In visible Hands

A project exploring music therapy practice through embodied process of viscerally-supported recall of practitioner knowledge and experience


Download the project publications here:

Gilbertson, S. (2015). In visible hands: The matter and making of music therapy. Journal of Music Therapy, 52(4), pp. 487-514. doi: 10.1093/jmt/thv014

Gilbertson, S. (2013). Improvisation and Meaning. International Journal of Qualitative Studies on Health and Well-being, 8, pp. 65-74.

See Publications for a full list of publications and talks

Project inertia

While studying real-time music improvisation in music therapy since the early 1990´s with people who had experienced severe head injuries and neurological diseases I have been interested in the multiple ways in which the interaction could be described, portrayed and explained. I have experienced the singular nature of every one of these individual's lives. I have experienced how central, peripheral and social processes are embedded in a unique material and physical ecology. In addition to contemporary conventions of prognosis and categorisation, I have been most interested by the hidden, the silenced and the unimaginable.

Project description

In a search for what might be hidden in music therapists' practice knowledge, the study explores what happens when a music therapist selects a specific moment from their practice with a client, focus on the position and ecological context of one selected hand in that moment in an interview, and to experience the visceral changes to their perception of their hand during the sensorial complex process of creating a body cast of their selected hand. After creating molds of teh hand with alginate, the hand casts were created with an acrylic called Acrylic One.
The participants worked as qualified music therapists in a range of diverse settings (their real names have been changed for the purpose of the study):
Alexander worked in a hospital providing care for people with Huntington's disease which is a neurodegenrative disease.
Nils talked about his work with an adult who had experienced abuse during childhood.
Roy chose to reflect on his work with parentless teenages in child welfare care institution.
Samuel talked about improvising with a man with a severe disorder of consciousness as a result of a traumatic brain injury.
Sissel talked about creating music with a 4-year-old boy with multiple physical and visual impairments.
Tommy talked about improvising on electric guitars with a young prison inmate during a Christmas event in the prison.

Project innovation

This project is innovative in two ways:
It is the first study in music therapy that during the research process facilitates a process of change to the central and peripheral nervous system state of an interviewee's hand whilst concurrently recalling and reflecting verbally and physically about a specific self-selected moment from their music therapy practice. It is unique to this study to combine body casting and semi-structured interviewing in a research project in this field.

Project findings

It is also the first study in music therapy that acknowledges the presence and influence of of the selected themes: The biographic hand, The body, space, place and time, The plural hand, Matter of the hand and The method in hand.

The biographic hand

The hand is organic biography, it is living history and physio-socially unique. Although when we speak of specific topics it is possible to separate the hand from the life lived and experienced, hands are physiologically, phenomenologically and historically inseparable.

The body, space, place and time

When playing music with the hands the body inhabits spaces and creates places of happenings that evolve over time. Thinking about these aspects highlights how hands are intertwined in the material and site of the events and the meaning that is driven by them.

The plural hand

Although hands are of a physically stable numeric total, and it is simpler to think of hands just doing or meaning one thing at a time, this has not found any support in the reflections of the participants or related literature. Quite oppositely, hands are involved, implied, lead, exhibit, dictate, perceive, symbolise and so on, and that all at the same and different moments in time.

Matter of the hand

The hand is a part of a material ecology of actions and thus has parts of materially complex processes. A manual immersion in and with the matter and material qualities of music instruments demonstrates how human intergration with tools and vice versa is meaning filled and knowledge filled.

The method in hand
To understand human actions, the actioning human must be involved in research projects which aim to acheive this goal. By giving the hands the possibility to be present and dictate the process of a research action, it's invisibility becomes tangable, details emerge from a self-silenced knowing and the participant is opened the opportunity of more extensive phenomenological undestanding of their work which can be shared with others.

What this project adds

This projects reminds of the option to consider patients, clients, therapists, in fact all humans, to be inseparably intertwined within an embodied, situated, narrative of living and non-living beings, materials, processes and stories. The participants uncovered previously hidden or difficult to access themes that emerged as significant to their relational work of perceiving, acting and reflecting as professional music therapists. Together with existing literature, the participants highlight inseparability and multiplicty that transcends diverse therapeutic approaches.

The consequences of this project are important in terms of a growing committment to an exploration of the hidden, silenced and multiple in future research projects, and make apparent the need for a retrospective analysis of music therapy approaches in terms of the project findings.

Finally, this project calls for a questioning of all grand narratives that solely call for theory-driven and evidence-based practice, especially when there are so many concurrently silenced and hidden ways of telling what is going on in music therapy. It is not bravery that is needed to extend conventions or explorations of research methods. We do not need a list of recognised research methods defined by the type of data that is apparently best at reflecting the research topic whether it be qualitative, quantitative, mixed or arts-based. What is required is a precise questioning of the phenomena that is chosen and an acceptance of the nature of the research topic. This is what should call forth an imagination of a researcher's response. This is ontology, epistemiology and ultimately anthropological stance.

In this project, the participants and related literature encourages a continuing exploration of the sum of music therapy narratives, including all forms and ways of knowing, hidden and obvious, and those with a significant past and an emergent future.

Below: Selected images of the process of the materials, process of creating a mold and a cast of a hand in acrylic.

Example images from the casting process

For more information about the acrylic used in this project visit the Acrylic One website.