapist touched the core of their being and awakened their true selves. During these moments, the participants experienced a sense of clarity and had a greater capacity to accept, understand and relate to both themselves and others. During these meaningful moments the participants expressed who they were at the present moment in an authentic manner, thus awakening a new energy of being more open and alive. Therefore, these findings are reflected in the title of this dissertation. Need for the Study Since I found very few articles in music therapy literature that deal directly with these moments, I looked in psychological literature. I found several books and articles in humanistic and transpersonal psychological literature. One type of a meaningful moment is the peak experience described by Abraham Maslow (1968) as an episode, or a spurt in which the powers of thea person come together in a particularly efficient and intensely enjoyable way, and in which he is more integrated and less split, more open for experience, more idiosyncratic, more perfectly expressive or spontaneous, or fully functioning, more creative . . . more ego-transcending. . . . He becomes in these episodes more truly himself . . . more fully human. (p. 97) Another term for such powerful moment is the Aha moment. It is described by Rollo May (1958): A moment when a person suddenly grasps the meaning of some important event of the past or future in the present . . . the grasping of a new meaning always presents the possibility and necessity of some personal decision, some shift in gestalt, some new orientation of the person toward the world and future. This is experienced by most people as the moment of heightened awareness. (p. 72) Even though these kinds of moments are familiar and important to music therapists, a review of music therapy literature indicates that there is a dearth of researchers who deal specifically with the description or understanding of meaningful moments in the process of music therapy as perceived by either music therapists or clients. Most writers focus on specific aspects such as goals (Gfeller, 1987; Lord, 1971; Wheeler, 1987), activities (Cassity, 1976; Rubin, 1976), and techniques (Alvin, 1981; Steele, 1984). Recently, it has been noted that most music therapy researchers have used quantitative research methods, and these methods fail to describe and therefore understand the meaning of the experience as a whole (Aigen, 1991; Bruscia, 1987; Forinash, 1990;8 Forinash & Gonzalez, 1989; Hesser, 1982; Kenny, 1976). Bruscia (1987) gives his explanation of the problem: In the more "psychotherapeutic" approaches, where music is used to facilitate the therapy "process," and where the primary goal is to induce covert, unmeasurable, "subjective" changes, the practitioner is more likely to base therapy on the nature of the musical and interpersonal relationships that have emerged with the client. In these approaches, therapy is regarded as more of an art than science, and objective research is often regarded as inadequate in dealing with the complexities of subjective or spiritual phenomena of central interest. (p. 25) Since these moments are subjective and complex, perhaps containing spiritual elements, a qualitative approach is used in this study, in which "a major focus . . . is the meanings and the experiences of the people who function in the cultural web one studies" (Eisner, 1981, p. 6). Research Quest: The basic question of this study is: How can these moments, which involve the complexities of subjective realities and are related to multilevel intrarelationships and relationships among clientis), music, and therapist (s), be described and understood in an authentic manner? Additionally, the researcher asks the following questions: 1. What are the meaningful moments in the music9 therapy process as perceived by music therapists? 2. How do music therapists describe their experience during these moments? 3. What is the importance of these moments to music therapists? 4. What are the meaningful moments in the music therapy process as perceived by music therapy clients? 5. How do clients describe their experience during these moments? 7. What is the importance of these moments to clients? 8. What are the contributing factors? 9. How are these moments the same or different when perceived and described by therapists vs. clients? In seeking answers to these questions I hope to deepen the understanding of the music therapy experience, which will improve clinical practice and training of future music therapists.10 CHAPTER IT RELATED LITERATURE The review of the literature is in three sections. The first presents the psychology literature on meaningful moments. The second presents meaningful moments in education, and the third presents the literature of music therapy. Meaningful Moments in Psycholoay Meaningful Moments in a Person's Life “Human experience is primarily lived as a series of moments or events" (Grant, 1985, p. 3). Some of the most powerful and meaningful moments in a person’s life are known in the literature as moments of ecstasy (Laski, 1962); peak experience (Maslow, 1968); mystical and religious experience (James, 1961); Aha! experience (May, 1958); and rebirth experience (Jung, 1965). Laski (1962) analyzed