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When adoptive families come to Music Therapy, they are often in crisis and struggling to think about, let alone, verbalise the challenges they are experiencing. Of course, I acknowledge that I am generalising here. However, in the teams that I have been part of, I have heard many sad and difficult stories about early life trauma, about parents struggling to have children and about families finding it hard to connect because they feel blocked in their communication and nurture giving. The impact of unresolved trauma for the child and family can be overwhelming and at these times, love isn’t often enough. They need some external support and that is where Music Therapy can help.

Music Therapy can help adoptive families hear their problems from a different perspective. The Music Therapist becomes the Transitional Attachment Object; they provide co-regulation, an objective perspective, consistency and safety for the family members so that they begin to mentalise their own and each other’s problems. The music created in the sessions becomes a clear externalisation of those difficult internalised feelings and everyone has to hear them. One of my favourite questions to ask families (and therapists in supervision) is, “If this interaction was a piece of music, what would it be?”. This helps families to put a shape around their individual feelings and see how they connect with each other. Empathy is fostered through the externalised music and the family can move from dissonance to harmony, through acceptance of each other’s melodies.

This brings to mind some sibling work I did a few years ago. The parents were at the end of their tethers because the children were constantly fighting and arguing. In the first sibling session, we played an improvisation where the brother played the xylophone quietly, sister played a djembe wildly and I sat in the middle, hopelessly strumming a guitar. At the end I asked the siblings what the music represented. Brother said, ‘it was like a beautiful flower opening up’, and sister exclaimed, ‘I was stomping!’. Here, we had a brilliant representation of their internal worlds and a good indicator of where the challenges in the relationships lay. The aim of the work became tolerance. I knew it was time to end when one day, brother played quietly with his lego in a tent, whilst sister crashed and bashed around the instruments and instead of getting annoyed with each other, they began passing each other objects from their part of the room. They had begun to appreciate each other’s differences through accepting each other’s melodies.

Part two: Misconceptions of Music Therapy and Adoption Work

As a manager and supervisor of Music Therapists working with adoptive families, the most frequently asked question I am given is, “Why are we not making music in the session?”. This is often asked in frustration or anxiety, sometimes even fear because if we are not making music, are we still Music Therapists?

There are two main themes at play here: the need of the therapist to do their job, and the capacity of the client to feel safe enough to play. The therapist holds a lot of responsibility as they begin working with a new family. The family may be in crisis and stuck, they may have been waiting a long time for therapy. The transference is strong in these initial dynamics. The therapist might feel overwhelmed at this pressure. They may feel they have something to prove - commissioners and families need positive outcomes so that therapists can prove their worth. Additionally, the therapist is a Music Therapist! They have trained long and hard to have this identity and now they are not doing what they are supposed to do! And then we have the adopted child.

In adoption, the child will have experienced disrupted attachment relationships. They will have lived in at least three homes with different adults and they may be distrusting of any new adults. They may not be used to accepting care and attention and it might feel uncomfortable and unusual. They may reject the lovely instruments the therapist has brought as a symbol of their internalised attachment experiences, and in turn, the therapist feels rejected. I once had a referral for a young person who loved playing the guitar. I learned to play the guitar for the sessions. Keen as mustard, I arrived at the first session with sore fingers and a handful of chords only to be told by the young person that guitar wasn’t his thing and he was more into piano…

So, here we are. We have a frustrated and worried Music Therapist, an anxious and distrusting child and no music. Firstly, there is always music. For the Music Therapist, the language of music is the biggest cognitive construct and I encourage you all to use this language to describe the interactions in the therapy space. What are the rhythms of your client’s movements?  What is their tempo? How does their voice sound or not sound - what are the dynamics? When they play, what music would be sound tracking their game? In your relationship, what piece of music would this be and what instruments would you be playing? And then we can use these descriptors to talk to others about our work. We can share our musical language in network meetings and with families, with commissioners so they understand our processes and in our written words, too. 

Secondly, the feelings we have in the therapy space are always related to the feelings in the family. Winnicott told us that we need to feel safe in order to play. We need to feel safe so that we can switch off our defences and relax into something creative and different. In adoption work, if the child is not playing in the space with us, chances are they are not playing in other contexts. So how do we help them to feel safe and trusting? Of course, our consistency of time, space and attention help and the therapeutic alliance is key to creating safety. And it is also the music that helps. We don’t need to find the words or work out complex social cues, we can see where the music takes us and really listen to others. Furthermore, the music is transient. It exists in the moment and then dissipates. You don’t need to worry about getting it wrong or being graded for it. It can be - and this helps the client to be.

So next time you are wondering why there is no music or if you are still a Music Therapist if you are not playing music, remember that the music is still there. All you need to do is listen.

Find out more about Rachel Swanick

Rachel Swanick is Clinical Lead for Oakdale Adoption Support and Trauma Service. She is a specialist in attachment theory with adoptive families, using creative arts and music therapy assessment to support positive wellbeing.

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