A notable aspect of creative therapy is observing how patients begin to pay attention to their inner world. Through creative work and dialogue, they learn to listen to themselves much more deeply. In this process, individuals start from a profound inner “deafness.” However, they manage to connect with their internal nature almost effortlessly. Ultimately, this connection is the very first step of true therapeutic listening.
This deep listening happens effortlessly because using music creates a highly flexible environment. In this way, it allows for the opening of deep emotional processing, relaxation, and reflection. Furthermore, this listening becomes intentional, conscious, and much less compulsive due to the effect of creative experiences. The emerging pattern tends to reduce anxiety and significantly improve cognitive function. All of this always occurs under the empathetic relationship and therapeutic listening of the professional.
The case of Carlos perfectly illustrates this clinical phenomenon. He was a hospitalized patient dealing with an addictive disorder and several relapses. Initially, he showed a strong pattern of resistance to cognitive-behavioral therapy. This defense mechanism and his aversion to reality kept him “deaf” to his surroundings. Being a very complex patient, his transformation required a different approach and great clinical patience.
Carlos’s Clinical Case
During a musical improvisation in his second session, Carlos expressed a desire for revenge against his ex-wife. This emotional thought was so intense that he stated intentions to hit her if he saw her with another man. He claimed he did not know what he would do while hospitalized. Consequently, this homicidal ideation disturbed him deeply and caused recurring nightmares. Carlos was a constant victim of anxiety, anger, and an extreme fear of abandonment.
He could not let go of his egocentric, aggressive, and insecure way of living. To help him, we decided to record his improvisations using the playback technique. This technical strategy allowed him to listen to himself from an external perspective. Over the course of the sessions and thanks to therapeutic listening, Carlos realized something vital. He noticed that musical improvisation allowed him to relax and achieve great emotional openness.Soon, hidden aspects of his personality began to emerge. He managed to observe his own mental state without judging himself destructively. Carlos had begun to listen to his aggressive side in a purely creative way, without violence. In short, improvising gave him a panoramic vision of his psyche. This profound therapeutic listening allowed him to act more consciously and regulate his aggression outside the clinic.
Indigenous Thought in Therapeutic Listening
Creating music, writing, dancing, acting, or drawing helps many patients combat compulsion. Jointly, these arts reduce the superficiality of their lives and frivolous impulses toward others. Listening carefully to the message that emerges helps the patient transfer those effects outside the sessions. On the other hand, the empathetic relationship and the professional’s therapeutic listening are absolutely fundamental. Initially, we are the patient’s mirror until a deep relationship is solidified.
In this sense, the framework of creative therapy is strongly based on Indigenous thought. Within this ancestral wisdom, listening transcends mere traditional auditory reception. In reality, it is a fundamental practice to connect with life, nature, and the spiritual dimension. Listening inside and outside of ourselves must be done with precision and great naturalness. Consequently, therapeutic listening is deeply nourished by these holistic values.
For example, Carlos María García is a spiritual authority of the Kalina people in Venezuela. He masterfully uses the community methodology of the “word circle.” In this space, dialogue and listening are fundamental principles for resolving conflicts and making decisions. Additionally, it is an active tool for social benefit and profound healing. Listening is directly associated with “listening in the listening” as a true process of inner transformation.
Practical Skills for the Professional in Therapeutic Listening
During my training years as a music therapist, great emphasis was placed on the ability to listen deeply. Without this vital skill, the therapist interrupts the process with destructive and deregulated reactions. When we fail in our therapeutic listening, we end up expressing our own unresolved emotions. Many professionals burn out, get bored, or generate a purely defensive distancing. In contrast, using those states helps to understand the patient through positive countertransference.
Profound therapeutic listening helps us identify any personal vulnerability activated in the clinical relationship. It also reveals difficult or obstructive feelings, such as aversion when working with a specific patient. Likewise, it exposes distress reactions, organizational frustrations, and feelings of professional inadequacy. On another note, many patients face severe linguistic barriers during consultation. Therefore, the power of active listening must include our attentive body language.
Non-verbal cues can foster a solid connection, even with patients of a different nationality. Respecting the patient’s inherent right to culturally sensitive therapy is vital. In the practice of therapeutic listening, we pay full attention to the creative product without judging it. We observe body language, paraphrase what the patient says, and ask for clarifications to avoid misunderstandings. Finally, we gently guide the conversation, avoid assumptions, and listen carefully before responding.
