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Tango Improvisation in Music Therapy L'improvisation de style tango en

musicothérapie

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Tango Improvisation in Music Therapy
L’improvisation de style tango en musicothérapie

Demian Kogutek, BMT, MMT, MTA

PhD Student, Rehabilitation Sciences, University of Western Ontario,
London, ON, Canada

Abstract
Little used in clinical improvisation, tango’s potential implications in music
therapy have not as yet been fully examined. The goal of this exploratory
research study was to incorporate tango music into a clinical improvisational
setting to see how the musical components of tango could expand the level of
musical communication possible in participants and how these components
could affect the therapeutic process. This qualitative research incorporated
both theoretical and practical applications, and the methodology was based
in grounded theory. Three clients from a long-term care centre participated in
tango music during clinical improvisation. They played tenor metallophone
while being accompanied by the researcher on classical guitar. The primary
data collection sources were audio and video recordings. The research
included a microanalysis of the improvisations, the results of which showed
how tango music had effectively altered the melodic contour, dynamics,
and tempo played by each participant. The research sessions also provided
a means for emotional relief and allowed the participants to incorporate
stylistic characteristics of tango into their improvisations. This is shown in a
measurable and quantifiable manner through music notation.

Keywords: music therapy, tango, clinical improvisation, qualitative

research, therapeutic relationship

Résumé
Peu utilisé en improvisation clinique, le potentiel de la musique de style
tango en musicothérapie n’a pas encore été suffisamment étudié. Le but
de cette recherche exploratoire est d’incorporer la musique de style tango
à l’intérieur d’un contexte d’improvisation clinique afin d’observer
comment les composantes musicales du tango peuvent élargir le niveau
de communication musicale possible des participants et comment ces
composantes peuvent influencer le processus thérapeutique. Cette
recherche qualitative incorpore à la fois des applications théoriques et
Canadian Journal of Music Therapy ∞ Revue canadienne de musicothérapie, 20(2), 166
pratiques et la méthodologie se base sur une théorie empirique. Trois clients
d’un centre de soins de longue durée ont participé à de l’improvisation
clinique utilisant de la musique de style tango. Ils ont joué du métallophone
ténor en étant accompagnés par le chercheur à la guitare classique. Les
sources primaires de collecte de données théoriques et pratiques provenaient
d’enregistrements audio et vidéo. La recherche inclut une microanalyse
des improvisations dont les résultats illustrent comment la musique de
tango a efficacement changé le contour mélodique, les dynamiques et le
tempo dans la musique jouée par chaque participant. Les séances de cette
recherche ont offert un relâchement émotionnel aux participants et leur ont
permis d’incorporer les caractéristiques stylistiques du tango dans leurs
improvisations. Ceci est démontré de façon mesurable et quantifiable par la
notation musicale.

Mots clés : musicothérapie, tango, improvisation clinique,
improvisation clinique, recherche qualitative, relation thérapeutique

The use of clinical improvisation has been extensively researched and

written about (Aigen, 2005; Ansdell, 1995; Bruscia, 1987; Lee, 2003; Lee
& Houde, 2010; Nordoff & Robbins, 1977/2007; Pavlicevic, 1991; Ruud,
1998; Wigram, 2004). However, a less explored research area of clinical
improvisation has been the use of different styles of music. Lee (2003) and
Lee and Houde (2010) posited that music therapists should be knowledgeable
about multicultural styles and the general theoretical makeup of different
music from around the world. According to Aigen (2005), Paul Nordoff
reported a remarkable experience with the first client he worked with in
a music therapy context. He observed that while the boy seemed content
and serene when a Chinese pentatonic scale was played, the boy reportedly
cried when Nordoff altered the tones to a Japanese pentatonic. Nordoff went
back and forth between the two scales, and each time, he observed the same
reaction. If two different musical styles can generate two completely different
emotional responses, what are the implications of using different styles of
music in clinical improvisation? How then, can these implications be utilized
in a therapeutic setting?

