Abstract. research, therapeutic relationship. Keywords: music therapy, tango, clinical improvisation, qualitative

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1 Tango Improvisation in Music Therapy L improvisation de style tango en musicothérapie Demian Kogutek, BMT, MMT, MTA PhD Student, Rehabilitation Sciences, University of Western Ontario, London, ON, Canada Abstract Little used in clinical improvisation, tango s potential implications in music therapy have not as yet been fully examined. The goal of this exploratory research study was to incorporate tango music into a clinical improvisational setting to see how the musical components of tango could expand the level of musical communication possible in participants and how these components could affect the therapeutic process. This qualitative research incorporated both theoretical and practical applications, and the methodology was based in grounded theory. Three clients from a long-term care centre participated in tango music during clinical improvisation. They played tenor metallophone while being accompanied by the researcher on classical guitar. The primary data collection sources were audio and video recordings. The research included a microanalysis of the improvisations, the results of which showed how tango music had effectively altered the melodic contour, dynamics, and tempo played by each participant. The research sessions also provided a means for emotional relief and allowed the participants to incorporate stylistic characteristics of tango into their improvisations. This is shown in a measurable and quantifiable manner through music notation. Keywords: music therapy, tango, clinical improvisation, qualitative research, therapeutic relationship Résumé Peu utilisé en improvisation clinique, le potentiel de la musique de style tango en musicothérapie n a pas encore été suffisamment étudié. Le but de cette recherche exploratoire est d incorporer la musique de style tango à l intérieur d un contexte d improvisation clinique afin d observer comment les composantes musicales du tango peuvent élargir le niveau de communication musicale possible des participants et comment ces composantes peuvent influencer le processus thérapeutique. Cette recherche qualitative incorpore à la fois des applications théoriques et Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 166

2 pratiques et la méthodologie se base sur une théorie empirique. Trois clients d un centre de soins de longue durée ont participé à de l improvisation clinique utilisant de la musique de style tango. Ils ont joué du métallophone ténor en étant accompagnés par le chercheur à la guitare classique. Les sources primaires de collecte de données théoriques et pratiques provenaient d enregistrements audio et vidéo. La recherche inclut une microanalyse des improvisations dont les résultats illustrent comment la musique de tango a efficacement changé le contour mélodique, les dynamiques et le tempo dans la musique jouée par chaque participant. Les séances de cette recherche ont offert un relâchement émotionnel aux participants et leur ont permis d incorporer les caractéristiques stylistiques du tango dans leurs improvisations. Ceci est démontré de façon mesurable et quantifiable par la notation musicale. Mots clés : musicothérapie, tango, improvisation clinique, improvisation clinique, recherche qualitative, relation thérapeutique The use of clinical improvisation has been extensively researched and written about (Aigen, 2005; Ansdell, 1995; Bruscia, 1987; Lee, 2003; Lee & Houde, 2010; Nordoff & Robbins, 1977/2007; Pavlicevic, 1991; Ruud, 1998; Wigram, 2004). However, a less explored research area of clinical improvisation has been the use of different styles of music. Lee (2003) and Lee and Houde (2010) posited that music therapists should be knowledgeable about multicultural styles and the general theoretical makeup of different music from around the world. According to Aigen (2005), Paul Nordoff reported a remarkable experience with the first client he worked with in a music therapy context. He observed that while the boy seemed content and serene when a Chinese pentatonic scale was played, the boy reportedly cried when Nordoff altered the tones to a Japanese pentatonic. Nordoff went back and forth between the two scales, and each time, he observed the same reaction. If two different musical styles can generate two completely different emotional responses, what are the implications of using different styles of music in clinical improvisation? How then, can these implications be utilized in a therapeutic setting? Purpose of the Study While I was growing up and studying music in Buenos Aires, Argentina, tango music was an integral part of my life. After immigrating to Canada at the age of 22, my connection to tango diminished somewhat, maybe because the environmental incentive was not present any more. Many years later, I began incorporating tango music in clinical improvisation sessions as a master s Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 167

