Music can be used to open up channels of communication with patients disturbed by a range of conditions, writes SYLVIA THOMPSON
WHAT CAN you do if your mind is too confused to permit normal conversation? How can you occupy a social space – in which to communicate with others – if you can’t speak? How can you share your distress with someone else if you can’t distinguish between internal voices in your head from those around you?
These were questions which were addressed at a conference on music therapy held in Dublin recently. Speakers from Ireland and Belgium gave powerful examples of how music opened up channels of communication with patients severely disturbed by conditions ranging from acquired brain injury to psychosis to dementia.
It was qualitative research at its best: short films of the interactions between therapists and clients showed better than any written report could how music gently stimulates neural pathways in the brain to allow patients communicate again.
The relief expressed on the faces of some clients, the eye contact between the therapist and client, and the actual shared experience of singing and playing musical instruments was powerful proof of a therapy at work.
Rebecca O’Connor, senior music therapist at the National Rehabilitation Hospital in Dún Laoghaire, Co Dublin, spoke about how music therapists there work alongside neuropsychologists, occupational therapists, speech and language therapists with clients and their families. Often the client’s communication through music shows everyone what is still possible for someone with an acquired brain injury.
“We have found ways to use musical markers throughout the day to signal activities for some clients,” she explained. For example, one patient found it extremely stressful to be helped to get washed and dressed in the morning, but when four pieces of contrastive music were played, the time taken to do this was reduced from 90 minutes to nine in the space of two weeks.
“In this way, we applied music like a prescription to deal with challenging behaviour,” said O’Connor. In other situations, music is used to help parents learn new ways to communicate with a child who has an acquired brain injury.
Watching and listening to music therapists describe their work makes one realise the patience required and the instinctive communication skills that a creative arts therapist brings to this work.
The keynote speaker at the conference was Prof Jos De Backer, head of the music therapy department at the Psychiatric University Centre at the Kortenberg campus of Leuven University in Belgium. He spoke about how young people with psychosis are offered two sessions per week of music therapy in group or individual sessions as part of their treatment.
“Music gives shape to the disintegration and timelessness of the psychotic world. The interior and exterior world is mixed up during psychosis. Even words are pure sound which is meaningless and not connected to the inner space. Music offers the client a pre-verbal psychotherapy,” he said.
Backer described how some young psychotic patients initially don’t connect with the music or the therapist.
“One patient played the same sounds for 25 minutes twice a week for eight months. It was a form of sensorial playing not inspired by the music. She was emotionally detached from the music and I found no resonance with her,” he explains. But then, something shifted and the patient began to play music with the therapist.
Backer also spoke about how, after many weeks of therapy, he sat in silence with one patient with psychosis for up to 20 minutes, after which she left the room but returned to join him in playing the piano. After this session, she began to get better. These therapeutic transitions are the basic condition for the treatment of psychosis, according to Backer.
Music therapist Elaine Cullinane spoke about her work with patients with dementia. “People with dementia are disorientated and lost in time. When everything else is strange, singing songs can provide something that is tangible and familiar that brings the patient into the present moment and gives them a sense of belonging,” she explained.
Two other music therapists, Kerrie O’Connor and Evelyn Horan, told of their work with Spirasi, a centre for asylum seekers and refugees in Dublin. “Many of the people who came to the centre had experienced sexual and physical abuse or the death of members of their family,” explained O’Connor.
Music therapy was offered as a safe space away from the sometimes fraught environment of hostel living. After several attempts to offer the clients opportunities to play or sing songs from their diverse cultural backgrounds, the music therapists found to their surprise that the story of Molly Malone resonated with them.
“Many of these people had left their countries in traumatic situations. They felt unwelcome here and were isolated from Irish society. Learning Molly Malone brought them into contact with Irish people,” said O’Connor.
RIGHT NOTE: SEEKING PROFESSIONAL STATUS
Music therapists are campaigning alongside other creative arts therapists – drama, art, dance and movement therapists – to be included in the Allied Healthcare Professionals Act of 2005.
“It’s about getting parity of pay with other healthcare professionals such as speech and language therapists, occupational therapists and to be recognised by the HSE as a health professional,” explains Jane Edwards, head of the Masters in Music Therapy programme at University of Limerick.
“In the UK, music therapists have been recognised as health professionals since 1990. Such professional recognition is also important for clients because it means music therapists have protection of title and no one can claim to be a music therapist without the correct qualifications,” she adds.
The Irish Association of Creative Arts Therapists is holding a series of event to celebrate its 25th anniversary and to campaign for statutory recognition for therapists working in educational and health sector in Ireland. See iacat.ie or contact Rebecca O’Connor on info@iacat.ie or tel: 087-9575641 for more details.
