Smeijsters, H. (2005). Sounding the self Analogy in improvisational music therapy. Gilsum, NH Barcelona Publishers

Book Reviews
Smeijsters, H. (2005). Sounding the selF. Analogy in improvisational music therapy. Gilsum, NH: Barcelona Publishers. 214 pages, ISBN 1-891278-22-3. $42.00.
ues of collaboration and inclusion are evident in many of the
chapters. Part I, "Research and theory in music therapy," begins with an overview of research topics that have been developed during the last 20 years of music therapy practice
while chapter 2 attempts to answer the questions: "What treatment modalities are indicated for a particular problem," and
"How can criteria for treatment be developed?" The author
includes examples of the research procedure he followed to
arrive at "indications" or treatments for specific behaviours
related to specific disturbances, and he provides examples of
approaches to the basic questions that he believes music therapists must try to answer in order to determine which treatment goals and procedures will optimize the client's health.
Chapter 3 explores ideas presented by various colleagues concerning the development of a general theory in music therapy;
the author critically reflects upon different points of view and
explores concurrences and dissimilarities in a cross-analysis.
Using peer debriefing, Smeijsters codes questions and statements to create a synthesis of categorical themes that serve as
landmarks in the development of a general theory.
Part II, "Towards a theory of analogy in music therapy,"
begins in chapter 4 with a philosophical exploration of epistemology. It describes how knowledge is acquired through different processes including cognitive and verbal processing,
referential meaning, and the particular knowledge that issues
from symbolic and intimate knowledge. Smeijsters concludes
with the view that the knowledge that is acquired in music
therapy differs from symbolic, metaphoric, and verbal knowledge. In his view, though it is important to write about music
therapy, the written word is a translation of the music therapy
process and it does not provide one with the essence of the
therapeutic experience.
Chapter 5 is at the heart of Smeijsters' theory of analogy.
He describes the first study that led him to develop this idea
by analyzing writings of music therapists to discover their
ideas about who music therapy works. He concluded that the
concepts that signified the link between musical processes
and intra and interpersonal processes could be encompassed
in the core category of analogy.
Having established the core category of analogy, the author
connects his theory of analogy with psychology and art therapy in chapter 6, and includes discussions on semiology and
Stern's developmental psychology to ground analogy in psychology and art theory. Smeijsters elaborates on Stern's developmental theory, drawing parallels with music therapy and
offering general indications for music therapy treatment based
on developmental stages and associated disturbances. He proposes that arts therapies are therapies beyond words that foster
personal change based on experiences that are analogous to
life experiences. Chapter 7 reaches a definition of analogy by
In his latest book, Henk Smeijsters tackles the fundamental
question of the meaning of the music in music therapy and
what it is about the music therapy process that renders it a
therapeutic medium capable of facilitating positive growth
and change. To do so, he takes the reader on a journey of
discovery leading to his concept of analogy, which he presents
as a foundational proposition in the development of a general
theory of music therapy.
Based on the premise that musical processes are analogies
of psychological processes and that meaning is sounded in
the musical structure, Smeijsters draws upon Daniel Stern's
concepts of vitality effects to explain how forms of feelings
can be directly connected to perceptual forms. Stern defined
these "feeling shapes" as, for example, "surging," "fading
away, .... fleeting," "explosive," "crescendo," "decrescendo,"
"bursting," and "drawn out" (p. 69). In essence, when a person "sounds" his or her "Self," there is a connection between
the musical expression and the person's intra and interpersonal processes. Thus, in Smeijsters's view, music exerts power
on one's psyche because it sounds our inner beings and our
connection to the world, articulating both the conscious and
unconscious parts of our soul. Music therapy occurs when
psychological processes are changed by means of musical
processes.
This theory is the culmination of years of theoretical inquiry
and naturalistic case study research from a number of different
points of view, much like the technique of triangulation in
qualitative research. The author examined the single case
studies of his own clients and those of other music therapists,
he considered the ideas expressed in dialogues with colleagues, and he analyzed his qualitative research case studies
and those of his colleagues. In addition, Smeijsters examined
his theory from a heuristic point of view. The author revealed
his personal struggle with depression which brought him to a
precipice many years ago, and he described how the vitality
effects he heard in Eric Clapton's Brown Sugar suddenly allowed him to connect to his own strength in the midst of
exhaustion and burnout. By playing and listening to music that
had similar vitality effects, Smeijsters began to heal his depression. Though he had not begun to develop the theory of
analogy at this time, he experienced a phenomenon that he
strove to understand by engaging in life-long research. Thus,
he is well-placed both as a recipient and as a practitioner of
music therapy, to understand the role of music in healing.
In her foreword to this book, Carolyn Kenny refers to
Smeijsters' spirit of collaboration as a guiding force. The val121
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describing all the properties of this core category and integrating all the concepts related to it. Using a case study, the
author proposes an intermediary" language that establishes
links between musical and psychological language. He also
discusses the difficulties posed by using verbal language to
explain the spontaneous intimate knowledge of analogy that.
is beyond words.