the experience of ecstasy and found that some aspects that were experienced by human beings included loss of time and space, joy, insights, and physical sensations. A peak experience (Maslow, 1968), is one of the most meaningful, joyous, and happy moments in aqa person’s life. During a peak experience people usually feel such emotions as awe, reverence and wonder. They also feel more alive, integrated, here and now, aud in touch with the transcendent and the sacred. Maslow based his description of the peak experience upon 80 personal interviews and 190 written responses of college students as well as readings from the literature of mysticism, religion, art, creativeness, and love. He instructed the participants to think of the most wonderful experience of their lives, the happiest moments, moments of rapture, perhaps inspired by being in love, or aroused by listening to music or suddenly being hit by a book or a painting. One of Maslow’s conclusions was that "the fully human person in certain moments perceives the unity of the cosmos, fuses with it and rests in it, completely satisfied for the moment in his yearning for one-ness" (1976, p. 95). Maslow questioned the meaning of these special moments. He concluded that the experiencing itself is the revelation of the truth. He believed that this experience is so powerful that it could permanently affect one’s attitude toward life. He suggested how important these moments are: "It is my strong suspicion that even one such experience might be able to prevent suicide, for instance, and perhaps many varieties of slow self destruction, e.g., alcoholism, drug addiction, addiction to violence, etc." (1976, p. 75).12 Another interesting finding underscored the relevance of time. Maslow found that during peak experience, there was a complete distortion of time: Not only did time pass with a frightening rapidity but the moment also was so fully lived that it felt like a very long period. It was a place where "time simultaneously stood still and ttoved with great rapidity" (p. 81). Mystical and religious experience was studied in detail by William James (1961), who found four major characteristics which appear to be present to some degree in all types of mystical experience: transient quality, noetic quality, ineffability, and passivity. Rollo May (1958) took Kierkegard’s term Augenblick, literally meaning the blink of an eye and generally translated as the pregnant moment, and described it. It is a moment when a person suddenly grasps the meaning of some important event in the past or future in the present. Its pregnancy consists of the fact that it is never an intellectual act alone; the grasping of the new meaning always presents the possibility and necessity of some personal decision, some shift in gestalt, some new orientation of the person toward the world and future. This is experienced by most people as the moment of heightened awareness; it is referred to in psychological literature as the "aha experience." (p. 71) Carl dung (in Jacobi, 1965) talked about transformation experiences as experiences of rebirth, in which the self becomes new and is rejuvenated.13 These experiences are an integral part of the universal individuation process, the process by which people strive to become whole and to fulfill themselves. He also believed that a real liberation comes not from xepressing pain but only from experiencing these painful feelings to their fullest. The experiences mentioned above are some of the most powerful experiences in a human being’s life. The result of these moments can be a radical change toward better health and self-fulfillment. Since this is the ultimate goal of any therapeutic process, it is surprising to see that little attention has been given to the existence and exploration of such moments within the context of the therapeutic process. Therapy means change, expansion. We therapists serve as guides and share our client's journey in discovering his own inner wisdom, knowledge and creativity. One would assume that such moments as peak experience, mystical, aha! and rebirth might exist more intensely and readily within the context of therapy. A better understanding of these moments will enable therapists to understand more fully the experience of therapeutic healing and to create an environment which encourages these moments. Meaningful Moments in Therapy When reviewing the literature of psychotherapy14 from the last twenty years, one notices that the emphasis has shifted toward the understanding of "specific events which facilitate specific changes in specific clients under specific circumstances” (Phillips, 1985, p. 3). Warren (1986) argues that "therapists know that the true healing and insigzt occur only through contact with a direct and personally meaningful experience" (p. 37). In search of literature on meaningful moments which occur within the context of a therapeutic process I found terms such as moments of engagement (Kramer, 1989); moments of congruence and change (Rogers, 1960); moments of insight (Ellenberger, 1958; Grant, 1988); and moments of transformation and awakening (Clark, 1977; Shainberg, 1983). Kramer (1989) describes therapy as "a series of moments of engagement separated by less important periods in which the work of