Recurring similarity: the meaning of musical objects in music therapy for adolescents with structural disorders

ABSTRACT

Finding and using a particular musical object (e.g. a special song, a musical instrument, a specific musical pattern) often helps adolescents with severe affect and contact regulation disorders to manage the building of a therapeutic relationship. The coincidence of the repeated recourse to a musical object and the diagnostic assessment of a structural disorder led to the question as to why these adolescents in particular repeatedly make use of such a consistent musical “third element”. To widen the understanding for this concurrence and to describe the phenomenology of the potentials of recurring musical objects in music therapy for adolescents with structural disorders, three different cases were analysed from a qualitative, hermeneutic perspective. The findings consist of typical characteristics of a musical object, central aspects of its psychodynamic variety of meaning, and its importance for the adolescent patient, as well as the key factors involved in the reconstructed and analysed music therapy processes, both in terms of the therapeutic stance and methodological needs. Music therapy immanent factors could be associated with the concept of a “third position” within the therapeutic dyad. Because of its safety-giving function, a musical object allows the development of exploration, contact regulation, mentalization and symbolization.

KEYWORDS:

• Youth psychiatry
• adolescence
• attachment
• third position
• recurrence
• psychodynamic music therapy
• case study

Acknowledgements

I would like to thank Dr Katherine Tiede for her professional editing advice, as well as Kate Cleary and Dr Walter Stockinger for their linguistic “fine-tuning” at the end of the writing process. Intramural support was provided by Drs Rainer Fliedl and Judith Noske at the Department for Child and Youth Psychiatry and Psychotherapy Hinterbrühl, Austria.

Notes

¹ Original: “Die Welt wird in ihm, wie auch er in der Welt wird.” (Noske, 2014, p.13).

² Names have been changed.

Additional information

Notes on contributors

Monika Smetana

Mag. art. Monika Smetana, PhD holds a master degree in music therapy and a PhD from the University of Music and Performing Arts, Vienna (Austria). She has been working as a music therapist in the field of child and youth psychiatry since 2002. Currently she is a University Assistant (PostDoc) in music therapy at the University of Music and Performing Arts Vienna, Austria. She is a core board member of the Viennese Institute of Music Therapy (WIM) and co-editor of the German journal Musiktherapeutische Umschau.