Music Therapy Session Archive

Maria’s music therapy session work with Dr. Alan Turry over the course of 24 years is comprised of dozens of unique, improvised collaborations—a journey into self-expression through music. Certain songs are accompanied by Alan’s analysis of the interplay between improvised words and music, as first described in his doctoral thesis. (Please note that the pseudonym Gloria is utilized in the dissertation.)

Tell The Truth (They Tell Me I’m Sick) – December 19, 1994 [Click for analysis]

The following archived material comes from a session very early during the course of therapy. Gloria was struggling to come to grips with the reality of her physical condition regarding her recent cancer diagnosis. 

No I don’t want to go to the next phase

I don’t want to suffer

I don’t want to be sick

So that’s It. I think treatment is making me sick

Gloria never did begin chemotherapy or radiation treatment. She went to many oncologists and found one who was willing to wait before starting treatment. She later shared that she meant to sing that she believed that treatment would make her sick. But her words could also relate to her attitude towards the helping professionals and the emotional reaction she had to the care she was receiving at the time as well. She reported having strong negative reactions to the bedside manner of some of the health care professionals treating her and a general mistrust of doctors who in her view acted in an omnipotent fashion.

Because I don’t really believe that I am sick now

When I heard these words as therapist I was concerned that Gloria might avoid treatment and silently noted that an important issue would be to help her deal with the reality of her condition. This informed my own creative process as I improvised music with Gloria. I responded to the lyric content describing her not believing the diagnosis by trying to make the music more emotional, more intense. The figure of speech “shaking things up” comes to mind. If she could start to feel emotion while singing about being sick, perhaps she could allow herself to feel the feelings related to being sick, and this would help her in believing she was sick.

Musically this increase in intensity was attempted by creating alternating contrasts of texture, playing in a louder dynamic, and using dissonant tones to create tension. Though Gloria was describing a situation that she understandably had trouble coming to grips with, the here and now process of improvising was something that Gloria could experience and invest in. This potential to experience and express emotion in music was a contrast to her admitted resistance to feeling the emotions associated with truly accepting the reality of her situation. It was my hope that musical experience would provide her with another opportunity to revisit the feelings triggered by the diagnosis, while tapping into her creative strengths. 

Tell the truth, tell the truth, tell the truth

I interpreted these words as revealing the part of Gloria that wanted to accept her situation and deal with her repressed feelings. Implicitly believing that this was an important idea, before I even knew why I was doing it, I repeated the melodic rhythm of Gloria’s lyric. This seemed to spur her on.

Tell the truth, tell the truth, tell the truth

Tell the truth, tell the truth, tell the truth….yes

What is it?

Tell the truth.

Stop this stuff.

What is it? What’s the truth?

Tell the truth

Awgh

Primal sounds that resembled vocal responses to physical blows and seemed to express the internal battle going on inside Gloria poured out of her at this point. 

Ugh! Ugh!

At the end of this primal sounds section there was a change in Gloria’s vocal quality. I sensed a quality of surrender in Gloria’s voice. She paused while the music from the piano continued. Then she sang a melody while creating the following words.

Oh I love to sing

And tell my story to you in a song.

Oh I love to sing

And tell you my story.

This final section of the excerpt has a clear song form as harmonic and melodic direction unfold with the words that are sung. Gloria sings clearly formed melodic ideas from this point, and I create a pulse and harmonic progression that combines with her melody and words. 

They tell me I’m sick.

They tell me I’m sick.

They tell me I’m sick.

And so I proceed

To learn all I can.

I organize everything.

They tell me I’m sick.

They tell me I’m sick.

They tell me I’m sick.

I move ahead.

I make appointments.

I take notes.

I analyze everything.

They tell me I’m sick.

They tell me I’m sick.

They tell me I’m sick

And I have to learn to believe it.

They tell me I’m sick.

As we ended this improvisation I was less concerned that Gloria would avoid treatment, though I recognized the need to help her deal with the emotional reality of her situation. The song ends with Gloria expressing her struggle to accept her diagnosis. The quest to accept the diagnosis will be ongoing, but the expression regarding the quest in this moment seemed to be quite satisfying for Gloria, as this was an excerpt she often shared with close friends and family when they asked how she was handling her cancer diagnosis.

Detailed Description and Analysis

Gloria is struggling to come to grips with the fact that she has recently been diagnosed with a serious form of cancer. She sings:

“No, I don’t want to go to the next phase. I don’t want to suffer. I don’t want to be sick. So that’s it, I think treatment is making me sick. Because I don’t really believe that I am sick now.”

She has been improvising out loud having a kind of dialogue with herself, but her dialogue is also with me. There is no verbal conversation between us as I am improvising at the piano, responding to her words by attempting to create music to assist her in her self-exploration and expression. Her statement was sung, with the words “want” and “suffer” emphasized with the highest tones of her melodic phrase:

The melody is step wise, with one exception – the ascending major third formed by Ab going to C – when Gloria sings the word “want”. Upon analysis, a relationship can be seen between the word “want”, describing a striving, and the ascending interval used to arrive at the word and sing it. As Cooke (1959) describes, the larger intervallic motion of the third reveals more effort in moving away from the tone. The striving quality in considering the word “want” and the larger ascending interval have qualities that work together and as Beardsley (1981) describes, fuse coherently.

As Gloria sings I harmonize her tones at the piano, moving chords from Ab major to a C minor in second inversion and then to an F minor ninth chord after she has ended her phrase. My notes relate to the tones she is singing and create a harmonic direction, but do not result in a cadence. I hold the harmony tones without motion as she sings her melodic phrase, and then as she pauses at the end of her sentence, I create tonal motion. 

The final tone of the melody with the F minor harmony lends the music an unresolved quality. The lack of a strict pulse or definitive meter lends the music a quality of deliberation, and I play the harmony slowly in part with the intention of allowing Gloria to create words and melodies at her own pace. The tones from the piano also reflect the unresolved emotional drama of Gloria’s lyric content, as she describes resisting what may be a painful future. Gloria sings with a dramatic ascending minor melody:

She holds the word “suffer” on the last tone. I respond by picking up on her tonal direction, improvising an ascending C minor scale that moves rapidly to the highest register on the piano. Both of my hands play notes of the scale at the same time creating an intervallic tension of a ninth -minor and major ninths – as it moves up through the scale. The music slows slightly at the end, and these scale passages do not reach the C tonic, which creates a suspended quality in the music: 

My musical response is an intuitive one based on many factors including: my developing understanding of Gloria and what her needs may be; my immediate reaction to her lyric content; the quality of her singing and the fact that her tonal direction has shifted from a descending direction to an ascending one; and my own relationship to the musical qualities we are both creating, tapping into past associations to music of a similar style and quality. My response is also a reflection of my underlying belief that entering into the flow of the emerging musical form will be of benefit to Gloria, so I want to both create forward momentum in the music and leave space for Gloria to participate in building the musical path we are taking. 

The ascending piano tones after Gloria finishes singing “I don’t want to suffer” serve to intensify the overall quality of the music that is being created by therapist and client. They create a tonal context for Gloria respond to. They expand the tonal range of the music to sounds that go beyond where Gloria can sing. Listening in retrospect, there is a sense that the music serves to sweep up both participants, creating a musical pathway that is more than the sum of its individual parts. 

As Robinson (2005) describes, these tones from the piano are also my commentary to Gloria’s melodic tones, emotional intensity, and lyric content. The piano tones create a sense of rising, and in combination with the rapid motion create a quality in the music of running or even escaping. It is my way of offering an experience to Gloria of hearing and actually feeling what it may be like to escape from the suffering. The rising melodic direction of Gloria’s vocalization has triggered an intuitive response on my part, as I sense that Gloria would like to escape from the suffering, and my music manifests this escape. It is a musical way to attempt to convey empathy as a therapist. Though I want to help her face the challenge her predicament poses, I can understand her desire to avoid suffering, and by playing the ascending tones I am saying “I join you in your quest to escape”. 

It could be argued that playing these ascending tones was my musical countertransference, my own emotional response manifested in music to Gloria’s struggle. From this perspective, my need to avoid feeling the emotional turmoil that Gloria was working to avoid, drove me to play tones that manifest running away. My musical countertransference was based in part on sensing Gloria’s state and partly based on my own instinctual reaction of not wanting to suffer. This is another perspective brought to bear upon the examination. In an earlier analysis (Turry 1998) I have written about how my musical countertransference reactions did not necessarily impede the therapy process; in fact at times they fueled the therapeutic process. In this case, it appeared to have the same effect. Gloria later commented that the music from the piano helped her to stay engaged and continue, rather than give up.

Upon further analysis, because the ascending piano tones have an intervallic relationship that creates tension, it brings awareness to the fact that there are two ascending melodic lines moving in parallel. These two melodic lines rising together can be heard as a metaphor, each line representing one of us. They suggest that Gloria and I will take a journey that may be painful. The journey may induce suffering, but we will do it together; she will not go on this journey alone. The fact that neither of the melodic lines reaches the tonic creates a quality in the music that the journey has not been completed. 

There is yet another perspective to this rising series of tones. The scale is minor, which brings a quality of sadness. As the tones of the minor scale rise they become thinner (each note played in the upper register of the piano strikes two strings rather than three in the lower registers). The piano music becomes softer as the tones rise. There is a quality in the music of moving, of fading away. This is a reminder of the grave nature of Gloria’s illness, and that she is in danger of fading away. The fact that the tones ascend into the highest register of the piano relates to the idea of leaving this corporeal life and ascending to heaven, an ethereal quality as Cooke (1959) describes. There is an allusion to Gloria’s grave situation even as the music offers an escape from it.

Bonny (2002) points out the religious or transcendent quality of rising pitches. Since Gloria is a religious person who seeks out God when looking for support and comfort, the ascending direction of tones bears further analysis. Gloria’s “I don’t want to suffer” melody makes a leap of an ascending perfect fifth and in response I play an ascending series of notes that go to the highest possible register of the piano. So this ascending run may not be an avoidance as much as a search for help from a higher power. 

The fact that the same portion of music can be experienced as both comforting and challenging is an example of one of the most profound qualities of music. It can contain opposing polarities in a single moment, blends of emotion as Robinson (2005) describes. Music conveyed both a sense of support and challenge for Gloria to experience. 

Returning to the unfolding musical description, after “I don’t want to suffer” Gloria continues singing after the ascending piano notes reach their apex:

In response to her vocal statement, “I don’t want to be sick”, which she sings using the tones of a C minor triad, I play a melody that uses many of the same notes that she sang, changing only the last note G, which actually is present in the bass tone I play at the end of the phrase. I harmonize the last tone of Gloria’s melody (“sick”) with tones that create parallel motion of perfect fifths. There is no major or minor third in this harmony and the sound is consistent with Organum music. This ancient style predates diatonic harmony as we know it, developing within the institution of the Church. This gives the overall music a kind of religious gravity with a grounded flavor. 

In contrast to the previous ascending run, when this piano music comes to rest, it is in a much lower register, another factor that adds to the grounded quality of the music. While ascending music was a metaphor which included running away, this lower register music is about being present. The final G minor chord does include a minor third. The bass tone of this chord is not the tonic of the implied key of C minor created by Gloria’s melody, and thus creates a sense that the music, though solid with a harmony in a root position, is not finished. The fact that the music has slowed down before reaching this chord lessens the rhythmic momentum and adds to the overall gravity of the music. 

The tones of the chord are held, and Gloria continues singing:

The lyric that Gloria sings at this point, “so that’s it!” leads me to believe that she has come to a realization. She sings it as a statement with more of a conversational tone than an actual melody. In this music psychotherapy creative process there is a potential for Gloria to discover unconscious beliefs and attitudes as she reflects on what she is singing, feeling and hearing around her. This can happen within the music making process itself, as both Brown (1999) and Austin (2004) have reported. 

Looking at the lyrics more literally, “I think treatment is making me sick” yields data for further analysis. Gloria has not begun medical treatment, so saying she thought treatment would be making her sick is not accurate. This error may reveal her difficulty in facing her fears about having cancer. At this point it may have been easier for her to assign her worry to the treatment, which she could decide to follow or not, rather than the cancer, which could begin to get worse at any time without her having any sense of control. Also, it might have been easier for her to focus her fear on the chemotherapy or radiation, something outside of herself, rather than the cancer, which was inside her. 

In retrospect, I’ve discovered I often employ the following combination of musical elements to give Gloria time to reflect on what she has just sung: play a melody at the piano that repeats what Gloria has just sung; create a harmony that holds tension and does not resolve; and slow down the overall tempo of the music. 

As Gloria makes this statement, “so that’s it! I think treatment is making me sick”, she is singing one tone but there is no melodic motion. This bears further analysis, because Gloria often sings on a single pitch. This can indicate that she is placing additional focus on her words and considering what she is saying. It can also indicate a feeling of being stuck emotionally in relation to the content. Repeating a single tone can often bring to the music a quality of relentlessness which is what Gloria often describes when she feels stuck in a particular emotion or with a particular issue. At other times singing one tone can be an indication of sadness or resignation. It may be an indication of being cut off from emotion, depicting a lack of energy. This is an example of what Cooke (1959) describes as monotonous deadness. Gloria may be gaining intellectual insight but at the same time be unable to emotionally internalize this understanding. She may need the safety of staying on the single tone rather than venturing outward by moving her melody tones. Or it could be that the singing of one tone allowed her to focus on feeling emotion rather than on the formation of a melodic idea. She may be getting more deeply into her process by locking in on one tone rather than trying to sing a melody that has tonal motion.

As her therapist, at the time of the creation I am not sure what the specific significance of singing one tone means for Gloria at this point in the session. But I do have an intuitive response based on the content of her lyric and the fact that she is singing a single tone. There is incongruence between the turmoil described in the lyric and the lack of motion and vocal energy in the melody. This triggers a musical countertransference reaction here. If I put myself in her place (finding out that something that was supposed to be helping me was making me sick) I would have a strong visceral reaction. The way that Gloria has sung this lyric triggers a musical response in me. I start to play a melodic fragment in the upper register with a sharper articulation, infusing the music with energy: 

These tones come as a surprise, reflecting the “aha” emotional quality of Gloria’s discovery in her lyric statement. This is another example of how my emotional response to Gloria feeds into the improvisational process as I shape the music in a moment to moment fashion. My emotional reaction is processed through my musical response, translated to my hands which shape tones in the context of the ongoing musical form. This musical form then becomes part of what I hear and respond to in addition to the words and music that Gloria sings. 

Gloria continues singing:

The pattern that I play in response continues after she stops, ascending and descending, creating a swirling quality:

Upon analysis it sounds as if I am trying to create a spell, or break Gloria out of her spell. I interpret her last two lines to be communicating ‘I am not really sick so there is no need for treatment’. Gloria’s actual lyric, “I don’t really believe that I am sick now”, seems to be revealing what the single tone she sang hinted at, a state of denial, a clue that Gloria’s expression is lacking the emotional content that her situation would seem to warrant. It is an indication that her single tone may be a manifestation of her lack of acceptance, at least on an emotional level, that she is sick. Looking at the course of therapy in retrospect and Gloria’s own description of how the music helped her to feel repressed feelings, gives this hypothesis added credibility. 

The music in this section had a suspended quality. The bass melody begins with a Bb. This is the same single tone that Gloria just finished as she sang “because I don’t really believe I am sick now.” This melody at the piano has the same rhythmic cadence (including a triplet pattern), played in the same register that Gloria sang, at the same tempo and lasts almost exactly as long as her vocal line. But at the end of the phrase, instead of continuing on the one tone, I create descending melodic motion. In retrospect, this is a way of literally matching and then attempting to enhance Gloria’s musical contribution, modeling melodic direction and furnishing an experience of what it would be like to move off the single tone. It is an attempt to change momentum both in the musical process and in Gloria’s intra-psychic process. By playing the melody that Gloria just sang, Gloria can hear it and reflect on what she just sang and how it felt to sing it. The combination of the piano melody repeating in the lower register, and the continuing tonal pattern in the upper register which does not resolve, creates the sense that change is inevitable and imminent. The bass note G also lends the music a sense of stability, since the music in the treble also contains a G at its highest point. The two G’s, one low and one high, create a containing quality. The space between the bass and the treble gives the music a balanced texture between the low and high register. So there is a blend of qualities in the music: unresolved questioning within the confines of a stable balanced relationship. The music enhancing Gloria’s single note melody is a commentary, as Robinson (2005) would describe it. It says to Gloria, “I hear you. I know we are facing a crisis. I will hold you and face this with you. Would you like to try this? What is next?”

