‘With music therapy, you learn how to tap into the subconscious’

Marina Cassidy on how instruments, melody and rhythm can help patients with issues around anxiety, speech and dementia

Marina Cassidy’s acclaimed soprano voice, as well as her talent as a harpist, has earned her many awards and recognitions. In recent years, as an advocate of lifelong learning, her career has taken a new direction as a music therapist in St James’s Hospital and in paediatric palliative care in Children’s Health Ireland, Crumlin.

In Ireland, the first music therapy post was established in 1983 in Our Lady’s Psychiatric Hospital in Cork by Catherine O’Leary. There are now more than120 music therapists in the country. Music therapy is known to increase motivation, decrease anxiety and help with mental health issues, as well as helping those suffering from dementia, recovering from strokes or brain injuries. “It is an evidence-based profession allied to other therapies – you work closely with speech, occupational and physiotherapists and social work departments as part of a multidisciplinary team,” Cassidy explains.

For her, it has been an interesting journey from music as performance and entertainment to using it as therapy. Hardwired into her DNA, her love of music started when she was a child growing up in Kilmainhamwood in Meath, her singing abilities encouraged by her parents and nurtured by her teacher at the local primary school.

Later in Mount Sackville, she was introduced to the harp for the first time and, having grown up within miles of Nobber where the famous Celtic harpist and composer, Turlough Carolan, was born, felt an innate connection with him and this ancient Irish instrument.

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“The harp”, she explains when we meet in Dublin, “is closely related to the piano in that it is based on scales. At school in Mount Sackville we had two wonderful teachers for harp and voice and we had a harp choir. And I remember that when we sang the humming chorus from Madame Butterfly accompanied by six harps it was a magic sound.” A gifted singer, she went on to win awards in the Feis Ceoil twice while still at school.

After graduation, two years as a primary school teacher in Dunshaughlin with 38 junior infants in her care put a hazardous strain on her voice. So she moved to Kerry where, during the summer holidays, she had played the harp in the Park Hotel in Kenmare and was offered many opportunities to travel and perform.

She also married, settled down and had five children, and lost both parents and her only brother. But throughout that time, she kept studying, earning a diploma in singing performance from ABRSM (Royal Schools of Music) and then for the harp from LTCL and two further awards from the Royal Irish Academy of Music. “I just had this hunger for new learning which is interesting in the light of where I am now working for Misa [Mercer’s Institute for Successful Ageing at Dublin’s St James’s Hospital]. I am an advocate for ongoing learning and there is no age limit to that.”

She continued teaching singing and harp for 12 years in the Academy of Music in the Ursuline Convent in Thurles, Tipperary. “You realise that music is an essential tool for emotional expression – a form of non-verbal expression and we use music to support people through many situations happy or sad. When Misa opened in 2017, I performed in the first Bealtaine Festival and went to one of the wards and saw how I could connect with the patients. That inspired me to train in how to use music in a clinical setting.”

A two-year MSc in music therapy in Queen Margaret University in Edinburgh in 2018 followed – a commitment involving commuting there every 10 days. “With music therapy, you learn how to tap into the subconscious. It is a psychodynamic approach and opens up the whole world of improvisation.”

She goes on to explain how it works. “When I meet a patient for the first time, I start with a phone, Spotify and talk – I don’t start with an instrument. Our approach is person-centred, not prescriptive. It’s about establishing a connection and music is the connection. Later we use a wide range of instruments, melodic and percussion, and elements of music – rhythm, melody, harmony, all ingrained from childhood – and so we can put that to use in functional rehabilitation in conjunction with other therapies.

“Neurologic music therapy includes techniques such as melodic intonation therapy to help restore speech. Another technique would be rhythmic auditory stimulation for movement rehabilitation. There is increasing evidence that damaged neuron pathways can be repaired or reactivated as music and language have common features and are processed in the same areas of the brain.”

She cites many studies and the work of one of the world’s leading experts in the neuroscience of music, Dr Michael Thaut, a professor of music in Toronto, who has developed a range of techniques for specific functional rehabilitation. “The approach is always patient-led and with children I let them lead. What I love about the job is that there is something new every day to encounter, and improvisation is a really key approach. In St James’s, Misa is based on four life pillars – clinical, research, education and creative life. I came in when I qualified in September 2020 and that was the beginning of integrating music therapy into other therapies, so creativity stands as an equal pillar alongside the others. We built that very carefully from the ground up.”

An example of how music can work therapeutically came home to her during Covid when she visited the ICU in St James’s with live music. “I was constantly assessing, picking up on the ambiance. ICU patients with high anxiety and agitation made me aware of their breathing, so I matched the music to their breathing to help relaxation. And even hearing sounds that were not warning beeps helped both patients and staff, so the acoustic environment was important. Some patients are so full of fear and music can soothe all that. Music speaks where words fail.”

An elderly patient who had broken a leg and had been in hospital for several months said to her when he was leaving “You didn’t fix my leg, but you fixed my heart.”

  • On Friday, May 26th, an all-day seminar on the subject of music and ageing will take place at the Davis Coakley Lecture Theatre, Misa, St James’s Hospital. Tickets €30. See eventbrite.ie
Deirdre McQuillan

Deirdre McQuillan

Deirdre McQuillan is Irish Times Fashion Editor, a freelance feature writer and an author