Smeijsters continues the research process by illustrating the
trustworthiness of his theory of analogy by means of two clinical cases in chapter 8 and seven cases in chapter 9. Chapter
10 will have particular appeal for those persons interested in
qualitative research in single clinical case studies. Smeijsters
explores topics related to how one develops knowledge in
research, triangulation of knowledge development, priciples
and techniques of naturalistic inquiry, and concludes with a
detailed example of the procedure he employed with a case
study to carry out research on analogy. In the spirit of collaboration and dialogue, chapter 11 closes with a discussion of
comments on the theory of analogy that have been put forward by colleagues in the last decade.
The research paradigm employed in this theoretical treatise,
though it is a rich resource of clinical material, raised some
questions for this reviewer. Smeijsters proposes that music
therapists put forth a collaborative effort to contribute to building a general theory that includes music therapy indications
for specific therapeutic goals through qualitative, evidencebased meta-analysis. However, in the paradigm of qualitative
research, results are applied only to the individual or group
involved in the research. Srneijsters' meta-analysis seems to
be similar to the grounded-theory approach in qualitative research. This theory proposes that conclusions are arrived at for
a specific group based on common outcomes and themes for
that particular group though the concept of generalization
from one sample to a larger population is not one that is found
in qualitative research. It appears that Smeijsters is proposing
a new research paradigm that is based on naturalistic research
but that also has characteristics associated with positivistic research; one characteristic is that of producing empirical results
that lend themselves to generalization. Although intriguing,
this idea merits further dialogue.
Another very interesting aspect of the author's theory is his
inclusion of ideas from other theoreticians that he feels supports an aspect of his theory of analogy. For example, he includes Carolyn Kenny's concept of "making special" as a
means to therapeutic change (p. 38), and he discusses Kenneth Bruscia's Improvisation Assessment Profiles (IAP's),
which, by using a specific method of analyzing a client's music described by that author, make it possible to draw analogies with a wide variety of psychological theories (p. 102).
Smeijsters also proposes that the language used in the IAP's
as well as in the compendium of 64 clinical techniques described by Bruscia, may form the basis with which to develop
an intermediary language between the musical and the psychological that can describe the music therapy process (p.
103).
This theory is not limited to creative music therapy and im-
Music Therapy Perspectives (2006), Vol. 24
provisational music therapy. Smeijsters states that in pre-composed music, the vitality effects in the music may sound the
individual's psyche so that the music is an analogy for one's
psychological dynamics. The primary characteristics of analogy, as used by Smeijsters, is that the music is a direct, analogous expression of the dynamics of the psyche and not a
representation of something else. The general theory of analogy then can be applied to receptive music therapy in general
and to the model of Guided Imagery and Music (GIM) in particular. However, this raises further questions about the theory
of analogy and the role of the imagination and its associations,
symbols, and metaphors, which are integral components of
the receptive and creative music therapy process because
these all denote meanings that are not sounded in the musical
structure; therefore, they exist beyond analogy. However,
Smeijsters does not attempt to answer this question, preferring
to limit his theory to the concept of pure analogy.
No discussion of music can be complete without considering the role of aesthetics, which Smeijsters understands as
a psychological category reflecting the beauty of the human
being, which is different from the beauty of the work of art.
Given the different but undefined role of aesthetics among the
major music therapy models, the author offers a way of defining aesthetics that may bridge the gap in these diverse approaches. Smeijsters suggests that for the music therapist, the
aesthetic is not found in the traditional sense of the beautiful
applied to the musical product, but rather, the aesthetic experience must include the concept of the psychological and
the impact of the music upon the client. This appears to be
an excellent concept to intiate a dialogue on aesthetics in
music therapy.
In addition to a detailed table of contents, a foreword by
Carolyn Kenny, and an introduction, this book contains an
author and subject index, references, and a short biography
of the author. The one disappointment for this reviewer concerns the lack of complete references to the many examples
of research cited in this book, particularly in the first two
chapters. Perhaps the author would consider adding these in
the next edition.
This book will be primarily of interest to music therapists
who are attracted to theory and research. However, the book
is rich in clinical material as well. The questions that Smeijsters suggests as criteria for music therapy indications and the
process he employs to answer these questions are interesting
and valuable for undergraduate interns who must grapple with
the question, "Why does music therapy help the client?" In
fact, this work contains a myriad of profound and well-presented ideas that touch on many aspects of music therapy
such as defining treatment goals and interventions for various
disturbances; determining effectiveness in clinical work; developing research; describing paradigms; theory and theory
development and identifying the gap between verbal and non
verbal expression, the meaning of symbols, metaphor and
analogy, and aesthetics, though this list is not exhaustive. This
book deserves to be kept close at hand as a source of inspi-
Book Reviews
123
ration for dialogue and as a reference both for the discerning
clinician and for the researcher.
