Ep. 058 | Understanding the Client Experience
Today, we chat with Wren Buse about how their experience as a client in therapy shapes their approach as a clinician.
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 chat with Wren Buse about how their experience as a client in therapy shapes their approach as a clinician.
Wren completed their bachelors of music therapy at the University of the Pacific and is now an intern at the Snohomish County Music Project. As an intern, Wren’s work has been centered on supporting queer youth, facilitating youth community music sessions, and supporting adult mental health, including developing a support group for fat adults seeking acceptance in their bodies and community. Wren is passionate about queer/trans rights and fat liberation, and hopes to use music therapy to help individuals with marginalized identities feel more embodied.
Also, exciting news: we have our very first sponsorships. So, today’s episode is sponsored by the Seattle Storm and the Angel Of The Winds Casino Resort.
Experience fun the whole family can enjoy. With virtual sports at All Things Sports, or bowling at Strikerz, there’s something for everyone - exclusively at Angel Of The Winds Casino Resort. (100% smoke-free - Seattle’s cleanest casino). Exit 210, off I-5 and Arlington, just 40 miles north of Seattle. AngelOfTheWinds.com.
The Seattle Storm is a 4-time WNBA championship team. Through the Force4Change Initiative, the Storm actively expresses its embrace of diversity, equity, and inclusion, through its practice of fighting for social and racial justice across the country. In addition, the storm promotes local youth development, in the areas of leadership and sports, with a focus on girls and women. For more information, visit StormBasketball.com.
And, the very last thing before we get started. We want to say thanks for all of your support over the last year. We’re looking forward to continuing to explore music therapy, and chat with more amazing guests. However, we want to let you know that we are changing our production model to shift from weekly episodes to season-based content. This will be a more sustainable model for us at the Music Project and ensure we can continue to have meaningful conversations. So we’ll be taking a break for a few weeks at the end of March, and encourage you to follow us on social media @SCMusicProject so you don’t miss any new episodes.
Please know that this episode includes talk about eating disorders and related content.
[Podcast intro music plays]
Erica: Well, welcome to the podcast, Wren. Thank you so much for being here. I’m excited that you’re on.
Wren: Thanks for having me.
Erica: Well, welcome to the podcast, Wren. Thank you so much for being here - I’m excited that you’re on.
Wren: Thanks for having me.
Erica: For listeners that don’t know, Wren is one of our current interns. And they’re finishing up their internship and leaving us —
[Wren chuckles]
Erica: And it’s really sad. Um, before we jump into the topic of our conversation, can you tell me a little bit about how you got interested in music therapy? What was your introduction to it —
Wren: Yeah —
Erica: All of that.
Wren: I did independent studies for high school, so I did work just out of like a textbook. And I would take it home - do different activities from it - so I got to do psychology as an independent study course. And, at that point in my life, I was really interested in potentially becoming a therapist. In the last chapter of the book, they had a section on treatment, and they had like a tiny little paragraph on music therapy. And really, all it said was: music therapy exists, music therapy is a thing, music therapists use music. Like it really told me nothing. But as soon as I saw that, I knew that that like had to be it.
Erica: Mmm.
Wren: This lovely combination of these two things I loved - which was like therapy and helping people, but also using music.
Erica: I love that. So, you had mentioned - yeah, of course, wanting to be a therapist. Where did that desire come from? What was your exposure to therapy growing up?
Wren: So, all of my life, I just had this idea that I wanted to help people. Like, I - it didn’t really matter like what I was doing. But, as a kid growing up, teachers helped me, so it just made sense - like, I should be a teacher because teachers help kids. And, when I was in like late middle school, and I started to really start struggling more severely with my mental health - and I started seeing a therapist - and I found out that therapists’ role is to help people, it felt like this really logical thing for me to do.
Erica: What was your experience like being in therapy? How would you describe your experience?
Wren: So, my experience in therapy started with one on one therapy. I started self-harming, and that was kind of like this major point of like, okay, this is really clear that Wren needs more support. So it was at that point that I started seeking individual therapy. Unfortunately, just given the nature of mental health and the way that people experience it, a lot of times individual therapy just isn’t enough. We need more supports. So over time, I went through other therapy experiences. I was in an after school youth DBT program at one point, I was also in an eating disorder treatment center - I went for a partial hospitalization program and the intensive outpatient program. And then I later returned briefly when I was in college, because I had a relapse in my eating disorder. And then, throughout all that experience, I have also had three hospitalizations.
I’ve had a very like wide range of experiences - I would say that the experiences in individual therapy and eating disorder treatment were the most person-centered - the places that I felt the most seen and cared for - and then, there were also the instances in my hospitalizations where it’s not really treatment - it’s stabilization. So, it’s really dependent on the type of care that I’m receiving and the intensity of it.
Erica: Sure. How do those experiences shape how you envision yourself moving into the future now? Does it change like what your personal goals are for yourself, or um your philosophy - etc.?
