Vocal holding techniques

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1. In Search of the Self: The Use of Vocal Holding Techniques with Adults Traumatized As Children - Diane Austin How does one lose a self? It can be sacrificed at birth…
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  • 1. In Search of the Self: The Use of Vocal Holding Techniques with Adults Traumatized As Children - Diane Austin How does one lose a self? It can be sacrificed at birth to fill up an empty parent.It can be shattered into fragments from unspeakable terrors like abuse, neglect andemotional and/or physical abandonment. It can become numb, deadened to life asthe only way to exist in an unsafe environment. Or, essential parts of the self canbe hidden away because when they first came forth they were not welcomed, seen,understood and valued, but were judged, shamed and rejected for being toodifferent, too needy, too much. Sometimes, the authentic self retreats into an innersanctum because it was envied and even hated for the bright light of potentiality itpossessed. Analysts and psychiatrists have various ways of describing this phenomenon.British object-relations theorists like Winnicott (1965) and Miller (1981) speak aboutthe loss of the true self; the young, feeling part of the personality, and itsreplacement by a false compliant self. This psychic split is caused by a chronic lackof empathy and/or erratic, overstimulating or grossly neglectful behavior on the partof the primary caretaker. Masterson (1988) describes how the healthy, individuating real self can becomeimpaired early in childhood when threatened with abandonment by the mother.This leads to the creation of a protective false self that suppresses painful feelingsand impedes autonomy. In Jung’s (1947) view, the psyche tends toward dissociability and is comprised ofcomplexes or part-personalities. Critical injuries to one’s developing sense of selfcould result in the ego’s identification with one complex (for example the parentalcomplex), to the exclusion of others. In his theory, one part of the psyche is 1
  • 2. capable of actively attacking and persecuting another part, thus causing it to recedefrom consciousness. Different manifestations of “self-loss” have been given different labels by thepsychiatric community over the years. Narcissistic, Borderline, Schizoid and otherpersonality disorders are the terms that have been used to describe the wide rangeof symptoms anddefenses that occur when connection to one’s authentic and vital center of being isbroken. Many of my clients, however, describe their plight in more poetic and poignantterms. They speak of being hidden inside a cocoon, trapped behind a glass wall,enclosed inside a bubble or hovering around the edges of life, longing yet afraid toenter. Alice alternately perceives herself as a helpless child or evil incarnate. Sandythinks she is broken. Mike feels there is nothing inside of him except a black hole,and Beth doesn’t know who she is; she just wishes she would stop having suchhorrible nightmares. These clients are all in various stages of working through unresolved trauma.The traumatic experience as well as the meaning attributed to it, critically affectedeach person’s experience of self and his/her capacity to participate in an intimaterelationship (Ulman and Brothers, 1988). Trauma is used here to refer to anyexperience that causes the infant or child unbearable psychic pain and/or anxiety.Since the rupture, breach, shock or shocks occur before a coherent ego and itsdefenses have been adequately formed, the intense affects are too overwhelmingto be metabolized and processed normally, thus, the devastating effects on thetraumatized person’s body, mind and spirit (Herman, 1992; Kalsched, 1996). Someof these effects can be observed in the way traumatized clients often alternatebetween a state of “overwhelm” and intense reexperiencing of the trauma, and astate of emotional constriction and numbing which can include avoidance of people, 2
  • 3. places and events that might trigger traumatic associations and bring on intolerableanxiety or panic (Van der Kolk, 1987; Levine, 1997). Traumatic experiences encompass a wide range of occurrences from the horrorsof sexual and physical abuse to the more cumulative traumas of unmetdependency needs, inadequate nurturing and interruptions of the attachment bond.Common to all these experiences is the rupture to the integrity of the self and thefeelings of confusion, helplessness and terror this rupture evokes (Terr, 1990;Kalsched, 1996). The inner world of the traumatized client contains split off, dissociated parts ofthe self which are often externalized in the client-therapist relationship and can beworked with in the transference-countertransference situation (Davies and Frawley,1994). In music therapy, the relationship field is enlarged to include transferenceand counter transference to and in the music. Parts of the self can also beprojected onto the voice, the music and the musicalinstruments (Austin, 1993). Clinicians