Abstract:
This paper is the product of a dialogue between two music therapists who have sought to understand the impact of silence in their
clinical work. That understanding is informed in part by the larger picture of silence in political, social and philosophical
contexts. The authors discuss aspects of these areas before focusing their argument more specifically on music therapy practice.
While we work with silence and sound, we tend to write and research only about sound. In this paper we
will make a case for actively thinking about silence in the following areas: musical silence, silence in interaction and silence
in therapeutic process.
The authors' particular interest in working with clients who have experienced violence and trauma provides
the frame for much of the clinical material. However, the paper will be of interest to all those who seek to further the
connections between therapist and client through both sound and silence.
JS:
This paper has emerged from the peculiar silence of an e-mail dialogue. Like the silences of which we shall speak, those that have
passed between us have had many different flavours: animated and fruitful, anxious and blocked, enjoyed and endured. We hope to
explore with you the place of silence within music, within human communication and in the experience of trauma. Through two brief
case studies we look to examine some of the functions and qualities of silence within music therapy.
CF:
The relationship between sound and silence in music was noted by Saint Augustine. To him, it reflected a universe in which matter
is created from nothing and returns to nothing. From silence we come, to silence we return. Silence is associated with eternity
and finds, because of this, a prominent place in the work of composers such as Taverner. Music emerges from silence as though
from an already existing music which was simply unheard. This unheard music connects with John Cage's emphasis simply on sounds,
"those that are notated and those that are not. Those that are not notated appear in the written music as silences.". (Cage 1973 p7)
JS:
The valuing of silence in music is prominent in the work of free improvisers such as Eddie Prevost who wrote of silence as a
'refined state of musical expression'. He felt that sound was meaningless unless the implications of the improvising musician's
silence were attended to, saying that, "the experience of silence is necessary for the interpretation of sound". Strikingly, he
emphasises not just the silence itself, but the experience of the silence.
It can be viewed as one of a set of musical strategies musicians may use to engender, in Stanyek's words:
"a very inclusive space for music making..." (Stanyek 1999 p45)
CF:
The place of silence in creating an inclusive space is also recognised from a different perspective by theologian Jeremy Begbie,
making a connection between improvising musicians and church communities. Both, ideally, allow individuals to be
'persons-in-communion' with each other.
"Giving space to the other through alert attentiveness, listening in patient silence, contributing to the growth of others by 'making the best' of what is received from them." (Begbie 2000 p206).
Silences then can have both a musical impact and a powerful interpersonal meaning, involving an openness to the experience of being with another. In the Quaker tradition
"Silence is simply a preparation for being still, the means of worship, not the worship itself." (Punshon 1987 p12)
Perhaps within music therapy silence could be valued both for itself and as a means to other ends.
JS:
In truth, however, the value of silence in therapeutic work has not always been appreciated. Frequently, in early
psychoanalysis, silence was seen as resistance, to be overcome before the work could progress (Sabbadini 1991). Only later
did analysts such as Balint urge that it might be studied as a 'form of information' in its own right (Balint 1968). This led
to a recognition that silences can have very different qualities. Some are the expression of states that are dead and
suspended, some seem more active and perhaps more inherently destructive. These a therapist may need to weather. They protect
the self and if broken it is the core self that comes under threat. Jungian analyst, Nathan Field describes a third type:
"phases of anxiety-free silence where each party simply rejoices in the existence of the other" (Field 1996 p103). He
connects these experiences with those that are so essential to early development.
CF:
As well as types of silence, Winnicott suggested that there might even be silent regions of the psyche.
"At the centre of each person is an incommunicado element, and this is sacred and most worthy of preservation" (Winnicott 1989)
The therapist must then learn to feel her way into the different types of silence that can arise. Sometimes the client may need the therapist to come and find them, at other times to weather something destructive, at other times still simply to wait. Some silences are spaces out of which a further communication may be born. Others are powerful communications in themselves. In all of this we are attending to the nuances of our clients musical expression. But in doing so we need also to recognise the impact of our own responses, our sounds and silences.
