Part 3.2

122 A COMPREHENSIVE GUIDE TO MUSIC THERAPY
researchers can explore and understand more deeply the interaction and collaboration
between therapist and client. The reason for this is the developed knowledge about
how human interaction is ruled by factors mostly outside or beyond consciousness
and control – within the implicit and unconscious domain – and it is of great
importance to understand how the therapeutic alliance is developed and maintained,
since its qualities are correlated to positive outcomes in psychotherapy (Norcross
and Lambert 2006). Research on parent–child interaction shows that children and
their parents are only affectively attuned about 40 per cent of their interactive time
(Stern 2004). During the rest of their time together they are unsynchronised, in the
sense that they are in different incongruent affective states and are in the process
of reconnecting or restoring states of match and attunement. This work is usually
described as ‘ruptures and repairs’ (Beebe and Lachmann 1994).
Jeremy Safran and Christopher Muran (2000) have researched this part in the
process of developing alliance and collaboration, and state that the balancing of
ruptures and repairs in the therapeutic relationship is crucial to a good outcome
of psychotherapy. The therapeutic relationship contains continuous negotiation
both explicitly and implicitly about differences between therapist and client, and the
ruptures and repairs are strengthening the alliance. Johns (2018) uses concepts from
music dynamics to describe intersubjective exchanges in time-limited intersubjective
psychotherapy with children who suffer from problems with emotion regulation.
The relational turn in psychotherapy emphasises process versus content. In
their parent–infant research, Beebe and Lachmann (1994) have explored relational
patterns that generate change. They describe three principles in this process:
‘ongoing regulations’, ‘disruptions and repairs’ and ‘heightened affective moments’.
Experiencing non-confirmation and difference on the one hand, and confirmation
and recognition on the other, can be seen as analogous to disruption and repair.
The process of surrender is also connected to altered states of consciousness
(ASC), or rather to the movement between states and into ASC. The phenomenon is
deeply human and connects humanities across cultural boundaries (Maslow 1968,
1999; Smith 1991; Wilber 2006). When we open up and connect with deeper levels
Copyright © 2019. Jessica Kingsley Publishers. All rights reserved.
of consciousness, we inevitably also connect to that which connects us all as human

beings. Surrender helps us to discover identity and self beyond psychodynamic
and cultural levels, senses of wholeness and unity with all living beings. In Western
cultures, as Ghent states, we suffer from the Cartesian duality of body and mind, and
still overvalue individuality, often with a strong sense of being lost and alone. We
might even characterise this as an existential ‘depression of abandonment’ (Masterson
2000), where dread takes many forms.
Almost like a hidden intention, our Western culture has also produced the
overwhelming richness in classical music that may assist in healing depressions
of abandonment. Granted that this healing takes place within a psychotherapeutic
framework, ASC and a surrendering process may generate transpersonal or
spiritual experiences.
A Comprehensive Guide to Music Therapy, 2nd Edition : Theory, Clinical Practice, Research and Training, edited by Stine Lindahl Jacobsen, et al.,
Jessica Kingsley Publishers, 2019. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/ualberta/detail.action?docID=5751478.
Created from ualberta on 2023-10-25 05:08:06.
Theoretical Foundation of Music Therapy 123
Studying the process of surrender in GIM therapy

With the purpose of further understanding the change potential of transpersonal and
spiritual experiences in guided imagery and music (GIM) therapy where Western
classical music is used, a small study of GIM transcripts was conducted (Mårtenson
Blom 2010). The intention was also to develop the theoretical understanding of the
general psychotherapeutic change process in GIM with the help of new developmental
and relational theory. The categories were constructed in a theory-based analysis of
a number of GIM session transcripts. The first three categories are basic ways of
sharing attention, intention and affectivity in the client–therapist dialogue. The last
three categories are truly interpersonal, shared experiences of confirmation, non-
confirmation and transcendence/surrender.
Table 2.4.1.1 provides a brief presentation of the developed categories of analysis.
Table 2.4.1.1: Categories of analysis, with definitions and examples from GIM
sessions (Bonde and Mårtenson Blom 2016; Mårtenson Blom 2010)
Category of analysis Definition Examples from GIM
sessions
1 Focus of attention – First-person descriptions and I see myself
sharing attention expressions of where in the I can sense water
experiential field the attentional
focus of the traveller is,
establishing a starting point for
movement and direction
2 Movement and Descriptions and expressions of Warm air is coming
direction – sharing intention, directions, movements, towards me
intention experienced as more or less Perhaps I will fall
deliberate
3 Affectivity – shared Descriptions and expressions of Sad and melancholic,
and conveyed in the affective qualities surrounding pleasant and powerful
words and expression and colouring the relational
– attunement sequence (vitality affects and/or
categorical affects)
4 Share and regulate Expressions of experiencing The air is balancing my
coherence/ qualities of recognition and/or body, me
correspondence in confirmation and belonging. Often I can feel the mountain
attention, intention also strong activating affects under my feet
and/or affectivity
5 Share and regulate Expressions of experiencing I need to work in order
difference/non- tensions, differences, ruptures and/ not to fall
confirmation in or non-confirmation. Often also Feel fear, and dizziness
attention, intention anxiety, shame or other inhibiting
and/or affectivity affects
cont.
Category of analysis Definition Examples from GIM

sessions
6 Surrender in relation Expressions of effortless containing I am connected to, one
to something ‘third’, fields of tensions, letting go and with, Nature
something ‘greater’ transcending duality, and qualities I am light, it is inside
and/or ‘beyond’ of core affects, core states and around me
When analysing the transcripts, it became clear how transpersonal and spiritual
experiences were connected to ‘the traveler’s ways of relating/being in relation; to courses
of events in her inner world, to the music and to the therapist’s presence’ (Mårtenson
Blom 2001, p.12). The surrendering process described in the transcripts moved the
traveller through ways of sharing focus of attention, directions of intentionality and
affect attunement in relation to the music and the therapist. The altered states of
consciousness were regulated (with music and the therapist’s presence) through fields
of tension between experiences of deep recognition (category 4) on the one hand, and
deep non-confirmation or differentiation (category 5) on the other. This field of tension
was found to be a crucial ingredient in the surrendering process, eventually leading into
experiences of transpersonal and/or spiritual character, transcending duality.
Surrender, as a concept from psychological and spiritual development, was in
Mårtenson Blom’s study further developed into the concept of the relational mode of
surrender, emerging from a process of surrender (category 6), and defined as follows:
A deepened capacity to share and regulate experiences of coherence and difference
in attention, intentions and affectivity, in different interactive meetings; being able to
find a surrendering mode in relation to something ‘third’, something beyond the self
and/or the other, or to something greater. (Mårtenson Blom 2001, p.11)
A surrendering process defined in terms of relational modes may be cross-culturally
crucial to mental health. Cultural differences, with reference to the culture-sensitive
areas identified by Maack and other researchers (Bonde and Mårtenson Blom 2016;
Maack 2007), can be managed in the therapeutic relationship. When music plays the
role of a relational partner (often called a ‘co-therapist’) in the therapeutic relational

field, like the surrendering process described above, music therapy can mediate
between culturally sensitive polarities such as:
• individualism and collectivism
• confrontation and tenderness
• postponed and instant satisfaction
• gender inequality and equality
• low and high tolerance of insecurity/ambiguity
• authoritarian and democratic
• self-assertiveness and caring compassion.
2.4.2 Wilber’s Integral Psychology

Lars Ole Bonde
In the history of psychology, transpersonal psychology is considered the ‘fourth

force’ (behaviourism being the first, psychoanalysis the second, and humanistic-
existential psychology the third). Abraham Maslow is often considered the initiator
of the third as well as the fourth force. Ken Wilber – whose integral psychology is
introduced below – represents an important development of, or transcendence of, the
fourth force (the transpersonal ‘school’), which focuses on the vast field of spiritual,
non-ordinary experience and knowledge in Eastern and Western philosophy and
psychology that should be considered as particularly relevant for music therapy.
The ‘transpersonal field’ – encompassing concepts such as spiritual, religious
and transrational, and often associated with the ‘eternal philosophy’ (‘philosophia
perennis’) – has been considered ‘unscientific’ during most of the decades since
psychology established itself as an experimental, natural and social science in the
late 19th century. However, gradually research has approached and settled in this
controversial area. In Chapter 2.4.1 we have presented a contemporary understanding
of transpersonal experiences as intersubjective and relational in nature.
Research into states of consciousness

The research of Freud and Jung already put ‘the unconscious’ on the agenda of
psychology in the early 20th century, as they developed their theories of the personal
and collective unconscious. Within psychodynamic thinking it has been assumed
that there are transitional states between conscious and unconscious states of
consciousness (e.g. primary, secondary and tertiary processes). These transitional or
altered states have been used in different psychotherapeutic models (see Chapter 2.3).
In the 1960s, Maslow, Assagioli and others added ‘super- (or supra-) consciousness’ to
the map of human consciousness, and with his concept of ‘peak experience’, Maslow
formulated a new psychotherapeutic goal: the self-actualisation of the human being

– the realisation of the full potential of body and mind.
Neuroscientists have done parallel studies in the ‘vigilance’ of the brain in different
states, and they have identified five frequency spectra or bands of brainwave activity:
1. The delta band, which is physiologically connected to deep sleep (and
pathologically to the coma state).
2. The theta band, which is related to states of deep introspection (e.g.
meditation) or light sleep.
3. The alpha band, connected to states of relaxation (often divided in lower and
higher alpha).
4. The beta band, which is the frequency band of the waking state, alert
conscious activity and awareness (often divided into lower and higher beta1
and beta2).
5. The gamma band, which is the area of extreme but effortless attention and
ecstasy.
Using advanced techniques of brain scanning (e.g. electroencephalography (EEG)
and positron-emission topography (PET)), researchers have gathered further
information on the activity of the brain in different states, and this has led to neuro-
phenomenology and psychophysiology of consciousness.
During the last four decades, psychologists, neuroscientists and psychotherapists
have studied the so-called ‘altered states of consciousness’ (ASC), which give access
to experiences beyond the normal, alert state (beta band activities). ASC (related
to the theta, alpha and gamma bands) can be induced by pharmacological stimuli
(hallucinogens like LSD or psilocybin), by psychological stimuli (sensory deprivation
or overstimulation, e.g. through autogenic training, meditation, trance dance or
hyperventilation) or by a combination of techniques.
Within music psychotherapy this knowledge of entering ASC is also used. The
physiologically stimulating (ergotropic) type is represented by Grof ’s holotropic
breathwork, in which hyperventilation and powerful rhythmic music is used to induce
ASC; the relaxing, introvert (tropotropic) type is represented by Guided Imagery and
Music, in which autogenic training or other relaxation techniques are used (Bonny
1975/1999; see also Chapter 3.2). Music can in itself induce and stimulate ASC.
Wilber – fulcrums and quadrants

Since the 1970s, the American philosopher Ken Wilber has written a number of books
and numerous articles and prefaces to other authors’ books (re-edited as ‘collected
works’ in eight volumes (see Bonde 2001), followed later by new publications, for
example Wilber 2006, 2007). He is often given a prominent, and somewhat con-
troversial, position within psychodynamic and transpersonal psychology. This

controversial position is based on Wilber’s strong desire to integrate Eastern and
Western traditions, and also to integrate scientific and religious thought. Wilber
is beyond doubt an important figure in modern psychology and philosophy. He is
one of the scholars who has done most to (re)integrate the transpersonal field in
the scientific discourse of psychology and philosophy, based on intense studies in
Western as well as Eastern psychology, philosophy and religion (Wilber’s publications
on psychology encompass development psychology, psychopathology, psychotherapy
and meditation practices).
The provisional result of Wilber’s work in progress is what he calls ‘integral
psychology’ (Wilber 2000) – graphically summarised in the All Quadrants, All Levels
(AQAL) model (see Figure 2.4.2.1 below). This is a synthesis of all the most important
and (more or less) well-known theories of the human mind, levels of consciousness
and the scientific study of five basic levels: matter (physics), life (biology), mind
(psychology), soul (theology) and spirit (mysticism). Wilber has developed the
concept of ‘holons’ (and correspondingly ‘holarchies’) to insist on the basic premise
that reality – material as well as immaterial – is not made from ‘objects’ and ‘processes’,
but from holons that are both whole in-themselves within one of the five levels and
parts of other wholes on the same level or higher levels.
Wholeness can be viewed as individual and ecological. Individual wholeness is
composed of all of the various parts/wholes (or holons) that make up the person, in
whatever ways they are defined and differentiated. Ecological wholeness is composed
of all of the parts/whole (or holons) that make up the contexts in which the person
lives (e.g. society, culture and environment) (Bruscia 2014a).
In this chapter, it is only possible to outline the framework and central
components of Wilber’s world of ideas, and a good starting point could be his
definition of psychology:
Psychology is the study of human consciousness and its manifestations in
behaviour. The functions of consciousness include perceiving, desiring, willing, and
acting. The structures of consciousness, some facets of which can be unconscious,
include body, mind, soul, and spirit. The states of consciousness include normal
(e.g., waking, dreaming, sleeping) and altered (e.g., nonordinary, meditative). The
modes of consciousness include aesthetic, moral, and scientific. The development
of consciousness spans an entire spectrum from pre-personal to personal to
transpersonal, subconscious to self-conscious to super-conscious, id to ego to spirit.
The relational and behavioural aspects of consciousness refer to its mutual interaction
with the objective, exterior world and the socio-cultural world of shared values and
perceptions. (Wilber 2000, p.433)
All concepts and categories mentioned in this definition are relevant for the theory and
practice of music therapy, but here we shall focus on Wilber’s theory of psychological
development – his so-called ‘spectrum theory’ of the developmental ‘fulcrums’ of
consciousness – and the related psychopathologies and psychotherapeutic models.

