Jazz, Music Therapy Improvisation, and Dialogical Moments

Different musical genres each have something to contribute to music therapy. When it comes to jazz, there are many commonalities with improvisation as an approach in music therapy. The interplay between jazz musicians creates moments of musical understanding—a mutual affective attunement that has clear parallels with dialogical moments in music therapy improvisations. Such moments are known by many names: warm, golden, moments of meeting, and so on. I have found two articles in the Nordic Journal of Music Therapy that describe and compare musical and dialogical features of jazz improvisation and musical improvisation in music therapy.

Musical Parallels

Kenneth Aigen explores how social interaction in jazz can shed light on and enrich music therapy practice (Aigen, 2013). He challenges the dichotomy between “clinical” and “musical” improvisation, arguing that stylistic and aesthetic elements can have therapeutic value—when used with clinical intent. He contends that many core elements of jazz—such as improvisation, listening, emotional attunement, and the balance between structure and freedom—have clear parallels with therapeutic music-making. Aigen identifies these parallels where process is prioritized over product, and where improvisation, spontaneity, creativity, intuition, and responsiveness in the moment are valued. He also highlights the defined musical roles of jazz musicians, which require a balance between freedom and structure. These many parallels suggest that the study of jazz has much to offer music therapy.

Aigen points out three key aspects:

1. Jazz as a model for therapeutic interaction. Jazz improvisation requires close collaboration between musicians, with communication occurring both emotionally and rhythmically. This mirrors therapeutic interaction, where both client and therapist improvise in the moment and influence each other’s expression.

2. Groove and shared synchrony as expressions of togetherness. Creating a groove together powerfully expresses “being with” someone. In music therapy, this form of shared attention and synchrony can provide clients with a sense of belonging and relationship they may not be experienced elsewhere.

3. Therapist-client as rhythm section-soloist. The relationship between the rhythm section and the soloist in jazz can be compared to that between therapist and client: the therapist supports, structures, and inspires the client’s musical expression without dominating it. The therapist’s role is to meet the client’s expression, respond musically, and enable new directions for exploration.

   
   

Improvisation as Musical Dialogue

Several aspects of jazz closely parallel music therapy. Jazz demands a kind of interpersonal interaction similar to that found in therapy. Aigen refers to jazz scholar Ingrid Monson (1996), who emphasizes that jazz is about interactions between people, and that improvisations can be read as a form of conversation.

Many authors use the conversation metaphor to describe jazz improvisation. Jazz involves an exchange of thoughts, feelings, and content—not just sounds. This kind of communication requires listening, absorption, and real-time response. Unlike verbal conversations, where listening and response occur in sequence, musical improvisation involves simultaneous listening and response—an activity that integrates cognitive, affective, social, and physical skills.

Jazz involves different types of interaction: interpersonal interaction between musicians, intrapersonal interaction as musicians relate to their own responses, and musical-personal interactions as musicians respond to musical elements.

All of these aspects of the conversation metaphor in jazz also apply to music therapy. Music therapists use many structured, goal-oriented methods based on predetermined material. In free improvisation, the task is simpler: therapist and client improvise without predetermined material. Clients may also “converse” with a composition by reacting to its musical structure and the personal memories it evokes. Interaction between clients, and between client and therapist, also occurs through musical interaction.

Groove Requires Social Interaction

Jazz researcher Paul Berliner (1994) describes how establishing a rhythmic "groove" is central in jazz and requires rhythmic attunement among band members based on listening, response, and mutual understanding. This also involves emotional alignment in the moment.

Creating a groove is the rhythm section’s most important function. Studies of jazz music—including interviews with musicians and detailed microanalyses—reveal two key findings:

1. Rhythm sections vary their playing to adapt to each soloist’s individual expressive style, especially their characteristic phrasing. What creates a groove for one soloist might not work for another.

2. Groove arises through small but essential deviations from perfect synchronization. These small variations, called participatory discrepancies (PD), are crucial for achieving synchrony. The term was introduced by music anthropologist Charles Keil (Keil, 1987; Ruud, 1989).

3. PD refers to slight rhythmic or tonal shifts that occur when musicians create a groove. This means that musicians in the rhythm section might play slightly ahead of or behind the beat within a phrase or metric structure. When musicians collectively master these PDs and fulfill shared musical expectations, the conditions for experiencing “good moments” are present. It should be added that these musical deviations are not exclusive to jazz—they are also found in popular, folk, and classical music, as documented by Nicholas Cook in his latest book (Cook, 2024).

