In short, I would not want to be without my clarinet in music therapy sessions. The only time I would not use it is if the client showed an active dislike of the sound or if I felt there was a risk that a client might want to damage it, but this is not something that happens too often. The clarinet is my musical voice in therapy, so to deprive myself of it would be pointless and counter-therapeutic.
I used to dream of the perfect clarinet sound…
Amelia Oldfield
As a child I learnt to play the piano first. Then as a teenager I wanted to play an orchestral instrument so I could play with other musicians. I spent hours listening to orchestral recordings as well as to the Young Person’s Guide to the Orchestra by Benjamin Britten, and quite quickly decided that I liked the sound of the clarinet best of all. As I was living in Austria at the time, I started learning the clarinet in Vienna, but luckily my teacher realised I would not be staying there for very long and started me off on the commonly used Boehm fingering system, rather than on the simple system clarinets that were still being used uniquely in Austria at that time. After a couple of years I moved to France, where I continued to have lessons, first at the Conservatoire in Montpellier, then at the Conservatoire in Aix-en-Provence from two clarinettists who happened to be brothers. Four years later I moved to Canada and had lessons at the music department at McGill University. By this time I had seriously fallen in love with the clarinet and it had become my first rather than my second instrument.
When I moved to the Guildhall School of Music and Drama to do my music therapy training I did not like the very different English clarinet sound my new teacher was suggesting to me. One day, as I was wandering down the corridor, I heard the most beautiful clarinet sound coming out of one of the practice rooms. I immediately knew this was what I was striving for and walked in to find the renowned Israeli clarinettist Yona Ettlinger. He agreed to teach me, and I continued having lessons with him, and then with his wife Naomi, for several years after I started working as a music therapist. I particularly remember the fortnightly Saturday master classes at the Guildhall, which usually led to dreams about the ultimate, perfect clarinet sound on Saturday nights.
I have always enjoyed using the clarinet in my music therapy clinical work. I love playing it, revel in producing as good a sound as possible, and feel I can convey emotion through my playing more effectively than through any other instrument. I have continued to play in various chamber groups and orchestras throughout my 34 years of music therapy practice. This keeps my own music and my passion for the clarinet alive, and provides me with inspiration for improvisations in my clinical practice. Conversely I have found that my regular use of improvisation in my music therapy practice has improved my tone and confidence when playing chamber music. I find I need to play, on average, about three evenings a week to maintain the control and flexibility of my embouchure in my clinical practice. If for some reason I don’t play my clarinet for a couple of weeks, I often notice that I start getting grumpy and irritable; somehow, I need to play to feel whole and complete.
Case vignette: Tim
Three-year-old Tim, who has a diagnosis of autistic spectrum disorder, gets up from the piano, which we have been playing together, and wanders to the other side of the room. He has no speech, but glances at the clarinet on top of the piano and then at me. I know exactly what he is communicating to me: ‘Come on, do what you usually do, pick up your clarinet and walk around the room with me.’ As soon as I start playing the clarinet he grins broadly. We march around the room together and I improvise a tune to match our walking pace. Then he lies down on the floor and kicks his legs in the air. I play a version of ‘Row, row, row your boat’ while his mother holds his legs and sways from side to side. Occasionally I stop playing to join in with the singing, but incorporate low trills on the clarinet to add excitement when the ‘crocodile’ appears. We repeat several variations of the song and on the third time, when we leave a gap before the dramatic ‘scream’ at the end of the song, he makes a tentative vocal sound, looking quite surprised that he has done this. His mother looks at me and grins; we are both delighted that Tim is starting to use his voice.
In later sessions Tim masters the technique of producing a sound by blowing the recorder or a reed horn. This enables us to have clarinet and horn dialogues and further encourages Tim to use his voice.
For Tim the clarinet is associated with a moment in the music therapy session when he moves around the room and I take his lead and follow him while playing at the same time. This is particularly useful for Tim, who finds it hard to remain seated or focused on any one activity for very long. He has always been interested in the clarinet, making good eye contact and smiling whenever I start playing. Tim’s mother is proud of her son’s particular interest in this slightly unusual instrument. It is also useful for me to be able to alternate playing and singing because it means I can use words in the songs, but then continue the tune on the clarinet to maintain the musical line and Tim’s interest. Tim recognises the sounds of the words and can occasionally be prompted to vocalise himself, but he needs the clarinet sound accompanied by my movements to maintain his interest.
Case vignette: Ella
Figure 1.3 Listening to that special sound
Ella is also three years old. She has profound and multiple learning disabilities, is very restricted in her movements, has severe epilepsy and is partially sighted. She does not sleep well, so both she and her mother are often quite tired. She can sometimes move her arms and hands a little to strum the guitar, or to scratch or tap a drum. She will also occasionally vocalise. For Ella the high point of the session is usually when her mother holds up some wind-chimes for her and I play the clarinet. Like Tim, she will nearly always smile when I start playing, and will sometimes get very excited, kicking her legs and moving her hands towards the chimes. At other times she plays more quietly and both she and her mother look sleepy. I try to match her mood while improvising, keeping the melodic line flowing and ‘open’, playing in pentatonic or modal keys. I know that high notes, squeaks and glissandi often make her smile, while lower, legato phrases help her to relax. In addition, the fact that I can bend the pitch of the notes to match her vocalisations is often useful. Ella’s mother is also affected by the clarinet. Like Tim’s mother, she takes pride in Ella’s interest in this instrument and is always pleased when Ella becomes engaged and interactive.
Case vignette: Group
In my weekly group of five children with a variety of emotional difficulties (Asperger’s syndrome, eating disorders, Tourette’s syndrome, attention deficit disorder) the children eye my clarinet case with suspicion. I have just suggested that there might be a rabbit in the case… but after some discussion allow them to convince me it must be a musical instrument. We establish that it is a clarinet and I ask them to guess how many pieces it consists of. One little boy who is six and has been to the group before shouts out ‘seven’ and is delighted when I put the instrument together and show he is right. I play a short tune, the children listen and I then suggest that they shut their eyes and guess how many notes I have just played by putting their hands in the air and showing a number.
Later in the group, my music therapy student who is a violinist gets out her violin and we form two teams, half the group play the xylophone when they hear the violin, the other half play the metallophone when they hear the clarinet. At first we take it in turns to play to make it easier for the children, but then we overlap and intermingle so they really have to listen.
Here I use the children’s interest in a slightly unusual instrument packed in a box to gain their interest and enthusiasm. The fact that it is a single-line instrument makes it easy for the children to distinguish