Development is not one but many processes. Wilber understands development
as several parallel lines (or ‘streams’) that are fairly independent of one another:
cognitive, emotional, moral, interpersonal and so on. It is possible and quite common
that a person has reached a high level within one area (e.g. emotional, empathic) but
a lower one in another area (e.g. cognitive, intellectual).
The different areas are not causally linked, and a development within one area
may be a necessary, but not a sufficient, condition for development within another.
This understanding of the lines as (to some degree) independent modules is, in
some aspects, similar to Howard Gardner’s theory of multiple intelligences, and
Wilber shares the educational optimism connected with Gardner’s perspective on
development.
Development is differentiation: the

fulcrums and the spectrum model
Wilber’s idea of the self is that it is the functional system (‘the navigator’ or ‘the
centre of gravity’) responsible for balancing and integrating the many different
developmental waves, streams, levels and states. The self has its own developmental
sequence, and Wilber makes a distinction between an ‘I’ (‘the proximal self ’) and a
‘Me’ (‘the distal self ’).
Independent of a theoretical platform, development can be described in
three phases, which the self goes through each time it encounters a new level of
consciousness:
• Identification or fusion (the unclear confluence or symbiosis of subject and
object).
• Gradual differentiation or separation (of subject and object).
• Integration (‘reflexive’ consciousness of the differentiation).
These three phases cover just one round in the long developmental span. When one
round is over, a new one can begin, with a new agenda of differentiation and integration.
The combination of nine levels and three sub-phases of each fulcrum gives a typology
of 27 major self-pathologies, described in detail in Transformations of Consciousness
(Wilber 2000, pp.117–133) and illustrated in Figure 2.4.2.1. Within psychiatry it is well
known that psychological disturbances are connected to problems of differentiation.
9 causal Causal pathology The path of sages

9
8 subtle Subtle pathology The path of saints
8
7 psychic Psychic disorders The path of yogis
7
6 existential Existential pathology Existential therapy
6
5 formal-reflexive Identity neuroses Introspection
5
4 rule/role Script pathology Script analysis

4
3 rep-mind Psychoneuroses Uncovering techniques
3
2 phantasmic-emotional Narcissistic-borderline Structure-building
2 techniques
1 sensoriphysical Psychoses Physiological/
1
pacification
undifferentiated
matrix
Basic structures Corresponding Characteristic Treatment modalities
of consciousness fulcrums pathologies
Figure 2.4.2.1: Wilber’s spectrum model. Relative positions of mental structures, fulcrums,
psychopathologies and forms of treatment (from Transformations of Consciousness, p.132)
Psychotic disorders are related to a disturbed differentiation on the physical

level, narcissistic and borderline disorders are related to problems on the
emotional level of differentiation, and neurotic problems to the mental level. This
corresponds to the first three levels of differentiation – or ‘fulcrums’ – in Wilber’s
theory (he also uses the metaphor ‘milestones’, 2000, p.467). As in fulcrums 1
to 3, the processes and the problems follow the same principle in fulcrums 4 to
6 and 7 to 9: if the differentiation process – learning to discriminate between
self and other(s) within different ‘developmental agendas’ – does not succeed,
pathological problems may develop and these may require a treatment finely
attuned with the level or ‘agenda’.
The prepersonal, the personal and the transpersonal

level – and corresponding pathologies
Wilber’s spectrum model has three basic levels (or ‘waves’), each divided into three
sub-levels or fulcrums. A characteristic pathology corresponds to each level:
1. The prepersonal level (fulcrums 1 to 3): sensory-motor/psychosis –
emotional/narcissistic-borderline – rep-mind (c: consciousness with psychic
representations of the outer world)/psychoneuroses.
2. The personal level (fulcrums 4 to 6): rule-role/‘life script’-disturbances –
formal-reflexive/identity neuroses – existential/existential disturbances.
3. The transpersonal level (fulcrums 7 to 9): psychic/psychic disturbances –
subtle/subtle disturbances – causal/causal disturbances.
This systematic account makes it – among other things – possible to make a precise
positioning of the different psychotherapeutic models: they are related to one or more
of the specific levels. Supportive, structuring therapy models thus relate to fulcrum
2, mentalisation-based therapy to fulcrums 2 and 3, the uncovering process of
psychoanalysis to fulcrums 3 and 4, transactional analysis to fulcrum 4 and existential
psychotherapy to fulcrums 5 and 6. Fulcrums 7 to 9 have not been addressed much

in Western psychotherapy models; they have been the domains of experienced and
advanced teachers and gurus within religious, spiritual and transpersonal traditions.
Wilber’s theory of development has been criticised from many sides. Some critics
find his theory linear and hierarchical – and far too simple. In particular, the theory of
the prepersonal level has been criticised for not including groundbreaking knowledge
from contemporary infant research, for example in the studies of Stern and Trevarthen
reviewed earlier in this book, and thus not taking the infant’s communication
competences into account. Wilber’s answer is that his theory implies that development
can be seen as fairly independent ‘waves’ running more or less parallel in the specific
domains (emotional, cognitive, moral, etc.). Successful parent–infant interaction
will lead to a healthy and early differentiation in fulcrums 1–3. There is no causal
connection between levels and domains.
The four quadrants

Wilber uses different models with a different number of levels in his books, which
can be confusing. His own explanation of this (and of the coherence of the different
models) is this:
The overall spectrum of consciousness, as outlined in The Atman Project, containing
almost twenty-four basic levels (which are simply an elaboration of the Great Nest of
Being, matter to body to mind to soul to spirit). I usually condense these into nine
or ten major levels, and sometimes use even fewer, such as the traditional five I just
gave (which are essentially the same as the Vedanta uses), and sometimes only three:
body, mind, and spirit (or gross, subtle, and causal). (Wilber 2000, p.11)
Only some of Wilber’s books are (presented as) genuinely scholarly achievements
(Transformations of Consciousness, 1986; Sex, Ecology and Spirituality, 1995; The
Marriage of Sense and Soul, 1998; Integral Psychology, 2000). In the last three books,
Wilber explored and developed his – until now – broadest model (or ‘template’) of
consciousness: the ‘quadrant model’(see Figure 2.4.2.2).
INTERIOR EXTERIOR
UPPER LEFT UPPER RIGHT

INDIVIDUAL
I IT
Intentional Behavioural
(subjective) (objective)
COL LEC T IVE
WE ITS
Cultural Social
(intersubjective) (interobjective)
LOWER LEFT LOWER RIGHT

Figure 2.4.2.2: Wilber’s quadrant model illustrating four equally valid and non-
reducible perspectives on reality (from Wilber (2006): Integral Spirituality)
Wilber developed this model as a graphic and comprehensible combination of four

different and equally important perspectives on development and consciousness:
the inside and the outside, the singular and the plural (also called the dimensions
of I, it, we, its). The ‘we’ quadrant, for instance, contains the developmental levels
of worldviews shared by a collective (from family to nation). The major point is that
each of the levels, lines and states of consciousness has these four quadrants.
The ‘all-quadrants, all-levels, all-lines, all-states’ (AQAL) model ‘opens up
the possibility of a more integral approach to education, politics, business, art,
feminism, ecology and so on’ (Wilber 2000, p.4). The AQAL model is a classification
of the many different developmental theories in Western and Eastern psychology.
The upper, ‘Northern’ half of this model deals with individual processes, while the
lower, ‘Southern’ half deals with collective processes. The left, ‘Western’ half deals
with inner, subjective processes of consciousness; the right, ‘Eastern’ half with outer,
objective processes of matter and materials. When quadrants are combined with
levels of development, the model looks like the one in Figure 2.4.2.3.
I IT
2n
d
8 self and brain and organism 8

integral self
tie
r
consciousness
.
etc
7 7
holistic self
s,
se
6 6
ur
co
sensitive self
eo
5 5
,n
achiever self
ms
1s
t ti
ste
4 4
er
mythic self
sy
ic
3 3 mb
warrior self
, li
tes
2 2
sta
magic self
nic
1 1
ga
instinctual self
or
archaic survival clans

1 1
animistic-magical ethnic tribes
fo
2 2
ra
g
power gods feudal empires

ing rtic
3 3
n
ho
er
mythic order early nations

od
ag
4 4
em
ult
ra
ur
pr
scientific-rational corporate states

ria
al
5 5
n
rn
pluralistic value communities

de
6 6
ind
mo
us
holistic holistic commons

inf
tri
7 7
al
WE ITS
or
n
integral
m
er
integral
at
od
8 8 meshworks
io
culture and social system

stm
na
l
po
worldview and environment

Figure 2.4.2.3: Quadrants and levels within quadrants: human development
This means that ‘developmental psychology’ (the area of Wilber’s fulcrums) belongs
to the upper left quadrant, while the corresponding upper right one shows the
development of the human organism and the brain. The lower left quadrant is the home
of the cultural development of human societies and their value systems, while the lower
right one shows the development of social and societal organisation systems.
The quadrant model can also be used to distinguish between therapeutic

models in a broad sense: medical therapy in upper right, psychotherapies in upper
left, and environmental therapies and rehabilitation programmes in lower left and
right quadrants.
Transpersonal experiences
An important point in Wilber’s theory is that transpersonal experiences may occur
at any level of development – no human being is excluded from the transpersonal
field. The cultural history of the human race bears numerous witnesses of these
often short and intense experiences of something mystical, sacred or ‘numinous’ (a
concept coined by Rudolf Otto). Even though these experiences have been studied
systematically, mostly within Eastern traditions, they are also known in some Western
philosophical, religious and mystical traditions (as meditative states or experiences
attainable through spiritual practices). Wilber makes a very important additional
point. A human being inevitably needs to interpret a transpersonal experience,
and this interpretation will be influenced and limited by the developmental stage,
or horizon, available. This is also well known, but not always properly recognised
in psychotherapy and self-developmental work. It may even explain some of the
enigmas of religious fundamentalism so sadly prominent during these difficult
months and years in the life of our planet.
The psychotherapeutic and music therapeutic

relevance of Wilber’s theory
In a developmental perspective it is useful to have a theory integrating the different
‘lines of growth’ described by well-known theories, i.e. Piaget’s cognitive operations
development, Erikson’s ego and psychosocial development, Kohlberg’s moral devel-
opment, and Fowler’s faith development, as observed by Clark (1999). What Wilber
provides is a contemporary theory based on ‘orienting generalisations’ about the
nature of body, mind and spirit.

