A Brief Rationale for an Integrative Approach

Music therapist integrative therapy Cape Town  Melissa Ellse
Integrative Therapy in Cape Town with Melissa Ellse

We are all unique ūüĆü

An integrative therapeutic approach draws thoughtfully from various theories, methods and techniques based on the individual’s strengths, needs and concerns.

There is no one-size-fits-all. It simply does not exist. Every single encounter we have with one another is both meaningful and unique. This is because we are human and beautifully complex.

I‚Äôve learned this first hand in my own therapeutic processes, which is why I strive to be integrative, intuitive and informed in my approach. And my approach will probably not work for everyone, because we are all unique ūüĆü and that is truly wonderful.

To find out more, click here.

Are substance-free psychedelic experiences possible?

psychedelic experience guidance cape town south africa spiritual awakening music therapy

Short answer: yes.

Longer answer: I have encountered surprisingly many people (older, younger and from all walks of life) who want to experience something of the the mind-manifesting nature of psychedelics without taking a substance. Some people are averse to the idea of substance-induced altered states of consciousness from pre-conceived ideas about “drugs”, some cannot explore any mind altering substances because of medications or psychological predispositions. Some don’t want to get entangled in something that is not legal. Some simply don’t like the idea of ingesting anything that affects their consciousness so profoundly. Some prefer to be in control. Some are fearful. These are all valid concerns.

Yet still, such individuals seek a transcendent (possibly spiritual) encounter that is different to everyday, waking life and that offers up something deeper, possibly holding more meaning, truth and authenticity than their ‘ordinary’ reality. In my experience, these individuals are usually on a voyage of self-exploration, igniting creativity, navigating a life transition and/or discovering meaning in life. My hope-filled and honest response is always yes, there certainly are ways to enter altered states of consciousness without any substances or plant medicines.

Psychedelic literally means ‘mind-manifesting’ or ‘mind-expanding’, the Greek root is psyche (mind, soul) d√™los (manifest, visible). Meditation is one avenue to such experiences, yet this usually takes a great deal of practice before potentially experiencing anything of a psychedelic nature. Still, I highly recommend a steady meditation practice for many, many reasons which I won’t address here. To get started with a meditation practice, the following apps are very useful: https://wakingup.com/ or https://www.headspace.com/.

I work with music and deep relaxation into an altered state of consciousness, eliciting imagery in the mind’s eye that allows the ‘traveller’ transcendent, even psychedelic-type experiences. However, the ‘traveller’ also retains complete personal control and is able to effortlessly emerge from the experience at any point. No substances or plant medicines are used and they do not need to be in order for the process to be effective. Guided Imagery and Music is a technique developed by Helen Bonny after working alongside the renown psychedelic researcher Stanislov Grof in LSD trials of the sixties. Bonny developed a “non-drug, psychedelic technique of music-listening for psychotherapeutic ends.”

This music-listening technique takes place in a 1.5 hour session, the traveller comfortably lying on a couch in an undisturbed, safe and comfortable setting (such as a therapist’s room). During the session, the guide will talk with the client/traveller and work toward setting an intention for the journey. A specific music program that relates directly to the traveller’s mental set and intention – a music program designed to elicit imagery, emotions, memories and even sensations – is selected by the guide. The traveller is taken through a deepening relaxation induction and reminded of their intention. When the selected music plays, the traveller journeys with the music in this deepened, relaxed and in fact altered state of consciousness.

Imagery, storylines and emotions may appear, sometimes sensations and memories, all emerging from the unconscious mind and guided by the music. During this process, the traveller is always free to ‘come out’ of the experience, should they want to. This is unlike a substance-based psychedelic experience, such as a psilocybin journey, where one is locked into the journey until the substance/medicine wears off. The guide asks questions and helps to deepen and intensify the experience. Afterward, the traveller makes marks on paper (creates a mandala), which is a creative output that helps to solidify and integrate the journey and is used for verbally processing the experience.

Guided Imagery and Music sessions are usually conducted once a week over a period of time, as personal narratives, archetypal material and images from the unconscious are developed and worked with.

If you are interested in exploring your consciousness through an alternative, experiential and substance-free way, click here. Offered in Cape Town, South Africa.

Note: BMGIM guides require extensive and rigorous training. I am currently in advanced training in the Bonny Method of Guided Imagery and Music.

What is Music Therapy?

Music is a profoundly powerful tool for connecting us to one another, to our emotions and to a sense of meaning. Qualified music therapists operate across the globe, including the tip of Africa, Cape Town.

Music therapy is the clinical use of music interventions and music experiences to achieve therapeutic goals, promote health and realise potentials. Music therapy is focused on the process of music experiences and the relationships developed through them.  Despite the name, musical training is not required; this is because all human beings respond to basic elements of music. Music therapy can provide opportunities for communication when words are insufficient and it can assist in releasing and exploring emotions. Like other therapists, music therapists encourage, provide support for and offer guidance to their clients.

