Music Therapist, JP

Published Date: 26th October 2011

Open Windows | In Conversation

Music Therapist, JP

October 26th, 2011

In music therapy the complex blending—active interaction, participation with music, engaging with emotions, facial expressions, and expressive body movements—makes the synergy of the individuals involved special. For the parent, it is the joy to see their child come alive. For the child, it is to experience emotions she has not known, and for an elderly person, it is to feel safe and connected.

In this space of wellness, the reward for the music therapist lies in the satisfaction of transforming lives. Natsu Nagae is a music therapist who values human connectivity and emotional stability. She believes that for families wanting the best for their loved ones and themselves, working through challenges in life and changing attitudes is what leads to celebrating the essence of life.

What motivated you to pursue music therapy?

I went to Music College to become a performer. However, when I went to perform at a competition, in this big concert hall, I did not enjoy myself. It did not appeal to me as much as I thought it would, and I felt distant from the audience. Shortly after, I performed at a concert for daycare services and had the opportunity to meet people with different challenges. They were surrounding me and listening to the music. I was able to see their faces better; I was able to talk about what I was going to play. It made me realize I not only wanted to perform; I wanted to work with people where I could enjoy both, communication and the performance.


What led you to the Nordoff-Robbins Center?

I studied in New Orleans where I received a degree in music therapy after which I met Dr. Clive Robbins, and that took me to study at the Nordoff-Robbins Center in New York.


How was the experience?

It is an intense training program; it is challenging. As a therapist and also as a musician, you have to be studying on two feet—you have to be a therapist, and at the same time you have to be able to navigate the system that goes through music.


Do you play instruments that are typically not used at the Nordoff-Robbins Center?

I play the piano, but I am originally a percussionist. When I was 12 or 13, I went to a concert where a marimba player was performing. This experience stirred something in me, and I wanted to play that instrument. So my mother contacted the marimba player, and I began taking lessons.

At Nordoff-Robbins, training is done with the piano or guitar because many people play the piano or the guitar, and it is easy to use. I was always self-blocked, not being able to do what I wanted to do with the piano. At Nordoff-Robbins they challenged me: “Why don’t you play the marimba?” Right now I use the piano more for practical reasons, and I also use my voice.


The openness in the West encourages a caregiver to enroll a loved one with special needs in schools, which facilitates learning and development. They also engage in therapy for the betterment of the individual. Whereas in a country like India, the focus is on selfishness—it is about one’s image and social standing. They would rather a child or loved one suffer and deteriorate; therapy is still largely taboo. Is this the case with the Japanese culture?

In working with and experiencing families in the United States, I feel people start to speak up earlier than in Japan. They know when the child gets treatment and therapy soon, the child benefits. But for Japanese people, it is harder to accept the facts. It is becoming more open these days, but there are a lot of people who still hide these issues.

It is rooted in a cultural understanding that it is taboo to show one’s suffering. It would be considered as a failure or as being weak. Sometimes I find that though the parents are not the ones suffering from the problems or difficulties, they are identifying themselves externally; they are not identifying themselves with the internal self. They are judging from an external view, what other people will say, what the neighbor will see or say.

Moreover, this makes them afraid to go out with their child, from stating the truth about the developmental disability or learning challenges. It is harder for them to accept the truth and they end up hiding the problem that has to be addressed.


Is this openness reflected in your training at Nordoff-Robbins?

It was very open. Regardless of gender, age, and role—a trainer or supervisor versus supervisee or trainees—everyone was welcome to voice what they wanted to do. If I had some idea or opinion, people would welcome me to speak out. There are many music therapists in Japan, but regarding education and the level of training, I would say that America is stronger. Also, a decade ago when I went to study in America, there were fewer schools that offered music therapy programs.


Are there marked differences in how music therapy is practiced in America versus Japan? If yes, what would you like to incorporate into music therapy in Japan?

I would say that the current situation in Japan might be similar to what it was in America about 15 to 20 years ago. Japan is quickly catching up and pursuing what it should have—adopting different models from countries like America and Europe. The quality of work here is quite impressive. However, it is true that there are pockets of work that can hardly be considered professional. Shifting mindsets to make our work acceptable by and accessible to people is important. If the society does not understand and accept music therapy, it is hard to root its goodness.


I associate the Japanese culture with a natural affinity for aesthetics and appreciation of arts. Do they extend the same to natural healing and alternative therapies, or are they consumed by the pharmaceutical wave?

