Ep. 044 | Community Mental Health

Today, we chat with guest, Alyssa Monas, a board-certified music therapist, about self-care and equity within a community mental health model.

TRANSCRIPT

Erica: Welcome, friends! You’re listening to The Feeling is Musical — as presented by the Snohomish County Music Project. My name is Erica Lee, and today, we are talking about community mental health, with board-certified music therapist, Alyssa Monas.

Alyssa is a board-certified music therapist who works for a nonprofit in King County, serving kids and families through a community mental health model. She focuses her work on breaking the barriers and power dynamics that exist within traditional therapist-client relationships, to build genuine partnerships and meet people where they are.

[Podcast intro music plays]

Erica: Welcome to the podcast, Alyssa. Thank you so much for being here and being willing to chat with me today.

Alyssa: Yeah! Thank you for having me!

Erica: So, I wanna start with the question I ask every music therapist that comes on. How did you originally become interested in music therapy? What is your story?

Alyssa: So um, throughout my whole life, music was just always my - my thing. That’s just the way that I thought of myself. Like, I was - I was just a musical person. Um, I remember my piano teacher - we were talking, and I remember saying to her, I - I don’t wanna be a piano teacher. And um I developed really bad performance anxiety, so I knew I didn’t wanna be a music performance major. Um, I kinda just said to her, you know, I - I wanna do something with music, but I don’t wanna do either of these things - and in my mind, those were the only 2 options. And, at that time, I was in high school, and she was like um, have you heard of music therapy? And I just looked at her like she had 5 heads. And I was like —

[Erica chuckles]

Alyssa: I was someone who was very private about the way I engaged in music, like - and engaged with music.

Erica: Mmm.

Alyssa: The idea of sharing space, and playing music, and like being really free was kind of my worst nightmare. I still have a hard time with that. So, at the time, I was totally turned off by it. So I started college. And first I started with commercial music, and I realized okay, I don’t want to do this. And then, I think I did, you know, just kind of like a general music thing - and I just had no direction. And it was my sophomore year that another professor brought up music therapy. And, this time, I looked into it. I just remember like, something clicked, and I was like, this is it. Like, this is what I’m supposed to do. It was kind of this really - this big shift in my life, because uh, right when. I realized I might wanna do music therapy, I immediately just auditioned for the college of music at FSU. I got into the school, I transferred, and like, after that, it was like I found my  - my calling. I think what really struck me about music therapy, once I got to the point where I realized that’s what I wanted to do, was the fact that I could engage with music and this thing that has been so important to me. And doing it in a way that’s not about me.

Erica: Mmm. Can you tell us a little bit about the work that you are doing right now?

Alyssa: Yeah. So, I work for a nonprofit in the Seattle area. We have uh branches in Seattle, Burien, Renton, and in Auburn. And - well, I guess I’m just gonna speak to the present - you know, we’re in the midst of 2020 —

Erica: Yes —

Alyssa: And the pandemic. Um, we’re serving kids - it was uh age like 0 to 12, but now we’re starting to increase the range of ages that we serve. I started working within the outpatient behavioral health program, and um, I’ve been able to start working as one of the therapists on the team and hold a billable case load through King County, because um I have a Master’s degree in Music Therapy. So I am able to do that. And so, I just have my supervisor do the intakes with me, and a licensed MHP (mental health professional) helps me do the diagnosis - ‘cause that’s not in our scope - um, and then I get to do the work with families.

Erica: Sure.

Alyssa: So I work with kids and families who are experiencing. Who have experienced a number of traumas or adversities throughout their lives, and who have some sort of mental health diagnosis. The kid is kind of designated as my client, but the way I approach my work is very kind of systems and family oriented.

Erica: Yeah.

Alyssa: And it’s - you know, as difficult as this pandemic has been, we’ve been able to kind of uh make our catchment bigger, and serve more kids doing telehealth. So that’s been kind of one advantage of this.

Erica: Absolutely. And there’s such a need for the mental health providers —

Alyssa: Mmhmm —

Erica: There’s just not - I mean, across western Washington at the very least, there’s just not enough providers —

Alyssa: Yeah —

Erica: For the number of people that have needs.

