Making My Body A Safe Place To Stay - A Psychotherapeutically Oriented Approach To Vibroacoustic Therapy in Drug Rehabilitation

Copyright © 2011. Barcelona Publishers. All rights reserved.
May not be reproduced in any form without permission from the publisher, except fair uses permitted under
Chapter Twenty
MAKING MY BODY A SAFE PLACE TO STAY: A

PSYCHOTHERAPEUTICALLY ORIENTED
APPROACH TO VIBROACOUSTIC THERAPY IN
DRUG REHABILITATION
Marko Punkanen and Esa Ala-Ruona
INTRODUCTION
This chapter describes a psychotherapeutically oriented approach to vi-

broacoustic therapy, called physioacoustic therapy, for a woman in drug
rehabilitation. Sara was 23 when she began therapy and had been using
drugs for ten years. Sara’s therapy started as a follow-up treatment after a
six-month period in a drug rehabilitation centre. She was directed to mu-
sic therapy by a local social and health services organization and the
therapy process occurred in a private practice. Sara had great difficulty in
regulating and tolerating strong and negative emotions, and this became
the main focus of our work. The whole therapy process lasted six months
and was divided into three phases, in which the intensity of the therapy
sessions varied from two sessions per day to one session per week. In a
secure therapeutic relationship, it gradually became possible for Sara to
notice and experience bodily sensations related to different emotions and
thoughts, and also tolerate and regulate emotions, which she had earlier
thought to be intolerable without drugs.
The clinical method described here, physioacoustic therapy (Le-
U.S. or applicable copyright law.
hikoinen, 1997), is a form of music therapy that uses low frequency

sound waves and music listening to address emotional, cognitive and
social problems, along with bodily sensations. The method is psycho-
therapeutically oriented (Ala-Ruona & Punkanen, 2007).
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Account: s4779031
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Making My Body a Safe Place to Stay 351
FOUNDATIONAL CONCEPTS
Physioacoustic Therapy in a Context of Music Therapy and Drug

Rehabilitation
According to Reed (1994), drug addiction is often defined according to

how often drugs are used, which drugs are used, how large the doses are,
and how long they have been used. Although these are important factors
to consider, they do not fully define the concept of drug addiction. Ac-
cording to Reed (1994), addiction is not so much a question of continu-
ous drug use, but is defined above all by compulsive use, combined with
loss of control, denial of the problem, and the continuation of use regard-
less of the negative consequences (Reed, 1994).
Drug rehabilitation can be divided into two main phases: the acute
phase, also called detoxification, and the follow-up phase. The possibili-
ties that music therapy offers in the treatment of different kinds of addic-
tion have been studied throughout Europe and the United States (e.g.,
Baker et al., 2007; Erkkilä & Eerola, 2001; Ghetti, 2004; Hairo-Lax,
2005; Horesh, 2006; Punkanen, 2002; Punkanen, 2006a; Robin, 2005;
Ross et al., 2008; Ryynänen, 2004; Soshensky, 2001). According to Pun-
kanen (2006a), music therapy in drug rehabilitation should be very inten-
sive in the acute phase. In practice, this means up to two sessions per
day. This helps the client to engage in the therapeutic process. In the fol-
low-up phase of treatment, the frequency of therapy should be two to
three times per week, and in order to maximize the potential for ongoing
recovery, should last two to three years.
Vibroacoustic therapy is traditionally considered to be a physical
and receptive form of music therapy, which uses pulsed, sinusoidal, low
frequency sound on a specially designed bed or chair (Skille & Wigram,
1995; Wigram et al., 2002). Vibroacoustic therapy is used with various
client groups, and different kinds of technical devices have been devel-
oped in Norway, Finland and the USA (Hooper, 2002). The vibroacous-
tic device described in this case study is a Finnish application called the
physioacoustic chair. This computer-controlled device produces low fre-
quency sinusoidal sound vibration between 27 and 113 Hz, and the main
adjustable sound parameters are pulsation, scanning and direction (Lehi-
koinen, 1997). Six loudspeakers divided in four channels are located in
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352 Punkanen and Ala-Ruona
the treatment chair. The chair is adjustable for comfort, and treatment
programs can be created and edited with special software. These individ-
ual treatment programs can be saved for later use.
Physioacoustic therapy uses this combination of low frequency
sound vibration and music listening to work with different levels of ex-
perience (sensations, emotions, images, memories and thoughts). Verbal
reflection is also part of the process. This kind of multimodal approach
enables one to work with the client’s physiological and psychological
experiences at the same time, in a flexible way. Use of these key ele-
ments varies between client groups and also depends on the framework,
training and competence of the therapist (Ala-Ruona, 1999; 2003). Fig-
ure 1 provides an overview of the relationship between physioacoustic
therapy and vibroacoustic therapy, of which a more detailed discussion
of the central elements of physioacoustic therapy are presented in the
following section.
Figure 1. Physioacoustic Therapy in a Context of Vibroacoustic Therapy