Music therapists are allied health care professionals registered with the HPCSA. Music therapists in South Africa hold a Masters degree in Music Therapy and have completed at minimum 1000 hours of supervised clinical internships at various placement sites. Music therapy techniques are highly adaptable and are suitable for use with a wide variety of clients including adults, teenagers, the elderly, children and even antenatal or end-of-life care.

What can a client expect to do in music therapy?

  • Music improvisation, using instruments and/or voice
  • Drumming
  • Music listening
  • Therapeutic singing
  • Songwriting
  • Verbal processing and reflection
  • Movement to music
  • Reminiscence-based music experiences
  • Guided Imagery and Music/music visualisation experiences
  • Creative Processes involving music (including drawing, clay and painting)

Book an appointment with Melissa Ellse (MMus, Music Therapy) by clicking here.


My brief foray into Dystonia: should we be ‘prescribing’ music therapy?

Music therapy can help patients with movement disorders improve motor functioning, improve mood, decrease anxiety, express and process emotions, acknowledge and confront their illness or symptoms, develop a stable identity and improve motivation for therapy.

Recently, I experienced an episode of dystonia, out of the blue, completely unexpected and rare in my case. Dystonia is a movement disorder. Muscles contract involuntarily and can spasm, often in repetitive motion, tremor and may cause the patient to physically twist.

Initially, I was intrigued. Being a music therapist, I have seen dystonic spasms and contractions in patients.  Before I was even worried for myself, I marvelled at how my body could contract, fold up, and move about like it had a mind of its own.

Soon the intrigue wore off. The uncontrolled, intensive and intrusive spasms in my face, trunk, neck and hands became tiring. All this movement. All this contraction. I could keep the contractions mostly at bay for short periods, enough to have a coffee at one of my favourite spots with a friend, although the twitches around my face, lips in particular, were still present. It was worse for me at night. When I became tired I lost the energy I needed to exert whatever control I could muster to restrain the spasms and contractions. My body would automatically seize up and contort in ways I didn’t think possible! I would lie awake for hours just being with these contortions.

I got tired. I got scared. And then I got emotional. Even my emotions stopped playing ball and ambushed me with unexpected bouts of sadness, seemingly rooted in the trauma of experiencing such an unusual degree of loss of control of my body.

man falling dystonia music therapy

About Dystonia

Dystonia is a movement disorder. Muscles contract involuntarily and can spasm, often in repetitive, rhythmical motion and may cause the patient to twist. Dystonia is sometimes painful and it may affect one’s speech. Dystonia can severely disrupt one’s lifestyle, work, social life and ability to care for oneself, depending on the severity. It can also affect one’s self-esteem, one’s sense of personal power and leave one feeling fearful. Understandably, dystonia may lead to depression, feelings of hopelessness and negative emotions because of a lack of agency and control over one’s body. Dystonia can be distressing for the patient and for the family.

As many as 250,000 people in the United States have dystonia, making it the third most common movement disorder behind essential tremor and Parkinson‚Äôs disease. It is a condition that knows no age, ethnic or racial boundaries ‚Äď it can affect young children to older adults of all races and ethnicities.


There are many causes for dystonia including:

My brief experience brought to my full attention the plight of many with symptoms of dystonia. Being a music therapist, I couldn’t help but be keenly aware of the specialised and effective interventions music therapy has to offer.

Should we be treating patients with movement disorders with more clinical music-making? Should we be ‘prescribing’ music?

Fortunately, my dystonic episode was short-lived. While it was uncomfortable, there was a great deal to learn. In my brief experience of dystonia, I tried my best to experiment with music therapy techniques and exercises. I found that while playing the piano, my symptoms were almost non-existent.  I also found that specialised music therapy exercises using vocals and tongue (or relevant body part) movement, as well as music and full body engagement exercises led to a feeling of increased agency, relief and control over my body. While I have worked with patients with dystonia, this experience afforded me an unbelievable window into the difficulty that some of these patients experience, as well as a clearer view as to how music therapy techniques are uniquely placed to offer relief, rehabilitation and experiences of freedom that may not be otherwise possible.

The research supports my experience: the¬†brighter side of music in dystonia’ shows how playing the piano, can cause an “instant and complete improvement‚ÄĚ in dystonia symptoms. This finding was unexpected because symptoms of dystonia are expected to worsen with activity. Piano playing — an active music making experience — seems to have a paradoxical effect.
Music therapists are able to treat dystonia at a musical-therapeutic level.

