In the year since my husband died, I have stopped listening to music at home. Not just “his” music or “our” music but “my” music too.
Silence has, de facto, become the sound of choice.
It was not a conscious decision and something I only started to recognise and question when a new book came across my desk. Avoidance of his beloved film scores and 1960s classics is understandable. However, why also the choral music that I had thrived on long before I met him, and had since loved to play in the kitchen on my own, even if it induced eye rolls in every other member of the family?
The book that prompted me to reflect is The Role of Music in Health and Wellbeing Journeys (Routledge), an Irish-edited, academic publication that includes a collection of first-person stories exploring the transformative role of music in people’s lives. It was the idea of Prof Hilary Moss, professor of music therapy at the University of Limerick.
“It was trying to turn on its head the idea that as music therapists, or any clinicians really, all the textbooks are written about what we should do for people and how we can help them. Very few people are asking the person: ‘Well, how do you use music for your health and wellbeing?’ It might be completely different to what we’re expecting.”
She invited PhD colleague Katie Fitzpatrick to collaborate, who in turn suggested they also needed a therapy participant on the editing team, as it was about professionals taking a step back to listen to individual stories, before adding commentary. Patricia O’Shea, a member of Chronic Pain Ireland, became the third editor of a publication that includes the work of nearly 20 authors, not just from Ireland but also countries including the UK, Finland, the US, Canada and Australia.
It offers glimpses of the power of music to communicate, to comfort, to motivate, in circumstances ranging from imprisonment and bereavement, to coping with dementia or chronic pain, and at end of life. Yet, several of those struggling with emotional turmoil talk of initially retreating into silence, before beginning to find a way out through music.
It is different for everyone but maybe there is psychological safety in quietness; it is easier to keep thoughts under linear control. Put on some meaningful music and who knows what emotions might bubble up and where they might go? Harnessing this potential for a positive impact is what music therapists are trained to do. To ensure benefit, it’s about “the right music at the right time and the right place”, as the editors explain at the outset of the book. That is what needs to be figured out, on a case-by-case basis.
“A lot of the work I’m doing at the moment is around how music might cause psychological harm or distress because nobody’s been asking that question,” Moss tells The Irish Times. “Everybody thinks it’s good.”
During 30 years of working in arts in healthcare, she has seen a “do-goody” tendency among some people. For instance, during a professional stint in a Dublin hospital, she observed “the amount of choirs that wanted to come in and sing Christmas music … and they didn’t want to come in January”.
Well-meaning musicians might want to spread good cheer but it is not always appropriate. “Sometimes people don’t want to listen to music, so it’s the wrong time. If they’re recovering and they’re in pain, they don’t necessarily want a banjo at the end of the bed. But they might …”
She recalls working at that hospital with members of the Irish Chamber Orchestra. One man, who had a stroke and thought he would never be able to get to a concert hall again, was uplifted by being able to hear playing of that calibre live from his hospital bed.
“You give someone a moment of hope,” she says. To be effective, does it need to be pieces or a genre of music with which an individual is familiar?
“Most of the research is that your preferred music is the music to use and that will be most beneficial. But we would improvise with people, making music that neither of us has heard before. Sometimes the arts challenge us to think differently about life.”
Songwriting, singing and participative improvisation are common techniques. Fellow editor O’Shea wrote a joint paper about her own music therapy, in which she talked about creating cacophony to sum up her pain, says Moss.
Quite apart from engaging in therapy, there is scope for everyone, she agrees, to use music more purposefully for health and wellbeing.
“I would work with people with dementia and I’d often be saying to relatives, ‘make a playlist of songs’. We would call it a life review, but it’s basically putting together songs that are significant to the person and having that playlist available for them. That’s a simple thing that anybody could do.”
Therapists work with playlists, as a way of motivation, say, for somebody with chronic pain. It moves them out of particular feelings, she explains, as the pain is so grinding and frustrating.