Alyssa: There are so many - so many providers that do private practice, and so access is really challenging. And then, in the community, mental health agencies - what I hear at least, from clients that I work with, from families, from friends who work for other agencies - is there’s always this constant turn over. And so it’s hard to build relationships with the community. Well, and then, of course, that goes into, you know, why do people get burnt out? Why do people leave their jobs? There aren’t enough providers. People aren’t getting paid enough. People aren’t able to afford to live in the places where people would benefit from services —

Erica: Yeah —

Alyssa: You know. We could go on and on, it’s a whole snowball. But yeah.

Erica: Yeah. I mean, we’ve kinda talked outside of this specific conversation about like what does it mean to practice self-care working in - I’m gonna call it like the therapy industry, because not everybody that works for therapeutic agencies or nonprofits is a therapist. There’s just so many different roles that work for these agencies that also need to practice self care. And —

Alyssa: Yeah.

Erica: What does that look like for you - especially in the middle of the pandemic? Like, what does realistic self-care look like? How are you avoiding burn out?

Alyssa: Yeah. That’s - it’s such an important question, and it’s also - it’s a great question. Because I think that this is something that I’ve been having to really really sit with. What’s kinda coming up for me, and something that I sort of struggle with is: in my work, I do my best to be as accessible and flexible and adaptable as possible for my - for the families and the kids that I work with. Because life happens. If someone, you know, misses an appointment, I’m not as strict with uh saying, like, open, we have to cancel. Or I’ll - you know, if I have time, I’ll see them a little bit later and then go over into my own personal time. And so, I’m really struggling with where is the line between really trying to kind of break those barriers and support people, rather than kind of like shunning them for being human - but where is the line between that and then also making sure I’m taking care of myself.

Erica: Yeah.

Alyssa: So for me, I think one of the biggest self-care strategies, or the - the thing that’s helped me the most, is learning how to say no. And when it comes to saying no or setting boundaries, it’s also something I struggle quite a lot within my personal life. It’s hard to say no. And it’s hard to sit with some of the feelings of like shame that come up when you feel like you’re not being there for a friend or a family member —

Erica: Mmm —

Alyssa: Because you’re just - you need to just take care of yourself. SO I think that just learning how to check in with myself more, and be able to kind of set healthy boundaries, and be okay with that has probably been my biggest um like self-care strategy. I tend to have this idea in my mind of, you know, I have this whole day off and I’m gonna clean my apartment, or I’m gonna journal, and really self-care! Take care of myself! Sometimes, during this pandemic, self-care is literally sitting on my couch and doing nothing for the entire day and being okay with that.

Erica: Mmm. What you were saying about like sometimes it looks like not doing anything all day and being okay with that —

Alyssa: Yeah —

Erica: I think that’s pressing up against this productivity myth that we have that comes from ableist culture —

Alyssa: Mmm —

Erica: That says that: if you’re not doing something, then you’re not being successful. That’s a myth, that like —

Alyssa: Mmhmm —

Erica: That your value is dependent upon what you can do.

Alyssa: Yeah. Well, I - and I really appreciate you bringing that up. Because, for me, personally - and with my job - I’ve been in this situation where I had sort of this pressure of  uh one of my grants running out.

Erica: Mmm.

Alyssa: And I had all of these plans to show how I’m growing this program and, you know, find creative ways to potentially get another grant, or find other ways to be sustainable. And then this pandemic happened. And I got very stuck in a lot of shoulds - of like, I should be trying to - ‘cause I’m the only music therapist, I need to kinda do everything —

Erica: Mmm —

Alyssa: And I need to do groups, and I need to do this ——

Erica: Mmm —

Alyssa: And I need to build a case load. But I was like going to sleep thinking like, I can’t do this - I can’t do this all. And so, being able to just focus on one thing, and actually be okay with that - and actually feel secure in that - has taken a lot of that weight off of my shoulders. And again, like, no matter who you are, we are all dealing with something during this pandemic. And it’s important to me to name like I hold so much privilege - and even with all of that privilege, it’s still —

Erica: It’s hard —

Alyssa: This is a hard time.

Erica: Yeah.

Alyssa: And so, being able to really get clear on what it is that you’re able to do, and really - really being okay with that, and giving yourself that - that grace and that understanding. That’s, like, kind of a pretty radical act of self-care.