The Role of Sound Vibration
Low frequency sound vibration is central to the therapeutic process. As

such, it can be used for either relaxation or activation. In most cases, the
main aim is to help the client calm down and reach a state of deep relaxa-
tion. This can be achieved by using the three main sound parameters of
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the physioacoustic device: pulsation, scanning and direction. Slow pulsa-

tion is used for relaxation and faster pulsation for activation. Scanning
changes the frequency of sound in a chosen range. This allows the thera-
pist to find the ideal sound frequency to resonate with the affected area
of the body. Each time a muscle resonates with a sound stimulus, it will
deepen the relaxation of the muscle. Sound can be directed to move from
the legs toward the head, or in reverse direction. Based upon clinical an-
ecdotes, changing the direction of the sound appears to be beneficial in
the treatment of stress-related symptoms and muscle tension. When
combined, these adjustable sound parameters provide diverse possibili-
ties in designing and editing treatment programs to meet individual the-
rapeutic needs (Lehikoinen, 1997).
The Music Listening Experience
The role of the music listening experience in physioacoustic therapy can

be entertaining, relaxing or activating in nature (Ala-Ruona & Punkanen,
2007). According to Punkanen (2007), in the context of drug rehabilita-
tion, it is closely related to the stage of treatment. In the acute phase, the
entertaining and relaxing aspects of music are most important. As such,
the main objectives are to increase the client’s feelings of relaxation and
safety (e.g., Pelletier, 2004; Bartlett, 1996). In the follow-up phase, the
role of music is both relaxing and activating. Here it is important that the
therapist sensitively assesses when the client is able to use music that
activates strong emotions, images and memories and when there is need
to use music that calms the client and helps him/her to relax (Punkanen,
2006b).
The Role of Therapist
The role of the therapist in this approach is multifaceted. In the begin-

ning of the process, the therapist is active in creating therapeutic condi-

tions where safety and trust can develop. The therapist begins by describ-
ing the basics of the treatment procedure and methods used during the
therapy process. The aim here is to reduce the client’s anxiety toward a
new and unfamiliar situation, and to help a client to adhere to the treat-
ment. The therapist encourages the client to engage in reflection and
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share emerging experiences by working with bodily sensations, emo-

tions, images, memories, thoughts and beliefs. Finally, the therapist helps
the client to integrate these experiences and insights into his/her current
life situation and personal history (Ala-Ruona & Punkanen, 2007).
The therapist is sensitive in observing the client’s psychobiological
states and he/she works as an interactive regulator for the client’s dys-
regulated states (Ogden et al., 2006; Siegel, 1999). When there is enough
safety in the therapeutic relationship, the therapist also confronts and
challenges the client to find alternative views to problematic issues. The
therapist’s interventions can be verbal or centered on choosing music or
treatment programs.
Figure 2. Key Elements of Physioacoustic Therapy
To summarize, the key elements of physioacoustic therapy are de-