Gloria responds to my G by beginning her phrase with the same tone:

Gloria appears to respond directly to the quality of the musical/emotional experience by spontaneously expressing her desire to be honest about how this crisis is affecting her emotionally. When she first sings this statement, she slides her voice and holds the sound so that she is singing on a G, goes slightly flat and then rises up to the G. This G pitch is significantly higher than her previous Bb tone and holds more tension because of this. The pitch she is now singing is, in fact, the same note that seconds before I had begun to play on the piano and repeat. The fact that Gloria slides up to the repeated piano tone seems to indicate that Gloria is taking in the piano music even as she continues to generate tones herself. 

While Gloria slides into, wavers below pitch and then comes back to the G as she sings “Tell the Truth” I add an accented Ab note and then F# note, and repeat these notes at a short duration while continuing to play the G. The Ab and F# surround the G creating half steps. Upon analysis these notes can be seen as accentuating the unstable quality that was created by the sliding pitch Gloria sang.

Gloria holds each tone as sings. Her longer tones sliding into and out of G and then back in, combined with the minor seconds from the piano that are being held with the sustain pedal, lend the music a haunting, almost ghostly quality. Her wavering melodic motion as she sings “Tell the Truth” – moving down slightly in the middle of the statement and then rising back up in pitch – may reflect her tentativeness and reluctance in trying to do what she is commanding herself to do: express herself fully and truly about her situation and its implications. 

There is a strong contrast between the long held vocal tones and the shorter accented piano tones. Upon analysis I heard the piano music’s shorter and more rapid tones create the effect of prodding or pushing against the longer tones of the vocal melody. Because the pitches are high and moving below and above the primary vocal tone that Gloria is singing the overall music has a hovering or flying quality. One image that came to me as I researched this excerpt and listened to this particular section was of a buzzing bee rapidly flapping its wings. My intention to support Gloria’s quest to tell the truth by helping her to break through the emotional wall she has constructed manifests as a hovering, prodding insect.

After this musical experience, perhaps partly in response to it, Gloria begins to sing, “Tell the Truth” with a sense of urgency. She changes her melodic rhythm from longer even beats to a rapid three beat phrase:

Her volume intensifies; she almost shouts as she sings. This adds a sense of insistence to her musical expression. She then moves back to the slower melodic rhythm which adds even more emphasis. In response I play a loud bass note D with a strong attack:

The image I have as a researcher listening to this loud piano bass note is of a hammer hitting something hard – maybe a kind of latch used on mouse traps – which then springs open and releases whatever contents was inside. 

In response, Gloria sings her rapid three beat phrase and continues to repeat it. As Gloria expresses more intensely, the music builds in intensity. I pick up on the rapid melodic rhythm and repeat it with my right hand in a high register on the tone below the tonic, often moving it to the tonic – a way of urging Gloria to tell the truth – on the last beat of each phrase: 

The tones I use in my left hand form Organum harmony built on a natural minor scale and move in a series of three notes in the same rhythmic relationship but much slower. Repeating Gloria’s melodic rhythm so directly helps to amplify the message even further, even though no words are heard:

The piano music continues and the quality of Gloria’s expression becomes more primal. It is more emotional, and less musically formed including talking, shouting, moaning, groaning, shrieking, spitting, screaming, and eventually crying, and pleading. Though many of these sounds are not overtly musical, there are subtle indications that Gloria is responding to the music. At times she begins her sounds at the beginning of a measure created by the music from the piano. At times her shrieks contain pitches related to the piano music. I continue the three beat bass pattern that repeats the ‘Tell the Truth’ rhythm:

Gloria’s sounds contribute to an overall sense that the message embedded in the repeated melodic rhythm at the piano (‘Tell the Truth’) is something she is being battered by and ultimately surrendering to. 

When Gloria begins to make her crying sounds I stop the melodic rhythm, stop playing tones in the bass and continue an evenly repeated tone. The tone is the same G that upon reflection I now realize was such a prominent tone during the ‘Tell the Truth’ section. Her more primal emotional expression at this point in the improvisation triggers an emotional reaction for me. Although as a therapist I recognize that expressing painful feelings is an important part of the healing process I am concerned for her and do not want to exacerbate her painful feelings. I even add a tone to change the music very briefly to major, in an attempt to soothe and comfort Gloria, but when she makes a spitting sound I realize her expression of conflict and turmoil is not completed. Upon analysis I recognize that I reacted as if the spitting was a literal rejection of the major tonal quality and shift out of the major key. My clinical stance is to play music that attempts to tune in to and manifest the quality of her emotional state. This is ultimately more supportive and satisfying for her than trying to move her away from a difficult struggle with more soothing or uplifting music. My change to major was in response to my own emotional defenses, rather than Gloria’s needs. I abort the major harmony and bring in an Ab a ninth higher than the G in the bass, creating a dissonant interval.

Gloria starts to grunt, as if needing to physically expel something held deeply within her. As a therapist I have faith that listening to Gloria’s vocalization as potential musical expression rather than a solely cathartic outburst can create opportunities for engaging her creativity. Creating a musical form can provide her with aesthetic balance, perspective, as she reflects on her expression. I respond with music from the piano that is rhythmic and responds to the length and dynamic of this primal expression with dissonant clusters to match its intensity. 

When her expression becomes more intense, I play tones in a higher register. This is a different register than the one she is making sounds in and thus can be heard more easily. I continue to create a pulse so that there is an overall tempo which at times quickens to reflect the intensity of her sounds. The piano music’s dissonant intervals and repeated tones contain qualities – turmoil, tension – that can be heard in Gloria’s sounds. Sustained tones create harmonic relationships which imply melodic possibilities for Gloria to take when she continues vocalizing. 

Gloria changes her sound by moaning softly with a sustained breath. In response to this moan I change the texture at the piano, making the music less dense and slowing down. There are still tones of tension in the upper register. There is a quality of unrest in the music at this point as the melody from the piano moves from one dissonant tone to another.

Gloria pauses briefly. The harmony of the piano music during this pause continues to contain dissonances. But the change in texture and the pause signal a shift in the overall music:

My image as a researcher in describing this music from the piano is of a parachute slowly unfolding, or a net opening, ready to catch a melody which may emerge. Often, after a tumultuous emotional expression during an improvisation, a shift occurs in the way that Gloria expresses herself. Gloria’s breathing and moan suggests the battle has been fought, and now after such a tremendous primal release of energy there is another way to tell the truth. She has a more relaxed singing quality after the intense release of emotional energy. 

Gloria takes a breath and makes a short soft tonal sound. This tone matches the G tone at the piano which I then double in a lower register:

Gloria begins to sing a slow melody, which includes one of the dissonant tones at the piano so that instead of a traditional diatonic melody, she sings tones that are significant tones in the Lydian mode, a Church mode which evolved before traditional diatonic scales:

The melody she sings has a major third, but also the raised fourth which is an identifying tone of the Lydian mode. The tonic tone and the raised tone were present in the music I had been playing previously, but upon analysis I realize that once I hear the combination of the major third and the unusual raised fourth tone in Gloria’s melody I establish more definitively tones in the harmony that are in the Lydian mode. It was Gloria who introduced the major third to help solidify this mode. This mode, because of the raised fourth step, can add a sense of imminence to the emotional content of the music. It is a mode that has emerged many times during the course of this therapy while imagery has occurred in the lyrics. The emergence of this mode comes out of a collaborative musical synergy and the actual quality the mode contains fuses coherently with the emotional sense of anticipation we both are feeling in the moment. 

Gloria has used the C#, the raised fourth in relation to the first step of G, four times in this melodic phrase. This adds some ambiguity to the musical quality. The major third that she uses is a significant change from the minor melodies we have heard previously. And her lyric content and formed melody is a striking change from the primal sounds she had been making just seconds earlier. This is an indication that Gloria has shifted her creative expression. Rather than continuing to vocalize with primal sounds, she puts her present expression within a context of sharing a story and supports her words with tones. Gloria often shifted perspectives in terms of who she was singing to as a way of continuing her flow in the process. Here she shifts from singing “tell the truth” to herself to telling her story to someone or some group outside of herself. 

Often during moments of abject hopelessness, Gloria would immerse herself into the music around her and create melodies. She took a sense of pride and satisfaction in creating them. She described them as giving her a sense of freedom and lessoning the critical judges that often impeded her from trusting and supporting her expression. Gloria continues to sing and the range of the melody expands:

This melodic phrase accentuates the musical ambiguity. It starts with a B and contains the first six steps of the B minor scale. As it ascends and comes to a close the melody notes surround the F#, rising above it before ending on it. These are all tones that could continue to be placed within the context of the Lydian mode. But starting on B and ending on F# also suggests a different possibility. Gloria’s first iteration of the phrase was a major melody, a manifestation and reinforcement of the shift in her perspective. Now by using the same tones, but starting her phrase on B and ending on F#, she has created the structural possibility for the melody to be harmonized in minor. Upon analysis I conclude that the combination of hearing these tones, hearing a new musical expression, and sensing the need for a response to Gloria’s new musical expression led me to move to the diatonic harmony of B minor and hold the tones of the chord as Gloria holds the tone F# on the word “story”.

Listening to the music as a whole, going to this definitive diatonic harmony of B minor rather than staying in the more ambiguous Lydian mode creates a sense of arrival in the music. Since I chose to harmonize the chord as a minor chord it supported the idea that now we will hear a story, a story that has a quality of sadness in it.

Harmonizing the same melody with a different harmony can create a different musical emotional landscape for the client. In this case it suggested a new perspective for Gloria to take. All the tones used in both the first and second melody could be harmonized to create the G Lydian mode or B natural minor. In retrospect, looking at it solely on a structural basis, because I had been playing harmony with G as a root, and because Gloria had started her first melody with a G, I took the G as the root and established the Lydian mode. But in the second melodic phrase, because Gloria has established a new melody, all with tones of the established Lydian mode but in a new order, a new harmonic choice is suggested structurally. 

Hearing the anguish in Gloria’s tumultuous expression to “tell the truth” and knowing the context of her challenges influences my shift in harmony at the piano as I move to a B minor chord. There is a transition taking place, based on Gloria’s shifting expression. Playing in a new tonal center emphasizes the new section for Gloria to sing her story. Yes, I still choose to play in a minor mode as in much of the earlier music, but now it is a new key, coming from a transition to a clear cadence. This new key provides a new path to tell her story. 

The musical actions that I make are for the most part based not on global clinical considerations and broad musical form, but on moment to moment responses to Gloria’s expression and an immersion in the emerging musical form as we create it. The current analysis reads as if the musical events were logically thought out and inevitable. That is not the case. Closer to what was conscious for me at the time is the following list of listening questions:

Is this the right music for your story to begin? What tone? 

Where is the melody headed? This harmony? 

How did you sing that? What does it imply harmonically? Stylistically?

Where can I go harmonically that leaves a choice for you but is predictable enough?

Play on every beat? How much pedal? Do we need more dissonance? Create tempo here?

The piano music continues, sounding like an introduction to a new section. Upon analysis I discovered that during moments of impasse during sessions I sometimes created music that sounded like an introduction to a yet to be formed song in order to orchestrate transitions. Usually the music would include some aspect of the music we were transitioning from, such as a rhythmic pattern that was significant.

An ascending melodic line reaches its apex and then the piano music comes to a pause in a very high register on a simple three note G major chord which is held:

One of the findings of the study was that I often created ascending melodic lines to create tension and then paused on a chord away from the tonic or the implied tonic. This was done to encourage reflection and to spur continued expression from Gloria.

At this point a new musical idea that leads to a new section is heard as Gloria sings a melody with the words:

As Gloria sings there is no harmonic motion, just the fading tones of the previous chord and the motion of her melody as she sings it. The lack of motion in the harmony brings the melody to the forefront. The lowest tone of the melody is a B and it’s highest an F#. These are tones that outline a B chord, the dominant harmony of the final tone of the melody, the E. These structural factors plus the lyric content influence the creation of the chord immediately following the melody, an E minor chord in root position. There is no musical ambiguity at this point. Gloria arrived at the tonic key first. Her E note was a primary factor in leading me to E minor. The fundamental tone of the chord is the same note as the one that Gloria is singing. The chord, unlike much of the previous harmony, is now in root position, with Gloria singing the tonic of the key. This gives the music a sense of declaration, of solidity, even as the minor tonality maintains an overall sadness. The placement of the chord, coming a brief moment after the vocal statement, creates a sense of call and response between us. The melody makes a statement and the harmony responds. There is a quality of affirmation in this harmonic response. It is as if the chord, with its quality and timing is responding to the lyric, making a musical commentary (as Robinson (2005) describes). It states, “Yes. You need to consider that you are sick.” 

There is no motion from the piano as the chord tones are all played at the same time and are held. This gives Gloria the opportunity of focusing on her own creative expression as she continues singing. The relationship between the singing and the piano remains the same, as the melody is the only motion that occurs, and then another harmony follows with the simultaneous tones CGDF#, incorporating the final tone of Gloria’s melody. This was a harmony that I did not calculate. I yielded to the reaction of my hands as I responded to Gloria’s unfolding melody. The held tones of the harmony without motion create space and upon analysis, this is a way that I try to emphasize the lyric because of its apparent significance.

Repeating these musical elements – a clear melody while only a single chord is played and held at the piano – is a significant contrast from the music heard in the previous sections. This second chord adds even more focus to the melody that Gloria sings. Her melody does change the second time she sings “They tell me I’m sick.”

It has a larger intervallic leap, stretching the range of the melody. The melodic sequence has higher pitches and ends on a higher pitch, creating more tension than the first melody. This higher pitch is an F#, and combined with the fact that the chord has a C in the bass, it creates a tritone relationship between the fundamental bass tone of the chord and the melody note. All of this gives the music a subtly different quality. Whereas the first melodic phrase had a tonic root position triad with a melody sung on the root, creating a definitive quality, the tritone relationship can be heard as lending an unresolved, searching quality to the music. This second C chord also does not have a third in it, adding a sense of suspension to the music. The verbal discourse is repeated exactly, yet words and music combine to create a different quality. 

The repetition of the words implies that something was not finalized by making the first statement; it needed to be repeated. This new fusion of words and music creates a quality in the music of unresolved tension. The highest tone of the melody is sung with the word “me,” creating an emphasis on that word. This might indicate Gloria’s attempt to make an effort to try and comprehend, try to integrate the idea that she is sick. Gloria’s repetition of the lyric is also an indication of this. Gloria often repeated lyrics, sometimes motivated by a desire to create a phrase structure and musical form while at other times because it appeared she was not sure what to sing next. This time it could be a way of trying to consider the meaning or ramification of her lyric. The fact that she uses the word “They” again, indicates Gloria’s lack of acceptance. She may be using that particular pronoun to distance herself from the message. She is not yet singing ‘I am sick’, perhaps because she is actively rejecting the idea.  

The repetition of the same lyric created a clinical opportunity for me to create music with a different musical element, such as a change of harmony, register, or articulation for Gloria to experience the meaning of the lyric in a different way. 

In this instance, the held harmony and repetition of the lyric left only the melody as the possible development in the musical form. The new melody that Gloria is singing here is not triggered by a change in the harmony; it happens out of her own initiative as the harmony did not move, and could be a manifestation, evidence of the new perspective she may be taking as she sings. 