JS:
This is taken up by Rosie Woo, describing her work with two clients who are silent in different ways during their therapy.
She concludes:
"Although the means of communication in our analytic work is verbal language, nevertheless the understanding of primitive mental states involves both the use of 'symbol and of sound' (Maiello 1995) by our patients and ourselves. In the end, it is our presence in all its forms, including our sounds and our words, that opens the way for 'more' to happen." (Woo 1999 p112)
Silence in the therapist can then be a form of presence, in the therapeutic relationship something that opens new doors.
French child psychotherapist and linguist, Danon-Boileau makes silent communication a precondition for the development of
other forms of expression.
He writes:
"I establish a dialogue without words. (Author's emphasis) That is because, before setting children on a path towards language, they must be given the feeling that they can be understood even without words." (Danon-Boileau 2001 p10)
CF:
Both he and Rosie Woo think about silence in a musical sense as part of a communicative flow between people, having both form
and content. It seems to be spoken of then as a developmental prerequisite, as almost a characteristic of key areas of the
psyche and as a crucial communication in a therapy, one that needs to be respected, understood and sometimes preserved.
We have already emphasized then two silences, the musical and the relational. Each of these can have a larger context, which is collective. This may be particularly important to bear in mind when working with the trauma that arises in communities where violence is an on-going part of daily life.
JS:
In 1987 I moved from London to a Belfast that was the scene of considerable military and paramilitary action. I was, to some
extent, traumatized by hearing reports of shootings, car bombs and of sitting in my home and hearing the dull thud of a bomb
in the city. It was difficult to talk about this to my friends and it felt like there was some kind of silencing going on
within the community.
Research has shown that coping mechanisms used by people included minimizing the severity of the violence ("oh no, it's far worse across town than here", or "well just look what's happening in other parts of the world") and denying the real impact of what was happening (Sutton, 2002). So a really complex kind of silencing went on. This also permeated the health professions. And it wasn't until the first ceasefire that people began to talk about the impact of living in a community where violence was taking place. With the guns silent, people could begin to speak.
Traumatic events destroy the feeling of being safe and secure in the world. As the post-trauma process unfolds, a grieving
becomes necessary, in order to mourn the world that once was and the person who will never be the same again.
If the trauma involves the death of someone close, then that grieving is further complicated. And right in the middle of all
this is silence. For one can feel silenced by those around, those who do not want to upset the traumatized person, those who
will not understand, and those who cannot bear to hear the facts of what has taken place.
CF:
Gill Hinshelwood, a doctor at the Medical Foundation for the Care of Victims of Torture writes about the experiences of
refugee women who have survived the trauma of rape (Hinshelwood 1999). In describing their overwhelming shame, she refers
to the 'voicelessness' which may be its consequence. This voicelessness frequently makes it possible for the perpetrators
to continue their atrocities with little fear of reprisal.
It is also carried by the individual into their closer relationships. When a wife cannot speak to her husband of what has happened for fear of his response, or when those around who seek to help can not breach this silent wall, then the burden is carried alone. Hinshelwood tells us of one woman's shame at her experience, of the utterly disabling effects of her silence and the importance, for her, of telling, and surviving the telling, of her tale.
JS:
My experiences in visiting Mostar and Sarajevo not long after the war ended also made me think a lot about community silence.
Paradoxically, it was an absence of silence that was most striking in this community. People
found it very difficult to stay in one place for long, and were clearly post-traumatically hyper-vigilant. In classrooms I
found that children would frequently fill even quite short silences with speech or on some occasions, shouts and screams. It
felt as though it was impossible to tolerate or contain a silence, externally and more importantly, internally. Here the
experience of 24-hour shelling or the sustained sniper fire of Sarajevo left adults unable to keep their homes and families
safe. Children were full not only of their own terror, but of the fear and insecurity of their parents also.