In a music therapy context, the presence of groove can be interpreted as a sign of deep interpersonal interaction, as such processes are necessary for establishing groove. The shared experience of creating a groove is a special form of interaction—a sense of connection. Interaction can be both conflicted and destructive or collaborative and constructive. Groove-making is an example of the latter. Groove is a form of “being with” that is invaluable for many therapy clients, as it may be something they lack elsewhere in life.

One of the strongest connections between social interaction in jazz and music therapy is the parallel between the soloist–rhythm section relationship and the client–therapist relationship. Both are based on a shared function: to contain, inspire, and propel the soloist’s or client’s musical expression.

In jazz, the rhythm section creates a musical backdrop for the soloist. This includes several dimensions and responsibilities: defining the pulse, outlining the harmonic-rhythmic structure, supporting each other’s musical development, and simultaneously playing individual parts with intrinsic value and musicality that evolve during performance.

Since jazz is improvised, “mistakes” are not viewed as deviations from a predefined perfection (as in a notated work), but rather as opportunities to take the music in new directions. This strategy is also essential in clinical improvisation in music therapy. The goal is to create musical contexts around the client’s expression so that it gains meaningful, communicative function. Treating habitual or unintended actions as if they were conscious musical expressions can awaken the client’s sense of self-awareness and intentionality, Aigen writes.

In free jazz, musicians must take responsibility for defining their roles and contributions. This can serve as a model in music therapy, helping to avoid predefined plans from dictating what happens in sessions. Highly structured, pre-planned, activity-based approaches minimize social interaction, since rules, roles, and interactions are predetermined by the therapist’s framework. In contrast, free improvisational approaches allow more room for interaction, as they prescribe less expected behavior and interaction.

The experience of improvising together in jazz, especially between rhythm section and soloist, creates strong and unique human bonds and relationships. This connection may take time to develop, but once established, it becomes a powerful source of motivation. Aigen emphasizes that music therapists should be attentive to the special feelings that arise between people who make music together. They must be sensitive to these feelings and their effects on those involved—and to the loss that can occur when therapy ends or groups dissolve.

Musical interactions are important because they activate processes like cognition, emotional expression, aesthetic experience, and motor control—all typical goals in music therapy. For many clients, these musical moments may be the only times in their lives when they feel in direct contact with another human being.

Music therapists should therefore consider exploring and integrating principles from jazz and other improvisational genres not just as stylistic choices, but as models for social and emotional interaction in music. Recognizing the client’s musical intent, responding authentically in the moment, and building community through improvisation can contribute to more resonant and meaningful therapeutic experiences, Aigen concludes.

Dialogical and Challenging Moments in Musical Improvisations

Music therapists Tamas Hadar and Dorit Amir have explored how jazz musicians and music therapists respectively experience entering into a shared improvisation (Hadar & Amir, 2021). While jazz musicians improvise with other musicians, music therapists improvise with a client. Hadar and Amir ask: How do musicians and therapists experience potential dialogical moments that may arise? Are there similarities and differences—and what can music therapists learn from such comparative studies?

We are well acquainted with how musical interplay and improvisation in music therapy create warm and meaningful moments—interpersonal “I-Thou encounters” in Buber’s sense—or “golden moments” as Gro Trondalen describes them (Trondalen, 2007). We also know how such moments, created through synchronized musical co-creation, are inscribed in Daniel Stern’s theory of the present moment. These are called “pregnant moments” with significant implications for joint attention, intersubjectivity, affective attunement, therapeutic relationship formation, and alliance-building. In this article, they are referred to as “dialogical” moments. Another point worth adding, from anthropology and philosophy, is that such dialogical moments foster a strong sense of togetherness—an “I–Thou community” or communitas, as described by anthropologist Victor Turner (Ruud, 1992).

Hadar and Amir investigated the conditions that allow dialogical moments to emerge. They interviewed music therapists and jazz musicians and listened to recordings of musical moments provided by the participants. Detailed phenomenological approaches made it possible to compare the jazz musicians and music therapist’s experience and understanding of such moments. Jazz was not chosen arbitrarily—this genre shares many of the musical and processual characteristics found in music therapy improvisations, as outlined in Aigen’s analysis.

Improvisational TraditionsI have always believed that free jazz improvisation provides a solid basis for musical interaction. Aigen notes that there are various improvisational traditions within music therapy. We are familiar with Paul Nordoff’s musical style, which some perceive as dogmatic, with clear suggestions about which church modes, exotic scales, and melodic formulas to use. However, in retrospect, many music therapists from this tradition—from Tom Næss to Gary Ansdell and Alan Turry—blend in elements from popular music and other genres without abandoning Nordoff’s ideals.