scribed in Figure 2. In the center is the client, because the basis of this
approach is to actively engage the client in the process. The main ele-
ments in treatment are the effect of sinusoidal sound, the effect of music,
and the effect of the therapist — how s/he contributes to the formation of
the therapeutic alliance, mutual interaction, and how s/he helps the client
to process emerging experiences. The areas of experiences to be dis-
cussed include thoughts (cognitive level), images (symbolic level), emo-
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tions (emotional level) and bodily sensations (sensorimotor level). Con-

ducting the therapeutic discussion on these levels enables the developme-
nt of an individually tailored and meaningful therapeutic process, along
with the evaluation of the physical, emotional and cognitive areas of a
client. This approach can also be utilized as a part of other therapeutic
methods (e.g., clinical improvisation) or with related treatments (e.g.,
physical therapy).
THE CLIENT
Sara was a 23-year-old woman who lived together with her spouse Matti.
They didn’t have children together, but Matti’s two children from his
earlier marriage visited them regularly. During physioacoustic therapy,
Sara was participating in an outpatient program. Before attending this
program, she had spent six months in a drug rehabilitation centre, and
physioacoustic therapy was planned for her as a follow-up after returning
home from the centre. When the therapy process started, Sara had been
off drugs for six months.
Sara had a ten-year history of drug use. She started to smoke when
she was thirteen, and one year later started to use cannabis and then am-
phetamines. Her drug of choice was amphetamines, although she had
also tried ecstasy, cocaine and heroin. Drug addiction had caused many
problems in Sara’s life, and now she was in a situation where she was
very motivated to work with the issues related to her addictive behavior.
Sara felt that returning from the rehabilitation centre to her home-
town was challenging and wanted to have as much support as possible to
maintain the changes she had made. She felt very lonely because she had
to sever all the relationships that were related to her drug use. Sara felt
scared to start living without drugs in an environment where drug use
had been the main part of her life. Sara was particularly scared about
how to handle all the strong and difficult emotions and memories that she
had previously regulated through drug use.
Assessment
The initial assessment was conducted by using a semi-structured inter-

view that consisted of five main themes: history of substance abuse, rela-
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tionship to music, relationships, emotions and emotional processing, and

aims and expectations of the therapy process.
When talking about music and its meaning, Sara spoke of how she
listened to lots of music and that song lyrics were the most meaningful
part of music for her. She said that she often found themes from song
lyrics, and that she selected music for listening based on her emotional
state at the time.
Sara said that for her, a good relationship meant that there was trust,
where each person could be honest with the other. She felt that she had
that kind of relationship with her spouse, Matti. Sara also felt that she
currently had quite a good relationship with her parents and brothers.
Earlier, there had been many problems in her relationship with her par-
ents and spouse because of her drug use. All her friends who weren’t
involved in drugs had disappeared from her life. Now that she had
stopped using drugs, she had to break up with those friends who were
also drug users.
When talking about emotions, Sara spoke of how she was very sen-
sitive on an emotional level. At first she said that emotional processing
of all kinds was easy for her when she was sober. However, as the inter-
view continued, it became clear that getting angry was impossible for
her, even though she wanted to be angry. Sara said that it was easier for
her to handle all kinds of emotions when she used drugs, because once
on drugs, she was no longer so sensitive. She said that when she was so-
ber she was always stressed and thought too much about things in her
life. So, it was a relief for her to reduce that sensitivity by using drugs:
When you take drugs you don’t have to think anything. There is
nothing that makes you feel bad. It is easier to be in that way, or
that’s how I thought earlier. But of course it is better to stay with
your real emotions and try to find ways to handle them without
drugs.
When Sara reflected on her style of emotional expression, she recognized

that it was easier for her to express positive emotions than negative ones.
Positive emotions for her were joy and happiness, while negative ones
were anger and sorrow. Sara described how she had been bullied at
school, and felt that she had to be stronger and harder to be able to sur-
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vive in relationships. She spoke of having taken on a kind of protective

shell, which included being rude and unfriendly. She felt that this role
was very contradictory to what she felt inside her. It had become a way
to survive in life and cope with threatening emotions. Sara noticed that
her experiences of being bullied had a direct link to starting to use drugs.
It gave her relief from her emotions and provided a social group where
she felt safe and accepted.
Sara identified working with negative emotions as the main theme
for her therapy. She said that expressing anger was so difficult for her
that, when she had a quarrel with her spouse, she totally froze. She de-
scribed these situations as follows:
I become like a little helpless child. I can’t do anything. And then I