Erica: Yeah, absolutely. And we’ve talked some on the podcast about community music therapy/community-based models - community groups. That, I think, tends to leave out the clinician?

Alyssa: Mmhmm.

Erica: That’s why I bring up self-care - I wanted to explore this a little bit further - is that —

Alyssa: Mmm —

Erica: I know you’re doing community-based work. And that includes you - as somebody in the context of the group or in the session. And that matters when we’re thinking about community mental health.

Alyssa: Mmm.

Erica: Your mental health is part of the community.

Alyssa: Yeah. And it’s like, as the therapists, you know, I think that we’re taught to not bring too much of ourselves into a session, right. And I know - I know this is something that you’ve talked about in - it was one of the earlier episodes I remember Vee mentioning, you know, when we come into a space that we bring all of these parts of ourselves.

Erica: Mmhmm.

Alyssa: But I - at - at least for me, the way that I feel I was kind of taught how to do music therapy - which I’m putting up quote fingers —

[Erica chuckles]

Alyssa: It was kind of uh you - you were supposed to not disclose a lot, keep a lot of boundaries, and kind of always be very like put together, right. And I think what’s so interesting, um about this pandemic specifically, is that this is something we are all, as a collective, experiencing together. What I’m dealing with is not the same as what my - what someone else is dealing with. But we also have this common thing that we’re all in. And I think that it’s been - it’s felt even more natural to be really open and honest about how I’m doing with this pandemic, um and the things that I’m struggling with, or  the things that are helping me. I think that it’s actually been - the more that I’ve disclosed about myself in a way - now of course, when we’re disclosing things, you don’t want it to get to a point where your participant’s like taking care of you —

Erica: Yeah —

Alyssa: So that’s not what I mean. But, by disclosing, you know, things about your life or things that you’ve dealt with that are relevant to what someone else is dealing with - it can be a really positive relationship builder.

Erica: Yeah.

Alyssa: Showing our human-ness I feel like is something we’re often kind of taught not to do. But I’ve found that the more human I am in my sessions, the deeper the relationship gets - the therapeutic relationship.

Erica: Absolutely. We’ve talked social justice stuff - just like in mentioning it here and there. I wanted to ask you like how are you working toward social justice in your work? What does that look like?

Alyssa: For me, everything that we do as therapists to work towards social justice - to work towards more equitable systems and a more equitable society - it all is about relationship.

Erica: Mmm.

Alyssa: I wanna just like shout out one of my close friends —

Erica: Do it —

Alyssa: Who you should totally have on this podcast ‘cause he’s amazing. His name is Hakeem Leonard - he’s a close friend of mine, and we’ve had many conversations, and I think - um, I don’t know - every time I bring up like relationship - and I’m gonna go more into that - but um, I always think of Hakeem, and just the conversations that we’ve had. Um, he’s really helped me expand kind of my way of thinking and the way that I even question and approach anything.

Erica: Mmm.

Alyssa: So I wanna say it starts with relationship. Um, and it’s really about being actively engaged in like questioning everything. And for me, it’s also been - like, working towards social justice and equity - and these are like kind of these big terms, right —

Erica: Yeah —

Alyssa: Like these big like umbrella terms —

Erica: Yes —

Alyssa: ‘Cause like, in - when you think about justice - I get overwhelmed when I think about social justice and equity, because what I think about is dismantling systems. And I’m one person, who has - I have power ‘cause I’m - I’m a therapist - there’s a power dynamic there —

Erica: Yeah —

Alyssa: I have a Master’s degree, I’m white, I’m cis-gendered. Um, And I get really overwhelmed. Like, how am I ever gonna, you know, def - defeat these systems, and, you know, break ‘em down so they can be totally rebuilt. And I think that I finally realized how much power there is in genuine relationship building. And so, when it comes to what that looks like in my practice it’s really important to me to name things that are present.

Erica: Mmm.

Alyssa: I feel like people - and - and this might not be true for everyone, but I - there have been a lot of times where clients - participants - you know, parents that I’m working with will kind of bring up something, and they don’t name - or maybe don’t feel like they’re allowed to name - that they experienced racism. Or that they were mistreated by a system. And that might be because they’re talking to someone like who’s in the system. So for me, like naming things that are present is - is really, really important. Because there are so many ways that um a number of systems are really negatively impacting the people that I’m working with. And they don’t even - it’s such a normal thing that they don’t even realize it sometimes. So like, using my voice to name things um is important.