who have studied trauma from different theoretical perspectives havediscovered the prominence of one dyadic structure that results from a split in theego or personality of the client. This dyad consists of a regressed part usually“feeling” in nature and a preciously advanced part usually associated with mentalprocesses (Kalshed, 1996). This advanced part persecutes the regressed part inwhat seems like a misguided effort to protect it from the dangers of connection tothe self and others. Getting close to others is perceived as dangerous because theprimary caretakers of infancy and/or childhood were undependable, neglectful orabusive. Making connections among the self-parts is threatening becausepsychological survival once depended upon the ability to disconnect thoughts fromfeelings and to emotionally distance oneself from experience. I turn to my clients once again for vivid descriptions of the inner persecutor: the 3
  • 4. witch; the predator; the beast; the rapist; as well as the inner victim: the orphan; thehurt puppy; the broken doll; the homeless man. These images are personal andarchetypal in nature and they emerge in dreams and in creative expression likevocal and instrumental improvisation (Austin, 1991, 1993, 1996, 1998, 1999). Primitive defenses like denial and dissociation protect the self from annihilationbut also affect the integrity of the personality. Severely dissociated clientsexperience the self as enfeebled, fragmented and/or lacking in continuity. Clientswho were unable to form a secure attachment to the primary caretaker and/orlacked an emotionally available and consistent “good-enough” mother (Winnicott,1971), have an accumulation of unmet dependency needs that pave the way forproblems with identity formation and self-esteem regulation. Without a fullydeveloped sense of self as a basis for ego functioning, these clients arecompromised in their ability to function as mature adults. “Adult-children” like Peter,describe it this way, “I wake up every morning feeling anxious and all I want to do ishide under the covers...I know I look like a grown-up and I have an important joband everything, but I feel like a fraud and it’s only a matter of time before they findout I’m faking it.” So how do we help these clients recover from unbearable life experiences sothey can have access to more of themselves and feel more authentic and alive? Ihave found thecombination of improvised singing and verbal processing to be one very effectiveway of working with the unresolved traumas of childhood. Giving Trauma a Voice Children who are raised in an atmosphere of fear, hostility, violence or neglect;children whose parents are alcoholic, emotionally disturbed, or absent (physically oremotionally), have been silenced. Sometimes this silence takes the form ofwithdrawing into a private world and choosing not to communicate because it is not 4
  • 5. safe to do so. Sometimes the silence is selective; some things are allowed to betalked about, some feelings are allowed expression and others clearly are not.Sometimes the silence is loud; words and feelings come tumbling out but fall ondeaf ears or are beaten down and stifled. Needs and feelings remain unmet andthe voice becomes inaudible, tight and tense, breathy and undefined, or simplyuntrue; perhaps lovely to listen to but not connected to the core of the person. Inessence, the traumatized person often survives by forfeiting her own voice. The process of recovering one’s true voice involves reinhabiting the body. Aspreviously discussed, the dissociative defenses that initially protect the psyche fromannihilation, sever the connection between the body, mind and spirit. Embodimentrequires the courage to remember and experience the sensations and feelings thatwere overwhelming as a child, intolerable because no one was present to help thechild contain, make sense and digest the intense affects. Singing is restorative for a variety of reasons. On a physiological level, singingfacilitates deep breathing. In order to sustain tones one has to take in more air,thus expanding the belly and diaphragm, and then has to fully release the breath inorder to continue the process. This kind of deep breathing slows the heart rate andcalms the nervous system, stilling the mind and the body. Relaxation is the result, astate that is beneficial to everyone but especially helpful to anyone in a state ofpanic or extreme anxiety who is hyperventilating, or breathing in short, shallowbursts. There is a reciprocity between the physiological and the psychological effects ofbreathing. By restricting the intake and release of breath, we can control ourfeelings. This is obvious when I watch clients hold their breath after revealing anemotionally charged issue. When encouraged to exhale fully, they often come incontact with a feeling they have beensuppressing. Likewise, the inability to take in nurturing or other kinds of experiences 5