For music therapists, his system or model may be especially relevant, because it
addresses the most important ontological and epistemological questions they face as
clinicians and theorists:
• What is the nature and potential of consciousness?
• Can science be integrated with art and religion?
• How can we understand spirituality and the transpersonal realm?
• Is truth always culturally situated?
• Are hierarchies always oppressive and marginal?
• How can the roles of music (king) be described within a larger epistemological
and ontological framework?
‘An archaeologist of the Self ’ is Wilber’s metaphor for ‘the full-spectrum therapist’
(Wilber 2000, p.541). Clients bring problems to therapy, and these problems may
be identified as belonging to one or more fulcrums. Thus the therapist must be able
to work with differentiation or integration problems of the body, the shadow, the
persona, the ego, the existential self, the soul and the spirit – when relevant – and help
the client bring these aspects of the self into consciousness as a whole. According to
Wilber himself, this is not eclecticism, as it is not a question of incommensurable or
competing paradigms or value systems; integral psychology has the noble and daring
ambition of dealing with all the aspects and forms of human existence. References
to Wilber’s books in the music therapy literature fall into one of the following areas:
• General and unspecific, more or less announcing a leaning towards Wilber’s
ontology and epistemology – ‘universal integralism’, not to be confused with
classic essentialism, also suggesting the importance of meta-theoretical
understanding of transformation processes in music therapy (Bruscia 2000,
2014a; Bunt, Burns and Turton 2000; Kenny 1989).
• Specific references to the fulcrums (or other versions of Wilber’s spectrum
of consciousness model) in analyses of client experiences, suggesting that
a client’s specific pathology or problem can be correlated with a specific
developmental stage (Bruscia 1991; Lewis 1999; Rugenstein 1996).
• Specific reference to, or elaboration of, Wilber’s evolution theory (the
quadrant model) in a music therapy context (Bruscia 1998, 2014a).
• The use of Wilber’s theory to underpin the understanding of transpersonal
experiences in therapy (Abrams 2002; Clark 1999; Lewis 1999).
It is not a coincidence that Wilber’s theory serves as a good theoretical framework
within GIM and is required reading in many GIM training programmes. Client
experiences in GIM are so manifold that a psychodynamic, a humanistic-existential or

even a Jungian framework is not always sufficient. GIM needs a metatheory including
archetypal as well as spiritual and transpersonal experiences (Wilber’s fulcrums 7
to 9). Imagery within this realm is very different from imagery within the personal,
psychodynamic spectrum (fulcrums 4 to 6) (Bonny 2001). Rugenstein (1996) has
described case examples where clients in their imagery experience ‘oscillate’ between
different levels of consciousness, in and between sessions.
Bruscia has used Wilber’s philosophy in many ways. For example, he based his
‘six basic models for designing the client’s musical experience’ on Wilber’s quadrant
model (Bruscia 1998). The model is discussed in Chapter 1.3. Bruscia also refers
to Wilber when he discusses how music therapy can enhance and ‘promote health’.
Health is defined as ‘the process of becoming one’s fullest potential for individual and
ecological wholeness’ (Bruscia 2014a). In his further discussion of wholeness and

how to reach this, Bruscia uses Wilber’s concepts of holons and holarchies, because
he finds them more inclusive and adaptable to music therapy than other definitions
of the relation between parts and wholes: ‘Webster’s dictionary cites the main parts of
the person as mind, body, and spirit, whereas Wilber divides the person into object
(exterior holons), and subject (interior holons), both of which include spirit’ (p.208).
The same goes for ecological wholeness, and Bruscia is also clearly referring to the
quadrant model here.
In Music Therapy Research, 3rd Edition (Wheeler and Murphy 2015), Hunt (2015)
uses Wilber’s quadrant model to explain ‘first-person research’ as related to the upper
left quadrant.
Abrams (2002) used Wilber’s philosophy as theoretical framework in his study
of how GIM therapists understand their clients’ transpersonal experiences. He has
also suggested Wilber’s quadrant model as the underlying basis for evaluation of
qualitative music therapy research (Abrams 2015; Abrams and Kasayka 2005).
McFerran-Skewes has used Wilber’s quadrant model as analytical framework in an
interview-based study of how a group programme for young music therapy clients
can be evaluated from eight different perspectives (McFerran and Campbell 2013).
Bonde (2011a, 2015) has used the quadrant model as inspiration for a descriptive
‘map’ of health musicking as a new ‘territory’ – see Chapter 3.13.
Credits
Figure 2.4.2.1 from Transformations of Consciousness: Conventional and Contemplative Perspectives
On Development by Ken Wilber, Jack Engler, and Daniel P. Brown. Copyright © 1986 by
Ken Wilber. Reprinted by arrangement with The Permissions Company, LLC., on behalf of
Shambhala Publications Inc., Boulder, Colorado, www.shambhala.com.
Figure 2.4.2.2 from Integral Spirituality by Ken Wilber. Copyright © 2006 by Ken Wilber. Reprinted
by arrangement with The Permissions Company LLC on behalf of Shambhala Publications
Inc., Boulder, Colorado, www.shambhala.com.
Figure 2.4.2.3 from Sex, Ecology, Spirituality by Ken Wilber. Copyright © 1995, 2000 by Ken
Wilber. Reprinted by arrangement with The Permissions Company LLC on behalf of

Shambhala Publications Inc., Boulder, Colorado, www.shambhala.com.
2.5 Music as Analogy and Metaphor
Lars Ole Bonde
We shall continue the discussion of meaning in music from Chapter 1.3. We now
present two important approaches to music as/in therapy: music as analogy and
music as metaphor. Both approaches have their limitations, of course. For instance,
they do not systematically cover all four levels in Ruud’s model of music’s properties,
or all six types of experience in Bruscia’s model (see Chapter 1.3). The investigation
of music as analogy and metaphor has a focus on the relationship between what Ruud
calls the syntactic and the semantic level. In Bruscia’s model, it refers primarily to
subjective and aesthetic music experiences.
The concepts of ‘metaphor’ and ‘analogy’ were not included in any standard
music lexicons or handbooks before 2010 (e.g. Decker-Voigt and Knill 1996; Decker-
Voigt, Weyman and Decker-Voigt 2009), and they are not indexed in The Oxford
Handbook of Music Therapy (Edwards 2016). However, both are included in a recent
‘dictionary’ (Kirkland 2013). A short definition: analogy (often called isomorphism)
describes similarities and correspondences between forms or phenomena that are not
related but have features or qualities in common (e.g. similarities between musical
form and biological form). Metaphor is a linguistic comparison, where ‘as’ is not
used to establish the similarity, or more precisely the use of features or qualities of a
well-known phenomenon to describe a less well-known phenomenon (e.g. Gustav
Mahler’s ‘credo’ that a symphony is a world).
Metaphor is closely related to play (see Chapter 2.3.5), and many music
therapists use metaphors every day to communicate with clients and patients, just
as they talk and write about music based on the (more or less conscious) axiom
that the client’s music, expression or experience is closely related – an analogy – to
the client’s personality or pathology. In an even broader sense, music is analogous
to a human being’s way of thinking, feeling and interacting. This is expressed in the
improvisations of active music therapy, and in the listening experiences of receptive
music therapy.
One of David and Gudrun Aldridge’s papers bears the title Life as Jazz (Aldridge
and Aldridge 1999), and David Aldridge has often used similar analogies or
metaphors in his characterisation of the relationship between music and the human
body, mind and spirit, and between music perception and music performance. In a
chapter entitled ‘Health as Performance’ (Aldridge 1996, Chapter 20), he suggests that
the creative act (especially musical improvisation) is a core element in the question
of how health is enhanced or promoted. Thus, Descartes’ classic motto Cogito,
ergo sum – I think, therefore I am should be replaced by Ago, ergo sum – I perform,
therefore I am. In a wider perspective, he suggests that personal identity should be
135
understood as a dynamic expressive act, very much like a musical improvisation

– or, with a metaphor, the human being is a composition, and the composed self
is an improvised order. Based on principles from phenomenology, neuroscience
and music psychology, Aldridge emphasises the close affinity between musical and
human processes: the perception of music requires a holistic strategy where the play
of patterned frequencies is recognised within the matrix of time. People may be
described in similar terms as beings in the world who are patterned frequencies in
time (Aldridge 1996).
Smeijsters has written extensively about the affinity between musical processes
and expressive properties on the one hand, and human life processes and pathological
characteristics on the other. He characterises metaphor and analogy as two new
models in music therapy theory:
The theory of metaphor as proposed by Aigen (2005) is based on the schema theory
of Lakoff and Johnson. It explains the connection between musical experience and
felt experience by means of its interconnection with metaphors that are based on
movement experience in space. The theory of analogy as proposed by Smeijsters
is based on Stern’s theory of vitality forms and Damasio’s theory of the core self.
Analogy explains the musical experience by means of the isomorphism between the
forms of vitality affects in the core self and the forms of musical phrases. (Smeijsters
2012, p.227)
Smeijsters has developed a comprehensive theory of analogy as a general theory of
music therapy, also with the intention of building a bridge between special education
and music therapy. The theory of music as metaphor is a narrower clinical theory
describing psychological equivalences of musical elements based on body schemata.
It also describes how clients’ experiences in music therapy are expressed through
metaphors, and how these metaphors have therapeutic relevance as information on
the self-experience of a client (Bonde 2000, 2007; Jungaberle 2007).
Music as analogy is described in more detail in Chapter 2.5.1, and music
as metaphor follows in 2.5.2. There is then a chapter presenting a taxonomy of
therapeutic music and a metaphorical listening to four selections of baroque music.
2.5.1 Music as Analogy

The Dutch music psychologist and professor emeritus in music therapy, Henk
Smeijsters, has worked intensively with the question of how musical processes
and life processes are related, and his theory of analogy will be introduced in this
chapter (Smeijsters 1998, 1999, 2005, 2012). The core axiom is that psychological/
psychotherapeutic knowledge and therapeutic knowledge of music are
interdependent, and that a music therapist develops their professional competence
by integrating them. Smeijsters writes:
…analogy in itself resembles the object it refers to. In analogy there is no dualism
between symbol and object, and therefore there is no need for interpretation. In
analogy there always is a resemblance with the object, but this is not a concrete visual
representation. When there is analogy, the person expresses his being in an object,
in the same way he expresses himself in other behaviours, in other contexts and
by other objects. For instance, the soft dynamics of a shy person’s musical play are
expressions of his personality. They are analogous to the way he expresses himself in
verbal communication. Playing pian(issim)o in musical improvisation is analogous
to staying in the background during a verbal discussion, not talking at all, or talking
softly. Because the musical behaviour is not the original verbal behaviour, because
it is ‘same and different’ (Ansdell 1995, p.180), it is called an analogy. (Smeijsters
1998, p.300)
There are many non-specific analogies between pathological problems and patterns
of behaviour, for example if a client feels isolated from the surrounding world and
is unable to engage in the therapeutic process (be it a talking cure or arts therapy).
Smeijsters’ theory sets the stage for an identification of specific analogies in music
therapy, because valid and useful indication criteria demand this specification. He
thinks that musical elements like melody, rhythm, tempo, dynamics, timbre, form
and interaction are specific symbolic equivalents of non-musical elements of human
behaviour and interaction. For example, a client who is unable to express his feelings
improvises without any noteworthy variation in tempo, rhythm, dynamics and so on.
Smeijsters thinks – proposing an equivalent analogy – that specific musical
processes corresponding to psychological processes may gradually set the client
free, enhance development and promote new life quality and wellbeing, for example
when a client struggling with boundaries learns to distinguish her own music from
the therapist’s and/or other clients’ contributions in a group, develops the courage
necessary to take the space of a soloist or to find a clearly defined role in the music
of a group. Many examples can be found in Chapter 2.3.
Smeijsters has coined the double conceptualisation of ‘pathological-musical
processes’ and ‘therapeutic-musical processes’. They refer to the two core analogies
in clinical music therapy. He underlines that comprehensive experience with and