I think part of - if you really wanna like break barriers and dismantle systems, you have to start by actually just connecting with the people you’re working with, rather than just making assumptions about them, right. If someone’s late, white supremacist society would tell us to think like, oh, this person’s irresponsible, or they’re flakey, or they’re this that and the other. If I just assumed like oh, you’re just - like, you’re just not interested in services, instead of like checking in and seeing how can I support you. Um, if you are just kinda forgetting sessions, why is that? There are a ton of reasons people might forget things. I can speak to I forget things all the time - I have ADHD - you know, my brain gets on one thing and then I can lose track of time. Um, checking in to see what people might need to be successful, or to be able to, you know, get what it is that they’re looking for.

Which then brings up the - when you’re thinking of what, you know, equity looks like - and social justice and breaking barriers in this work - in community. It’s all about - you know, there’s always this - this dynamic, right, where I’m the therapist and I’m the expert - so I come in and I tell you what you need. And nonprofits make decisions based around money, right, and don’t really actually always ask the communities what they need or what they want. So part of - in my work as uh as a therapist, what I try to do when I’m connecting is to ask people what it is that they want, what it is that they feel they need support with, and how can I partner with you.

Erica: Mmm.

Alyssa: How can I dismantle this power dynamic that exists, whether we name it or not. And then I have to think like how can I decenter myself. How can I make this not about what my agenda is, or what I think you should be doing, or what I think this music therapy session - or this session should look like. How can I get rid of that and, instead, be totally attuned to what’s happening in the moment, and totally just in relationship.

I think that’s something that’s been really challenging for me, honestly. Because, especially coming from this cognitive behavioral music therapy background, where you’re kind of taught like: do this intervention for this goal, and this will happen. And um, you know, so many of these, kind of, evidence based practices that we’re taught uh don’t really work [chuckles].

Erica: Yeah. And nobody’s - nobody’s life, or healing, or insert whatever word you wanna use - is that linear. Like —

Alyssa: Right.

Erica: Yeah.

Alyssa: Well - and - and it’s so interesting. And this is where it comes back to the - the problem with all of this, and the problem with the ways we’re taught to do therapy, is that - it’s like we -we treat people as like these individuals that exist in a vacuum, rather than acknowledging the systems that they exist within. Their family system, their school system, their um their community —

Erica: Yeah —

Alyssa: Whatever community they’re a part of. And like, the problem with cognitive behavioral therapy is it’s all about: like, okay, you need to change your way of thinking. And, if we wanna be equitable as music therapists, and if we wanna really actually work towards social justice, we need to throw that stuff out the window. We need to say, what systems - and what things - are contributing to what’s going on.

Erica: Absolutely.

Alyssa: It isn’t about you. You’re not a bad kid. You’re not a bad mom. Like, I had this conversation with a parent where it’s like, you know, they were talking about just um a number of traumas —

Erica: Mmm —

Alyssa: That they’ve been through, and they talked about using. And I was like, yeah - you’ve been to hell and back. Like, of course you wanna numb the pain. And the issue - so then what the system does is it villainizes people who use, right. It villainizes people who end up homeless. And - instead of saying like, what happened. What happened that - that this is where you are? And how can we help you?

Erica: Absolutely.

Alyssa: So, back to the - the question of like what equity and social justice looks like in practice for me: it’s about using - using my voice to name these things —

Erica: Yes - yes —

Alyssa: Because, gosh, as therapists, there are tons of us that do harm and that have done harm. And I’m - I’m one of them. We have to start to name these things. And not just name them, but like acknowledge the harm. And then - and then talk about like how do we do better? What do we need to do better? And so, again -goes back to relationship, right. Like, what - what do you need? Like what do you want this to look like?

Erica: Mmm.

Alyssa: I used to think that I had to always have the perfect intervention, or the perfect song to go with every scenario. And my brain would just be on total overload, trying to think about intervention, intervention, intervention. And it’s - it’s relationship. And - and when you’re in the moment, and when you’re actually attuned, you’re gonna know what to do.