At the point where Gloria ends her melody note on F#, I play the CGDF# chord to create the tritone relationship, but slightly softer. This chord could lead us in several harmonic directions. It could resolve the suspension created by DF# and go to C major. It could move the two bass notes down to create a B minor chord. It could move the two bass notes up to create a D major chord. Since the progression moved by thirds in the bass, from E to C, it could move down another third to A minor. It could also move to a B dominant 7, since E minor is such a strong harmonic presence in this sequence and B is the dominant of E minor. Gloria again repeats the lyric, and after she finishes her single note F# melody I play an F# chord:

The melody is the same note as the root of the chord, but because of the unfolding harmonic progression, and the fact that the F# chord is major, this current harmony actually sounds unexpected, a structural surprise that plays with our expectation to evoke an emotional response as Meyer (1956) describes it. Yet it is also a stable musical moment as the chord is in root position and Gloria is singing the root. So the stability and surprise together in the harmony create a blend of qualities as Robinson (2005) describes. We are solidly in a new-if unexpected- place. Like the first E minor chord in root position, this F# chord creates a musical commentary as Robinson (2005) describes, affirming the fact that Gloria is sick, but because it is major, also suggests it might not be an entirely unhappy place. There is some quality of ambiguity with this word/music fusion. The F# chord being an unexpected harmony could also be heard as fusing with the lyric content and corroborates the fact that Gloria’s sickness is not something she expected.

There are more factors that are part of the equation in understanding the blend of qualities in this musical moment. There is also a quality of solemnity and loneliness in the music based on the way Gloria is singing the melody, the meaning of the lyric, and the softer dynamic. Contributing to this quality is the structure of the melody, which has changed to a repeated single tone that Gloria sings as she repeats “they tell me I’m sick” for the third time. As Gloria holds the final tone of this phrase, her pitch is actually slightly sharp. An assumption I held as therapist listening to Gloria’s tones was that her intonation could be an indication of her emotional state with regards to her lyric content. In this case, the slightly sharp pitch could indicate the conflict that Gloria is experiencing as she tries to take in emotionally the idea that she is seriously ill. 

The melody has no motion, no direction and is sung with a slightly sharp intonation. The pitch of the single tone is relatively high and Gloria sings it with support and sustains the last tone. There is tension in the tone; the melody has dynamic force even though it does not move. The lyric and melodic repetition of Gloria’s singing may be an indication of her struggle in trying to comprehend the meaning of what she is singing. 

The repeated tone could also relate to Gloria’s process in considering the implications of the lyric. The first time she conveys what “they” have told her, her melody moves. The second time it moves with an even wider tonal range, as if she is more urgent to hear and take in what she is saying. The third (and what ends up to be the last) time she sings the lyric in this section she sings it on the single tone, as if she is struggling to take in the message and is only now realizing the ramifications. This is not a conclusion but a tentative hypothesis based on the construction of her melody and the vocal quality she uses as she sings it. Singing the same tone may reveal Gloria’s dawning realization that no matter what she tries to do, the situation is not going to change.  

Right after I play the F# major chord and hold it, I repeat an F# note, softly, creating a pulse at a slow tempo, encouraging Gloria to proceed, and helping her to hone in on the tone she is singing:

This is a change from the held chords that had no pulse. There is a sense of forward momentum coming from the repeated tone. I change to an E minor ninth chord, continuing to incorporate the repeated F# tone:

This is the beginning of a harmonic progression that contains descending inner voice motion as Gloria continues to sing. The music has the element of repetition with the repeated F# and the held E tone in the bass, like the words, and also provides a sense of motion by changing the harmony by the descending inner voice line. As the progression continues in a stable tempo with the change in harmony, Gloria is able to ‘proceed’:

A review may reveal what is perhaps a subtle yet significant interconnection between the music and words. My musical intervention to play the repeated F# note in tempo, intended in part to encourage Gloria to continue is followed by Gloria singing “and so I proceed.” There appears to be a confluence of events: Gloria describing her actions to go forward in dealing with news of her diagnosis, and her actual experience of going forward by allowing an improvised song form to continue to emerge and develop. It may be that the music from the piano helped her to proceed. 

In contrast to a portion of the earlier music that functioned to support the desire to escape, this section has qualities more likely to lead Gloria to face the possible results of her diagnosis, her mortality, head on. The slow repeated tones lends the music a sadness as it has similar qualities to music used for funeral marches as Cooke (1959) describes: slow, even, deliberate repeated tones in a minor key. Yet there is also a quality of Gloria’s strong singing that gives me the sense that this is what she wants to sing, this is what she needs to sing, to “tell the truth”. She describes taking an analytical approach in dealing with her crisis, but now it appears that she is seeking a change in her emotional stance regarding her illness. Her immersion in the improvisation process is an indication of her hope that music can be a way of doing this; she can move forward.

Upon reflection, it could also be true that my belief that my music could have this kind of influence on Gloria’s process – that I would like her to continue in the music and she then sings about proceeding – is a countertransference reaction. I am ascribing the ability to control and guide Gloria through a process that may be painful and difficult with music, and by using specific kinds of music I can help her go in certain directions. The fact is that neither of us can control what may happen in terms of the evolution of her disease. Just as Gloria tries to control her situation by ‘analyzing everything,’ I may be overanalyzing. I may be assigning an ability to control future events with music and her ongoing process that may not be there. I may be picking up on Gloria’s need to experience a sense of control in response to a situation that could trigger feelings of being out of control.

It could also be that my desire as a researcher to find significance in the interconnections between music and words has affected my perception and has distorted my reasoning as I analyze. I have employed trustworthiness mechanisms, including listening to the excerpts with peers to gain other perspectives on the material, in order to ensure that this is not the case.

Returning to the description, Gloria’s vocal line continues:

After the harmony cadences on F# again the familiar E minor chord with the same inner voice descending line follows as it did earlier. The call and response reverses as the chord starts the measure and then Gloria continues with her melody: 

As the section and the song form come to an end, I play a G major seventh chord as Gloria sings one final melody with the words:

Gloria’s final melody clearly indicates B as the tonal center, but my G major chord creates the sense that though this song may be ending, the issue at hand can be explored further. The C# is a reminder of the Lydian mode and also adds to the sense that there is something more to come.

Concluding Thoughts on Tell the Truth

It is certainly feasible that Gloria could have proceeded to sing without even hearing my music. She may just have decided that she was going to keep singing. There are strong indications that once she did sing her expression was influenced by the music I was playing and my music was influenced by her expression. 

In “Tell the Truth” there were several times when I repeated a melodic rhythm or a portion of her melodic rhythm to enhance the musical form and convey in a general sense that I had heard what she had sung. I picked up on a particular portion of her lyric content to reiterate what she was saying or asking herself. Countermelodies were also used to create tension, provoking or stimulating a response from Gloria. During the singing of the forte “Tell the Truth” section, my countermelodies often contained tones a half step away from Gloria’s and this created a sense of juxtaposition between us. I also played melodies softly at the same time that Gloria sang, creating a sense of companionship and closeness between us as we created melodies together. During the times that Gloria did not sing, countermelodies functioned to keep the forward momentum going while holding some quality of the last melody and lyric that she sang.

The tone G, prominent in the first section of the song and then during Gloria’s more cathartic expression, was an anchor tone and provided stability for me. The G was a returning significant tone that allowed for other musical ideas to spring from. This relates to Lee’s (2003) idea of a melodic cell and how it functions during an improvisation.

Music Therapy Session Audio Clip
Studio Recorded Version

Woman Why Are You Weeping – April 26, 1995 [Click for analysis]

The next excerpt revealed some of the life-long psychological conflicts that Gloria began to grapple with in music therapy. “Woman Why are you Weeping?” contained issues of loneliness, sadness, and the sense of having a weak sense of self, which Gloria attributed to her mother’s smothering parental style. 

Choking, choking on her tears

Gloria sings about a “her”, a woman who is crying, and is also identifying with the woman. Singing ‘her’ instead of ‘my’ was a way to gain some distance over the potentially overwhelming feelings and to create imagery and a dramatic story.

Choking on her tears

Suffocating

Silent tears

Choking on her tears

The song of the tears

The song of the tears

Oh…oh… oo

Woman why are you weeping?

Woman why are you weeping?

Woman why are you weeping?

Why are you weeping?

Gloria often sang questions to herself, developing a way to reflect on the content of what she was singing. A religious person, she was familiar with the Bible and often used words and images from it. The woman she is singing about in this example has to do with herself, while also relating to the image described in the Bible of Mary Magdalene crying after the death of Christ. Religious imagery not only gave her a source of inspiration in creating lyrics, it also lent a spiritual tone to the music making process. She often sang in a prayer like style or chant. At times she consciously referred to Biblical text, at other times only afterwards realized the connection. She often made conscious efforts to find solace in singing to God or singing from God’s perspective. So there is a dual perspective, as Gloria asks a question to the woman, and also seems to relate the experience to her own feelings in the moment. 

They’ve taken away my song

They’ve taken away my voice

I have no voice!!!!!!!!!!!!!!

Gloria shared that the sense of being stifled, of being rendered powerless by having cancer, was related to life long feelings of being stifled, of having “no voice.” Though the feeling was familiar to her, she had never framed the issue in quite that way.  

One of the powerful effects of the infusion of words and music was that it allowed for Gloria to make statements related to her inner life of thoughts and feelings that were at once contradictory, yet true to her experience. She sang the lyric ‘I have no voice’ with a very strongly supported tone that lasted for a significant amount of time. So even as she sings she has no voice, she experiences having a voice. The frustration in trying to express herself fueled her expression. These paradoxical moments came up often in therapy and seemed to hold special significance for Gloria. It seemed to be a way that Gloria integrated previously disparate parts of herself. She was experiencing her voice, discovering her voice, even as she sings about having no voice. Austin (2004) writes that “the process of finding one’s voice, one’s own sound, is a metaphor for finding one’s self” (p.215).

What do you want to sing about?

I don’t know anymore

It’s all gone

I don’t know anymore

Whatever was there, I don’t know anymore

And I can’t find it anymore (the music cadences to the tonic)

Though the content of the words convey a sense of hopelessness, the experience of the music making – both creating it and listening to it while creating it – evoked a powerful sense of satisfaction for Gloria. She described the process as going deeply into her own pain, the “underworld of darkness”, and coming up feeling changed, feeling more accepting of herself. 

After a powerful improvised song like the one above, she often reflected on the experience by taking a different perspective within the same session. Later in the session in which we improvised “Woman Why Are You Weeping?” she continues to refer to its content. She begins to sing once again about the woman who cannot find her voice, but as the music continues and Gloria renders the characters in greater detail, a connection to her childhood appears to develop. The weeping woman becomes a child, a “kid” and her interrogator becomes – partially in response to music from the piano that Gloria later characterized as nurturing – more involved and concerned. Here are the lyrics that exemplify this development:

Now this is a sad sad story indeed. I’m so sorry to hear it.

Let’s go down to the cellar and bring that kid some cold water

Put my arms around her

Just prop her up, hold her, give her a little hug

Drink the water

Don’t be afraid to drink the water

It’s safe

It’s safe to drink the water and tell your story

Sing your song

I was lonely and afraid

I was lonely, no one to talk to 

I was lonely and afraid.

Like a dream, the characters she created in these song improvisations represented distinct parts of herself. There is a part of herself that feels lonely and damaged. And there is a part of herself that is capable of nurturing and accepting feelings towards herself. Like a dream, the characters give her some distance from the material so she can explore the emotional conflicts of her psychological condition that the characters represent. She sings of a kid in a cellar, representing the isolation she felt as a child and that has affected her as an adult. She also creates the point of view of a character that can nurture the child. The musical experience seemed to provide an environment of nurturance that contributed to the emergence of this nurturing character. After being nurtured the isolated kid character can answer the question to which the woman who was weeping could not voice a response. Why was she (the child) weeping? She wept because she was “lonely and afraid”. Gloria explained that the answer to the question “Woman, Why are you Weeping?” was found during this experience. Though the answer was intensely sad, the experience of finding the answer was powerfully satisfying for her.  

I too, experienced an intensity of emotion and a powerful sense of completion as the experience of creating the music with her words and melodies came to a close. The mutual music making experience allowed us to journey together. This was integral in order for me to resonate with and understand Gloria, and for Gloria to experience my presence and support as she continued to tap deeply into her creative expressive process.

Detailed Description and Analysis

Gloria is half singing, half sighing in a breathy voice, a series of gentle moans. She sounds tentative, fragile and tenderly sad. I play a D minor arpeggio and then hold a D minor chord. I add an E on top of the chord:

This E is also repeating but at a faster rate than the sound of the moans. Because it is being played in a higher register, repeated and played more quickly, the E note brings a quality of urgency to the music. Gloria’s vocal sounds are moans of short duration. Upon reflection her moans are related to the music in that they have pitches – E and then D. I add a D in the bass D, and this D minor chord adds a sense of finality. When this happens there is no tempo from the piano, but the tones are still heard as they are held and begin to fade. This is a decisive moment in the music: it can come to an end by simply fading, or continue. 

But Gloria continues to moan, creating a pulse as each moan has the same duration and the same length of time between them, and I take up that pulse and begin to play D minor chords in a very low register and in marcato articulation, playing a chord for each moan:

The low register and close spatial relationship of the chord tones, in addition to the rhythmic articulation of the piano creates a more primal rhythmic quality in the music. The combination of Gloria’s moans, the repetition of both the voice and the piano on the same pitches, and the piano accompaniment lends the music a more ominous quality. The entire section described occurred in eight seconds. The next three paragraphs will review these eight seconds.

My intention is to help Gloria involve herself in musical expression even while supporting her non-musical sounds. The D minor ninth harmony, which upon reflection is one I often use to create a blend of sadness and warmth, creates a tonal context for Gloria to sing. My faster E note in the higher range of the piano is a provoking, stimulating factor for Gloria to respond to. By matching the tempo of Gloria’s moans in the left hand while playing at a faster tempo in the right hand, I am attempting to follow and lead at the same time. Yet upon analysis this is a limited understanding of the interaction. Gloria is also leading me, and the sounds are going on at the same time, so that there is no clear cause and effect. There is rather a simultaneous and mutual shaping of the music.

The ominous quality of the music created by my repeated marcato D minor chord in the low register is a musical commentary; “I hear that something painful is present and there is more that has yet to be expressed. Go ahead.” The fact that the chord at the piano does not change tones and does not sustain tones brings the thick texture and rhythm to the forefront. This is done in an attempt to match the primal quality of the vocal sounds. Yet it also provides tonal possibilities that might lie ahead for Gloria if she chooses to sustain her vocal sounds. She has a harmonic context within which to make melodies. The fact that the primal moans she makes are in the tonality of the music is an indication that the harmony is being perceived and responded to on some level, and that melodies are possible in the future.

It is not apparent that Gloria is making a conscious choice to match the music she hears from the piano. Her sounds are breathy, revealing of her physical state and her respiration. Upon analysis, the shifting of my music at the piano from a higher to a lower register was an invitation to Gloria to sing, as the higher register sonority of her vocal range was now available for her. It was an invitation for Gloria to take up where I left off in that register of the music. The bass notes create the ground, the platform for the vocal melody.

Returning to the description, the D minor ninth chord continues in a marcato articulation at a slow, steady tempo. Gloria stops her moans, and then comes in at a higher pitch. She sustains her higher pitched moan, and then does two shorter moans. Her pitch on the last moan is an Ab. I add this note into the harmony, adding an additional tension as this note has a tritone relationship with D, the bass tone of the chord:

 I now begin to roll the chords of the harmony so that we hear the bass note first with the other notes following rapidly, almost but not quite simultaneously. The chord ends with the Ab, in effect emphasizing that note. The Ab, a tritone away from D and a dissonant tone in D minor, adds a more painful quality to the already painful sounding music. 

Gloria reenters with a sound close in pitch to Ab for each beat of the music. In tempo and matching the length of the harmony, the vocalizing sounds like the beginning of weeping that is being restrained. More breath is heard after the tone of each short vocal sound. The music has more of a rhythmic emphasis now, as the marcato articulation and the voice entering together accent each beat. I bring back the E natural we heard earlier in the higher register. This E alternates with the Ab below it, and then tones G and A above the E are added in pointilistic fashion, slightly anticipating the pulse:

Upon analysis, these tones are suggestions for Gloria and from Gloria. They start with the Ab which she barely moans, and then move with each moan that she makes. 

Gloria stops vocalizing. After five beats of piano alone in marcato, I change the articulation to legato, and the dynamic becomes louder, emphasizing the highest note E:

Upon analysis I did this in response to Gloria’s stopping. No longer responding to her sounds, my music now has a slightly dreamy quality, and there is more forward momentum in the music as notes are heard on every eighth note of the pulse. During recursive listening the metaphor that came to mind is that the legato has created a pool for Gloria to enter into.

