Note: Alive Inside just came out, about music therapy. My work here is for my regular gig as a writer – Spokane Magazine. It is currently out. Before my piece, a compelling quote from an MD from the documentary, Alive Inside.
Dr. Bill Thomas, a gerontologist and advocate for long-term care reform, points out the film, “The health care system imagines the human being to be a very complicated machine. We have medicines that can adjust the dials, but we haven’t done anything medically speaking to touch the heart and soul of the patient.
“What we’re spending on drugs that mostly don’t work dwarfs what it would take to deliver personal music to every nursing home resident in America,” Thomas says. “I can sit down and write a prescription for a $1,000 a month antidepressant, no problem. Personal music doesn’t count as a medical intervention. The real business, trust me, is in the pill bottle.”
Some axioms like “music goes to the heart of the soul” are both so obvious that the phrase seems redundant. Yet in today’s world of data-driven rationalists, steeped in science-preened-and-juried language, many folk need journals and longitudinal studies to prove that music is both soul touching and physiologically, psychologically, kinetically, holistically curative beyond the veracity of any research that might be conducted at an Ivy league school.
The art of music is honed into the science of psychology, meeting up with the power of the curative arts and the art of care giving in this 60-year-old profession called, Music Therapy. For Spokane, the power of therapy to bridge people’s mental and physical disabilities, pain and challenges is counted on one hand – three board certified Music Therapists for this Inland Empire.
“Spokane residents deserve to know about Music Therapy, and know there are board-certified music therapists who serve individuals and groups with autism, Alzheimer’s, dementia, developmental disabilities, cancer treatment, mental health, depression, PTSD, well-elders, typically developing children, and more,” says Carla Carnegie, music therapist and owner of Willow Song Music Therapy Services. “I spend time educating, presenting, as well as providing Music Therapy for individuals and groups.”
For right-brain creative types with grounding in the sciences and systems thinking, the ecologies of the earth and those varying ecologies of humanity and culture are easy to grasp, so the idea of using music to work with folks with Parkinson’s or in the early-late stages of Alzheimer’s makes perfect sense.
It’s easy to wrap our heads around the recent state initiative (unfunded, albeit) that passed narrowly calling for smaller classroom sizes (17) for PK12. Attention and more one-on-one opportunities. For music therapists in this state and Oregon, music is a fundamental source of life in our schools, giving many youth lessons in leadership and collaboration skills. To listen, then to integrate those musical lessons, followed by performing those songs, well, that pushes cognition to a higher level than a school with no music.
Studies have shown that music learning and practice also benefit many mental and behavioral processes, including cognitive development, language learning, reading ability, creativity, motor skills, and personal and social adjustment. – Norman M. Weinberger
At the legislative level, music therapists have to be a necessary service in school systems, according to Music Therapist Jodi Winnwalker who graduated from Marylhurst University in the early 1990s and runs a music therapy practice in Portland. Children with developmental disabilities such as Asperger’s, autism spectrum, intellectual delays, attention disorders and a whole host of other disabilities are helped when music therapy enters their lives.
We can utilize a plethora of neuropsychiatric terms like autonomic nervous system, rhythmic auditory stimulation, neural plasticity, visual cortex, limbic system (or paleomammalian brain) and hundreds of others to go deep into the effects of music therapy on people. At the Russian institute where Pavlov studied, neurophysiocologists and others developed a special technology that turns a person’s unique brain waves into piano music. That’s called BMT, or brain music therapy.
Talking with Jodi and Carla, anyone will see they know their psychology and music, and their ability to understand the functional neuroanatomy of humans. Says Jodi, “So much of the research shows that music is represented in mechanisms widely distributed throughout the brain rather than localized in a single region as are other kinds of information, such as visual or movement information.”
It’s a paradigm shifting field, Music Therapy. New work shows that there is a right brain region for notes and musical passages corresponding in location to a left brain region for letters and words. This bodes well for memory care and working with persons who suffer from varying levels of post traumatic stress disorder (PTSD).
For Washugal music therapist Karla O’Hagen-Hawley, who is currently in Oso, Washington, as part of a grant and impetus to help the community heal from the tragic mudslide disaster that took the lives of 43 people, she knows what works to heal adjudicated youth, those young and old in various degrees of PTSD and to bring a community into the healing process.
