For this purpose, music therapy primarily makes use of "free improvisation." This experience of the patient or group of patients and the therapist playing together is called "active music therapy". The patients select the instruments themselves and play, usually without any instructions, even if they have never learned to play an instrument. In the process of playing together, the therapist receives something like a sound image of the individual's emotional situation or an acoustic scene from a relationship experience. We frequently discover how an initially harmless plunking away at an instrument increases in urgency; it becomes necessary to change instruments and a completely different way of playing develops. For example, a depressive patient suddenly went to the kettledrum and banged it with all her might. After years of suppressing it, she finally showed her long pent-up anger at her husband, who had often hit and humiliated her.

In the subsequent discussion, the emotional impressions from the improvisation are once again brought to consciousness. Through the two approaches of verbal expression and non-verbal interaction by playing the instruments, the connection between the feelings and consciousness that has frequently been interrupted through the suppression process in traumatic experiences is restored.

In conclusion, we compare the individual's way of playing with how the patients talk about their families, their partners or the workplace. This makes it possible for us to achieve a more complex image of their psychological structure and the social environment, as well as the way in which these people have come to terms with what they have experienced.

Here is another example: A man in his late fifties was intimidated at his workplace and now felt that he completely lacked drive and was unable to work. He was employed in the administration of a municipality, for which a new mayor from the opposing party had been elected; the man felt that he was the victim of an intrigue. In the first group hour, he briefly introduced himself and then remained silent for most of the time. He did not participate in any of the improvisation. In the second therapy hour, he set up an entire arsenal of five drums and a drum cymbal, which he then played as loud as he could using his entire body. The other members of the group and the therapist sat down on their chairs after just a few moments because they could barely hear themselves. After about seven minutes, his facial expression relaxed, he smiled and stopped playing. I asked him how he felt. He answered that it had been good for him. I asked further questions about how he had experienced himself in contact with the others.

To the amazement of the group, he said that he had played together with everyone until the very end and had heard all of them. His subjective perception was completely counter to the reality of the situation. It was also highly probably that his impression of being intimidated was influenced by an extreme self-absorption, which had actually developed into an obsessive-compulsive neurosis in his case. Because of mayor's election, the man's rigid worldview had been shaken. This led to depressive symptoms that were very difficult to resolve.

Like no other medium, music creates a direct access to emotions. We hear music in order to put ourselves into a certain mood and play or sing so that we can feel a sense of community with others. When we do this, we register the finest nuances and recognise whether this is in harmony with the gestures and facial expressions of the person we are playing with. The latest findings of research on infants shows that the mother and child are already intensively communicating with each other through musical forms of expression. In his many publications (such as The Interpersonal World of the Infant, 1992), the development researcher Daniel Stern refers to the affective attunement between the infant and the people with whom it interacts at an early age, which is perceived through the musical parameters such as rhythm and intensity. Through music we therefore reach the earliest levels of consciousness, which no other form of therapy can access so directly. However, music accompanies us throughout our entire lifetime. For example, do you remember your first kiss and the music you heard at the time?

In therapy, music serves on the one hand to access the suppressed or separated affects. However, it also has an immediate effect of its own as sound, rhythm or dynamic movement. The patients have a fine sense of which sound is pleasant to them or which sound they experience as threatening. This is why we offer different types of easily played instruments, ranging from the kantele to the cylindrical wood block. People like to use the steel drum and congas, as well as the piano and xylophone. One example here is that of a chronically psychotic patient using a piece of rosin that he softly dropped on the lid of the piano time and again, thereby producing a counterbalance to a manic patient who was playing etudes at a second piano.

Such scenes illustrate the dynamic processes in groups in a way that they could never develop during conversational therapies.