am totally hysterical. I feel that everything will fall apart until
someone solves the situation.
THE THERAPEUTIC PROCESS
Sara’s therapy lasted six months and was divided into three phases. The
first phase was very intensive in nature, as therapy sessions were held
twice a day. This phase lasted only one week, but helped Sara to engage
in the therapy process. The second phase was over two months, where
sessions were held twice a week. In the third phase, sessions were held
once a week, and this period lasted four months.
The basic structure of every session included an initial discussion,
which lasted about ten minutes. During this discussion, general issues in
Sara’s current situation were addressed and preparations were made for
her physioacoustic treatment, including the choice of music she would
listen to. The physioacoustic program and music listening method that
followed lasted from 25 to 30 minutes. After this came a therapeutic dis-
cussion wherein Sara’s sensations, emotions, images, memories and
thoughts raised during the physioacoustic and music listening program

were reflected upon and integrated. Each session lasted 60 to 70 minutes.
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Phase One (sessions 1–10)
In Sara’s first session, the therapist chose a modified relaxation program,

which used frequencies from 27 to 80 Hz with slow pulsation and mild
strength. Music used in the first session was from Kitaro’s Silk Road IV,
which is Oriental instrumental music with a slow tempo and a stable
rhythm. Melody lines in Kitaro’s music are slow and sustained, and the
dynamics of his music are also very soft, which works well with the phy-
sioacoustic program used.
After the physioacoustic and music listening experiences, Sara felt
very relaxed and safe. Music awoke images of water, a small river and a
beautiful summer’s day. During the therapeutic discussion Sara started to
talk about her feelings of insecurity that she often felt when she was
home alone. She said that she didn’t know how to be alone and that made
her feel vulnerable and insecure. When exploring these feelings of inse-
curity, Sara said that she didn’t feel insecure when she was a child and
these feelings began when she was being bullied at school. In the first
session, the therapist also started to ask questions that helped her to be
aware of what was happening in her body. According to Ogden et al.
(2006), the therapist can teach the client to be mindful of his/her body
experience by asking questions that require awareness of bodily sensa-
tions in the present moment. Sara noticed positive sensations all over her
body. She was somewhat surprised because normally she was only aware
of negative sensations linked to negative emotions; emotions that she
wanted to get rid of. Now she was connected with positive body sensa-
tions related to feelings of security and relaxation, along with the positive
images evoked by the music.
In the second session the same physioacoustic program was used.
This program was used, with small adjustments, as the main program in
Sara’s therapy. This time classical music was used (Albinoni’s Adagio
for Strings), and it evoked strong emotions of sorrow in Sara. She didn’t
feel insecure, but she said that it wouldn’t be possible for her to listen to
that kind of music by herself at home. Sorrow was something that she
couldn’t imagine herself feeling while alone. She said that it was good
and important for her to feel it now in therapy. The therapist helped her
to relate her bodily sensations to her feelings of sorrow, and she noticed
that it was hard to breathe. She also noticed that there was a lot of tension
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in her stomach and chest area. Noticing this and integrating it with feel-
ings of sorrow connected her to images about church, funerals and her
grandfather’s death. Her grandfather had died two years before, and this
experience helped her to integrate his death at all levels of information
processing. According to Ogden et al. (2006), it is important to link sen-
sorimotor, emotional and cognitive levels of information processing to-
gether when processing traumatic memories with the client. Caldwell
(1996) talks about the addictive spiral that begins with an intolerable ex-
perience. It is typical that this kind of experience is felt as a threat to
one’s physical, mental or emotional survival. An intolerable experience
stimulates a fight or flight reaction that makes us search for a relief from
the situation. The deep sorrow that Sara brought up in this session re-
vealed this kind of intolerable experience, which she wasn’t able to han-
dle by herself. She needed someone to help her tolerate and regulate
these strong emotions.
In the seventh session Sara felt very relaxed and happy after the
physioacoustic program and music listening. However, she had difficulty
trusting these feelings and was afraid they would be taken away from
her:
I am so happy now, but it has always been so that when I am happy,

