When Words Fail: An interview with registered music therapist Tanya Marie Silveira
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;
Story

When Words Fail: An interview with registered music therapist Tanya Marie Silveira

Issues/Mental Health , Stories/119
Mascot NSW 2020, Australia
10th Sep 2017
When Words Fail: An interview with registered music therapist Tanya Marie Silveira
Our editor sat down with registered music therapist Tanya Marie Silveira to talk about why Australians need to give music therapy the acknowledgement it deserves.

Tanya Marie Silveira is a registered music therapist and PhD candidate in stroke recovery at the National Music Therapy Research Unit at University of Melbourne. With a family history tied to Goan jazz traditions, she has already worked with young refugees at Sydney's KidsXpress, set up a community music program in Mumbai and pioneered research into stroke recovery within the first four years of her career.

I sat down with Tanya to discover what motivates her passion for this mode of creative therapy, and to discuss the importance of acknowledging it as a research-based Allied Health profession.

tanyasilveira 1

ALLY: How did you know music therapy was your jam?

TANYA: A pivotal moment for me came when I was studying the Master of Music Therapy course at University of Melbourne. My grandmother had dementia and we would listen to old recordings, play instruments and sing her favourite songs together. It became a ritual we shared as grandmother and granddaughter. Watching her come alive in the process made me recognise that music therapy was something I wanted to do - when you see someone that you love so much and know so well go through positive shifts as a result of music, you realise first-hand what a powerful tool it is.

ALLY: Most people agree that there is something transcendent about listening to music. Why do you think this is and how does it relate to using music therapeutically?

TANYA: I have always had a strong connection to music. I am from a jazz background and play the flute. When I was an adolescent I found that improvising and letting go, even though it was generally within a framework, was a huge release for me. I didn't know how it explain it at the time, but the process of improvising when you are going higher up, playing louder, playing with an ensemble and all shifting dynamics together - there is something transcendent about it. It's powerful to be able to use that knowledge, that feel, and those techniques to help others now.

My most visceral responses are from what I listened to as an adolescent. It is interesting to reflect on that now because a lot of the research shows that your adolescent years are the years where your musical tastes stick out down the track. Thinking about it in my own work, when I meet a new patient who may even be 92 years old, I don't ask them what music they like. I ask them what they listened to when they were an adolescent because that seems to be the most evocative approach.

ALLY: What are the differences between music therapy and community music programs and why is it important for clear distinctions to be made between the two?

TANYA: People often don't understand what music therapy is. On the surface, community music programs and music therapy programs can sometimes look similar. The main distinguishing factor is the fact that music therapists in Australia are trained at a Master level to become qualified. In order to practice after completing the Master degree in Australia, you need to be registered with the Australian Music Therapy Association.

Community musicians may come from teaching or performance backgrounds. They do some remarkable work, but as you can imagine, it's more on a performance basis. When community musicians play wartime songs in aged care facilities, it can sometimes be painful for some of the residents to revisit certain memories. My concern is that, without a music therapist present, there is nobody who can therapeutically support these people both musically and verbally.

Unlike community musicians, a music therapist will rarely work with a big group. I don't have groups of more than 7 people to make sure we can really delve deep into the therapy. It is important to note that not all pieces evoke positive memories for people and that is not necessarily a bad thing - I am a firm believer that physical responses are a great release. There are psychological components in the music therapy training so we are able to therapeutically hold the space and validate any feelings that may arise.

ALLY: Do you consider music therapy's inclusion in the NDIS (National Disability Insurance Scheme) a significant victory?

TANYA: It's a significant step forward. Even though we come under "Allied Health" in terms of our award rate and education, the wider community isn't always aware of this. We are sometimes perceived to be volunteers, or just there for fun. It's our responsibility to continually advocate but it becomes quite exhausting and you don't want to become too preachy with people. The fact we are considered in the NDIS validates our profession.

ALLY: Your family has a rich musical history. How does your cultural and musical heritage inform your music therapy practice?

TANYA: That's a great question, I've never thought about that before! My interest in playing jazz can be linked to my family. Both sides of my family are jazz players, and I was surrounded by it as a child. It's the familiar, it's the known, it became what I wanted to do. Whenever we get together as an extended family, everybody naturally bursts into harmonies when singing. I never realised how different that was until friends would come to family events and comment on it.

