A Tipping Point

There has recently been a tremendous amount of change in the field of music therapy. In the last 5 or so years, I have seen us reach what feels like a tipping point. The point where all of our advocacy, research and clinical work are making a difference both in the media and the general public. People are coming to us now, the therapists, and seeking our services with degrees of familiarity and knowledge about our work. We are less engaged in talks about what music therapy is--the elevator pitch we all have honed over the years.

We are now involved in collaborative problem solving of clinical cases, starting small businesses to meet demand and becoming employed with greater success than I have seen in the thirty five years I have been in the field. The opportunity to do a TEDx talk in April of 2015 was beautifully timed with these currents of change.

Years of giving lectures prepared me to speak about the power and beauty of music. As both a scientist and an artist, I have found my role to be that of a bridge builder. I help physicians understand the work that we do and I help artists understand the world of medicine and research. I help nurses and therapists understand the way music can support their patients’ well-being and recoveries. And I prepare aspiring music therapy students to understand the world of nursing, physical, occupational and speech therapy.

In my talk, I brought these artistic and scientific elements together for viewers to consider music from womb to tomb. The research of fetal and early childhood demonstrates the innate abilities that we have in music. In the womb, fetuses are able to hear the sounds of the outside world in the final trimester and discriminate novel from familiar music. In their first several days of life, brain imaging demonstrates the capacity of a newborn to detect the beat in music, something that a computer still cannot do. Music is essential to learning language. It is not secondary or ancillary to language.

At the end of life, I have seen music fill the empty void of a hospice vigil. In the last days or hours of life, music can help regulate the ragged breathing of a patient who is actively dying. This ability to smooth out breathing puts the family and patient more at ease. Then the music can fill the space with love in sound which makes the impending loss somehow more bearable.

In between birth and death are a whole myriad of experiences in which music can support well-being. Recently I took a course with Herbert Benson, the originator of the Relaxation Response. In this course, it was said that over 95% of medical office visits in the U.S. were stress related. This is an astounding statistic! People naturally and intuitively use music for relaxation and comfort. This is important in the very demanding world in which we live. I know I effectively used music in this way before my TEDx talk.

When I arrived at the venue, there was naturally a great deal of nervousness around me. As a therapist, I felt I could sense it and it was beginning to unnerve me. So I left the venue and went to another part of the Oceanogràfic. I found refuge in the benches around a dolphin pool. There was no show on so I was able to sit in relative solitude with the sun shining on my face. There I listened to my favorite sedative and relaxing music tracks--Elgars variations on an original theme, Mozarts clarinet concerto, Charpentiers Depuis le jour, Finzis Eclogue for piano and strings and a number of other beautiful pieces by Beethoven, Schubert and Schumann. As I listened to the music under headphones, the dolphins began to play with a ball that was in their tank. It was all so natural, so calming, so magical. My anxiety in anticipation of the talk melted away. By the time I returned to the venue, a bomb could have gone off and I wouldnt have startled a bit. This musical moment I gave myself helped me stay in the flow of the words I wrote and even to improvise a little bit on stage.

These were some of the same pieces of music I had used for surgery five years ago and that I continue to use frequently to manage the stressors of everyday life. In the work of music therapy, the intuitive uses of music for relaxation and comfort are transformed into a scientifically informed protocol for well-being.

The ability of a newborn to detect the beat in a signal is operational throughout life and can be a tremendous asset when disease or disorder affects movement. When we use rhythmic music with patients who have had strokes or who have Parkinsons disease, they walk better. The rhythm helps to organize the brains ability to activate movement patterns. We are able to offer a brain based treatment for a brain based disorder. As insurance companies continue to minimize support for treatments, we must find ways to maximize outcomes and music has tremendous power to meet those needs.

I think that music therapy is a remarkably noble and honorable profession, a tremendous resource for people in medical, educational and mental health settings. To add to the currents of change, I hope to make a few more waves with a new project I created called Music Therapy Tales. This project pays homage to the writings of Oliver Sacks, whose clinical stories, particularly those based on music, have informed and inspired me for decades. The clinical stories of my colleagues also inform and inspire me. So I am filming them telling stories from their work in autism, early intervention, hospice, neurorehabilitation, mental health and dementia care. The website Music Therapy Tales will be populated in 2016 with these films and continue the momentum of education and advocacy that I have been committed to for the last 35 years. It is my aspiration that every person who could benefit from music therapy will know about it, request it and receive it. And I sure do think thats an idea worth spreading!

For more about Kathleen and her work:

Kathleen's TEDx talk

kathleenhowland.com