Purpose of the Study

While I was growing up and studying music in Buenos Aires, Argentina,
tango music was an integral part of my life. After immigrating to Canada at the
age of 22, my connection to tango diminished somewhat, maybe because the
environmental incentive was not present any more. Many years later, I began
incorporating tango music in clinical improvisation sessions as a master’s

Canadian Journal of Music Therapy ∞ Revue canadienne de musicothérapie, 20(2), 167

degree student at Wilfrid Laurier University in Waterloo, Ontario, Canada.
During these individual sessions, I noticed clients who had a tendency to play
similar rhythmic and melodic patterns throughout improvisations. My aim
as a student was on incorporating not only tango, but also different styles of
music, instrumental arrangements, and improvisational techniques in order
to expand clients’ musical vocabulary and communication while assessing
the clients’ acquirement of musical patterns and ideas over time.

It was because of my clinical work that I decided to conduct this

research. The purpose of this research study was to incorporate tango music
in improvisational music therapy. The objective was to expand each client’s
level of musical communication by analyzing the qualities of improvised
tango, specifically dynamics, rhythm, melodic patterns, and tempo, ultimately
linking the participant’s musical expansion to the development of the
therapeutic relationship.

In order to understand the implications of tango style during clinical

improvisation sessions, I formulated the following two questions:

• How do the musical components of tango expand the client’s level of

musical communication?
• How do the musical components of tango affect the therapeutic
process?

Methodology
Research Design
This qualitative research used a grounded theory approach. The goal of
this research method is to develop interrelated concepts that can describe
reality and at the same time generate new ideas (Amir, 2005; Glaser & Strauss,
1967). Semeijsters (1997) stated that reality is not described by means of an
already existing theory and hypotheses; instead, these can be generated from
and become grounded in the reality of a research study. This process requires
the researcher’s total immersion in the data in order to become intimately
acquainted with the data and develop a detailed knowledge of it.

The research began with the collection of data, and through this process
I was able to identify patterns, relationships, concepts, and categories. This
phase is called open coding. The second step, axial coding, was then done. This
involved procedures for connecting and relating categories and subcategories
found in the open coding (Wheeler, 2005). Most grounded theory research,
including the one described in this article, also incorporates data related to
self-reports, audio recording, and observations (Smeijsters, 1997).

Canadian Journal of Music Therapy ∞ Revue canadienne de musicothérapie, 20(2), 168

 Four clients living in a long-term care home were chosen to experience
tango style during clinical improvisation sessions. I invited the participants
to play the tenor metallophone while I accompanied them on classical guitar,
which is my main instrument. I chose the tenor metallophone for several
reasons: (a) the instrument produces a pleasant and interesting sound;
(b) it is simple to play and requires no previous musical training (Nordoff
& Robbins, 1977/2007); and (c) the instrumental sounds of the guitar and
tenor metallophone complement each other, providing the opportunity to
engage on equal musical terms (Pavlicevic, 1991), ultimately allowing me
through musical notation to explore not only rhythmic but also melodic
characteristics of the client’s response to tango improvisation.

For the purpose of the research, a reflective improvisation technique

was used (Wigram, 2004). This technique required me as therapist to begin
the improvisation with music that was reflective of the client’s mood at that
time. Grounding techniques were also incorporated to create a stable musical
environment by including music that acts as the anchor for the client’s music.
The similar techniques of holding and containing were employed, acting as
the musical anchor for a client who was ungrounded in his or her playing
and whose music was random and without direction (Bruscia, 1987).
Approximately five to ten minutes of improvisation, I transitioned into tango
style. After approximately two to five minutes of tango improvisation, I
transitioned back to the original style of improvisation and then continued
with the clinical improvisation intervention. I used an overlap transition
technique (Wigram, 2004), where the musical style was introduced while
continuing with the existing way of playing by using legato or smooth tango
arpeggios.

Participants
A total of four participants ranging in age from 46 to 87 years old each
attended one individual music therapy session per week for a period of eight
weeks. Three participants were female and one was male. All had different
diagnoses, which included Alzheimer’s disease, dissociative identity disorder,
and chronic obstructive pulmonary disease. Sessions lasted between 20 and
40 minutes, depending on the length of the improvisation.

In order to have greater transferability, which refers to a generalizability

of the research findings to broader populations and settings (Pomerantz,
2008), three out of the four participants were selected on the basis of their
different ages and diagnoses. A university research ethics board approved
this research, and informed consent was obtained from all participants
involved in the research.