3 degree student at Wilfrid Laurier University in Waterloo, Ontario, Canada. During these individual sessions, I noticed clients who had a tendency to play similar rhythmic and melodic patterns throughout improvisations. My aim as a student was on incorporating not only tango, but also different styles of music, instrumental arrangements, and improvisational techniques in order to expand clients musical vocabulary and communication while assessing the clients acquirement of musical patterns and ideas over time. It was because of my clinical work that I decided to conduct this research. The purpose of this research study was to incorporate tango music in improvisational music therapy. The objective was to expand each client s level of musical communication by analyzing the qualities of improvised tango, specifically dynamics, rhythm, melodic patterns, and tempo, ultimately linking the participant s musical expansion to the development of the therapeutic relationship. In order to understand the implications of tango style during clinical improvisation sessions, I formulated the following two questions: How do the musical components of tango expand the client s level of musical communication? How do the musical components of tango affect the therapeutic process? Methodology Research Design This qualitative research used a grounded theory approach. The goal of this research method is to develop interrelated concepts that can describe reality and at the same time generate new ideas (Amir, 2005; Glaser & Strauss, 1967). Semeijsters (1997) stated that reality is not described by means of an already existing theory and hypotheses; instead, these can be generated from and become grounded in the reality of a research study. This process requires the researcher s total immersion in the data in order to become intimately acquainted with the data and develop a detailed knowledge of it. The research began with the collection of data, and through this process I was able to identify patterns, relationships, concepts, and categories. This phase is called open coding. The second step, axial coding, was then done. This involved procedures for connecting and relating categories and subcategories found in the open coding (Wheeler, 2005). Most grounded theory research, including the one described in this article, also incorporates data related to self-reports, audio recording, and observations (Smeijsters, 1997). Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 168

4 Four clients living in a long-term care home were chosen to experience tango style during clinical improvisation sessions. I invited the participants to play the tenor metallophone while I accompanied them on classical guitar, which is my main instrument. I chose the tenor metallophone for several reasons: (a) the instrument produces a pleasant and interesting sound; (b) it is simple to play and requires no previous musical training (Nordoff & Robbins, 1977/2007); and (c) the instrumental sounds of the guitar and tenor metallophone complement each other, providing the opportunity to engage on equal musical terms (Pavlicevic, 1991), ultimately allowing me through musical notation to explore not only rhythmic but also melodic characteristics of the client s response to tango improvisation. For the purpose of the research, a reflective improvisation technique was used (Wigram, 2004). This technique required me as therapist to begin the improvisation with music that was reflective of the client s mood at that time. Grounding techniques were also incorporated to create a stable musical environment by including music that acts as the anchor for the client s music. The similar techniques of holding and containing were employed, acting as the musical anchor for a client who was ungrounded in his or her playing and whose music was random and without direction (Bruscia, 1987). Approximately five to ten minutes of improvisation, I transitioned into tango style. After approximately two to five minutes of tango improvisation, I transitioned back to the original style of improvisation and then continued with the clinical improvisation intervention. I used an overlap transition technique (Wigram, 2004), where the musical style was introduced while continuing with the existing way of playing by using legato or smooth tango arpeggios. Participants A total of four participants ranging in age from 46 to 87 years old each attended one individual music therapy session per week for a period of eight weeks. Three participants were female and one was male. All had different diagnoses, which included Alzheimer s disease, dissociative identity disorder, and chronic obstructive pulmonary disease. Sessions lasted between 20 and 40 minutes, depending on the length of the improvisation. In order to have greater transferability, which refers to a generalizability of the research findings to broader populations and settings (Pomerantz, 2008), three out of the four participants were selected on the basis of their different ages and diagnoses. A university research ethics board approved this research, and informed consent was obtained from all participants involved in the research. Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 169

