The Language "Barrier"

Going into the first children’s rehabilitation group at Sirindhorn National Medical Rehabilitation Centre (SNMRC), we were left to our own devices to plan and deliver a 60-minute session to approximately 8-10 children with Autism Spectrum Disorder (ASD) and Cerebral Palsy (CP).  This was week 3 in the trip. At this point, I was comfortable with small amounts of Thai and had memorized most of the words (sounds, really) to many of the Thai children’s songs.  We also had the opportunity earlier in the trip to observe and participate in music therapy sessions led by Thai students.  A small group of us planned the session together for that day, including almost all of the Thai children’s songs we knew (here is a video of one of my favorite Thai songs).  Each U.S student contributed to the session, as did Dr. Register and Karn; Karn led in Thai and Dr. Register led in English.  The (90-minute) session was a success!  

Reflecting on my part in that session, though, I was disappointed.  As an MT-BC, why hadn’t I stepped up more?  Why didn’t I feel as successful as I have in past sessions in the U.S.?  The main answer to that question is that when I was planning, I assumed that the language really mattered.   I had never considered using music I have used before, songs in English.  

I knew the importance of nonverbal communication from my perspective as a therapist working with nonverbal clients in the U.S.   The client can communicate so much without words and, as the therapist, I can be attuned and responsive.  I never fully considered the reverse: the weight of the nonverbal communication by the therapist. In other words, I always placed too much importance on the language I used with my clients.  It would be foolish to suggest that as a music therapist I don’t use any language to lead sessions, or that at times language is helpful and necessary.  However, to quote Dr. Register, “Language is not the center of what we do.” 

My previous travels abroad have given me a new understanding of and empathy for immigrants to the United States and international students.  Until this trip, I had never connected how the experience of traveling to a country without speaking the language mirrors the experience of a client in therapy.  Traveling abroad presents one with challenges including not being able to communicate one’s needs or do what was done so easily before, like find a bathroom (or even use a bathroom!), order food and get from one place to another.  After this session, I saw this connection easily with the clients with ASD and CP, as well as my previous and current clients in the U.S. -how many times have their needs gone unmet or have they been misunderstood?  

I had not made the connection until our final clinical day that this metaphor is even more suitable for an adult recovering from a traumatic brain injury or a stroke. We started at SNMRC, again, but this time with a group of adults in rehabilitation.  Susan Dustin and Ron McDiarmid, Laughter Yoga leaders, led the session (more information about Laughter Yoga can be found here). The group of clients has worked with Susan for about 18-months and they easily followed Susan’s lead, laughing with her rhythmically and freely.  One of the most impactful moments was when Ron, guided by Susan, led the clients in gibberish talk.  The clients were invited to “say” whatever they came up with, free from words but not from expression.  We laughed as a group to see and hear pure emotion move between the players in each conversation.  

Music also does this, not as a universal language but a way to connect with one another which, in turn, facilitates change.  Practicing music therapy has been just that in Thailand: a chance to practice and deepen the ways I use music with clients. Music and connection are at the center of how I will practice music therapy from here forward- language is ancillary.

Susan, Ron, Mam and all of us after the adult session (Photo credit: Lily Karrer)