Canadian Journal of Music Therapy ∞ Revue canadienne de musicothérapie, 20(2), 169

 A music therapy assessment was conducted in order to evaluate whether
potential participants were capable of playing the tenor metallophone. In
addition, clinical goals and interventions were established to address specific
needs of participants in order to maintain a therapeutic focus throughout the
research process. Table 1 presents the most relevant information gathered
during the clients’ assessments.

Data Collection Procedures

Audio and video recordings were the primary sources of data collection.
In each session, the participant sat across from me, and a digital video camera
was placed two metres from the participant and set at an angle that captured
both the participant’s and my profile. Two microphones were used; these
recorded the audio portion of the session to ensure a high quality of sound.

Data Analysis
For each participant, the tango portion of an improvisation was
selected and transcribed from the audio recording using Finale software. I
also selected and transcribed 30 seconds before and after the tango portion.
These two 30-second portions were used to compare the tango portion with
the surrounding musical style of the improvisation that was based on the
client’s mood. After printing the notation of the improvisation portion to be
analyzed, I employed three methods for data analysis.

The first method I used was Holck’s (2007) ethnographic descriptive

approach to video microanalysis. This is an informed approach to observational
research that studies everyday settings and seeks to understand actions and
their meanings in a social context. Using this method of recording interactions
for analysis, I began with standard music notation and then added gestures
and facial movements over the notation line, a technique described by Wosch
and Wigram (2007).

The second method I used was De Backer and Wigram’s (2007) analysis
of music notation examples. I analyzed the musical score of the selected
improvisation, and I notated figures in a structured way to identify relevant
sections and points in the score. I marked major sections with letters and
indicated details such as accents and dynamics in standard musical notation.

Having used these two methods to transcribe the music and add printed
notations, I then did a simultaneous analysis of both methods horizontally
and vertically. The horizontal analysis allowed for interpreting music and
meaning of action independently across time, while the vertical analysis
allowed comparison between music and action at specific points in time.

Canadian Journal of Music Therapy ∞ Revue canadienne de musicothérapie, 20(2), 170

Table 1
Client Assessments
Participant Client A Client B Client C
Gender/age Male/85 Female/63 Female/47
Diagnoses Alzheimer’s disease Chronic obstructive Dissociative
pulmonary disease identity
disorder as a
result of herpes
encephalitis
Assessment Client tended to Client thrived in the Client presented
become stuck in palliative care unit, negative
repeating rhythmic becoming ambulatory and behaviours such
and melodic patterns. virtually independent, but as entering other
He played up and still required oxygen therapy. patient’s rooms,
down the scale Neurologically, she remained agitation, verbal
with both hands intact. From an early age, aggression,
alternatively, leaving client was obligated by her non-compliance
a tone or semitone mother to take piano lessons. to requests,
in between. He She stopped studying music and socially
demonstrated rigid after completing several inappropriate
and perseverative grades at the conservatory behaviors. These
patterns in his of music. Her mother was behaviours were
improvisation. displeased with her decision. difficult to manage
Client felt her learning on the unit.
process was too forceful
and was not an enjoyable
experience for her.
Clinical Goal To provide client To reconnect client To increase
with meaningful with music-making in a client’s ability to
social interaction nonthreatening way. Clinical remain on task by
through the improvisation intervention maintaining goal-
use of clinical suited her needs. directed behaviors
improvisation. through clinical
improvisation.
This provided
her with social
interaction skills
and furthered her
communication
through musical
dialoguing.
Intervention Attempts were made A decision was made not Provided
to change the client’s to encourage her to play client with the
rhythmic, melodic, the piano, which the client opportunity to
and dynamic patterns disclosed intimidated her, improvise on
by encouraging and instead decided that her instrument of
different rhythms, playing the metallophone choice with
chord progressions, would be a more positive prompting and
and the use of experience. encouragement
different musical with a minimum
styles. amount of verbal
interaction.

Canadian Journal of Music Therapy ∞ Revue canadienne de musicothérapie, 20(2), 171

 The third method I used was an indexed account of each session in its
entirety. The process of sessions was described, which led to interpretations
of the therapeutic process. This included a component where I engaged in
ongoing self-reflection. A critical component of the research process was
documenting the intrapersonal–interpersonal experiences and physical
sensations not visible on the video recording. Finally, any particular
interpretation of the data from the first two methods was compared to the
indexing of the entire session.