More time passes without the voice. The D minor chord with the E on top continues until a high C that rings out at a louder dynamic enters strongly and is held:

Upon analysis, I hear the playing of the C as a way of calling out, searching, for a direct response from Gloria. It is an invitation and a stimulation to try and encourage her to come back actively into the musical creation. 

More tones- both tonal (A) and nontonal (Ab), are added to the D minor accompaniment figure, so that it takes on a rocking quality. This combined with the legato articulation creates a more soothing effect than the earlier marcato music.

I am adapting the music to make the accompaniment pattern more soothing, but at the same time acknowledging the dissonant quality of her feelings. It is my attempt to convey my acknowledgement that Gloria is in turmoil, and yet continue to present possibilities for movement and development. The combination of elements creates a blend of emotional qualities: soothing, comforting, painfulness and foreboding. This is an example of how music can blend a variety of emotions in the way that Robinson (2005) describes. 

Gloria begins to sing now in a low register. The vowel “oh” is used as she enters and ends on pitches that are predominant in the harmony. The melody begins with E and quickly rises up to F and then leaps up to Bb before settling on A to end. It takes up 2 beats and ends right in tempo:

This is the first truly musical vocalization of the improvisation, and as such it bears analysis. There is an unsettled quality to this phrase as it slides from pitch to pitch before it ends on the A and sustains this pitch. E and F are half steps and Bb and A are half steps, and so the melody has qualities of tension. The Bb is a minor sixth away from the minor tonic and creates painful tension as described by Cooke (1959) that resolves sadly downward to the fifth of the D minor chord. 

Gloria makes more soft primal vocal sounds in tempo and then moves to the higher melody note D and sings:

She holds the note for a sustained period before fading it out gradually over the steady pulse of the emerging ostinato-like bass line with the D being held. The vocal phrase ending on the tonic D combined with the bass line pattern has now contributed to the establishment of a definitive pulse and tonal center. This creates a quality in the music of finally arriving at a starting point. D is clearly heard as the starting point for both the voice and the bass line. It is both the highest note and the lowest note heard. The combination of the clearly established D in both the highest and lowest register, with the repeated bass line creates structural stability yet an ominous quality. There is more animation in the music as Cooke (1959) describes since the bass line is establishing the steady eighth note subdivision.

The harmony that has been heard from the beginning of the improvisation and established up to this point includes the extended tones – E, Ab, C – over the primary D minor harmony. These tones create potential alternatives for Gloria to sing that can add tension, ambiguity, and emotional color by creating dissonance. They are potential melody tones that will sound congruent with the overall harmonic landscape that has emerged. However, they are not tones of relaxation, of resolution, but of tension. This creates the possibility of musical and emotional exploration. 

The piano bass line continues as we hear the first words sung:

Gloria has moved from moans, to tones, to sung words, to creating melodic phrases. Upon analysis, the first words sung – “choking on her tears”- reflect her experience a few seconds earlier. She is describing her physical state as she made the sounds described earlier in this analysis as “weeping that is being restrained.” Considering what she is experiencing, reflecting on her previous inability to make more sustained sounds and sing words, Gloria then creates words and melody. Singing specifically about her struggle, about her inability to express, is a successful approach for her in finding her creative voice. 

The first melodic phrase starts on the tonic and goes down to the fifth step of the key. The downward direction of the tones of the natural minor scale combined with the words give the music an expressive quality of anguish. This is reinforced by the repetition of the word “choking” and the repeated tonic note D. Yet the words “she” followed by “her” rather than ‘I’ and ‘my’ add an ambiguity to this inward quality. At this point it is difficult to know: is Gloria singing about herself, or is she telling a story about someone else? The ambiguity is amplified by the actual tone on ‘her’ going upward rather than down. By emphasizing “her” through this tonal movement, Gloria appears to be distancing herself from the character of being observed. 

The phrase “she’s choking on her tears” starts on the melody tone A and repeats with some pitch variation before sliding up on the last note of the phrase to D. There is a metric implication to the timing and length of her lyric, and the content of the words sets the stage for a story to be told. The words “choking” and “tears” begin to explain Gloria’s previous expressions of anguish, adding to what is now emerging as the basis for the creation of a lyric song form, with the theme of a protagonist who is in turmoil.

After the first singing of the words “choking on her tears” I respond harmonically by echoing the rhythmic pattern of the lyric phrase, then rising to a higher register, with the notes moving in parallel motion in fifths to create a counter melody, as Gloria repeats the phrase:

The parallel motion and the use of the B natural to establish tones of the Dorian mode on D give the music a slight suggestion of Organum. 

The fluctuation in her vocal pitches seems to be a reflection of Gloria’s tentativeness. Yet her entrance and exit reveal her sense of phrasing and that she is feeling the pulse and meter of the improvisation, and that she is in the flow of the music. The musical process allows her to experience and express her vulnerability even as she takes a developmental step forward by creating a melody with words. The fact that Gloria is now creating words that reveal her being reflective of her experience conforms to Robinson’s (2005) description of the process of how feelings emerge. There is cognitive monitoring here, evidenced by the addition of words, and this music and word combination adds to and alters the experience that Gloria is having.

Gloria continues to sing using words:

The limited tonal range of the melody, the repetition of tones and words, and the content of the words create an overall quality of being constricted that is relentless in its persistence. The accompanying harmony reassumes an ostinato-like repetitive form reflective of the relentless constriction of the experience. The accompaniment continues the clearly D minor harmonic base, while creating motion with the descending half step motion of F to E. 

The fusion of the word “suffocating” with the repeating tone A, harmonized in minor with a repeated ostinato harmony, gives the sense that there is no escape from Gloria’s predicament. Yet the basic pulse of the harmony, and the more sustained melodic rhythm are creating and building forward momentum at the same time. The word “tears” is held for the longest amount of time of any melody note sung to this point, then fades out gradually.

By beginning to use words and melodies, Gloria has accepted the invitation to enter into the song form and in doing so there is hope that at the very least she can discover and express herself in music. The words imply any feelings present are repressed. Perhaps there are tears that need to flow outward in order for the sense of choking to diminish. Singing is a way of breathing with support and not suffocating. 

The vocal melody comes in at a louder dynamic and on the tonic D:

The accompaniment pattern continues in eighth notes, alternating the C and A notes on top of the D minor harmony. Harmonically the F and E movement is still heard inside the chord. Parallel motion of perfect fourths and perfect fifths are utilized within the pattern. Then a piano melody emphasizing the E and accompanied by parallel motion in fourths underneath enters:  

The B which is repeated below the E melody note brings out the Dorian modal quality and the parallel motion of fourths and fifths in the overall accompaniment create an Organum quality. The parallel motion of the interval of the fourth, which begins and ends away from the tonic, brings attention to two notes searching together, a metaphor for the journey Gloria and I are taking. The phrase swells dynamically and continues. The piano melody, coming after the vocal phrase, has a mournful, introspective quality. The dynamic swell and the slight quickening of tempo lend a searching quality to the music. 

Gloria starts singing on “lu.” These tones are the highest we have heard sung to this point: 

These high tones are in a similar range as Gloria’s earlier crying like sounds. A break can be heard between her head voice and then the chest voice when she moves down to sing the D. Her first D is in her head voice, and then shifts to chest voice. This has as much to do with breath support as pitch range. She is sustaining her breath here as she sings with legato, in contrast to her brief vocal sounds of her earlier singing. There is a physiological shift occurring in how she is breathing and supporting her sounds. She is supporting her expression more strongly and her vocal range is expanding.

The harmonic pattern from the piano continues, with the bass tone D and tones of the Dorian mode, with dynamic swells on occasion to create a sense of motion and energy. A new melody with words, entering on the upbeat at a louder dynamic, is begun:

The louder dynamic, regular rhythm and repeated tones contribute to an overall quality of definition. There is a countermelody in the accompaniment that echoes the non-verbal melody heard a measure before. The harmonic pattern with the countermelody adds a reflective quality and a sense of forward motion. Upon reflection the image I have is a canoe being paddled steadily, carefully, moving through waters that are unknown. The dynamic swells and the parallel fourths of the accompaniment contribute to this image.

The fact that Gloria’s melody returns to a repeating note on the tonic D after containing tones both ascending and descending on nonverbal singing could be an indication of the difficulty in improvising lyrics while simultaneously creating melodies that have tonal direction. But the rhythmic entrance, on the upbeat, and the ensuing rhythmic phrase with its syncopation, is a more complex rhythm than previously heard. Upon analysis this is an indication that what has occurred to her initially is the verbal phrase. “The Song of the Tears” will be the subject of her singing. The phrase itself automatically organizes the rhythm. The lyric reveals that Gloria is aware of how to put her words and music into the structure of a song. 

Gloria’s vocal melody continues without words and now has an ascending direction:

The melody ascends from the tonic and quickly descends to the tonic. It is a tentative attempt at creating a melody that would accommodate the phrase “the song of the tears.” 

Again Gloria’s melody has more movement when the singing is nonverbal rather than when it contains words. This alternation of singing a melody without words and singing words on a single tone is a developmental step towards creating a melody with both words and tonal motion. The repeated single tone reflects an emotional state, and also a stage in the creative process of becoming able to improvise melodies. It is noteworthy that whether she uses single tones or multiple tones without words she is locked into the basic tonality of the accompaniment. The more she sings the stronger and clearer her voice becomes and this seems to be an indication that she is drawing support from the music of the piano.

Gloria enters with a defined vocal melody in a steady moderate tempo right on the downbeat of the established metric structure of the music. She sings:

This is an essential moment in the development of the improvised song and Gloria’s ability to enter into this creative process. She has created a melodic idea that is the same exact range as the non-verbal melody she sang right before. Upon analysis this non-verbal melody could have been accommodated to the phrase “song of the tears.” But Gloria has shifted in significant ways. First she conceived of a different lyric to be used with the emerging melodic idea she is forming. Second, in fusing the new phrase to the melodic idea she has also changed her perspective on the psychological issue she is dealing with. Rather than continuing to experience and suffer the effects of the constriction that had been eloquently portrayed musically, she now addresses the constricted character, asking “Woman, why are you weeping?” She has moved away from the emotional vortex to explore the situation from a perspective in which she can be more contemplative, and not restricted in her use of her creative musical and vocal capacities. The melody and words continue:

The music overall is getting stronger, more forceful. The second phrase of the melody which starts on the fifth above the tonic gives the question “Woman, Why are you Weeping” a sense of assertion. The accompaniment during this eight beat phrase swells, utilizing and an even wider range of dynamics, becoming louder and slightly faster. In addition the articulation in the right hand of the piano ostinato is changing, with a more attacking sound on the entrances. 

The overall musical quality creates the sense of a quest for something without much hope of getting it, given the sense of finality of the melody’s tonic D. I hear the lyrics and understand them in terms of Gloria’s personal feelings. In retrospect, my change in articulation in the right hand to a sharp attack is revealing of the psychological theory that depression can be anger turned inward toward the self, and I begin to model turning the energy outward.

Now I change tones of the repeated harmonic pattern, which have consistently been in the Dorian mode, by making a striking shift in the bass register, adding an Ab, a tritone away from the tonic D, while the D remains the lowest tone:

The Ab in the bass replaces the A, the stable fifth of the key. The alternation between phrases based on the now familiar D and the suddenly interjected Ab gives the music an unbalanced, turbulent quality. This contrasting harmony contributes to the instability, and yet there are also common tones to the previous D minor harmonies, suggesting links to what has gone on before. The change in harmony I make is a way to intensify the psychological question by musically adding unresolved tones of tension, and in effect creating more momentum to encourage an answer to the question. It supports the questioning by creating a harmony that is unstable, less resolute, and this harmony creates new tonal possibilities for Gloria.

As the new Bb harmony reaches its apex, Gloria continues:

The harmony resolves back to D minor as the final word of the phrase is sung on the tonic D. This final word “song” is sung at a louder dynamic, and the harmonic accompaniment is also louder and adds a counter melody with a B natural in a high register, a strong contrast to the Bb of the previous harmony. Taken all together there is more intensity in the music, a sense of surging and swelling. The metaphor I use retrospectively is that of a storm, with ocean waters swelling.

It is significant that now Gloria is singing in the first person, using the word “my”: 

Clearly the “song” she sings at this point is hers. The music is fueling her, creating momentum and energy as the intensity builds. The harmony is in reverse order as the melodic phrase now starts on the tonic D minor harmony and moves to the more unstable and dissonant one based on D and Ab. The counter melody from the piano, which started on B and moved down a third to G, now starts on G and ends on E, another descending third. These countermelodies occur after the vocal melody is sung, creating a kind of echo response to the vocal line. These descending thirds amount to a sense of falling.

The melody and lyric continue, and for the first time Gloria uses the word “I” which signifies more ownership of the content and the sentiment: 

Gloria continues, singing forcefully and with full breath support:

This strongly sung melody ascends to the final tone of A, which is a noticeable contrast to the previous vocal phrases which ended by descending to the tonic. Even more striking is that the last word is held for nine beats – over two measures –and is by far the longest tone to this point. While the tone is held vocally, the right hand piano countermelody, now in octaves ascends and then descends, using repeated tones and a sharp attack:

This adds to the overall intensity of the music. The vocal tone gets softer and fades, while the piano music continues at a loud dynamic. The piano music has an articulation that creates sudden shifts in dynamics, which create the sense that it is responding to the message of the protagonist, reacting with desperation to her fading voice.

Gloria seems to be nourished by the paradox of singing “I have no voice” with a tone of the longest duration and on a phrase that rises. She indeed is using her voice here. It is impossible to deny this as she gives herself the support necessary to sustain a pitch of that length. I acknowledge the intensity of her duration and the idea that she has no voice by playing countermelodies with great intensity. There are multiple messages being communicated here. Gloria is desperate because she has no voice, yet she is actually giving herself the opportunity, is allowing herself to support her voice most strongly. On the narrative level she is experimenting with the idea that she can and does have a voice. In the music she is giving herself an experience that is expressive and very self-assertive. I play more intensely and with a particular melodic countermelody that comments on her cry: “I hear your cry and I am responding. Don’t give up. It is horrible to feel that you have no voice. I will try to keep you going. Don’t stop, this is a dramatic moment and I will make an effort to join you.”

I continue a driven countermelody:

After this, Gloria sings, all on the tonic tone D:

This melodic rhythm is slower here, with half notes starting the phrase. Gloria’s repeated D and her use of “you” rather than I, indicates a shift of persona again. She has moved back to a distanced stance by singing “you” rather than “I”, and singing only a single tone that has no motion. She has removed herself from the statement, and therefore cannot infuse her melody with life to let it have motion. The singing of “I have no voice” had tonal direction and was a personal statement. The lyric with the question using the word “you” is outside of herself, and has less melodic contour, less animation, less life, less involvement. After making such a powerful statement that she, personally (“I”) has no voice, she has fulfilled the prophecy of that statement by following her strong melodic statement by singing with no melodic motion. Here is evidence that a lack of melodic motion is indicative of the feeling, the sense that Gloria has about herself, that she has no voice. But even a single tone is evidence of the desire to have a voice, to try and communicate. The fact that the tone goes to the well established tonic D is indicative of the congruence of this image of herself, the acceptance of the idea that she has no voice. Though she poses a question, the melodic phrase is definitive: Here is that old familiar place, that feeling that there is no where to go, nothing to say. The tonic is comfortable, just as the idea that she has no voice is comfortable, fits her self image, is a well established stance, even though she never would have thought to put it in this way. Only because she is singing does she sing “I have no voice.” Having no voice is symbolic of her not having a sense of herself, but the phrase is a new metaphor for an old characterization.

Yet upon analysis there is another perspective to gain an understanding of the music and words here. It may be that Gloria’s experimentation with musical form leads to the use of two contrasting melodic themes, one with a wide vocal range and the other utilizing only a single tone. This return to the single tone can therefore be interpreted as the discovery of a musical technique – the alternation of theme and counter theme – and a facet of her musical development, as well as evidence of a psychological paradox. To give credence to one perspective over the other is an arbitrary and distorting act of interpretation. Gloria is developing a way of being musical, and being musical helps her to evolve, as music naturally evolves and develops. 