Anna Bertha Dakudzi, who came to Ireland from Ghana many years ago, was left in serious pain after a car crash. After some negative experiences within the medical system, when at times she felt she was not being believed and multiple medications had made her drowsy, she was referred for music therapy.
“It was a godsend to me during a tough time,” Dakudzi writes in the book. “I have really come to a good place through it. I love music. I love gospel music. It helps me to forget pain and release stress.”
When using music therapy in palliative care, there may be no obvious treatment path, says Moss, but it’s about enhancing quality of life. She becomes very frustrated when she sees nursing homes that don’t offer residents quality recreational activities.
Even with extreme brain injury, there can still be reactions to music, she says, praising the very specialised work of music therapists at the National Rehabilitation Hospital in Dublin. “There’s a validated tool for assessment, which the team use, and it’s music based because somebody might turn to the sound and that tells them they have some recognition when other things aren’t happening.”
Moss recommends that everybody should think about how music can help their health and wellbeing. “How they could use it to supplement what’s happening for themselves; it’s not going to be a cure. How it can help their mood or help them get motivated.
“Just noticing how they use music in their lives and maybe doing it more intentionally. For some people it’s putting background music on all the time because they feel anxious if they don’t have it on.”
Participation in music can be beneficial for patient and carer alike in the case of chronic illness such as Parkinson’s and dementia, as reflected in choirs formed for this purpose.
“I worked with a man in hospital, and his wife would visit every day and do things like brushing his hair. He couldn’t talk at all, and he was quite disruptive. Then he started singing with us in a group, and she was able to just come and sit with him and hold his hand and sing songs,” says Moss. “It changes the way you can have some time together.”
She would encourage family members to consider whether music or music therapy is available for a person they might be caring for at home and, if not, to question that.
“We desperately need to recognise the importance of music in child and adolescent mental health and for people with dementia. In German care homes, there is a music therapist in every facility and this is a requirement under care quality indicators there.”
Moss also invites readers to email her (hilary.moss@ul.ie) if they have any experience of using music as part of their own health and wellbeing. Meanwhile, I for one am taking tentative steps back to Bach, Handel and Fauré …
Finding freedom in the beat behind bars
A young male prisoner, “Southsider#1”, discovered the power of songwriting at the age of 21, after years of improvising rap lyrics in his head.
“It was the first time I felt I was able to talk about things that I didn’t speak about. The unspoken words were suddenly right there on the page in front of me,” he writes in The Role of Music in Health and Wellbeing Journeys. “I haven’t stopped since.”
But “when I came to prison, I lost everything. I had to leave my life, my family and my music behind.” It was a place he had never expected to be and found it hard to adjust. “All I wanted to do was write. I had things I needed to say and I knew that songwriting would give me a chance to speak, even if the words were never heard.”
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He grabbed that opportunity when he discovered the music class in the prison’s education unit. A group there was playing a song they had been working on in previous classes but there were still a few empty bars.
“I was immediately inspired and wrote a few bars in response,” he says. “I remember their reaction to my lyrics, the energy in the room, and the sense of achievement I felt. The encouragement and validation that came from my peers was unmatched and immediately built my confidence.”
He started to attend music class three times a week, has achieved a QQI certification (the equivalent of Junior Cert) in it, has learned to play basic chords and scales on guitar and piano and understands enough now about music technology to produce his own songs. He hopes to work towards completing a university degree in music.
“For me, songwriting allows me to escape. I am not thinking when I am writing; it allows me to get everything off my chest. I write about love and relationships, people I am missing, and the pain I am feeling … I write to remember the good times that will never be again, how I can’t change what’s been done, and I write to say sorry.” He also uses songwriting to protect himself from deeper thoughts.
“It distracts me from my sentence; it gives me a focus and a purpose … I do wonder had I gotten into music earlier, if I would be sitting here today. I can get through my hardest days with music: just give me a pen, paper, and a beat.”
