To be human is such a twisted blessing. We have an embodied existence with all the horrific and ecstatic feelings that come with it. But as we learn to find presence within the range of all of it we can discover a power to change our destiny. What can seem like a curse of pain can transform into an experience of empowerment (Samuel Hanser, 2009, p. 20).
Music immerses us in the range of feelings that guides self-discovery along the path to healing. It also anchors us, as we grasp the meaning of music in our lives and create new ways of expressing ourselves. While we access, explore, and communicate the deluge of emotions that can flood us when we are ill, it is possible to become well, even if we are not healthy. Music therapy empowers us to embark on a sacred quest to find the healer within, and come to peace with our physical conditions and their psycho-spiritual concomitants.
The purpose of this book is to explore ways to reveal this inner healer through combining empirically verified music therapy techniques with holistic practices, two seemingly dichotomous approaches yoked together in the loving presence of the music therapist. The book is designed to guide you as a music therapist to unearth the creative, healing capacity within yourself and within every individual you encounter along a path to wellness. It addresses you, as music therapist, musician, therapist, and evolving person who is privileged to witness the journeys of others who are ill. It is written for your patients or clients, whom I call companions on the journey, who can benefit from being privy to how clinical choices are made in music therapy. The book is also written for those who are not ill but are seeking a musical path to wellness or optimal health for themselves or in the service of others. Because not all of the interventions require music therapy expertise to implement, integrative practitioners will also find ways to apply music in their work.
This bookâs vocabulary originates in Eastern philosophy and embraces Western science. Its methods derive from ancient sources, nascent ideas, scientific method, and contemporary thinking. Its inspiration springs from the vision of healing empowerment that my son, Sam, of blessed memory, crafted in his short lifetime. Its core is music and the awe that can emanate from engaging in music.
The ocean that divides East and West has become a symbolic chasm for the ways that these continents have viewed disease and health, as well as treatment and wellness. Because the traditional medical model in the West rejects interventions that are not scientifically verified, the wisdom of Eastern health practitioners has not been widely accepted. Yet complex healthcare systems, such as Traditional Chinese Medicine (TCM) and Ayurveda, have flourished in the East for centuries. Thankfully, the emerging field of âIntegrative Healthâ recognizes the validity of these holistic models among more reductionist treatments for individual symptoms. It is the basis for this bookâs philosophy.
In the field of music therapy, a dichotomy exists between those strategies that have been scrutinized in Western research literature and those that derive from less scientific sources. Sound healing and energy work have existed for many generations, but have not been conducive to experimental validation. The elusive nature of energy and its manipulation cannot be clearly observed and measured, and its impact cannot always be explained. As a result, Western research and medical science does not acknowledge the possible influence of this phenomenon. However, in holistic health systems, these invisible influences are not ignored. On the contrary, they are honored and revered as the life forces that they represent. In Music: The New Age Elixir, Lisa Summer (1996) differentiates between those who apply sound and music in healing and those who are trained and qualified to provide professional music therapy services. Summer urges us to challenge unfounded claims of twentieth-century New Age practitioners who prescribe certain tones and vibrations to heal disease. She says, âThe vast majority of New Age music healing philosophy is fatally flawed by the oversimplification of the complex psychological, physiological, acoustical, and musical phenomenaâ (p. 9).
Just like energy, there are aspects of living that are difficult to comprehend, and yet as human beings, we feel them and know them to be true and powerful. The powers of music and of the human spirit have been rhapsodized in poetry and philosophy, but are considered far from the domain of scientific inquiry. However, if we are to derive true healing in our work in the more holistic sense of the word, then we cannot discount those things that cannot be measured and seen. It is often the unseen that brings us the greatest advancement on our journeys from physical, emotional, and spiritual illness to wellness. This book, though written by a trained musician, therapist, and scientist practitioner, suggests that true healing can be found when we practice with a new openness to strategies that are as yet undocumented, in deep respect for their origins and sometimes inexplicable mechanisms.
