Psychoanalytic music therapy (Pellizzari)

Domain VIII · Creative & expressive arts therapies · Patricia Pellizzari · 1993 · Buenos Aires, Argentina

What it is

This is a theoretical orientation, not a manualised method. Pellizzari's 1993 book reads music-therapy practice through Lacanian psychoanalysis. Its subtitle, "the malaise in the voice", points to voice and sound as the place where the subject's suffering shows itself. The author is Patricia…

Format

• None of the sources describes phases, session counts or criteria for moving between phases for Pellizzari's approach. The frame below is a based on psychoanalytic convention and on the UBA case material. It is not taken from Pellizzari.
• Working phase. Aim: musical and spoken production inside the transference. The therapist chooses at each moment between a stance of comprensión (understanding) and one of análisis, a distinction reported from Pellizzari pp. 51–52. In severe cases (psychosis, autism) the work may consist of building…

Who practises it, and how they are trained or regulated

• Preliminary phase (assessment and the start of transference). Aim: hear the reason for consultation, observe how the person uses voice, sound and silence, form a structural diagnostic hypothesis, and find out whether a transference can form. The UBA authors treat transference as something that shapes diagnosis itself, not as something that comes after it. Format: individual, about weekly. Time: often 3–6 meetings.…
• Ending. Plan the ending when the complaint has shifted, when the person can sustain their own musical or social link outside sessions (for example, performing at institutional events in the UBA case), or when the frame cannot continue. Prepare the ending over several sessions and work through it in the transference.
• Professional frame. Use this approach only if you are a qualified music therapist with psychoanalytic training, or a psychoanalytic clinician working jointly with one. In Argentina, music therapy is a regulated health profession under the national Ley 27.153 de Ejercicio Profesional de la Musicoterapia (sanctioned 10 June 2015, published in the Boletín Oficial on 3 July 2015). The law reserves practice to: holders…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Technique replacing listening.
• Speech felt as intrusive or persecutory.
• Doing it mechanically. It is working when the shift brings out new material.
• Intrusion felt by the patient: covering ears, leaving, rising agitation. Step back.
• Fixing a diagnosis too early. Using musical behaviour alone as proof of a diagnosis.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.