Psychodynamic group music therapy with profoundly learning disabled residents and their carers : developing a theory and practice for the realisation of therapeutic aims for residents and the acquirement of therapist's skills by carers.

This thesis explores psychodynamic group music therapy with institutionalised, profoundly learning disabled residents, while introducing a novel way of including carers in the music therapy sessions. It is based on a detailed analysis of one case-study consisting of three residents, four carers and myself as the music therapist. Based upon theories from psychoanalysis, the dissertation firstly explores the inner world of learning disabled people and how this is affected by a traumatic early environment and institutionalised care. It then discusses the musical and psychological concepts that delimit this work. The particular way in which the carers participated in the music therapy treatment is then analysed, drawing from the theories of attachment and object relations. The case-study that follows is a detailed analysis of sessions or extracts from sessions spanning a period of three-and-a-half years. The thesis studies the methodologies and techniques that facilitated the following development in the group: a) Though at the beginning the patients functioned within an autistic type of isolation, they evolved into individuals who expressed their needs for human intimacy, creative exploration and autonomy; b) The carers shifted from being emotionally unresponsive to functioning as auxiliary music therapists; c) The music therapy setting became the ground for the evolution of life attachment bonds between the patients and the carers of the group. This music therapy setting included a particular way of perceiving, understanding and responding to the patients' sounds, based on the principle that any sound or non-verbal signal is meaningful and forms part of a patient's unconscious association to the phenomena in the group.