I don’t dare to feel that way because I am afraid of what will hap-
pen next. So now I am waiting for what horrible things would hap-
pen next. I can’t be happy. But on the other hand, I think that finally
it is time for me to be happy.
Trying to control situations and experiences through denial is part of the

addictive spiral (Caldwell, 1996). Sara’s comments reflect a basic mis-
trust of life. She seemed to be prepared for the worst, even though things
were quite good at that moment. Her belief about the outside world was
negatively colored. However, now that she was in therapy, she was able
to reflect and discuss all these things with the therapist, as she was expe-
riencing them, and without the use of drugs.
During the first week of intensive therapy, Sara had many good
compensatory experiences from the therapy sessions. She noticed that it
was possible to experience positive body sensations and emotions with-
out drugs. She was also able to experience negative feelings without get-
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ting overwhelmed by them. That made her motivated to continue ther-

apy, and built trust with the therapist.
Phase Two (sessions 11–26)
In the second phase of the therapy, we started to go deeper into themes

and emotions that had emerged during the first phase.
In session 17, when music identical to the first session was used
(Kitaro), images relating to water rose again, and Sara surprisingly spoke
of how she was afraid of water. However, in music-based images, water
had also appeared to her as a place of safety. This strengthened the link
between images of water, positive sensations and feelings of safety. In
discussions about fears, Sara said that being alone at home made her hys-
terical sometimes. In those situations, she felt strong negative sensations
in her body. It was intolerable to stay with these painful sensations and
feelings and she felt that she wanted to leave her body because of them.
Sara described drug use as an effective way for her to escape those
intolerable experiences. Drugs certainly can be a relief for this kind of
situation. According to Caldwell (1996), when using drugs, control loos-
ens and we feel freer for a while. Through this, an illusion is created in
which we feel that we are taken care of. At the end of this session, the
therapist guided Sara to visualize this positive water image again, and at
the same time asked her to notice what was happening in her body. Sara
reported sensations of warmth in her chest and hands and the therapist
encouraged her to just feel those sensations and stay with them for a
while. According to Siegel (2007), it is important to notice that “sensing”
is different from “noticing” because they involve two different streams of
our awareness. In integrative therapy work, we want to bring both these
streams into balance, increasing our client’s integration of both. In Sara’s
case, she was now willing and able to stay with these sensations, “just
sensing” what happened in her body and mind.
In session 24, a more activating program from the physioacoustic

device was used with progressive and stimulating music from Finnish
composer Pekka Pohjola. Memories started to emerge for Sara. She re-
membered her first day at school, and it was quite a traumatic memory.
She remembered that her parents drove her to school, and then she had
an image of herself standing in front of school, crying and looking at her
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parents going away. She was afraid and didn’t want to stay there. She felt
like running away, but couldn’t move. As the image of this forgotten
memory was rekindled in Sara’s body, she felt herself tense up as she re-
experienced the same emotions that were experienced on that day. The
therapist helped Sara to link these body sensations to the image of her
standing at the school. He asked her how she felt and, if it were possible,
to stay with those sensations and emotions. Sara answered that she was
sad and felt sorry for that little girl standing there alone, but it was toler-
able for her. The therapist asked if it was possible for her to reassure that
little girl that everything was fine now; and that she was not alone any-
more. An image was used where Sara was an adult, standing with that
little girl, holding her hand, and telling her that everything was okay.
After a while the therapist directed Sara to be aware of her body
sensations and emotions again. She noticed that her breathing had be-
come deeper and her body didn’t feel as tense anymore. She also noticed
tears in her eyes but said that it actually felt good to cry. At the end of the
session, Sara was very surprised that this memory had come to mind be-
cause she hadn’t remembered it for many years. She also made a connec-
tion between her body sensations during this memory and those body
sensations she had to face in her life now. Sara spoke of how she reacted
before coming home from the rehabilitation centre:
I was so scared about coming home that for two weeks I threw up
several times a day. I reacted so strongly. That has happened to me
before when there has been a lot of stress or anxiety in my life. I
start to react in a psychosomatic way.
According to McDougall (1989), psychosomatic symptoms are some-

times connected to drug addiction problems. It is probable that psycho-
somatic vulnerability increases with people who use drugs, as protection
against psychic pain when recalling an emotion would be a more suitable
way to deal with the pain.

