Music therapy looks different in
different cultures, just as other forms of healthcare look drastically
different in other countries based on cultural norms. In an American hospital,
it is common to see individual music therapy sessions happening in patient’s
rooms, as well as group sessions in common areas. Thai hospitals operate
differently. Many Thai hospital units have rows of beds in one large room
without partitions. Because of this, most music therapy on these units is done
in group sessions only. Even in Thai units where the patients have private
rooms, it would be seen as an invasion of the patient’s privacy for a music
therapist to come into the patient’s room.
This was a
big change for me to process. We were placed into our first sessions with a few
Thai students at Siriraj hospital early in the trip. I had no idea what to
expect. At first, the hospital looked
very similar to American hospitals I had seen. Seeing the unit for the first
time was shocking, and leading a group session with the entire unit was a very
strange experience. Even little differences really stuck out to me. The nurses
wore uniforms like nurses in America wore in the middle of the 20th
century. I was allowed to wear my Birkenstocks as a therapist on the unit. I
don’t have any experience in any of these settings, so I didn’t know what I was
looking for. The nurses seemed overjoyed
that we had come, but it was harder for me to take data on the patients because
I was with a new group each week.
It took me a long time to process
my experiences at Siriraj even after we discussed the cultural norms of Thai
hospitals in class. The students we were working with were also first year
students, who had just begun the music therapy program one month before our
arrival. I finally began to realize that
this was an opportunity where we could all learn from each other. Being a farang,
I had more clinical experience than the Thai students, but I was clueless about
Thai culture, especially in a medical setting. Before my final session at
Siriraj, I sat down with one of the Thai students I was working with to plan
our session. I asked her questions about the hospital and what her sessions
looked like when I wasn’t there. I then suggested ways we could engage the
clients more and focus on the intentionality of the music.
This is a picture of my friend Ploy
and me talking after our final session at Siriraj.
Another striking difference between
Thai and American sessions was emotional expressions. Generally, Americans
speak more freely of their emotions than Thais. The Thai people are generally
very reserved, and are taught from a young age not to express significant
emotion in public. In our final session with older adults recovering from
strokes at Sirindorn Rehabilitation Center, these two cultures combined
beautifully. The American students teamed up with Susan Dustin and Ron
McDiarmid, Laughter Yoga leaders who work with the group weekly (Read more about
Laughter Yoga here: http://www.laughteryoga.org/english).
At the end of the session, we sang “May the Road Rise to Meet You” to the Thai
patients to express our gratitude and well wishes. Many of us were teary-eyed
by the end of the song. One woman, a caregiver for her father, was so touched
that she led the rest of the Thais to sing a Thai song of encouragement for us.
She shared her gratitude for the joy and physical improvements she had seen in
her father through our sessions. Previously, this woman had been fairly
reserved, only speaking to greet and thank the staff. She told us with tears in
her eyes that this was the first time since her father’s stroke that she had
seen him sing an entire song. This moment set aside cultural differences and
allowed us to relate to each other beyond our nationalities.
Through my clinical work here in
Thailand, I have seen how crucial it is to consider one’s culture in a clinical
setting. I don’t know the whole story, but I need to be willing to learn in
order to be therapeutically effective. I treasure these relationships I have
developed with the Thai people. It is so hard to say goodbye to people that
have become family, and a culture that has come to feel like home.
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