There is also a freer school in England, going back to Juliette Alvin and Mary Priestley. Here, we find completely free improvisation as taught at Guildhall in London, or Priestley’s more referential improvisational style. I vividly recall visiting Priestley in the basement of her London apartment, where she had set up a rich array of instruments in a corner of the living room, also used as her therapy space.

Shared ElementsIn Hadar and Amir’s study, they began by identifying the many shared elements between music therapy improvisations and jazz improvisation. By comparing the two, they hoped to shed new light on both similarities and differences. Their research questions were:

1. How do jazz musicians describe and understand the meaning of shared improvisations with other musicians?

2. How do music therapists describe and understand the meaning of their shared improvisations with clients during music therapy sessions?

3. What are the most prominent similarities and differences between the two groups in terms of their experience of shared improvisation?

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Analysis of the responses revealed that dialogical moments had two aspects: they included dialogical components or so-called “primary moments,” as well as the conditions necessary for these moments to arise.

Jazz Musicians

When it comes to the primary moments for jazz musicians, it is about listening and attuning, as well as having an inner readiness in relation to the other musicians to create dialogic moments. This involves translating what one feels into the music. Furthermore, it is important for the musician to alternate between their own inner world and the outer world. It is about moments of outward orientation by adapting to the other musician. As the authors write: “In that sense, listening and attuning emerged as a state of mind, which enabled the musicians to oscillate between two different spaces: their inner space and primary instruments; and their partner’s musical expression.”

On the other hand, an important prerequisite for the emergence of dialogic moments is musical proficiency. For the experienced jazz musicians, this was a feeling rooted in their high level of musical skill.

Mature Moments for the Musicians

For the jazz musicians, improvisation was perceived as a way of establishing connection with other musicians, or as in a teacher-student relationship. Such connections or relationships could be short-lived or more enduring and complex. Improvisations with other musicians were seen as equal conversations through music, a kind of “give and take” relationship, similar to Ingrid Monsen’s use of the conversation metaphor. However, encounters with master improvisers could evoke a form of humility within the teacher-student relationship, creating a special framework for the musical meeting.

The analyses showed how the musicians shared deep emotions with each other, thereby forming closer bonds. Such moments of emotional responsiveness were often perceived as highlights. Terms such as “intimate” and “closeness” appeared frequently to describe the experience, especially in duo improvisations. These peak or transcendent relational experiences were accompanied by musical flow, in which the musicians were lifted beyond their own limitations and became fully absorbed in the music they created together. Improvisations could also give rise to complex and challenging moments accompanied by feelings of irritation that threatened the relationship and pushed the boundaries of the musicians’ comfort zones.

The jazz musicians emphasized the importance of challenging one another in joint improvisation and pointed to different forms of relationships that could emerge—teacher-student, peer relations, or relationships characterized as emotional, intimate, erotic, transcendent, or multifaceted.

Music Therapists

For the music therapists as well, “listening and attuning” were fundamental components of these dialogic moments, along with what was referred to as “transforming the moment.” These were the key conditions for dialogue to take place.

In the musical examples, the music therapists demonstrated a high level of attunement to the various aspects of the client’s being. One mode of listening involved adapting to the client’s dynamic level, while at other times, it was about expanding the dynamic range. The therapists also listened to the client’s needs and emotional state, physical condition and movement, as well as the client’s musical play. The therapists exhibited a greater tendency toward “metaphorical listening,” focusing on the client’s movements and emotional state rather than strictly on musical parameters.

Regarding “transforming the moment,” the music therapists utilized the temporal dimension of joint improvisation to allow meaningful moments to emerge. The analyses revealed two almost opposing characteristics of this temporal dimension: on one hand, immediate and simultaneous reactions with instant changes in emotional and musical expression; on the other, an extended timeframe that allowed time to be experienced at a slower pace. The ability to respond in a timely manner to different aspects of the client’s expression proved to be a key technique for enabling an authentic “here-and-now” connection.

