Musical Improvisation and Free Association with Rafael Ornstein, MD

Mar 6, 2022

Guest Dr. Rafael Ornstein, a psychiatrist and jazz pianist, discusses using musical improvisation to make sense of patients' fragmented harmonies. The podcast explores the parallels between musical improvisation and free association in psychoanalysis. They delve into creating new motifs through improvisation to represent challenging elements for deeper examination. The episode also touches on the intersections between music therapy and psychoanalysis, highlighting the importance of structure for meaningful expression.

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Introduction

00:00 • 2min

Harmony of Improvisation

01:39 • 7min

Harmonizing Passions: Music and Mental Health

08:18 • 19min

Exploring Resistance and Beauty through Music

27:36 • 3min

Relational Freedom in Improvisation: Music and Therapy

30:16 • 7min

Exploration of Listening, Finding Voice, and Musical Appreciation

37:27 • 2min

"Patients may be bringing in harmonies that are tough to connect, fragments of life or things that cannot be integrated. And part of the improvisation in a way is to make sense, to create maybe a new improvisation that ties together different affects or maybe clusters of chords that feel unpleasant. Can we work with them musically to make sense of them at least? And maybe represent them not always in a pleasing way but through our improvisation, be able to create a new motif that now can be examined in different ways."

Episode Description: We begin by recognizing the well-known analytic challenge which is to learn the basic scales and then learn to improvise — both being essential tools for creating a dependable and creative analytic space. Rafael shares with us his early familial psychoanalytic influences and his search to find his own voice. We discuss the similarities between analytic free-association and musical improvisation. He demonstrates his clinical observations with three live musical renditions — first the melody and then two riffs off it with increasingly loose connections to the original theme. We discuss how this is similar to the deepening of an analytic process allowing for greater freedom of imagination and self-awareness. We consider the musical versions of countertransference as well as the termination capacity for improvised self-reflection.

Our Guest: Rafael Ornstein, MD is a psychiatrist and psychoanalyst with a private practice in Brookline Massachusetts. He is a graduate of and on the faculty at the Boston Psychoanalytic Society and Institute. He is an Instructor in Psychiatry at Harvard Medical School and he supervises psychiatry residents at Massachusetts General Hospital. He is a frequent contributor to the Harvard Medical School continuing education course on psychodynamic psychotherapy. He enjoys playing piano in the sextet Bluedog Jazz, a band with monthly gigs in local restaurants and clubs. You can find them on Spotify.