The Medicine of Music
A jackhammer drilling. An office mate’s humming. A plate crashing to the floor. Static. A child banging on piano keys. Muffled conversation. Some sounds are just noise. They distract us. They irritate us. They send us in search of a way to make them stop.
Other sounds give information. The honk of a car horn tells us to get out of the way. The blare of a smoke alarm signals fire danger. The wail of a siren alerts us to clear the road for emergency vehicles. These noises create stress in order to initiate a response.
Then there are sounds that soothe us, such as a mother’s low lullaby. Sounds that inspire us, such as a synchronous recitation of the Pledge of Allegiance. Sounds that trigger memories, such as the faint whistle of a distant train. The full range of human emotion rises and falls on rustles and whispers, gongs and grrrs, beeps and bangs, tweets and twangs.
The fashioning of sounds into a combination in which they complement each other creates music. Sounds ordered in this way charm us. They move us, literally and figuratively. They entertain us. And in the toolbox of trained experts, they heal us.
Music therapy is more than singing along to the radio or learning to play the guitar or pounding a bongo drum or performing for an audience or composing scores or writing lyrics. Its purpose extends beyond music for the sake of entertainment or distraction or accomplishment or recreation. “For music to be therapeutic, goals have to be defined. A music therapist has to be available to meet the needs of the patient,” explains Christian Ndeti, MT, a trained music therapist who works in the recreation therapy department at the Charlie Norwood V.A. Medical Center. Music therapists use assessments to identify patient needs. They work with patients to establish individualized goals for patient progress. Music—the production of it, the consuming of it, the performing of it, the critical analysis of it, the physical and emotional responses to it—is the portal to meeting those health and wellness goals.
Though music has served restorative purposes for humans for thousands of years, the formalized use of music in a medical setting has its roots in WWI and WWII. Medical professionals in military hospitals employed active and passive music activities to ameliorate pain associated with injuries incurred on the battle front. Caregivers noted significant psycho-social, physiological, emotional and cognitive improvements as well.
for healing harmonizes with medical interventions.
In 1944, the first collegiate training program in music therapy was offered. Soon after the profession organized and developed academic standards and board certification requirements. A surge in clinical research and journal publications contributed to defining the scope and validity of music therapy in the healing arts.
Currently, education requirements for music therapy professionals include a bachelor degree plus a six-month internship. The credential Music Therapist—board certified (MT-BC) is awarded to music therapists who pass a national exam. It provides an objective measure of proficiency. In addition to board certification, state licensure for music therapists went into effect this year. Licensure is by application and requires continuing education credits to maintain it.
The therapeutic use of music for healing harmonizes with medical interventions. “Music is universal in some ways,” says Stephen Montgomery, MMT, MT-BC, who is employed in the recreation therapy department at the V.A. Medical Center. “It gives us therapeutic access to a patient.” Sheri Smith, MT-BC, creative arts therapist/music therapist at the V.A. Medical Center, agrees, saying, “Music is non-threatening. It’s not sterile in a white coat.”
“Most music therapy goals are not music based,” says Ndeti. “Music is just the modality we use to meet those goals.” Numerous patient populations with a variety of diagnoses benefit from music therapy strategies implemented in group and one-on-one settings. Prior experience with or mastery of music is not a prerequisite for participation in music therapy.
For patients recovering from injuries or illnesses resulting in reduced range of motion, music therapy strategies can improve mobility. For patients struggling with psychological impairments affecting social relationships, music therapy strategies can encourage and/or ease interpersonal interaction. For patients suffering memory loss, music can be used to trigger recollection of past events or as a mnemonic for retaining new information. For patients coping with cognitive impairment, music can stimulate the brain’s problem-solving centers. Music as a medical tool has even been shown to aid premature babies in gaining weight and leaving the hospital sooner.
Congresswoman Gabby Giffords, who suffered critical brain damage after being shot in the head in 2011, regained her speech partly due to music therapy. The area of her brain responsible for producing speech was damaged by the bullet’s destructive path. Associating language with melody and rhythm trained Giffords’s brain to reroute speech production.
Music is the mode of delivery of services not the central focus of the interaction between caregiver and patient. To the outside observer, the activity in a music therapy session may resemble a group of folks hanging out having fun. Yet, throughout the process, the music therapist is watching and assessing patient progress, asking questions and prompting the patient to respond to cues and refining strategies based on patient response. The desired outcome of the therapist-client relationship shapes the way music concepts are introduced and manipulated.
In the CSRA, in-patient treatment facilities are the primary employers of music therapists, but this does not preclude a music therapist from hanging his shingle and opening shop as an independent provider. Seeing clients in an office setting is a growing trend in the field and there’s a movement afoot to lobby for insurance reimbursement for services. As the number of practitioners swells, the non-sick person needing assistance with stress reduction, relationship skills, relaxation techniques, situational depression, pain management or any of the other routine problems of daily life will have access to music therapists. Ndeti states, “More people are seeking alternative medicine. They’re becoming aware of treatments that don’t involve medication or hospitalization.” Demand will lead to access.
A partnership between Symphony Orchestra Augusta (SOA) and the Charlie Norwood V.A. Medical Center will extend the benefits of music to a broader patient population and allow volunteer musicians to use their talents to give back to the community. Modeled after the Pittsburgh Symphony Orchestra’s music and wellness program, the ongoing project will begin this fall with the intention of promoting healing through intentional interaction with music. “We want music to be more available to our patients,” says Montgomery. “It’s difficult for us to get around to everybody all the time and we want to fill that need.”
Montgomery and his colleagues are working out a training program for the volunteer musicians. This is not typical music appreciation or arts exposure outreach. “It’s not meant to be a performance,” explains Montgomery. “It has to have a more specialized purpose.” That purpose will be defined by the particular needs of the patient group.
SOA is recruiting and screening symphony and community musicians. Raine Wheeler with SOA, who is spearheading the partnership in collaboration with Montgomery, hopes the initiative will spread to other CSRA patient treatment facilities, as well as attract more music therapists to the area. “Music is a powerful tool,” she says. “The SOA is committed to providing music for entertainment and to making the community well as a whole.”
Sounds, discordant and harmonious, flow through every moment of our lives. We learn to ignore the tap-tap-tap of our fingers on a keyboard or the clink of dishes in the sink. We expectantly anticipate the clap of thunder that follows a flash of lightening or the cry of a baby waking from a nap. We love to hear the DJ announce our favorite song on the radio. Even silence has a sound that fills the spaces between the gongs and grrs, tweets and twangs, bleeps and bangs on which our moods rise and fall. It makes sense that our bodies and brains respond to music, that the music creates a conduit for healing.
Lucy Adams is a Thomson, Ga.-based newspaper columnist, freelance writer and author of two books, including her latest, Tuck Your Skirt in Your Panties and Run.