HEINRICH GRAY

Healing Sounds

Music therapy resonates where words can’t reach

By Kim Gray

She sits on an office chair—the kind that swivels around in all directions—and suggests starting the session with a piece by Joni Mitchell. An audience of 10 wheelchair-bound, brain-injured people surrounds her in a circle. The music has yet to begin and the small crowd is already mesmerized.

They’ve seen this musician before. They see her every week.

Moments later, Calgary music therapist Jennifer Buchanan launches into Mitchell’s most famous song, wheeling from client to client, addressing each person individually:

Bows and flows of angel hair
and ice cream castles in the air and feather canyons everywhere,
I’ve looked at clouds that way.

 Her song builds in volume to create an instantly thrilling, larger-than-life performance. The 32-year-old knows how to deliver a tune.

But now they only block the sun, they rain and snow on everyone.
So many things I would have done, but clouds got in my way.

The people gathered here at Calgary’s Association for the Rehabilitation of the Brain Injured once led regular lives. They are survivors of car accidents, assaults. One older man suffered a blow to his head during a sawmill accident near Rocky Mountain House. Another is a former peacekeeper whose armoured personnel carrier smashed into a ravine in Bosnia.

Today, as one of Canada’s best-known and most respected music therapists performs an intimate (and eventually interactive) concert, members of the group smile. They hum. They breathe deeply. Toes tap. Fingers move. Heads swing from side to side. Those who know the song, and are still able to verbalize, sing along.

Buchanan’s presence ignites a lightness and joy in what might otherwise be considered a tragic environment. The mix is poignant.

According to the caregivers of Buchanan’s brain- injured clients, music therapy plays a critical role in rehabilitation. In fact, throughout Alberta—and to the delight of practitioners from Red Deer to Canmore— music therapy services are being sought out not only by people representing the brain injured, but by those looking out for autistic children, seniors with Alzheimer’s and even young offenders.

The formerly fringe health profession is teetering on the verge of the mainstream, and it’s doing so in typical Albertan style. “We’re all in private practice. I would say that about 60 per cent of therapists in other provinces are employed within health care institutions and 40 per cent are in private practice. In Alberta, everyone is generating his or her own livelihood. It’s a province that supports private enterprise,” says Buchanan, whose company, JB Music Therapy, is celebrating its tenth anniversary this year.

Just 14 years ago, Alberta claimed only two practictioners, according to John Downes, the Edmonton-based president of the Music Therapy Association of Alberta (and one of the two early practitioners), whereas recent figures from the Canadian Association of Music Therapists (CAMT) indicates that 25 therapists currently practise in the province. “Perhaps the reason we’re doing so well is in part because we’re not in the recession that other provinces are in,” says Buchanan, who employs six consultants to keep up with an ever-increasing workload (and who is a former CAMT president). “I also hope that our success is because people are recognizing that music therapy is a very current and beneficial type of therapy. We see over 600 individuals a week. It’s a great small business.”

Music therapy needs little validation these days among experienced health professionals. Still, most of us aren’t quite sure what the process entails. If you research the topic on the web, you might pull up an ad for singing crystal bowls or advice on how to quiet a crying baby or suggestions for piano compositions that will ease chronic anxiety.

Skip to the Canadian Association of Music Therapists’ website—the organization claims a membership of 394 countrywide—and you will find the following definition: “Music therapy is the skillful use of music and musical elements by an accredited music therapist to promote, maintain, and restore mental, physical, emotional, and spiritual health. Music has nonverbal, creative, structural, and emotional qualities. These are used in the therapeutic relationship to facilitate contact, interaction, self- awareness, learning, self-expression, communication, and personal development.”

In other words, if you happen to be a great pianist who occasionally plays for seniors at an old folks’ home, you don’t qualify as a “music therapist” and what you are doing isn’t music therapy. Not in the formal sense. “You wouldn’t say you were a psychologist if you listened to a friend’s problems and offered advice. Just like you wouldn’t say you were a nurse just because you’ve been trained to give an insulin shot to a child,” says Downes.

