The analysis of therapeutic improvisatory music with people living with the virus HIV and AIDS

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by  Neil Stewart

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Citation: Lee, C.A. (1992). The analysis of therapeutic improvisatory music with people
living with the virus HIV and AIDS. (Unpublished Doctoral thesis, City University London)
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The Analysis of Therapeutic Improvisatory Music with People
Living with the Virus HIV and AIDS.
Submitted by Colin Andrew Lee
as a thesis for the degree of Doctor of Philosophy.
'
The City University
Department of Music
June 1992
0/0/1 3( cfc\
This Project is dedicated to :
Eddie and Charles, and to the memory of
Francis Towerseg and Celia Mulville.
"Here is no final grieving, but an abiding
hope. The moving waters renew the earth.
It is Spring."
(Tippett : A Child of Our Time.)
Contents.
Page No
VoluJmnee One. The Main Text.
Introduction.� 13.
Part One.
Chapter One. Music Therapy and Terminal Illness.� 22.
1.1. Introduction.� 22.
1.2. A Brief Medical and Sociopolitical Survey of HIV and AIDS.�22.
1.2.1. Definition - Immunology - Virology - Drugs.� 23.
1.2.2. Transmission - The Stages of the Virus - Diseases�31.
Common in AIDS.
1.2.4. Sociopolitical Issues and Human Rights.� 33.
1.2.5. Changing Client Groups - The Future.� 34.
1.3. AIDS. Psychological Responses, Psychoneuroimmunology�35.
and Therapeutic Intervention.
1.3.1. Psychological Problems.� 35.
1.3.2. Dementia and Psychiatric Needs.� 37.
1.3.3. Psychoneuroimmunology.� 38.
1.3.4. Immune Suppressive and Supportive Behaviour.� 38.
1.3.5. The Effects of Therapeutic Intervention.� 39.
1.4. Music Therapy in the Palliative/Hospice Care Setting.�42.
Problems of Practise and Definition.
1.4.1. Pre-Composed Music.� 44.
1.4.2. Pre-Recorded Music.� 47.
3.
1.4.3. Improvised Music.
49.
1.4.4. Summary. 51.
1.5. Music Therapy and AIDS. 52
.
1.5.1. Guided Imagery and Music. (GIM) 52.
1.5.2. Improvisational Music Therapy. 53.
1.5.3. Characteristics of Playing in Improvisational 54.
Music Therapy.
1.5.4. The Clients Evaluation. 55.
1.6. Issues Facing the Therapist. 56.
Chapter Two. Aspects of Improvisation and Music Therapy. 58.
2.1. Introduction. 58.
2.2. Studies and Meanings. 58.
2.2.1. Improvisation as Performance. 60.
2.2.2. Improvisation as Invention. 61.
2.2.3. Improvisation as Process. 62.
2.2.4. Improvisation as Interaction. 63.
2.2.5. Expertise and Musicality. 65.
2.2.6. Conscious and Subconscious Elements. 67.
2.3. Models of Improvisational Music Therapy. 68.
2.3.1. Core Models. 69.
2.3.2. Component Models. 69.
2.3.3. Improvisation Assessment Profiles and their Relevance in 75.
Analysing Therapeutic Improvisation.
2.4. The Musical Components of Therapeutic Improvisation and 77.
their Significance in the Investigation of Music Therapy.
2.4.1. Problems of Transcription. 78.
2.4.2. Modalities of Research. 78
2.5. Stages in the Analysis. 80.
4_
Chapter Three. Experimental Procedure and Methodology. 83.
3.1. Clinical Placement. 83.
3.2. Prior Investigations. 84.
3.3. Method. 85.
3.4. Formulation of the Methodolody. Boundaries of the 86.
Analyses.
3.4.1. Research Location. 89.
3.4.2. Quantative and Qualitative Aspects of Interpretation 90.
and Design. Problems of Verbal Validation and Assessment.
3.5. Stages of the Analysis. 92.
Part Two_
Chapter Four. Analysis One. Eddie. 95.
4.1. Stage One : An Idiosyncratic Description. 95.
4.1.1. Introduction. 95•
4.1.2. Description of the Therapeutic Process. 98.
4.1.2.1. Sessions One to Ten. 98.
4.1.2.2. Sessions Eleven to Thirty. 101.
4.1.2.3. The University (Research) Session. (Twenty-One) 103.
4.1.2.4. Sessions Thirty-One to Thirty-Eight. 104.
4.1.2.5. Sessions Thirty-Nine to Forty-Five. 107.
4.2. Stage Two. An Integral Investigation. 108.
4.2.1. Principal Improvisational Schema. 108.
4.2.2. Aspects of Metric Transcription. 108.
4.2.3. An Inventory of Musical Interrelations. 109.
4.3. Stage Three. Two Constituent Analyses. 114.
5.