knowledge of these analogies makes it possible to decide whether music therapy is
an indicated treatment or not, and in Grundlagen der Musiktherapie (Foundations of
Music Therapy, Smeijsters 1999) he unfolds the theory within two clinical core areas
of music therapy – 1) psychiatry (schizophrenia, depression) and 2) special education
(autism, developmental delay). The very close affinity of analogy, diagnosis, indication
and goals, procedures and techniques of the treatment is carefully worked out.
Smeijsters’ theory of analogy is based on Daniel Stern’s studies in mother–infant
communication (Chapter 2.3.3) and his theory of vitality dynamics and dynamic
form. The experience of vitality is embodied and non-verbal – it is not about what
is communicated (content) but how it is communicated (form). This aspect of
communication is of critical importance for the infant, and for the adult this ‘experiential
register’ is often more or less intact or even further developed through life, but in
Western cultures it is not attached any importance. In music therapy, however, vitality
affects and forms are at the centre of the client’s experience of the musical interaction,
regardless of age and problem area. Smeijsters explains why and how:
A person is able to experience his felt temporal, dynamic, kinetic vitality affects
when listening to the vitality forms of musical phrases. The equivalence of the
vitality affects in the person and the vitality forms in the musical phrases is
what analogy means. There is equivalence because the vitality affects of inner
experiences and the vitality forms of music are processed by the same parameters.
(Smeijsters 2012, p.230)
The analogy between the elements of music and the existential themes and qualities
of human existence is also a core construction in the Improvisational Assessment
Profiles (IAPs) of Ken Bruscia (1987, 1994) (see also Chapter 5.2). When developing
this method for the description and interpretation of clinical improvisations,
Bruscia looked for concepts that would give the six ‘profiles’ each a specific listening
perspective and also psychological relevance (Stige 2000). What he came up with was:
• salience (with five scales forming a spectrum: compliant, conforming,
attending, controlling, dominating)
• integration (with the spectrum: undifferentiated, synchronised, integrated,
differentiated, overdifferentiated)
• variability (rigid, stable, variable, contrasting, random)
• tension (hypo-tense, calm, cyclic, tense, hyper-tense)
• congruence (unengaged, congruent, centred, incongruent, polarised)
• autonomy (dependent, following, partner, leader, resistor).
In the preface to the Norwegian translation of the IAPs, Bruscia (1994) wrote that
the method gives guidelines for how the musical elements and the process of an
improvisation can be interpreted, based on psychoanalytic and humanistic existential
theories. The IAPs are an assessment tool based on two basic assumptions:
• Improvised music is a sound reflection of the improviser’s way of ‘being-in-
the-world’, not only in the here-and-now world of the improvisatory moment
itself, but also of the more expanded context of the person’s life world.
• Each musical element provides a universal metaphor – or perhaps archetype
– for expressing a particular aspect of ‘being-in-the-world’. Thus each musical
element has its own range of possibilities for expressive meanings which are
different from the other elements. (Bruscia 1994)
The first assumption is basically identical with Smeijsters’ analogy concept, and we
consider it an axiom of psychodynamic music therapy. The second assumption is
explored in the IAP method, but here we will try to give a short overview of Bruscia’s
metaphoric interpretation of the musical elements on the basis of psychoanalytic and
existential psychology (Table 2.5.1.1).
Table 2.5.1.1: Bruscia’s metaphoric interpretation of the musical

elements, based on psychoanalytic and existential psychology
PARAMETER Salient elements Metaphor of Metaphorical
questions
FORM Theme: a metaphor for entity Being in time Is the entity
Being: a gestalt, a metaphor of identifiable? Does it
wholeness develop? How? Is it in
balance? If not, why?
Form is composed of entities
Is it dynamic or static?
in a mutual relationship
(similarities/differences)
TEXTURE Melody with accompaniment: Being in Is it characterised
a metaphor of cooperation with space by cooperation,
a leader competition or
Solo with orchestra: a metaphor conflict?
of an individual versus a group/ Is there a leader?
community How many voices are
involved? Are they
grouped?
TIMBRE Spectrum of overtones: the The specific Who, what, how is
identity of the entity quality of it? How is the sound
Tone formation: related to a being in produced? Where
body area space does it enter the body?
Mixture: contrast versus Is it in balance,
complementation harmony – or the
opposite?
VOLUME Power: metaphor of giving and The specific Is it convincing?

taking space over time quality of Is it present and
Intensity: metaphor of the being in time intense, also when
quality of the experience of the soft/loud?
entity Does it leave time and
space for me?
cont.
PARAMETER Salient elements Metaphor of Metaphorical

questions
PULSE/ Pulse: holding and supporting The Can I follow it(s
RHYTHM, (or not) organisation development)?
METRE AND Rhythm: metaphor of the of life energy Can I count on it(s
TEMPO independence of the entity as in time support)?
related to the pulse (physical/ Is it flexible? Is it free
Metre: regulation system temporal or frozen?
relationships)
Tempo: metaphor of the
flexibility of the entity as related
to material
MODALITY Modus/key: metaphor of the The Does it speak clearly
basic emotion belonging to a organisation to me?
matrix with a centre of life energy Does it speak freely
The mode/key is an emotional in space and in a differentiated
matrix, the home base (emotional/ way?
special Is it centred or chaotic
relationships) (unreliable)?
MELODY Melody is a specific model The Do I understand what

gestalt (like an aria): metaphor expression of it is saying to me?
of an emotion being formed the self Does it understand
and experienced. The melody what I am saying?
carries the message and relieves
Does it talk precisely
the feeling
and in nuances?
‘How do feelings feel?’
(Langer)
HARMONY Harmony: gives the melody The specific Do I understand what
colour, direction and context character it is up to?
Consonance/dissonance: of self- Is it banal or
creates and releases tensions expression adventurous? Is it
Complexity: the differentiation challenging?

of the melodic expression Is it organic?
Is it complex?
Bruscia considers metaphoric interpretation or psychological analogies as two of

many possible and available perspectives or modes of consciousness – the clinician or
researcher may choose them when relevant. The use of the concept ‘archetype’ must
not be misinterpreted as an ontological claim that the elements described as such
exist as universal or context-independent entities. According to Bruscia, ‘archetype’ is
a Jung-informed construct that may be used to describe how a client experiences ‘the
implicate order’ (see Chapter 1.3). We are convinced that many music therapists share
the basic assumptions of the IAPs, and that music therapy theory needs these types
of concrete, detailed suggestions for the interpretation of the relationship between

music and human existence.
2.5.2 Music as Metaphor

‘All the world is a stage, and all the men and women merely players…’ says Macbeth in
the final scene of Shakespeare’s Scottish play. This is a classical example of metaphor
as a figure of speech – a comparison or equation of otherwise separate and unrelated
elements without the use of the preposition ‘like’.
Until recently, metaphors of this type, for example ‘the eyes are the mirror of the
soul’ or ‘music is the language of emotions’, were considered mere decoration, an
ornamentation or embellishment of language. Aristotle was sceptical towards the
metaphor, which he considered ‘dark’ and manipulative. For this reason, it was not
awarded any epistemological or argumentative value. For centuries metaphor was left
to poets, dramatists and other people with a talent of verbal imagination.
Contemporary scholars have a quite different understanding of the metaphor.
The French philosopher Paul Ricoeur studied how metaphor creates tension within
discourse and in this way contributes to the development of cognitive strategies
(Ricoeur 1978; see also Bonde 2004). Within the field of contemporary cognitive
semantics (the study of the epistemological functions of language), metaphor is
considered a basic tool of cognition, closely related to the body and the development
of body schemata. It is connected to physical experiences of being-in-the-world – for
example: joy = ‘up’, while sadness = ‘down’. The metaphor contributes to the image of
a person’s life world, its elements and dynamics (‘If your husband was a car, what car
would he be?’), and it helps us to understand the surrounding world and ourselves
better. Metaphor bridges mind and body, and the theory of metaphor transcends
the classic dualism of emotion and cognition. This is underpinned by contemporary
neuroscience in the documentation of the close affinity of emotions/body and reason/
consciousness (Damasio 1994, 1999; Johnson 2007; Lakoff and Johnson 1999; see also
Chapter 2.1). From a psychological perspective, metaphor gives us an opportunity to

(re)create and (re)interpret our life world by adapting meaning from one area of life
and transferring it to another. The metaphor is a specific ‘transfer of structure’ used
by the human being to grasp his or her world better (Jensen 2011).
For the same reason, many psychotherapists have studied metaphors in therapy
(Siegelman 1990; Skårderud 2007; Theilgaard 1994). They assign special importance
to the inherent tension and ambiguity of the metaphor, which enables significant
moments of awareness and insight. The metaphor ‘reveals and hides’ at the same
time, and this makes it well suited as a therapeutic tool, not least because it is based
on the client’s personal imagination and language.
In active music therapy, metaphors are extensively used in the verbal dialogue
on improvisations and how they are experienced; for example, ‘It was like being in a
witch’s cauldron’, ‘I felt beyond time and space’, ‘The melody hit me right in the heart’.
An analysis of these metaphors not only shows very clearly how clients experience
the music, but also how they experience themselves, and how they may (not) benefit
from music therapy.
Jungaberle (2007) studied musical metaphors extensively, first through an
analysis of music reviews, then through an analysis of clients’ verbalisations of
their therapeutic experience of music. In the review, a series of core metaphors was
identified, like ‘Music is xyz’ (e.g. ‘Music is space’, ‘Music is a landscape’, ‘Music is
water’). These metaphors were also found in the clients’ verbal reports on their music
experiences, but they were even richer, containing several new core metaphors (or
‘metaphor families’, in Jungaberle’s words).
For example, one family is ‘Music is energy and power’ with subgroups like
‘Music gives access to the inner world’ or ‘Music moves me’. Another family is ‘Music
is language’ with subgroups like ‘Music can hide truth’ or ‘Music makes the ineffable
understandable’. Jungaberle attaches special importance to the family ‘Music is a
landscape’, because it expresses the spaciousness of music – there is ‘room for everyone’,
and most people can ‘find their place’ in the music. Based on this study, Jungaberle
formulated a theory of ‘the metaphorical circle’: extramusical structures influence the
music experience, when we hear or project into the music specific qualities from our
life world. Conversely, intramusical structures (the music experience) have an impact
on our life experience, when we extract or project qualities from the music that give
meaning to our life. Structures are transferred both ways – through the metaphor.
And thus metaphors provide clients and therapists in improvisational group music
therapy with ‘maps’ of musical experiences.
Metaphors also play an important part in receptive music therapy. The client’s
‘music travel’ in guided imagery and music (GIM; see Chapter 3.2) is often composed
of imagery in different modalities (even if the client’s eyes are closed, they ‘see’, ‘hear’,
‘smell’, ‘taste’, ‘feel’ and ‘move with’ the music). The imagery experience is reported
verbally, and in dialogue with the therapist (metaphorically the ‘guide’), the client’s
inner world stands out as different types of imagery, reported verbally as metaphors.
For example, if the therapist/guide suggests the opening image of ‘a garden’ to the
client/traveller, and chooses Beethoven’s Emperor Concerto (second movement) as a
travel accompaniment, the client may experience the garden as anything from a vast
open park with flowers in all colours, to a small, narrow backyard with burnt-off
grass and a dead pear tree. The five stages of the GIM session are often interpreted as
metaphors, for example ‘the music travel’. Zanders (2008) studied how GIM clients
expressed their understanding of the five stages as metaphors.
Of course, metaphors invite interpretation – and the interpretation will be
based on the principle that only the client knows the true meaning of the image or
metaphor. In contrast, the German psychotherapist Hanscarl Leuner, who had some
influence on GIM in its early years, used specific induction images diagnostically,
based on a classic psychoanalytic interpretation of their meaning. This position is not

considered appropriate in GIM. The crucial element in GIM (and other metaphor-
based therapies) is how the metaphors are configured and transformed over time – in
the single session and/or through a complete therapeutic process.
Based on a substantial amount of empirical GIM material (primarily session
transcripts), Bonde (2000, 2004, 2005, 2007) suggested that the metaphors are
configured in smaller or larger narrative units, and he identified three levels of
metaphoric thinking in GIM, which, in the light of narrative theory, have profound
implications for psychotherapy:
1. The narrative episode, configured round one or more core metaphors of the
client. The configuration often follows specific structural patterns related to
specific types of protagonists, for example the victim, the executioner, the
spectator, the abandoned child.
2. The narrative configuration of metaphors of the ego and the self (in therapy).
This configuration makes the client’s personal voice audible and clarifies their
psychological position, for example when the client takes responsibility for
their own story, or dares to be the protagonist of the story.
3. The full narrative, where the imagery and metaphors of the client are
configured into a coherent narrative with a plot (in one session or over time).
This narrative often resembles myths or fairytales, for example the plot of the
‘Hero’s/Heroine’s Journey’ or the myth of ‘Amor and Psyche’).
The narrative episode is often configured during listening to a specific music selection,
where the mood and intensity of the music supports and stimulates the client’s
multimodal imagery. Core images like ‘a volcano’, ‘a giant octopus’, ‘an impenetrable
wall’ and ‘a one-legged woman’ (all from the GIM literature) indicate the metaphorical
power of such episodes. The configuration – a shorter or longer course of events
with the client as protagonist, often with a simple plot (finding something or doing
something to solve a problem) – is supported by dynamic changes in the music, or
in the transition between music selections: Will the volcano erupt? Can the wall
be penetrated by some kind of help? Can the octopus be conquered? How will the
one-legged woman transport herself? The complete narrative unfolds like a coherent
story of the protagonist’s destiny – in several chapters or acts. In retrospect, client and
therapist can discuss core metaphors, narrative configurations, as well as the overall
plot: who or what is the driver of the story?
Of course, there are no causal relationships between music, metaphor and
narrative. The imagery of the clients cannot and must not be directed. The music
offers a number of affordances (DeNora 2000). However, a music selection cannot
stimulate or support any (random) kind of imagery and metaphor. The affinity of
musical elements and metaphoric potential is discussed in the following chapter.
2.5.3 The Psychological Functions of Music

