"Patient Declined": Contemplating the Psychodynamics of Hospice Music Therapy

Abstract

The literature on music therapy with hospice patients often accentuates the positive aspects of the process and places less emphasis on difficulties the therapist may face. This article examines specific obstacles that may arise when working with dying patients. Four vignettes are presented, which include issues of apathy, depression, anger and frustration. The seemingly overprotective family member scenario is also viewed in relationship to its effect upon the dying patient. A closer look at such difficulties may deepen the understanding of what a person may experience when approaching death. The therapist's reactions to the patient's experiences (countertransference) are explored and emphasized as well. The author's work within the hospice setting was guided in weekly Analytical Music Therapy supervision sessions, whereby, over a period of one year, helpful lessons on coping with patients' rejection were discussed. The lessons and the supervision techniques that were used to teach them are outlined at the conclusion of this article. (PsycINFO Database Record (c) 2012 APA, all rights reserved). (journal abstract)