4.3.1. Analysis One. 114.
4.3.1.1. Observational Data. 115.
4.3.1.2. Interval ic and Harmonic Consequences. 116.
4.3.1.3. Rhythmic Consequences. 121.
4.3.1.4. Textural Considerations. 125.
4.3.2. Analysis Two. 128.
4.3.2.1. Observational Data. 129.
4.3.2.2. Harmony. 130.
4.3.2.3. Melody. 135.
4.3.2.3.1. Melodic Rhythm. 137.
4.4. Stage Four. Evaluation and Synthesis. 140.
Chapter Five. Analysis Two. Charles. 143.
5.1. Stage One. An Idiosyncratic Description. 143.
5.1.1. Introduction. 144.
5.1.2. Description of the Therapeutic Process. 144.
5.1.2.1. Sessions One to Ten. 144.
5.1.2.2. Sessions Eleven to Fifty. 146.
5.2. Stage Two. An Integral Investigation. 151.
5.2.1. Principal Improvisational Schema. 151.
5.2.2. Aspects of Metric Transcription. 151.
5.2.3. An Inventory of Musical Interrelations. 152.
5.3. Stage Three. Two Constituent Analyses. 158.
5.3.1. Analysis One.�. 158.
5.3.1.1. Elements of Perseveration. 162.
5.3.1.2. Harmonic Implications. 164.
5.3.1.3. Melodic Features.
167.
5.3.1.4. Rhythmic Components. 169.
5.3.1.5. Textural and Gestural Considerations. 171.
6.
5.3.2. Analysis Two. 172.
5.3.2.1. 11:29 - 12:26. Improvisational Development. 176.
5.3.2.2. 13:33 - 14:07. A Melodic Development. (C) P2. ' 179.
5.5. Stage Four. Evaluation and Synthesis. 183.
Chapter Six. Analysis Three. Francis. 189.
6.1. Stage One. An Idiosyncratic Description. 189.
6.1.1. Introduction. 189.
6.1.2. Description of the Therapeutic Process. 190.
6.1.2.1 Sessions One to Ten. 190.
6.1.2.2. The University (Research) Session. (Eleven) 193.
6.1.2.3. Sessions Twelve to Twenty-Four. 194.
6.1.2.4. Sessions Twenty-Five to Thirty-Two. 197.
6.1.3. The Music. 199.
6.1.3.1. Musical Awareness. 201.
6.1.3.2. Tonality and Atonality. 202.
6.1.3.3. Silences. 202.
6.1.4. Conclusion. 204.
6.2. Stage Two. An Intergral Investigation. 206.
6.2.1. The Generative Cell. 206.
6.2.2. An Inventory of Musical Interrelations. 215.
6.3.�Stage Three. Two Consituent Analyses. 221.
6.3.1. Analysis One. 221.
6.3.1.2. Consequences of the Cell. 226.
6.3.1.3. Ambiguity as a Therapeutic Improvisational Schema. 231.
6.3.2. Analysis Two. 235.
6.3.2.1. Sub-Section Nine. The Therapeutic Improvisational Peak. 235.
7
6.3.2.2. Sub-Section Ten. The Therapeutic Improvisational�242.
After Peak.
6.3.2.3. Peak Relationships.� 244
6.4. Evaluation and Synthesis.� 247.
Part Three_
Chapter Seven. Review and Findings.� 253.
7.1. Introduction.� 253.
7.2. Results.� 254.
7.2.1. Hypothesis One. Musical Representation and
Therapeutic Development.� 255.
7.2.2. Hypothesis Two. Importance of Musical Components.�257.
7.2.3. Hypothesis Three. Generative Musical Themes.� 258.
7.2.4. Hypothesis Four. Musical Preference and Culture.� 261.
7.3. Antithetical Expression and the Dialectic of Opposites.�266.
7.4. Emotional Responses and Objective Data.� 268.
7.5. Personal Evaluations.� 271.
7.6. Possibilities for Futher Research.� 273.
7.7. Conclusion.
References.�
276.
EL
Volume Two The Improvisations and Appendix.
Improvisation Number One. Eddie.� 3.
Improvisation Number Two. Charles.� 37.
Improvisation Number Three. Francis.� 70.
Structural Analysis of Therapeutic Improvisatory Music.
Structural Analysis of Post-Tonal Therapeutic Improvisatory Music.
Endings.
Audio Transcriptions.
1) Eddie. - Side One. Extract A.
ii) Charles. - Side One. Extract B.
ii) Francis. - Side Two.
9.