The modern medical trend in Japan is towards prescribing medicines, more like the American model. However, some people prefer natural healing and also a spiritual connection with health, and that is key.

Nordoff-Robbins music therapy was once a significant movement, and many people studied this model and people connected strongly with this approach. And it is my impression that this was because of the spiritual connection. The image people had was warm and bright, filled with positive energy. Emotions bring unity in group work. Emotions can be resonated, shared, expressed, and somehow it facilitates human development. It is a healthy part of an expression. Some part of the Japanese culture, as you mentioned, about aesthetic, musical or artistic expression is connected to this kind of artistic world. Moreover, people innately believe that the expression of music and artistic modality can channel into a unique area of the human being. And people believe it is helpful for the healing process, even if people have different degrees or various mental problems, it can tap into the healthy part of the person.


As a female music therapist, in Japan, what challenges and obstacles do you face with your clients, their families, and within the hospital setting?

There are some courageous women in Japan pushing forward with their beliefs. Coming back from the United States and working in a hospital, I face the vertical structure of a top-down hierarchy. Some doctors are women, but they remain in positions that have fewer responsibilities. Customarily men still hold positions of authority. Having women’s voices reflected throughout the organization will be welcome. With clients and their families, I feel the core challenges lie in the fundamental understanding of “therapy,” perhaps this can apply to some other Asian cultures as well.


How do you overcome these challenges or how do you work around them?

As you mention, I work around them. In our creative work, seeing is believing. Moreover, experiencing (experiment) goes beyond seeing (observation). So I try my best to do my work thoroughly and wait to talk when there is an appropriate moment. Sometimes my education and work experience in the U.S. brings me to the attention of a person with authority. After a year and a half of working intently with my clients as well as with staff members and colleagues, I had a chance to talk to the chairman of the hospital. In this manner, I can gradually step in and voice my ideas. It does take time, but it is better to have continuous change than building something quickly that falls apart easily.


Your work appears easy from the outside but in reality being a music therapist must demand a great deal of emotional and mental effort as one has to orchestrate the sessions with clarity and effectiveness. What personal qualities must one possess to be an excellent music therapist?

Qualities like calmness, empathy, introspection, and being emotionally stable are important qualities.

At the same time, a person has to be strong enough to make decisions for clients, and that has to be done both therapeutically and musically. And I think it is important to believe in music, and also to provide musical experiences of pure intention of the therapist.


Without stability, therapists can project their personal issues on clients. How do therapists work towards being emotionally balanced?

I find with some younger therapists, they need their therapy. There is a very delicate zone; you cannot use your clients for sessions to help yourself. You have to do self-care for yourself before coming to the sessions. If self-care was not there, it is a dangerous thing. You cannot be a therapist.


So, it is important to have introspection and an understanding of self before one assists another through therapy?

Right, because you can misinterpret what was happening with the client. Then you mislead them and misinterpret the session; this is not professional.


What challenges does a music therapist face?

As you mentioned music therapy appears easy from the outside, what we do, what happens musically, but it is quite demanding. And it is quite challenging, in that people have to understand towards what the therapist is assessing and working.


You want people to understand the complexity and depth of your work.

Yes. To bring out the maximum level takes time. With the Japanese people I often come across the reaction: “Oh, you sing and have happy times, right?” No, it is not like that. We are looking at a much deeper level, and the connections that take place during the sessions are not just surface contacts, rather they are deeper connects. Also, every client has a certain point where they stop growing and are unable to make that next step, a developmental threshold, and we have to help them go up to the next level.


Is it coming to a point where the client struggles to overcome a barrier?

Yes, it is like a growth step. You are at a child’s milestone, but the client is having a hard time making that one little step. It is huge for him, and you have to assist him to get there, and you do it through music.


What’s the rewarding part of being a music therapist?

The reward is that this is life, and only music can make this moment happen; connections happen because of music, and it is wonderful. Also, music is alive, just like the human clock, it does not go back. And the way we work, we improvise music, we use live music in the session, so there are no repetitive moments; those moments are precious. It is a reward.


What does it take to become honest therapists?

An important aspect of becoming a music therapist is to think carefully about music and its connection to human beings. I will say the person does not have to be a professional musician to become a music therapist. It is better to have a good experience or a background in music, but I feel music therapy is very different from performance. It is not performing for others, you are creating the moment through music, and it has to be done with you and the person who is in the session at the moment. So one must think about what music can enhance, what music can bring to people, and search for it. It is one step toward becoming a music therapist.


