A Brief Rationale for an Integrative Approach

Music therapist integrative therapy Cape Town  Melissa Ellse
Integrative Therapy in Cape Town with Melissa Ellse

We are all unique ūüĆü

An integrative therapeutic approach draws thoughtfully from various theories, methods and techniques based on the individual’s strengths, needs and concerns.


There is no one-size-fits-all. It simply does not exist. Every single encounter we have with one another is both meaningful and unique. This is because we are human and beautifully complex.


I‚Äôve learned this first hand in my own therapeutic processes, which is why I strive to be integrative, intuitive and informed in my approach. And my approach will probably not work for everyone, because we are all unique ūüĆü and that is truly wonderful.

To find out more, click here.

Are substance-free psychedelic experiences possible?

psychedelic experience guidance cape town south africa spiritual awakening music therapy

Short answer: yes.

Longer answer: I have encountered surprisingly many people (older, younger and from all walks of life) who want to experience something of the the mind-manifesting nature of psychedelics without taking a substance. Some people are averse to the idea of substance-induced altered states of consciousness from pre-conceived ideas about “drugs”, some cannot explore any mind altering substances because of medications or psychological predispositions. Some don’t want to get entangled in something that is not legal. Some simply don’t like the idea of ingesting anything that affects their consciousness so profoundly. Some prefer to be in control. Some are fearful. These are all valid concerns.

Yet still, such individuals seek a transcendent (possibly spiritual) encounter that is different to everyday, waking life and that offers up something deeper, possibly holding more meaning, truth and authenticity than their ‘ordinary’ reality. In my experience, these individuals are usually on a voyage of self-exploration, igniting creativity, navigating a life transition and/or discovering meaning in life. My hope-filled and honest response is always yes, there certainly are ways to enter altered states of consciousness without any substances or plant medicines.

Psychedelic literally means ‘mind-manifesting’ or ‘mind-expanding’, the Greek root is psyche (mind, soul) d√™los (manifest, visible). Meditation is one avenue to such experiences, yet this usually takes a great deal of practice before potentially experiencing anything of a psychedelic nature. Still, I highly recommend a steady meditation practice for many, many reasons which I won’t address here. To get started with a meditation practice, the following apps are very useful: https://wakingup.com/ or https://www.headspace.com/.

I work with music and deep relaxation into an altered state of consciousness, eliciting imagery in the mind’s eye that allows the ‘traveller’ transcendent, even psychedelic-type experiences. However, the ‘traveller’ also retains complete personal control and is able to effortlessly emerge from the experience at any point. No substances or plant medicines are used and they do not need to be in order for the process to be effective. Guided Imagery and Music is a technique developed by Helen Bonny after working alongside the renown psychedelic researcher Stanislov Grof in LSD trials of the sixties. Bonny developed a “non-drug, psychedelic technique of music-listening for psychotherapeutic ends.”

This music-listening technique takes place in a 1.5 hour session, the traveller comfortably lying on a couch in an undisturbed, safe and comfortable setting (such as a therapist’s room). During the session, the guide will talk with the client/traveller and work toward setting an intention for the journey. A specific music program that relates directly to the traveller’s mental set and intention – a music program designed to elicit imagery, emotions, memories and even sensations – is selected by the guide. The traveller is taken through a deepening relaxation induction and reminded of their intention. When the selected music plays, the traveller journeys with the music in this deepened, relaxed and in fact altered state of consciousness.

Imagery, storylines and emotions may appear, sometimes sensations and memories, all emerging from the unconscious mind and guided by the music. During this process, the traveller is always free to ‘come out’ of the experience, should they want to. This is unlike a substance-based psychedelic experience, such as a psilocybin journey, where one is locked into the journey until the substance/medicine wears off. The guide asks questions and helps to deepen and intensify the experience. Afterward, the traveller makes marks on paper (creates a mandala), which is a creative output that helps to solidify and integrate the journey and is used for verbally processing the experience.

Guided Imagery and Music sessions are usually conducted once a week over a period of time, as personal narratives, archetypal material and images from the unconscious are developed and worked with.

If you are interested in exploring your consciousness through an alternative, experiential and substance-free way, click here. Offered in Cape Town, South Africa.