– A Taxonomy and Metaphorical Listening
to Four Selections of Baroque Music
The psychological functions of music
In Chapter 1.3, we introduced three levels of music application in therapy – an
auxiliary, an augmentative and an intensive level (an adaptation of Bruscia’s four
levels). Here we will suggest three levels of music itself, in a process of metaphorical
listening, referring to the theories of music as analogy and metaphor described earlier.
When talking about ‘music’ in the context of pain management, alleviation
of stress or anxiety and psychotherapy, we must be specific. Not all music has the
potential to support pain or stress relief, and when music is used in psychotherapy
we must differentiate. Music can be labelled supportive, explorative, regenerative,
etc. However, it would be sad if the music of Mozart, Mahler, Messiaen, Mendelssohn
or Miles Davis should be considered primarily on the basis of their medical or
psychotherapeutic potential, and not on their experiential, existential and aesthetic
qualities. Music can be arousing, hypnotic, anxiety provoking, mind healing or
shattering, a source of inspiration or spiritual vision – it is like a magic mirror
enabling the listener, be it a client or a therapist, to find answers to deep existential
questions (Stensæth and Bonde 2011).
No clear distinction can be made between the existential-aesthetic (non-
therapeutic) and the psychological (psychotherapeutic) potential of music
experience and awareness. As an alternative, we will present a ‘musical taxonomy’,
a classification system identifying general musical types or functions as related to
therapeutic goals and contexts (Wärja and Bonde 2014). We can also call them
three specific psychological functions of music. One of the professional qualifications
of a music therapist is to assess and evaluate the medical, social or psychological
potential of improvised or composed music – based on the following or equivalent
systematic criteria.
An early attempt to classify musical qualities by mood was developed by
American music psychologist Kate Hevner in the late 1930s. Her so-called ‘mood
wheel’ (Hevner 1936) is a model arrangement of moods that can be expressed in
music and recognised by listeners. The ‘Mood wheel’ is a categorical model with
discrete moods arranged in opposites (1–4, 2–5, 3–7, 4–8), with a ‘light’ (3–4–5–6)
and a ‘dark’ half (7–8–1–2). In contemporary music psychology it is more common
to see dimensional models where moods and emotions are positioned relatively in
a multidimensional space, typically within dimensions such as Valence (happy–
sad) and Arousal (active–passive). See Music listening and emotions in Chapter 2.1
for further discussion.
In the 1st edition of this book, a revised version of the ‘mood wheel’ can be
seen on p. 59. In order to include typical moods from popular music a new category
was inserted between 6 and 7, with the following qualities: active, energetic,
straightforward, extrovert, encouraging. The ‘mood wheel’ is frequently referenced
in the Guided Imagery and Music literature and it can be used together with the
taxonomy described below.
6
7 merry
5
joyous
exhilarated humorous
gay
soaring playful
happy
triumphant whimsical
cheerful
dramatic fanciful
bright
passionate quaint
sensational sprightly
agitated delicate
8 exciting light 4
vigorous impetuous graceful lyrical
robust restless leisurely
emphatic satisfying
martial serene
ponderous tranquil
majestic quiet
exalting soothing
1 2
pathetic
3
spiritual dreamy
lofty doleful
yielding
awe-inspiring sad
tender
dignified mournful
sentimental
sacred tragic
longing
solemn melancholy
yearning
sober frustrated
pleading
serious depressing
plaintive
gloomy
heavy
dark
Figure 2.5.3.1: Hevner’s ‘Mood Wheel’
Trondalen (2004) and Bonde (2005) independently developed the concept of

a ‘musical intensity profile’. Composed music as well as improvisations can be
experienced as having low, moderate and high intensity, and intensity can be stable
or medium or highly variable through the music. Based on a study of music selections
used in a number of GIM sessions, Bonde (2005, 2009) identified three prototypical
profiles: the supportive, the mixed supportive-challenging and the challenging profile.
Wärja and Bonde (2014) further developed the categorisation into a taxonomy where
each main profile is divided into three subtypes.
The taxonomy is music centred – in contrast to the client-centred categorisations

suggested by Summer (1995). Summer first introduced the two basic notions of music
as holding and music as stimulation, based on ideas from Winnicott (1971). The
therapist must find music that is ‘good-enough’ to address client states of ‘me-ness’
and ‘not-me-ness’ in the therapeutic process. Later, Summer (Summer 2002; based
on Wheeler 1983) coined the concepts of supportive, re-educative and re-constructive
group music and imagery therapy as a psychotherapeutic continuum, and she
provided examples of music corresponding – in structure, complexity, predictability
and dynamics – to the three levels. The taxonomy of Wärja and Bonde can be seen as
a music-centred elaboration of Summer’s ideas. In Table 2.5.3.1, intensity increases
from top to bottom.
Table 2.5.3.1: A taxonomy of therapeutic music – with examples from the GIM repertoire
(Wärja and Bonde 2014). Mood categories refer to Hevner’s Mood Wheel (see above)
SUPPORTIVE MUSIC
1. Supportive and safe. Music that is reliable and predictable with no or few surprises. It will
take you by the hand and lead you gently. Simplicity in musical elements and form, perhaps
a solo instrument and/or one or two supporting instruments. Light moods only.
Examples: Stefan Nilsson: Nr 17, Wilmas Tema. Jan Johansson: Bandura.
2. Supportive and opening. Music that can open up to one or two ‘tiny surprises’. Music with
dialoguing instruments, possibly two different themes and at least two instruments.
Examples: Steve Dobrogosz: Mass and Chamber Music, Nr 13, Resting Place. Benny
Anderssons Orkester, Nr 9, Sånger från andra våningen.
3. Supportive and exploring. Music with some dynamic tension and complexity in texture
and form. Gives further support for surrender and a possibility of exploring differences.
Crescendos/decrescendos and accelerandos/ritardandos. Moderate harmonic tension.
Examples: Secret Garden: Papillon. Beethoven: Piano Concerto #5, Adagio.
MIXED SUPPORTIVE-CHALLENGING MUSIC
4. The explorative field with surprises and contrasts. The music often presents a non-familiar
soundscape, with surprising shifts in melody, harmony and specific instrumental texture.
The musical course of events contains at least one major surprise, and there is moderate
harmonic tension.
Examples: Bach: Shepherd Song. Respighi: Gianicola.
5. The explorative and deepening field. This is music that invites the listener into a well-
defined emotional field, a certain mood or emotion, and holds the listener there, even
though this can be challenging. The music is often in a minor or modal key, expressing a
‘dark’ atmosphere, typically through intense and expressive melody.
Examples: Bach: Mein Jesu. Elgar: Sospiri. Mendelssohn: 5th symphony, Andante.
6. The explorative and challenging field. Music in this category offers some surprises and
contrasts, often with a rather high degree of melodic or harmonic tension. The balance is
often obtained by letting the piece begin and end in a calm and supportive character/quality.
The profile can also be movement towards a climax.
Examples: Bach/Stokowski: Passacaglia and fugue in D. Debussy: Sirenes. Brahms: Violin
Concerto, 2nd movement. Rodrigo: Concierto de Aranjuez, 2nd movement.
CHALLENGING MUSIC
7. The rhapsodic field. The music is a sequence of often unrelated (or loosely related) musical
ideas, presenting many different moods, textures, tempi and timbres. Ideas/elements can be
quite elaborated or even improvisatory.
Examples: Bach: Toccata and fugue in D. Wagner: Siegfried’s Funeral March. Copland:
Appalachian Spring (excerpt).
8. The field of metamorphosis. Music is characterised by one or a few significant ideas
that are elaborated in many different ways (shape, timbre, dynamics, tempo) and even
transformed into something very different from the first form.
Examples: Ives: The Unanswered Question. Schostakovich: 5th symphony (excerpt).
9. The field of mystery and transformation. Music in this category cannot be generalised.
However, it is often music that is intended to describe, express or facilitate transformative
or mystic states of consciousness. The tempo is often slow, the mood predominantly dark,
sombre or solemn.
Examples: Bach: Crucifixus. Rachmaninov: Isle of the Dead. Gorecki: 3rd symphony, 2nd
movement. Mahler: Der Abschied (excerpt from Das Lied von der Erde).
The taxonomy has informed several clinical studies where, for example, music with a
supportive or a mixed profile has been used to match and mirror the needs of specific
client groups and therapeutic processes (Bonde 2010; Hertrampf 2017; Rudstam et al.
2017). Hertrampf (2017) worked with cancer patients in group music and imagery
therapy over six sessions, and she planned the process to include music with a mixed
profile in the working phase (sessions 3–4).
The taxonomy has also guided the development of playlists for a specially
designed system of software and hardware called The Music Star. In The Music
Star, only supportive music is used, but in all three subcategories: ‘The supportive
and safe field’, ‘The supportive and opening field’, ‘The supportive and exploring
field’. Independent of musical style or genre, there are no sudden or major musical
surprises. The tempo is steady, often slow-medium, the rhythm is regular, and the
melodic and harmonic progressions are clear and predictable. There is a ‘touch of
the well known’, even if the music is new to the patient. The purpose of the music in
these fields is to allow for surrender and comfort, and metaphorically speaking to let
the listener ‘give in to the musical embrace’ (Lund, Bonde and Bertelsen 2016). Wärja
developed a special music and imagery method called Korta Musikresor (Short Music
Journeys) where clients (individually or in groups) listen to supportive music from
the first three subcategories only (Wärja 2015; Wärja and Bonde 2014).
Of course, the taxonomy is a theoretical construction, and some examples
may help the reader to gain a clearer understanding of the idea. We have chosen
to focus on four selected examples of composed music from the baroque period
(1600–1750). The argument is that in baroque music it is fairly easy to isolate one
musical feature (variable), which is held stable, while other features (variables)
change. However, we think that, in principle, the considerations presented here are
valid within a psychodynamic, metaphoric interpretation of music, independent

of style, genre and origin (improvisation or composition).
Metaphorical listening to four selections of baroque music

A favourite musical principle in the baroque period is called basso ostinato (with
cognate names like canon, ground, chaconne and passacaglia). The basic idea is well
known from (but not quite identical with) the canon Frère Jaques, where each of the
three parts are identical and introduced with a certain time interval. (In the third
movement of Mahler’s Symphony #1, the first section is such a Frère Jaques canon, but
in minor and with a special orchestral colour, endowing this simple canon with an
uneasy, almost surreal quality.) A typical baroque canon or chaconne has a bass part
that is repeated unchanged from the beginning to the end of the piece/movement. The
upper parts imitate each other with specific time intervals, presenting the primary
melodic material of the composition (more or less like Frère Jaques). A composition
of this type is described next.
Pachelbel: Canon in D (four string parts

with basso continuo) – Music example 1
The bass introduces the ostinato in a solo over two bars. The metre is 4/4, and the
ostinato is composed of eight notes of the same length (crotchet), beginning on
tonic d and ending on dominant a – a new round can begin. The ostinato is repeated
over and over without changes, while the upper string parts unfold a three-part
canon. Violin 1 introduces the melody, two bars of stepwise melody progression
in crotchets (like the bass), then violin 2 begins on the same melody while violin
1 proceeds with a new phrase. Two bars later violin 3 enters, following the same
procedure. The most catchy characteristic of the composition is that the canon
melody becomes more and more lively and varied, while the ostinato remains the
same, in its steady and stable ‘rocking’.
Is it possible to find a suitable analogy to this composition in (developmental)

psychology? Is it possible to experience this canon as a metaphor for interaction
principles? We think so. The bass conducts itself like any ‘good enough’ father or
mother would behave towards a child – it creates a perfect ‘holding environment’
(Winnicott 1971). No matter what the child comes up with, it will be held and
contained. If one listens to Pachelbel’s Canon it is obvious that the three ‘canonic
parts’ unfold in a more and more lively and ‘independent’ manner. They ‘dare’ do
this exactly because their base is safe and predictable. This is a perfect metaphor for
what developmental psychologist Margaret Mahler called ‘the rehearsal phase’, where
the child by turns tests itself in experiments in the surrounding world and returns
to ‘fill the tank’ and be confirmed by a significant other. Within guided imagery
and music, numerous client experiences confirm that Pachelbel’s Canon is ‘holding
music’, a safe and predictable composition enabling a safe ‘arrival’ after a long and
maybe frightening journey in the world of imagery. This is an example of music with
a supportive intensity profile (subgroup 3: the secure and exploring field).
Now, the question is, do all compositions based on an ostinato have this
‘holding’ quality? A closer investigation of other selections will demonstrate that it
is not so. A provisional explanation is that music is a multi-layered composition (or
configuration) of many elements, which play their specific role in the construction
of meaning. When a composition is more complex, the ostinato may change its
metaphoric potential. This is evident when we take a closer look at two ostinato-
based compositions by Johann Sebastian Bach.
J.S. Bach: Passacaglia and fugue in