When an individual suffers a traumatic event he is, in Caroline Garland's words
"flooded with unmanageable quantities of raw unprocessable 'stuff', and his mental functioning is thrown into disarray. For a while he is overwhelmed, and out of action." (Garland 1998 p184)
When a community is traumatised, something equivalent takes place at a collective level. It is then unsurprising that children in Mostar where unable to contain silence, living in a town where they had been subject to the constant sound of shells over days and nights. The very experience of safely contained silence was stolen from them.
In clinical work within this community my colleagues have frequently spoken of a "wall of sound" that children presented, where their music was continuous, explosive and blocking out any potential for the therapist to connect with them. The silently received shell sound (and its impact), which had had to be contained within the child inside the family home, was now being projected back out into the world.
Only after this was achieved could the therapist begin to find ways to make connections with the child. I have experienced something of the same with some children in Belfast whose changed behaviour had been related to the violence in their community. Yet while the children produced such volumes of sound with the instruments, at first their voices were silent. As their initially unformed music found form, so they then began to reclaim their previously silent voices. Claire is going to give an example of this process for one refugee family.
CF:
I am currently working with a 10 year old boy and his family at the Medical Foundation in London, an organisation working with
people from many countries, who have experienced political violence.
Hamid was referred to our service to help him and the family deal with the legacy of traumatic events which had surrounded his early years. In the family's country of origin, the political views of the father attracted first the threat of violence then its reality. Suddenly, Hamid, 4 years old at the time, was kidnapped and held under what we believe were quite appalling conditions. The degree of danger for the rest of the family led them to flee the country immediately, facing the unthinkable anguish of leaving their oldest son in hostile hands.
It has been difficult to establish the exact timing and course of events, but it appears that two years later, the Red Cross negotiated the boy's release and reunion with his family who were living in this country. Now, four years on, the family are reasonably settled in practical ways, but struggling to manage some aspects of Hamid's behavior.
Difficulties with sleep were the presenting issue for the referrer. Hamid finds getting to sleep difficult, and is often awake until the early hours of the morning. He needs someone to be with him throughout the night, his parents and older sister taking turns in the vigil. The feeling of a vigil is carried into the day too. His sister is in his class at school, and his family appear to find it hard to let him be independent even within the confines of their home. Clearly Hamid and his family have been left struggling terribly with issues of separation and loss.
Hamid is a small, slight child who, in our early sessions, sat quietly in the music therapy room, hands folded on his lap, looking watchfully around the room. He was quiet, often silent in our initial sessions, looking carefully at all the instruments and occasionally asking a question 'What's that made of?', or 'how do you use that?'. His voice when he spoke was whispery and faint, not quite a proper voice at all.
His music seemed similarly unformed, often so quiet that it was hard for me to hear it, and although containing some clear rhythmic patterns, generally quite wandering and amorphous in structure. At times his playing could go quietly on and on, Hamid seemingly impervious to my attempts to create form, direction or even the crudest of endings.
Listen to a short extract of this playing. Here, we are playing together on two pianos. As we play, almost alternating with
our sounds, his playing seems tentative, cautious - the sounds barely there.
TAPE EXAMPLE 1 : "Hamid" (Mini disc 'Extract 1' Track 1 first 45 seconds.)
Yet amidst the fragility of the sounds, there also seem to be intimations of strength and shape to his own music. As I thought about him in supervision, this meeting of the whispering, barely there Hamid, evident in his speech and music, with the more solid musical child heard in his determined rhythms seemed striking. Here is a boy who has a voice, but struggles to find it.
I wondered how it was possible to be with a virtually silent child, who played so softly, and still feel as though he presented me with a 'wall of sound'. His music may have been quiet, but the lack of breaks, pauses and silences made it strangely impenetrable. It seemed as though Hamid was not so much blocking me out with his continuous sounds, as keeping himself in, holding himself together with his music.