The piano music continues and I play with greater intensity, playing with more rhythmic emphasis on each beat of the measure, picking up on the more deliberate melodic rhythm of the previous vocal line. The first beat is played in the bass register giving us the tonic pitch D and then notes of the harmony in the upper register of the piano on the next three beats. This music continues as Gloria continues to sing:

The dynamic intensity is at an apex here, with both voice and piano at forte. The bass notes on the tonic D are loud and ring out as Gloria sings the word “song”. The harmony moves briefly to Bb7#11 under the melody note A on the word “away”. This adds a new tension/dissonance between the A of the melody and the Ab in the harmony. The highest tones of the vocal phrase are sung strongly by Gloria and held for a longer duration than the other tones. This gives the sense of a drama, a battle, a great struggle being waged, through the song at this point. The loud notes from the extreme registers of the piano are creating an orchestral texture to the music and amplify the intense sentiments of the singer.

The frustration of having no voice is fueling the expression and allowing Gloria to exercise great strength in communicating, in fact finding her voice. The strong and various countermelodies I play on the piano actually offer more melodic choices for Gloria and may give her added confidence in freely singing tones other than the tonic. The musical intervention has a direct bearing on her emotional state. If she can feel she does have a melodic direction, she can feel she has a voice. There is an internal battle going on in a sense here, as Gloria’s tentatively newly emerging sense of self battles with the old sense of self, as Nordoff and Robbins (Robbins and Robbins 1991) describe. Can she have a voice – can she break out of this sense of having no voice? Harnessing her frustration seems to be fueling the strength and determination of her singing. 

As the music continues, the harmony I play becomes softer, echoing the fading vocal note Gloria sings, and has a different quality here. The high register counter melody descends and lands on F. At the same time the bass note moves from the relentlessly repeating D to a new tone, Bb:

These strongly consonant tones being heard at the same time diminish the tension heard in the music. These tones are primary in creating a root position Bb major chord. This Bb chord has been heard only once a few moments before at the end of a vocal line, and this is the first time we hear it in the bass of the harmony at the beginning of a phrase, before the vocal line starts. This is a significant change in that the harmony now moves to the relative major. The change to the relative major chord, gives the music a more hopeful quality, although the fact that these tones have been heard earlier during the D minor harmonies indicates that we have not moved too far from the turmoil. The softer dynamic lends a more reflective quality to the music. 

The change in harmony suggests to Gloria that there is another option, a direction, a path to an answer and a way out of the turmoil that she has not considered. It is an opportunity to experience her tones in a new context. The fact that the change of harmony is the relative major allows for all of the tonal sentiment to be accepted and included among possibilities for future melodic creation. It eliminates nothing but re-contextualizes the very tones that have been sung to express turmoil and sadness, into harmony that is capable of inducing a less painful, more hopeful emotional state for Gloria. The change to a softer dynamic also acts in this way.

Gloria continues to ask questions as she sings:

Gloria once again distances herself from the acute emotional turmoil of the situation that stifles her, shifting her perspective to ask a question of the person in distress. Upon reflection it seems that she is trying to focus on what she needs to do rather than what is stopping her from doing it. By asking “What do you want to sing about” she is giving herself the option: if you had a voice what would you sing about? By doing this she is trying to find who she is, what she has within her. This happens almost immediately after a strong expression in a loud dynamic claiming that she has no voice. The new question “What do you want to sing about” offers new possibilities, and my shift to the Bb major harmony and softer dynamic helps to manifest this shift. It is as if both participants sense that this is the natural direction the music can take, after such a strong and intense musical section. There is a natural alternation to the contrasting harmony and dynamics and this corresponds to a potential shift of perspective for the client. 

The harmony moves back to D minor and the countermelody enters after the vocal phrase ends:

The countermelody GFGFA repeats with GFGFB, the B creating the effect of reaching, of striving, of ascending, supporting the sentiment of the words in trying to find a new perspective. The vocal line returns: 

I support this question harmonically with tones from the whole tone scale. This creates a cohesive fusion of words and music as Beardsley describes in that the whole tone scale has a questioning quality which matches the question of the lyric. 

The music continues. I stop the accompaniment and play a countermelody in the high register, playing the phrase in octaves:

This is a dramatic alteration and upon reflection seems to be a way for me to make the commentary “What do you want to sing?” In fact the melodic rhythm of this phrase articulates these very words. Gloria continues: 

An instrumental interlude then occurs for about 17 seconds: 

This is the longest wordless gap of time since the lyrics began and creates the sense that Gloria is deliberating, trying to come up with an answer. The repeated ostinato motion in the left hand creates a sense of marking time, of contemplation occurring, of silent activity in the absence of vocalization. Because the usually present low register bass note D is not present, there is a less heavy quality in the music. The melodic fragments in the right hand manifest the search for content that Gloria is undertaking.

Gloria begins to sing again. The harmony is held after the vocal line enters and then shifts on the last melody note D to Bb major:

The fact that the harmony is not the tonic, and that the rhythmic pulse is continuing as there is an echo in the melodic rhythm of the countermelody, helps to create the sense that the sentiment is not final, that we are in a process. The D melody tone is comforting to Gloria, giving her stability as she tries to ponder the answer to the question. 

Even without knowing what she wants to sing about, Gloria continues singing:

After this vocalization, I move to D in the bass and introduce a new idea from the piano. Upon reflection I wanted to change the music somehow and break out of the pattern. The music called for a change, and I suspected Gloria needed a chance to break away from the constricting structural aspects of the song. I play a chromatic descending line in octaves beginning on the tone A in a higher register and continuing downward. The descriptive image is of a heavy object getting heavier as it falls. This music from the piano continues as the vocal line returns:

The piano melody and the vocal melody intersect. The piano tones continue past D to C# and then C, repeating these last two tones before stopping. I am stopping the flow of the pulse in the music. There is less of a quality of traveling forward here, of journeying.

As Gloria pauses to take a breath the chromatic descending line from the piano repeats again at a slightly louder dynamic and slows down, finally resting on C#. The vocal line returns on D, a dissonant half step away from the C#:

The accompaniment from the piano now has the single pitch C#, played in octaves and in different registers, while Gloria sings the D, accentuating the tension between these two tones. I am musically commenting on the lack of movement of the single tone that Gloria sings, the stuckness of it, by repeating a piano tone a mere half step away from her vocal tone.

I add a D so that now I am playing the half step of C# and D simultaneously in various registers of the piano. I am deliberately creating tension, bringing out the fact that Gloria is repeating a single tone by repeating the same tone as well as a tone a half step away, that creates a dissonant clash. This is an intervention to stimulate and evoke a response. Gloria’s tones are under pitch and rise up to the D, as if the C# is pulling her down and the effect is like releasing a taut rubber band as she rises to the D. The tension between the two tones creates energy for her, and triggers her to sing in response to the C#. 

Gloria continues to sing on one tone: 

The harmony at the piano continues to consist of repeated soundings of the D C# interval. These become more frequent and more insistent and spread to all registers of the piano. They become almost continuous, bursts of energy that threaten to engulf Gloria’s monotone in a swarm of dissonance. Then the bass tone C# is heard in a low register and held as the minor second interval of C# and D continues above it. This C# in the bass, shifting of registers plus the erratic rhythmic patterns of the intervals creates a sense of transition in the music, suggesting we may be moving away from the tonal center D even as the vocal line continues to repeat it. 

Gloria’s tones now are occasionally a little sharper than D, suggesting a yearning to move out of her present state. Her sharper tones may be in response to the closeness of the half step intervallic relationship between the emphasized C# in the piano and her D vocal tone. 

With a hollow vocal quality and with little change in dynamic or inflection, her tempo gets faster as she sings: 

The pace of my piano music becomes quicker as the vocal phrase is sung. The lack of pause between words also creates a sense of rapidity. This rapidity and the continued dissonance tones add intensity:

As Gloria sustains her last tone on the word “gone” I bring this turbulent music to a close, ending on a gentle Bb and E tritone as Gloria sings more softly.

The tone of the music is warmer with legato articulation and a brief melodic phrase that echoes “anymore” The Bb E tritone, plus the pause leaves an expectant space in the music. This is the first time in this transitional section that Gloria’s vocal melody moves from D. After the vocal phrase ends, a very low bass tone D is heard from the piano. There is no motion as the previously articulated tones fade away and only the D remains: 

Gloria returns with a descending melody and a familiar question. The low D repeats creating a funereal quality, while the right hand enters with soft descending parallel fifths starting on E and B moving by half steps:

The rhythm of this half step movement in the treble is the same rhythm as “Woman why are you Weeping?” It is a way to continue to support and amplify the theme of the improvisation, and emphasize that not having an answer does not have to squelch expression.

The pulse gently returns to the music and the D minor tonality is reestablished. The harmonic accompaniment pattern returns while the chromatic descending right hand continues. Two returning musical ideas-the familiar harmonic accompaniment pattern, and the chromatic descending right hand tones- are integrating into one sound now. This creates within the music the sense of returning to a familiar place having dealt with turmoil without fully resolving it. There is a potential synthesis within the music that is not quite realized.

Gloria continues to sing:

Gloria continues as the music intensifies. Chromatic dissonances from the piano supporting long held tones that Gloria sings contribute to this intensification:

Gloria’s downward bends to C# may be in response to the downward direction of the piano notes. Perhaps it is easier to leave her primary tone of D by going down, rather than going up. It takes less musical/psychic energy. Upon analysis it is a positive event that her tone is shifting, not static, and may represent some sense of inner psychic motion within her.

Gloria’s vocal line is sung while the harmonic accompaniment continues in D minor. The right hand plays an interval of the fourth that moves chromatically starting on D creating moments of dissonance as it descends. 

The tones of the piano come to a slightly softer dynamic in the right hand, landing on a consonant tone, the F, the minor third of the D minor tonality:

The music gets softer. With the landing on the F natural the harmonic and the dynamic intensity diminishes. This gives the music a qualitative shift from swirling turmoil toward calm, even gentleness. Soft and painful music is heard as Gloria enters into the music, singing more softly:

The vocal melody note A is held for almost 2 measures. The quality of her voice is different here as she is singing softly in a high register and sustaining the tone, really trying to create a musical gesture that describes her sense of loss. The phrase continues: 

The high register of the piano music echoes the melodic rhythm “voice and my song” with the tones E AE E:

Gloria continues, obviously feeling emotions as she sings: 

Gloria sings this while beginning to cry, and though she starts out by singing an A on the last tone, she wavers and bends the tone down to G#. Though the style of the music is not blues, the Ab that she sings, the minor seventh in relation to the Bb chord, gives an aching quality reminiscent of the expressiveness of the blues idiom. It sounds as if Gloria is feeling the pronouncement as a final, unalterable condition. Yet she keeps singing: 

After this lyric I play and softly repeat the tonal sequence DFGA in the left hand of the piano, creating a minor pentatonic sound, while the right hand repeats pairs of staccato E’s in the high register, the first one on the weak beat short and soft, and the second on the downbeat, strongly articulated:

This high E is a reminder of the E that started off the improvisation, but it is played in a higher register, as if distant, or moving away. The pentatonic sound of the harmony adds a less emotional, more soothing quality to the music. The repetition is also meant to reassure. It is my way of trying to comfort Gloria. I continue being motivated to comfort, playing a melodic phrase:

The parallel thirds lend a quality of sad warmth with each tone having a companion tone. The thirds are a different quality than the fourths and fifths that we have often heard. The sonority of the third brings a fullness that the interval of the fourth earlier does not. The thirds are closer together, but there is less tension in the harmony. This conveys that there we have been through the most painful part of the expression and our relationship has been sustained. 

This movement of thirds in the high register with syncopation in a soft dynamic has a child-like quality. Upon retrospect it is music I have used to visit painful childhood imagery of Gloria’s with a sense of delicacy, sadness, and a hint of playfulness. The thirds also support the possibility of resuming the journey. The melody plus the syncopated rhythm help to create a small measure of momentum and hopefulness within the overall sense of exhaustion after great effort.

After these thirds from the piano, Gloria sings with every word being sounded with the tone D. It is sung with a soft fragile quality. As the vocal line begins, the harmony tones shift to a Bb chord, and then the D melody tones are harmonized with a series of chords, some major and some minor:

These are the most chord changes we have heard in the entire piece. There is a fusion of words and harmony here as Gloria sings “I can’t find it” as the song comes to a close, and the harmony moves from chord to chord, in a sense trying to find the final chord of the cadence before finally coming to a close. The harmonic cadence finally arrives to its destination of D but shifts to major. This is the first time we are hearing the tonic D in a major key. This gives the music a sense of rest, of finality, of completion, and some solace. Ending on D major adds a hopeful quality to the music. Gloria has just had the experience of utilizing her voice, creating a musical form, and the D major chord functions as an affirmation, a punctuation to the experience. The dissonant augmented chord alternating with the major chord as the music ends is a reminder of all we have been through, the musical psychological journey we have taken.

Concluding Thoughts on Woman Why Are You Weeping?

Placing Gloria’s single tone within different harmonic contexts offers the possibility of creating different qualities of musical-emotional expression. She can gain a sense of the possibilities for forward momentum through tonal movement which she is unable to perceive or realize while she restricts herself to the single melody tone. The sense of moving through to a cadence, even as she continues to sing on one single tone which does not move, can provide Gloria with a sense of moving to completion. 

Within the sadness of the overall mood of the music, the emotional process intensifies, amplifies, diminishes, and the mood shifts to other emotions such as frustration and indignation. There is a sense of exhaustion, a sense of resignation, acceptance, and the possibility that the journey will continue even as this music ends.

By improvising a song with words and melodies Gloria is relying on her own musical impulses. This is a way to overcome the sense of having no self, of being stifled, of having “no voice”. 

Gloria utilizes repetition throughout the improvised song. Several melodic phrases and lyrics repeat, yet the changes in the other elements of the music – dynamic swells, tempo shifts, changes in register, alteration of chord voicings – helps to keep each repetition fresh. The repetition works as an unfolding expression within the context of the developing song form. Each repetition allows for a revisiting and therefore another possibility to have a new experience. This is reflected both in how the actual music is produced, and the emotional intensity and quality conveyed in the music. The tension of unresolved questions stated in the lyrics – “Woman why are you weeping?” “What do you want to sing about?” – is reflected in the tensions of the unresolved harmonies of the music. 

Music Therapy Session Audio Clip
Studio Recorded Version
Uncharted Waters – June 30, 1995 [Click for analysis]

There were times when Maria experienced strong feelings of fear as we began to make music, and the lyric content containing imagery of being lost in the ocean (“Uncharted Waters”) was a way that Maria found to express words related to these feelings. Singing together gave Maria the sense of safety and support she needed to not only talk about the fear, but also to express her feelings while experiencing feelings of fear. Maria explained that facing and working on her fears in this way was only possible through music.

We might think we are lost

We are in uncharted waters,

The sailing is not always smooth The darkness

We are in uncharted waters

We may feel like we are lost

No I don’t want to see these sights

No I don’t want to see these sights

I want to know where I am and where I am going

We are in uncharted waters, we are in uncharted waters 

We are in uncharted waters, we are in uncharted waters 

We will see sights that are frightening

We will see sights that are frightening

We will see sights that are frightening

Go ahead go ahead

God won’t leave you God won’t leave you

Go ahead nothing can separate us from the love of God

Not the water not the fear not the darkness, nothing

Not height nor depth, nor powers nor principalities

Nothing, not fear, not darkness, not uncharted waters 

no nothing, can separate us from the love of God

The lyric, “we will see sights that are frightening”, relates both to the emerging emotional states that could emerge for Maria in the current session as well as in future sessions, and situations outside of the sessions. Maria commented that the music allowed her to access feelings and imagery about significant events in her life that could not be accessed verbally. She recognized the power of the experience and thus was willing to enter into “uncharted waters.” It is interesting to note that Maria sang “we may think” and “we may feel that we are lost,” but not that we actually are lost.

As the improvisation came to a close she sang about God to comfort herself and find solace, something she has done in several of the improvised songs.