Lillian Eyre, M.M., MTA
Doctoral Student
Temple University
Philadelphia, PA
Skaggs, R. (2004). Music: Keynote of the human spirit. Baltimore, MD: PublishAmerica. 189 pages, ISBN 1-41374601-2. $19.95.
This well-written book is a rich resource about music's power to expand human consciousness and promote healing. The
author, Ruth Skaggs, has been trained in professional counseling, expressive arts therapy, and the Bonny Method of
Guided Imagery and Music (BMGIM). She has also been a
trainer in BMGIM. This book is the culmination of her 21 years
of experience as a psychotherapist and her study of many diverse sources. A statement in the introduction stood out for
me as a focus for this work. She writes, " T h i s book is an attempt to explore the meaning of music in the whole of humanity, its part in the evolution of consciousness, its role as a
carrier of unconscious universal motifs, and its power to heal"
(p. 11). She increases the reader's awareness of the need for
healing music in our world today, and she challenges the
reader to be responsible and intentional in the use of music.
In discussing the dynamic and universal role music can play
in healing, she states, "music can provide a connection to our
human roots" (p. 13).
The book is thought provoking, inspiring, and easily understood, even by a reader untrained in psychology or music.
There are 9 chapters and many include short exercises for
listening, "using music as a guide" (p. 21) in purposeful and
focused way. Skaggs has taken great care to warn the reader
about using these exercises without proper training for someone else. Each exercise has clear guidelines to prepare the
listener and suggestions for processing afterwards. There are
many examples given from her therapy sessions throughout
the book. As someone also trained in the BMGIM, I found
these examples to be very helpful and inspiring. I see this book
as being useful for music therapists, counselors, or psychotherapists, medical professionals, hospice professionals, hospital chaplains, spiritual counselors, massage therapists, music
teachers, musicians, and lay readers who are interested in using music for personal growth.
In chapter 1, Music as Oracle, Skaggs captures the reader's
attention by sharing many inspiring examples from her sessions with clients. She discusses how music has acted as an
oracular guide throughout history and in many cultures. She
clearly shows how music functions as oracle through images,
metaphors, and synchronistic moments. She compares sound
patterns to the visual patterns in Rorschach ink blots "in that
the response to them is unique to the individual's psyche" (p.
22). She also provides some scientific theories from physic as
a basis for ways music can act as an oracle to sometimes
predict future events, including accurate medical information.
In this chapter she lays the groundwork for ways music functions to evoke archetypal images.
The second chapter, Expanding ConsciousnessThrough Music, is derived from a wide variety of sources ranging from a
seventeenth-century poet to twentieth-century physicists.
Skaggs provides the reader with several theories about consciousness. The lay reader is shown the value in exploring the
inner world of the unconscious and how music can be a
bridge between the conscious and unconscious worlds. She
provides concise information on how brain waves change in
different states of consciousness and how narrowing the focus
of attention, as in BMGIM, enables one to reach these states.
There are several fascinating examples relating music to the
science of cymatics and quantum physics. She demonstrates
the importance of using classical music over other types of
music in exploring the unconscious. She states, "Music that
has its source in an intentionality devoted to the deepter nature of humans reaches the listener physiologically, emotionally, neurologically, and spiritually. It facilitates an expansion
of awareness into limitless realms of experience" (p. 47).
I found chapter 3, The Archetypal Nature of Music, to be
the most interesting chapter in the book. Skaggs clearly explains archetypes and how they influence our lives. She states,
"Music, either in making it or listening to it, consists of fundamental patterns that contain encoders for the creation of
life, human relationships and communication and for the survival of the human spirit. These encoders can be referred to
as 'archetypes' " (p. 51). She gives excellent examples for the
death-rebirth archetype, the archetype of dualism, musical
form as archetype, ground bass as a vessel, music as a path
to center, and archetypal rhythms. There is an important section on the overtone series, which she describes as an archetype of creation. She argues that omitting a large part of the
natural harmonic series, as in synthesized music, constricts
the human psyche and physiological responses to the music.
As evidence for this theory, she includes research on analogies
of musical laws and natural laws. I was reminded of the title
of the book when reading this section, and I found it to be an
important chapter.
Chapter 4, Music from the Beginning, provides the reader
with a historical background on the role music has played in
culture. She states that ancient peoples "used the arts to define
who they were, where they were going, and to find meaning
in their existence" (p. 76)..She poses that creativity and spontaneous expression of music have been squelched in today's
culture. She shares examples of the role music has played in
rituals, both past and present, and sees it as a means for man's
connection to God.
In chapter 5, Music at Healer, Skaggs presents information
that clarifies how music can be a healing agent. I felt that this
chapter was directed more to the lay reader. She points out a
general misconception in our society that music labeled as
"healing" needs to be tranquilizing. She makes it clear to the
lay reader that this chapter is "not meant to be prescriptive"