Other efforts were also being made to keep Hamid together, the constant presence of his family being one. I realized that, at no point in the week was Hamid ever alone. At night, at school, in the home, someone was always with him. The only time in the week when he was not with a family member, was when he came into the music therapy room. Here, for this child and his family who had experienced the most brutal of separations was an experience of being able to manage a brief physical, and indeed, emotional, separation.
In order to further explore this issue of separation, I want to look in some detail at one particular session, four months in to the therapy. In so doing, it is possible to explore how aspects of separation can be understood musically, particularly through the experience of silence.
Interestingly, in this session Hamid chose the xylophone. This was the first time he had selected a less sustained instrument, one with the capacity for spaces. As we play, our music is more spiky than usual, slightly louder in volume, and with a quicker tempo and more energetic feel. His touch on the instrument is stronger, his grip firmer which makes the sound ring more fully. Our Bartok-like music is exciting and quite unpredictable.
As you listen to this example, you'll hear two things. Firstly, that emerging from our prickly playing we reach a point where we join together in a melodic phrase which, in a bar of 4/4, has the last beat silent. This happens twice more, before the music moves on.
This, although a fine detail, is an important musical event, which can be seen as carrying with it other significant meaning. The significance is found in the silences which the crotchet rests bring. Here the sound ends, an absence of sound follows, then both players begin again simultaneously. It seems as though, for a boy who had faced such a separation as his, and who could not now be apart from siblings or parents, this small absence then resumption of sound might say something of a faint but growing potential to manage being healthily separate. Winicott suggested that the infant learns to be alone through the experience of being alone with another (Winnicott 1965). This seems particularly pertinent here.
Then, in the extract comes a delightful development as Hamid launches into a quirky little melodic line, beautifully formed
and structured, while I, with my oom-cha bass accompany him.
To hear such a distinct melody from him, incorporating as it does it's own moments of silence, was unusual. The healthy
separation of our musical roles here, melody and accompaniment, further hints of the together-but-apart experience it was
possible to have in the music.
Quite abruptly we come to an end, a slight musical surprise. But again, this ending, the first clear conclusion of an
improvisation we had had, with a silence to follow, has significance. In musical terms, he and I are more connected, able to
hear and respond to the musical cues of the other, and allow the concluding silence. Within the therapeutic relationship it
is the sound of that silence which resonates so strongly. An experience, a connection has ended, a separation takes place, and
yet that separation is chosen, managed and survived.
TAPE EXAMPLE 2 : "Hamid" (Mini disc 'Extract 2' Track 2 first 1.05 seconds - until the silence at the end.)
Prévost's emphasis on the 'experience of silence' for the musician seems apt here. For Hamid to incorporate silences within his playing would be an important step, but for him to be able, at some level, to 'experience' them and their meanings, seems vital. That he was able to report, a few weeks later, that he had slept through the night gave added weight to this thinking about separation and silence. To sleep is to be separate, to be abandoned in some way. To be able to sleep easily is to be able to bear an absence, a silence in relationship. His growing musical experience of silence appeared to help with the absences and separations that have been so difficult to manage recently and which were so traumatic in his past.
JS:
I have also thought about the ability to hold onto and experience silences or pauses in the therapy room for those on the
autistic continuum. Autistic people are also traumatized. The world around them may feel untrustworthy, not always reliable
and safe. Those with autism have experiences of 'flooding' that can be seen as similar to post-traumatic flooding. Jane
Bunster used this very term in describing her experience of two autistic children in psychotherapy sessions:
"Both children, in their different ways, tried to flood me and confuse me and this, we may surmise was related to their own experiences of feeling flooded and confused. It would seem that for both of them, the fear of flooding and being flooded was total and catastrophic." (Bunster1988 p201)
Clearly, such 'total and catastrophic' fear needs constant managing and defending against. The required hypervigilance makes it difficult to have a digestible experience of the world, and to connect safely with it. Dissociation easily prevails. When traumatic experiences disrupt trusted ways of regulating emotional states, dysphoria can result, a confusion of feelings, including a dreadful emptiness and isolation. The state of 'annihilation panic' is powerfully described by Hill:
"I am icy cold inside ...., as if I am flowing and spilling and not held together any more. Fear grips me and I lose the sensation of being present. I am gone." (Herman, 1992 p198-9)
What we are suggesting is that this describes equally the experience of a child like Hamid and that of many autistic children. It has a bearing on their capacity to tolerate silence and on the meaning of those silences that do occur. It is this that I want to take up in thinking about my work with a five year old autistic child called Brian.