C minor, BWV 582 – Music example 2
(This was composed for organ, but also arranged for orchestra by (among others) L.
Stokowski.)
The bass ostinato of this passacaglia is twice as long as Pachelbel’s, and Bach’s
composition has a much larger scope. The melodic, canonic parts are ever-changing
in timbre and character (which is emphasised in the orchestral arrangement), and
there are many contrasts in the passacaglia alone. From a musical point of view, this
ostinato is not as predictable and stable as Pachelbel’s. Even if the actual notes remain
the same, duration, rhythm, timbre and volume do not. The first half of the ostinato
is preserved in the fugue (as the ‘dux’ theme), and according to the principles of a
fugue it is heard in all (four) parts respectively. In the fugue version, the ostinato has
a stable and more extrovert, powerful character. Taken as a whole, it is a majestic and
quite overwhelming composition.
Experienced metaphorically, the ostinato is a voice-in-command. No matter what
other parts may say or do, it maintains its ‘dictum’, it cannot be persuaded or ‘moved’
to ‘change its mind’. This may be experienced as a dominating, patriarchal voice

(the father, boss, even God), and it makes the passacaglia a genuine psychological
challenge. Many brave GIM clients have fought against such an antagonist, a
commanding authority or a superego figure.
Bach’s Passacaglia is a good example of music with a mixed supportive-challenging
intensity profile (subgroup 6: the explorative and challenging field). The example
makes it clear that an ostinato may be anything but supportive and calming. We
meet a third and completely different type of ostinato in a movement from Bach’s
Mass in B minor.
J.S. Bach: Crucifixus from the Mass in

B minor, BWV 232 – Music example 3
(The following analysis is based on the recording by the New Philharmonia Orchestra/
Otto Klemperer, EMI: 7633642 – a slow and solemn, romantic interpretation.)
This movement is based on a four-bar ostinato in E minor, which is repeated 12
times. One of its specific characteristics is that it features a descending chromatic
line with five halftone steps from the fundamental e to the dominant’s b. With some
knowledge of symbolic meaning in Bach’s compositions, it is possible to identify this
chromaticism as an expression of the utmost agony and its passionate mystery. The
agony is amplified by the four vocal parts, not only due to the text (‘He was crucified
for us…’), but also because the music exposes a variety of extreme dissonances. There
is tremendous tension between the four parts internally, but also between the vocal
parts and the ostinato. The parts ‘cross’ one another; Bach has composed a ‘tone
painting’ of the crucifixion. No matter if the listener experiences this as pure music,
as religious litany or metaphorically, it is music of an oppressive character. Death on
the cross is inevitable, and the music takes an iron grasp of the listener. This is not the
voice of a stern father or super-ego, it is rather the voice of absurdity, the inescapable
destiny bringing death or loss of ego and self. Bach has composed this existential zero
point in absolute contrast to the exaltation and joy of the following movement – ‘…
et ressurrexit-…and was resurrected from the dead’.
In the GIM music programme Death-Rebirth, the Crucifixus is the turning point
in a life-giving journey, a descension into the symbolic land of shadows, which is
followed by a slow ascension to a new beginning (Mahler: an excerpt (the last ten
minutes) of Abschied from Das Lied von der Erde). This music can only be used for
special clinical (or self-experiential) purposes, and it is an example of music with a
challenging intensity profile (subgroup 9: the field of mystery and transformation).
The bass is fundamental. In the baroque period, this so-called ‘thorough bass/
Generalbass’ symbolised the very harmonic order of the universe, on which the
expressive melodic parts depended. This is very clear in the next example.
J.S. Bach: Air, second movement of Orchestral Suite

No. 3 in D major, BWV 1068 – Music example 4
This bass part is firm and stable, almost like Pachelbel’s ostinato. However, this is
not an ostinato, rather a ‘walking bass’, moving untiringly forward in stable and slow
major or minor seconds (sometimes with octave leaps). The composition is in two
sections (the second twice as long as the first), and both sections are repeated. Most
listeners experience this composition as very relaxing and comforting, not the least
because the tempo is close to 60 beats per minute – the pulse of a slow and steady
heartbeat. But how does this relate to the salient contrasts and tensions between the
calm progression of the bass and the expressive melodic lines of the upper parts?
The movement is an ‘Air’ – ‘a song without words’. However, it is possible to
approach the ‘words’ or the meaning of the song. The baroque doctrine of ‘musical
affects’ makes it possible to identify the emotions (affects) expressed in violin 1 (and
to a lesser degree in violin 2). The melody is complex, irregular, characterised by
large melodic intervals and ‘sighing’ accents (‘Seufzers’) or suspension that create a
harmonic tension between melody and bass. This is a symbol of suffering. There are
also melodic episodes characterised by a striving upwards, in syncopated rhythms
and with increasing volume. This is a symbol of passion. Heard as a whole, the
passionate voices express longing – a longing of the heart.
Experienced and interpreted in this way, Bach’s Air is a musical expression of the
passionate human being, longing or striving for a higher order. This (divine) order
is (re)presented by the bass and its accompanying harmonic chords, proceeding in a
solemn progression undisturbed by human suffering, passion, longing and mistakes.
In our postmodern era, it is not common to understand man as ‘enfolded’ in a higher
order. However, the experience of ‘coming home’, ‘belonging’ and ‘being accepted’ is
accessible through music listening, and many GIM ‘travellers’ have experienced this
during their imaginal journey through Bach’s Air. The music is therefore identified
as an example of music with a supportive intensity profile (subgroup 3).
Other examples
If you listen to the four music selections on the website it becomes obvious that
Pachelbel’s Canon and Bach’s Air can be used in pain management and supportive
psychotherapy. The other two Bach selections would be inappropriate for these
purposes; however, their potential can be explored in intensive psychotherapeutic,
existential or spiritual processes.
If the reader wishes to compare the four selected examples with other ostinato-
based movements, we can suggest a few. An example of a fast, merry and reassuring
ostinato movement is the final Halleluja of Buxtehude’s cantata Der Herr ist mit mir.
The Death of Falstaff from Walton’s suite Henry V is based on an ostinato of the same
length and melodically quite close to Pachelbel’s. However, as it is in a minor key and
the mood is very different, this rather simple composition has a mixed intensity profile.
The title of Bach’s cantata BWV 12 is Weinen, Klagen, Sorgen, Zagen. This is also the
text of the first chorus, based on the same music as the Crucifixus. Through the text,
we gain information on the nuances of pain and suffering expressed in the music,
and if the interpretation accentuates the many advanced dissonances, the music will
probably function as music with a mixed rather than a challenging profile. Much the
same can be said about Dido’s Lament, the final aria When I am Laid in Earth from
Purcell’s opera Dido and Aeneas. A movement with a chromatic descending ostinato
may also have a lighter character. An example of this is the instrumental Ground
from Blow’s opera Venus and Adonis (a predecessor of Purcell’s more popular work).
Melodically this ostinato is very close to the Crucifixus ostinato, but it is in triple time,
the tempo is relatively fast, and so together with the poignant rhythm this makes the
movement noble and light at the same time – a supportive intensity profile.
The rock group Procol Harum recreated Bach’s Air in A Whiter Shade of Pale
(1967), giving it a very different character, and of course the ostinato principle is also
used outside the classical tradition, for example in blues, jazz, rock and electronica.
‘Riff ’ is often the concept used instead of ostinato.
The selected recordings of baroque music in GIM are all more than 40 years old, in
arrangements for full orchestra or a fairly large string body, and the performances follow
the romantic style of performance and recording that dominated in this repertoire
until 1980. Contemporary baroque performances are very different, including the
use of period instruments and based on scholarly studies of baroque performance
practice. However, many of these excellent ‘period’ recordings cannot be used in GIM
because they do not have the absolutely necessary ‘holding quality’ of the romantic
performances, enabling the client to let go and delve into the music experience.
Conclusion
In summary, we will present some general characteristics of music with a supportive
intensity profile that may be applied in pain and anxiety management, in deep
relaxation and in supportive psychotherapy (called ‘sedative music’ by Helen Bonny):
• medium or slow tempo (60 beats per minute or slower)
• steady, predictable rhythm (matching the breathing and pulse of the client)
• simple structure with recognisable melodies or themes (instrumental
or vocal)
• simple, consonant harmony without sharp dissonances, sudden shifts or
modulations
• stable dynamics without sudden shifts or contrasts.
Similar characteristics are presented by Grocke and Wigram (2007, p.46) and by
Grocke (2016, p.687). Even though Bonny recommended classical music, it is
obvious that these characteristics can be found in almost any musical style or genre.
We also know that some people achieve relaxation and wellbeing using stimulating
music, which differs from the above by having a faster tempo and a more active
rhythmic drive. Two different principles may be followed when music is selected for
modification or transformation of mood:
1. Following the ISO principle, music must be selected that matches the mood
of the client in the beginning, and then gradually induces the intended
mood.
2. Following the Compensation principle, music must be selected that contrasts
the mood of the client and thus gradually (re)attunes the client’s mood.
The two principles are not mutually exclusive, as they can be related to two different
aspects of the music. The ISO principle works on a vegetative level where the musical
sequence corresponds to the listener’s bodily sense of tempo (slow/fast; accelerando/
ritardando), excitement and relief, tension and release. The compensation principle
works on the emotional level where there is a complex interaction of the mood
expressed in the music and the client’s mood and emotional state.
Music with a mixed or a challenging intensity profile cannot easily be
characterised in the same way as music with a supportive profile. Not only is the
music more complex in itself, but the combination of selected movements is like a
psychologically informed composition. It is part of the qualification of a GIM therapist
to make clear distinctions between the three levels in clinical practice (using the
music programmes with a length of 30–45 minutes and their, in principle, unlimited
combination potential). This expertise is developed not only through traditional
music analysis of structure, melodic material, harmonic progression and so on, but
also through self-experience (the music as heard in an altered state of consciousness)
and phenomenological description of the music sequence – what is salient in the
listener’s experience of the music as it is unfolding – and of the imagery potential,
based on personal and client imagery.
In other words: a GIM therapist is systematically trained in metaphoric music
listening. However, music experienced as metaphor is not the privilege of experts
or therapists. Using a final metaphor, we can say that open and attentive listening
is the Pearly Gate to a thorough understanding of music’s enormous existential and
therapeutic potential.
3
Selected Music
Therapy Models
and Interventions
3.1 Perspectives on Internationally
Well-Known Music Therapy
Models – An Introduction
Lars Ole Bonde and Gro Trondalen
In international music therapy there are many methods, schools, models, procedures
and techniques and different ways of practising and understanding music therapy.
But how can a ‘model’ be defined, as different from a ‘school’ or a ‘method’? In an
early, extensive anthology with contributions from 38 countries, Maranto (1993)
identified 14 models or schools in the USA alone, including more than 100 different
techniques. Similar information can be found in the ‘Country of the Month’ series
published in the e-journal Voices.1 Before selecting models for presentation in this
chapter, there is a need for an outline of our understanding of some core concepts.
Bruscia’s definition of what constitutes a method, variation, procedure, technique
and model is a point of departure in connection with understanding terminology in
theoretical descriptions (Bruscia 2014a, p.128), as he summarises:
A method is a particular type of music experience in which the client engages for
therapeutic purposes; a variation is the particular way in which that method is
implemented; a procedure is everything that the therapist has to do to engage the
client in that experience or method; a technique is one step within any procedure
that a therapist uses to shape the client’s immediate experience; and a model is a
systematic and unique approach to method, procedure and technique based on
certain principles.
In some countries and languages, especially European, there does not seem to be a
sharp distinction between the words method, approach and model, and this may
cause linguistic confusion and communication challenges. For example, Cohen

