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From Community Music Therapy – edited by Mercedes Pavlicevic and Gary Ansdell

Promoting Integration and Socio-cultural Change:  Community Music Therapy with Traumatised Refugees in Berlin - Oksana Zharinova- Sanderson

For over three years I have been working at the Treatment Centre for Torture Victims in Berlin, establishing a music therapy service there in a project organised by the University of Witten-Herdecke and sponsored by the German Nordoff-Robbins Charity. The work with this clientele has strengthened my belief in music as a valid therapeutic medium across cultures.

Herr A, a Kurdish man from Turkey, was imprisoned many times, beaten and tortured. After years of living in hiding, he escaped to Germany, whilst his wife and children decided to remain in Turkey. He lived alone in a refugee hostel outside Berlin, being generally very depressed, drinking and spending most of the time alone in his room.

Herr A was referred to me by one of the centre's social workers. She said that he was always unhappy, complaining about his life situation and could not see anything positive in what she was trying to do for him. He often did not listen to her and sometimes got very angry blaming all his helpers for not doing enough. He mentioned to her that his rescue from his 'bad thoughts' was often his music, and that he played the Kurdish instrument, the saz.

In the initial music therapy sessions he played his instrument and sang whilst never looking at me and relating very little to any of my efforts to join his music. Then, for a long period he did not come again. From the social worker I found out that the reason for his absence was that he was too embarrassed at being alone with a young woman. He said that the only woman he had ever been alone with was his wife. Looking at a woman directly he felt was too close and disrespectful to her. The social worker suggested that I ask his interpreters whom the patient trusted, to join us, in order to help him to overcome the feeling of awkwardness with me. I had never worked with interpreters before, believing in the power of direct communication through music, but I agreed, as it was my only chance to continue working with this patient.

The presence of an interpreter put me in the position of an outsider in their verbally based relationship of trust and masculine solidarity as Kurdish men. The patient still did not look at me and I often had a feeling he did not notice I was there at all. When we were playing drums together, the patient would take and pass the rhythmic patterns to the interpreter, but would avoid giving direct drumming answers to me. When he played songs from his culture, the interpreter would drum with him in the Kurdish style and whatever I played and sang did not seem to become a part of their music.

At this point I made the conscious decision of working with what I was offered, without imposing any expectations of what music therapy should be like, and allowing the process that was already taking place to develop. So I let them play together and sometimes just listened. I believed that eventually, if I listened accurately enough, I would find a way in and a role for me in their music and a chance to connect with the patient.

Two plus one and the emergence of the trio.

The first real feeling of the patient's acceptance of my presence came a few sessions later. He wanted to try out a new instrument and since it was nothing to do with familiar Kurdish music, the interpreter stayed silent. It was the first time I connected with the patient so directly. He played marimba standing with his back to me. It felt as if in this music we were being close without needing to face each other. Then we played a Kurdish song together. After we stopped he said that he thought I was a proper musician and sounded good accompanying his song.

He then smiled and said that all three of us were like a group and that one day we would become famous and would earn lots of money with our concerts. From this time on the three of us worked as a group - a singing and playing trio from which I was no longer excluded. He recognised the musician in me and related to me as a person, not just a woman.

Eventually we had a repertoire of songs, with me playing the piano, the interpreter a drum and the patient a guitar, which he decided to play instead of his saz. He would play the melody line on the upper E string and just strum the rest without any particular chord, just as he would do it on his native instrument. When I asked why he had chosen the guitar, he said that the guitar tuning fits the piano sound better than the scale of a saz.

ln my experience it was unusual that the Kurdish saz player would exchange his instrument for another. The saz is normally very meaningful for a Kurdish person; it is a symbol of Kurdish culture and the political aspirations of statehood. Here however his concern for the quality of the musical relationship between us became more important. Whilst before he was interested in what he was doing, now he was concentrated on what we were doing - a real shift in his perception and actions.