5 A music therapy assessment was conducted in order to evaluate whether potential participants were capable of playing the tenor metallophone. In addition, clinical goals and interventions were established to address specific needs of participants in order to maintain a therapeutic focus throughout the research process. Table 1 presents the most relevant information gathered during the clients assessments. Data Collection Procedures Audio and video recordings were the primary sources of data collection. In each session, the participant sat across from me, and a digital video camera was placed two metres from the participant and set at an angle that captured both the participant s and my profile. Two microphones were used; these recorded the audio portion of the session to ensure a high quality of sound. Data Analysis For each participant, the tango portion of an improvisation was selected and transcribed from the audio recording using Finale software. I also selected and transcribed 30 seconds before and after the tango portion. These two 30-second portions were used to compare the tango portion with the surrounding musical style of the improvisation that was based on the client s mood. After printing the notation of the improvisation portion to be analyzed, I employed three methods for data analysis. The first method I used was Holck s (2007) ethnographic descriptive approach to video microanalysis. This is an informed approach to observational research that studies everyday settings and seeks to understand actions and their meanings in a social context. Using this method of recording interactions for analysis, I began with standard music notation and then added gestures and facial movements over the notation line, a technique described by Wosch and Wigram (2007). The second method I used was De Backer and Wigram s (2007) analysis of music notation examples. I analyzed the musical score of the selected improvisation, and I notated figures in a structured way to identify relevant sections and points in the score. I marked major sections with letters and indicated details such as accents and dynamics in standard musical notation. Having used these two methods to transcribe the music and add printed notations, I then did a simultaneous analysis of both methods horizontally and vertically. The horizontal analysis allowed for interpreting music and meaning of action independently across time, while the vertical analysis allowed comparison between music and action at specific points in time. Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 170

6 Table 1 Client Assessments Participant Client A Client B Client C Gender/age Male/85 Female/63 Female/47 Diagnoses Alzheimer s disease Chronic obstructive pulmonary disease Assessment Clinical Goal Intervention Client tended to become stuck in repeating rhythmic and melodic patterns. He played up and down the scale with both hands alternatively, leaving a tone or semitone in between. He demonstrated rigid and perseverative patterns in his improvisation. To provide client with meaningful social interaction through the use of clinical improvisation. Attempts were made to change the client s rhythmic, melodic, and dynamic patterns by encouraging different rhythms, chord progressions, and the use of different musical styles. Client thrived in the palliative care unit, becoming ambulatory and virtually independent, but still required oxygen therapy. Neurologically, she remained intact. From an early age, client was obligated by her mother to take piano lessons. She stopped studying music after completing several grades at the conservatory of music. Her mother was displeased with her decision. Client felt her learning process was too forceful and was not an enjoyable experience for her. To reconnect client with music-making in a nonthreatening way. Clinical improvisation intervention suited her needs. A decision was made not to encourage her to play the piano, which the client disclosed intimidated her, and instead decided that her playing the metallophone would be a more positive experience. Dissociative identity disorder as a result of herpes encephalitis Client presented negative behaviours such as entering other patient s rooms, agitation, verbal aggression, non-compliance to requests, and socially inappropriate behaviors. These behaviours were difficult to manage on the unit. To increase client s ability to remain on task by maintaining goaldirected behaviors through clinical improvisation. This provided her with social interaction skills and furthered her communication through musical dialoguing. Provided client with the opportunity to improvise on instrument of choice with prompting and encouragement with a minimum amount of verbal interaction. Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 171

7 The third method I used was an indexed account of each session in its entirety. The process of sessions was described, which led to interpretations of the therapeutic process. This included a component where I engaged in ongoing self-reflection. A critical component of the research process was documenting the intrapersonal interpersonal experiences and physical sensations not visible on the video recording. Finally, any particular interpretation of the data from the first two methods was compared to the indexing of the entire session. The use of these three methods of analysis made it possible to understand the implications of tango from three different perspectives. The music notation analysis provided a closer look at the improvisation, while the recording of the participants actions provided a visual understanding of the phenomenon. Finally, through analysis of the indexing of the session, an even greater understanding of tango s implications was gained. Throughout this process of data analysis (axial coding), I was able to formulate categories and sub-categories based on open coding. Results Categories Three categories, each with subcategories, were developed from the musical analyses: music qualities (phrase contour, tempo, dynamics); emotional relief (sing, sigh); and incorporation of stylistic components (glissando, syncopation). Examples of Clinical Music Analysis Example 1 (Phrase Contour). In the category of music qualities, the tango style showed certain implications in all three participants musical responses. This was expressed as shortening phrase contouring and increasing dynamics and tempo. Phrase contour denotes the gross motion of pitch, which contains the balance between steps and skips, and the role of the melodic range over time (Müllensiefen & Wiggins, 2011). An example of shortening phrase contour could be seen with Client A, who tended to become stuck, repeating rhythmic and melodic patterns. He played up and down the scale on the metallophone with both hands alternatively, leaving a tone or semitone in between scale notes. Baker and Tamplin (2006) describes this as perseverative playing, a tendency of some people with cerebral lesions to persistently repeat the same note, movement, or word. Although Client A s rhythmic pattern appeared to be triplets, this was not obvious due to his lack of accentuation of down beats. I supported his Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 172

