TABLE OF CONTENTS

Contributors xvii

Preface xxi

Chapter 1: An Introduction to Music Psychotherapy

Kenneth E. Bruscia

A context for the book is provided by defining music psychotherapy and explaining the specific ways music can be used. Three methods are highlighted: improvisation, songs and music imaging. Basic characteristics of a psychodynamic orientation are delineated. 1

Chapter 2: The Many Dimensions of Transference

Kenneth E. Bruscia

The literature on transference is reviewed and a definition of transference is provided that frames the clinical essays in the chapters that follow. The many dimensions of transference are then examined as continua along which each transference can be analyzed, such as past/present, appropriate/inappropriate, intra-personal/interpersonal, unconscious/conscious, pre-oedipal/oedipal, sources, and objects 17

Chapter 3: The Dynamics of Transference 35

Kenneth E. Bruscia

The relationship between transference and other phenomena is examined, including introjections, projections, identification, projective identification, introjective identification, and resistance. Three levels of intervention are offered for working with transference.

Chapter 4: Understanding Countertransference

Kenneth E. Bruscia

The literature on countertransference is reviewed and a definition of countertransference is provided that frames the clinical essays in the chapters that follow. Five components are examined in detail: sources (where it originates), activators (what brings it out), identifications (the person or thing being replicated), objects (the person or thing toward which it is directed), and outcomes (whether it obstructs or facilitates therapy). 51

Chapter 5: The Signs of Countertransference

Kenneth E. Bruscia

The ways in which countertransference is manifested are described, both in the positions that therapists develop toward their work (such as clinical specialties and styles, theoretical orientations, use of music) and in their moment-to-moment interactions with clients (such as somatic, emotional, and interpersonal reactions; decisions, ruts; burnout). 71

Chapter 6: Techniques for Uncovering and Working with Countertransference

Kenneth E. Bruscia

Several techniques for investigating and managing countertransference are presented. Techniques that can be employed during a session include self-clearing, moving ones consciousness, following procedural cycles, and using helpful images. Techniques that can be used away from the client include referential and experiential self-inquiries, supervision, self-experiences, and nurturing the musical self. 93

Chapter 7: Resistance in Individual Music Therapy

Diane S. Austin and Janice M. Dvorkin

While everyone who enters psychotherapy has the conscious intention of wanting to change, clients often exhibit ambivalence through resistance to communicating thoughts and feelings to the therapist. Much has been written about this phenomenon in verbal psychotherapy; this chapter addresses its manifestation in music therapy sessions. Also discussed is the effect of transference and countertransference on the therapists clinical judgment regarding the amount and type of music used in each session and through out the therapy process. 121

Chapter 8: The Role of Aesthetics in Countertransference: A Comparison of Active Versus Receptive Music Therapy

Edith Lecourt

Aesthetic concerns contribute to and shape the therapists countertransference in different ways for active versus receptive music therapy. Of specific concern in the extent to which the therapist idealizes, denies, recognizes, or uses the aesthetic dimension of music in therapeutic work. The discussion is organized around three forms of countertransference: classical countertransference, concordant identification, and complementary identification. Also considered are the main psychological functions aesthetics in music therapy: sublimation, defense, perversion, and pleasure. 137

Chapter 9: Transference and Countertransference

In Nordoff-Robbins Music Therapy

Alan Turry

The creative process of improvisation is explored, focusing on the client-therapist relationship and the dynamics inherent in the musical interaction. Included are a description of current Nordoff-Robbins practice and an examination of its specific principles and their implications for transference and countertransference. A careful analysis of music created by a client and therapist illustrates transference and countertransference phenomena. Issues that may impede the creative process are considered. Examples from supervision and clinical cases are used to explain concepts. 161

Chapter 10: The Role of Musical Countertansference

In Analytical Music Therapy

Benedikte B. Scheiby

Three variants of musical countertransference are considered classical countertransference, complementary countertransference (c-counter-transference), and e-countertransference (specifically, traumatic e-counter-transference)along with how they manifest in clinical musical interactions. Characteristics of Analytical Music Therapy and its use with depressed clients or those who have been emotionally, sexually, or physically abused are described, with particular emphasis on how countertransference can present in music. 213

Chapter 11: Transference Experiences in Two Forms

Of Improvisational Music Therapy

Susan J. Hadley

The nature of transference in Analytical Music Therapy and in Creative Music Therapy are examined and compared from the clients perspective. Although evoked, expressed, and worked through differently under each method, the transferences were essentially the same. 249