ALLY: While training as a music therapist, you set up a community music program working with children in an oncology ward in Mumbai. Can you describe an interaction with a patient that moved you not only as a therapist but as a human being?

TANYA: The context for that was that I had just finished my first year of the Master of Music Therapy course and there had been a lot of changes going on in my life including a death in the family. This opportunity came up and I grabbed it - it's my cultural heritage and part of my identify, so naturally, I wanted to be part of it. Unfortunately, I don't speak the national language Hindi but I tried to use a few colloquial expressions while I was there. I thought the language barrier would be the hardest thing, but our common language was music.

There was one little girl in particular who stood out. She wanted to learn English and she was about 4. Her mum couldn't speak English but I encouraged her to sit in the session with us. We used the song "You Are My Sunshine". It's a timeless song that you can use with any age group or cultural background. I drew picture cues to get her to finish the lyrical lines. After the first line, "You are my", I would hold up a picture of a sun. "Sunsine" is how she would say it. Then I would keep holding them up with different pictures. By the end of our first session, she had memorised the ending words. Finally, we made actions. Whenever we sung "sunshine", I would get her to open up her hands and reach really high to open up her body which helped with her breathing and respiratory function. I barely used the guitar with her - it was just using the human voice and universal body language. This is one of the sessions that has stayed with me most during my career as a student and as a therapist.

tanyasilveira 2

ALLY: How was your experience in India different to working in an Australian context?

TANYA: I am very passionate about cultural differences in music, and became more acutely aware of this during my time in India. I will often use a combination of notes or a scale as a basis to accompany the client, or just play with them depending on what instrument we use. In India, music is a significant part of religion and the Hindu culture. When you look at combination of notes and scales, they actually coincide with the Ragas used in Indian classical music.

With those combination of notes, you are only supposed to play them at certain parts of the day because they mean different things at different times. For example, some are known to have healing powers. So, in approaching improvisation in India, I chose to use certain Ragas that coincided with western classical music scales to ensure that I wasn't being culturally insensitive. After returning to Australia, I became more aware of the different combination of notes and scales used in a variety of cultures, and now in my practice I use this as the basis to accompany the client, or just play with them depending on what instrument we use.

ALLY: Up until recently, you worked with children, many of whom are from refugee backgrounds, at KidsXpress in Sydney. Can you tell me a little bit about working there?

TANYA: I lucked out at KidsXpress because I got to work in a team with a play therapist and art therapist. The basis of our work was using these creative, expressive therapies to help kids work with whatever they want to bring to us, Music, art and play are non-verbal tools that allow kids to simply be kids, show us what they choose to show us and bring it on their terms. They are non-evasive and non directive.

In this context, cultural sensitivity is paramount. I am primarily a flute player and in a lot of the Arabic speaking backgrounds flute is a prominent instrument. So, I could draw upon that and use scales from Arabic music in improvising with the kids, often using flute. Some of those combinations of notes might sound "sad" to someone brought up in the Western world but these kids would listen to them and feel happy because it reminded them of other childhood songs.

ALLY: If there was one thing you could change about how music therapy is viewed by those outside the profession, what would it be?

TANYA: Because I am both a flute player and music therapist, people often assume that my main role is to help people "relax". Although that is part of what I do, there is a lot more to it. For example, my approach could on the surface appear like relaxation but the tempo that I choose to play at is actually meeting the clients' breathing cadence. This is an example of using a physiological response to induce relaxation. Or alternatively, I might use relaxation to help people with neuropathic pain; to distract patients from their pain and avoid them taking extra medications. Do I help people relax? Yes I do, but we're a research-based health profession and we're doing much more than meets the eye.

ALLY: What is your vision for the future of music therapy?

TANYA: I don't know if it's a vision or a dream, but for music therapy to be on Medicare! At the moment, if you have a sports injury you can go to see a physiotherapist but many people don't even think about seeing a music therapist in that instance. I also think it is unfortunate that the people who need to access this service the most are the ones who don't have the money afford it.

While I don't think it is as present as it used to be, there can sometimes be a continued stigma attached to music therapy as it is a "therapy". That's part of the reason why I openly share that I see a psychologist for regular clinical supervision. I guess my dream would be for that stigma to be gone... and for more funding opportunities for people who need it.

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