This article is concerned with a physiological investigation into what happens when two people play music together in a situation that is similar to that of music therapy. Active music therapy is a process of dialogue, with both therapist and patient as part of one musical process. In evaluations of music therapy the musical process is often emphasised, although the question remains as to what effect this musical process has on the body of the patient. In this paper we take this question one step further by asking what effect this musical process has on both partners in the process of playing improvised music. Such a perspective is not trivial. We expect that the therapeutic contact influences both therapist and patient. At the end of this paper we will hypothesise about the ramifications of this idea for other clinical encounters. It is important, in explaining the benefit of music therapy to others, to know what happens when people improvise music together. Our intention is to be able to demonstrate the influence music therapy has on the physiology of the patient and the therapist. This is to accept not only the ramifications music has for mental well-being but also the physical effect that music therapy has on the patient's body. While music can be demonstrated to have direct physical effect on the body, it is organisation, the non-material aspect, that is vital to communication both within the person and between persons (Aldridge 1996a) However, the ground from which we will argue is that music has the ability to bring about physical changes in the human body, an understanding that has been in our culture since antiquity (Aldridge 1993).

This paper is an account of our work at Fulbourn Hospital, a psychiatric hospital in Cambridge, running an open group once a week for a year, and of our experience of working as co-therapists. To a lesser extent, we also draw on our experience as music therapist in other settings. We have a particular interest in co-therapy. It is unusual in music therapy, in this country at least, for two music therapists to work together; it is a little more frequent in group analysis, and much of our thinking draws on that tradition. We will look at some examples of clinical material and consider the potential value of running a group of this kind. We will also examine the relationship of the group with this institution, particularly in its more recent history, as well as the dynamics of our continuing relationship as co-therapists. At times throughout the paper we refer to ourselves by our initials: A (Alison) and E (Eleanor).

This article looks at the concept of the True and False Self (Winnicott 1960, Laing 1960) and relates it to case material of music therapy with two children who were diagnosed as being on the autistic continuum. At the beginning of the therapy, both children showed great difficulty in expressing themselves spontaneously or creatively, resorting instead to rigid and stereotyped responses. Attempts to involve either child in shared musical improvisation were met with what I shall refer to as a musical False Self, or persona, which was used as a grandiose or omnipotent defence to protect the vulnerable True Self. I will show how it was necessary to accept and to work first with this musical False Self before the True Self could begin to emerge, spontaneously, creatively and authentically.