Chapter 12: Transference and Countertransference

in Group Improvisation Therapy

Janice M. Dvorkin

Transferences can occur in music therapy groups just as in verbal analytical group therapy. The music, however, provides a structure through which the unconscious process can be expressed and heard, as can behaviors and perceptually distorted verbal expressions of transference material. Just as conscious versus unconscious choices can be explored in dream work, so can the choice of composed music versus improvisational music be explored and interpreted directly in the group environment. Improvisational music therapy in the group setting is valuable because both group members and therapist are available as observers of and displacements for the transference object and because it offers each member a variety of responses to his or her transferential statements and validation of transference material. 287

Chapter 13: Relational Issues in Psychoanalytic

Music Therapy with Traumatized Individuals

Louise Montello

Transference and countertransference reactions that emerge within the music therapy matrix between traumatized client and therapist are analyzed. Several case vignettes are used as clinical examples commonly found in work with traumatized individuals both within and outside of the musical context and to show how music can be used to elucidate and transform both intra- and interpersonal conflicts. 299

Chapter 14: When the Psyche Sings:

Transference and Countertransference

In Improvised Singing with Individual Adults 315

Diane S. Austin

Transference and countertransference during vocal improvisation in analytically oriented music therapy are examined as they emerge as transformative aspects of the therapeutic relationship. Singing techniques developed by the author are illustrated in two case examples.

Chapter 15: Unconsciously Induced Song Recall:

A Historical Perspective

Cora L. Diaz de Chumaceiro

An overview is provided of the application of psychoanalytic principles to the analysis and interpretation of unintentional evocations of vocal music in treatment and in everyday life, from the turn of the twentieth century to the mid-1980s. The contributions of Sigmund Freud, Carl G. Jung, Theodore Reik, Jean B. Rosenbaum, Frances Hannet, Cassandra M. Klyman, and Daniel S. Jaffe are examined. 335

Chapter 16: Consciously Induced Song Recall:

Transference-Countertransference Implications

Cora L. Diaz de Chumaceiro

Two research studies conducted in Latin America are presented, both applying the induced song recall technique to both members of psychotherapy dyad, along with a more recent supervisory case. A technique is presented for detection and resolution of transference-countertransference dynamics that can lead to impasses and premature flight from treatment. 365

Chapter 17: Countertransference in Clinical Song-Writing

Paul Nolan

Listening to songs stimulates unconscious processes. In clinical song-writing, the music and lyrics stimulate subjective responses in the therapist, including countertransference reactions. A process is described whereby the therapists awareness and acceptance of all music- and relationship-invoked feelings can be guided toward conscious use within the treatment process. This enhances the therapists understanding of the client and limits the negative consequences of unconscious countertransference responses. 387

Chapter 18: Manifestations of Transference in Guided Imagery and Music

Kenneth E. Bruscia

Case examples are used to illustrate the specific ways in which transferences are activated, configured, and expressed in Guided Imagery and Music (GIM). First, the various objects, sources, and valences of GIM transferences are examined, then those aspects of the GIM experience that activate transference are considered. 407

Chapter 19: The Pure Music Transference inGuided Imagery and Music

Lisa Summer

In, GIM, classical music, not the therapist, is the primary therapeutic agent and is therefore placed centrally as part of the primary transference relationship. Clinical material from a clients first GIM session shows how a transference relationship is first established with the music and then expressed in the imagery. The author labels this phenomenon the GIM pure music transference and examines its origins and theory. 431

Chapter 20: Transference Structures in Guided Imagery and Music

Connie Isenberg-Grzeda

Transference and transference resistance within the context of GIM are considered. The notion that the therapists theoretical ideas shape his or her perception of the therapeutic process and that this in turn shapes the nature of patients transference reactions is explored. Three different con-ceptualizations of the role or function of music in GIM are presented, and their potential impact on transference resistance is described. The relationship between structural aspects of the GIM process and transference phenomena is examined. 461

Chapter 21: A Self-Analysis of Transference in Guided Imagery and Music

John Pellitteri

An analysis of transference as it occurs in GIM is presented. A therapist in the role of client illustrates the imagery, the music, and the GIM facilitator as objects of transference. Interpretations of transference resolution are presented from various psychological theories. 481

Chapter 22: Modes of Consciousness in Guided Imagery and Music: A Therapists Experience of the Guiding Process

Kenneth E. Bruscia

A case example is used to introduce a reflective form of self-inquiry aimed at explicating what it means for a therapist to be there for a client during the GIM experience. A theory is explicated on how a therapist expands, centers, and moves his or her consciousness into various experiential spaces while guiding the client through the music-imaging experience. 491

Chapter 23: Reimaging Client Images: A Technique for Exploring Transferences and Countertransference In Guided Imagery and Music

Kenneth E. Bruscia

A case example is used to introduce reimaging, a technique developed by the author for uncovering unconscious aspects of the client-therapist dynamic in GIM. The therapist has a short GIM experience, focusing on an image created by a client previously, then analyzes his own version of the image to discern countertransference and transference. 527