The use of these three methods of analysis made it possible to

understand the implications of tango from three different perspectives. The
music notation analysis provided a closer look at the improvisation, while
the recording of the participants’ actions provided a visual understanding of
the phenomenon. Finally, through analysis of the indexing of the session, an
even greater understanding of tango’s implications was gained. Throughout
this process of data analysis (axial coding), I was able to formulate categories
and sub-categories based on open coding.

Results
Categories
Three categories, each with subcategories, were developed from
the musical analyses: music qualities (phrase contour, tempo, dynamics);
emotional relief (sing, sigh); and incorporation of stylistic components
(glissando, syncopation).

Examples of Clinical Music Analysis

Example 1 (Phrase Contour). In the category of music qualities, the
tango style showed certain implications in all three participants’ musical
responses. This was expressed as shortening phrase contouring and
increasing dynamics and tempo. Phrase contour denotes the gross motion of
pitch, which contains the balance between steps and skips, and the role of the
melodic range over time (Müllensiefen & Wiggins, 2011).

An example of shortening phrase contour could be seen with Client

A, who tended to become stuck, repeating rhythmic and melodic patterns.
He played up and down the scale on the metallophone with both hands
alternatively, leaving a tone or semitone in between scale notes. Baker and
Tamplin (2006) describes this as perseverative playing, a tendency of some
people with cerebral lesions to persistently repeat the same note, movement,
or word.

Although Client A’s rhythmic pattern appeared to be triplets, this was

not obvious due to his lack of accentuation of down beats. I supported his
Canadian Journal of Music Therapy ∞ Revue canadienne de musicothérapie, 20(2), 172
playing by introducing a tremolo accompaniment in a romantic classical
style on my guitar. In the following example, the notation of the client’s music
is located in the upper staff. The client’s repetitive motion was evident in
measures 16 to 20, among other measures in the excerpt:

Figure 1‐1 

Figure 1‐1 
Figure 1‐1 

  I introduced the rhythmic section of the tango style in measure 59.

Instead
  of maintaining the repetitive motion, the client began changing this  
motion to only one or two measures during the rhythmic part of the tango.  
 Figure 1‐2 
By
  measure 81, his melodic shape had a clear contour of an ascending and
descending
  line:
 
Figure 1‐2 
Figure 1‐2 

   
 
 Figure 1‐3 
When I transitioned back to tremolo accompaniment in a romantic style
 
in
  measure 169, once again the client’s repetitive motion lacked melodic
contour:
 
Figure 1‐3 
Figure 1‐3 

   

   

  
Canadian Journal of Music Therapy ∞ Revue canadienne de musicothérapie, 20(2), 173
 
 Example 2 (Increase in Tempo and Dynamics). Before the
introduction of the tango section, Client B was playing mezzo piano in a slow
tempo as I improvised in a 20th-century musical style with arpeggios in the
lower register of the guitar:
 

Figure 2‐1 
 

Figure 2‐1 

 
With the introduction of tango, the rhythm intensified the dynamics and
 
tempo
  of the improvisation. Client B’s dynamics changed from mezzo piano
to  mezzo forte, and her tempo also sped up, resulting in shorter melodic
Figure 2‐2 
phrases:
 

Figure 2‐2 

 
 
 
 
Example 3 (Incorporation of Stylistic Components). Two participants
Figure 3‐1 
 
incorporated stylistic characteristics of tango with the addition of rhythmic
cells, adding glissandos and syncopations to their playing. Rhythmic cells are
Figure 3‐1 
defined as a small rhythmic design that can be isolated or can make up part
of a thematic context (Nattiez, 1990). Before entering into the tango portion
of the excerpt, I matched Client C’s rhythm in a classical style using a simple
melody with an Alberti bass accompaniment. The rhythm contained eighth
notes that imitated the client’s musical style. She played eighth-note and
quarter-note rhythms with phrases that extended over several measures:  

 
 

 
Canadian Journal of Music Therapy ∞ Revue canadienne de musicothérapie, 20(2), 174
  