An important distinction between musical entertainers and music therapists is intent. Take Buchanan’s performance of Both Sides Now. The lyrics conjure up images of shapes one might see in clouds. Pointing this out, she works her clients’ damaged minds by asking if they remember the kinds of activities they enjoyed as children. Grown men and women, with varying degrees of speech impairment, slowly and pointedly tell what they recall. A smile flashes across a young woman’s face as she says she used to perform plays for her parents. A young man remembers the thrill of catching lobsters as a boy. Another says he liked to run through sprinklers. A tough-looking biker type with a deck of cigarettes in his shirt pocket remembers “getting into trouble” when he was a kid. His comment elicits laughter from his peers.

Once Buchanan collects the memories, she weaves them together to compose new lyrics which she then performs to the tune of Both Sides Now. Her clients listen intently for their own stories in the song. The sense of accomplishment in the room is palpable. Sixty-year-old

What is it about music that reaches people in distress when other types of treatment make little or no progress?

Nonnie Howes, the one who survived the sawmill accident, sums up music therapy in three words. “It feels good,” he beams after the session.

Nonnie Howes’s younger brother and part-time caregiver, Lorn, a Calgary firefighter, insists that the only time Nonnie breathes deeply and with little effort is during music therapy: “In physiotherapy, he only takes little puffs. As well, music therapy draws emotions and memories out of him that he doesn’t usually talk about. He looks forward to it and really likes to sing with the group.” Music therapy, insists Howes, is work—but isn’t felt as such.

The members of the group don’t only listen and reminisce during their weekly session with Buchanan. They engage in songwriting tasks. They are social in a group set- ting. One man makes prolonged eye contact with Buchanan—an intimate gesture he otherwise rarely demonstrates. Later in the session, individuals will be offered various instruments to play, such as rain sticks, bells, drums, tambourines and maracas.

Buchanan and other music therapists may, on one level, be performers; but they are much more.

“The official word from CAMT is that the only people who should call themselves music therapists are those who have their music therapy accredited status,” says John Downes, president of the Alberta association. To achieve “accredited” status, an aspiring music therapist must complete a recognized music therapy program (of which there are four in Canada—see p. 44). An additional six-month internship, under an already accredited mentor, involves completing 300 hours of clinical contact time and writing a case study.

That there isn’t a training program in Alberta presents a variety of challenges for indigenous music therapists. “If you are in Waterloo or Toronto or Montreal or Vancouver, you have the support of a nearby educational facility. There is so much more power to getting the word out. You’ve also got students doing practicums and spearheading music therapy programs in various institutions,” says Downes.

There’s the isolation factor, too. Downes says that the goals of his provincial association, founded in 1998, have been less about politics and more about ending the isolation of practitioners like himself. (One political issue facing all music therapists is that their services—which cost between $40 and $60 an hour—are not covered by provincial health care anywhere in Canada. Until this happens, many therapists argue, their profession will not be taken seriously.)

Red Deer-based Judy Ewart is one beneficiary of the Alberta association and their quarterly meetings. “You’re by yourself. You’re the only music therapist in town. If you have some questions about how to approach a client you can’t exactly call someone and say ‘Come and observe,’” says Ewart. “Also, there’s no-one local to call if you think a different music therapist’s skill set might be more appropriate for an individual.” However, thanks to her provincial association, Ewart can at least pick up the phone if she needs support, albeit from afar.

“They might not be able to say ‘I’m angry’ but they can beat a drum angrily.”—Jackie Ryan

But the question remains, why music? What is it about music that reaches people in distress when other types of treatment make little or no progress? Some might suggest it is in our bones, our DNA, as much a part of us as language. Those with religious inclinations suggest it speaks to our spirit. Another position insists the music/human connection goes back to comforting early memories of our parents singing us lullabies. There is no shortage of theories.

About a year ago, CBC radio’s Ideas aired a documentary about music therapy called “Body, Mind and Music.” The program made reference to a 36,000-year-old musical artifact found in Geissenklösterle, Germany—a bone pipe. The instrument’s design, “pierced just at the right points to enable fingers to be moved up and down to change the pitch,” was an extraordinary feat for the time, and showed that “about as early as we find humans, we find musical humans.”

One of the more poetic explanations regarding the potency of music therapy comes from Mickey Hart, the drummer for rock band the Grateful Dead, during a 1991 address to a U.S. Senate panel on the benefits of music for aging populations: “Rhythm is there in the cycles of the seasons, in the migration of the birds and animals, in the fruiting and withering of plants, and in the birth, maturation and death of ourselves.”

