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Book Review – Lee (2016)

Lee. C. A. (2016). Music at the Edge (2nd ed.). Abingdon, England: Routledge.

 

Reviewer: Laura Halligan
LLB, BA, MMusTher, NZ RMTh
Cranford Hospice, Kowhai Special School and private practice

 

Music at the Edge (2nd ed.)1, by Colin Lee, is a detailed and engaging account of thirty-three music therapy sessions between music therapist Colin Lee and Francis, a musician living with AIDS.

Lee is refreshingly honest throughout the book about his own personal fears and insecurities in working with Francis. Francis is a brilliant pianist with incredible improvisation skills. He also has a unique ability to articulate his own thoughts and feelings about each improvisation. Lee expresses his initial feelings of intimidation at working with someone so musically and verbally proficient. He also has a strong sense of excitement, as a composer and improviser, at having a client who is an accomplished musician and the potential this represents for their work together. Lee is able to be honest and open about his feelings of inferiority and insecurity that arise during sessions with Francis, which is both refreshing and inspiring. As Lee faces these feelings through reflections after sessions and in his own supervision session, he comes to realise that these music therapy sessions are providing him with opportunities to reconsider his perspective of what music therapy is, what it can be, and the place of improvisation within music therapy sessions. This is inspiration for Lee’s evolving concept of Aesthetic Music Therapy.

Francis has very strong and clear ideas about what he expects from music therapy and a music therapist, often to the point of bluntness. “I expect your musical inventions to be of the highest order…” (p.45). Francis is unapologetic at expressing his need for a musically proficient music therapist who is able to meet his musical strength and abilities. Francis articulates his needs and what he would like from Lee in every session. Lee reflects on the pressure he feels to respond in the exact way that Francis needs, “My answer would have to be at least miraculous…” (p.48). His honesty about this makes him relatable and encourages music therapists to be open about their own limitations and boundaries.

The audio files that accompany the book are integral to witnessing and understanding the powerful work that takes place between Lee and Francis. Listening to these excerpts emphasizes that Francis is a very gifted musician. The excerpts also provide us with a sense of what it was like in the music therapy room –an experience that words cannot adequately express. We are invited in, at the moment of musical creation, to witness the power of Francis’ music. The recordings are both beautiful in and of themselves, and also strongly evoke in the listener some of the feelings Lee himself feels –a sense of being stifled at times, or confronted with really strong and often overwhelming feelings of loss, sadness, grief.

Lee is a composer and improviser as well as a music therapist, and had always hoped to work with a musically talented client. He is able to meet Francis’ challenges with passion and anticipation –while also continuing to acknowledge how daunting it is working with him. Part way through their work together, Francis begins to play solos that take up the entire session and no longer needs Lee to be musically active in sessions. Lee is required to consider what he can offer as a listener, and it is interesting to hear his reflections about what he can offer if he is not a musical participant, and how disempowered he initially feels to give up this role.

Lee initially has a strong sense of discomfort in how much time Francis spends verbally reflecting on each improvisation. He comes to the conclusion that “if words came directly from music they can be equally meaningful”. Francis’ ability to articulate himself at such a deep level following his improvisations indeed adds power to the music and gives Francis himself power to name his feelings and to say them out loud, when for so long he has felt unable to do so. Lee comes to highly value Francis’ abilities to reflect on music therapy sessions, particularly given the fact that often, “spending one’s life as a music therapist is a journey of intuition and faith” (p.73). Music therapy clients are often unable to provide articulate responses to their experiences within a session. In contrast, Francis’ “precise evaluations connecting musical structures and their connection to his emotional well being often left [Lee] in awe” (p.60).

During one session, Francis asks that Lee improvise for him on his own. Lee again questions their roles and what implications this might have for their ongoing work together. However, he discovers that, “by improvising for clients, attempting a reflection of their feelings and mine, I found it possible to offer an emotional exchange that would allow for intense expressions of grief” (p.80). This again leads to a deepening of their therapeutic connection and illustrates another way that the flexibility of music therapy can meet the needs of clients.

As Lee becomes more comfortable and familiar with what is required of him in each session his responses are a source of comfort to Francis, who often needs reassurance that the music he creates is received as he wants it to be, and that it means something to someone else. A theme in the book is Francis’ deeply felt need to leave something behind – a legacy, something that was real, something that captured his pain and his passion and who he truly was. This is a common theme in palliative care music therapy, and clients can reach a deep state of peace when they feel they have passed something on that will live on beyond the time they have left.

The relationship that evolves between Lee and Francis, right up until Francis’ death, is central to the story. Towards the end of Francis’ life, it is no longer possible to maintain their therapeutic relationship. They decide to navigate the rest of the time Francis has left as friends. The ethical implications of this decision are interesting to contemplate, but it seems clear in this instance that continuing their relationship is central to Francis’ well being. Further exploration into this seems necessary, in a general sense, particularly when working with clients who have life-limiting illnesses.

What most resonated with me in this book is how open Lee is about his personal responses to working with Francis. It shows how crucial the time spent reflecting before and after each session as well as regular supervision are to our continued effectiveness as music therapists. There are passages and ideas within Music on the Edge that will remain with the reader long after finishing it, perhaps particularly those who continue to navigate their relationships with clients who are nearing the end of their lives.

Note:

  1. First published as: Lee, C. A. (1996). Music at the edge: The music therapy experiences of a musician with AIDS. London, England: Routledge.


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