Figure 3‐1 

 When the tango syncopation with glissando was introduced, Client C

used syncopation for the first time in measure 36:
Figure 3‐2 

Figure 3‐2 

   

  
At measure 105, Client C played several glissandos:
  

 
Figure 3‐3 

Figure 3‐3 

   

   Once again, Client C acquired the two most noticeable stylistic

components of tango—syncopation and glissando—and incorporated them
  
into her improvisation. She also used the syncopated cell and glissando after
the
  tango section was no longer present.
Figure 4‐1 

Figure 4‐1 

Canadian Journal of Music Therapy ∞ Revue canadienne de musicothérapie, 20(2), 175

 
 Example 4 (Emotional Relief). The use of the tango seemed to provide
emotional relief to all three participants. This was seen as singing or sighing  
after the rhythmic portion of tango ended. The intensity of the tango rhythm
 
provided Client B and Client C with emotional relief, as the syncopated
rhythmic
  sections transitioned to simple tango arpeggios. It was in measure
119
 
where Client B expressed a deep sigh:

Figure 4‐1 

 
Client A reacted in a similar manner, but instead of sighing, he simply
stopped
  playing the metallophone and began to sing in measure 179, just
before
 
the end of the analyzed example:

Figure 4‐2 

Conclusions and Self-Reflection

Most resources that relate to clinical improvisation focus on techniques
that support the client’s musical intention (Bruscia, 1987; Lee, 2003; Ruud,
1998). As well, to meet and match the client’s musical intensity is an essential
starting point in clinical improvisation (Ansdell, 1995). The question that
arises is whether or not the therapist should establish music that challenges
the client. Pavlicevic (1997) stated that it is not always helpful to the client for
the therapist to match and meet the client’s music. In order to assist clients to
begin exploring and growing into the full potential of their dynamic form, the
therapist needs to alter the musical form, offering something new.

Canadian Journal of Music Therapy ∞ Revue canadienne de musicothérapie, 20(2), 176

 Within the context of this study, the tango portion of the improvisation
had two distinct moods. First, the tango arpeggios, which were used as
musical transitions from the client’s initial musical idea to tango and
vice versa, depicted the typical melancholic characteristics of the genre,
and a descending bass line with eight notes created an inviting musical
environment that supported the client’s musical intent. During the tango
arpeggios section, all three clients maintained the role of soloist. During the
rhythmic portions, the syncopation and upbeat marcato dance-like rhythm of
tango style contributed intensification and excitement to the improvisation.
These dance-like qualities of tango and its rhythms contain strong accents,
which can be interpreted as the rhythmic force that encourages movement
in dancers.

Thus, participants seemed to encounter some of this rhythmic force

during the improvisation, and the rhythmic qualities of tango created a
switch in the clinical improvisation. Within the musical structure of tango
style, participants were able to play more freely. The rhythmic portion of
tango created a middle ground in the improvisation where participants were
able to change their style of playing in response to the tango music. This
change process was most evident in the participants’ incorporation and use
of syncopation and their louder dynamics and faster tempos.

Musical intensification can also generate emotional relief. This was

manifested through a participant’s singing and sighing at the end of the
rhythmic portion of tango. Although this finding was the most interpretative
and was not clearly evident in the musical notation, I do believe that it was as
a result of the intensification of the musical style.

The structure of tango served as a means for musical dialogue where

participants expanded their musical communication by incorporating
stylistic characteristics into their own improvisation. This can be interpreted
as empowering clients within the therapeutic relationship through musical
equality during improvisation. The use of a musical style such as tango
can be fundamental to the therapeutic relationship, where the therapist
aims to empower their clients through music. If we consider that clinical
improvisation mirrors the therapeutic relationship, what then are the
implications of musically challenging our clients? If clients are asked to
musically match the intensity of a certain musical style, what then might the
benefits of that intervention be and in what context?

As clients develop their musical communication, the therapeutic

relationship may also gain equality. Sharing a social system with equal power
(e.g., improvisation) is the foundation for growth (Pavlicevic, 1991). The use

Canadian Journal of Music Therapy ∞ Revue canadienne de musicothérapie, 20(2), 177

of tango in the clinical improvisation process can offer a similar exchange of
support and challenge found in relationships by incorporating its rhythmic
qualities of musical intensity.

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