  • 6. and information is mirrored in restricted inhalation. The way we breathe influenceshow we feel and what we feel has a direct effect on how we breathe. Singing is also a neuromuscular activity and muscular patterns are closely linkedto psychological patterns and emotional response (Newham, 1998). When we sing,we are the instrument and the vibrations that we produce nurture the body andmassage our insides (Keyes, 1973). Internally resonating vibrations break up andrelease blockages of energy allowing a natural flow of vitality and a state ofequilibrium to return to the body. These benefits are particularly relevant totraumatized clients who have frozen, numbed off areas in the body that holdtraumatic experience. According to Levine (1997), this residue of unresolved,undischarged energy gets trapped in the nervous system and creates thedebilitating symptoms associated with trauma. Singing can enable the traumatized client to reconnect with her essential natureby providing her with access to, and an outlet for, intense feelings. Singing offers away for the disembodied spirit to incarnate because the way home can bepleasurable and the painful feelings can be put into an aesthetically pleasing form.Lynn explained it this way: “When I sang just now, I took something ugly thathappened to me and made it beautiful.” The structure inherent in songs andpresent in vocal improvisation can shore up a weak inner structure in the psycheand help contain strong emotions thus making it safer to express them (Austin,1986). The act of singing is empowering: sensing the life force flowing through thebody; feelings one’s strength in the ability to produce strong and prolonged tones;experiencing one’s creativity in the process of making something beautiful; havingthe ability to move oneself and others; and hearing one’s own voice mirroring backthe undeniable confirmation of existence. Owning one’s voice is owning one’sauthority and ending a cycle of victimization. Vocal Holding Techniques 6
  • 7. Vocal holding techniques is the name ascribed to a method of vocalimprovisation I developed and codified that involves the intentional use of twochords in combination with the therapist’s voice in order to create a consistent andstable musical environment that facilitates improvised singing within the clienttherapist relationship. This method provides a reliable, safe structure for the clientwho is afraid or unused to improvising; it supports a connection to self and otherand promotes a therapeutic regression in which unconscious feelings, sensations,memories and associations can be accessed, processed and integrated. Theseunconscious experiences are directly related to parts of the self that have been splitoff and suspended in time due to traumatic occurrences. When contacted andcommunicated with, these younger parts can be reunited with the ego and the vitalenergy they contain can be made available to the present day personality.Developmental arrests can be repaired and a more complete sense of self can beattained. Unlike jazz or other forms of clinical improvisation where shifts in harmoniccenters are to be expected, this improvisational structure is usually limited to twochords in order to establish a predictable, secure musical and psychologicalcontainer that will enable the client to relinquish some of the minds control, sinkdown into her body and allow her spontaneous self to emerge. The chord pattern isplayed repeatedly as a basis for the client’s improvisation. The simplicity of themusic and the hypnotic repetition of the two chords, combined with the rockingrhythmic motion and the singing of single syllables (sounds, not words initially) canproduce a trance-like altered state and easy access to the world of the unconscious.The steady, consistent harmonic underpinning, the rhythmic grounding and thetherapist’s singing encourage and support the client’s vocalization. Within this strongyet flexible musical container the client can explore new ways of being, experiencethe freedom of play and creative self-expression and allow feelings and images to 7
  • 8. emerge. (Austin, 1996, 1998, 1999) The client’s voice, feelings, and emergingaspects of the self are all held within this musical matrix. This method is especially useful in working through developmental injuries andarrests due to traumatic ruptures in the mother-child relationship and/or empathicfailures at crucial developmental junctures. Interpretation and illumination of psychicconflict is of minimal value in working with adults traumatized as children, until thelink between self and other is rebuilt and the client’s capacity for relationship isrestored (Herman, 1992; Hegeman, 1995). Improvised singing seems ideally suitedfor this reparative work. The voice is a primary source of connection between amother and her child. Even in utero, infants begin to recognize the voices of thosewho will care for them. Babies begin to vocalize at around five weeks of age andthe attachment between the infant and its caretaker develops slowly over the baby’sfirst year of life through physical closeness and an ongoing dialogue of cooing,babbling, gazing and smiling. The gaze between