therapy seemed to be going well" (p. 13). Kramer sees certain moments as breakthroughs in the therapeutic process and describes these situations as "moments where we begin to see beneath surface signs to essential and endearing human qualities" (p. 21). Rogers (1980) recognizes moments of irreversible change for the client in the course of therapy: "when a person’s previously denied feeling is experienced in a full and complete way, in expression and in15 awareness, and is experienced acceptantly, not something wrong or bad, a fundamental and irreversible change occurs" (p. 224). Rogers emphasizes that a basic condition for these moments is for the therapist to be real, congruent, and genuine and for him to have the strength to permit the client to be his own realness and to be separate. Therefore, moments of congruence are powerful moments for both client and therapist. Shainberg (1983) finds that in every human life, there are places and relationships which a more ope! These include "moments with oneself when one is temporarily open to life’s possibilities" (p. 37). She explains that therapists are particularly interested in moments where the patient participates in a more engaged way in the session where there is a greater involvement. According to Shainberg, (1983), meaningful moments in the therapeutic process are moments of greater participation, increased realization of options, spontaneity, and creativity. New thoughts and new ways of feeling or seeing oneself, others, and the therapist are expressed. She identifies moments in almost every session in which there is "a transformation" of both patient and therapist. These events signal the awakening of the healing powers available in a human relationship. Some characteristics are an awakening of energy, a sense16 that something new is happening, a difference from other moments, and a more active participation which is rooted in the present instance. Clark (1977) considers transpersonal psychotherapy a process of awakening. Part of the process, as in waking up from a dream, involves recognizing the illusory nature of one’s limited perceptions of reality and the infinite possibilities of expanding inner vision. Intensive exploration of the symbolic dimensions of reality may also lead to the kind of dramatic awakening commonly referred to as a rebirth experience. (p. 74) In the therapeutic process there are also moments of insight and realization. Ellenberger (1958) describes the changes that take place in an important therapeutic encounter: Something totally new is revealed, new horizons open, one’s weltanschauung is revised, and suddenly the whole personality is restructured. . . + An encounter can bring a sudden liberation from ignorance or illusion, enlarge the spirit horizon and give a new meaning to life. (p. 119) Grant (1985) studies the formation of a powerful insight in psychotherapy as experienced and lived by the client. He gives a very vivid description of the experience of a power insight in psychotherapy based on the client’s description of his actual experience of the insight. Meaningful Moments in Education In the subject of education, Ely and Anzul (1989) identify special moments in teaching and characterize17 them as "moments of passion." They describe them as moments when such a strength of emotion enters into a classroom episode that teaching/learning interactions are swept out of their usual course and onto a different and unanticipated level . such moments are almost always unexpected, and can vary greatly in the nature and depth of emotions involved, and in how these emotions are expressed and interwoven with cognition. (p. 743) According to Ely and Anzul, although it is difficult to capture the essence of these moments, teachers must consider and support the importance of these moments to the process of teaching. These authors state that moments of passion have no standard form, but can be characterized by a series of interwoven layer: surprise, intensity, teachers’ agenda override, changes in pacing, nonverbal tone and talk. These authors find that these moments include that central teachers and their roles are frequently as members rather than as directors even when they are directing. "Moments of passion create kinship ties that quite cut across the lines of authority" (p. 747). For these moments to transpire, teachers have to be aware of them and prepare the ground for them. Music Therapy The Concept of Time Since this study is dealing with moments in the process of music therapy, it is important to examine18 the concept of time in music therapy literature. From reviewing the literature, I found that the music therapy experience has been studied from the point of view of time and space. (Bonny, 1975; Kasayka, 1991; Kenny, 1985, 1989a; Nordoff and Robbins, 1971; Pavlicevic, 1987; Priestley, 1975; Robbins and Forinash, 1991; Stephens, 1983). Kenny (1985) argues that the experience of music therapy can be explored from a time and space perspective, and she prefers to look at the experience as one that takes place in space. In The Field of Play: A quide for the Theory and Practice of Music Therapy (1989a), Kenny talks about the musical space as one of the main elements in the music therapy experience. She defines this as a contained