At the end of the second phase of therapy, Sara said that she was
going back to the job that she had before drug rehabilitation. She had
allowed her boss to tell everyone why she had been away for so long.
Sara felt that being honest about this made it easier for her to go back.
She was unsure about how she could adapt to a ‘normal’ daily routine in
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her life again, as this meant getting up early in the morning and working
the whole day. But, she was ready to try.
Phase Three (sessions 27–42)
The aim of the therapy during phase three was to strengthen Sara’s re-
sources and insights discovered during phases one and two. Two trau-
matic memories that surfaced during the physioacoustic program and
music listening were processed. These memories were not fully explored
or integrated, so Sara began work in these areas. The first of these was in
session 32, when Sara started to talk about her parent’s divorce:
When my parents divorced I stayed with my mother. I always waited

for those days when I was able to spend time with my father, just the
two of us together. I remembered when my father’s new girlfriend
moved to my father’s house with her son and her son started
to call my father ‘his father.’ It felt so bad to me.
Sara was thirteen at the time, and it was very difficult for her to accept
that her parents didn’t live together anymore. Sara recognized feelings of
jealousy toward her father’s girlfriend. She was also very angry about the
situation and blamed herself. The therapist helped Sara to understand
how it often happens that children will blame themselves for what hap-
pens around the separation of their parents, even though they are not re-
sponsible for this happening. The therapist also encouraged Sara to feel
the anger inside her and express it both verbally and with movement. The
therapist directed her to just be aware of what her body would like to do
with all that anger, and she started to clench her fists. Encouraging her to
verbalize that movement, Sara said “I am so angry because they di-
vorced and broke our family.” The therapist continued to encourage and
support her expressions of anger, affirming that it was safe for her to do
it now. After staying with that emotion for a while, its intensity started to
fade, and she said that she was not so angry anymore.
In session 36, Sara listened to music by the Finnish composer and
musician Jukka Leppilampi. His music is very powerful and shamanic in
nature, using singing without any words. This music evoked strong emo-
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tions of being held by sound and voice. In the therapeutic discussion,

Sara talked about how important Matti was to her. She started to cry:
It was so close that I would have lost him. He had taken my epilepsy
medicines, and when the ambulance came, they were quite sure that
he wouldn’t survive from that. They didn’t even allow me to go with
the ambulance. When I called the hospital they told me that if I
didn’t come soon I wouldn’t see him alive anymore. But he sur-
vived…and after that I was ready to go to the rehabilitation centre.
And I made him come with me. There were no other choices any-
more.
That memory, along with the emotions and bodily reactions related to it,
were processed for the next three sessions and helped Sara to integrate
this very traumatic episode into her newly emerging identity. It was no
longer something that made her hysterical, where she would experience
tremendous panic whenever she talked about it or remembered how it
felt. It became part of her life story — something that she could say had
happened to her, but was now over.
CONCLUSION
At the end of therapy, Sara felt much more confident and stronger in her-
self. She felt that physioacoustic therapy had created a safe place for her,
like being held by someone you can trust, where there was no need to be
afraid. This place had given her a space and time to reflect on her experi-
ences and be aware as a whole. It also gave her the support to return suc-
cessfully to work, fulfilling her duties appropriately.
According to Kurtz (1990), “the goal of therapy is not any particular
experience” but “a change which organizes all experiences differently”
(p. 139). This means that the client’s way of experiencing themselves
and the world around them will change. In Sara’s case, this change was
clear. She started to give more value to her bodily experiences and emo-
tions so that they were more balanced with her cognition. Physioacoustic
therapy created the conditions for Sara to process a whole range of expe-
riences, including emotions that had previously been intolerable. In so
doing, Sara discovered that there were many surprising and unexpected
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things within, and that by staying with these sensations, emotions and
memories, she rediscovered the fullness of herself:
It was sometimes so surprising how all those old memories came to