For instance, if a person has had a bad experience while swimming it is probably not the best idea to get him into the water for any form of therapy. Do you find the same with music therapy, where a client rejects it due to a bad experience or association with music?

Yes. I have. I had a 4-year-old child who was coming into music therapy for the first time. She did not have smooth language communication at that point, and it was extremely hard for me to evoke any reaction from her. I worked with her for at least a year and a half but it was difficult to see any music reaching her, or any sound holding her attention. I could not feel anything from her, and she was like that in most situations, in any therapy. Everyone felt that in spite of making an effort we were not getting any reaction. It was quite difficult for therapists to maintain the motivation to work with her. The more we tried, the more disappointed we would get and go further into a forest, getting lost in the process.

A responsive child reacts quickly, but at the same time, few children come to music therapy and make no progress. I do not deny that not everyone is musical. One key to her was that she related to movement better than sound. So we recommended movement therapy afterward. I think it is good to be open to other modalities. We do not have to say that music therapy is the best. I hope music can be a good drive for many people, but sometimes it is not.


How important are trust and transparency while working with a client?

To bring out quality in therapy, authenticity is important. And for the client, sessions should be natural within the therapist-client boundary for the client to feel safe and comfortable, to share their issues and experiences.

Does harmony and balance within the home environment facilitate therapy?

Yes, I would say it is supportive. Music therapy sessions, especially in the individual sessions, are very protected and cut off from parts of the environment. However, the best result is when something happens in the course that then helps him or her live better and relate to other people better. Often children or elderly are not choosing to come to music therapy sessions themselves; it is often the parents or their families who want them to attend the sessions. And that is because the parents or families want to be able to see the child connecting and communicating as the parents have a hard time doing it. It is not a problem with a child who has difficulties, but parents feeling they cannot connect with a child.

I think music therapists are bridging these two parties. The therapist understands where the difficulties are and bridges the distance between the child and parent, improving their relationship, making it smoother and of better quality. And once they go back after the music therapy sessions, having a better environment is good. It can bring out better results for the child.


Is therapy moving away from being a profession of care to becoming a business—running the money meter instead of addressing the emotional meter?

I was thinking about this the other day, how human emotions can be a marketing business. In my opinion, it should not be a target for business. However, all over the world, many vocations, as well as therapy are becoming a business, and it is just not clicking.


It is exploitive.

Yes, because emotions are not material things. I think it is important that therapy or counseling be accessible to everyone. More and more people have started accepting they might have mental or emotional issues and go to clinics, so it is more accessible compared to 10 or 20 years ago. People do not say: “Are you crazy, you are going to the psychiatric hospital?” The question is how do you open doors for everyone, be accepting and welcoming of people and say: “You are okay. You might have some issues, and you need to have counseling.”


You have worked with Dr. Clive Robbins. What quality of his do you admire the most?

Dr. Robbins’s spiritual quality that has nothing to do with culture or race or the language you speak. Once you see him you are welcome, you instantly know this person and feel comfortable.

Clients who went to therapy where Dr. Robbins was in sessions felt that way. That is why he has such an incredible development with all the clients and the students he teaches


Being in the field of care, you must have to nurture yourself. How do you energize yourself?

Well, this is also self-care. I enjoy baking, love walking in the park and spending time with my friends. Sometimes I like to do just nothing—it helps me reboot my energy. As a therapist, if I cannot enjoy things other than my profession, I will narrow my vision and hinder myself from creating a broad range of creativity. If I can enjoy other areas like cooking or sports, or have conversations with people from different fields, then I have inputs from outside, and that can create different pathways, I can also relate to patients and clients better.


What do you think drives people to pursue visible short-term fulfillment with immediate gratification as opposed to nurturing long-term positive emotions that will give high returns?

It is the internal locus, the location inside of you. It is the opposite of external locus, the place you find around it. If your internal locus is secure and you know your identity, you will not be shaken by what is happening around you. I tend to find that people identify themselves not by who they are but, rather, by what others say is good, or what marketing says is good. These people cannot feel grounded, as they have to be secured by other people’s approval of them.

Those individuals with a secure internal locus can bring parts of themselves and give to others. Whereas those who identify with external locus only want to take from others all the time, to feel secure, to feel cared for, to feel full.