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Guided Imagery and Music (GIM: The Bonny Method)

GIM, is a receptive music therapy approach developed by Helen Bonny, a trained music therapist and violinist, in the 1960s during her participation in a research study at the Maryland Psychiatric Research Centre. Helen Bonny’s role in this research study was to select music during the experimental psychotherapeutic treatment of substance abuse and terminally ill patients with hallucinatory drugs such as LSD. Her curiosity was aroused as she discovered how powerfully evocative music could be for patients in a deeply relaxed state or altered state of consciousness (Bonny, 2002). Through years of clinical work and on-going research, Helen Bonny developed over 40 classical music programmes with specific clinical intentions used as an integral component of the GIM method. These programmes are 25-50 minutes in duration and comprise between 3 and 5 pieces each.

Bonny (1990) describes GIM as “a process where imagery is evoked during music listening” (Wigram, 2002, p.115). Goldberg (1995) comments that “GIM is a depth approach to music psychotherapy in which specifically programmed classical music is used to generate a dynamic unfolding of inner experiences….(it is) holistic, humanistic and transpersonal allowing for the emergence of all aspects of the human experience: psychological, emotional, physical, social, spiritual, and the collective unconscious” (Wigram, 2002, p. 115).

Whereas, in creative Music Therapy, music works as a communicative, creative and non- verbal tool, in GIM music works mainly as a projective tool, through which images, emotions and a range of experiences are possible. The symbolic and experiential material evoked through music listening is processed in an explorative, non–directive manner in order to facilitate the client accessing insight (Bonny, 2002). A GIM session comprises the following structure:

  1. Pre-talk - the client and therapist discuss the presenting problem. The therapist guides the client in setting an intention, or focus for the session. The therapist then selects the music programme appropriate to the agreed intention.
  2. Induction – the therapist invites the client to lie in a comfortable position and guides the client through a process towards a state of deepened relaxation. At the conclusion of the induction, the therapist will inform the client that the music is about to begin and will reiterate the clinical intention for the music listening
  3. Music listening – In GIM (The Bonny Method) the music is positioned as the co therapist. Approximately fifty GIM programmes have been developed to address a diverse range of clinical intentions. While the client listens to the music the therapist assumes a non- directive approach, dialoguing with the client through a series of open questions which guides the client’s experience. Music evokes, inter alia, imagery, emotions and a range of experiences. Clients are encouraged to engage with whatever is necessary for their growth and transformation.
  4. Post talk – the client is invited to visually represent images or experiences evoked through the music listening. The therapist provides the client with paper and pastels and witnesses this process silently. Only once the client has completed this do client and therapist verbally process imagery or salient issues arising from the music listening. The drawing is mostly the point of departure for verbal processing and can provide valuable insights to unconscious dynamics at work within the client.

GIM is a very specialized and manualised technique, but illustrates the evocative power of music listening. There are numerous creative ways in which music listening can be employed in clinical work, where music takes on the role of a projective tool in addressing a wide range of presenting problems.

Analytically Orientated Music Therapy (AOM) – The Priestly Model

AOM is a form of Analytic Music Therapy that was founded by Mary Priestly, a music therapist and violinist, in the 1970s. She defines AOM as:

“the analytically-informed symbolic use of improvised music by the music therapist and client. It is used as a creative tool with which to explore the client’s inner life so as to provide the way forward for growth and greater self-knowledge” (Priestly, 1994: 3).

In AOM, clients are involved in active music making in the form of clinical improvisation. The music therapist analyses the joint music of client and therapist in order to determine clinical goals and on-going clinical work. Creative Music Therapy typically does not include verbal processing during or after improvisations with clients, whereas AOM emphasises the role of verbal processing after improvisations between client and therapist, which elicit meaning and insight for the client. What is emphasized in AOM is the transference phenomena and the relationship between the client and the therapist (Wigram, 2002). An AOM session typically includes the following:

  1. Pre-talk – client and therapist discuss the presenting problem. This serves as the basis for identifying a working topic formulated into a playing rule for the joint improvisation between client and therapist.
  2. Improvisation – the working topic is non -verbally explored through music, during which the therapist supports the client’s music introducing a variety of musical interventions as and when clinically appropriate. The music can be tonal or atonal and it can include sections where either client or therapist play alone. It is standard procedure for the improvisations to be audio-recorded.
  3. Verbal reflection – Client and therapist discuss the improvisation. The therapist may play the recording of the improvisation to the client. The role of verbal reflection is to bring to consciousness intra and inter personal dynamics evoked during the improvisation. This guides the client towards insight necessary for growth and transformation.
  4. Final improvisation – an AOM session is typically concluded with a clinical improvisation based on insights gained during the verbal reflection between client and therapist.

In this model we have a combination of a music centred approach, similar to that of Creative Music Therapy, with a psycho-analytic approach employing music as a projective tool which serves as a canvas for the landscape of the client’s inner world. AOM is suitable for work with clients wishing to explore a range of emotional, psychological and spiritual challenges.

Behavioural Music Therapy (BMT)

Behavioural Music Therapy focuses on the concrete use of music for the purposes of behaviour modification, including physiological, motor, psychological, emotional, cognitive, perceptual and autonomic behaviour. BMT can address a variety of non-musical goals such as social engagement, physical activity, communication, cognitive processes, attention and concentration, enjoyment, reduction and elimination of antisocial behaviour and independence skills (Wigram et al, 2002, p. 134-135). Bruscia (1998) defines BMT as “the use of music as a contingent reinforcement or stimulus cue to increase or modify adaptive behaviours and extinguish maladaptive behaviours” (in Wigram, 2002, p. 134).

Madsen and Cotter (1968) identify four ways in which music is used as treatment in BMT: a) as a cue, b) as a time structure and body movement structure, c) as a focus of attention and d) as a reward. In BMT music can be regarded as a stimulus and reinforcer of non- musical behaviour. It can involve teaching a client a musical skill, the use of music listening or improvisation. The primary focus of BMT is to achieve changes in the client’s behaviour.

BMT is an appropriate intervention for clients with mental and physical challenges; children with ADHD; clients with disorganised psychosis and children with learning difficulties.

 

 

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