A Musical Improvisation Framework for Shaping Interpersonal Trust

Introduction: Individuals with Personality Disorder commonly find it difficult to intuitively adapt to changing social situations such as small errors, ruptures and misattunements. This difficulty has been attributed to impairments in attachment, mentalization and epistemic trust. Recent research in music therapy addresses how patients can be supported to achieve co-adaptation with others. What is currently lacking is an understanding of how music therapy can enable patients with Personality Disorder to become safe and confident to improvise, i.e. to manage social uncertainty and the risks this entails.

Method: This paper presents a novel musical improvisation framework for Shaping Interpersonal Trust (SIT) within the field of music therapy. The SIT framework is a practice-based theory that enriches our understanding of interpersonal trust as a maturing process of integration within interactive events of connection, pause, and repair.

Results: The Shaping Interpersonal Trust (SIT) framework presents four levels of developing and shaping interpersonal trust between therapist and patient, each requiring an appropriate kind of therapeutic intervention.

Discussion: The SIT framework is intended to guide the music therapist by promoting insightful reflections, and to intervene appropriately where the patient is stranded in the developmental process of shaping interpersonal trust. Interpersonal trust plays an important role in enabling us to manage the social uncertainty of everyday social interactions, facilitating stable interactions over time to build friendships, and to form romantic, supportive, informal, and professional relationships.