Listening to the musical examples also revealed how the music therapists used these timeframes to encourage clients to actively engage in the music. The analyses identified three different techniques used by the therapists when employing such “temporal gestures” in improvisation. They included the use of pauses and resting points in the music; pedal points, repetitive riffs, and various harmonic contextualizations to create an open sense of time for the clients. This made synchronization between client and therapist possible. Synchronized discrepancies were used when the therapist and client played at different tempos. The therapist could support the client in maintaining their musical choices and amplify the client’s free and elaborate musical expression, affirming it by giving the client agency over the dialogue.

Musical Encounters in Music TherapyAmong the music therapists, several levels of musical bonds between client and therapist emerged through improvisation. One level concerned how improvisations could resemble early pre-verbal dialogue between mother and child, also known as proto-conversation.

Moments of mutual connection arose in actions that elicited a response—based on the principle of give and take—a joint improvisation that created a genuine conversation between client and therapist. In these moments, the client could become an equal partner, providing an opportunity to strengthen self-esteem through spontaneous exclamations, laughter, and other expressions.

Reciprocal Moments

Hadar and Amir use the term “reciprocal moments” to describe what happens in improvisation, referencing Stensæth (2017). Moments of mutuality represent a more balanced and shared relationship in which both parties support and influence each other, focusing on collaboration and shared interests, where both contribute to and benefit from the relationship, and both feel a sense of ownership of the process. Stepping out of the therapist-client relationship occurred when the musical dialogue brought about flow, intimacy, equality, shared joy, and joint leadership.

Challenging moments also occurred within the therapist-client relationship, moments that strained the relationship and hindered the development of a good connection. These could involve struggles over power and control or emotional blockages. The researchers note that there appears to be a connection between such negotiations among the players and the ability to experience dialogic moments.

Musical Techniques

The music therapists used several techniques to create new timeframes and increase the client’s musical engagement in joint improvisation. The use of pauses created space for the client to express themselves, as music therapist Julie Sutton has described (Sutton, 2006). Kairotic moments were created through the use of monotonous, repetitive harmonic frameworks. Other musical devices included pedal points, repetitions, synchronized discrepancies, or musical deviations akin to “participatory discrepancies.”

ConclusionHadar and Amir conclude that joint improvisations reveal the players’ authentic expressions and enable the exploration of musical and para-musical relationships. Among the musicians, these dialogic moments manifested in challenging episodes and in interactions characterized by participatory discrepancies (PD). In the group of music therapists, such distinct musical moments also became apparent in synchronized musical deviations—in moments where the client presented their individuality in the presence of the other.

Tamar Hadar and Dorit Amir emphasize that the value of comparing music therapists and jazz musicians lies in the exploration of methods that include challenging moments, moments of confrontation, and intimate moments in the musical dialogue with clients. Furthermore, the analyses of the music therapists highlighted the creative and flexible approaches used to reshape the timeframe in order to adapt to the client’s needs. These extended timeframes in the joint improvisations between therapist and client allowed clients to experience a sense of authority and agency through the musical dialogue.

References

Aigen, K. (2013). Sosial interaksjon i jazz: implikasjoner for musikkterapi. Nordic Journal     of Music Therapy, Vol. 22, Nr. 3, s. 180-209.

Berliner, P. F. (1994). Thinking in Jazz. The Infinite Art of Improvisation. Chicago University Press.

Cook, N. (2024). Cook, N. (2024) Music, Encounter, Togetherness. Oxford University Press.

Hadar, T. og Amir, D. (2021): Intimacy, mutuality & negotiations: Dialogic moments in joint improvisation. Nordic Journal of Music Therapy, Vol. 30, No. 5, 460–484

Keil, Charles (1987). Participatory Discrepancies and the Power of Music. Cultural Anthropology, 2 (3).

Monson, Ingrid 1996. Saying something. Jazz improvisation and interaction. Chicago: The University of Chicago Press.

Ruud, E. (1992). Improvisasjon som liminal erfaring – om jazz og musikkterapi som overgangsritualer. I: Odd Are Berkaak og Even Ruud Den påbegynte virkelighet. Universitetsforlaget: Oslo. s. 136-162.

Stensæth, K. (2017). Responsiveness in music therapy improvisation: A perspective inspired by Mikhail Bakhtin. Barcelona Publishers.

Sutton, J. P. (2006). Hidden music. An exploration of silence in music and music therapy. I

Deliège, I. og Wiggins, G. A. (red.) Musical Creativity. Multidisciplinary Research in Theory and Practice. New York: Psychology Press. Taylor and Francis Group.

Trondalen, G. (2007). A moment is a moment is a moment. Om gylne øyeblikk i musikkterapeutisk teori og praksis. Psyke og logos, 28, 574-593.