I find myself drawn to depth, musically, spiritually and psychologically.
When I was 30 I embarked on my music therapy training and found that the piano and the clarinet were equally valuable in my work. I find the piano helps most in providing structure and containment, but it feels, to me at least, quite a masculine instrument. The clarinet gives me access to a more tender, fluid, feminine voice, with a greater pitch range than my rather low singing voice. This can be particularly useful when working with people whose mother was absent or abusive. They can experience a maternal voice that is caring and responsive, expressing unconditional positive regard (Rogers 1957).
Although I use the piano a lot of the time, finding it very expressive and valuable, I sometimes observe a tendency to use it defensively, with it creating a physical barrier between the client and myself. It can also be connected with my expertise on the piano compared to that of the client, who might feel intimidated and unable to use the piano to express themselves. The clarinet, although also requiring expertise, doesn’t seem to have that effect, as it mirrors the voice closely and reveals a vulnerability in the therapist that the piano might not. If I become emotional in our shared music, this will affect my breath, which will affect my playing. My tone may crack or seem a bit wobbly, reflecting the way I feel. This is in response to the client’s emotion and can happen without conscious thought, in the moment. I feel that the clarinet is my voice in a way that the piano never could be, and that this vulnerability on my part gives the client permission to also become vulnerable. It is this sense of joint openness that can be so powerful in music therapy and is perhaps harder to achieve with verbal therapies.
The clarinet is also very portable. I can move around with it and not be fixed to the spot as I am on the piano. I can sit on the floor and play, or I can chase round the room playing it. It is also useful in environments where there is no piano or keyboard.
Case vignette: Julie
Julie, a woman in her 50s, was referred to me owing to her anxiety and her bipolar disorder. Not long into our work she was given a diagnosis of breast cancer, which spread to her spine. She loved to hear the clarinet, either played by me or in recordings that we listened to in order to aid relaxation. She particularly liked listening to Mozart’s Clarinet Concerto.
During our improvisations she played a variety of percussion instruments and requested that I play the clarinet. Sometimes she would stop for a while and just listen to me play. I found that I could respond very quickly on the clarinet to any changes of mood, tempo and volume, and it was easier to sit facing towards her than it would have been at the piano. Playing the clarinet seems to give a greater intimacy – it is more an extension of me than the piano, as it is my breath that is making the music, with less of a mechanical gap between the player and the resulting sound than on the piano. I could then non-verbally express care and compassion in a way that felt more powerful and warm than words alone.
Julie had been estranged from her mother for several years and did not want any contact with her. It occurred to me that the maternal sound of the clarinet was providing some kind of substitute for this. It also enabled me, as a male therapist, to provide an element of maternal function that would not otherwise be accessible to me.
I often use the clarinet to mirror vocalisations of clients who are non-verbal. The communicative vocalisations are reflected back in a more musical form, moving from mirroring to affect attunement (Stern 1985). I am taking the client’s emotional communication and transforming it in a way that is still recognisable but also distinctly mine. This sense of shared meaning, balanced by an awareness of the other, can be a crucial development in therapy. For clients with autism, this type of exchange can help to develop the ability to relate to another as a distinct and separate person who attends to, and responds empathically to, their emotional communication. In addition, the expressive qualities of the clarinet can encourage clients to move from a monotone voice to one with more variation in pitch and expressiveness. It can encourage non-verbal dialogue that is playful and creative, and that is able to convey a wide range of emotions.
I have also used the clarinet with children who have suffered trauma to the brain or were born with an underdeveloped brain. For example, I worked with a young boy who had nearly drowned, suffering hypoxia. He was left in a virtually comatose state. I played my clarinet to fit with his breathing and eye movement, and there was some small sense of reciprocation in the way his breathing and eye movement changed with my playing. I also worked with a six-month-old baby whose brain scan had not shown any activity. When I played the clarinet she seemed to come alive, her eyes showing life, a hint of a smile on her face. There seems to be a quality about the clarinet that is able to awaken even the most unreachable clients. Maybe this is connected with the maternal sound, maybe there is something about the vibrations it causes. With children who are deaf, or deaf and blind, I frequently play the instrument close to their body so that they can feel the vibration. This often seems to have a calming effect and can relax the muscles. Many people that I work with find the sound relaxing, sometimes falling asleep – the opposite of the awakening effect mentioned earlier.
In short, I would not want to be without my clarinet in music therapy sessions. The only time I would not use it is if the client showed an active dislike of the sound or if I felt there was a risk that a client might want to damage it, but this is not something that happens too often. The clarinet is my musical voice in therapy, so to deprive myself of it would be pointless and counter-therapeutic.
I used to dream of the perfect clarinet sound…
Amelia Oldfield
As a child I learnt to play the piano first. Then as a teenager I wanted to play an orchestral instrument so I could play with other musicians. I spent hours listening to orchestral recordings as well as to the Young Person’s Guide to the Orchestra by Benjamin Britten, and quite quickly decided that I liked the sound of the clarinet best of all. As I was living in Austria at the time, I started learning the clarinet in Vienna, but luckily my teacher realised I would not be staying there for very long and started me off on the commonly used Boehm fingering system, rather than on the simple system clarinets that were still being used uniquely in Austria at that time. After a couple of years I moved to France, where I continued to have lessons, first at the Conservatoire in Montpellier, then at the Conservatoire in Aix-en-Provence from two clarinettists who happened to be brothers. Four years later I moved to Canada and had lessons at the music department at McGill University. By this time I had seriously fallen in love with the clarinet and it had become my first rather than my second instrument.
When I moved to the Guildhall School of Music and Drama to do my music therapy training I did not like the very different English clarinet sound my new teacher was suggesting to me. One day, as I was wandering down the corridor, I heard the most beautiful clarinet sound coming out of one of the practice rooms. I immediately knew this was what I was striving for and walked in to find the renowned Israeli clarinettist Yona Ettlinger. He agreed to teach me, and I continued having lessons with him, and then with his wife Naomi, for several years after I started working as a music therapist. I particularly remember the fortnightly Saturday master classes at the Guildhall, which usually led to dreams about the ultimate, perfect clarinet sound on Saturday nights.
I have always enjoyed using the clarinet in my music therapy clinical work. I love playing it, revel in producing as good a sound as possible, and feel I can convey emotion through my playing more effectively than through any other instrument. I have continued to play in various chamber groups and orchestras throughout my 34 years of music therapy practice. This keeps my own music and my passion for the clarinet alive, and provides me with inspiration for improvisations in my clinical practice. Conversely I have found that my regular use of improvisation in my music therapy practice has improved my tone and confidence when playing chamber music. I find I need to play, on average, about three evenings a week to maintain the control and flexibility of my embouchure in my clinical practice. If for some reason I don’t play my clarinet for a couple of weeks, I often notice that I start getting grumpy and irritable;