Music therapists view human beings musically. Our breathing is rhythm, our voices melody, our tone timbre, our way of speaking articulation, our movement form, for example. Repetitive twists and spasms can be viewed as musical events and be treated using clinical musical interventions. Music therapy, the clinical use of music processes, interventions and exercises in the music therapy relationship, can have an ordering, relieving and empowering function.

Rhythm, often with melody, used in music therapy are powerful forces for drawing the patient into a sequence of controlled rhythmic movements. Music therapists and the particular music therapy techniques helps to motivate, encourage and reward controlled movements, sometimes allowing for extended range of motion or more controlled movements.</strong> Music therapy techniques also allow a client to use their bodies more intentionally and to develop a different relationship with their body, pain or discomfort. 

Because of the musical nature of the therapy, the patient may naturally or automatically feel an inherent motivation to complete the therapeutic movement within the musical frame.  Difficult therapy sessions can be  made easier for the patient, even more enjoyable, by the medium of music, and may increases patient motivation to take part in therapy. 

We all have an innate understanding of the ability (the “power”) of music to prompt movement, restraint, expression and relief. Music therapists are highly trained and skilled in using music clinically, deliberately and specifically to work toward therapeutic goals in a way that music uniquely offers.

The transferability of these techniques into the patient’s life show great promise in the cutting edge research and practice coming out of Neurologic Music Therapy. These music therapy techniques give patients with dystonia hope and allow them to recognise that even with their symptoms, they can yet experience a measure of control and selfhood.

A music therapist will require that you have seen a medical doctor if you present with dystonia. There are also pharmacological treatment options, that should be explored. In extreme cases of dystonia or related conditions, music therapy addressing dystonia should be provided multiple times per week in order for neuroplastic rehabilitation to take¬†place.¬†There is a great deal research on music therapy and related disorders, including Parkinson’s,¬†Huntington’s¬†Disease,¬†and¬†many¬†more.

We all have an innate understanding of the ability of music to move us, prompt physical movement, restraint, expression and relief. Music therapists are highly trained and skilled in using music clinically and deliberately to achieve therapeutic goals and are doing such work worldwide, including in Cape Town, South Africa.

What do you think? Should doctors be ‘prescribing’ music making for patients with dystonia?

What would you want as part of your treatment protocol if you experienced Dystonia?

Share this page with anyone whom you think may benefit from music therapy, or who might like to know more. If you want to book a music therapy session or consultation, please email me via the contact form, clicking here.

Melissa Ellse holds a Bachelor of Music (University of Cape Town) and a Masters in Music Therapy (cum laude, University of Pretoria). She is a part-time lecturer in music therapy at the University of Cape Town and a research supervisor at the University of Pretoria. She practices as a registered music therapist in the Southern Suburbs of Cape Town. She is registered with the Health Professions Council of South Africa (HPCSA reg no AT 0001350).

Music Therapy For Teens

We often hear that teenagers today face a greater burden than ever before.

Indeed, they have a significant load, including navigating social media, screen time, cyber-bullying and sexting not to mention overt peer pressure, academic pressure, pressure from family members and from themselves. These stressors all come at a time of identity formation and often confusion, frustration and difficulty regulation emotions, which can lead to overwhelming feelings of isolation, misunderstanding, high levels of anxiety and distress. Teenage suicide in South Africa is something to be taken very seriously, and the rising statistics are alarming. 

It is difficult to compare the challenges of teens today with the teens of every other generation. We can say with certainty, however, that our teens have new and different, never-before-faced challenges, which bring both new innovations and joys, as well as new problems. These new problems require new and creative approaches.

In my experience, music therapy is a non-threatening, creative and engaging therapeutic process during which teenagers tend to be open to building rapport, trust and establishing a working therapeutic relationship. Music itself is an important aspect of adolescent identity formation and plays a significant role in many teens’ daily lives – this helps to improve motivation, interest and engagement in the therapeutic process. This is especially important when faced with screen time addictions or lack of motivation to engage in other creative or social interactions owing to electronics/gaming/social media. In the music therapy process, teenagers can use non-verbal, creative means to express themselves in ways that they may not be able to in words alone, yet. This may provide some relief from overwhelming emotions as well as offer perspective. Teenagers may also reflect on their participation in the creative work, and develop their capacity for introspection and self-reflection. This also helps with developing coping skills. In group work, teens are able to offer support to others, develop social skills and reciprocal behaviours as well as share a range of experiences.¬† The relationships developed in music, expressive arts processes and reflection become forces for change in the teenager’s life.¬†

Contact me if you would like to find out more about music therapy for your teenager.

Melissa Ellse, registered music therapist, completed a Bachelor of Music (University of Cape Town) followed by a Masters in Music Therapy (cum laude, University of Pretoria). She is registered with the Health Professions Council of South Africa (HPCSA reg no AT 0001350) as well as the South African Music Therapists Association (SAMTA) and the South African National Association for Arts Therapists (SANATA).