Erica: Mmm.

Alyssa: The great thing about like decentering yourself, and kind of like dismantling that like expert dynamic, is: there’s actually a lot of relief in not having to be quote unquote the expert. And in being able to instead be with a family, or be with a child, and empower them - and help them see that like you know what your body needs.

Erica: Yeah.

Alyssa: You know what feels right and what doesn’t feel right. I don’t need to tell you. I can support you, and I can give you more tools - and I have information about some of the specifics of why a certain thing feels really helpful - you know, in - in terms of like neuroscience and music and the brain —

Erica: Sure, sure —

Alyssa: Like, I can provide that. But we have to empower people to know that they’re - they’re in power of themselves.

Erica: Mmm. Absolutely. I want to - we’re running to the end of our time for today —

Alyssa: Nooo —!

Erica: I know! It’s so sad ‘cause we’re having such a good conversation!

Alyssa: And there’s just a lot —!

Erica: And I really think we could talk about this for a long time.

Alyssa: Yeah.

Erica: Um, but you had said something that I wanted to come back to really briefly. Oh, you had said the asking the question like what has happened to you - or what is happening to you. Something I learned from learned from Vee really recently is - we were having a conversation about ACEs —

Alyssa: Mmhmm —

Erica: Adverse Childhood Experiences study. And um, maybe in addition to asking like what’s happened to you - asking what are you facing?

Alyssa: Mmm!

Erica: Because what are you facing then starts to address the systems —

Alyssa: Yeah —

Erica: Of what is happening. And it’s not so much in a - an acute or one time traumatic event, but it addresses ongoing traumas - historical trauma - generational trauma - system-based trauma. And - to also recognize in that question, that not all trauma can be healed. Especially if it is —

Alyssa: Still happening —

Erica: Ongoing trauma that is happening all the time - every day.

Alyssa: Right. Like, how do you heal something that’s still happening? And that’s the thing: is like , these systems are still here. And so, it’s like - which I guess - something that I didn’t mention that I feel is very important - in terms of what it looks like for therapists to be engaging in social justice work - is: not only using our voices to name things with our families and participants, but also like speaking up when you see things within your organizations that you work for.

Erica: Mmm.

Alyssa: Um, and using your voices there. That’s also something that I do - I - I tend to be pretty vocal, and I’ve really found my voice. And um, that’s also something that’s - that’s so important. That needs to be the focus. And it can feel so overwhelming when you’re one human being. But it’s like: every time you name something, and every time you call something out, it’s like - I feel like you just like pull a little pebble off the mountain or something. I don’t know - I’m trying to think of like a —

Erica: Yeah. Um - ‘cause we really do have to wrap up, and I really am so disappointed about it. Do you like have any like closing thoughts that you want to share?

Alyssa: I just want anyone who’s listening to this to know that, where ever you are, whatever you’re doing to get through what’s happening - whatever you’re doing to care for yourself - whatever you’re doing to be there for your kids, for your clients, your co-workers - like, it is enough. We are all struggling, and we just have to like - we just have to recognize that whatever we’re bringing to the day is enough. It has to be.

Erica: Yeah. We just need reminders, and like: you’re doing everything you can be doing.

Alyssa: Yeah.

Erica: Be gentle with yourself.

Alyssa: That’s something that’s so hard for me, and I will say that that mindful self-compassion - like that idea of showing yourself compassion um has been a hard one, but um really is very helpful.

Erica: So important, so —

Alyssa: Yeah.

Erica: Well, thank you, Alyssa, again, so much. This has been a lovely conversation.

If you’d like to know more about the Music Project, please visit our website at S as in Sam C as in Cat Music Project dot org (scmusicproject.org). On our website, you can also find transcripts for every podcast episode. We encourage you to connect with us on social media @SCMusicProject on all social media platforms. Never miss notifications for new episodes or other projects. Thank you for all the messages we’ve received about the podcast, we really appreciate the encouragement and sharing this space with you.  We want to continue and grow and highlight music therapy as another therapeutic option for the community - an easy way to make this happen is to share episodes with people in your circles and network. Let’s work together to advocate for music therapy.

Thanks again to Alyssa for being here today. Thank you, listeners, for listening. And we’ll talk to you next time.

[Podcast outro music plays]