A Music Therapist on a Journey
I was introduced to the language of the piano soon after mastering the alphabet, and this magnificent instrument has accompanied my life. At the piano, I am decidedly unscientific, and, on occasions, imbued with supernatural powers. At least that is how I feel when I sense an indescribable connection with a composer, or when I am able to express something musically that I could never express in words. While growing up in New York City, I became privy to the secrets of music through classes at the Preparatory Program of the Juilliard School, where I learned composition, theory, harmony, ear training, sight-reading, pedagogy, and the fundamentals of violin, flute, and contemporary dance. I also learned who I was and who I wanted to be.
When I began my career as a music therapist in 1971, there was little empirical research to support or explain the techniques I was implementing. Trained in behavioral music therapy at The Florida State University, I learned the science of human behavior, and observation and assessment guided my work. I went on to graduate school at Columbia University, where I was a Fellow in the Center for the Behavioral Analysis of School Learning, specializing in methods of music-enhanced learning. As a scholar and researcher, I approached music therapy with a discerning eye and devoted much of my career to assembling data on its impact in a variety of clinical populations. When feasible, I conducted randomized controlled trials, the gold standard of research methodology, to test the efficacy of music therapy and to contribute to its body of evidence. A post-doctoral fellowship from the National Institutes of Health (NIH) enabled me to engage in biomedical research at Stanford University School of Medicine, where I honed the science of music therapy within the Western medical model.
Still, I was never content to simply practice, research, and teach. I felt that the training that had been gifted to me obligated me to work more diligently to establish music therapy as an evidence-based and widely accepted practice within medicine. As President of the National Association for Music Therapy (currently the American Music Therapy Association) from 1992 to 1994, and President of the World Federation of Music Therapy from 2002 to 2005, I dedicated my efforts to advocate for the profession as a science as well as an art. Throughout my formal and informal education, I filled many bookcases: with medical science and research methodologies on the shelves by the window; musiciansâ perspectives and aesthetics nearby; psychological theories and treatises next to those; and, closer to my study, texts on the cosmos, the mystical, the ancient, and the spiritual. Five years ago, I added to that collection when I inherited Samâs library, and as I read through his books, I became enlightened to esoteric, energetic practices and healing literature. Thankfully, as I have run out of empty shelves, I now have access to vast virtual collections that integrate the disparate syntaxes of these disciplines into a unified dialect to complement my clinical thinking as a music therapist.
All of these volumes have informed my work. In my practice, I have applied the evidence-based techniques that my colleagues and I have investigated so carefully and systematically over the years. But I have also implemented strategies that are not found in the technical literature. These strategies have led to defining moments in music therapy, when I have stood in awe of the inexplicable process that unfolded before my eyes and the subsequent transformation that transcended verbal description. While my personal journey has wandered into spiritual realms that address the meaning of these experiences and beyond, my publications have largely avoided the vocabulary of the soul and spirit. In my urgency to convince the scientific community of the value of music therapy, I have been extremely cautious about how I communicate. However, my clinical experience has been informed and delighted by introspections and insights that defy explanation.
Fortunately, the current climate in the West is one of great curiosity about the ways of the East, and the integrative health movement has spawned cross-continental exploration and research. As a Western-trained music therapist, I have been grateful to participate in some of these collaborations and have benefited significantly from Eastern wisdom. At this time, I am empowered to write this book, not only because of lessons learned from my son and my own experience, but also because of the respectable status that music therapy has gained for its research and clinical practice in medicine.