Wren: Yes. In so many ways. I think that there are like the ways it effects how I practice music therapy as a clinician day to day - and just the way that I experience my relationship with clients - and then there’s also ways that I think about it in my overall career, and my career aspirations. It feels really important to me in the future to be serving some of the same settings that I’ve been in, like eating disorder treatment centers. There’s not usually fat people in eating disorder treatment - there’s not usually trans people that are providing care. And it feels really important to me to be filling in that gap in these ways, and to also be - in the future, I hope to be a part of higher education and supporting people to think about things differently while their still learning - make sure that people understand how to empathize with the client’s experience earlier on in their journey to becoming a music therapist.
Erica: Can you tell me more about what you mean by that?
Wren: I think that one of the personal gifts that I have received from having been through so many therapeutic experiences myself, is this really deep understanding of what it means to be vulnerable on the other side. And I think that we’re not talking about the client experience enough in music therapy education. I think we talk a lot about the things that we’re providing - and the things that we’re bringing in for them. But like, what about how they’re experiencing it? I feel like, sometimes we just have these interventions and music ideas and kind of tend to throw them at clients. I wanna think about like some more of the broader impact about these.
Erica: That makes a lot of sense. Yeah, I really liked that statement you said about thinking about the client experience more when we’re in uh therapy education. And I think I - I would broaden it, and I kind of assume you would also, to just generalized therapy, not solely music therapy.
How have you, um, maybe grown in recognizing client experience as a clinician - over the course of your internship?
Wren: Mmm. I’ve really grown by learning to trust our clients - especially in this pandemic.
Erica: Mmm.
Wren: That it can be hard, for us as therapists, when we’re really trying to connect with clients, and trying to get them onto Zoom sessions, and get our sessions going. But it’s also really hard to just get on another Zoom session - even think about some of the tough things that are going on - even acknowledge them - even if it’s in a safe space with your music therapist. So I think, really stopping and taking steps back whenever these things happen. And trying to put them into context, and really not taking things personally —
Erica: Mmm.
Wren: Trusting that our clients are bringing everything they can into our sessions. Even if we can’t literally see them on screen, and even if we can’t always experience what their bringing into the session.
Erica: Mmm. I’ve had a lot of conversations lately that included elements of trust within the therapeutic relationship, and just looking at it from different angles. Um, trust is so important and critical to relationships in general, but especially the therapeutic relationship. And I am encouraged by the fact that we continue to examine trust from the point of view of the clinician - and what the clinician is trusting in, or how their trust is growing in the client. And, trust can sometimes be really hard when it feels intangible.
Um, how does your lived experience, and then the experience also of just your internship program and what this has been like for you, how does it change how you explain your work to others?
Wren: I think this kinda goes back to what we were saying before. I think that it’s subtle, but I think that, when I describe the work that I do, I’m really not centering it on what I’m providing to the client. I’m trying to really center it on the whole experience. So yes, I’m gonna say, oh, we write music together, we might listen to music, we might improvise - we might do these things - but I’m also gonna talk about the ways that the client shows up/ways that they engage in therapy - talking about the importance of our relationship together.
Erica: I think when we talk about the relational aspect of what music therapy is and what therapists do, I think that gives the community a greater foothold to understand more. Because, if you’re just like, oh yeah, we write songs and we play instruments, a lot of people have an initial reaction of, oh, like I can’t access that - I can’t write a song/I can’t sing is a phrase that I hear a ton. But people have relationships. Yeah, I think it’s a good - I don’t know - this probably wasn’t your point, but I think it’s a good advocacy tool. Like, it’s more accurate to what’s happening in the therapeutic process, but also it gives people something to link to and create a stronger connection um to what you’re talking about.
How does your experience shape your self-perception as a clinician?
Wren: I feel like it’s just been this like - in the most positive ways - this huge crush to my ego.
Erica: Ooh —!
Wren: I truly, truly understand that I am not an expert. I truly understand that I have been to so many different places in my life and in my mental health experiences - I’ve gone to many like parts of myself in therapy, and I know that those parts are all still within me. And, as a therapist, in the therapist role, I am still on this healing journey - just as my clients are. And there’s no like, I’m farther ahead than them or anything like that. It’s just that I’m in a place in my healing - in my experience as a human being - where I’m able to hold space for other folx in this way, and help them go along on their journey as well.
Erica: Mmm. That makes me curious about - the way that you were saying like I’m not farther along than they are reminds me of kinda like the tortoise and the hare - that like mental health is a competition in some way —
Wren: Yeah —
Erica: How do you think that idea of mental health journeys being a competition - and some sort of like I’m ahead of you or you’re behind me, etc. - harms the therapeutic relationship? Either harms like the clinician, or harms the client?