Note: BMGIM guides require extensive and rigorous training. I am currently in advanced training in the Bonny Method of Guided Imagery and Music.

Hallmarks of a Mystical Experience

William James, in The Varieties of Religious Experience, delineated four major hallmarks of what might be described as a mystical experience.

  1. Ineffability: the individual just can’t put words to the experience, verbal description does not – cannot – do it justice or even begin to portray the authority, significance or nature of the event.
  2. Noetic Quality: the experience appears extremely significant and important for to the individual and it carries a kind of deep authority, inner knowing and personal truth.
  3. Transiency: the mystical state is not sustained as in it’s peak, but fragments, traces, parts, a felt sense and innate knowing – these do persist and are subject to ongoing development, meaning that the insights/wisdom/truths can deepen in richness and significance over time.
  4. Passivity: it is not by the individual’s active will or direction that the mystical experience occurs. Rather, the individual will is suspended for a time and it is as if the individual is ‘moved’ by something larger than him or herself (such as a higher power).

Clearly, this describes an experience that is quite enormous, powerful and outside of ordinary life experience. This is something that is remembered, owned, held tightly and nurtured. Something that becomes precious, guiding and indeed transformative in one’s life. A deep truth, knowing, reality or beauty may be revealed that is intrinsic to something ordinary, everyday and obvious. The experience of such states can be immensely powerful and transformative in one’s personal journey as well as for collective wellbeing. Does such a state have to have anything to do with religion?

It is possible but uncommon to enter such an altered state of consciousness without intention in everyday life, perhaps but not necessarily while listening to music or being in a sacred or natural space. However, there are various ways to prime for such an experience. For example, one way is through a meditation practice, another through Guided Imagery and Music, and another is through facilitated breathwork. Another increasingly acceptable and accessible way is through the use of sacred plant medicine, such as magic mushrooms (psilocybin) and ayahuasca which through their psychedelic (that is ‘mind-manifesting’) properties may occasion such mystical experiences. While mystical states and religion can seem confusingly intermingled, they are not the same thing. There are many religious people who have never had a mystical experience of this nature, while there are stalwart atheists who have. It is a human experience, not owned by any denomination, school of thought, medical practice or form of therapy. It is true that such experiences may absorb a kind of religious quality, depending on many factors such as the individual’s life experience, the place the experience occurs and even the music playing during the event.

Have you ever experienced an altered state, a mystical state or a spiritual state that relates to James’ conception?

For more information about altered states of consciousness, psychedelic integration, guided imagery and music, mind expansion, transformation and mystical states, please contact me to find out more.

References:

Griffiths, Roland & Richards, William & Mccann, Una & Jesse, Robert. (2006). Psilocybin Can Occasion Mystical-Type Experiences Having Substantial and Sustained Personal Meaning and Spiritual Significance. Psychopharmacology. 187. 268-283. 10.1007/s00213-006-0457-5.

James, W. (1902), The varieties of religious experience. New York: Longmans, Green & Co.

Pollan, M. (2018). How to change your mind: What the new science of psychedelics teaches us about consciousness, dying, addiction, depression, and transcendence. New York: Penguin Press.

Grinding Into The Pain

Embracing Pain

What happens when Pain visits a little too often, a little too long? Like an obnoxious guest who overstays her welcome, talking and talking without listening, eating and eating without offering. Well perhaps this is uncomfortable, but just bearable. After all, it is not all that uncommon. And then perhaps, what if Pain decides to visit a great deal too often and a great deal too long? What if the visitor decides not to leave? What if the talking and the eating just don’t stop – on and on and on. What are we to do then? What happens when we are held hostage?

Do we have any control over pain’s inevitable and suffocating visitations? According to the Stoic Epictetus,

Some things are in our control, while others are not. We control our opinion, choice, desire, aversion, and, in a word, everything of our own doing. We don’t control our body, property, reputation, position, and, in a word, everything not of our own doing. Even more, the things in our control are by nature free, unhindered and unobstructed, while those not in our control are weak, slavish, can be hindered, and are not our own.