8 playing by introducing a tremolo accompaniment in a romantic classical style on my guitar. In the following example, the notation of the client s music is located in the upper staff. The client s repetitive motion was evident in measures 16 to 20, among other measures in the excerpt: Figure 1 1 I introduced the rhythmic section of the tango style in measure 59. Instead of maintaining the repetitive motion, the client began changing this motion to only one or two measures during the rhythmic part of the tango. By measure 81, his melodic shape had a clear contour of an ascending and descending line: Figure 1 2 When I transitioned back to tremolo accompaniment in a romantic style in measure 169, once again the client s repetitive motion lacked melodic contour: Figure 1 3 Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 173

9 Example 2 (Increase in Tempo and Dynamics). Before the introduction of the tango section, Client B was playing mezzo piano in a slow tempo as I improvised in a 20th-century musical style with arpeggios in the lower register of the guitar: Figure 2 1 With the introduction of tango, the rhythm intensified the dynamics and tempo of the improvisation. Client B s dynamics changed from mezzo piano to mezzo forte, and her tempo also sped up, resulting in shorter melodic phrases: Figure 2 2 Example 3 (Incorporation of Stylistic Components). Two participants incorporated stylistic characteristics of tango with the addition of rhythmic cells, adding glissandos and syncopations to their playing. Rhythmic cells are defined as a small rhythmic design that can be isolated or can make up part of a thematic context (Nattiez, 1990). Before entering into the tango portion of the excerpt, I matched Client C s rhythm in a classical style using a simple melody with an Alberti bass accompaniment. The rhythm contained eighth notes that imitated the client s musical style. She played eighth-note and quarter-note rhythms with phrases that extended over several measures: Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 174

10 Figure 3 1 When the tango syncopation with glissando was introduced, Client C used syncopation for the first time in measure 36: Figure 3 2 At measure 105, Client C played several glissandos: Figure 3 3 Once again, Client C acquired the two most noticeable stylistic components of tango syncopation and glissando and incorporated them into her improvisation. She also used the syncopated cell and glissando after the tango section was no longer present. Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 175

11 Example 4 (Emotional Relief). The use of the tango seemed to provide emotional relief to all three participants. This was seen as singing or sighing after the rhythmic portion of tango ended. The intensity of the tango rhythm provided Client B and Client C with emotional relief, as the syncopated rhythmic sections transitioned to simple tango arpeggios. It was in measure 119 where Client B expressed a deep sigh: Figure 4 1 Client A reacted in a similar manner, but instead of sighing, he simply stopped playing the metallophone and began to sing in measure 179, just before the end of the analyzed example: Figure 4 2 Conclusions and Self-Reflection Most resources that relate to clinical improvisation focus on techniques that support the client s musical intention (Bruscia, 1987; Lee, 2003; Ruud, 1998). As well, to meet and match the client s musical intensity is an essential starting point in clinical improvisation (Ansdell, 1995). The question that arises is whether or not the therapist should establish music that challenges the client. Pavlicevic (1997) stated that it is not always helpful to the client for the therapist to match and meet the client s music. In order to assist clients to begin exploring and growing into the full potential of their dynamic form, the therapist needs to alter the musical form, offering something new. Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 176

12 Within the context of this study, the tango portion of the improvisation had two distinct moods. First, the tango arpeggios, which were used as musical transitions from the client s initial musical idea to tango and vice versa, depicted the typical melancholic characteristics of the genre, and a descending bass line with eight notes created an inviting musical environment that supported the client s musical intent. During the tango arpeggios section, all three clients maintained the role of soloist. During the rhythmic portions, the syncopation and upbeat marcato dance-like rhythm of tango style contributed intensification and excitement to the improvisation. These dance-like qualities of tango and its rhythms contain strong accents, which can be interpreted as the rhythmic force that encourages movement in dancers. Thus, participants seemed to encounter some of this rhythmic force during the improvisation, and the rhythmic qualities of tango created a switch in the clinical improvisation. Within the musical structure of tango style, participants were able to play more freely. The rhythmic portion of tango created a middle ground in the improvisation where participants were able to change their style of playing in response to the tango music. This change process was most evident in the participants incorporation and use of syncopation and their louder dynamics and faster tempos. Musical intensification can also generate emotional relief. This was manifested through a participant s singing and sighing at the end of the rhythmic portion of tango. Although this finding was the most interpretative and was not clearly evident in the musical notation, I do believe that it was as a result of the intensification of the musical style. The structure of tango served as a means for musical dialogue where participants expanded their musical communication by incorporating stylistic characteristics into their own improvisation. This can be interpreted as empowering clients within the therapeutic relationship through musical equality during improvisation. The use of a musical style such as tango can be fundamental to the therapeutic relationship, where the therapist aims to empower their clients through music. If we consider that clinical improvisation mirrors the therapeutic relationship, what then are the implications of musically challenging our clients? If clients are asked to musically match the intensity of a certain musical style, what then might the benefits of that intervention be and in what context? As clients develop their musical communication, the therapeutic relationship may also gain equality. Sharing a social system with equal power (e.g., improvisation) is the foundation for growth (Pavlicevic, 1991). The use Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 177