The music contained both tender consonant tones and  dissonant tones with shifts of tonal centers and at times the whole tone scale is utilized. This amplifies the quality of “feeling lost” which is sung about, and mirrors the emerging sense of apprehension as to what the future holds. The singing together and warm harmonies provide support at the same time. A blend of emotional qualities is contained within the improvised song that shifts and transforms as the music unfolds.

Music Therapy Session Audio Clip

Do I Dare Imagine – November 27, 1995 [Click for analysis]

This excerpt comes from a session right after Gloria’s first public sharing of music from the music therapy sessions to an audience of close friends and family. During preparation for the concert she acquired a piano and was beginning to try to play it, improvising while she was alone at her apartment. In the music therapy session this excerpt is taken from she is reflecting on one of first experiences in her apartment trying out the piano, and more broadly reflecting on her new found relationship to music. She is singing while I am at the piano:

Playing the piano wondering what my mother is thinking.

Playing the piano wondering what she is thinking. 

Gloria’s mother has been dead for many years. Gloria reports that the two had a tumultuous relationship and fought often. One point of contention was practicing the piano. Gloria refused to do so as a child, but now as a result of her new relationship to music she bought a piano. As the therapist, I recognized from her singing that Gloria is simultaneously taking a risk and creating an opportunity to work on her relationship to her mother. As her therapist I wonder if there is a way of lessening the intensity of the conflicted feelings about her mother in the present, despite all their conflict in the past? Perhaps she can shift her internalized representation of her mother to one that is more nurturing and supportive. This could be a key in helping Gloria to feel less critical of herself. 

Is she angry with me, angry because I didn’t try?

Is she angry with me, angry because I didn’t try?

Playing the piano, fooling around.

Hanging out with the piano.   

I’m not disciplined, but I do hang out with the piano

amazing

What is my mother thinking?

Is it possible to think that she 

Might be rejoicing for me?

Might she be rejoicing for me?

Might she be rejoicing for me?

Might she rejoice? 

That the depression has lifted that music is in my life.

Is it possible she might be rejoicing for me?

Or do I always have to see her…..criticizing

Angry….criticizing…. angry….

Never satisfied…criticizing… angry

Never satisfied never satisfied

Would she be rejoicing for me? 

Dino was rejoicing for me, impressed and amazed

What is my mother thinking?

Could she be possibly be rejoicing for me

Relieved to see me coming out of the depression.

What could she be thinking?

Do I dare imagine that she would rejoice for me?

Do I dare imagine that she would rejoice for me?

Do I dare? Do I dare?

Upon analysis, the repetitions in the lyric facilitate both the creative and the therapeutic process. They make it easier to create the song form by establishing a predictable metrical structure. They also allow Gloria to consider the content of the lyric and the feelings it brings up. When the lyric is a question, the repetition allows time for Gloria to consider the answer. 

Do I dare imagine…oh……oh…oh….oh

Do I dare imagine?

That she would be

Full of joy to see

To see 

Me smile and sing and play the piano

Would she just be angry and say she didn’t listen to me

She didn’t listen to me so now she has to do it on her own she didn’t listen to me

Would she be resentful? 

Resentful of my success

Keep pointing out my failures

Pointing out how long it’s taken

How much darkness I went through

Would she ridicule me?

All that darkness

Would she say you didn’t have to do all that.

You chose that, you were a fool. You were a fool.

Would she ridicule me?

Put me down?

Or would she rejoice?

That I’ve found my life at last.

I’ve found my life at last.

I’ve found my life at last.

I’ve found my life at last.

Oh oh oh oh oh. 

I’ve found my life at last.

Leaving the darkness behind.

Sailing south to calm waters.

In considering the significance of Gloria’s lyrics, I note the imagery of the final phrase. Imagery involving water is a literary device Gloria uses in several improvisations. In other excerpts she has sung about swimming with the dolphins, driving in a car, and a train traveling on tracks. It could relate to Gloria’s desire to move to a better place emotionally, to feel more hopeful about her future. The sense of forward motion that is created by the music seems to be a strong impetus behind imagery that has to do with travel.

Navigating through the icebergs

Sailing south.

Blue skies turquoise waters

Songs, music

Would she rejoice

Would she rejoice for me? Oh

Who knows?

Gloria sang this improvised song “Do I Dare Imagine?” several times during the early years of treatment. In her public performances she would choose an additional lyric to end with depending on what would feel true to her in the moment regarding her attitude toward her mother and her general emotional state. The addendum would either be a confirmation that Mom would rejoice, or a conditional statement wondering whether she would.

Detailed Description and Analysis

This example is rich in material for analysis related to the tentative hypothesis that musical choices by the therapist at the piano influence the unfolding psychological process of the singer. The uses of major and minor harmonies are a vital component of this idea. Smeijsters (2005) asserts that “when there is a change in the musical act, then there is a change in the intra-and /or interpersonal process” (p. 85).

The music is in a slow tempo (about 45 beats per minute) as Gloria sings about playing the piano:

Overall the music has a kind of sentimental quality to it, as if supporting the idea of remembering a past event. The melody from the piano is slightly louder than the harmony, so that it stands out from the harmony. This melody that I play after Gloria has sung “what she’s thinking” has a melodic rhythm that does not match Gloria’s exactly, but matches the unspoken words I have in my mind. I do not say it aloud but I play the rhythm ‘what is she thinking’:

It is a musical commentary on Gloria’s musical and emotional expression. My intention is to support reflection and keep the process going, a process that includes both musical creation and emotional exploration.

Gloria continues to sing about her mother:  

Gloria sings this lyric with two tones, C and Db. I create two harmonies, Gb major and Bb min 9. The relationship between the melody tones and the harmony creates a tonal ambiguity. The Gb chord combined with the C sung creates the sound of the Lydian mode. This has both a more hopeful and questioning tone than the minor chord. The Lydian mode is often used to create a sense of mystery and wonder, hope and opportunity. Throughout the course of treatment I utilized it to both trigger and enhance imagery. The Bb minor creates a quality of sadness, yet there is also a blend of warmth and comfort with the C being a ninth in the chord. The harmonic ambiguity created both within each chord and between the two chords reflects the questioning content of the lyric that remains unanswered. It also leaves open tonal possibilities. 

The music is dramatic, and open ended. As she sings “because I didn’t try”, a countermelody from the piano descends down to the C she is singing, conveying a sense of companionship in the music as we travel to the same note together. It also adds to the intensity of the word “try”, animating the conflict that Gloria feels as she remembers disappointing her mother by not practicing the piano. The tone that ends both the melody that Gloria sings and the countermelody from the piano is not the tonic but a step away.:

Gloria continues as the chord progression establishes the minor key of Bb minor: 

Gloria shifts her attitude and sings content related to her conflict with her mother, who felt she did not practice the piano enough:

In response to Gloria’s vocal statement I play a harmonic response with a similar melodic rhythm, playing a melody a third above what Gloria sang. The dynamic is louder and the articulation sharper, in effect intensifying her sentiment while making it more harmonious:

After hearing these chords played at a forte dynamic, Gloria shifts her subject back to singing about the piano and then returns to the conflictual topic, her mother: 

After hearing her melodic phrase about her mother, I repeat it starting on the same tone that she did, both to let her know that I hear her and also to encourage her to continue to reflect on the question. I play it again in octaves and then Gloria does continue to ask herself about her mother:

Gloria repeats might she be rejoicing on Bb as I play a Bb minor harmony:

The minor chord with the tonic note being sung lends the music a sad quality. So as she sings about the possibility of entertaining the notion that her mother might be rejoicing, the music I play has a quality of sadness that suggests that it may not be possible. Realizing the influence my accompaniment could have, I change its sonority with clinical intention. In the space after Gloria finishes her phrase, I do not repeat the melody as Gloria sang it as I had earlier, but play a melody that ascends while harmonizing it with a major chord, the Gb chord that we heard earlier:

Since the Gb major chord is closely related to the Bb minor chord (they share two common tones and the Gb is the natural harmony on the sixth step of a Bb minor scale), the music at this point can still be heard in the context of minor, even as we hear the major chord. Instead of Bb minor sadness, playing the major chord and the melodic motion manifest to a hopeful sound, reflecting my sense that it may be possible for Gloria to feel more hopeful about her mother. I am modeling a musical experience for her to try out as she sings the words expressing her desire to feel more positive about her mother. 

Gloria’s lyric content expresses her desire for a better relationship, but the limited tones in her melody are sung with weak support, resulting in a vocal quality that indicates a lack of emotional involvement. She is singing what she hopes without truly believing it. My implicit intention as music therapist is to create the opportunity for Gloria to try out the experience of singing about her mother as a more positive, supportive presence. My challenge is to create the emotional qualities in the music of possibility, without exceeding Gloria’s current tolerance level. 

The music cannot be too hopeful, too major. This would impede Gloria’s investment in the music and hamper the sense of mutuality needed in creating meaningful music together. It has to leave the situation more fluid than that, and the close relationship between the Gb major chord and the Bb minor chord allows for that. The music can easily shift back to the Bb minor tonality even as the Gb major chord is sounded. The word possible utilized by Gloria in the lyric is a strong influence on the direction that I take at the piano after hearing it. It is a key word that stands out in terms of therapeutic significance. I am trying to create possibilities in the music that have a more hopeful quality to support a new possible perspective regarding Gloria’s relationship to her mother. I make a strong musical intervention that has a clear clinical intention. I continue to use the Bb melody tone as Gloria sings “the depression has lifted, but I do not continue the harmonic progression to Bb minor:

Gloria has made a powerful statement that is hopeful and I want to reflect this. I harmonize by staying on Gb major chord, adding a major seventh to the chord as the progression moves, and then harmonize the last melody note of the phrase with a new major key of Db major. Gloria is still singing a Bb melody note. The Bb note in relation to the Db major chord is a major sixth. This gives the music a happier quality as Cooke (1959) describes, matching the lyric content that Gloria created regarding her acknowledgment that she is less depressed. Db is the relative major of the Bb minor key established earlier. So the major chord has a strong relationship to the minor key.

Gloria pauses as I continue to play melody notes to accentuate the harmonic tonal presence of Db major, playing tones that clearly establish tones of the Db major scale:

The notes in Db major move in an ascending direction. My intention here is to suggest to Gloria that she can indeed experience her mother in a more positive light; that she can sing about her mother with less sadness. Even as she sings the same tone, she can experience a new context for it, just as she can consider her mother’s attitude with a new emotional framework. Gloria sings the same lyric again and it is interesting to note that as she starts to sing it her first two melody notes are higher than her often repeated Bb tone. But she falls back to the Bb melody tone and repeats it. Perhaps her musical reaction triggered an incipient response but she was not psychologically ready to sing a tone away from the Bb and she returns to it.

She returns to her less hopeful consideration regarding her mother, singing the words “see her” with a descending interval of a minor third ending on the Bb. The word-music combination here – the word “see her” with the melodic interval of the minor third – suggests to me that it is not right to continue with the new Db major tonic. It was premature. Gloria was not ready to move from her emotional stance which was reflected in her tonal choice and lyric content, and I shift back to Bb minor:

My piano music becomes more rhythmic, louder, reflecting the tension of the word meanings. Gloria continues to sing with a quality that suggests she is feeling victimized and perhaps overwhelmed by her mother’s critical voice. She sings the stinging words of the lyric in a soft dynamic that conveys a kind of hopelessness. The louder and more intense music from the piano is an intervention that tacitly seeks to energize Gloria. By playing with more intensity I am reflecting the content of the words and also hoping to invite and encourage Gloria to sing with more intensity, more anger, to feel less paralyzed in response to the way she depicts her relationship to her mother. At this point in the session a clinical hypothesis emerged for me. I theorized that she may need to express her anger toward her mother, to feel she could stand up to her in an emotional sense, before she was ready to accept the possibility that her mother could be rejoicing. Here she is singing as if she is in the role of the daughter meekly responding to her mother’s criticism. Could she sing with the same intensity she brings to her lyrical description of her mother’s attitude towards her, identifying with the aggressor as she has done in past music therapy sessions to fuel her expression? In this way she can also move beyond the role of the helpless daughter waiting for her mother’s acceptance. Gloria’s dynamic does not change much in response to the intensity of the piano. She does show some melodic movement as she leaves the Bb to sing an A natural in response to my moving the harmony to an F chord, the dominant chord of Bb minor:

After Gloria sings these words, I pause on the Gb major chord. This is a chord that can go either to Db major or Bb minor. The musical intervention serves to create harmonic pathways to different musical and emotional destinations: 

 I try the major key again:

As Gloria sings this lyric, she sings in a softer, gentler dynamic that I clearly identify as sad. I hear this and sense that there has been an emotional shift. Gloria sings about an important male family member who she misses and feels a strong sense of support from. Then she returns to the family member who is the catalyst for much of her expression, again asking what her mother might think about her involvement with music:

Hearing Gloria again sing the lyric about depression lessening, I play a melody and then move to the Db major chord again, but this time in second inversion:

Once more I sense that it may be possible to move Gloria to a more hopeful stance by moving to a major tonality. As I play the second inversion Db major chord, I repeat Gloria’s Bb melody tone and begin a melodic phrase that rises and then falls, coming to rest on Ab, the dominant tone in relation to the key of Db: 

There is a strong sense of leading to Db now. This melodic idea from the piano is a suggestion for Gloria. By beginning my melody on the exact tone Gloria sang, on Bb, I join her musically and psychologically, and then try to take her a little further. Musically I suggest she move a little closer toward the new tonality, manifesting the psychological possibility of her mother’s acceptance with the acceptance of the new key. 

Gloria responds to this by singing a Db without words and then with words:

Sensing that Gloria can now sing in the Db major tonality, I set up a harmonic rhythm and progression that sounds like an introduction to a song leading to Db major. Gloria’s self enhancing attitude reflects a new emotional state that is now present and the music is used to anchor it, establish it. 

I alternate the Db major chord in second inversion with an Ab sus chord. An Ab chord that also contains a Db. This is a harmonic device that I find useful and use often in creating a new key and establishing the potential for a song to unfold.:

In my right hand I play a melodic figure with the melody tones Db and C. These are the same two tones that Gloria sang as this excerpt began and the harmony that emerged was minor, but now the harmonic context and emotional quality are very different. As I play the Db, Gloria enters into the music by singing a Db:

Gloria sings a clear melody with a tonal range that is wider than anything she has sung up to this point. Her melody starts on Db and rises! She uses five different tones for her melody, with her highest tone on the word “dare”. Musically she dares to clearly sing a high tone in a major key as she seems to accept the psychological dare to imagine that her mother is rejoicing. Perhaps she is taking steps to rejoice by singing this melody, whether or not her mother would rejoice for her. In any case, the melody Gloria sings indicates some kind of an intra-psychic shift. The tone she sings on the word dare is an F, the major third of the Db chord. She is clearly in Db now with her melody. Her voice does wobble slightly on the word rejoice, revealing how challenging it is to enter into this experience. But she continues on in the new key as the song becomes more established:

The song form is clearly established at this point, with a clear though flexible tempo, definite measures and an accompaniment pattern that is consistently creating the beats of the song. I chose to play a countermelody along with Gloria’s melody, since I am confident that she knows the direction and length of the phrase. The natural musical-aesthetic impulse also had the effect of solidifying a sense of mutuality between us while heightening the forward momentum of the music. Gloria continues to try out the more hopeful stance. In between each ‘do I dare’ lyric, I play a melodic phrase that at once echoes hers and also creates dialog, beckoning further response: 

As Gloria sings “Do I Dare Imagine” I go to an extremely high register, reinforcing the idea suggested in the lyric of imagining: 

In response to Gloria’s lyric I play a light countermelody in the upper register representing her idea and then she continues, shifting the sentiment:

As Gloria sings the word angry I start to play descending chords. At this point Gloria starts to speak rather than sing, taking the perspective that she imagines her mother might take:

Gloria pauses as the pulse of the music slows and I play chords in the lower register of the piano. She returns to singing and asking about her mother’s perspective: 

As Gloria sings I play the two minor chords that Gloria had chosen and played earlier in the session that she said represented her conflicted relationship with her mother:

As Gloria sings I respond by alternating G major seventh with B minor to support her lyrics. She continues to vacillate between trying out a more hopeful attitude, and then punishing herself for even daring to open herself to the possibility:

Hearing the word “rejoice”, I move the harmony from G major 7, which contains the notes of B minor to B major 7, and then move to a new key:

This shift to a new key mirrors and heightens the contrast between the attitudes that Gloria is taking as she creates the lyrics. “I found my life at last” is a significant statement, a definitive statement that I hear as a change from what has been sung by Gloria up to this point. I play music suggesting a movement to a new major tonality. Gloria pauses, and I continue, using the B major that Gloria suggested and the B that Gloria has continued to sing to transition the music into a new key, E major. This is another point where I play a harmonic sequence that suggests the possibility of a transition like a transition to a new section, an introduction to a new musical place:

Harmonic direction has influenced Gloria to emerge from meekness and conflict and take the stance of psychological strength represented by her singing the lyric “I found my life at last.” This psychological stance in turn leads both participants to the establishment of a new key. The B tonality, whose alteration between minor and major exemplified psychological conflict, now serves as a dominant pivot for the establishment of a new key and new tonality, E major: 

Gloria is singing a melody with tonal motion and a wider range. This entire section includes tones that span her widest range up to this point, an octave from B to B. The music here is delicate, tender, with the harmony tones in the higher register of the piano. There is a firmly established and predictable harmonic progression that moves with Gloria’s melody. Gloria continues to sing with a more hopeful attitude. In response to the lyric “leaving the darkness behind,” I play a descending melodic line, to manifest the motion of leaving: 

The motion of the tones may have triggered imagery for Gloria as she continues to sing:

After hearing Gloria’s lyric content, I begin playing tones in an arpeggio-like fashion, using E Lydian alternating with E major, to manifest the sense of water and motion. The fact that it is in a lower register creates the sense of a big expanse of water: 

The lyric content continues to be filled with imagery that is congruent with the warm flowing quality in the music:

As the song comes to a close, the A minor chord reminds us of previous minor tonalities, blending emotional qualities as Robinson (2005) describes, and Gloria ends not definitively but with a question:

Though the words depict doubt, the quality of her voice and the shift of the music from minor to major indicate that something has changed for Gloria regarding her relationship to her mother. 