(2018) describes four ‘advanced methods of music therapy practice’: Mary Priestley’s
analytical music therapy, Helen Bonny’s guided imagery and music, Nordoff-
Robbins music therapy, and Diane Austin’s vocal psychotherapy – all ‘models’ in
Bruscia’s sense. Edwards (2016) has selected 11 ‘approaches and models of music
therapy’, including, for example, feminist perspectives, Carolyn Kenny’s field of
play, antroposophical music therapy, and resource-oriented music therapy. Aigen
(2014) writes about ‘models and orientations’, including neurological music therapy,
aesthetic music therapy and complexity-based music therapy, just to mention a few.
Aigen makes a clear distinction between models and orientations:
1 www.voices.no – the series stopped in 2012.
157
I call them orientations because they are tendencies of thought. They offer a mode of
expressing, describing, and explaining the value of existing music therapy practices.
Comprising values, concepts, and overt philosophical foundations, they cannot
be described merely as theories, although they do contain theoretical constructs;
because they do not contain specific interventions, procedures and goals, the term
models would not be appropriate. (Aigen 2014, p.223)
Many of the models, orientations or approaches mentioned above could also have
been included here (e.g. relational music therapy; Trondalen 2016). However, what
we describe in this chapter is a careful selection of internationally well-known and
acknowledged models of music therapy.
The 9th World Congress of Music Therapy in Washington in 1999 had ‘five
internationally known models of music therapy’ as a concurrent theme. These
five models were introduced and illustrated from many different perspectives –
history, therapy theory, clinical practice, research and training – and included
guided imagery and music (developed by Helen Lindquist Bonny), analytical music
therapy (developed by Mary Priestley), Nordoff-Robbins music therapy (developed by
Paul Nordoff and Clive Robbins), Benenzon music therapy (developed by Rolando
Benenzon) and behavioural music therapy (developed by, amongst others, Clifford
Madsen). Four of the founders were present at the conference – only Mary Priestley
was unable to attend; she was represented by Johannes Th. Eschen. In addition to
the models mentioned above, we describe community music therapy (early traces
were initiated by Even Ruud and elaborated further by Brynjulf Stige, Gary Ansdell
and many others). This approach was already presented clinically and theoretically
in the 1980s (Ruud 1980); however, it has only been internationally acknowledged
and theorised as a model mainly during the last decades. Aigen (2014) understands
community music therapy as one of 13 ‘orientations’, not a ‘model’, because it does
not prescribe or define specific clinical interventions (procedures and techniques).
We also include a description of free improvisation therapy – the Juliette Alvin
model, which is still a source of inspiration, promoted by internationally well-known
pioneers like Ken Bruscia, Tony Wigram and Amelia Oldfield.
The selected seven models are presented in the same format: 1) a historical outline
and definitions from the literature; 2) the session format; 3) clinical applications; 4)
documentation; and 5) classification (using Bruscia’s (2014a, Chapter 20) classification
with four levels of practice: auxiliary, augmentative, intensive and primary). Bruscia
describes the fundamental difference between the augmentative and the intensive
levels using Piaget’s concepts of adaptation, assimilation and accommodation:
the essential differences between augmentative and intensive practices can best be
described in Piagetian terms of accommodation (adapting existing structures to
meet new demands) and assimilation (adapting new demands to fit into existing
structures). When used as an augmentative modality, music therapy accommodates
Selected Music Therapy Models and Interventions 159
the goals of other treatment modalities and thereby assimilates the client’s needs
into the framework of music. When used as an intensive or primary modality, music
therapy assimilates the goals of other treatment modalities into itself in order to
accommodate the client’s needs. (Bruscia 2014a, p.128)
After the presentation of the seven selected models follows a section on ‘Methods in
music therapy’ (3.9), reviewing four methods that transcend the boundaries of the
models and are used all over the world: 1) Improvisation, 2) Songwriting, 3) Therapeutic
voice work, and 4) Receptive methods. Then follows a section on physiological reactions
to music (3.10), leading to a section (3.11) defining music medicine as something
different from music therapy in theory as well as practice. The chapter closes with
a section on music and healing (3.12) and finally ‘Health musicking’ (3.13). This last
section presents a broader understanding of how music experiences can be used also
in public health contexts. In the descriptive model of the field presented there, music
therapy is a sub-field with specific characteristics – the ‘map’ includes a lot of other areas
where music experiences are used to promote health.
3.2 The Bonny Method of Guided
Imagery and Music (GIM)
Lars Ole Bonde
A historical outline and definitions

In receptive music therapy the most important procedure is active music listening.
There are several models and procedures within receptive music therapy (Grocke and
Wigram 2007), for example ‘regulative music therapy’ developed by Dr Christoph
Schwabe in Germany (Schwabe 1987; Wosch in Frohne-Hagemann 2007). However,
the most internationally renowned model is the Bonny method of guided imagery
and music (hereafter GIM).
In the 1960s, Helen Lindquist Bonny was trained as a music therapist and researcher
in the behavioural tradition, but her background as a musician (violinist) and a
minister’s wife, working for many years in pastoral counselling, led her in a different
direction. In the early 1970s, she worked at the Maryland Psychiatric Research Center
in the USA, where she selected the music used in conjunction with the experimental
psychotherapeutic treatment of alcoholics and terminal cancer patients, which was
based on hallucinatory drugs such as LSD. This work is described in a classical paper
written in collaboration with Dr W. Pahnke (Bonny and Pahnke 1972/2002). The use
of LSD in research was prohibited in 1972, and Bonny gradually developed a drug-
free psychotherapeutic model: deep relaxation led to an altered state of consciousness
and was followed by shorter selections of classical music, which were sequenced to
assist deep psychotherapeutic work on different issues and problems. It is interesting
to observe that Helen Bonny and Stanislav Grof, who were colleagues and had a
common starting point in the LSD-based research at the Maryland Center, later found
complementary ways in the music-based or assisted psychotherapeutic models: Grof
went the ‘ergothropic’ way when he developed his holotropic breathwork (Grof 1988a,
1988b), while Bonny went the ‘trophotropic’ way with GIM (Bonny 2002).
One of the problems in the LSD-based therapy was that clients could not
remember much of their very strong experiences after the session, and GIM developed
as a procedure utilising two non-drug components: the altered state of consciousness
(facilitated by autogenic training (Schultz) or progressive relaxation (Jacobson)) and
the dynamic evocative potentials of classical music. Gradually, Bonny developed a
session format in five phases and a series of music programmes. The session format
is described in detail below.
Throughout the years, GIM has grown significantly and is currently practised
worldwide (Bruscia and Grocke 2002; Parker 2010). In particular, GIM is growing
in popularity in Asia and Europe (Bonde 2015; Papanikolaou and Beck 2017).
160
At Temple University in Philadelphia, there is a Bonny archive, where historical

material describing the method can be studied.
The official definition of GIM informs us that:
The Bonny Method of Guided Imagery and Music is a music-centered, consciousness-
expanding therapy developed by Helen Bonny. Therapists trained in the Bonny
Method choose classical music sequences that stimulate journeys of the imagination.
Experiencing imagery in this way facilitates clients’ integration of mental, emotional,
physical and spiritual aspects of wellbeing. (Association of Music and Imagery 2018;
see also McKinney and Grocke 2016)
However, such a definition could also refer to other models of music psychotherapy.
According to Bonny, ‘GIM is a process, where imagery is evoked during music listening’
(Bonny 1990/2002, p.101). Frances Goldberg (1995) offers a more elaborate definition:
GIM is a depth approach to music psychotherapy in which specifically programmed
classical music is used to generate a dynamic unfolding of inner experiences. …[it
is] holistic, humanistic and transpersonal, allowing for the emergence of all aspects
of the human experience: psychological, emotional, physical, social, spiritual, and
the collective unconscious. (p.114)
In GIM, specifically sequenced classical music programmes are used to stimulate and
sustain a dynamic unfolding of inner experiences. Facilitators who conduct sessions
in this one-to-one modality have backgrounds in the helping professions and are
formally trained in the Bonny Method. The music is Western classical and ranges
from the Baroque period to the 20th century, both instrumental and vocal (Bonny
1976). Eighteen of the programmes are created by Bonny and are often referred to as
‘core programmes’. In 1995–96 Ken Bruscia developed a set of ten CDs, Music for the
Imagination, and he published a manual describing the story of the programmes, their
revisions and the new collection based on Naxos recordings. In 2014, Bruscia created
the Digital Compilation of Guided Imagery and Music Programs (Bruscia 2014b). The
number of music programmes is rapidly growing: in 2002, there were 66 programmes
available (Bruscia and Grocke 2002), and in 2009 over 100 (Bonde 2009); new
programmes are continually being created, which also include non-classical music.
The music programmes have a duration of 30–50 minutes and are typically
composed of three to eight longer or shorter selected movements or single pieces from
the classical music heritage. The music is sequenced in order to support, generate and
deepen experiences related to various existential and psychological (or physiological)
needs, such as ‘the experience of unconditioned support and a safe base’, ‘an invitation
into deep grief ’ and ‘creating a ritual of transition’. GIM combines listening to music
with relaxation, visualisation, drawing and verbal conversation and allows for
experiences at different levels of consciousness. In the music travel, clients have the
opportunity to experience aspects of their life as imagery in many modalities – inner
pictures, bodily experiences, sensations, feelings, thoughts, ‘messages’, memories and
noetic experiences (Goldberg 2002; Grocke 1999; Muller 2014).
The session: procedure and techniques

The components of the GIM session are analogies to the sections of the sonata form:
exposition – development – recapitulation – coda. The analogy or metaphor refers
to the dynamic principle of both therapy and musical (sonata) form: it is a process
where material is introduced, developed, transformed and integrated. However, in
the following we will use the concepts normally used in GIM to describe the five
phases: prelude, induction, music travel, return, postlude (Bruscia 2015a). The
interventions of the therapist are chosen and may be described within a spectrum of
possible attitudes or orientations, corresponding to theories outlined in Part 2, and
in the following text this spectrum is made explicit. One end of the spectrum is more
cognitive, the other more intuitive.
The prelude
This takes 15–20 minutes and has, as a point of departure, the client’s life world and
conscious experience of their problems. During the verbal dialogue in the prelude
the therapist will gradually try to turn the client’s attention from the outer to the
inner world, and a focus point for the session must be identified. With this in mind,
the therapist chooses the music programme. The transition from the conscious
experience of the outer world to a more open awareness of the inner world is marked
by the client’s physical change of position – they lie down on a mat and close their
eyes. The therapist takes a position enabling physical comfort, full control over the
audio system, and overview of the full body of the client. During the music travel,
the therapist writes down the client’s words for their images. The client gets this
transcription when the session is over, while the therapist keeps a copy.
The induction
This lasts from two to seven minutes, and within the spectrum of attitudes the
therapist may choose a more cognitive position A, to select elements of the client’s
conscious narrative, or a more humanistic position B, listening carefully to identify

a more emotional level, the level of the ‘subtext’.
Example: The client gives a detailed report of her daily feelings of ‘loneliness’. From
Position A, the therapist may choose to focus on a concrete situation that can be
formed – like a ‘gestalt’ – in the relaxation and in an induction image, for example
‘Tense the muscles in part a…b…c…of your body as much as you can (without
putting pressure on yourself) and…relax… Feel the difference…’ (duration is
approximately five minutes, without music). ‘Now imagine yourself in a situation
just before meeting X’ (whom the client has described as playing an important role
in her life). The music begins, and the therapist asks: ‘How is the situation for you?’
From Position B, the therapist may choose a suitable metaphor or equivalent image,
such as ‘No one is holding you’. The induction may sound like: ‘Lift part a…b…c…
of your body and feel how light or heavy it is.’ The music begins and the therapist
may say, ‘Allow the music to help you hold part a…b…c… Can the music help you
hold your body?’
The purpose of the induction is to facilitate a transition from ego-dominated to
deeper levels of consciousness and to surrender to a more flexible experience of time
and space. A focus, a limitation of the possible choices, is necessary in order to avoid
insecurity or confusion in this exploratory time space. The focus serves as ‘a miner’s
lamp in the darkness’.
The music travel