my mind. And even though they were difficult memories to talk
about, it felt right to do so. It really gave me a relief to feel those
emotions and express them in here, in safety. I am also very happy
that I have been able to enjoy my bodily sensations. It is not just a
source of anxiety and distress anymore. My body is now a much sa-
fer place to stay in.
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Making My Body A Safe Place To Stay - A Psychotherapeutically Oriented Approach To Vibroacoustic Therapy in Drug Rehabilitation

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MAKING MY BODY A SAFE PLACE TO STAY: A

Marko Punkanen and Esa Ala-Ruona

This chapter describes a psychotherapeutically oriented approach to vi-

hikoinen, 1997), is a form of music therapy that uses low frequency

Making My Body a Safe Place to Stay 351

Physioacoustic Therapy in a Context of Music Therapy and Drug

According to Reed (1994), drug addiction is often defined according to

352 Punkanen and Ala-Ruona

Figure 1. Physioacoustic Therapy in a Context of Vibroacoustic Therapy

The Role of Sound Vibration

Low frequency sound vibration is central to the therapeutic process. As

Making My Body a Safe Place to Stay 353

the physioacoustic device: pulsation, scanning and direction. Slow pulsa-

The Music Listening Experience

The role of the music listening experience in physioacoustic therapy can

The Role of Therapist

The role of the therapist in this approach is multifaceted. In the begin-

ning of the process, the therapist is active in creating therapeutic condi-

354 Punkanen and Ala-Ruona

share emerging experiences by working with bodily sensations, emo-

Figure 2. Key Elements of Physioacoustic Therapy

To summarize, the key elements of physioacoustic therapy are de-

Making My Body a Safe Place to Stay 355

tions (emotional level) and bodily sensations (sensorimotor level). Con-

had previously regulated through drug use.

The initial assessment was conducted by using a semi-structured inter-

356 Punkanen and Ala-Ruona

tionship to music, relationships, emotions and emotional processing, and

When Sara reflected on her style of emotional expression, she recognized

Making My Body a Safe Place to Stay 357

vive in relationships. She spoke of having taken on a kind of protective

I become like a little helpless child. I can’t do anything. And then I

THE THERAPEUTIC PROCESS

thoughts raised during the physioacoustic and music listening program

358 Punkanen and Ala-Ruona

Phase One (sessions 1–10)

In Sara’s first session, the therapist chose a modified relaxation program,

Making My Body a Safe Place to Stay 359

I am so happy now, but it has always been so that when I am happy,

Trying to control situations and experiences through denial is part of the

360 Punkanen and Ala-Ruona

ting overwhelmed by them. That made her motivated to continue ther-

Phase Two (sessions 11–26)

In the second phase of the therapy, we started to go deeper into themes

In session 24, a more activating program from the physioacoustic

Making My Body a Safe Place to Stay 361

According to McDougall (1989), psychosomatic symptoms are some-

way to deal with the pain.

362 Punkanen and Ala-Ruona

Phase Three (sessions 27–42)

When my parents divorced I stayed with my mother. I always waited

Making My Body a Safe Place to Stay 363

tions of being held by sound and voice. In the therapeutic discussion,

364 Punkanen and Ala-Ruona

It was sometimes so surprising how all those old memories came to

Ala-Ruona, E. (1999). Fysioakustisen Hoidon Kehittämisprojekti

uli. In D. A. Hodges (Ed.), Handbook of Music Psychology. San

Making My Body a Safe Place to Stay 365

stress: A meta-analysis, Journal of Music Therapy, 41(3), 192–

366 Punkanen and Ala-Ruona

Punkanen, M. 2006a. Musiikkiterapia osana huumekuntoutusta: hoitoon

Making My Body a Safe Place to Stay 367