The song above is a simple folk song. I’ve listened to Pete Seeger singing it since I was a young teenager. His is the version I have in my head. I sang it in my singing lesson this week. And sang the version I knew. Which is subtly different to the original version. So my teacher played the version she had in front of her, following the notes on the page. I sang the version in my head. And so we kept on getting slightly out of sync. Like tripping over an uneven paving stone. It wasn’t enough to send me flying. But enough to put me off-balance. It spoiled the rhythm of the song. After a few run throughs I sang the song we had in front of us and we were in harmony.

I don’t read music so when I’m having a singing lesson I’m dependent on accurately mimicking the sound my teacher makes. Which works well most of the time. I gather that even if I could sight-read I would need a few goes before I was accurately singing the notes on the page. Even then there is a good deal of room for interpretation.One can leave more or less time between notes. Or linger over one phrase slightly longer than another. All these small changes mean that my version of L’ll Liza Jane can be subtly different to another version. But before I can make changes, I need to know the original.

When I’m teaching students about different states of being, I’m always surprised by their superficial responses. (I mean no criticism! They are still learning their trade and will need to keep very strictly to the script in front of them. Walking before they can run. But an experienced therapist can improvise quickly because we have learned our tunes a long time ago.) I remember an encounter with a patient many years ago. She was a young woman who was admitted to an acute admission ward. We  were all told that she was sexually disinhibited. So, men, protect yourselves! None of us asked what being sexually disinhibited meant. Nor how did anyone know. We accepted the information unquestioningly. She was also thought to be a suicide risk so she had to have a nurse following her at all times. (Again, nobody asked her if she was going to kill herself. We got on with following the tune as we had heard it.)

On one shift I was following her. (The technical term is “specialling”. How ironic!) She went into the woman’s dormitory. I panicked. What should I do? I didn’t want to be alone with her in such a dangerous place. Who could tell what might happen? Equallly I wasn’t allowed to not keep her within arm’s reach. In the end I followed her to the dormitory but lounged against a wall well out of her reach. She left her bed area and went to leave. As she did she turned to me. Kissed me gently on the cheek. Stepped back and said “That’s to teach you not to be afraid of me, Terry.” I learned more in that encounter than in many years of training before or since!

“So,how to bring together words and music? Nurses, along with many other health care staff, are given a lot on information about patients. Some of it is official. “Mabel has an ingrowing toe nail which needs removing”. Much of it unofficial. “She’s an old cow, that one. Watch yourself.” Or “He’s a real sweety.” One’s care is determined much more by the unofficial story than the official one. We are given a particular version of a person’s song and too often fail to check out their version of their song.

In therapy, the risk is as large. My patient begins to sing their song. I listen for a few bars and “know” how the rest of the song goes. I’ve heard this song lots of time before. The danger is that the patient wants to change the last few notes. To put an emphasis on this word or phrase not that one. This changes the entire meaning of the song.(It is, after all, your song to do with as you wish!)  It is a simple song. Deceptively so…