A few times, when the interpreter was ill, Herr A still came to music therapy. I was surprised that he did not mind us being alone.

'We are not alone any more', he said, 'the music is there with us'.

I liked his personification of the music as a living organism. I suddenly remembered the first sessions we had together, and the feelings of exclusion and helplessness I had experienced because of his cultural attitudes that did not allow us to meet. I thought how lucky I was to have music on my side to help him trust me as a musician and as a person, in the safety of a musical dialogue.

The dancing four

The initial joke of the patient about us being a group became a reality when I was asked whether any of my patients would like to perform for the official ceremony dedicated to the 10th anniversary of the foundation of our centre. I asked Herr A what he thought about performing in front of other people and he said: 'Why not, we are a group and we have got something to show them, haven't we?'

I was aware of the pressure that such an event can put on a patient (Turry 2001), so I told Herr A that if he did not feel comfortable in any way about this performance we could always cancel it.

This new task made a constructive change in our work - it gave us a clear aim. We had to choose a few of his songs, arrange and rehearse them. It was a difficult process of balancing three different players with very different ideas. The verbal function of the interpreter became redundant so he had to readjust and try to grow in his musical confidence - a process in which he was encouraged and supported by Herr A. Advising the interpreter on this or that aspect of playing, he had exchanged roles with the interpreter:

Herr A now became the expert.

One of the songs that we were rehearsing had a catchy refrain, which in Kurdish tradition is sung communally. I suggested that we could sing this refrain together with the audience at the concert. Herr A liked the idea, adding that in this way the German audience would be able to experience the Kurdish spirit. In our rehearsals, we were certainly moved by this spirit - by now we were dancing as well as singing. However, the asymmetry of three dancers did not feel right. We needed another person. I asked a colleague of mine to join us so our group became a group of four. The dance had a strong musical impact on our singing. The rhythmic accents became more defined and the patient's whole musical expression became more authentic and exuberant. His movements became freer, he bent his body, swayed to and fro and when approaching another person in the circle he communicated with his movements and inspired us to dance in that way too. It was difficult to match the authenticity of his expression.

Herr A had the role of a leader in many aspects of our rehearsals, including, for example, starting the first line of the song alone and thus tuning us in. I noticed the change in his body language. The feeling of responsibility made him look straighter, stronger and more alert. While sometimes he still came in quite depressed, he always left the room energised and focused. He also seemed completely aware of others in the room. All four of us were working immensely hard together, sweating, exchanging ideas and arguing - all natural aspects of the creative process. Along with this process came a feeling amongst us of acceptance and belonging.

The final stage

Unexpectedly for me, some members of my team found the idea of trying to engage the audience not appropriate. The audience was going to consist of politicians and other VIP centre supporters, who were not expecting to be asked to sing! They were there to hear the speeches. The organisers expected that the patient would perform to make the programme less dry, but they did not expect us to involve the audience actively. They warned me that the patient and I might feel very embarrassed if the audience did not get inspired to join us. Eventually they agreed to put this song at theend of the evening, before the reception.

At the same time, as the rehearsals went on, some colleagues said to me that the sounds coming out of my room were so inviting that they could hardly resist coming in and joining us.

The big day of the concert arrived. As we finally got to sing and dance in front of an audience, many people clapped and joined us in the rhythm of the music. It felt natural and it did not conflict with the agenda of the evening, in fact it added meaning to it. After the concert the patient was congratulated and thanked many times by the guests. There was a look of pride in his eyes. His doctors and social worker were impressed with his calm and healthy performance. Many guests speaking to me afterwards said that seeing a person share his soul and culture with them was a moving experience, something that turned the concept of 'a traumatised refugee' into a real person with real feelings that they could empathise with.

To me this was a confirmation of the need for building bridges between refugees and their host society, and that music can and should be used as a building material for creating such bridges.

The work with Herr A is continuing. He has expressed his wish to play some new music - 'something that we can perform together again'.