Brian was referred because of his difficulty in engaging with peers and his tendency to solitary play. In his interactions he could appear to be very blank. At other times he became distressed and hit out. Social cues, such as facial expression and eye contact, were very difficult.
In our first session, Brian seemed distant and anxious, physically barricading himself behind an array of percussion instruments. His glancing at and touching the instruments invited from me a reciprocal sound at the piano. Silence followed before Brian shot me a look and moved to another instrument, where the same thing happened again. Another silence, then another piano chord from me. Brian jumped up and down, ran to the other side of the room, then from one side of the room to the other, making excited vocal sounds. He seemed keyed up and tense, yet also pleased and energized. I waited in silence for a while and without looking at him, I played another quiet piano chord. This seemed to help him gather himself, and he settled a little, coming back to the instruments again.
I found the interaction delicate and fragile. It would be all too easy to overwhelm him - after all, it was difficult enough for him to stay with and contain himself during the slow-moving exchange that had occurred. On the other hand there was a sense that Brian wanted to play the instruments and that he was taking in how I responded to him.
By session three, Brian was responding to the many pauses between sounds, becoming more able to stay with the instruments. He was also taking risks - stealing glances at me and twice making fleeting eye contact.
The following extract comes from this third session. Brian is in front of the metallaphone, with two beaters, playing tentatively, single sounds or a few notes at a time. I play slow, dance-like music in a minor key, thinking that the melody and its accompanying figure will help Brian join up his fragmented responses. You may hear this beginning to happen.
I leave many pauses for him to take part, offering him a turn to play, rather than expecting or wanting him to contribute.
He risks exploring the upper register of the instrument, playing for longer and with more confidence. The silences are
important, weighted with Brian's effort to sustain the interaction. In the end, he stays at the instrument for ten whole
minutes. During the final silence, which Brian breaks with a kind of sigh, he stands at the metallaphone, sticks poised
mid-air, holding eye contact with me throughout. Brian's inbreath conveys that something is taken in and held onto.
EXAMPLE 3 : CD- "Brian"
The music and the silences contain the emotional impact of this fragile, delicate interaction. The silences, brief and longer, help us gather together and reflect on the experience of our connectedness. Perhaps above all, the silences help us to listen, not only to the quality of sound but to the quality of relationship. This listening brings a heightened sense of awareness - of both self-with-an-other, and self-alone. It is this sense of awareness that can be so tenuous and fragile for Brian and others with autism. It can be similarly damaged by the experience of trauma as was the case with Hamid.
CF:
Listening in this way demands that we learn to tolerate our own anxieties and those of our clients. We need to be alert to the
signals we emit during these times of silence, our failure to value the more empty space. Two millennia ago in China, Lao Tse
wrote eloquently of how the artist works to shape clay into a vessel, but it is the space within that makes that vessel
useful. Perhaps our music, like the pot, is most valuable if it has space inside, the space of silence.
JS:
In the work that we have described, silences have been imbued with tremendous meaning. They have been the expressions equally
of absence and of presence, the voice of the unspeakable, times of connectedness and times of aloneness. They provide
opportunities for us and our clients to experience ourselves differently, to relate both to what is within and what is
without. The silent space can be one of holding and reflection. It can be a moment of rest, an opportunity to gather oneself
together, to integrate. Sometimes demanding a response, sometimes evoking it, silence is the space into which a response
may come.
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