space, an intimate field that is created in the relationship between client and therapist. "It is a sacred space, a safe space, which becomes identified as ‘home base,’ a territory which is well known and secure" (p. 79). Bonny (1975), who developed the technique of Guided Imagery and Music, (GIM), views the process from a combined concept of time and space. Traveling in the GIM experience involves traveling to altered states of consciousness where there is an expansion of consciousness beyond the ordinary consciousness. The client during these moments does not experience any limitations of time and space.19 Priestley (1975) thinks that an important feature of music is its existence in the dimension of time. It is her opinion that this is what enables the individual to undergo a transformational process. Priestley’s work is influenced by the philosophy of Carl Jung. She explains that the time element in music offers the client the opportunity to experience the process of what Jung calls enantiodromia, meaning "the love to hate" in order to transform. It offers tremendous freedom and confidence in the goodness of life to be able to give full vent to one’s hate through an acceptable musical channel and find that after a time of mounting, incredibly savage fury and destructive emotion and cacophony, nothing is destroyed . . . but that one is wonderfully changed and liberated inside and where there was only darkness and distress there is now light, vibration and courage. (p. 35) Robbins and Forinash (1991) view the music therapy experience from a time point of view: ‘There are experiences in clinical work when therapist and client are engaged in a misical and emotional sharing that time seems suspended. We become so involved in our music making, so present in the moment of our emotional expression that we lose track of time. We look at the clock and realize an hour has passed in what was felt to be only a few moments. (p. 46) They look at the concept of time as a multilevel experience. Physical time is time in the physical reality. Growth time occurs as ideas develop, and understanding and maturity are gained. motional time is the personal time of feeling: "The quickness of time in excitement, intense interest, ardent pleasure,20 enraptured absorption. . . . It is operative in the speed of our movements as we express our emotional state" (p. 52). Now time or creative time: "This is a moment of intuition, perception, of sudden insight or understanding. . . . It is felt in the moment of recognition, of knowing with certainty how to proceed with what we are doing, saying or thinking" (p. 53). ‘The realization that occurs in creative time is born within a state of action and therefore becomes instantly expressed in that action. Mei 1 Moments in Music Thera Nordoff and Robbins (1977) find meaningful moments in clinical musical improvisation with handicapped children. These are the moments when the therapist gets in touch with the music child. Nordoff and Robbins explain that the music child is "the individualized musicality inborn in each child. . . . Zt also points to the distinctly personal significance of each child's musical responsiveness" (p. 1). They describe that the conditions for the "music child" to be awakened and synthesized include the development of some communicative direction, some responsive order, some perceptive openness, and some freedom from confining habitual activity. These factors lead to the moment when the child becomes emotionally involved in the music, to his own self-realization and self-2a integration within the therapy session. Nordoff and Robbins believe that the time process is an important factor in allowing these moments to come to birth. They find that in the initial stage of therapy the children’s responses are fragmentary or reflexive and that one cannot see the "music child" within severely handicapped children. Stephens (1983) identifies moments of connection and disconnection in the musical improvisation. "In a moment of connection, there is a pull in the rhythmic chant which renews all the players through its own special magic--the magic of music" (p. 41). Pavlicevic (1987) reflects on the premusical moment in the music therapy process with adult psychiatric patients and finds this to be a crucial moment in the music therapy context. "Once the patient’s trust has been gained on a personal- professional-non musical level, the musical process can begin and the therapeutic relationship can take its own course" (p. 24). She claims that this is a very important moment--the instant where trust is being gained and the relationships between the therapist and her patient start to be established. It is the moment which introduces music as a healing force to come. It is interesting to note that even though the music is the unique element in the music therapy experience, she believes that trust can come only from the verbal22 moment. The nonmusical moment is, in fact, a precondition to start the musical process. I would argue that trust can be gained sometimes more immediately and effectively through the nonverbal process of music making. Kasayka (1991) writes in her dissertation about meeting and matching the moment of hope in the Guided Imagery and Music experience. She talks about "moments in each human life that are transformational" (p. 1) and finds that all of the clients in the study experienced transformations in the transpersonal realm on an intrapersonal level. All the above authors have identified the importance of time and specific moments in the process of music therapy. Even though we can see that there is some attention given to these issues, a review of the music therapy literature indicates that there is little discussion of the music therapy experience from this point of view. Further, only a few researchers deal specifically with the description and understanding of the experience of music therapy from music therapists’ or clients’ perspective. We music therapists experience and witness special moments with our clients quite frequently. The question become: : Why is so little written about this phenomenon in the literature?23 of Quantii ech In examining the studies in the music therapy literature, it seems to me that most writers focus on specific aspects of music therapy such as goals (Gfeller, 1987; Lord, 1971; Wheeler, 1987), activities (cassity, 1976; Rubin, 1976), and techniques (Alvin, 1981; Steele, 1984). In most of the research articles, the findings come from a quantitative, positivistic kind of research. Recently, it has been noted that quantitative research methods fail to describe and therefore to illuminate the meaning of the music therapy experience as a whole in terms of its internal and external qualities (Aigen, 1991; Bonny, 1984; Bruscia, 1987; Forinash, 1990; Forinash & Gonzalez, 1989; Hesser, 1982; Kenny, 1982, 1985, 1989; Munro, 1985). In 1978, the Task Panel for the Use of the Arts in ‘Therapy and the Environment of the President's Commission on Mental Health in Canada stated: ". . . the measurement techniques of present statistical methodology are not enough to capture the qualitative effective gains made through exposure to the arts" (in Kenny, 1982, p. 25). Kenny (1982) says that although quantitative research has been utilized in the arts, results have not shown consistent significant change. Internal24 changes, inspired by art therapies, are not easily observed. Kenny offers three reasons for this effect: First, artistic experiences usually occur on a deeper level and change is more gradual and does not happen immediately. Second, the spiritual qualities of artistic experiences are vague and mysterious and therefore are difficult to quantify. Third, since quantitative methods can measure only part of the artistic experience, the rest of it remains unknown and unaccounted for. I choose to examine this difficulty and to take as an example a quantitative study from Music Therapy: Julia Haines’s study of "The Effects of Music Therapy on the Self-Esteem of Emotionally Disturbed Adolescents" (1989). Since self-esteem is a major concern in the overall treatment of emotionally disturbed adolescents, and since music therapy has been demonstrated to be an effective modality with this population, Haines’s purpose is to determine the specific effects of music therapy upon this age group. Nineteen subjects were selected by convenience sample, then divided into two treatment groups: ten subjects participated in a music therapy group and nine subjects participated in a verbal therapy group. Subjects were pre-and posttested with the Coopersmith Self Esteem Inventory (CSEI). There were no significant differences between the two groups or between the25 Pretest and posttest scores. However, the resp. nses of the subjects to their placements as noted by the researcher in her daily logs were very significant: None of the subjects in the music therapy group was disappointed or complained about his or her placement. In contrast, all but one of the subjects in the verbal therapy group were disappointed about their placement. This divergence in attitude pervaded the entire course of the study and effected the subjects’ motivation within their respective groups. (p. 88) Another difference between the groups was the subjects’ thematic material. In the music therapy group, themes included friendship, loneliness and heroism. One subject talked about his personal experience during the whole process: ". . . it sure felt good to come in and play the drums when I was angry" (p. 88). This was a meaningful experience for him, In the verbal therapy group the main theme was disappointment. After the groups had been announced, one subject stated: "I don’t want to be in this group. I learn by doing, not by talking" (p. 88). In conclusion, there were significant differences in the clients’ responses which were noticeable only through the therapist’s process notes and the clients’ own description of being in the group. In this example, the researcher attempts to understand a phenomenon from an objective point of view. She is interested in results rather than26 process, in explaining rather than describing. The client is viewed as "the object of research" (Racette, 1989) rather than as an experiencing participant. The researcher uses a quantitative method, which requires the phenomenon to be observable, measurable, and the data collected, quantifiable. The researcher attempts to operate within a controlled procedure in order not to influence the results of the research but fails