mother and infant contributes tothe vocal rapport between the two (Bowlby, 1969; Winnicott, 1971). Vocalinteraction in sounds, song and later speech are critical to the child’s development(Newham, 1998). Tomatis (1991) has even suggested that the mother’s voice isjust as important to the child as the mother’s milk in providing adequate relationalbonding. The importance of the voice and vocal holding in building and repairingthe connection between self and other has significant implications when working indepth with clients suffering from the consequences of pre-verbal wounds to the self. Vocal holding techniques are not meant to be a prescription or recipe and arenot necessarily used in the order that follows. For the sake of clarity, I will describethe process as it appears to complement the developmental stages. As with anytherapeutic intervention, however, the client’s history, diagnosis, transferencereactions and unique personality and needs should determine the approach takento accomplish therapeutic goals. For example, when improvising, some clients will 8
  • 9. initially feel safer using words and may experience vocal sounds as more regressiveand associated with loss of control. Other clients may feel less exposed in the moreopen realm of non-verbal singing because words are more specific and definitive.Still others may need even more structure in which case pre-composed songs maybe more appropriate, particularly in the beginning phase of therapy. In the initial “vocal holding” phase the client and the therapist sing in unison.Singing together on the same notes can promote the emergence of a symbiosis-like transference and countertransference. This is important for clients who neverhad a satisfactory experience of merging with an emotionally present, calm,consistent mother. Through a replication of early mother-child relatedness, theseclients can eventually internalize a stable sense of self and then graduallyrenegotiate the stages of separation and individuation. Sometimes sounds andphrases emerge that are reminiscent of the babbling sounds of a three to six monthold (Gardner, 1994). The next phase of harmonizing creates the opportunity for theclient to experience a sense of being separate yet in relationship. Mirroring occurswhen a client sings her own melodic line and the therapist responds by repeatingthe client’s melody back to her. Mirroring is especially useful when a client needssupport in finding her own voice and/or when new parts of the personality areemerging and need to be heard and accepted. This musical reflection providesencouragement and validation. Grounding occurs when the therapist sings thetone or root of the chords and provides a base for the client’s vocalization. Theclient can then improvise freely and return to “home base” whenever she wants to“refuel” (Austin, 1998, 1999). One client referred to the grounding tones as “touchtones”. This musical intervention is reminiscent of a typical pattern of interaction betweenthe child and the maternal figure that occurs when the child begins to move awayfrom the mother to explore the environment. In the ideal situation, the mother stays 9
  • 10. in contact with the child and supports and encourages her increased efforts toindividuate; otherwise the stages of separation-individuation become associatedwith object loss. Lack of empathy, attunement and of course abandonment and/orimpingement during the earlier developmental phases will negatively impact thechild’s ability to individuate (Bowlby, 1969; Mahler, Pine and Bergman, 1975). Vocal holding techniques are introduced into the music psychotherapy session invarious ways. With a client who is especially anxious about improvising but wants totry, I might explain this method in detail. Usually, however, I give a minimaldescription or simply ask: “Would you like to try singing about this (person, situation,feeling etc.)? We could improvise or make it up as we go along”. I then ask theclient if she wants two or more chords. She sometimes chooses the exact chords orgives a general description (“something minor”), but if she has little or no knowledgeof chord structure or needs help finding the sound she wants, I might play examplesof different chord combinations (major, minor, suspended etc.) and ask for herpreference. Occasionally, a client will describe a mood or feeling she would like toevoke and together we search for and find the fitting chords (Austin, 1999). Theclient may also suggest a rhythm and a piano setting (I use a clavinova that hasvarious settings such as organ, strings etc.). Giving choices and workingcollaboratively empowers the client and helps to create a safe therapeuticenvironment. We begin by breathing together. As previously described, deep breathing iscritical in focusing, relaxing and grounding the client in her body. Breathing togetherbegins the process of vocal attunement that continues as the therapist attempts tomatch the client’s vocal quality, dynamics, tempo and phrasing. Bein
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