Epictetus, Enchiridion, 1.1-2

The pain of loss, grief, depression, neurochemistry, external events such as motor car accidents and more – these are not in our control. This may be disheartening or even crushing when fully realised. Why am I forced to sit by while Pain visits the full reign of hell upon me? Why am I not allowed to eject Pain, to revoke visitation rights? How can I escape? Why am I not even permitted to escape my own home with what little I have left? This is a brutal invasion!

As the Stoic relates, the sense of control sought in our bitter fight against Pain is won in our thinking, our choices and our exposure to that which will help us reframe our attitude toward our relationship with pain. Ultimately, our gains are made in our own relationship with and to pain. To those experiencing true, unadulterated suffering, this idea may be received as trite or it may even be impossible to imagine. However, even where chronic mental, emotional or physical pain are involved, the ‘Enemy’ that is Pain can change into something new, something more approachable, something we can negotiate with and engage with in a more balanced relationship. Pain does not have to remain the Enemy, it can become the Teacher, the Healer, even the Beatific Vision. Never losing it’s identity as Pain, and never lessening or coming under our control, Pain’s visits – even those long, excruciating and seemingly never-ceasing visits, can be experienced differently, without fear and without loss of control. The transformation and growth, even healing, that Pain can bring – if we let it – is illustrated in the lines below.

What is pain but a reminder that we are

grinding into the ground

flung into the fight

grating against the wound

slicing into the light

walking the two worlds

lost in daylight, found in night

taking the clean medicine

gaining vision, losing sight.

There are practical steps to forging this new relationship with pain. These really depend on the individual, but in general it is not an overnight process. Meditative practices, including mindfulness techniques and yoga help many. Exercise and diet/nutrition – as insufficient as that seems in the face of enormous pain – can play a large role in re-negotiating your relationship with Pain. Broadly, relationships, spirituality, talking, creating, music, nature and stillness are all ways to explore this different way of relating to Pain.

I wish you well on your journey. For more information on renegotiating your relationship with Pain, contact me by clicking here.

Sunrise

Friend, this Peak you face is high and the climb is brutal.
When you look up, you will see darkness; when you look down, you will see darkness – I won’t lie to you.
Yes, you know this is a long, dark, cold night,
and you feel each step, each breath, is a fight.
I won’t lie to you, my friend.

You will continue the climb in these conditions, harsh, unforgiving, painful.
You will continue because you want to see.
You will continue because you have to.

Friend, when your last reserves’ last reserves have been depleted,
you will turn inward and find coldness;
you will turn outward and find coldness.
I won’t lie to you.

Listen closely, my friend, to what will happen next:
First you will feel, then you will see.
Slowly, the cold, the dark, the timelessness will be erased.
Life will become vivid and warm again.
Friend, your reserves will be restored, you will be restored.
I won’t lie to you, you will not know how to speak of your experience.
For those who have faced the Peak, it is called the Sunrise.

Let Creativity Work For You – Building teams and gaining perspective with art and music

I have facilitated creative processes drawing on music therapy, arts-based learning and experiential learning at corporates, schools, universities and NGO’s in Cape Town. While these workshops/sessions fulfil different purposes depending on the client, they are playful, creative, non-invasive and ultimately offer new or different perspectives and insights.

The workshops are most often used for team-building, personal development and conflict management. However, more bespoke or tailored options are available too, such as a workshop for women in leadership or self-care workshops for employees.

The sessions are unique, drawing from my own interest and expertise in a variety of therapeutic, creative and healing modalities, including music therapy, as listed on the home page. Sessions will usually include a number of elements, including (for example) sensitively facilitated active music making, such as djembe drumming, as well as music listening and relaxation and also art-based processes that may include pastel, paint or collage work. These creative modalities offer employees, executives or students different ways of relating to one another and different ways of thinking about problems. The Full Circle is a creative space, offering enjoyment, insight and relationship.

To enquire about a group workshop at a company, NGO, school or university, click here.

My brief foray into Dystonia: should we be ‘prescribing’ music therapy?

Music therapy can help patients with movement disorders improve motor functioning, improve mood, decrease anxiety, express and process emotions, acknowledge and confront their illness or symptoms, develop a stable identity and improve motivation for therapy.

Recently, I experienced an episode of dystonia, out of the blue, completely unexpected and rare in my case. Dystonia is a movement disorder. Muscles contract involuntarily and can spasm, often in repetitive motion, tremor and may cause the patient to physically twist.

Initially, I was intrigued. Being a music therapist, I have seen dystonic spasms and contractions in patients.  Before I was even worried for myself, I marvelled at how my body could contract, fold up, and move about like it had a mind of its own.

Soon the intrigue wore off. The uncontrolled, intensive and intrusive spasms in my face, trunk, neck and hands became tiring. All this movement. All this contraction. I could keep the contractions mostly at bay for short periods, enough to have a coffee at one of my favourite spots with a friend, although the twitches around my face, lips in particular, were still present. It was worse for me at night. When I became tired I lost the energy I needed to exert whatever control I could muster to restrain the spasms and contractions. My body would automatically seize up and contort in ways I didn’t think possible! I would lie awake for hours just being with these contortions.

I got tired. I got scared. And then I got emotional. Even my emotions stopped playing ball and ambushed me with unexpected bouts of sadness, seemingly rooted in the trauma of experiencing such an unusual degree of loss of control of my body.

man falling dystonia music therapy

About Dystonia

Dystonia is a movement disorder. Muscles contract involuntarily and can spasm, often in repetitive, rhythmical motion and may cause the patient to twist. Dystonia is sometimes painful and it may affect one’s speech. Dystonia can severely disrupt one’s lifestyle, work, social life and ability to care for oneself, depending on the severity. It can also affect one’s self-esteem, one’s sense of personal power and leave one feeling fearful. Understandably, dystonia may lead to depression, feelings of hopelessness and negative emotions because of a lack of agency and control over one’s body. Dystonia can be distressing for the patient and for the family.

As many as 250,000 people in the United States have dystonia, making it the third most common movement disorder behind essential tremor and Parkinson‚Äôs disease. It is a condition that knows no age, ethnic or racial boundaries ‚Äď it can affect young children to older adults of all races and ethnicities.

https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Dystonia

There are many causes for dystonia including:


My brief experience brought to my full attention the plight of many with symptoms of dystonia. Being a music therapist, I couldn’t help but be keenly aware of the specialised and effective interventions music therapy has to offer.

Should we be treating patients with movement disorders with more clinical music-making? Should we be ‘prescribing’ music?

Fortunately, my dystonic episode was short-lived. While it was uncomfortable, there was a great deal to learn. In my brief experience of dystonia, I tried my best to experiment with music therapy techniques and exercises. I found that while playing the piano, my symptoms were almost non-existent.  I also found that specialised music therapy exercises using vocals and tongue (or relevant body part) movement, as well as music and full body engagement exercises led to a feeling of increased agency, relief and control over my body. While I have worked with patients with dystonia, this experience afforded me an unbelievable window into the difficulty that some of these patients experience, as well as a clearer view as to how music therapy techniques are uniquely placed to offer relief, rehabilitation and experiences of freedom that may not be otherwise possible.

The research supports my experience: the¬†brighter side of music in dystonia’ shows how playing the piano, can cause an “instant and complete improvement‚ÄĚ in dystonia symptoms. This finding was unexpected because symptoms of dystonia are expected to worsen with activity. Piano playing — an active music making experience — seems to have a paradoxical effect.
Music therapists are able to treat dystonia at a musical-therapeutic level.

Music therapists view human beings musically. Our breathing is rhythm, our voices melody, our tone timbre, our way of speaking articulation, our movement form, for example. Repetitive twists and spasms can be viewed as musical events and be treated using clinical musical interventions. Music therapy, the clinical use of music processes, interventions and exercises in the music therapy relationship, can have an ordering, relieving and empowering function.

Rhythm, often with melody, used in music therapy are powerful forces for drawing the patient into a sequence of controlled rhythmic movements. Music therapists and the particular music therapy techniques helps to motivate, encourage and reward controlled movements, sometimes allowing for extended range of motion or more controlled movements.</strong> Music therapy techniques also allow a client to use their bodies more intentionally and to develop a different relationship with their body, pain or discomfort. 

Because of the musical nature of the therapy, the patient may naturally or automatically feel an inherent motivation to complete the therapeutic movement within the musical frame.  Difficult therapy sessions can be  made easier for the patient, even more enjoyable, by the medium of music, and may increases patient motivation to take part in therapy. 

We all have an innate understanding of the ability (the “power”) of music to prompt movement, restraint, expression and relief. Music therapists are highly trained and skilled in using music clinically, deliberately and specifically to work toward therapeutic goals in a way that music uniquely offers.

The transferability of these techniques into the patient’s life show great promise in the cutting edge research and practice coming out of Neurologic Music Therapy. These music therapy techniques give patients with dystonia hope and allow them to recognise that even with their symptoms, they can yet experience a measure of control and selfhood.

A music therapist will require that you have seen a medical doctor if you present with dystonia. There are also pharmacological treatment options, that should be explored. In extreme cases of dystonia or related conditions, music therapy addressing dystonia should be provided multiple times per week in order for neuroplastic rehabilitation to take¬†place.¬†There is a great deal research on music therapy and related disorders, including Parkinson’s,¬†Huntington’s¬†Disease,¬†and¬†many¬†more.

We all have an innate understanding of the ability of music to move us, prompt physical movement, restraint, expression and relief. Music therapists are highly trained and skilled in using music clinically and deliberately to achieve therapeutic goals and are doing such work worldwide, including in Cape Town, South Africa.

What do you think? Should doctors be ‘prescribing’ music making for patients with dystonia?

What would you want as part of your treatment protocol if you experienced Dystonia?

Share this page with anyone whom you think may benefit from music therapy, or who might like to know more. If you want to book a music therapy session or consultation, please email me via the contact form, clicking here.

Melissa Ellse holds a Bachelor of Music (University of Cape Town) and a Masters in Music Therapy (cum laude, University of Pretoria). She is a part-time lecturer in music therapy at the University of Cape Town and a research supervisor at the University of Pretoria. She practices as a registered music therapist in the Southern Suburbs of Cape Town. She is registered with the Health Professions Council of South Africa (HPCSA reg no AT 0001350).

Why do we ‘use’ music?

Music Therapy, Health and Self-Medication

Many of us self-medicate with music yet if asked we may not be aware that this is what we are doing. It seems we intuitively know we need music and most of us are particular about what, when and how we engage in music experiences. These six points briefly detail why we ‚Äėuse‚Äô music, and why it is such a potent medication:

  1. Music reflects, magnifies and connects with that which is greater than me, the individual. Through music experiences, I can be connected to others, to community, to purpose, to shared values, to the spiritual and the collective unconscious.
  2. Music reflects, magnifies and connects to that which is within me. Through music experiences, I can witness and experience the complexity of my emotions and psychological states, even my thoughts. I experience myself differently.
  3. Music is a temporal form. Concrete, uninterrupted time is essentially and vitally linked to experiencing music as an art form. This means that through music experiences, I experience myself in time. This also means that through music experiences, I can experience time differently and experience myself differently in time.
  4. Linked to the above point, music has an ordering function. This means that through music experiences, I can experience myself as moving in an ordered manner through time, continuously unfolding, organised, with a beginning and an ending.
  5. Music reflects and magnifies the complexities of life, which may be too subtle and nuanced to notice or make sense of, or too difficult and complex to pay attention to.
  6. Music adds context and continuity to life. Emotions are magnified when music adds context, allowing me to deepen, release or clarify my response.

Music is powerfully transformative as a healing modality. There is no trite or simple explanation how or why, as both music and the human brain are infinitely complex phenomena. I encourage my clients to pay attention to how they respond to different kinds of music as a way to ignite interest and intuition in this area and I certainly promote self-medication with music!

 

38204344_1833578016724375_7769933706361307136_o (1)Melissa Ellse, registered music therapist, completed a Bachelor of Music (University of Cape Town) followed by a Masters in Music Therapy (cum laude, University of Pretoria). She is registered with the Health Professions Council of South Africa (HPCSA reg no AT 0001350) as well as the South African Music Therapists Association (SAMTA) and the South African National Association for Arts Therapists (SANATA).

Book an appointment with Melissa Ellse by clicking here.