has become my non-verbal voice in the group.
When I am assessing clients or when I sense an uncertain quality to the dynamic in the therapy room, I know that I can pick up my clarinet and explore the situation with confidence. Alongside the personal and emotional connection I have with playing the clarinet, I can rely on the tone of the instrument to match, acknowledge and support the client in their playing, particularly when they play chordal instruments – piano, keyboard, guitar even – in such a way that they become increasingly absorbed in their playing, filling the room with a dense texture of sound. Playing the clarinet can state my presence subtly or not so, depending on the need, and can challenge or tenderly coax a response as appropriate. I consider the clarinet an instrument for many eventualities that is a more flexible alternative to my voice, yet as personal, unique and communicative.
The clarinet in a family’s loss
Colette Salkeld
I have been playing the clarinet since the age of eight, and prior to training as a music therapist I worked as a professional clarinettist for a number of years. I have always felt the clarinet was an extension of myself, a means of personal expression, a way of conveying meaning beyond words. Since working as a music therapist I have found that the clarinet seems to allow me the freedom to respond empathically and to be physically closer to the clients, particularly in group work.
Case vignette: Artem
Artem was a five-year-old boy from Ukraine who was in the terminal phase of cancer. I was asked to see him during my first week in a new music therapy post and was told that he had only a matter of weeks to live. I was aware of the work of Nigel Hartley at St. Christopher’s Hospice and the importance of supporting the whole family at this stage in a child’s life, and because the work was in Artem’s room my intuitive response was to take my clarinet.
Session 1: Lullabies and dreams
When I first met Artem he was lying in his hospital bed, in a private room, with his father sitting beside him. Because of the nature of his cancer, Artem had lost the ability to use his limbs and also his voice. His only means of communication was his eyes. To say ‘yes’ he would look up, and to say ‘no’ he would look down. I was aware that I was coming in to this family’s life at a very sensitive time and I did not want to appear as an uninvited guest. Artem’s play specialist, who had worked with him for a number of months and had made the referral for music therapy, introduced me and stayed for the first session. In this way she provided the link, as someone whom they could trust.
To begin with, I sat beside Artem and sang hello to him, and following this Artem’s father supported him in strumming on the guitar. Artem communicated that he enjoyed this and during this time I improvised vocally, to support his playing. The play specialist then said that Artem had wanted to become a soldier and loved marching music. It was at this point that I used my clarinet for the first time and, supported by his father, Artem beat his hand on the drum. Again, Artem said that he liked this. It was interesting as I found myself standing and marching as I improvised on the clarinet, almost as though we were in a marching band, soldiers together. In this way the music seemed to reflect Artem’s dreams, his wishes. Shortly after this Artem began to yawn and to close his eyes, and I improvised a lullaby on the clarinet as he drifted off to sleep.
Session 2: Storytelling
When I arrived for the next session Artem lay in his bed and this time his mother sat on one side, his father on the other and a family friend was also sitting in the room. Through the interpreter I was told that Artem wished to play the guitar and the drum once again. He then wanted me to play the clarinet. As I improvised, Artem’s mother stroked his head, holding his hand and as he gazed into her eyes she told him a story. I will never know what the story was, but it struck me that her words and phrases seemed to reflect the musical phrases of the clarinet and the highs and lows of the melodic line seemed to be mirrored in the intonation of her voice. It was also remarkable that we ended the ‘story’ together. I have often wondered since that day about how it was possible for two people from entirely different cultures, speaking different languages, to connect so closely on a first meeting except through the language of music.
Following this improvisation, I asked through the interpreter if the family might like to sing a song in their native tongue. Artem’s father asked if he could play my guitar and tentatively he began plucking a melody line. It was at this point that the room began to glow, rather like candles being lit on a dark night as first Artem’s mother and then each member of the family and the interpreter joined in, singing with the guitar. As they sang, I wove a harmony on the clarinet, connecting and empathising without words. Once again, Artem and his mother gazed into each other’s eyes and she stroked his head. It was very moving, an acknowledgement of Artem’s cultural heritage and a brief piece of Ukraine in London.
Session 3: Goodbye
My third session with Artem and his family was to be the last time that I saw him. When I entered the room he seemed pale and lethargic. The room was full of family members, with his mother, father, two other adults and another child sitting around the bed. I asked Artem’s mother if she wished me to call the interpreter and she said strongly, ‘But music is universal, you can talk to me and I understand.’ I wondered if she wanted to keep this session between the family and myself. Maybe the interpreter would feel like an intrusion. Her comment also reminded me of the previous session when she and I had connected so strongly in the storytelling.
After I had sung hello to Artem, his father took the guitar and once again Artem’s mother began to sing a Ukrainian song. Just as in the previous session I took my clarinet and wove a harmony to support their music. This time I felt that I was supporting the family in their loss, the music enabling them to share together in their grief in a culturally appropriate way. As she sang, Artem’s mother became very tearful, choking on her words. Following the song she allowed me to comfort her and to acknowledge the pain of her loss. Following this exchange she asked me if I could play the Beatles song ‘Yesterday’. As we sang and played this symbolic song she gave an ironic laugh as the tears flowed. I then sang goodbye to Artem to end the session.
I was not aware at this point that this would be the final time I would see him and his family. I feel immensely privileged to have had the opportunity to meet Artem and his family at such a precious time. I believe that the choice of the clarinet enabled me to draw near to them and support them in their loss, especially when my relationship with them was so brief. Shortly after this session Artem and his family returned home where he ended his days in a hospice.
Finding a different voice
Henry Dunn
I first fell in love with the clarinet as a young boy, at the age of about eight or nine. Some family friends were having a musical evening at their home, and I heard someone playing the clarinet. I immediately decided that I had to learn, and fortunately my parents supported me in that aim. I worked my way through the graded exams, but wasn’t able to improvise, despite my love of jazz. That changed as an adult, and I discovered that I could improvise and create my own music, expressing myself through the voice of the clarinet. I now find that my playing in jazz informs and improves my playing in therapy, and vice versa, although the purposes are very different – the former to entertain, the latter to express emotion, no matter how unpleasant it may sound.
This ability to improvise developed on a working party at a beautiful Christian community in North Devon when I was about 20 years old – we were gathered round a piano, playing songs, and I suddenly found myself playing notes on the clarinet without really knowing where they were coming from. For this reason improvisation also has a strong spiritual element for me, reaching a very deep, unconscious part of myself. This in turn is reflected in the psychoanalytically informed approach I have to music therapy, which seeks to find the unconscious dynamics behind people’s