Jackie Ryan, executive director of the Family Linkages Foundation of Alberta, reiterates Hart’s point about rhythm. Her organization provides services to children with autism. “Rhythm in music helps synchronize the senses of autistic children—senses that are often otherwise scrambled,” says Ryan, who has an autistic son. The foundation lends support to 71 autistic children between the ages of 2 and 8. Alberta Learning, Ryan says, will provide some funds for music therapy to families whose children have “severe special needs.” These funds are available until the children reach five years of age, after which there is no other financial support available for this therapy from the province—a sticking point for families who already face enormous challenges.

“My son’s first string of words to me was the Happy Birthday song. That’s when I knew he was capable of verbal expression. Sometimes with nonverbal children, their first words will be songs,” says Ryan, who lives in Edmonton. “Children with autism can experience a great deal of anxiety and frustration because of their difficulty understanding their environment.  Music can calm both of those feelings. Music therapy can also provide focus to help the children attend to different tasks. Different instruments may also give them tools to express their feelings. They might not be able to say ‘I’m angry’ but they can beat a drum angrily. And one thing we haven’t mentioned, which is as important as the rest, is that music therapy is fun.” She says her son exhibited “pleasure” during his music therapy sessions.

An American Medical Association article on music therapy from February 2000 quotes an excerpt from the Bible in which David is asked to play a song on the harp for an anxiety-ridden King Saul: “Whenever a spirit from God came upon Saul, David would take his harp and play. Then relief would come to Saul; he would feel better, and the evil spirit would leave him. (1 Sam. 16:23)”

Reached in Nashville, Alberta country singer Paul Brandt says he is convinced that music’s power comes from the fact that it is inherently spiritual. “Even back to biblical times, music and poetry have been used as therapy—used to bring comfort to people’s spirits. I think music is very spiritual.”

Brandt, a former registered nurse, recalls observing music therapy in practice: “I’ve had the chance to see how it can comfort people. Learning to play instruments can also help them get their co-ordination back.” The 29- year-old musician maintains that one of the most touching compliments he has received as a performer came from a cancer patient in a Memphis hospital. “This great big 15-year-old kid comes up and taps me on the shoulder. He says, ‘Mr. Brandt, I just wanted to tell you something. The doctors told me I’m cancer free. I’m going home today. Your music helped me get through.’ Somehow the music brought him to a different place.”

Mary-Lou Duncan, manager of recreation therapy for Edmonton’s South Terrace Continuing Care Centre, works with seniors who have moderate to severe dementia. Three years ago, hiring a music therapist was unthinkable. Yet, over the past two years they’ve brought in a music therapist once a week. And, with a new budget, they’ve recently managed to increase that to twice a week. “I think the benefits are overwhelming for the residents,” says Duncan. “I’ve heard that the last thing to go with people who have dementia is music. That music still reaches them when we no longer can. Personally, I think it is because music has always been part of our lives in some way. It starts with nursery rhymes. How [the patients] respond truly is astounding. Everyone is recognizing that music therapy is important, especially in continuing care.”

She’s singing again. Not Joni Mitchell this time. Jennifer Buchanan is performing a song called I Am a Peacekeeper, thanks to Matthew Schovanek—the Canadian soldier injured in Bosnia six years ago. The group at Calgary’s Association for the Rehabilitation of the Brain Injured has, with the help of individual caregivers, completed a music therapy exercise that involves finishing the lines of a song.

The improvised ballad goes something like this:

I’m looking…for a man to love me I’m learning…to get healthy
I’m listening…to country western music
I’m hoping…I can go back to the farm

I am a…peacekeeper

I am waiting…to hear more
I used to be…a terrific hairdresser I’m taking…a rest in the corner I’m waiting…for the snow to melt

I am a…peacekeeper

This week’s session is complete, and Buchanan’s next group is waiting impatiently by the door.

Kim Heinrich Gray is a graduate of Carlton University’s Master’s of Journalism program. She has worked for several newspapers and for CBC television and radio. Her work has been published in Saturday Night and enRoute.

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