to show significant results. Why is almost all of the research in the music therapy literature based on quantitative methods? Hesser (1988b) explores this issue and concludes that music therapy is a unique profession, bridging art and science. There is a need to interact and to learn from the related disciplines in music and science. "We learned to speak their ianguage, tried out their models of research, followed their lead educationally, and have developed our professional standards from theirs" (p. 21). In addition, we also needed to be accepted by the related professions and therefore had to follow their ways. Hesser (1988b) urges that now is the time to move on and to strengthen our own identity as a separate and unique discipline. "It is time to focus on developing our own theoretical foundation, using the language and the forms of research best suited to our unique experience of music as therapy" (p. 12). She suggests that what we need is to explore new research27 methods that reflect the art and the beauty of our work as music therapists. Kenny and McMasters (1976) made an attempt to evaluate the effectiveness of music therapy in a number of clinical settings in Vancouver, Canada. They used both hard and soft data. The psychological tests showed no significant effect of music therapy as a treatment medium. The soft data, however, which included the patients’ reports, showed that the patients were generally enthusiastic about music therapy. The soft data also indicated that it was a valuable experience for them. Here is an example of one such report: It was good to feel the freedom of an unstructured music. . . . I really got in touch with some of my aggression during this time, and for the first little while really wanted to hammer on the drums. (p. 57) This response indicates that there was an inner, unobservable shift in this participant. This shift was not indicated in the hard data. The researchers conclude that the fact that this shift was not shown in the hard data is due partially to the inability of traditional research tools to detect shifts in patients as a result of the use of music therapy. In 1982, New York University hosted the World Symposium on Music Therapy. The participants divided into working groups, and one of the groups focused on research. Each of the participant had to write a28 statement related to the topic of discussion. Hesser, who organized the symposium and was a member of che research group, wrote in her statement: I think the experimental research model necessitates a neutral, technical and objective look at music and often leaves music without its passionate, playful, artistic qualities. Much of the essence of our profession may be lost if we continue in this vein. I think we need a new paradigm of research which allows us to look at music therapy without loosing its essence (Unpublished manuscript) . one of the conclusions of the symposium was that the use of a combination of methods would provide a more holistic picture of the experience. Toware New Language Another conclusion in the 1982 symposium was that any language used to describe the experience of music does not necessarily capture the essence of the actual experience. There is agreement among music therapists about the lack of language to describe effectively the music therapy experience. This difficulty in describing the experience is mainly due to the nature of art, which is often nonverbal, secretive, and mysterious. As such, it contains both internal and external elements such as spirituality, emotions, and beauty. In her statement in Music Therapy, Hesser (1988a) writes: Each year my personal relationship to music seems to deepen and expand as I open myself more and more to receive the beauty and power of its29 gift. Being in the field of music therapy has allowed me the opportunity to experience music as a transformative agent in my life, in relationships, and in communities. Yet my understanding of this gift remains illusive. Whenever I attempt to describe and share what I understand, I am struck by the limitations of words to communicate the experience of music and the deepest essences of life. (p. 70) Another question arises: What are some of the concepts and words that are being used in order to describe authentically the inherent, secretive qualities of the music therapy experience? There have been a few attempts to describe the inherent qualities of the music therapy experience. Bonny (1975) studies the connection between the use of psychedelic drugs and music at the Maryland Psychiatric Institute. Bonny suggests that our experience with music is a healing one and can best be described in the realm of consciousness. Since music taps different levels of consciousness, it is difficult to observe this experience in concrete and immediate behavior. Bonny explains that when a person is in a heightened state of consciousness, the mind is able to contain many ideas and experiences. Awareness seems to be intensified and enlarged, while consciousness itself can become multidimensional. Music seems to acquire color, shape, motion, taste and scent. When a person is listening to music in a state of heightened awareness, music is able to generate levels of emotional intensity, depth and comprehensiveness: