Critical Theory, Community Music Therapy and Conflict Transformation

Home , Critical psychology, Music therapy, Social conflict theory

Critical Theory, Community Music Therapy and Conflict Transformation:

A Critical Review of the Literature

A Thesis

Submitted to the Faculty

Drexel University

Zein Hassanein

in partial fulfillment of the

requirements for the degree

Master of Arts in Creative Arts in Therapy – Music Therapy

Department of Creative Arts Therapy

May 2018

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ACKNOWLEDGMENTS

I would like to thank firstly, my parents, Jodi and Adly, for having a little idea. Thanks to my brother and sister, Karim and Amber, for all of your faith. You believe in me more than I believe in myself. Thanks to Kate for being the best thesis advisor I could have asked for. I always felt like my ideas were important because of you. Thanks to Janelle for all of your incredible feedback, and the inspiring work you have done. Thanks to Flossie and Scott for everything you have taught me. You were always there when I needed you. Thanks to all my other professors and supervisors, I want to grow up to be like all of you one day. Thanks to my classmates. I learned just as much from all of you as I did from the professors. Thank you to my

Seeds of Peace family for being the “seed” for this capstone Thanks to my friends for being ok with me not hanging out with you while I worked on this and continuously asking me to explain my thesis, it was really good practice for trying to conceptualize it all.

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Table of Contents 1. Introduction……………………………………………………………………………………..1 1.1. Significance of the Critical Review………………...……………………………………...…6 2. Literature Review……………………………………………………………………………….7 2.1. Critical Theory and Its Impact on the Mental Health Profession……………...…..…………7 2.1.1 Origins of Critical Theory…………………………………………………………..…..…...7 2.1.2. Origins of Critical Psychology……………………………………………..…….…………8 2.1.3. Critical Psychology and Social Justice……………………………………...…….………12 2.1.4. Critical Psychology and the Creative Arts Therapies………………………..……...…….16 2.2 Conflict, Conflict Transformation and Music Therapy……………....…………….………..20 2.2.1. Conflict and Peace……………………………………………………………..…….……20 2.2.2. Psychosocial Impact of Conflict………………………………………………..…………24 2.2.3. Conflict Transformation………………………………………………………..………….27 2.2.4. Conflict Transformation and Music Therapy………………………………….………….28 2.3. Community Music Therapy…………………………………….……………...……………37 2.3.1. What is Community Music Therapy? …………………………………….……………....37 2.3.2. Community Music Therapy and Conflict Survivors……………………….….…………..43 2.2.3. Community Music Therapy and Conflict Transformation………………………………..44 3. Synthesis………………………………………………………………………………………47 3.1. Intersections…………………………………………………………………………………47 3.2. Recommendations…………………………………………………………………………...54 4. Reflection……………………………………………………………………………………...58 References………………………………………………………………………………………..63

ABSTRACT

Critical Theory, Community Music Therapy and Conflict Transformation: A Critical Review of the Literature

Zein Hassanein Katherine Myers-Coffman, Ph.D, MT-BC

The following capstone literature review explores music therapy (and allied creative arts therapies) and their impact within the realm of conflict zones and conflict transformation. It defines the traditional approaches music therapy has taken with conflict survivors as well as makes a case for a movement towards community music therapy frameworks rather than consensus model individual therapy models. Delving into the history of critical theory and the impact of critical psychology and liberation psychology, the literature review advocates for incorporation of critical theory into more music therapy education programs. This is identified as a means to facilitate more culturally reflexive anti-oppressive practices by Western music therapists working with non-Western clients.

CHAPTER 1: INTRODUCTION

Conflict is central to human experience, yet the avenues through which it manifests in our lives are constantly developing. As Augsburger (1992) wrote, it is a natural phenomenon, which is “essential to, ineradicable from, and inevitable in human life; and the source, cause, and process of conflict can be turned from life-destroying to life-building ends” (p. 5). Conflict itself exists on multiple levels, whether internal or between two people, whole ethnic groups, or countries. It can appear quiet or loud, physical or psychological, as an act of war, or an act of isolationism (Bergh, 2010; Dunn,

2008; Urbain, 2015). Since the 1990s, there has been increasing attention to the new ways conflict is experienced by people (Bergh & Slodoba, 2010). Whereas wars like the

Cold and World Wars seem relatively simple in terms of their “bi-polarization,” conflicts such as the circumstances set in motion by the dissolution of Yugoslavia, the Irish

Liberation movement of the late 20th century, or the sectarian violence in Sub-Saharan

Africa and the Middle East are much more complex (Bergh & Slodoba, 2010, Robertson,

2010, Woodward, 2012). Bergh and Slodoba (2010) call these “protracted social conflicts,” a term coined in the 1970s by conflict resolution pioneer Edward Azar referencing the Israel-Palestine conflict.

Many people, such as soldiers and civilians (Lederach, 2005), attempt to leave their home countries or are unintentionally displaced due to conflicts. The 2017 global trends reported by the UN High Commissioner for Refugees decoded that at least 22.5 million people are currently refugees seeking asylum in countries other than their own

(United Nations High Commissioner for Refugees, 2017). Refugees, who leave their countries of origin to escape political persecution or conflict, represent a variety of 2 ethnic, religious, and cultural backgrounds, making the targeted allocation of social services by host countries challenging (Comte, 2016; DeAntiss & Ziaian, 2010; Khawaja,

White, Schweitzer & Greenslade, 2008; Segal & Mayadas, 2005). Western mental health professionals have worked to develop strategies to address the refugee crisis through focusing on symptoms of trauma, feelings of isolation/depression, and acculturation stress. It should be noted that for many refugees, these interactions may be their first experience with Western approaches to mental healthcare (Inter-Agency Standing

Committee, 2007). Thus, studies have shown that a lack of cultural responsiveness by practitioners and a lack of trust/understanding of Western healing methods by refugee communities have negatively impacted success of the aforementioned outcomes (Comte,

2016; Fondacaro & Harder, 2014; May, Rapee, Coello, Momartin & Aroche, 2014).

Within the interdisciplinary field of peace and conflict studies, conclusions are being drawn regarding the role the arts (and specifically music) in facilitating conflict transformation on multiple levels. Conflict Transformation is an interdisciplinary peacemaking approach devised by John Paul Lederach (2005). It views conflicts as not simply issues that can be resolved through legislative action, but through creative action and reparatory dialogue; many nonprofit community arts organizations are at the forefront of incorporating this phenomenon into their projects (Coombes, 2017,

Gottesman, 2017; Lederach, 2005; Urbain, 2015). Theorists and arts-activists advocate for the use of music to transfer learning around peacemaking due to its accessibility across groups of people (Dunn, 2008; Urbain, 2015;). However, occasionally this accessibility can be mistaken for universality, which could lead to facilitators using music 3 in ways that are not culturally responsive and that do not achieve desired goals (Coen,

2015).

Music therapy could serve as a bridge between creativity, accessibility, and conflict transformation. Music therapists working with refugees have employed techniques such as vocal holding to increase client self-awareness and validation of feelings, folk music to aid with acculturation and instill a sense of control, and guided imagery in music to help participants reconnect with their emotions (Orth, 2005; Urbain,

2015). Despite evidence that most refugees who experience conflict display normal distress rather than disorders such as Posttraumatic Stress Disorder (PTSD) (WHO &

UNHCR, 2012), trauma and treatment of PTSD symptoms are often the focus of mental health practitioners (Hasan et al., 2016). Comte (2016) criticized the music therapy literature on treatment of refugees, arguing that in most instances, the “refugee identity” of the client was elevated over their cultural identity. This assumption subversively homogenizes refugees, uniting them under experiences of trauma, rather than developing an understanding of them as parts of a collective from their respective societies.

Comte (2016), along with many practitioners, believes that focusing purely on trauma symptoms does not provide holistic treatment for refugees and that a community- based approach needs to be incorporated. The Inter-Agency Standing Committee (IASC)

Guidelines on Mental Health and Psychosocial Support in Emergency Settings suggests that strengthening community and social support structures should be priorities to addressing clinical mental health concerns with this population (Hasan, Ventevogel,

Jefee-Bahloul, Barkil-Oteo & Kirmayer, 2016; Inter-Agency Standing Committee, 2007).

Community music therapy (CoMT) is a model that extends beyond the perspective of 4

Western healthcare paradigms by addressing conflict through building community first and then allowing trust between participants and practitioners to develop to the degree that mental health topics are more approachable (Comte, 2016; Enge, 2015; Fondacaro &

Harder, 2014; Lopez Vinader, 2015; Pavlicevic & Ansdell, 2009). Therefore, CoMT may prove successful in strengthening the community and social support structures that IASC identifies as important, thereby providing more culturally appropriate and significant treatment.

Conflict transformation, as conceptualized by Lederach (2005), is the process of viewing conflict not as something that can be simply “resolved,” but that can be observed in new light, and therefore “transformed” through critical dialogue and interaction by participants (Urbain, 2015). Often those who experience conflict carry feelings of isolation and memories of past trauma with them. If they are refugees, they also feel pressures of assimilation from the host country, leading to internalized conflict, familial disagreements, or conflict with members of the host community (DeAntiss & Ziaian,

2010; Marks, Patton & Coyne, 2011; Segal & Mayadas, 2005). Olivier Urbain (2015) argues that peace is not simply the opposite of war, but “the realization of the concept of

‘human security’ in all its aspects,” including mental health stability (p. 5). Though trauma-informed therapeutic approaches and conflict transformation approaches to working with refugees have both had documented success separately, a synergistic strategy to treatment incorporating the two within music therapy has yet to be explored. It is my interest to investigate the philosophy of conflict transformation and propose how it could be utilized by music therapists, specifically through CoMT, to effectively serve the 5 health needs of refugees and other conflict survivors interacting with Western healthcare providers.

The link to making sense of these phenomena and how they may be addressed in music therapy can potentially be found in the exploration and manifestation of critical theory. In his seminal writings on CoMT, Ansdell (2002) presents the ideology as a socially motivated contrast to the consensus model, which he describes as the traditional music therapy approach, a practice grounded in Western medical and mental healthcare strategies. As Comte (2016) argues, the consensus model of music therapy may be negatively impacting people who do not identify with Western views of mental health, and the danger of neo-colonialism within the field is looming. Critical theory, although rooted in European philosophy, is the foundation for Critical Psychology and Liberation

Psychology, which are approaches that examine the social and systemic influences on psychopathology with a goal of self-liberation of the individual from oppression (Hook,

2005; Parker, 2017; Brown, 2015). These movements have been honed in non-Western communities with the goal of connecting people who may not feel as comfortable in the

Western mental health world for a variety of reasons including, but not limited to, a lack of exposure, understanding, or trust. They examine the connection between social justice, advocacy, therapy, and peacemaking (Fox, Prilleltensky, & Austin, 2009). Although not always clearly outlined in the literature, CoMT practices are grounded in critical theory

(Ruud, 2009). I hope to illuminate the ways in which critical theory, CoMT, and conflict transformation intersect and interact with each other and the impact these interactions can have on clients who are survivors of conflict.

Significance of the Critical Review

In the introduction to Music and Conflict Transformation: Harmonies and

Dissonances in Geopolitics, Urbain (2015) discusses the poignant story of the Refugee

All Stars, a band from Sierra Leone who managed to find success internationally. The band’s description says they were “born in the midst of a violent, decade-long civil war, through music they have found a place of refuge, a sense of purpose and a source of power” (p. 1). Though this success story does not necessarily mean that the same future is ensured to all refugees, it is a source of inspiration, a possible future. It is my view that the same place of refuge should be available for all survivors of conflict whether soldier or civilian, as critical psychology aligns with the oppressed and it is rarely those who experience the worst of violent conflict that maintain the power that galvanizes it (Fox et al., 2009; Teo, 2015). The incorporation of critical theory into the creative arts therapies is largely underrepresented in literature and educational programming (Saviano, 2012). In highlighting the instances where it is a core theoretical framework, implications of this critical review could be far-reaching. They could potentially provide new insights into methods of engaging survivors of traumatic conflict, both within their native environs and beyond, which have not been explored within the music therapy forum. Doing so could lead to healthier individuals, stronger communities, and a framework for dealing with conflict that facilitates empathy, compassion and ultimately peace.

CHAPTER 2: LITERATURE REVIEW

Critical Theory and its Impact on the Mental Health Profession

Origins of Critical Theory

Critical theory is a social theory, which has its roots in the Neo-Marxist Frankfurt

School. Although referred to as a school of thought, it could more adequately be described as a movement; the foundational contributors of critical theory did not all work at or frequent the same institutions, though they originally were all from Germany, were primarily Jewish, and much of the initial work was done at the Institute for Social

Research at Goethe University (Held, 1980; Jay, 1973). The progenitors of this philosophy were scholars in the interwar period who were disillusioned by the failure of communism in Germany and had a distrust for other economic and social systems prominent at the time, i.e., capitalism and fascism. As Nazism threatened Germany in the early 1930s, many critical theorists moved to New York City and the Institute was re- established at Columbia University. It was at this stage in 1935 that the leader of the movement, Max Horkheimer, published his seminal work, Traditional and Critical

Theory (Coradetti, 2017).

In this essay, Horkheimer attempted to deconstruct theory itself. He proposed a separation between what he deemed ‘traditional’ scientific and social theories grounded in analytic research or deductive reasoning, and his critical social theory (Jay, 1973). In doing so, he rejected a prevalent view of social sciences that he considered positivistic, which is to say that social interactions mimic a set of universal laws or truths similar to scientific laws. Horkheimer, along with his contemporary, Theodor Adorno, wrote the series of essays, Dialectic of Enlightenment in 1947 (Jay, 1973). In it, they argued that 8 the social truths touted by positivist social scientists did not grasp the full picture of social interactions in the real world and were in fact rooted in their own social and historical contexts. By omitting the impact of the socio-historical contexts on their observation and postulation, positivists helped to maintain a socio-political status quo

(Held, 1980; Horkheimer & Adorno, 2002; Jay, 1973). Contrary to this, critical theorists explored the relationship between knowledge and socio-historical context. They asserted that scholars were not able to separate themselves from the world they live in, in an impartial, God-like manner, and all knowledge is situated within the larger social system, complete with the history and biases built up throughout the development of that society

(Coradetti, 2017; Jay, 1973). They were vigilant about remaining ‘critical’ of knowledge presented as fact.

Origins of Critical Psychology

As practitioners and scholars in psychology began to propose new theories based on their work, some turned to the foundational works devised by Horkheimer and other critical theorists. Although German intellectualism had a large impact on the development of Western philosophy and psychology, attention diverted after the second

World War to theories being devised within the United States (Teo, 1998). However, during this period Klaus Holzkamp, considered the forefather of Critical Psychology, was actively devising a theoretical framework that built upon the philosophical ideology of the Frankfurt School in Berlin (Osterkamp, 2009; Teo, 1998). At its core, their ideology was that the bourgeois society had underpinned society with a system that benefitted them and misrepresented the population. Their role was to uncover these narratives in realms of society that were not purely economic, as Marx had previously done (Jay, 9

1973). Furthermore, they believed in the importance of a dialectic method, rejecting the idea that philosophical systems, including their own, are closed and cannot be debated

(Jay, 1973). Unfortunately, the work of Holzkamp is not widely studied within the United

States, as much of his writings were never translated into English (Teo, 1998).

During Holzkamp’s early professional years, there were widespread movements internationally (mostly youth-led), which challenged the roles of the institutions that had been established around them more than previous decades. These included the anti-war and pro-civil rights movements that were taking place in the United States and parts of

Europe. People asked why they had to participate in systems (such as military draft), which they had no part in devising (Hall, 2011; Osterkamp, 2009; Teo, 1998). Holzkamp proposed a similar approach be taken to the field of psychology, as the Frankfurt School had done with philosophy, questioning the empiricist nature that the field had adopted to legitimize itself as a “new” science (Teo, 2015). He adopted a viewpoint akin to social- constructionism, adding the notion that as psychology attempted to become more empirically founded by codifying psychosocial phenomena into measurable data points, a divergence was created from the social contexts of the phenomena, which obstructed the full picture and therefore one’s understanding of it (Teo, 2015; Osterkamp, 2009).

As with the original Frankfurt School theorists, the movement’s roots in Marxism meant that critical psychology was deemed an approach meant to emancipate the working-class people from the oppressive control of the wealthy elite (Teo, 1998). In his critical-emancipatory period (1968-1972), Holzkamp’s definition of criticism focused around three central themes: questioning the importance of psychology and who it served, determining the subversive assumptions of psychology, and problem solving 10 traditional methodology (Papadopoulos, 2009; Teo, 1998). These questions became influential in the development of qualitative research methods in psychology and in the field of liberation psychology (Burton & Kagan, 2009; Martín-Baró, 1994). Ultimately,

Holzkamp concluded that traditional psychology viewed individuals as concrete and society as abstract, a derivation of bourgeois intellectualism (Teo, 1998). This perspective, in the eyes of critical psychologists, was contrary to the reality of the world in which they worked, as the influences of external political, economic and social forces, strongly impacted individuals.

Osterkamp (2009), a fellow German critical psychologist (and coincidentally

Holzkamp’s wife and colleague at the Free University of Berlin) discussed the “one- sidedness” of traditional psychology. In her view, the field of psychology had developed with a limited lens, whereby too much attention was focused on the individual experience as separate from the influence of society (Osterkamp, 2009). Consequently, the complexity of the individual’s interactions within prevailing social narratives was minimized in mainstream psychology (Osterkamp, 2009). However, she acknowledged the challenge in addressing the dichotomy of individual-society interactions as well.

Simply integrating other social sciences into psychology can dilute the psycho-analytic approach such that systemic/societal influences are a “limiting instance”, especially if the integrated theories borrowed from other social sciences themselves do not adequately address the dichotomy (Osterkamp, 2009, p.168). This prevents social sciences from developing a quantifiable determination of the subjective interaction between the individual and society. Osterkamp’s (2009) solution to this paradox was through exploring the unity of the individual’s subjectivity and “societability” (the term she used 11 to describe an individual’s functioning within society). However, Osterkamp (2009) asserted that this was not enough. Beyond expanding the lens through which we view the individual (to include society), critical psychologists must also question the biological preconditions that required us to produce the individual view in the first place.

Osterkamp’s (2009) critical examination of her own theory is a strong example of the reflexivity present at the core of critical psychology.

Despite many writings on critical psychology, it is often difficult to parcel out the unified perspective of the movement, partially because of the name, and partially because, as with many social sciences, it has been used as a framework to explore a variety of phenomena. Inspired by the social movements of students in Europe in the

1960s and 70s, Holzkamp attempted to build a framework through which scholars might criticize the aspects of the social sciences that had been accepted without question; however, the idea was often met with confusion (Papadopouous, 2009). For those attempting to study critical psychology, the term was often misappropriated to describe movements of students literally critical of psychology and who wished to dismantle the field as a whole, rather than as a restructured, open, dialectic philosophy (Teo, 1998;

Parker, 2015). Ultimately, attention to German critical psychology dwindled as the world changed, and universities hired less critical psychologists. Arguments were made that

Holzkamp’s ideas were more theoretical than applicable, contrary to other theories such as cognitive behavioral theory. The emergent resolution however, and one which is foundational to this literature review, is critical psychology’s ties to social justice and post/anti-colonial practices in therapy (Teo, 2015; Teo, 1998; Hook, 2005; Fox,

Prilleltensky & Austin, 2009) 12

Critical Psychology and Social Justice

In their book chapter, Critical Psychology for Social Justice, Fox et al. (2009) challenged the notion that “mainstream” psychology (or what Holzkamp might have called “traditional” psychology) does enough to address the field’s ethical obligation to

“promote human welfare” (p. 3). The authors implied that ethical values of beneficence and nonmaleficence can be practiced within traditional psychology settings, but therapists might still be participating in a system that oppresses their clients, thereby contradicting their own ethical guidelines. Through an emphasis on empiricism, they argued the field ends up doing little beyond maintaining a status quo, which allows dominant institutions to maintain social, political, and economic power as well as cultivate inequality and oppression (Fox et al., 2009). The authors elaborated, suggesting that psychology itself is an institution with power which is exerted over oppressed people, a juggernaut seeking to engulf all viewpoints that do not match its own.

Teo (2015) echoed this statement, implicating Western psychologists in the oppression of the colonized. He argued that the field carries an often-understated racism, ethnocentrism and colonialism. He referenced Edward Said’s (1979) Orientalism, asserting that mainstream psychology, though claiming to develop universal knowledge by observing colonized peoples’ conceptual frameworks, does so through coaxing and intimidation without ever actually attempting to truly listen to or learn from them. Fox et al. (2009) were adamant that the psychology most commonly practiced is in Western society, yet it is still its own form of indigenous psychology (a term often used to describe non-Western people) with its own roots in individualism, nationalism,

Christianity, and capitalism. Yet, this was often taken for granted by practitioners, who 13 have not examined the contexts through which they practiced their work. Fundamentally,

Western (as Teo states, mainly American) psychology assumes that it is “world psychology, and that…clinical categories can be used without modifications around the world” (Teo, 2015, p.121).

The quandary faced by many “mainstream” therapists is that by looking at an individual’s issues, within the context of their immediate environment or circumstances, the therapeutic response can differ greatly from client to client, regardless of the objective similarity of their experiences, even if the issues present as similar. Fox et al. (2009) viewed this as reductionist, stating that a critical psychologist would widen their lens further to apply a systemic view of the issue. This inevitably leads to a desire to approach the issue with a goal of systemic change, as working to make the individual’s personal experience better does not serve to impact the system affecting their experience. By convincing a hypothetical individual that their issue can only be solved individually

(within their own therapy sessions, for example), it isolates and discourages them from advocating against the social systems contributing to their issues.

Critical psychology seeks to deconstruct dominant narratives or ideologies that are typically maintained without question. Examples include the idea that one ‘gets what they deserve’ or ‘hard work pays off’. These narratives keep marginalized people burdened by systemic oppression, from self-actualization or liberation (Fox et al., 2009).

Paulo Friere (1972), father of critical psychology’s educational cousin, critical pedagogy, described these as “limit-situations,” or the oppressive forces keeping people from developing a full understanding of the world that can only be combatted through the 14 development of critical consciousness. Critical psychologists seek to develop this consciousness both within their profession and alongside the clients they serve.

It is important to note that critical psychology has spawned its own variations in different regions of the world, designed to work with the needs of the people indigenous to those environs (Teo, 2015). The most well-known of these variations is liberation psychology, an approach developed by El Salvadorean priest and psychologist Ignacio

Martín-Baró, a contemporary of Friere. Martín-Baró was assassinated by his own government for his views, which challenged the oppressive political forces of Latin

America in the last three decades of the 20th Century (Teo, 2015; Lykes & Sibley, 2014).

Martín-Baró’s assessments of the deterioration of the mental health of his fellow El-

Salvadorans, regularly impacted by the trauma of civil war, led him to reconstruct psychologists’ role in their interaction with people, aligning them with the oppressed rather than remaining an impartial witness (Moane, 2003). This resulted in the development of community action projects aimed to unite people over their shared humanity, an active intervention against the polarizing impact of civil war, which mandated people take a side regardless of their understanding of the circumstances

(Lykes & Sibley, 2014; Martín-Baró, 1994).

Martín-Baró’s impact within Latin America (and beyond) cannot be understated.

He was lauded and viewed as an altruistic community leader by participants and students alike (Portillo, 2012). Many of his colleagues and students have kept his ideas alive through retrospective writings and the creation of the Martín-Baró Fund, continuing to support community-based anti-oppressive efforts (Jiménez-Domínguez, 2009; Lykes &

Sibley, 2014; Portillo, 2012). His concept of de-ideologization – receiving the original 15 experiences of people then giving it back to them as objective information so that they may begin to examine it more critically– is still used by social psychologists today

(Burton & Kagan, 2009). Madrigal and Tejeda (2009) used de-ideologization to educate men in El Salvador about gender-based violence. Results from surveys they conducted after the implementation of the method suggest that ideologies in men who participated shifted. Men reported improvement in family relationships an increase in their inclination to advocate for women’s rights in the future (Madrigal & Tejeda 2009). In identifying the differences between Western social psychology and Latin American Liberation

Psychology, Burton and Kagan (2009) proposed a method for how Martín-Baró’s de- ideologization might become more applicable in Western society. They refer to their approach as “really social psychology” (p. 65) and describe it as “avoiding the errors of individualism, relativism, value freedom and parochialism” (p. 65).

Beyond liberation psychology, other movements evolved out of the rejection of a uniform Western psychology. Hook (2005) used the critical lens to examine the psychology of post-colonial people, primarily in South Africa, but with observations that could provide inferences for other post-colonial nations and the hopes for a deeper level of research and understanding such that psychologists may learn to “decolonize the mind” (p. 496). Similarly, Virgilio Engriquez (1994) explored the Philipino perspective in his book, From Colonial to Liberation Psychology: The Phillipine Experience.

Psychologists under the banner of Sikolohiyang Pilipino sought to devise an approach devoid of the judgement of Western colonizers, from the eyes of Philipinos (Pe-Pua &

Protacio-Marcelino, 2000). 16

Critical theory forms the foundation of multiple lenses including feminist, queer and disability theories (Teo, 2015). These theories seek to examine power dynamics and advocate for liberation from oppression (Asch, 2001; Brown, 2017; Butler, 1990; Teo,

2015;). It should be noted that despite its large potential, critical theory is not studied widely in mental health graduate programs, limiting its application by professionals

(Saviano, 2012). More research should be conducted regarding the way critical theory is being approached in educational programs versus its applications in practice. In summation, the field of critical psychology is broad with limits which have yet to be reached, but the emphasis on power dynamics, critique of dominant discourses and decided need to politically advocate for the oppressed is at the center of all who practice it (Fox et al., 2009; Parker, 2015; Teo, 2015).

Critical Psychology and the Creative Arts Therapies

The relationship between critical theory and the creative arts is evident, though not always explicit in the literature. It has only been in recent years that practitioners and scholars have called for therapists to adopt the moniker of “critical creative arts therapist”

(Hadley, 2013; Marxen, 2008; Sajnani, 2012). One clear example of this intersection is the use of photovoice, which has been widely utilized in social sciences. This approach was first developed by public health researchers Wang and Murris (1997), grounded in

Friere’s theories of critical consciousness, as a means of giving a voice to oppressed people (in their case, Chinese women living in villages in the poor Yunnan Province) to advocate for systemic changes in their communities.

Liberation psychologists Lykes and Hershberg (2015) modeled their participatory action research projects with migratory Mayans, survivors of Guatemalan civil war, after 17 the precedents set by Ignacio Martín-Baró. In another project Lykes incorporated photovoice as a central technique for empoweringMayan women to represent their own

‘protagonism’ (Lykes & Scheib, 2015). In both cases, the researchers denoted the limitations of photovoice, namely the potential negative attention that could be brought onto the already oppressed people who are documenting their experience. This illustrates its own power dynamic in that the therapists, operating from a position of power, put their participants into a state of potential harm, in order to source information. In certain communities, drawing attention to the injustices present in society may allow for those in power to target those who seek to change the system (Wang & Murris, 1997; Lykes &

Scheib, 2015). This author believes that said unwanted attention could result in possible conflict, social isolation, exile or in some cases, such as that of Ignacio Martín-Baró, death. While this does present an important ethical issue, the actions of Martín-Baró suggest that the therapist has to be prepared to face the same ills that may befall their clients, to stand with them in the face of their oppressors.

Drama therapy has been equipped to explore themes of oppression and power for decades due to the foundational work of the Theater of the Oppressed, a body of theater exercises and techniques devised by Augusto Boal (Sajnani, 2012). A Brazilian theater practitioner and contemporary of Friere and Martín-Baró, Boal’s treatise on theater drew from the philosophies of Hegel (an early inspiration of Frankfurt School theorists) and the productions of Brecht, the famed Marxist director and playwright, to create a basis through which the people of Latin America could produce works that challenged the status quo in their societies (Boal & McBride, 2008). As one might imagine, he was viewed as a threat by those in power and was exiled from Brazil, though his ideas spread 18 to the United States and Europe. Sajnani (2012), an American critical drama therapist, incorporated Boal’s exercises into her work. She stated that through the use of theatre exercises and ‘embodied techniques,’ therapists and clients are able to untangle their relationships to oppression by taking the roles of their oppressors or rewriting their own narratives. The ‘games’ devised by Boal have been used with populations and goals as diverse as building self-efficacy and empowerment in homeless women in Connecticut to raising awareness about toxic chemicals in communities close to power plants in the Rio

Grande to its initial application working with poor Brazilians in the favelas (Boal, 1979;

Sullivan, et al., 2008; Woodson, 2012).

In her article Dominant Narratives, music therapist Sue Hadley (2013) explained how her identification of the prevailing narratives surrounding her led to embracing critical theory. In developing a critical consciousness, she discussed how she used theory in therapy to disrupt the narratives rather than continue to try and assist “individuals to function more adequately in a system/world not wired for them” (Hadley, 2013, p.374).

The first way she did this was through examining power differentials with clients and emphasizing transparency. This meant not simply seeking out cultural music of her clients to appear culturally competent, but being explicit about her whiteness and the other privileges she may have over her clients with them.

The second way Hadley (2013) disrupted the dominant narratives was through the fostering of ‘response/ability’. In this instance, the slash in the word, devised by drama therapist Nisha Sajnani, refers to the therapist’s ability to respond to the immediate presenting pathologies of the client and against the oppressive systems that illicit them simultaneously within the creative, collaborative process (Hadley, 2013; Sajnani, 2012). 19

Despite her calls for music therapists to critically examine the ways in which they may perpetuate dominant narratives and, as such, oppress clients whose identities are contrary to said narratives, Hadley (2013) did not provide a list of practices which might serve as guideline for a “critical music therapist”.

Rebecca Zarate offered her approach to applying a critical lens to music therapy practice in Critical Perspectives in the Arts Therapies, an article she co-authored with

Sajnani and art therapist Eva Marxen (Sajnani, Marxen, & Zarate, 2017). Informed by culture-centered and aesthetic music therapy, Zarate, utilized critical social aesthetics, a framework aiming to acknowledge the cultural differences between therapist and client within improvisation (Sajnani et al., 2017). By paying attention to how the aesthetic experience could provide context regarding the client’s (or her own) culture, she explored the power dynamics and examined why or why not music decisions may occur. Zarate also proposed the phenomenon of what she called “clinical listening-cultural listening”.

Within an improvisation, her role is to be intentional, reflexive (which in this case is akin to Sajnani’s response/able), aware of the multiple layers of listening to the improvisation

(hers, the client’s, society’s and beyond), and aware of culture projections on the music

(both her own and her client’s), with the goal of honoring, exploring, and uncovering the shared roots of the symptom (Sajnani et al., 2017). In this statement, Zarate implies the societal/systemic role present in her client’s pathology.

Within the art therapy modality, discussion often turns to the accessibility of art and its historic position as an elitist field (Sajnani et al., 2017). Art is often displayed in institutions and financial or educational limits can prevent people from exploring it. This contributes to the anxiety clients may feel in trying to produce it in therapy (Marxen, 20

2008; Nolan, 2013). However, recent contemporary art has focused much more on community involvement and interaction (often called social practice art) and is drastically different in terms of motivation and accessibility than the cannon held in museums

(Marxen, 2008). As Nolan (2013) explained, clinical diagnosis has no space in her therapy sessions, and is simply “a way to manage relationships with insurance providers”

(p.179). The practice requires adopting a radical acceptance of the client’s knowledge of their objective experience contrary to the dominant narratives around their pathology.

One possibility as to why critical theory is not widely utilized within the creative arts therapies as much as other theories is due to how closely the demographics of practitioners within the modalities mimic those of the oppressors (i.e. White, cis- gendered, heterosexual, middle-class, well-educated, able-bodied) and, as such, there is less awareness of the need to operate critically within the profession (Fox et al., 2008;

Hadley, 2013). For example, in a study conducted in 2013 on American Art Therapy

Association members, over 90% identified as white females (Awais & Yali, 2013).

Gipson (2015) identified this in her critique of art therapy pedagogy. As a black professor who teaches mostly white students, she finds they are often apprehensive to discuss issues of race or other identity markers with her, which undoubtedly leads to a workforce less willing to engage in critical therapy with clients (Gipson, 2015).

Conflict, Conflict Transformation, and Music Therapy

Conflict and Peace

Having established a critical lens in the creative arts therapies, the following section explores the current literature discussing the intersection of conflict, psychology, the creative arts, and conflict transformation efforts. This is done with special attention to 21 the therapeutic applications of music. It explores music as a tool in the transformation of conflict and its associated negative outcomes for people presently or formerly involved in a conflict. For the purposes of this critical review, it is imperative to define conflict.

However, this is rather challenging to do. As Augsberger (1992) illustrated, conflict is something universally experienced, yet its appearance, degree, and impact can vary. It can be an intimate interaction such as an argument between loved ones or can affect multiple people such as the unifying trauma of sectarian violence or war (Johnston, 2010;

Urbain, 2015). Conflict transformation theorists and practitioners assert that it can sometimes even be a creative process that does not lead to a negative outcome (Galtung,

2000; Bergh, 2010).

Johan Galtung (2000), founding theorist and practitioner of peacebuilding and conflict transformation, noted all conflicts large or small in terms of social impact have a common set of criteria and natural progression. They emerge out of two or more parties having certain goals. If these goals are incompatible, a contradiction emerges. This leads to negative attitudes or disdain, and, eventually, outward aggressive behavior and even violence. However, it is notable that this is a theoretical description of conflict and often multiple parties with competing goals are involved in creating what is called complex conflict. Indeed, cultural identities are often built out of the violent results of these circumstances, which complicates the situation for survivors and those trying to support them in social or healthcare realms (Robertson, 2010).

Many of the conflicts discussed in this literature review are commonly regarded as ‘protracted social conflicts,’ which occur outside of Western nations (Azar, Jureidini &

McLauren, 1978; Bergh & Slodoba, 2010). This implies a long-term conflict 22 characterized by sporadic flare-ups. While less common in the West, they could be likened to the experience of people living in low-income communities historically impacted by gang violence (McFerran & Wölfl, 2015; Skyllstad, 2015a). An example of such a conflict, which has been explored by many in the field of peace and conflict studies is that of the Bosnian war in the 1990s. The fracturing of the former Yugoslavia led to a humanitarian disaster and the contradiction of goals between many ethnic, religious, and political groups; these groups were generalized into Croats, Bosniaks, and

Serbs, though contradiction exists within these groupings as well (Bergh, 2010; Galtung,

2015; Heidenreich, 2005; Robertson, 2010; Woodward, 2012). It should be noted that identities themselves do not explain conflicts. For example, to imply that the Rwandan

Genocide happened because the Hutus and the Tutsis hated each other is an oversimplification. It limits participants to singular identity markers, rather than trying to understand their full humanity or the colonial context that history shows directly led to the Genocide (Mamdani, 2001). Bergh (2010) remarked that it is in fact identity politics that breed conflict. Some identity markers are chosen, while others are forced on to people by the societies they live in.

Indeed, conflict survivors are a diverse group that includes refugees, internally displaced people, soldiers, and those actively living in conflict zones (Lederach, 2005).

Their involvement in the conflict may be active and intentional, or they may be caught in a situation they did knowingly enter. It is important to note, that regardless of intent, often those most affected by conflict are those without the power to make larger political decisions (Bergh, 2010; Lederach, 2005; Wagner, 2015). 23

Peace is as difficult to define as conflict, and many within the interdisciplinary field of peacebuilding and conflict transformation approach it from contrasting angles

(Johnston, 2010). Lederach (2005) described it as a transcendence of the cycles of violence that occupy communities, while still living within those communities. Galtung

(2015) asserted peace runs contrary to conflict, yet it is not simply its opposite, as it involves a process that must be maintained in reactive aftermath of a conflict. He calls it a realization of the “concept of ‘human security’ in all its aspects” which includes mental health and wellness (Galtung, 2015, p.5). Galtung’s (2015) TRANSCEND method proposes that peace is not simply the absence of needs, but an engagement in the creative act of devising reconstructive and reconciliatory means to meet them. It is a method that is utilized widely in conflict transformation groups including United Nations peacekeepers.

When applying a humanistic lens, one can state that peace envelopes all levels of

Maslow’s hierarchy of needs, from physiological and safety, to love/belonging and self- esteem, and ultimately self-actualization (Maslow, 1943). Peace is a factor contributing to their attainment as it is the counter to violence, which impacts physical safety and can cause ruptures in loving relationships (through death, imprisonment, betrayal and more).

It is common for those who bear witness to or commit violent events to feel guilt, whether due to surviving when others do not, or for committing atrocities, which negatively affects self-esteem and motivation towards self-actualization (Kanyangara,

Rimé, Paez & Yzerbyt, 2014; Noor, et al, 2008).

Galtung (2000) had his own list of basic needs that are more directly related to peace and conflict: survival, well-being, identity, and freedom. Both Maslow and Galtung 24 would agree that the destructive nature of violent conflict robs people of their basic needs. The examples of this in the world are extensive. Similar to the Bosnian war, though longer in duration, is the Palestinian-Israeli conflict; violence and apartheid have torn families apart, led to countless deaths, impacted access to social services, and injured the self-esteem of individuals (Abi-Ezzi, 2015; Nets-Zengut & Bar-Tal, 2014; Urbain,

2015). This can especially be said for Palestinians living in Israel as citizens, who often experience personal struggles to define their identities with the context of their society

(Gottesman, 2017).

Psychosocial Impact of Conflict

Galtung (2000) proposed conflict can be divided into three phases: before, during, and after violence. While survivors should be supported through all these phases, much of the psychosocial research looks at people in the aftermath of violent conflict. Indeed, this is useful as it allows us to examine the way that conflict can reshape communities

(Bergh, 2010). An unfortunate reality is that many people who wish to avoid conflict and try to leave their environments end up facing other daunting challenges as a result. The

United Nations High Commissioner for Refugees (2017) reported that at least 22.5 million people are refugees seeking asylum in countries other than their own, out of 65.6 million forcibly displaced people. Refugees who travel from various and culturally diverse places to mostly homogenous communities can be seen as a burden to host countries who struggle to provide them with appropriate social services (Comte, 2016;

DeAntiss & Ziaian, 2010; Khawaja, White, Schweitzer & Greenslade, 2008; Segal &

Mayadas, 2005). The impact of diaspora is the perpetuation of contrasting ideologies beyond the borders of their initial conflicts, as many within a diaspora carry a collective 25 memory with them, and feelings are often left unresolved (Bhatia & Wallace, 2007;

Mahmoud, 2011; Nets-Zengut & Bar-Tal, 2014).

Regardless of the status as displaced people, soldiers, or civilians, the literature suggests survivors of conflict confront a recurring set of psychological issues. Primarily, there are stress disorders such as acute stress disorder and post-traumatic stress disorder

(PTSD), as well as comorbid anxiety, depression, and drug abuse (Annan & Brier, 2010;

Moscardino, Scrimin, Capello & Altoe, 2009). Sutton’s (2002) historical inquiry into the definition of trauma described its insidious nature. For most people with PTSD, the symptom onset occurs within 48 hours of the traumatic even, though the diagnosis is made after 1 month has passed. Symptoms include flashbacks, increased and consistent arousal, dissociative tendencies, and numbing or emotional ‘flatness’. These create an internal conflict in people with PTSD, which impacts their ability to confront their past and attend to their present needs. In effect, the symptoms of PTSD transform the trauma from a singular event into a constant battle. Sutton (2002) proposed how trauma “is enmeshed in an internal process of an attempt to assimilate how the event has irrevocably affected the individual” (p. 24).

Many people in conflict zones witness or are survivors of indescribable violence and destruction, and they struggle in the aftermath to make sense of atrocities committed.

This categorizes the trauma as more than a singular event as it is often referred in trauma- informed literature (Sutton, 2002). As Neuner et al. (2004) noted, the conditions created by organized violence, namely poverty, isolation, lack of safety, and changes in family structure, all impact mental health negatively. Studies have shown that women (displaced or not) experience high rates of physical, psychological, and sexual violence from 26 unknown subjects and intimate partners alike (Annan & Brier, 2010; Horn, 2010; James,

2010). In some cases, the act is meant to degrade survivors, in others it is a tool for ethnic cleansing (Horn, 2010; James, 2010). Sometimes it is an act of rejection by family members, such as in the case of former female child soldiers in Uganda who attempted to reenter their communities after being kidnapped, manipulated or forced to commit violent atrocities towards civilians, and often sexually abused by alleged spiritual leader and warlord Joseph Kony and his associates in the Lord’s Resistance Army (Annan & Brier,

2010).

It is important to note that there is debate as to whether using Western-healthcare diagnoses is useful for survivors not from non-Western cultures, as it can be seen as neo- colonialist (Bracken, Giller and Summerfield, 1995; Comte, 2016; Miller & Rasmussen,

2010; Neuner et al, 2004; Neuner and Elbert, 2007). This presents a challenge when interacting with asylum seekers in Western countries or when Western health workers are involved in humanitarian work in non-Western conflict zones, as the cultural divide between healthcare professionals and their clients may be quite large. By adopting a critical lens, some Western healthcare practitioners are attempting to bridge the cultural gap through integrating critical theory into their examination of conflict survivors. Miller,

Kulkarni and Kushner (2006) described what they call “trauma-focused psychiatry epidemiology” as focused on information that is not actually relevant to community health workers. They pointed to religious leaders as allies in healthcare and focused on building international communication between people who have experienced similar circumstances. This included connections between former child soldiers in different 27 conflicts to learn coping techniques from each other rather than through traditional

Western therapy paradigms.

Conflict Transformation

The field of conflict transformation grew out of an inherent desire on the part of survivors and witnesses to minimize violent conflict and its outcomes in the world and to work towards peace (Galtung, 2000; Urbain, 2015). Though a term often used interchangeably with conflict resolution, there are distinctions between the two from an ideological perspective. Conflict resolution as a field rose out of the Cold War in subsequent efforts to prevent ‘mutually assured destruction’ during the nuclear arms race of the time (Dunn, 2008). In his book, The Moral Imagination, John Paul Lederach

(2005) criticized traditional conflict resolution views. He argued that scholars motivated by an empiricist desire to categorize conflict end up minimizing its complexity. These scholars saw conflict resolution as a linear process in which violence increases until a peace agreement is met, and then the conflict diminishes rapidly. This perspective hinges on the assumption that a statistically demonstrable decrease in violence means that peace is inevitable (Lederach, 2005). It also implies that conflicts can be easily resolved through signing of a political document, often facilitated by external parties who may have a limited understanding of the intricacies of the situation (Bergh, 2010; Kaufman,

1996). In contrast to this, Lederach (2005) argued that conflict is nonlinear and cannot be rectified through a single legislative measure. Rather, it can be transformed through a creative reframing of factors and goals, while promoting reconciliation, reparation, and dialogue between groups. 28

Conflict transformation is founded on Galtung’s (2000) concept of positive peace and negative peace. In negative peace, targeted violence is diminished, yet the circumstances are still present for conflict to emerge (Bergh, 2010; Galtung, 2000). Often brought up in literature about conflict transformation is an emphasis on creativity (what

Lederach (2005) refers to as the moral imagination), and its role in transcendence.

Galtung (2000) defined transcendence as the ability to create a new reality that satisfies the goals of all parties without having to declare anyone a winner or loser in the conflict

(which war ultimately does). Rather than try to end something that is not desired (i.e. conflict resolution), it aims to end the things that are harmful, and build something desired (Dunn, 2008; Lederer, 2005). Miall (2004), in attempt to create a uniform theory, called it the “process of engaging with and transforming the relationships, interests, discourses and, if necessary, the very constitution of society that supports the continuation of violent conflict” (p. 4). In this way, conflict transformation examines conflict from a systemic viewpoint. Beyond creativity, core conflict transformation principles are nonviolence and empathy (Bergh, 2010; Dunn, 2008). These qualities are expressed through the practices of mediation, reconciliation, and facilitated dialogue, where parties are invited to voice their grievances with each other and explore potential solutions (Bergh & Slodoba, 2010; Galtung, 2000; Miall, 2004).

Conflict Transformation and Music Therapy

Since the Cold War, peacebuilding has shifted significantly from being a top- down approach controlled by small groups of politicians, to being the work of non- governmental organizations, including mediation groups and artist-activist organizations, operating in large numbers from the ground-up (Gottesman, 2017; Lederach, 2005; 29

Slodoba & Bergh, 2010;). Indeed, as protracted social conflicts continue to occur, the number of displaced people rises (Internal Displacement Monitoring Centre, 2017).

Meanwhile, as the world globalizes, and news of foreign conflicts spreads via the internet in the West, more creative arts therapists are exposed to stories from conflict zones and are interested in using their skills to contribute to the conflict transformation field (Bergh,

2010). The first well-known music therapist to identify the field’s unique potential impact in peacemaking was humanistic therapist Edith Boxill, who founded Music Therapists for

Peace in 1988 (Lopez Vinader, 2015). However, the organization has not been maintained despite passionate advocacy from therapists such as Lopez Vinader (2015) and Ng (2005). As such, while there is a historical precedent for music therapists to work with conflict, many of the projects have been in the last decade, and there has been no unified approach for working with populations affected by conflict, whether they are displaced or residing within the conflict zone (Bergh & Slodoba, 2010; Johnston, 2010;

Ng, 2005; Urbain, 2015).

Before discussing what music therapists have done to address the needs of conflict survivors, it is important to address the notion of why music might be a useful therapeutic tool in the context of conflict. While the common answer might be its presence in most (if not all) human cultures, one should be cautious of this as reason alone. As Comte (2016) made clear in her critique of music therapy literature on refugees, the assumption that therapists will be able to connect with people solely through music, is just that: an assumption. It ignores the cultural differences that may exist between therapist and client, which may be damaging to the relationship. Coen (2015) echoed this sentiment, questioning the “universality” of music. 30

She noted that between cultures the function of music in society varies. She identified the limits of cross-cultural musical understanding using the Bosnian war as an example. At the time, both Serbs and Croats produced large numbers of patriotic anthems to cultivate a national identity. After the conflict, Serbs who heard their songs were filled with nationalistic pride. However, when they heard the Croatian music, they were struck with feelings of dread. The opposite was true for Croats. Music, for its benefits, has been used to promote violent agendas prior to the outbreak of violence itself, as in the case of

Al Qaeda’s recruitment music or pro-Nazi music at the Nuremberg rallies (Bergh &

Slodoba, 2010; Coen, 2015; Kent, 2015). It has been used as motivation for soldiers, and as a torture mechanism (Cloonan & Johnson, 2002).

Yet, as music therapists understand, the impact of music therapy on a person is conditionally based on the appropriateness of the interventions and the strength of the therapeutic relationship, not simply the music itself. Physiologically, experiencing relaxing music has been demonstrated to effectively decrease cortisol levels in men, and increase oxytocin, minimizing aggressive behaviors (Ooishi, Mukai, Watanabe, Kawato,

& Kashino, 2017). Music therapy, which borrows from cognitive-behavioral approaches and incorporates psychoeducational forays into the nature of anger and how to cope, has been shown to decrease aggression in participants as well as increase prosocial behavior

(Hakvoort, Bogaerts, Thaut, & Spreen, 2015; Skyllstad, 2015b). It has been used to treat

PTSD and symptoms associated with trauma since the Vietnam War (Ng, 2005; Landis-

Shank, Heinz & Bonn-Miller, 2017). The majority of parties involved in creative arts therapy as a tool for conflict transformation use it to address psychological symptoms in survivors rather than the many other goals of conflict transformation such as changing 31 pervasive negative perspectives or visualizing alternate realities for communities in conflict (Bergh & Slodoba, 2010). Shank and Schirch (2008) categorized arts-based conflict transformation projects into four broad areas: waging conflict nonviolently, reducing direct violence, building capacity, and transforming relationships.

Within music therapy specifically, the focus has mostly been on the fourth category, transforming relationships. This is due to music’s ability to access our emotional and empathetic selves. In her book chapter, Music and Empathy, Felicity

Laurence (2015) examined the processes leading to empathetic relationships. She defined an empathetic relationship as the opposite of a power relationship. Through cooperation, non-manipulation, support, and a desire to know the other, Laurence believed an empathetic relationship can be developed. She also advocated for these values in the music making process. Musician-activists and music therapists have been incorporating these values into work done to facilitate conflict transformation in Israel and Palestine, where a protracted social conflict has been raging for over 50 years.

For example, Heartbeat.fm is an organization that brings together Palestinian and

Israeli youth to perform music written collaboratively to amplify their struggles growing up in a conflict zone and work towards empathy and reconciliation (Heartbeat, 2018).

Project Bethlehem combines human rights education and music therapy, bringing humanitarian healthcare professionals and peacemakers to the occupied Palestinian city of Bethlehem, with a focus on integrating music therapy into the community (Coombes,

2011; Speiser, 2013). Polyphony Youth Orchestra brings together Jewish and Israeli youth in an orchestral context inspired by Barenboim and Said’s West-Eastern Divan

Orchestra to develop common understanding through shared music making and 32 performance (Jaggi, 2014). For critical music educator and Jerusalem YMCA Chorus facilitator, Shoshanna Gottesman (2017), the therapeutic process for working with the intercultural youth choir includes a large emphasis on co-creative songwriting as well as drumming as a means of dialogue. Despite the religious differences between many

Palestinians and Israelis, their music is often very similar, which Gottesman (2017) suggested is a means for them to find other similarities and cultivate empathetic relationships. She also sees the musical space as an environment to produce transferable learning, which enables participants to reframe the conflict as a systemic injustice and move towards positive peace.

Lopez Vinader’s (2015) music therapy practice is directly informed by Galtung’s

(2000) TRANSCEND method of conflict transformation, as well as logotherapy.

Developed by holocaust survivor Viktor Frankl (1995), logotherapy is an existentialist therapeutic approach that aims to help people discover the meaning in their lives while also take ownership of their actions and behaviors. Vinader (2015) posited the connection to creative arts therapy is based on its experiential, creative, and attitudinal values.

Through her work with Music Therapists for Peace, alongside Boxill Hillman, Vinader has built a network of music therapists who travel to conflict zones to work with traumatized youth. However, though she has highlighted the connections between conflict transformation theory and music therapy and the potential for their integration,

Vinader has not published any articles on the outcomes of music therapy utilizing conflict transformation principles.

Boxill Hillman (2003) also contributed to the theory of music therapy and conflict transformation from the angle of practicing nonviolence (a core principle of the 33

TRANSCEND method) through her introduction of nonviolent language in music therapy. As she noted, terminology can often be unnecessarily violent, which could bring up trauma for clients. Examples include phrases like “Give it a shot” or “Give me a beat”.

Furthering the theoretical discussions, Robertson’s (2010) examination into music therapy and conflict transformation determined that while much of the literature is theoretical, few grounded theory studies have been done. He conducted a study in post-

War Bosnia on Most Dusa, a multi-religious choir in Sarajevo, which performs music from Catholic, Jewish and Muslim liturgy. Through his observations he concluded that although the participants took pride in their reconstruction of pre-war “normalcy” (where people were tolerant of ethnic and religious differences) there was still war being waged musically. This echoes the first area Shank and Schirch (2008) presented through their arts-based conflict transformation projects: the practice of waging conflict nonviolently.

Thus, the musical war Robertson observed might not be a negative outcome, but rather, a natural part of the transformation process.

Heidenreich (2005) surveyed the actions of music therapy projects in war-effected areas around the world. Heidenrich conducted semi-structured interviews with people from humanitarian healthcare organizations working in conflict zones to identify what goals therapists had, where music therapy was being practiced, if it was helpful, and what the barriers were to success. Results showed music therapy was being practiced in 15 countries that had experienced war. The music therapists reported decreases in trauma- associated behaviors such as self-isolation and aggression in those receiving services.

Barriers to success seemed to center around the complexity of working with traumatized children whose behavior was notably erratic. This research is limited, however, in that it 34 did not interview music therapy participants to determine their views on the challenges and successes of the music therapy experience.

Interestingly, the music therapists surveyed in Heidenrich’s (2005) study did not report cultural competence to be an issue for therapists. This is surprising, given the evidence that contradicts it (Augsburger, 1992; Awais 2013). In their article on multicultural competence in music therapy, Hadley and Norris (2016) showcased how all musical interactions are cross-cultural, and indeed Western music therapy training programs are often limited in how much time they spend exploring culture and biases.

This prevents music therapists from having insight into how their clients might see music and therapy. In her thematic analysis of her own music therapy work in Ecuador,

Gadberry (2014) found that differing views of therapy and a language barrier affected the potential for success in music therapy with her clients. Heidenrich (2005) did suggest that her results might have been due to “Western ignorance,” perhaps a consequence of inadequate training as suggested by Hadley and Norris (2016) or the fact that the majority of the respondents to the interviews were working in Eastern Europe rather than Africa or

Asia. This presents an ethical quandary, as we cannot be sure of the impact of the service we are providing clients if we cannot find a clear way to communicate with them.

Alpha Woodward (2012) is a Canadian music therapist who, like Heidenreich

(2005), developed an interest in the efficacy of music therapy programs for conflict transformation after working as a music therapist at the Pavarotti Music Center in

Bosnia-Herzegovina. Recognizing a need in her community, she noticed a lack of empirical research on the topic that was confounded by inadequately supported programs.

In Woodward’s view, despite the large amount of humanitarian aid sent to the region 35 after the armed conflict, much of these resources did not go to the music programming, which was viewed as an afterthought. Woodward did an exhaustive literature review based on a five-step search process, which initially yielded 75 articles utilizing certain key words related to conflict and the creative arts therapies. After narrowing her search down to 27 articles, based on the reflexive approach recommended by Ken Aigen (2008) in his critique of research methods used in music therapy, Woodward noticed salient details.

The majority of studies focused on former Yugoslavian countries (9 out of 27), children (31 %) and were qualitative (24) (Woodward, 2012). This illustrates the gap in quantitative research, as many populations have not been adequately studied, such as non-European conflict survivors and female conflict survivors. Woodward opted to include articles that referenced both displaced and non-displaced conflict-survivors yet noted this made his results more complex and harder to draw conclusion. Furthermore, she acknowledged how quantitative studies have the potential to be harmful to marginalized populations if they are not cautious in their reflection of the information.

This is especially true if the research is not conducted with a culturally competent lens, as

Comte (2016) noted, for it can be easy to make sweeping generalizations about people when they are confined to a singular identity, such as a refugee, or a traumatized child.

Although Woodward identified a deficit in quantitative research, as previously mentioned, this aligns with a critical lens that does not conform to traditional research paradigms in order to focus on the impact of the subjects’ social-political context.

Though the literature is lacking in terms of specific actions music therapists have taken to work towards conflict transformation, one technique which is described is 36

Guided Imagery in Music (GIM) (Jordanger, 2015). Developed by Helen Bonny, GIM is an approach that has demonstrated success in working with traumatized clients. Utilizing relaxation induction techniques combined with supportive music listening, it was used extensively with Vietnam veterans in the 1970s and 80s (Blake, 1994; Ng, 2005).

Jordanger (2015) employed GIM as a method for building what he calls “collective vulnerability” during tense dialogues in Crimea (a contested area coveted by multiple ethnic groups), where people shared complex and personal views on their cultural claims to the region.

In the aftermath of the GIM listening, the facilitator noted that the shared experience allowed the participants (a group of 13 young adults from Russia, North

Ossetia, Chechnya and Crimea) to bond on “a level deeper than mere disagreement on the verbal discursive level of conflict analysis” (Verdanger, 2015, p. 136). Essentially, they were able to start to form the empathic relationships Laurence (2015) described.

Verdanger (2015) asserted that the success of GIM with conflict survivors hinges on five assumptions: participants entered the experience with similar states of mind; the transformation of emotions happened on a collective level rather than personal; the music’s unique qualities produced a physiological effect in humans; and emotions experienced collectively were the main influencers of individual visualizations.

Ultimately, Verdanger believed that if effectively administered, GIM has the potential to significantly work towards transformative goals in conflict zones.

The reviewed music therapy literature seems to suggest a growing interest in working with populations who have experienced conflict. It also shows how much of the work done is difficult to quantify, which this author attributes to the tension derived from 37 a desire to scientifically study a topic that is multifactorial and subjective. An emerging approach and philosophical orientation within the music therapy discipline that addresses some of these tensions is that of Community Music Therapy.

Community Music Therapy

What is Community Music Therapy?

In the early 2000s, music therapist Gary Ansdell (2002) began to question the dominant approaches adopted by the music therapy profession over decades. He pondered whether the profession was operating effectively in addressing the issues people faced in a rapidly changing world. As Ansdell and Pavlicevic (2004) remarked, music therapists were challenged by the need to address issues such as refugee crises or the stresses of modern urban life. Previously, these were deemed too political or circumstantial to fall under the scope of music therapy practice, or therapists would focus solely on strictly mental health outcomes of these situations such as stress disorders

(Ansdell & Pavlicevic, 2004; Comte, 2016). Therapists who were trying to address social issues in therapy were plagued by the question of whether their actions could truly be called “music therapy” in the absence of clinical language (O’Grady & McFerran, 2006).

By the end of the decade, Ansdell had enlisted other prominent voices in the field to develop a framework for music therapy contrasting what they called the ‘consensus model’ of music therapy (Ansdell, 2002; Ansdell & Pavlicevic, 2004; Ruud, 2010; Stige,

2003).

Understanding Community Music Therapy (CoMT) can be difficult. The movement is young relative to music therapy as an entire field. Furthermore, its scope is rather broad and dependent on the individuals practicing it (Stige, 2003). Ansdell and 38

Pavlicevic (2004) described it as an “anti-model that encourages therapists to resist ‘one- size-fits-all-anywhere models’” (p. 21). Bryjulf Stige (2003) described it as “a concern with real-world challenges” (p. 18) that seeks to identify the relationship between music and society as well as what music therapists’ roles are within this relationship. Ruud

(2009) called it a “reflexive use of performance-based music therapy within a systemic perspective” (p. 128). More recently, Guylaine Vaillancourt (2012) described CoMT as

“the use of music therapy approaches in the community to increase social and cultural awareness and bring a sense of societal participation to all concerned” (p. 175).

Evidently, the relationship between how community music therapists view their practice is complimentary to how modern critical psychologists view theirs relative to mainstream psychology. Indeed, Ruud (2009) described CoMT as critical in his discussion of how systems theory has informed music therapy overall.

Often the best way to develop a picture of what CoMT entails is to compare it to the consensus model. Traditionally, music therapy is something tethered to institutions, diagnoses, and clinical goals. It is also something private, where the music created by therapist and client(s) would not necessarily be shared with the institution at large (Ruud,

2009). There is often minimal attention based on developing musical skills or continuation of music making after therapy ends, and emphasis is rather placed on the process (Ansdell, 2002; Wood, Vern & Atkinson, 2004). Ruud (2009) divided music therapy into three main practical frameworks: instrumental-functional, which is found in medical music therapy; hermeneutic and dialogical, which is utilized in relational and analytical; and critical, which he argued is the realm of CoMT. 39

It should be noted that some of the controversy around CoMT stems from differences in music therapy between Western countries. Whereas English and

Norwegian music therapists have argued the need for socio-political issues to be addressed in music therapy, many Australian music therapists have argued on the online journal and forum, Voices, that they have always dealt with these issues and just have not received widespread recognition (Maratos, 2002). They accuse CoMT as being a Euro- centric intellectualist rebottling of a therapeutic practice that already exists, as music therapists have always been concerned with social issues (Maratos, 2002; O’Grady &

McFerran, 2006). This author would counter arguments made by those Australian music therapists and posit that CoMT is indeed its own distinct practice within the field, rooted in a critical theoretical orientation. While some Australian music therapists have focused on expression of multicultural identity within music therapy sessions, especially with their large refugee population, to argue that what they were doing was CoMT would be presumptuous (Baker & Jones, 2005). The theoretical orientation for the work by these therapists was identified as humanistic rather than critical, and thus music therapy still occurred within a traditional framework: private, non-performative, and absent of social or political commentary (Baker & Jones, 2005; Jones, Baker, & Day, 2004). By Ruud’s

(2009) definition, this work could be called hermeneutic and dialogical, not critical, and thus, intentionally or otherwise, not CoMT.

Community music therapists do not attempt to claim the consensus model is ineffective, but rather that it serves the needs of some participants better than others.

They expand the definition of illness to include socio-political and cultural ails as well as bio-psychological symptoms (Ruud, 2009). Ansdell (2002) postulated the existence of an 40 individual-community continuum to define the boundaries between the work of music therapists and community musicians. As Amir (2004) echoed, the emphasis on individual sessions in traditional music therapy may serve to further isolate the client from their community, creating a rift between what they experience in therapy versus the world outside. Stige and Aarø (2012) outlined the PREPARE acronym to represent how CoMT is performative (as explained previously); resource-oriented (i.e. strengths-based and less reliant on diagnoses); ecological (referring to the reciprocal relationship between individual and society); participatory (referring to people as participants rather than clients); and reflexive (describing the need for the therapist to consistently re-evaluate their understanding and practice cultural humility)

O’Grady and McFerran (2007) postulated that healthcare exists on a “continuum involving four major stages: 1. Acute illness/Crisis, 2. Rehabilitation, 3. Community, and

4. Well-Being” (p. 20). They argued that whereas consensus model is designed for institutions that serve clients with acute illness and rehabilitation, CoMT can be much more impactful to the other two stages, focusing on the importance of aesthetic communal experience. Wood et al. (2004), who practice CoMT within a neurological rehabilitation facility, asserted that it has the power to act as a bridge between the institutions and society beyond its walls by embracing the value of skill-acquisition and performance in the overall well-being of a client.

In contrast to CoMT, the field of community music (note the lack of the word

‘therapy’) is a field that developed concurrently with music therapy, however, the focus was upon building community, rather than addressing healthcare needs (Ansdell, 2002;

Ruud, 2009). Unlike music therapy, community musicians are not necessarily certified by 41 a board authority; rather, most enter the field through experience as professional musicians who are passionate about building community. However, they overlap with music therapists philosophically in their fundamental ideology that music can and should be used to benefit society. Ansdell (2002) argued that CoMT could be a way to unite the two realms, in the hope that music therapists could harness the benefits that community musicians possess. He noted that the lack of confidentiality guidelines enables community musicians to develop potentially more intimate social relationships with their participants and connect them with others in their communities who they may benefit from knowing. This, can lead to a stronger sense of trust in their communities (Ansdell,

2002). In contrast, the traditional role of a music therapist as an allied health professional concerned with patient privacy prevents them from taking therapy outside of the office and helping to facilitate beneficial social connections because it leads to the ethical dilemma of dual relationships (Ansdell, 2002).

Oosthuizen, Fouché, and Torrance (2007) wanted to examine the different ways that music therapists and community musicians might be able to operate synergistically and what they chose to focus on in a collaborative CoMT setting in South Africa. They determined that whereas community musicians were able to provide cultural knowledge, aesthetic musicality and modeling, music therapists were more adept at managing group dynamics and providing overall mentorship (Oosthuizen et al. 2007). In this, they determined that both community musicians and music therapists are necessary in the process of doing community-based music therapy work. These results further counter the point made by Australian music therapists that CoMT is a Euro-centric rebottling of traditional therapy. This project illustrates the importance of integrating cultural 42 knowledge, values and music into therapy, rather than purely the skill of the music therapist. Furthermore, it shows how collaboration with the community rather than isolating from it to maintain confidentiality can indeed have benefits for those receiving music therapy services.

One of the most important aspects of CoMT is its emphasis on performance. This means that performance may be used as a therapeutic technique as it helps to cultivate resilience in clients and strengthen bonds between participants and their audiences

(Ansdell, 2010; Turry, 2005; Zharinova-Sanderson, 2004). However, performance in the

CoMT definition is not limited to musical performance; it concerns performance of identity and relationships (Enge, 2015). Essentially, community music therapists address the ways their participants/clients are interacting with each other as partial indication of their overall health. Healthy relationships are paramount to building healthy communities

(Stige & Aarø, 2011).

It is difficult to properly to devise community health goals without acknowledging the culture of the people making up that community. As such, CoMT is culture-centered. Brynjulf Stige (2002) proposed culture-centered music therapy as a means of addressing the ways that culture impacts the therapeutic relationship. It acknowledges that both the therapist and client carry a plethora of cultural identity markers with them into every session, and these have the potential to impact it. This is an explanation for why CoMT and other culturally centered therapies have the potential to be successful with conflict survivors, who are often seeking connection to a community that was in some way diminished (Enge, 2015; Zharinova-Sanderson, 2004). Many of the people who are involved in conflict come from collectivist cultures, which have different 43 definitions of health than Western health professionals. These views often intersect more with the view community music therapists have of health and wellness. If health professionals are not examining their work with the collectivist context of their clients in mind, they may unknowingly be isolating their clients rather than supporting and empowering them.

Community Music Therapy and Conflict Survivors

In his original writing on CoMT, Ansdell (2002) used the refugee crisis as a specific example of a situation in which music therapists could optimize their practice.

This is because traditional music therapy approaches have focused on the trauma history of survivors, rather than their resilience, acculturation stress, or desire for community

(Comte, 2016; Fondacaro & Harder, 2014; Hasan, Ventevogel, Jefee-Bahloul, Barkil-

Oteo & Kirmayer, 2016). In her critical review of the music therapy literature on refugees and music therapy, Comte (2016) found that the majority of articles carried a romanticized notion of the universality of music and had reduced images of refugee clients. In contrast, some findings in the literature exemplified the successes of community music therapy projects. Amir (2004) used a CoMT approach to help new immigrants integrate into Israeli society, from places like Russia. She focused on both preserving traditions and creating new ones, which allowed for participants to celebrate where they came from and have a say in where they were going. The Irish World Music

Café is a project set up by Irish community musicians, arts-researchers, and music therapists using singing as means of easing social integration of asylum seekers and local

Limerick residents. Through cultural exchange and public performance, the participants came to understand the similarities in each other regardless of national origin. 44

Furthermore, the project has helped local community members take interest in the protracted social conflicts that the asylum seekers come from. In doing so it assists in easing the acculturation stress felt by asylum seekers, enabling them to foster healthy social relationships (Phelan, Hennelly, Chappell & Roberts, 2017).

People experiencing conflict within their own countries also participate in CoMT sessions. For Western music therapists working in non-Western environments, the CoMT framework can be helpful for understanding the challenges present in these communities.

Beyond this framework, this author would assert that Western music therapists should critically examine themselves and their real or perceived power in the CoMT experience.

Wagner (2015) discussed how cultural differences and views on the nature of healthcare left her concerned about her effectiveness in working with Gulu children in Uganda.

Through reflecting on the PREPARE approach of CoMT, she was able to reframe her perspective to see how her decisions were beneficial to the socialization and emotional healing of her participants, even when some of her actions may not have been deemed appropriate under the consensus model. Similarly, in Cape Town, the Music Therapy

Community Clinic works with poor black South Africans, many of whom were alive during the challenging Apartheid era, and experience trauma symptoms as a result

(Oosthuizen et al., 2007). Even youth born after the fall of Apartheid continued to witness violence and poverty, contributing to the generational trauma symptoms they present. There are many more examples of CoMT being done within conflict zones, however, in many instances the work is not described as CoMT, perhaps due to a lack of familiarity with the approach (Gottesman, 2017; Ng, 2005).

Community Music Therapy and Conflict Transformation 45

The literature suggests, based on its culture-centered, ecological approach, that

CoMT would be effective when engaging clients from the collectivist communities where many protracted social conflicts occur. However, there is a dearth of literature on the intersection of these two approaches (Junkin, 2017). Inspired by the success of

Barenboim and Said’s West-Eastern Divan Orchestra, which consisted of Palestinian and

Israeli musicians who toured Europe and North America to promote peace, Junkin (2017) aimed to address the literature gap by developing an orchestra program for Philadelphia youth, entitled Orchestral Dialogues: Accepting Self, Accepting Others.

Junkin’s (2017) first orchestra had 14 participants (ages 9-14) from low-income neighborhoods. Her goal was to determine how deep listening used in orchestra rehearsals and private lessons could impact transformational dialogue that members participated in. The research was an ethnography, based on her view that not enough existing literature explored participants’ perspectives. Over five months of participation,

Junkin documented participant responses to the project through informal conversation, archival data, and focus groups, categorizing them into themes. Thematic findings revealed orchestra members were able to understand the basis of what deep listening was and use that understanding to inform how they interacted in dialogues. Junkin (2017) noted that participants were able to demonstrate the transformative skills of “self- reflexivity, self-expression, responsibility, affirmation, co-creation of a new reality” (p.

63). This was directly related to the relationships developed with the adults facilitating the program and their efficacy as role models.

Using a critical, person-centered approach to music therapy, Junkin (2017) is one of the first music therapists to illustrate what a CoMT music therapy process might look 46 like and its potential benefits with people who have experienced or are experiencing conflict. Her research is an example of the positive yield of a foray into the connections between CoMT and conflict transformation. Many more studies that aim to find commonalities between theoretical principles of the two fields and how they might look in practice need to be done. Examining themes present across the fields of CoMT, critical theory, and conflict transformation may provide insight towards clinical recommendations in order to best serve conflict survivors as music therapists.

CHAPTER 3: SYNTHESIS

Intersections

The areas where CoMT, critical theory, and conflict transformation intersect, as

Junkin (2017) identified in her dissertation research, are the areas where music therapists who desire to work with conflict survivors should focus their attention. Shared between these three fields is a strong challenge to the status quo. Foundational critical psychologists sought to liberate their clients from the oppression of mainstream psychology. Likewise, Ansdell (2002) and other early community music therapists were motivated by a novel ideology that music therapy could better serve people on the individual-community continuum by focusing less on consensus model psychopathology and more on the health of relationships between participants and their communities.

Finally, conflict transformation challenged the notion that conflicts could be resolved altogether and shifted to focus to transcendence through mutual engagement, dialogue, reflexivity, and reconciliation (Galtung, 2015; Lederach, 2005).

Unfortunately, in some cases the new ideas presented by critical psychologists, community music therapists, and conflict transformation practitioners have been met with suspicion by the institutions they challenge, which has limited their potential impact. This can be observed in the assassination of Martín-Baró and exile of Boal by their governments for their work with the oppressed in their countries (Lykes & Sibley, 2014).

It can also be seen in the resistance on the part of the greater music therapy community to initially accept CoMT, as proposed by Ansdell and Pavlicevic (Maratos, 2002). Even conflict transformation, which is widely used by the United Nations Peacekeepers, has faced resistance (Galtung, 2015). As a concept that seeks to challenge dominant 48 narratives among people involved in conflict, it receives criticism from those who struggle to see the possibility of peace without violence and single recognized victor

(Galtung, 2017). In this author’s eyes, skepticism towards ideas and approaches that question the current way mental health and peacebuilding is done is important and expected. However, such approaches that challenge mainstream ideologies should not be dismissed. Rather, they should be investigated to produce new knowledge and insight for professionals and consumers of mental health and peacebuilding.

Another area of note is training. Many mental health professionals (in the creative arts therapies or otherwise) have limited exposure to critical theory, a lens through which to view their work within academic training programs (Fox et al., 2009). It may not be studied as much as it should be considering the potential impact it could have on the healthcare field overall, especially in community-based settings where clients are regularly less privileged based on economics, race, and education. Saviano (2012) called for more integration of critical theory education into psychology training programs in his doctoral dissertation, but since its publication, no empirical studies have emerged that document how prevalent critical theory is in education programs or the impact of its inclusion for students on their experience as developing therapists.

This is unfortunate, as the literature notes how much work has been done in developing psychology tailored to certain communities or populations. This is often work done by psychologists of color who devise therapeutic approaches for people of their own culture, such as black psychology or Sikolohiyang Filipino (Hook, 2005; Marcelino,

2000). If Western music therapists want to work in areas that are culturally foreign (as many conflict zones are), it is important to have an understanding of differences, 49 particularly as they relate to views on music and mental health. As Hadley (2013) did,

Western therapists must explore the dominant narratives which shape how they perceive society on a systemic level and their participation within it. If they are working in regions which have been affected by colonialism, it is critical for the therapist to understand its impact on their clients and the community psyche overall, as well as themselves.

The resistance to CoMT from mainstream music therapy may be due to a lack of clarity around its theoretical foundation. While this literature review identified its roots in critical theory, they are not explicitly stated as such in much of the cannon describing

CoMT. Without this understanding, CoMT can seem unrestricted. Consensus model music therapy, as a profession, is grounded in decades of theory and practice, founded upon medical or psychoanalytic theory, whose roots are even older than music therapy

(O’Grady & McFerran, 2007). It has developed its own specific language and a standard set of principles that are taught to and upheld by music therapists, which echo the language used by medical doctors and psychologists (O’Grady & McFerran, 2007). In this author’s view, this was done to legitimize the field in the eyes of other healthcare professionals.

When CoMT challenges traditional principles and language, arguing that they are not relevant in all circumstances, consensus music therapy can easily refute CoMT altogether, by relying on its longstanding evidence base and adjacency to empirical medical and psychological theory. Examples of differences include the consensus model’s views towards counselor self-disclosure and performance in music therapy; neither are commonly recommended in therapy. However, in CoMT they are encouraged.

Without a clear theoretical rationale in CoMT, it would be natural for the consensus 50 model to resist changes to its theory-driven practices. However, when considering how

CoMT is rooted in critical theory, decisions made by therapists may indeed be more theoretically grounded.

This author views CoMT as a “way of being” as a therapist, which exists beyond being anti-oppressive. Being anti-oppressive is a practice that can exist within a private music therapy session, through being aware and respectful of the clients’ cultural backgrounds (Baines, 2013). CoMT envelops such anti-oppressive practices and additionally places a large emphasis on liberation from the oppression of the societal status quo (Enge, 2015; Ruud, 2009). Community music therapists view themselves as social advocates and activists beyond therapy walls. This can lead to a difference in the way ethics are imbued in therapy. An anti-oppressive therapist can apply mostly standardized ethical guidelines to their work (i.e. ACA Code of Ethics or AMTA Code of

Ethics). The community music therapist is responsible for understanding and applying the ethics of the community they operate in to their practice..

Critical psychology directly counters the format and goals of traditional therapy, and as such, it is fully appropriate for community music therapists to not follow traditional writing standards in the music therapy field. Indeed, the majority of writings on CoMT utilized in this literature review are free and open-sourced, rather than tied to subscription-only academic journals. Furthermore, it is justified for community music therapists to contradict the traditional models for studying efficacy (i.e., receiving large grants to conduct quantitative research, which decentralizes subjective experience).

However, CoMT exists as a grey area between a theory and a practice, and this can make it confusing for those who are not well versed in it to understand it, which limits its 51 potential impact. As such, CoMT practitioners should emphasize the theoretical underpinnings for their decisions to reject traditional paradigms, as this will provide more clarity for critics and dispel misinformation without sacrificing its own anti-model identity. To conclude, two central recommendations for CoMT are 1) for more music therapists to gain exposure to critical psychology in their education, and 2) for CoMT literature to more adequately explain the theoretical orientation behind the work and how it translates into the CoMT practices

As Norris and Hadley (2008) noted, a lack of training around conceptualizing cases in a culturally sensitive way can limit the success that music therapists have with their clients. Heidenreich (2005) pinpointed how music therapists working in war- affected areas did not mention a need for cultural-competency, and it is this author’s view that this speaks volumes for why it is needed. Critical theory is an umbrella term for many theories that challenge the dominant narratives of society. It puts issues of power and oppression at the center of therapy. Conflict transformation also asks participants to challenge the dominant narratives that have been constructed to perpetuate the conflict. If therapists are not examining the way dominant narratives shape their interactions with clients, they may misinterpret client responses in sessions as well as systemic factors outside of sessions that affect their clients. This could lead to pigeon-holing clients based on certain aspects of their known identity, such as refugee status, and thus reinforcing the neo-colonialism in music therapy Comte (2016) warns readers against.

On the subject of training, one thing that becomes clear is the gap between wanting to help conflict survivors and being educated in the foundations of conflict transformation. There have been no studies that have examined how many people 52 conducting music therapy with conflict survivors or in conflict zones have been trained in conflict transformation. This would be a useful subject for a survey research study and could lead to deeper knowledge of how conflict transformation can be applied in music therapy. As was noted in the literature review, the TRANSCEND method is a standard approach used by U.N. peacekeepers, and yet only Lopez Vinader (2015) explicitly references it in her practice. This should not be underestimated. Especially given how creativity is an essential element of the method, TRANSCEND lends itself naturally to the creative arts therapies.

Junkin’s (2017) work serves as an example of how conflict transformation concepts can be translated into music therapy. As such, this author believes that an effective music therapist who works with conflict survivors must be adept in approaches that stretch outside of what is taught in mainstream psychology courses. This means learning the language of peacemaking, viewing their own work through a critical lens, and seeking supervision from music therapists who operate from a critical framework.

Music therapists must develop an understanding of their clients that is culture-centered and highlight themes of power and oppression.

For example, conflict survivors are familiar with having their personal lives affected by external powers, but they may not have a deep understanding of how power has a role in their lives. Therapy with a conflict transformation-informed practice can explore these dynamics, helping clients to take ownership of their lives in a way that is meaningful for them. This approach to practice may help clients to seek commonality with those who they may have previously seen as enemies by exploring how they are both oppressed by the conflict itself or by the narratives that perpetuate it. If therapists do 53 not explore power and oppression, they risk being a part of it by focusing on therapeutic goals that do not consider societal factors that impact the client’s presentation in therapy.

Having a client’s culture centered by the therapist and having narratives heard should allow for the trust to develop. Clients might see their therapist as more than a foreign person presenting them with a foreign concept (talking about or playing music to cope with their issues), but rather as an ally in their goal of living a peaceful life. Therefore, conflict transformation-informed music therapy practice has a great deal of potential and should be further discussed and investigated.

CoMT is a growing philosophy in music therapy that has been struggling to define itself as its own approach. The integration of conflict transformation practices could serve to clarify its distinction from consensus model music therapy. The literature shows that community music therapists are already attempting to work with clients who have survived conflicts (Wagner, 2015). However, with increased confidence in their conflict mediation skills, in addition to pre-existing psychodynamic training, counselors could be even more targeted in their treatment.

CoMT has not had a lot of quantitative research done on it to support its efficacy.

Implicit power dynamics are imposed between consensus-model music therapy and

CoMT, where it must prove itself in a system which does not entirely understand its potential. A paradox exists in that while empirical studies may legitimize it in the eyes of the institution, as Woodward (2012) noted, it could potentially have a negative outcome on the populations that therapists are trying to serve. This may be due to an inherent distrust of Western psychology or science, which tends to overlook or generalize the experiences of marginalized groups. 54

While it is unfortunate that funding for wellness projects is often contingent on the presentation of quantitative data as representative of potential impact, this is something that CoMT should stand against. It is this author’s view that CoMT does not ascribe to the same principles as the consensus model of music therapy, and thus should not focus on quantitative research purely for the sake of recognition, as this runs contrary to its foundations in critical theory. However, as mentioned, it should be clear about why it is abstaining from the quantitative approach and highlight its theoretical groundworks.

If research is desired within the CoMT movement, the focus should on centering and amplifying the voices of the participants, as Junkin (2017) did in her ethnography. These thoughts are proposed with full acknowledgement that this author’s voice in the field of critical psychology and CoMT is new, and there are undoubtedly areas of growth to be had in understanding research paradigms as a whole.

Recommendations

Music therapists desiring to work in community settings that accommodate with conflict survivors must develop an appropriate set of goals (Shank & Schirch, 2008). It is beneficial to allow war to be waged musically as a means of limiting direct violence, especially when engaging participants who are on opposite sides of a conflict. This could be done in a variety of ways, such as songwriting around prevalent themes of the conflict, or improvisations of emotions that can be expressed in musical dialogue. Shank and

Schirch (2008) proposed relationship transformation as an attainable goal, and Jordanger

(2015) demonstrated how this can be achieved using GIM and dialogue in tandem to create “collective vulnerability”. In this author’s own attempts to use music therapy at a conflict transformation camp for adolescents from Palestine, Egypt, Jordan, Israel, 55

Pakistan and India, the most successful activities (based on informal feedback from participants) were receptive techniques. When campers were invited to use the music as a safe container to facilitate relaxation and reflection on their motivations for being at the camp, they reported feeling more peaceful, connected to other campers and prepared to engage in respectful dialogue. Their response was overwhelmingly described using spiritual lexicon, which at the time, this author was hesitant to engage in.

At the core of both the Palestine-Israel and India-Pakistan conflicts are narratives that are regularly broadcast as religiously motivated. However, these are narratives that are perpetuated by political entities (governments) with political motives (land control) and power. Galtung’s (2000) approach challenged the notion that religions serve to separate and used the unifying features of religions as a tool for connection between groups. The foundational rules of the TRANSCEND method can all be traced back to a different religion. This is something which this author believes would be beneficial to integrate into music therapy sessions, and not see as an area of contention. It can be a way of enabling participants to feel that the therapist is responsive to their cultural history and views it as a resource. In the appendix of Bergh’s (2010) thesis, he provided a song he composed using lines from Sufi saint Jalal al-Din Rumi’s poem, Soul, Heart and Body

One Morning. It is shared below as an example of material that incorporates spirituality into music therapy and conflict transformation:

“Out beyond ideas of wrongdoing and rightdoing, there is a field. I’ll meet you there. 56

When the soul lies down in that grass, the world is too full to talk about.

Ideas, language, even the phrase each other doesn’t make any sense.” (Barks, 1995, p.36)

Coincidently, the sign that greets all visitors to Seeds of Peace Camp, where this author first became interested in conflict transformation and how music therapy could be informed by it, reads, “This is the Field”. While the inclusion of spirituality into music therapy and conflict transformation was not an area that was focused on in this critical review, it is an area that warrants further exploration, as spirituality is indeed a large contributor to cultural identity in many communities impacted by conflict. A starting place for navigating the vastly different religious terrain in these circumstances is to search for intersections as a means of building on inherent commonalities between groups.

The last recommendation is inspired by the work of Edith Hillman Boxill (2003).

Therapists should take the time to examine the ways that the language they use may perpetuate violent themes and develop a vocabulary that is anti-oppressive. They could support their clients in the development of a list of therapeutic terms which coincide with the language of conflict transformation that is transferrable in meaning across cultural differences. An example of this might be the replacement of words like “hit” or “beat” the drum with “engage with” or “play”. Furthermore, therapists working in conflict zones should work to build a network so that information on techniques can be shared more easily. This could be an informal social media group on Facebook and/or LinkedIn (such as the Music Therapists for Social Justice group), which would allow for international 57 voices to be spread easily. Likewise, a subcommittee of the American Music Therapy

Association could work to develop standard practices for therapists working in conflict zones.

In conclusion, the connections between conflict transformation, critical theory, and community music therapy are numerous, yet not necessarily evident upon first inspection. They are all rooted in a desire to question the status quo. They ask whether correct actions are being taken to meet the needs of people, whether they are involved in conflict, or therapy, or both. It is this author’s view, that by being more well versed in theory behind critical psychology and conflict transformation, music therapists interested in working in conflict zones (or with conflict survivors) will be able to make more informed therapeutic decisions that work to uplift their clients and situate them in the context of their social climate. Furthermore, CoMT practices may be the most effective in working with this population, based on a minimal emphasis on pathology and a focus on development of communal solidarity. A demonstrated need for music therapists to study critical theory as a core theory in training programs has been established and may lead to an overall deeper understanding of the difference between CoMT and the consensus model of music therapy.

CHAPTER 4: REFLECTION

Because this chapter centers on personal reflection, I will discuss my thoughts in first person. The process that produced this thesis began in the summer of 2017, when I worked at Seeds of Peace, a summer camp for teenagers with a conflict-transformation model, which was celebrating its 25th anniversary that summer. Having completed my first year as a music therapy graduate student, I was confident in my ability to use music therapy ideas to create meaningful musical interactions in the music activities I ran.

However, I was a counselor who had never been to camp before (many counselors were campers in their youth) and as I later came to understand, I was required by the rules of the camp to keep “the conflict” out of my activities. The heated discussions were reserved for the dialogue huts and the rule was “what happens in dialogue stays in dialogue”. While I understood the rationale behind this, it was something I struggled with. I knew music could play a deeper role but I was not sure how.

There were two main moments which guided me further into the direction of incorporating music into conflict transformational dialogue during camp. The first, as mentioned above, was the success of sessions which focused on guided imagery and receptive techniques. The second was Arts Day. I was asked by the camp leadership to devise an activity with one dialogue group (the most volatile group, as I later found out) to produce a musical piece to perform for the rest of camp that night on the theme of unity. I decided on a modified song rewrite where participants compiled lines from their favorite songs around the theme into a new piece, which was read over improvised music.

I allowed them to use lines from songs in any language, provided they translated them to group members. In the moment, there were no issues. However, at the time of the 59 performance, a screaming match developed over certain interpretations some campers had taken with certain lyrics. The screaming lasted three hours with the group unable to make a unanimous decision to perform or not. Meanwhile, the whole event continued without them. In the end, I felt demoralized at my ineffectiveness at managing the situation. How could I have overlooked the importance of preferred music for adolescents, never mind the intense political nature of it for those youth? I made a promise to myself that I would be back and I would do better.

At the same time, I was trying to devise a topic for my thesis, and I settled on music therapy and conflict transformation. Since the population I was working with was not clinical, I decided now would be the time to explore CoMT more deeply. I had come across it through research for a final paper I had written for a qualitative research class but wanted a fuller understanding. I began formulating a critical review on conflict transformation, community music therapy and refugees. However, something was missing. I realized that an exploration of conflict transformation and CoMT was ineffective without a theoretical framework, one which was present but hardly articulated in the literature. I felt that critical theory was this missing link and through this realization the true structure of the paper began to take form. The process was a lesson in trusting my intuition in identifying a research gap, as although I could see a clear connection personally between the three main topics of the literature review, I had not come across any literature which directly linked them.

The more I read, the more connections I began to see in the three fields, in shared terminology and shared goals. I also became acutely aware of how misunderstood critical theory, conflict transformation and CoMT were by many practicing clinicians. The topic 60 which was the most challenging to fully comprehend was critical psychology. I found myself agreeing with it, despite struggling to understand it. It is so expansive and open yet is mostly articulated in complex philosophical jargon which took a lot of time to tease apart. I still feel that there is much to unravel on this topic, especially as someone with a limited knowledge of philosophy and its evolution. As an auditory learner, some of my issues stemmed from a difficulty staring at dense material on a page for so long, rather than having it explained to me. However, I think this is representative of a larger issue. I was not taught this information in my courses which focused on theory, I had never had it explained to me verbally. My understanding of critical pedagogy had begun with reading

Freire in my undergraduate studies, but it was still relatively basic.

In reflecting on this process, I realize that I was developing my identity as a critical music therapist. I noticed how I was now grounding my responses in classes in critical theory. I articulated the importance of understanding critical theory to classmates and professors alike. I found myself arguing when people described community music therapy as apolitical. I attended sessions at National and Mid-Atlantic Region (MAR) conferences which focused on issues of oppression, social justice or international work and created a mental checklist with which to assess how critical the speakers were. My research projects in Theories classes tended to focus on feminist therapy as it was the closest I could get to critical theory in those we had studied.

I do think it should be noted that there is an inherent power dynamic in the academic system through which music therapists are educated. This is at the foundation of critical pedagogy and is something that should be addressed through deep rather than surface-level analysis of the critical pedagogy/psychology literature. To illustrate this 61 point, I will use a recent personal experience: at a recent conference, I attended a talk by two college professors (both teaching at the undergraduate level) on how they were attempting to incorporate critical pedagogy into their curriculum. The presentation took on a traditional lecture-based model with the “teachers” standing at the front of the room, and the “students” seated in rows, despite presenters saying they wanted a dialogue. They presented the struggle of trying to expand the viewpoints of their students, inviting them to think critically, while still suggesting that they had to grade them in the end to meet institutional requirements. I was one of two attendants at the session who was a student. I could not help but think of Freire’s (1972) banking system of education, a concept he introduces early in the Pedagogy of the Oppressed. Simply stated, this is a system in which teachers are the purveyors of intellectual capital, and students are the banks that store it. There is no reciprocity or concept of both groups being able to teach and learn from each other. Freire (1972) considered this a limit-situation, as it consequently controlled students’ education and thus their liberation from oppression. Even within a presentation on critical pedagogy, this concept was not being applied. Furthermore, as a student, I felt that I could suggest approaches that would challenge the institutional system the presenters said oppressed them, but I felt uncomfortable sharing due to the power dynamic that had been created in the room. For example, one way to give students more power in their academic experience is to let the class collectively decide how assignments and tests are weighted in terms of their overall grades. This gives students experience in self-advocacy and compromise, while also allowing them the potential to emphasize their strengths in class. Furthermore, it creates a dynamic that says the teacher welcomes the voices of their students and challenges the assumption that they know what 62 is most valuable in their students’ education. Finally, the students still come out of the class with a grade, which is the institutional requirement.

Acknowledging that at its core critical theory is a reflexive and constantly morphing ideology that reacts to the changes of dominant society, I recognize that my views may morph alongside it. I am not afraid to acknowledge my limitations as a music therapist in training who found my orientation independent of my academic training. In the future, I think there is a lot to be done to amplify the potential of critical theory and conflict transformation in how music therapists do community-based work with conflict survivors. The interest in the field is growing, as the first critical pedagogy and creative arts therapies conference will be held in September 2018. Writings by Ruud, Hadley and

Norris are becoming much more widely read and accepted as greater attention on a large scale is being paid to implicit bias, and the role of culture in healthcare outcomes and experiences. I anticipate that this writing will be the first of many that more explicitly examine the intersection of the creative arts therapies and social justice initiatives, and I hope to be a part of this discourse.

REFERENCES

Abi-Ezzi, K. (2015). Music as a discourse of resistance: The case of Gilad Atzmon. In O. Urbain, (Ed.) Music and conflict transformation: Harmonies and dissonances in geopolitics, (pp.93-103). London: IB Tauris

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