Concluding Thoughts on Do I Dare Imagine?

The fact that Gloria sang many of her lyrics on only one or two tones allowed me to create different tonal centers. This has the effect of creating a sense of momentum and movement even as the melody tone does not change. Many of Gloria’s melody tones were either Bb or Db. I created harmonies related to Bb minor or Db major. When she sang the lower tone it usually related to the minor, the higher tone to the major. At a particular point in response to the ongoing process, I harmonized the lower tone with the major tonality, and this seemed to make it easier for her to take advantage of the musical and psychological possibilities presented by the major tonality. Her tonal range expanded as the improvisation progressed. This expansion of range corresponds to an expanded capacity for emotional experience and expression.

Music Therapy Session Audio Clip

Studio Recorded Version

Scared and Paralyzed – January 26, 1998 [Click for analysis]

“Scared and Paralyzed” was a blues improvisation that grew out of an exploration of a frightening dream Gloria had about two hats. She described the dream as triggering feelings of being scared, paralyzed and frightened. In the session she decided to name each hat and joked about the names, singing them with a vocal quality and phrase structure that suggested a blues form to me. The experience became a paradoxical one as the song contains fearful imagery yet has celebratory and joyful qualities as Gloria sings in the blues style and laughs heartily while creating the words and melody.

We can name each hat

Scared and paralyzed

Scared and paralyzed

I can put on my scared hat

I can put on paralyzed

Scared and Paralyzed

Scared and Paralyzed

Scared and Paralyzed (Laughing in time to the music)

Scared and Paralyzed

My two hats

Scared and Paralyzed

We’ve been to this one before

She lifted each hat and looked inside

She lifted up each hat and looked inside

And what do you think she saw?

A label

Scared and Paralyzed

She put on scared first

And she started shivering in her boots

Scared and Paralyzed

A pair of hats floating around 

Scared and Paralyzed

This is so silly

Scared and Paralyzed

A pair of hats floating in the elevator

She put on paralyzed

She put on paralyzed

She stood straight 

She looked out

She was paralyzed with laughter

Scared and Paralyzed

A pair of hats floating in the elevator

Scared and Paralyzed (laughing) 

Paradoxical experiences where contrasting qualities were contained within one song form were particularly noteworthy for Gloria and seemed to have special clinical significance. Her psychological stance around a particular issue or feeling seemed to shift or expand after these experiences.

Music Therapy Session Audio Clip

Performance Version

All My Life – May 20, 1998 [Click for analysis]

This is an improvised song in which Gloria describes her life long struggle to become more of a participant in life and less constricted by her conflicts. In the song she acknowledges that she has made progress but recognizes that it is still a challenge for her. As we start, Gloria actually cues me by snapping her fingers to indicate she would like me to infuse the music with a pulse.

All my life I have tried to be here 

All my life I have tried to come into the light

It has been a long journey

All my life I have tried to come out of the dark 

All my life I have walked with my crutches with my chains 

With my blindfolds 

All my life I have tried to throw them away

All my life I have tried to cut the chains 

Slowly one by one I have taken them off 

Slowly one by one they have fallen away 

All my life, I have tried to take the chains off 

To walk without the crutches 

All my life I have tried 

All my life 

Music Therapy Session Audio Clip

Performance Version

There, There – June 9, 1998 [Click for analysis]

This excerpt contains examples of the many attitudinal and emotional shifts that can take place within the stream of an improvisation. Gloria sings of how she can take a superficial stance towards the world, and how this is a kind of protective shield, a “bubble” that hides her authentic feelings. She sings of the pain she is in, and then sounds angry as she blames herself for the condition she is in.

Much of Gloria’s frustration is expressed here not by singing but by speaking the words. She has a conversation with herself, taking on an impatient tone as she criticizes herself for having the same complaints again and again, using the pronoun ‘I’ in describing her pain and ‘you’ in expressing her frustration in dealing with the same issues again and again. There is also a dialogue taking place between us. This is because Gloria uses quite descriptive imagery and as she pauses I play particular musical elements in response to the words. She in turn responds to my music and continues her lyric creation.

In general the music from the piano supports her shifting attitudes, playing repetitive music as she sings of her repeated complaints, and also animates her expression by adding sharply attacked single notes that are dissonant and trigger Gloria to sing with more energy, at a louder dynamic and higher pitch. This seems to shift Gloria’s expression from a more cognitive experience to a more emotional one. The music helps to sustain this difficult emotional state. Then in a mutual fashion the music slows and becomes tender as Gloria shifts her attitude from disgust and anger to tender and sad. She takes on the position of God in her lyrics, singing comforting words of nurturance. Gloria cries as she sings. The excerpt ends as Gloria sings about God, and the music shifts to a Gospel style.

Another thrill

I hide so you can’t see me (Gloria snaps her fingers)

And I go for another thrill

I hide

so you can’t see me

In a swing style, Gloria sings happily about her self defeating behaviors. When she celebrates her shortcomings in this way, the swing style often helps her to become unstuck and more creative in the sessions. Rather than complain about the fact that she was driven to hiding from the world, here she brings out the sense of satisfaction that she derives from hiding with the quality of her vocal expression. There was a slight sense of irony in her attitude at this point. We both were aware that hiding was not something to reinforce. Yet in this instance the paradoxical experience of fusing happy music with this problem fueled her to explore it more deeply.  

I hide

so you can’t see me

I hide

so you can’t

so you can’t

see me

The music changes here and Gloria’s story unfolds as she creates imagery describing her desire to move past the isolated stance she often takes in relating to the world, and what lies inside her when she removes her outer “bubble”.

I step

out of the bubble

I’m a mess

I’ve been cut and slashed

I’m bleeding

I’m throwing up

As the imagery becomes more graphic and violent, Gloria’s voice becomes more detached. She begins by talking rather than singing.

My knees are weak

My ankles can’t hold me up very well

Everything’s fine

Gloria often commented critically about her ability to relate to others as if everything was “fine” when in fact she was experiencing emotional pain. She also knew there were times when she could keep the fact that she was in emotional pain from her own consciousness as she went about functioning in her daily life. Now she has a dialogue between her “I” and her “you”.

Everything’s fine

But I’m bleeding

You did it to yourself

You did it to yourself, who the fuck cares?

Gloria often battled with her intense self criticism and judgment of herself. Two perspectives have clearly emerged. One persona is describing the pain and asking for help, and the other impatient, holding back and judging.

I’m bleeding,

I can’t walk,

I’m bleeding

I can’t walk

What’s the use of helping you?

There’s no use in helping you

There’s no use to help you because

You’re just going to do the same thing again

Why should I help you any more?

You keep coming in this room all bloody

Oh you keep coming in this room all bloody

Gloria often worried that she came to music therapy and described the same issues over and over. It was difficult for her to find a way to accept and be patient with her exploration of issues that did not easily resolve. She was also worried that I would become tired of hearing the same issues. It may have been that her words represented her fears of what she projected I might have felt as she kept “coming in this room all bloody”. By taking all of her expressions seriously and supporting them musically I attempted to help her to dissipate her worry that I would eventually tire of hearing about her painful issues. 

I’m supposed to wash you up and put bandages and ointments on you

Comb your hair, wash your face

Give you a place to sleep,

Comfort you,

Talk to you

Listen to you

Play music for you

The quality of expression and the music start to shift here to a more gentle tone.

Cuddle you and say “there, there my dear”

“There, there my dear it’s going to be ok”

“There, there my dear it’s going to be ok”

At this point a song form with a predictable meter and pulse has been established. Gloria is singing now in a tender way. 

Oh my dear

oh my dear

Rest with me it will be ok

Oh my dear it’ll be ok

I’ll wash your face

I’ll dry your tears

I will bind up your wounds

I’ll wash your face

There is a quality of nurturance in Gloria’s voice at this point as she sings with reference to the Bible and God’s perspective.

I’ll clean you off,

I’ll bind up your wounds

I’ll comb your hair

Rest my dear

Rest my dear

The broken pieces have

Such sharp edges

They’ve cut you my dear

Oh rest my dear

Oh rest

Oh rest

Oh rest my dear one

Oh rest

I’ll wash your face

I’ll bind up your wounds

I’ll comb your hair

Oh rest, rest in my arms

I know what you’ve been through

I know what you’ve been through

Oh rest, oh rest, oh rest my child

God doesn’t leave us, God doesn’t leave us

Another shift in perspective occurs and now Gloria sings about God, reflecting on the words she has just sung from God’s perspective. The music shifts to a soft gospel feel.

God doesn’t leave us no matter what I do

God doesn’t leave me, God doesn’t leave me, God doesn’t leave me

The intensity and contrasting qualities of emotion contained in an improvisation that lasted over nine minutes combined to create a powerful experience for Gloria. At times the experience was physically exhausting for both participants. There was also a sense of relief and physical release. The pacing within the session was an important factor in modulating the emotional intensity.

When the issues she was wrestling with were daunting, Gloria’s ability to express from different perspectives was the key to enable her to continue her process. 

Detailed Description and Analysis

Since much of the improvisation in “There, There” contains dramatic imagery, and the form of the interaction between us is call and response, this example led to the emergence and consideration of specific ideas regarding how the words Gloria chose and the quality of how she expressed them influenced the music that I played. The example begins with Gloria snapping her fingers as she sings. The music has a jazzy swing feel here and Gloria sounds happy, as if she takes pride in her ability to hide:

Knowing her issue regarding her conflict about hiding emotionally, about not being noticed but wanting to be noticed, contributes to my consideration of her lyrics and the significance of them for Gloria. The fact that Gloria’s pitch is not entirely accurate and her vocal quality is a little wobbly is also information that I note. The swing feel has often bolstered Gloria in the past and connects her to her body as she sings:

Even as the jaunty swing feel continues, dominant ninth chords move in parallel motion containing a minor seventh interval that contributes to a more dissonant sound. This functions as a subtle form of questioning to Gloria regarding her attitude about what she is singing. The chords happen after each short phrase that she sings, creating a subtle call and response form between her melody statement and an answering harmonic statement. This foreshadows much of the form between her melody and my harmony throughout this improvisation. As I play a walking bass Gloria sings a melismatic phrase on the word “can’t,” a kind of bluesy sound that she sings with a sense of satisfaction: 

There is some dissonance in the harmony and in combination with the bass this creates a momentary minor chord where there had previously been a major chord in the progression. There is also a subtle clash between her melody tone D and the E which is at the top of the harmony. The bass plays some tones out of the key, hinting at breaking out of the form. This is an example of a blend of emotions in the music as Robinson (2005) describes. The music is both predominantly happy and subtly questioning.

Gloria starts to sing slightly softer and holds her last tone even longer, changing the phrase structure of the melody. I respond by playing fewer notes, and the overall effect is that the music begins to lose some of its rhythmic drive. Gloria leaves space in her melody after this last note and I slow down and then completely stop the walking bass. Gloria sings this last “see me” with a gentle, vulnerable vocal quality. Keeping the same key of D major, I switch the style of the music and the emotional mood here. 

I play a melodic fragment A and then F# that breaks the swing feel, holding both tones. The tempo slows and I play the D chord in second inversion in an open voicing, giving the chord a less stable quality. I then move the A up a half step from the fifth to Bb. I play the same movement an octave lower: 

This half step motion upward is clearly heard, and then Gloria utters:

I continue the harmonic motion of a half step rising to represent the idea of stepping. The tone is a dissonance, and not in the key of D major. It is a step out of D major, mirroring a step out of the bubble.

Tones that are dissonant are added to the harmony off the beat, creating a messy sound:

In response to the lyric “cut and slashed,” I move from the major triad to dissonant intervals moving down on the keyboard. The downward direction relates to the idea that being cut and slashed would trigger falling. The fact that Gloria’s voice also gets softer and falls in dynamic, also contributes to the descending direction of the tones at the piano. The form of our musical interaction is call and response, as Gloria creates a lyric, and I respond, while sustaining tones from the piano between the interactions:

The contrast between the dramatic lyric and the hollow, almost numb tone that Gloria uses to say the word “bleeding” more than sing it, triggers a musical countertransference in me. Rather than mirror the hollow tone, I respond to the painful verbal image her words evoke, playing forcefully with clusters in a higher register of the piano:

It is if I am saying “this is a terrible thing, the fact that you have been cut and slashed and now you are bleeding.” This is an example of a musical commentary as Robinson (2005) describes, the music commenting on the persona presented by the voice.

My music continues to convey turmoil, yet Gloria speaks the words rather than sings them with a kind of hollow detachment, with a hint of disdain: 

In response to the lyric about her knees and ankles lacking support, I move to the low register, the supporting component of the piano, and play dissonant tones and intervals. The fact that the bass is moving and has dissonant tones creates a quality of instability, and this relates to the lyric describing her unstable ankles. The last harmonies that I play in the pause contain the tritone interval, amplifying the sense of instability:

Gloria sings “everything’s fine”, in a high register with notes somewhat related to the harmony I have just played. In response I play the melodic rhythm of everything’s fine, using Gloria’s last pitch as the first pitch of my phrase, and end with an ascending interval of a tritone, which gives the melody a quality of not being fine, of being strange, of being unstable. It is also noticeable because it goes up. My melody has highlighted and magnified the incongruity between the words that Gloria has sung and her vocal and musical expression. Gloria hears this melody from the piano and immediately picks up on the strange melody with the tritone:

Again I take the melody and echo it, moving it to different tonalities so that there is a questioning quality in the musical commentary. It is as if the music is saying, “everything is not fine; something is wrong, and we are not sure what is happening”. This is reflected in my lack of a clear tonal center and the emphasis on the tritone.