Yet, broad knowledge of and then validity for her profession are still always challenges created by how of the powers that be see and unfortunately shape the world in their profits-above-all- else minds: “It is mostly unheard of –- perhaps because insurance companies and the medical profession have NOT entirely embraced the efficacy and evidence-based practice of music therapy, but instead due to ignorance see it as a Woo Woo therapy based in ‘hippy hippy’ philosophies. Perceptions are not based in fact but in fear,” O’Hagen-Hawley said to me while on a ferry north to work her musical wonders in Snohomish County.
I know first-hand the power of the guitar, accordion, piano and drum on adults with developmental, psychological and intellectual disabilities, through my most recent reincarnation as a skills instructor for folks in a private program set up initially as a memory care facility. My own bumbling piano playing has unlocked great creative and cognitive bursts and spurts in the clients I work with.
Better yet, we brought in a guru in the music therapy profession, Jodi Winnwalker, who has her Earthtones Music Therapy business in Oregon. There is a syncopation and almost tidal balance coming from the students who get to have hands on work with instruments. Winnwalker also works with experts in horticulture therapy. There is a magic genie out of the bottle kind of relationship with music, tone, rhythm, classic songs and the folks with Downs syndrome, Fetal Alcohol Syndrome, and various other cognitive disabilities.
She’s been heading up Earthtones since 1996, starting out with only Winnwalker at both the business and therapist helms, but she quickly took on independent contractors and now full-time employees. Carla, Jodi and Karla all attest to the fact there are around 6,000 music therapists in the USA, which is not enough by a long shot.
While talking to the three therapists, I gained deep insight into their holistic abiding affection for the human condition, and for helping people reach a sense of some peace, calm, healing and success in their lives. Years ago, I understood the power of the arts (and in my case, the power of the Humanities as a literature-creative writing college instructor) way back.
I worked with Central American refugees in the 1980s — fathers, mothers, aunts, uncles, siblings and children who were victimized in Guatemala, Honduras, El Salvador and made the trek to the US-Mexico border.
In El Paso, while a college instructor and journalist, I also helped these incredible survivors gain the skills and language and legal documents to gain legal sanctuary in the US or Canada. Many of the stories of village atrocities of the most unimaginable kind for children to witness came in the form of drawings. The adults wrote, sometimes poetry, sometimes memoirs. Those forms of art helped bridge the PTSD and emotional and psyche wounds into a forward moving liberation. A beginning.
Music was always at the core of those two refugee houses in El Paso and Juarez: music from their own regions and villages, and, well, the music of pop icons like Michael Jackson. We didn’t need three PhD’s and one MD in the neurosciences and psychology to see that healing power. Music was the language of the oppressed. A welcoming. A bridge from disharmony, hell, really, to some brighter horizon.
Here, some timeless words on music’s power from some heavy-hitters:
I was born with music inside me. Music was one of my parts. Like my ribs, my kidneys, my liver, my heart. Like my blood. It was a force already within me when I arrived on the scene. It was a necessity for me – like food or water. Ray Charles
One good thing about music, when it hits you, you feel no pain. Bob Marley
Music is a moral law. It gives soul to the universe, wings to the mind, flight to the imagination, and charm and gaiety to life and to everything. Plato
Without music, life would be a mistake. Friedrich Nietzsche
Here are some interesting facts about Spokane-based Carla: she went back to school in her 40s, after her eldest daughter graduated from high school. She was born and raised in Spokane, into a musical family, and she studied piano and played and sang, as no TV was allowed in the house . . . music filled the time. When she was 15, she was in a car accident caused by a drunk driver who critically injured her and killed her older sister.
She missed four months of school, “and when I went back, I couldn’t keep a thing in my head.” She went through years of mental and physical healing. At first the doctors were sure Carla wouldn’t live, then when she did, they were sure she wasn’t going to be there mentally, and then they were sure she wouldn’t ever walk again, and, finally, she would never have babies, the doctors declared.
She had four children, plays in a Celtic band and decided to get a bachelor’s degree from Whitworth in her middle years. She works all over town, including Sacred Heart hospital where she practices her craft through a Cancer Foundation grant to use music therapy with patients.
She can go back 40-plus years and recall the power of music in her own healing: “I distinctly remember, though, when I was down to one crutch, trying to walk somewhat fluidly, and rhythmically, I used my familiar reels, which have a 4/4 time, or jigs, which have a feel of 2 to them which I would hum or sing out loud while walking to teach myself to walk,” Carla said. “The melody and rhythm of the songs were simple, easy to sing, and would neurologically be the activator to my motor cortex to fire the neurons to move in a fluid manner. These tunes were instrumental only. Words were not necessary, nor desirable in getting me to walk. Music was the stimulant, the healer, the motivator, the calming agent, the balm I needed, and it became more important to me than ever!”
