Telling your story, together : musical collaboration as a resource for intellectually disabled persons who communicate without speech to express a self-determined narrative in music therapy

Abstract

This study explores the ways music therapy, and in particular, collaborative music making allows the expression and configuration of non-verbal narratives. It presents three cases of music therapy with intellectually disabled persons who communicate primarily without speech. Each case is presented individually. In total, 21 sessions of music therapy were analysed. Reflexive Thematic Analysis and Arts Based Methodology were used to generate main themes for discussion. Across the full dataset, 13 main themes were identified, organised collectively into five overarching themes. 1) Embodied Themes featured: a) Embodied Communication; b) Navigating Interpersonal Dynamics and Expectations Without Words; and c) Unspoken Understanding and Connection: Conveying With The Body. 2) Identity Themes included: a) Defining Characters; b) Navigating Interpersonal Dynamics and Expectations in the Music; and c) Making Contact and Meeting in the Music. 3) Presence Themes were: a) Presence Invites Presence; b) Supporting Authentic Expression; and c) Listening and Leaving Space. 4) Dialogue Themes were: a) Musical Dialogue; b) Making Meaning Through Interaction; and c)Channels of Dialogue - Establishing and Configuring Narrative. 5) Mystery Themes included a single main theme: a)The Unknown as a Path to New Stories. The findings point to the immense value of clinical improvisation in fostering musical dialogue and establishing shared meaning where words are not accessible. Relevant musical and interpersonal tools used in this endeavour, as well as emergent narrative structures, are explored. This study also highlights key factors that promoted the development of the therapeutic relationships, namely: reciprocity, respect and a radical openness to non linguistic modes of connection. Non-verbal narratives seem to operate differently to verbal ones, and so effective dialogue calls for a relationally focused way of being present that fosters acceptance and collaboration.