13 of tango in the clinical improvisation process can offer a similar exchange of support and challenge found in relationships by incorporating its rhythmic qualities of musical intensity. References Aigen, K. (2005). Music-centered music therapy. Gilsum, NH: Barcelona. Amir, D. (2005). Grounded theory. In B. Wheeler (Ed.), Music therapy research (2nd ed., pp ). Gilsum, NH: Barcelona. Ansdell, G. (1995). Music for life: Aspects of creative music therapy with adult clients. London, England: Jessica Kingsley. Baker, F., & Tamplin, J. (2006). Music therapy methods in neurorehabilitation: A clinician s manual. London, England: Jessica Kingsley. Bruscia, K. (1987). Improvisational models of music therapy. Springfield, IL: Charles C. Thomas. De Backer, J., & Wigram, T. (2007). Analysis of notation music examples selected from improvisations of psychotic patients. In T. Wosch & T. Wigram (Eds.), Microanalysis in music therapy: Methods, techniques and applications for clinicians, researchers, educators and students (pp ). London, England: Jessica Kingsley. Glaser, B. G, & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago, IL: Aldine. Holk, U. (2007). An ethnographic descriptive approach to video microanalysis. In T. Wosch & T. Wigram (Eds.), Microanalysis in music therapy: Methods, techniques and applications for clinicians, researchers, educators and students (pp ). London, England: Jessica Kingsley. Lee, C. (2003). The architecture of Aesthetic Music Therapy. Gilsum, NH: Barcelona. Lee, C., & Houde, M. (2010). Improvising in styles: A workbook for music therapists, educators and musicians. Gilsum, NH: Barcelona. Müllensiefen, D., & Wiggins, G. (2011). Polynomial functions as a representation of melodic phrase contour. In A. Schneider & A. von Ruschowski (Eds.), Systematic Musicology: Empirical and Theoretical Studies (pp ). Frankfurt, Germany: Peter Lang. Nattiez, J.-J. (1990). Music and discourse: Toward a semiology of music. Princeton, NJ: Princeton University Press. Nordoff, P., & Robbins, C. (2007). Creative music therapy: A guide to fostering clinical musicianship (Rev. ed.). Gilsum, NH: Barcelona. (Original work published 1977) Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 178

14 Pavlicevic, M. (1991). Music in communication: Improvisation in music therapy (Unpublished doctoral dissertation). University of Edinburgh, Scotland. Pavlicevic, M. (1997). Music therapy in context: Music, meaning and relationship. London, England: Jessica Kingsley. Pomerantz, A. (2008). Clinical psychology. Science, practice, and culture. Thousand Oaks, CA: Sage. Ruud, E. (1998). Music therapy: Improvisation, communication, and culture. Gilsum, NH: Barcelona. Smeijsters, H. (1997). Multiple perspectives. A guide to qualitative research in music therapy. Gilsum, NH: Barcelona. Wheeler, B. L. (Ed.). (2005). Music therapy research (2nd ed.). Gilsum, NH: Barcelona. Wigram, T. (2004). Improvisation: Methods and techniques for music therapy clinicians, educators and students. London, England: Jessica Kingsley. Wosch, T., & Wigram, T. (Eds.), Microanalysis in music therapy: Methods, techniques and applications for clinicians, researchers, educators and students. London, England: Jessica Kingsley. Canadian Journal of Music Therapy Revue canadienne de musicothérapie, 20(2), 179

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