Like most skilled music therapists – think core classes in a music major AND core classes in a psychology major, plus 1,200 clinical hours internship AND a national board certification test – Carla sees her work with Parkinson’s sufferers and Alzheimer’s patients as vital to the very fabric of our culture. She keeps keenly abreast of the research in her field, but results on the ground are what make her feel self-fulfilled at age 57 almost three years into the career.
Carla points out some key challenges for Parkinson’s sufferers: the disease affects the person’s gait, his or her respiration system, the communication system ( as in volume decreasing and articulation becomes very mushy due to the disease process affecting facial muscles) cognitive function, and emotional function.
“I am aware of the right tempo to use, strong rhythm in a particular melody, and the client’s music of preference,” she says. “Clients tell me how much the music therapy interventions help their depression, increase their psycho-social function, as the group is doing this together, and they all are living with the same disease, so the elephant in the room is acknowledged. Their volume is increasing, and their spouse doesn’t have to say, ‘speak up!’ as they are remembering to use their deep breathing to produce more air over the vocal chords to be heard. They also remember to practice during the week some of the fun vocal exercises I have them do repetitively, which works those facial and tongue muscles helping to speak more articulately.”
Using music to inspire citizens to do good things is one recent calling Karla answered which precipitated her quitting a high paying job for an Austrian refiner as their Tualitin-based plate and pulp mill equipment sales force. She’s been all over Southeast Asian, South American and beyond. But working with adjudicated youth, trauma victims, veterans, and all those “Oliver Twist” sorts of youth inspires her.
Free piano lessons for high risk students. This is in an area where readers just heard of the Marysville school shootings, and more recently, a school stabbing. “It’s also an opportunity to play together,” Karla says of the idea of having the Oso residents move forward away from the initial shock. She sees her profession as the “second responders” for trauma.
The simple but facilitated act of drum circles is where the power of vibrations, tone, timbre and rhythm moves people to heal, as well as tapping into their amygdala. She harkens back to primitive tribal cultures and how they deal with traumatic events: “Song about the trauma release emotional energy and helkp begin the exploration of verbal processing in a gentle, non-threatening way.” Karla also talks of “bilateral brain stimulation” and the “social sensory power
of music as a symbol that says we a moving forward.”
For the 60-year-old Karla, a sixth generation Oregonian, she sees traditional American songs helpful for most of her memory-challenged clients who have dementia and Alzheimer’s. “Every music therapist has a Pete Seeger song in her playbook.”
“You are my sunshine, my only sunshine, you make me happeny when skies are grey. You’ve never know dear, how much I love you, please don’t take my sunshine away . . . .”
Working with the young and the old, whether they are well-elders in retirement communities or terminal patients on an oncology ward, Jodi, Karla and Carla see the power of music, song and reclaiming memories as all part of well being and healing.
Here, Carla, recalls clearly 42 years ago, when she was recovering from the tragic accident: “I had songs within my memory which I would hum, or just think about. That humming was good for my respiration and was a tension releaser, but it would have been good for me to have someone there facilitating and encouraging me as we musicked together. Music Therapists often work in the hospital setting doing just that with clients to help them with self-expression, using music as a diversion through procedures, pain management, uplifting the mood, and working on breathing deeply through relaxation techniques, singing, etc. However, there was no Music Therapist in Spokane at that time.”
It’s like traveling into other people’s worlds, entering a memory care facility. Music engages folk, they are more animated, and anxiety is lowered. Medications are reduced. People who have stayed silent for years locked in their Alzheimer’s have in many instances started singing Ella Fitzgerald and Louis Armstrong songs after a music therapist intervenes in that locked-in world.
The profession may or may not grow, depending on how this culture positions this deeper, kinder and beneficial treatment (yes, more expensive and time intensive). Most states do not cover music therapy in medical plans, nor do many school districts – like District 81 in Spokane – cover music therapists working with fragile youth in special education programs.
Even end of life decisions can be made easier with music therapy. Carla recalls a testy hard-nosed retired Army officer with just weeks to live. Two music therapists were working with him, and asked what his last wish was before dying. He said that he had been estranged for years from his adult children. He wanted to write and record a song to them, as a way to apologize for the years of no contact. The music therapists helped, performed the music and sang the lyrics and sent the CD to the children. “He could only do this in song. It broke down barriers and they were able to spend time with him in his last few weeks,” Carla said.
So the song plays on and on, as does the healing, even after death!