The Journey
The book escorts you on an expedition whose mission it is to inculcate the experience of illness with meaningful and creative coping strategies. The journey refers to the experience of someone from the first signs of discomfort to a point of wellness, wholeness, acceptance, or optimal health. This is the journey of an individual, and its cartography reflects that. Its maps are conceptual, holistic, and integrative networks, drawn for navigating this multifaceted and individualistic journey. On the road, there are often common steppingstones, like first signs and symptoms, diagnosis, treatment, recovery and resilience, and acceptance of condition or wellness. Yet death is the inevitable destination of every lifeâs journey, and we music therapists can carry the person through lifeâs final moments. Before guiding our companions through these passages, however, we must also prepare ourselves for piloting this exploration. Our own journey is one of self-analysis and awareness before coming into therapeutic relationship with the person in need. As we accompany the person in whatever direction they take, we are integrating music into holistic approaches to pain, anxiety, and resistance, and methods that work through the body and breath, mind, and spirit. With such attention on music, it is important to acknowledge and include silence in the lessons along the way, and to glimpse the uncharted, future journeys that lie ahead.
Parts of the Journey
This book is divided into three parts that track the journey. Part I presents a technical introduction to health, wellness, integrative health, and the roots of healing music. Part II is written through the eyes of music therapists and companions who become fellow travelers along the journey from illness to wellness. Part III describes music-facilitated and music therapy techniques designed to accompany the journey. Each chapter follows its own distinct outline, in order to best mirror the variety of paths that travelers follow in their quests for wholeness.
Part I charts the journey with conceptual maps that explore the meaning of health, integrative health and medicine, holistic healing, and the foundations of integrative music therapy. This section introduces the technical vocabulary, history, and underlying mechanisms that explain holistic approaches and potential roles for music therapy. In the journey idiom, holistic health and wellness, optimal health, and acceptance offer goals or destinations for the person who is ill or suffering.
Chapter 2 describes what it means to be well, and suggests ways to thrive and achieve a state of flow, even when we are sick. Engaging in music offers an outlet for creativity, while focusing on the parts of the self that are active and healthy.
Chapter 3 explores how alternative and complementary medicine began to include wisdom from healing traditions around the world and embrace ideals from integrative health and medicine. Advances in technology and psychoneuroimmunology have also informed the healthcare community that mind and body are intimately connected and that an eclectic network of treatments can guide the process of becoming well.
Chapter 4 scrutinizes maps for the journey and investigates the holistic health systems of Traditional Chinese Medicine and Ayurvedic medicine. These models exemplify Eastern ways of enhancing health and offer frameworks for treating the whole person, not just the ailing physical body. Holistic health delineates expectations for the healing process that include emotional and spiritual growth, not just physical health and wellbeing.
Chapter 5 follows the history of musical healing practices. True to its word, an integrative model of music therapy draws from multiple cultures, traditions, and ways of communicating through music.
Part II is about the journey and the process of journeying. Health and wellness take on new meaning when a music therapist brings out the creative talent within each person who is on the journey to wellness. As a guide for one who is suffering, the wise music therapist arrives equipped with the presence of body, mind, and soul to accompany a person through the voyage. This section of the work offers techniques to help the music therapist become that ideal.
Chapter 6 includes activities that prepare you, the music therapist, physically, emotionally, mentally, existentially, spiritually, and musically for the journey with another. It all starts with the self.
Chapter 7 explores the evolving relationships between you, the music, and your companionâthe person who is ill or sufferingâfrom the initial preparation for a session to its conclusion.
Chapter 8 presents case studies, telling the stories of a few special individuals as they begin the journey. Sallyâs initial discomforts and concerns about signs or symptoms lead to worry, stress, and entry into the medical labyrinth. Diagnosis brings challenges to Helenâs identity that will follow her throughout her life.
Chapter 9 continues the journey to wellness through additional case studies. Treatment is often accompanied by side effects, pain, and suffering, as told through Shulaâs story. Accepting the diagnosis and understanding its ramifications can be a source of additional challenges. Recovery may be accompanied by rehabilitation and new lifestyles and habits, but it may also spawn a period of hibernation to prepare for re-entry into the world of the healthy. Garrisonâs experience is one of shock and acceptance. Arthurâs story exemplifies resilience after serious illness. Sometimes our companions have no treatment options or do not recover. In this case, acceptance of a chronic condition or loss of functioning may be the focus of music therapy. Karl contemplates the final destination of his life.
Part III is devoted to the musical pathways through the journey, including interventions that ad...