Let’s Talk About Iso-Principle: Part 2 – The Questions

Last week I introduced and reviewed the topic of iso-principle. If you missed that post, you might want to head back to it here so that you are on the same page with me. I broke down my thoughts and opinions on the topic because I wanted to discuss something even more important: all of my related questions.

If you haven’t caught on yet, I am a person who questions everything in what I like to think is a healthy way. I used to consider my constant questions and re-evaluations as “over-analyzing”, but I truly believe that if you are aware enough of why you are posing these questions to yourself or to people close to you, then you are simply seeking ways in which to grow and evolve.

An example of this might be you simply observing someone else in the store and questioning why they may be looking so frazzled. This is your brain asking yourself, how can I help this person be more comfortable? But also, why does it concern me to see someone else uncomfortable?

Another example of this might be when you seek out a friend to discuss how another friend reacted to a comment you made. This is you considering what you said from another perspective and seeking out opinions other than your own to help you learn how you could have handled this situation in a more beneficial and harmless way.

If you don’t pose questions, how do you learn?

I like to think of myself as someone who knows a lot about iso-principle. I also like to think of myself as someone who hardly knows anything about iso-principle. I distinctly remember going to music therapy conference the first year I was a new professional and being ecstatic that I was going to spend the long weekend interacting with other music therapists. I was especially looking forward to being able to pick their brains about every question I had filed away throughout my first 6 months in my new job. During these 6 months I was the only music therapist in my company, and I was getting accustomed to being the expert in music therapy amidst doctors, nurses, massage therapists, marketing reps, etc. Iso-principle was the one technique I had continuously worked to refine and master throughout internship, which, realistically, had me grow from being completely oblivious at the start of my internship to being aware of the principle and how I used it, but no where near “mastering”. I was still lightyears away from being fully in charge of iso-principle, self-awareness, and working “in the moment” during sessions.

What had ended up happening as I was thrown out into the real world on my own was that I realized after leaving the safety of being a student, that’s when all of the questions flooded in. When you are now the expert in your field, who can you pose your questions to? This is where conference came in. I was so excited to get answers!

Except, I didn’t. In fact, I just had more questions. My number one question about iso-principle, which was very related to my work in hospice care at the time, was this:

1. When you are working with someone who is hard of hearing, how do you utilize iso-principle? Let’s say that patient Patricia is depressed, lethargic, isolated, and irritable. Oh, and she is hard of hearing, despite her hearing aids. This challenge may be a contributing factor to her current demeanor and affect, so how do I meet her where she is at? I want to provide music and a therapeutic demeanor/environment that matches her mood, but what if she can’t hear me? Do I speak so loudly that I end up yelling, which alarms her because I am yelling (and therefore not matching her mood), or do I end up speaking in a normal voice to meet her reserved state, and therefore end up frustrating her more because she can’t hear me? What is the correct balance?

I started with this first question, but then immediately continued to question similar scenarios, until I had multiple related questions; such as:

2. How do you know you are correctly using iso-principle with a client with locked-in syndrome? Locked-in syndrome essentially means that someone is cognitively present and understanding their environment and conversation, but their brain is unable to communicate their understanding. This is a current challenge of mine with my TBI client, who cannot control facial expressions or motor movement to convey feeling or responses. How do I know past my best judgement that I am meeting them where they are at?

3. How do you match iso-principle in a large group session? This can be done a little easier with particular groups of clients or patients, but this question is a bit more specific to my current clientele. I recently had a too-large group of adults with IDD, and spend some time checking in with each client (Hello, how are you doing today?). What happens if one person is feeling very low while the rest of the group is high energy and happy? How do you validate this person’s feeling and help connect them better to the group when your focus is divided by 10+ other people?

And finally, most importantly:

4. How do you self-evaluate your abilities as a therapist against all of these considerations and un-answered questions?

Sometimes I wonder if there really are answers to these questions beyond using your best therapeutic judgement. It would be wonderful if there were black and white answers, but I have a feeling there aren’t. Although I didn’t find these black and white answers at conference, what I did end up learning was much more revealing. Not only did I not find answers, but I found that no one else seemed to be asking these questions. In fact, some people I spoke with had no reaction to these questions!

A lot of these experiences are what helped me to decide to continue my music therapy studies at the master’s level. I want to seek out supervision, participate in tough conversations, and follow more guidance on how I can better obtain these answers. If you have any ideas on how to answer some of the above questions, please, let me know! Otherwise, I’ll try and keep you posted…. Nevertheless, I hope it encourages you to be more questioning, whether in music therapy, or in life.

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