Wren: I think that - well, one thing I feel like I just wanna mention is that like, really, it can impact like this power difference and this hierarchy. And like, regardless of however much we name it, we still have these roles that we’re filling of a therapist role and a client. And, I think the - the idea of any kind of race, or even any like fixed point of what mental health is, can be harmful. Because, even when we get through some of the symptoms that make our mental illnesses worse - and we’re not necessarily in the thick of it, and we’re just kind of like able to survive more comfortably, and we’re not just clinging on to survive - um, there’s still things that are - that can be worked on. We’re never done. And I think that having this idea of like competition - even like in yourself, too - even just on your own and being like, oh well, I was more mentally well then than I am now, doesn’t mean that you’re back to like step zero.
Erica: Mmm —
Wren: Just a different part of the experience. It’s just a different part to the race, and there’s no like linear like race track for anyone. And we all have such different experiences, it just feels harmful to compare them. Even if you have similar experiences and maybe similar behaviors and ways that your mental health manifests itself, that experience is still so different for other people.
Erica: Mmm. I agree - big head nods for that. Um - and I was thinking about while you were talking - as somebody that also did eating disorder treatment, we have talked about our separate, uh, experiences. I just so agree with like that each person brings their own history, their own stuff into it, that it just wildly changes it. So, for me to try and say that like I’m doing well in my recovery, by comparing it to your recovery, doesn’t like serve either of us - it benefits neither of us. And I think that’s a harmful game that can be modeled - I’ve had therapists, teachers - people that are well-meaning - compare me to other people, and that doesn’t serve anybody. Because, again, yeah, just like you were saying, it’s so non-linear. Um, my therapist is still telling me how non-linear it is going to be - and it is - and that’s totally normal and expected, and I don’t need to have any extra stress because I’m not doing things the same way that this person is doing it, or like my sister is doing it, or etc.
What have you learned in your client-based therapy experience that you wish more clinicians heard or understood?
Wren: It’s so funny [chuckles] ‘cause my two main things are things that we have totally already touched on. Which is that clinicians really need to set aside their feelings and just trust us as clients. I felt this frustration particularly in eating disorder treatment. One of the aspects of it is normalizing how you eat food, and the first time I was in eating disorder treatment, um, the way that we did portions and mealtime was much more like set to specific portion sizes and all this. And then the second time, when I went back, it was more like a general plate kind of thing - it wasn’t like you have to measure every food, which felt so much more normal. But I remember, the first time around, having these moments being like, look, it’s this like small amount of food - like, can you just trust me? Like, can you look at my whole plate and trust that I really just forgot my extra side of olives, and that I wasn’t trying to like have some ulterior motive of like —
Erica: Mmm —
Wren: Messing up my whole food schedule? Like, I’m really just human.
Erica: Yeah.
Wren: I wish that I would see more clinicians actively naming the power hirearchies at hand like in the session, and acknowledging them as they come up. Um, I think that, in starting to develop the relationship, it’s really important to set the precedent that like you, as a therapist, know that the client is the expert. And that like, you’re not here to do therapy like to them or at them. You’re here to do therapy with them.
Erica: Mmm.
Wren: So I think making it really clear how you stand in that way - and also, what you’re bringing to the table, in terms of your biases and your identities, and your frameworks for therapy, and also for being a human, too, and interacting with others.
And then, the last thing that I wish that clinicians really understood more is that some of the like best moments in therapy have come out of like the simplest conversations. I think that all therapists kind of learn this over time, uh that it’s okay - that we don’t have to immediately go into intervention, or activity, or specific processing - like, it’s important to take time to be authentic in the space - do what feels good. I wish that clinicians trusted that, too, and just trusted the space. I wish that they could know that just being with us sometimes is all we need.
Erica: Mmm.
Wren: You don’t have to work to hard to like therapy all over me. [Laughs]
Erica: [Laughs] That’s funny. Yes. Um, we are coming to the end of our time for today. Is there anything additional that you would want to share from your process?
Wren: Yeah. I think that, if there’s any message that I want to share, it’s that we are all on a human journey, and we all hold a therapist and client role in some way in our lives. We all hold space for other people, and we all take moments to be held. And there is no clear marker for when you can step into that role as a therapist: my whole time after I decided I wanted to be a therapist was I had this idea - some day, I’ll be healed enough.
Erica: Mmm.
Wren: And I can feel confident in saying that I have reached a tipping point, where I do feel comfortable in spending the amount of time that I do in internship, and in the future as a music therapist, to hold that role. And I know that. But at the same time, I know that I’m not fully healed, and I never will be. And my clients never will be, and I can never expect that I’m gonna take them to that place.
Erica: Wow… That was so good! Um, well, thank you again for chatting and sharing - I just appreciate your time - and your vulnerability in sharing about your own personal experiences. You are very appreciated.
Wren: Thank you.
Erica: 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. Also, as a reminder, connect with us on social media @SCMusicProject so you don’t miss any new episodes.
Thanks again to Wren for being here today. Thank you, listeners, for listening. And we’ll talk to you next time.
[Podcast outro music plays]