During this phase, the therapist is the guide for the client. In the induction, the
guiding may be quite directive, and the choice of music is also the responsibility of the
therapist. However, during the ‘music travel’ the therapist takes a totally non-directive
attitude. They must be a trustworthy companion, who will follow the client anywhere
the client chooses and dares to go. The task of the therapist/guide is to ‘help the client
to describe the experience, to stay close to it, and to feel the full impact of it’ (Grocke
2005, p.46). Client and therapist share the imagery of the client, broadly understood
as inner experiences in different modalities: visual, auditory, olfactory, gustatory,
tactile. Memories and emotions are also included in the concept of imagery. The
imagery of the client may be clear or diffuse, rapidly or slowly changing, personal or
impersonal, disconnected or coherent. Every client has a specific ‘style of travelling’,
and it normally takes a few sessions to develop optimum response to the imagery
and the music. Again, the orientation of the therapist may be exemplified through
the spectrum.
Example: From a more cognitive position, the therapist uses the music as a specific
stimulus evoking imagery. The music is a ‘projection screen’ on which the unconscious
of the client may project its content. The therapist wants to know as much as possible
about the image potentials of the music (pieces and programmes).
From a more humanistic-existential position, the therapist considers the music

a ‘co-therapist’ or even ‘primary therapist’ (Bruscia 2015a). The complex interplay of
music and imagery is at the centre of the experience. Some GIM therapists consider
music an ‘archetypal field of energy’ where the mythical structures of the music
operate and facilitate therapeutic change.
No matter what orientation the therapist may have, they will do their best to
engage the client in the music travel and the exploration of the imagery, which
may also lead to transpersonal experiences. The music travel lasts 30–50 minutes,
depending on the programme or improvised music choice of the therapist, and the
client’s actual imagery and process.
The return
When the music is over, there is a return phase where the therapist guides the client
back to a non-altered state of consciousness. As part of the return, the client is then
encouraged to make a drawing such as a ‘mandala’ (Kellogg 1984), a sculpture (clay
work) or freestyle writing (e.g. a poem) to capture what stands out as important
experiences and images emerging during the music travel. This phase lasts 8–10
minutes, and the guide will often start with the question: ‘What stands out for you as
the most important in your experience?’
The postlude
This is a short dialogue (10–20 minutes). The ‘visible’ experiences in the form of, for
example, a mandala serve as a focal point in a verbal conversation, where the therapist
helps the client to connect the experience to daily life and the session focus.
Example: From a more cognitive position, the therapist will guide the client into an
interpretation of the imagery, aiming at new insight into the problem.
From a more humanistic-existential position, the therapist considers the music
and imagery experience transforming in itself. The therapist will probably stay in the
metaphors of the imagery and encourage the client to explore the most important
parts further.
The therapist may be informed by theories of metaphors, narratives and
symbols (Bonde 2000); however, the client’s own interpretation of the experience is
acknowledged as authoritative.
Clinical application
GIM is used in a number of clinical settings and with many different populations: self-
development and transpersonal work of neurotypical people, music healing, training
therapy, drug addiction, abuse, neurotic disturbances and trauma, and in the somatic
field clients suffering from heart problems or cancer, and people living with HIV and
other life-threatening diseases. Modifications of the format have been developed for
other clinical populations (e.g. psychiatric patients or patients in end-of-life care),
and also different group formats are commonly used (Bonde 2010; Grocke and Moe
2015; Muller 2014; Summer 2002). The clinical field of applied GIM is broadening
quite fast and can be described as a spectrum ranging from short, unguided sessions
of music and imagery to interactive, guided group sessions (Grocke and Moe 2015).
The following elements are typical of interventions less complex than the classical,
individual session described above:
• Sessions may be shorter (3–20 minutes of music) and the music listening
may be unguided.
• Music and interventions may be supportive rather than exploratory and

challenging.
• Music other than classical is included in the repertoire.
• Guiding may be more directive, both with individuals and in groups.
There can be contraindications to therapeutic work with music and imagery: if clients
have problems in differentiating between fantasy and reality, borderline issues,
mental handicaps or are addicted to drugs or medicine, they may not benefit from
these methods.
Music and imagery (MI) work is used with groups as well as individuals. A Group
Music and Imagery (GrpMI) session follows the same five phases as the classical
individual GIM session described above, although the prelude is much longer –
it takes time to find a group focus – and the music travel is much shorter (4–10
minutes) and unguided. This format is often used in psychiatry (Bonde 2010; Bonde
and Pedersen 2015) and in cancer care (Hertrampf 2015; Wärja 2015), and it is also
used with patients suffering from trauma (Rudstam et al. 2017), fibromyalgia (Torres
2015) and adults with substance addictions (Van Dort 2015).
Another popular group format is guided group music (fantasy) travel, often used
in team building and in educational settings. There are many manuals or ‘scripts’
available – one example is given below (Bonny and Savary 1973; Bush 1996; Grocke
and Wigram 2007).
Example of a guided induction (Bush 1996, p.190): Create a safe place (can be used
both individually and in groups, and also for personal journeys without a guide).
This induction is helpful when you feel fearful or anxious. An induction that engages
the senses also immediately helps the body/mind to make the shift inward. Start
by calling to mind words that express peace, comfort and safety to you. Now allow
a place, real or imaginary, that expresses this to form. Allow this scene to emerge
slowly, focusing on details, taking time to perceive with all your senses. When the
image is clear, notice colours, space dimensions, aromas, tactile impressions. Let
them become vivid. Allow yourself to sense the mood of the place. Project yourself
into the scene. Allow yourself to move and experience some contact with the place.
You might want to touch or smell a flower or sift sand through your toes, run, dance,
skip. As you become more and more relaxed, call to mind your objective for the
journey. Allow it to form into an image or question to the inner self… Start the music.
Then follows the music journey. Bush recommends, for example, Mozart: Clarinet
Concerto, 2nd movement; Mozart: Concerto for flute and harp, 2nd movement; and
Frank Bridge: Lament. The therapist guides the return and the processing dialogue.
For individual (home)work Bush formulates the following steps:
1. Formulate a focus for the journey.
2. Choose the music.
3. Relax with a simple induction (and read the script).

4. Become a traveller in inner space.
5. Write a brief account of the experience. (Bush 1996, p.192)
The Swedish GIM trainer and researcher Margareta Wärja has developed a method
called Korta Musikresor (Short Music Journeys). The session format is almost
classical; however, the music travel is short (2–8 minutes) and unguided, the music
is supportive and often non-classical, and other artistic media are included in the
process (Wärja 2015).
Documentation
The GIM literature is comprehensive. Most of Helen Bonny’s articles are published in
one volume edited by her former student Lisa Summer (Bonny 2002). An anthology
by Bruscia and Grocke (2002) describes the model as practised and studied today.
The research literature covers clinical case studies, and studies of both process and
effect, conducted in quantitative, as well as qualitative and mixed-methods, designs
(e.g. Beck 2012; Bonde 2000, 2002, 2005, 2010, 2015; Grocke 2010; Körlin and
Wrangsjö 2001; Maack 2012; Moe, Roesen and Raben 2000; Summer 2009; Wrangsjö
and Körlin 1995). Over the years, devotees of GIM have concentrated increasingly on
metaphors and narratives in their work (Aksnes and Ruud 2006, 2008; Bonde 2000,
2004, 2007; Perilli 2002; Ruud 2003), and personal development has become linked to
personal empowerment (Trondalen 2009–2010, 2011). Research demonstrates that
GIM can change counterproductive behaviour patterns, increase self-understanding,
empower people to solve problems, reduce stress and increase access to personal
creative resources (e.g. Abrams 2002; Beck 2012; Bruscia and Grocke 2002; Grocke
and Moe 2015; Maack 2012; Martin 2007). In 2010, Voices (vol. 10, issue 3) published
an online commemorative issue, dedicated to the life and work of Helen Bonny,2 and
in 2017 a special issue of the e-journal Approaches was devoted to the theme ‘GIM in
Europe’, based on papers from the 12th European GIM Conference in Athens, Greece.
Categorisation
Relating to Bruscia’s systematic account of music therapy models, GIM is placed
at the intensive level as a transformative music psychotherapy, because in GIM ‘the
music experience is therapeutically transformative and complete in, of, and by itself,
independent of any insights gained through verbal exchange’ (Bruscia 1998, p.219).
2 The issue contains articles in all categories including perspectives on practice, reports, examples of
research, essays, stories, a Refshare document with links to the huge research materials on GIM, archival
texts, and a keynote speech by Helen Bonny that appears for the first time as a written text. See www.
voices.no

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122 A COMPREHENSIVE GUIDE TO MUSIC THERAPY

of consciousness, we inevitably also connect to that which connects us all as human

Studying the process of surrender in GIM therapy

Category of analysis Definition Examples from GIM

role of a relational partner (often called a ‘co-therapist’) in the therapeutic relational

2.4.2 Wilber’s Integral Psychology

In the history of psychology, transpersonal psychology is considered the ‘fourth

Research into states of consciousness

formulated a new psychotherapeutic goal: the self-actualisation of the human being

Wilber – fulcrums and quadrants

troversial, position within psychodynamic and transpersonal psychology. This

consciousness – and the related psychopathologies and psychotherapeutic models.

Development is differentiation: the

9 causal Causal pathology The path of sages

4 rule/role Script pathology Script analysis

Psychotic disorders are related to a disturbed differentiation on the physical

The prepersonal, the personal and the transpersonal

psychotherapy to fulcrums 5 and 6. Fulcrums 7 to 9 have not been addressed much

The four quadrants

UPPER LEFT UPPER RIGHT

LOWER LEFT LOWER RIGHT

Wilber developed this model as a graphic and comprehensible combination of four

8 self and brain and organism 8

archaic survival clans

power gods feudal empires

mythic order early nations

scientific-rational corporate states

pluralistic value communities

holistic holistic commons

culture and social system

worldview and environment

The quadrant model can also be used to distinguish between therapeutic

The psychotherapeutic and music therapeutic

nature of body, mind and spirit.

experiences in GIM are so manifold that a psychodynamic, a humanistic-existential or

ecological wholeness’ (Bruscia 2014a). In his further discussion of wholeness and

Wilber. Reprinted by arrangement with The Permissions Company LLC on behalf of

understood as a dynamic expressive act, very much like a musical improvisation

therapeutic music and a metaphorical listening to four selections of baroque music.

2.5.1 Music as Analogy

in clinical music therapy. He underlines that comprehensive experience with and

Table 2.5.1.1: Bruscia’s metaphoric interpretation of the musical

VOLUME Power: metaphor of giving and The specific Is it convincing?

PARAMETER Salient elements Metaphor of Metaphorical

MELODY Melody is a specific model The Do I understand what

Complexity: the differentiation challenging?

Bruscia considers metaphoric interpretation or psychological analogies as two of

of concrete, detailed suggestions for the interpretation of the relationship between

2.5.2 Music as Metaphor

Chapter 2.1). From a psychological perspective, metaphor gives us an opportunity to

based on a classic psychoanalytic interpretation of their meaning. This position is not

2.5.3 The Psychological Functions of Music

Figure 2.5.3.1: Hevner’s ‘Mood Wheel’

Trondalen (2004) and Bonde (2005) independently developed the concept of

The taxonomy is music centred – in contrast to the client-centred categorisations

valid within a psychodynamic, metaphoric interpretation of music, independent

Metaphorical listening to four selections of baroque music

Pachelbel: Canon in D (four string parts

Is it possible to find a suitable analogy to this composition in (developmental)

J.S. Bach: Passacaglia and fugue in

to ‘change its mind’. This may be experienced as a dominating, patriarchal voice

J.S. Bach: Crucifixus from the Mass in

J.S. Bach: Air, second movement of Orchestral Suite

cause linguistic confusion and communication challenges. For example, Cohen