At this point Gloria speaks. In response to Gloria bringing back the bleeding lyric, I bring back the dissonant clusters from the first time she used the words:

The repeating musical response to the repeating lyric statement gives the music a form. It also emphasizes the musical aspect as a contrast to the fact that Gloria has again gone back to saying rather than singing the lyric. The first time I created this cluster it was a spontaneous, unpremeditated reaction. This time it is somewhat more controlled, as I am returning to it with intention. The music continues:

Now Gloria uses the word “you”, responding to the character that was bleeding. This character has little empathy for the bleeding character: 

It is striking that Gloria curses, as it is extremely rare for her. I sense the intensity of her turmoil. I continue the dissonant thematic music first used when Gloria first mentioned her bleeding. At the end of the phrase I play a D in the bass, the key that the entire improvisation began with:

I start to play a bass line, creating a slight sense of pulse, without establishing a definitive tempo:

The lyric “I can’t walk” triggers my response to abort the establishment of a pulse. Music with a pulse would not support the idea of not being able to walk. Instead I hold a minor chord with dissonance as Gloria continues to sing on the one tone D, wavering slightly below pitch as she sings: 

Gloria’s melody stays on the one pitch D as she sings “I can’t walk.” I sense that the lack of direction described in her lyric is reflected in the lack of a melodic direction. On the word “walk” Gloria’s pitch is slightly below the D. In response I play a C# in the middle register of the piano and the grounding D tone in the bass. I then move this D-C# major seventh interval up a third to an F#-F: 

The overall musical quality is that there is something unresolved, something painful, something unable to be completed. Upon analysis, these two tones that form the dissonant interval are a manifestation of the conflict between the two personae that Gloria has manifested in singing the lyric: the voice that is bleeding, and the voice that is frustrated and contemptuous of the bleeding voice. The two perspectives clash, just as the two tones clash. There is very little musical change suggested here. Gloria continues to speak the words and the dissonant major seventh interval is sustained:

Now I play the dissonant interval and move it up again, as if mirroring the ongoing and intensifying frustration that Gloria has singing from the persona of the potential helper:

There is a pause here as Gloria emphasizes the reason for not helping. She then continues:

The statement — again spoken and not sung — of frustration with her repeated self- injurious behavior, triggers a musical response for me. I begin an ostinato pattern, manifesting the repetition in the lyric. Upon analysis this is a way for me as therapist to “join the resistance”, a psychotherapy concept that was congruent with my clinical ideas but not conscious for me in the moment. There is strong pulse in the music here as the harmony moves from a consonant to a dissonant chord: 

Gloria continues to speak these words rather than sing them. The dynamic of the music from the piano is building. While Gloria starts her spoken phrase, as she forms the word “keep”, I add a loud, sharply articulated single tone that is dissonant to the continuing harmony and hold it while the harmony continues to be driven by the same accompaniment pattern:

The note is a Bb, and because I play it an octave higher and slightly before the G7 chord it stands out against it. Gloria reacts to the note by raising her voice to a higher register and beginning to sing rather than speak. It was not my conscious intention to trigger this, but Gloria seems to sing with more energy. Upon analysis, it is as if the note jars her back into the act of singing. Perhaps the intensity of my reaction gave her permission to give fuller voice to her own feelings, breaking through an unbroken “sound barrier”, to feel and express anger, to embrace and embody more fully the critical persona. I repeat the tone several times, reinforcing a jarring quality in the music: 

I play a C#, another dissonant tone as the harmonic accompaniment pattern continues. This C# played with the G major tonality emphasizes the tritone, a subtle reminder of the “everything’s fine” tritone heard earlier. It is clear that everything is not resolved, and the tritone embodies this which is heard by Gloria as she sings the C#: 

Not only is there a tritone relationship between the bass note G and the melody note of C#, but there are other intervals – F/B, E/Bb – that are also creating the sound as well. As Gloria continues to sing with some disdain about how she is “supposed” to have compassion for the persona who is victimized, the music from the piano starts to change:

The harmony continues to be dissonant but is softer. Because the previous syncopated harmonic accompaniment pattern has stopped there is a sense that something new can develop. In place of the previous harmonic pattern is a kind of tumbling descending harmonic motion with dissonant intervals moving in parallel motion, and since there is no tonal clarity, it is not clear where the harmony is headed. Gloria continues to sing in a kind of detached disdain, as if the critical voice does not believe it’s worth trying to support the character that is in pain, all bloodied:

The words describe acts of compassion, but the tone of the singing reveals a lack of compassion. I reflect this ongoing conflict continuing to play mainly dissonant harmonies, but a quick consonant C major chord is heard. This is a different tonality and hints of relating to the actual nurturing content of the words. It lasts very briefly and the dissonant chords continue: 

The harmony at the piano is moving to a higher register as Gloria continues to sing:

The harmony continues to contain dissonances but with a more gentle lyricism in how they are phrased. An F# tone in the middle register of the piano is repeated and thus serves as a bass tone. The tones above it do not relate in a consonant way, but the fact that this F# tone repeats gives the music a little more anchor, a little more stability. Something is about to happen but it is not clear what. Gloria pauses briefly and so do I. Something is starting to shift, both in the piano and in Gloria’s vocal persona. The F# bass tone in the middle register now moves up and down a half step, as if manifesting the shift that is occurring and will continue to occur in the way that Gloria is using her voice:

There is a little more of a pause before Gloria utters “talk to you”, and in response I pause and hold the harmony notes before continuing to play. As Gloria states “listen to you”, I move the harmony notes to a higher place on the piano. This adds a sense of building tension in the music. Then I play an ascending run that both responds to the growing tension and adds to it. After Gloria gently and softly states “ play music for you” the bass moves up, and while still below the other harmony tones from the piano, begins a melodic line that is chromatic, adding a searching quality to the music. The music has contradictory qualities – tumbling yet ascending, floating upward, lightly, heading for an unforeseen destination. The image I have is of a tumble weed being blown gently. Gloria continues and on the word “cuddle,” she takes a tone played at the piano to this moment, a Db, and begins to sing the entire phrase:

The quality of Gloria’s voice changes here, as she sings with a more sustained tone and a quieter dynamic. She has entered into the emotional quality of the lyric content, singing “cuddle” and conveying a quality of gentleness needed in order to actually cuddle. The rhythm of her singing at the end of the phrase implies a triple meter. In response I play even more gently in the higher register, and hearing her Db, I prepare to harmonize it. After she sings “There, There my dear” I play an Eb minor chord as she repeats the words and melody and create a phrase. An accompaniment pattern emerges just as Gloria starts to sing :

Now the music has a clear pulse and meter, with gentle countermelodies occurring from the piano in the high register. At this point the shift that has been anticipated for some time actually occurs. The piano music and lyrics now go forward jointly as the pulse and harmonic path can be anticipated by both of us. Gloria’s voice sounds tender and fragile. She sustains her melody tones on the last word of the phrase, and sounds as if she may be about to cry. On the last tone of her phrase, the harmony moves from Eb minor to Bb minor, so that she is singing the minor third of what is now the new tonic. The music from the piano has qualities of sadness and warmth – blends of emotion as Robinson (2005) describes – with the countermelodies actively conveying gentle support and compassion as a commentary, as Robinson (2005) also describes. Gloria is reassured by her words even as she wonders if their promise will be borne out.

The same phrase structure repeats, and Gloria enters into the music with a little more support in her voice, anticipating the return of the chord that starts the phrase again. The harmony provides predictability and stability. A gentle countermelody continues in the high register of the piano, as Gloria continues to sing now in a soft, sad voice, continuing to sing on the Db. A clear song form has emerged at this point:

After two repetitions of the same lyric and harmony, both Gloria and I change the form of the music while keeping the same pulse. She moves to a higher tone while I move to a different chord. The form of the music is propelling both of us at this point, even while the arpeggiated accompaniment rhythm at the piano stops:

The forward motion is provided by the anticipation of the melodic rhythm. This adds a sense of mutuality to the music in that the creation of the pulse is shared between us rather than being provided solely by the piano. I stop the pulse, and play close to the melodic rhythm that Gloria sings. I play a very soft tone that adds a dissonance to each of the chords, giving the music a sense that things are still not quite ok. But there is a gentleness created by the soft attack and articulation in the music that also lends it a comforting quality. My commentary from the piano is a gentle way of asking Gloria “Are you sure it will be ok?” The music continues:

On the word “ok” Gloria’s intonation begins to rise above the pitch and falters. The piano has both minor arpeggiation that have a pretty sound along with dissonant tones. The music blends the emotional qualities of pain and comfort: 

Now the pulse of the music is being driven by the harmonic rhythm, as chords are changing after every three beats and there is a clear tonal direction, while Gloria’s melody leaps up an ascending perfect fifth interval and she sings the higher tone through the measure:

This is a wider interval and higher tone than she has been singing previously. The accompaniment pattern is a series of rising arpeggios. The high melodic tone that Gloria is singing, plus the form of the accompaniment pattern, combine in a synchronous way, lending the music a flowing quality, as if flying. The chords of the progression – Eb minor, Gb major, Ab major – include several major chords, giving the music a more optimistic quality. This form persists as Gloria continues:

The music gets softer and a little slower here, less rhythmically driven as the arpeggiation stops. Gloria is able to support herself as she continues at a louder dynamic, confidently singing with a sense of the form of the song as it goes forward: 

There is a strong sense of mutuality in the music here as Gloria and I both arrive at the same tonality after a series of chords and melody notes that created the possibility of moving in a different tonal direction. The pulse is not emphatic yet the entrance to the phrase happens simultaneously between us. The form of the song influenced the arrival at the familiar Eb minor tonality: 

There is a gentle, lilting quality to the music as countermelodies fill in the space between the sustained tones of the melody. 

As Gloria sings “broken pieces” the melody of the lyric goes up, while the bass in the harmony goes down. At the end of the phrase the word “have” is sung with the highest note, while a surprising consonant harmony is reached. This gives the music a quality of expansion and reinforces the sense of mutuality between us: 

There is a strong contrast between the vocal references to “sharp edges” and “cut”, and the smooth flowing consonance of the piano music: 

This music is assisting the healing voice in tending to the wounds of the injured persona. Gloria continues to sing as we both slow down. In response to the word rest, I stop the flowing accompaniment pattern and hold the tones of the harmony, playing the melodic rhythm as Gloria sings it:

This creates the effect of reinforcing the sentiment of resting. Then a dominant B7 chord from the piano is slowly arpeggiated from low to high. The chord has an added flatted fifth so that a significant part of the chord is actually constructed with two tritones. Elements of the whole tone scale are heard in the high register. This lends a quality of mystery to the music, as if something new is going to happen. Something does happen as Gloria begins to sing a new lyric:

A strong shift in the music as a rubato occurs in both the voice and the piano. On the word “wounds” a sustained countermelody acts in a metaphoric sense to heal the wounds. Gloria’s vocal quality is more gentle and relaxed here:

The tempo of the music continues to be very slow. Gloria’s voice quivers as she sings, indicating she is feeling strong emotion here: 

As Gloria sustains the last note on the word “child”, I introduce a gentle countermelody in the high register. It includes thirds above a harmonic progression (also in a high register) starting in minor, moving to major and then ending in minor chords:

Upon analysis, this is another instance of a moving interval reflecting an intrapersonal relationship. Earlier, the dissonant interval moving in parallel represented personae locked in ongoing conflict. Here, the gentle and consoling quality of the moving thirds represents the relationship between the healing voice persona and the wounded sufferer. The high register of the piano melody adds an ethereal quality to the music, hinting at a connection to Gloria’s words being sung from God’s perspective. Gloria does begin to sing about God, and the music shifts to a gospel style:

As Gloria sings about God rather than from her perspective speaking through Gods voice, I shift the style of music to Gospel. The tempo is flexible, and the meter is shifting, but the low bass tone and chord progression with a sense of triplet sub-division lends the music this quality. The “us” she sings about could be understood as the two voices that have been in conflict with each other, but now join together to sing about God:

Concluding Thoughts on There, There

As the excerpt ends Gloria sings using the word “me”. This is a significant indication of a shift in her psychological state. After singing from different parts of her personality and then singing about God not leaving “us”, she is singing as one integrated person now, rather than taking the position of one or the other personae. The experience of dramatically engaging her different sub personalities helped her to bring those polarities within herself together so she could feel more whole.

Music Therapy Session Audio Clip

Open Up My Arms – September 21, 1999 [Click for analysis]

“Open up my arms” refers to the desire on Gloria’s part to embrace the world, and accept the life enhancing activities and possibilities that can bring her more satisfaction. One of the issues Gloria sang about was her tendency to hide and her ambivalence about being noticed. She recognized that her self-defeating behaviors were a way to keep her from being in the world in a more fulfilling way. During clip one Gloria began to cry. Several times during the improvisation process Gloria stayed connected to the creative process of improvising and singing while also feeling strong emotion and crying. 

It’s a real illness this compulsive overeating

It’s a real illness, it’s a real illness

Oh these compulsions, they’re real

They make you sick

They take away your soul, your heart, your spirit

It’s a real illness

It’s a real illness, real illness

Real…oh

Oh…oh…oh…oh…oh (singing a nonverbal melody) 

Oh…oh…oh …oh… oh (after her singing, therapist plays melody, she cries)

It’s pretty

Ooh…ooh…ooh……ooh

I open up my arms, I sing my song

I open up my arms (soft moans after the phrase)

Ooh…ooh……ooh… ooh (therapist sings after her phrase ends)

I open up my arms (therapist joins in singing)

I open up my arms,

I say stop hiding

I open up my arms

I say stop hiding

I open my arms

I ask you to come in

I ask you to come in

I open up my arms

I ask you to come in

Later in the same session (clip two) Gloria sang about what triggered her crying during the singing.

Why did that make you cry?

Why did that make you cry?

Well Alan, first thing I think of is

It made me cry, cause you listen to me deeply

You listen to me deeply

You listen to me deeply

Can you tell me why else it made you cry?

Can you tell why else it made you cry?

We’d like to know. Yea? We’d like to know?

We’d like to know

Well maybe the other reason is that there’s pretty in me

Like you said

There’s pretty in me 

Getting shtupped down

Getting kept in jail

With all that eating

All that desperation

What’s pretty in me

Not showing

Not coming out

What’s pretty in me

Buried under, buried under, buried under

An earthquake of food

Sadness, buried under

An earthquake of food

Sadness, desperation, repetition 

Buried under an earthquake of food

Sadness, desperation, repetition

An earthquake of food

Leaving me pinned, chained, locked, crushed, smashed

An earthquake of food

How can I open my arms

If I’m crushed, smashed, pinched, constrained, eheww 

How can I open my arms

If I’m buried under an earthquake of food

Repetition, oh how can I fly

How can I open my arms

Oh, another earthquake victim

Ahhhahhmm, Badoobadowaybadadoo

I’m going to open my arms

How I want to open

To open, to open my arms

That’s why I was crying

I want to open my arms

I want to sing my song. Ohh

Open your arms (therapist sings)

I’m buried under an earthquake of food

I want to open my arms

Sing your song (therapist sings)

I’m buried under

Open your arms (therapist sings)

I’m buried under

I want to open my arms

I want to open my arms and sing

Gloria often sang questions to herself as she reflected on her experience. Playing the melody on the piano that Gloria sang triggered her intense emotional reaction. During times of intense emotional expression I supported Gloria by singing with her, often playing in a blues form, and creating a solid harmonic accompaniment so that she could feel confident knowing the future direction of the musical form.

Music Therapy Session Audio Clip 1
Music Therapy Session Audio Clip 2

Thank You Mother (Full Session) – July 18, 2002

What Is Music Therapy?

The Nordoff-Robbins approach to music therapy rests on two basic principles. The first is that all human beings are innately, inherently musical. No matter who the client is, no matter the extent and severity of his or her afflictions, the ability to perceive music and the motivation to respond to music remain intact in some form. The second principle is that music making–interactive, communicative, improvisational music making by therapist and client together–is an inherently developmental process. The sheer sound energy that is music, skillfully controlled through its organizing principles of tone, melody, rhythm, harmony, dynamics, and tempo, offers “an enormous and potentially unlimited range of active, self-integrative experience that is available for therapeutic use,” according to Nordoff and Robbins.


Visit Nordoff-Robbins Foundation Website >

Visit Nordoff-Robbins Center for Music Therapy at NYU >

“Through music, a client can express with growing eloquence their presence in this world and relate to and communicate with others with ever-increasing mutuality and intimacy.

-Alan Turry, DA, MT-BC, LCAT, Nordoff-Robbins Music Therapist