Music, drugs, and rock n’ roll

c70f72d2f5ec952d0cc995fce1d4536cYou know that feeling when you hear a song and it instantly becomes your new favorite? When you can’t get enough, you put it on repeat, and you find yourself hearing it everywhere? I searched for a long time for a word or phrase that encompassed that feeling. Or more specifically, the feeling when the song finally loses its emotional spark and becomes ordinary again, subtly whisked away into the endless sea of playlists. Well, I found that phrase several years ago, in a play that I wrote some music for. The play was a series of poems, and in one poem, the speaker “wore out the magic” of a Spanish dance. I was struck.

A few years later, I was listening to a very complicated and interesting lecture in one of my music therapy graduate courses. Basically, my professor was discussing how music motivates parts of the brain at the cellular level. He said, “Dopamine gives cells their seeking behavior,” which makes sense. We all know music causes our bodies to release dopamine and endorphins through the chemical reactions that occur in the brain.

I thought back to my idea – wearing out the magic. I asked my professor about this idea and how it related to the discussion – the release of dopamine. What happens when you no longer feel that rush? And also, what is happening when you introduce novelty (like a new song)? He responded with a fascinating answer. He said the only thing he could compare it to was drugs. The more you indulge in a song, the more of a “fix” you need to feel that renewed high. Novelty can bring that. And time. Have you ever noticed how excited you get when you hear a song you used to love (see top) but haven’t heard it in a long time. There’s your fix.

After processing all of this information, it seemed pretty clear to me why so many famous musicians turn to drugs. They write (or are the voice of) a hit song, perform to thousands of fans – they must being riding quite a high. And then it all comes down. Night after night. That’s a lot of up and down, which can create a very unstable feeling, especially if the person is still maturing or insecure. So what else can give them that high? What’s a quick….fix?

I don’t have a solution to this problem, but perhaps a rather unique insight because of my work as a music therapist, and it’s this: Musicians might use drugs to provide that high – to match the benefits they get from their music. I use music to provide the benefits of drugs without using drugs.

Troubled musicians use drugs in place of music. I help the troubled by using music in place of drugs.

My patients are in hospice. They take a lot of medications, mostly for pain and anxiety. Personally, I don’t believe music therapy can completely take the place of drugs, but I believe music therapy can allow for a smaller dosage and lessened frequency of drugs.

Music is supposed to make you feel better, it was designed that way. So are drugs. But the difference between music and drugs is that music has (very little to) no harmful side effects. And that’s what I love about music therapy. It is a positive, enriching way to lift someone from a dark place without any* threat of harm. As a music therapist, it’s my job to pick the right drug (song) in the right dosage (volume, tempo, complexity) to reach the proper outcome (smile, memory, relaxation). I trust the music. I just hope the magic never wears out.

*It doesn’t escape me that some music can bring back painful memories and events, but for the most part, I think people would agree that music is painless.

Real Musicians

From the Academy Award winning documentary 20 Feet From Stardom, a quote from Sting:

Real musicians – there’s a spiritual component to what they do. It’s got nothing to do with worldly success. The music is much more an inner journey. Any other success is just cream on the cake.

There’s this idea that you can go on American Idol and suddenly become a star, but you may bypass the spiritual work that you have to do to get there. And if you bypass that then your success will be wafer thin.

Two months in!

Today starts month 3, or week 9, of my internship. At the end of this month I will go through the mid-term evaluation, where my supervisors will watch my sessions for a week and thoroughly evaluate my music therapy. Yikes!

Things are starting to get into a routine now, if there is such a thing. What that really means is I’ve learned to start the week with a certain schedule and by the end of the week, that schedule has completely changed. That becomes the norm because, well, people die.

That sounds awful, I know, but it’s literally true (and I’m correctly using the word literally here). When I get word that a certain patient has died, I find myself responding in different ways. If the quality of life for the patient was really bad and they were ready and their caregivers were exhausted, then it’s a feeling of relief when you hear they’ve died. The spouse will finally get to sleep, the patient is no longer in pain. Sometimes the death is a shock, even though the patient is in hospice. I might have seen the patient one or two days before and they didn’t seem close to death. Sometimes a patient is admitted to hospice and they die within hours of being admitted.

Some patients are discharged, due to stability or even improvement. A lot of times it’s hard on the patient because we provided a good support system for them and now it will be gone, just like that. But Medicare won’t pay for someone to be in hospice if they don’t show signs of being terminal.

On a personal note, I just had a very quiet, peaceful weekend that was a long time coming. I hadn’t had a weekend where I slept in my bed the whole weekend since before my internship started. I’ve slept in tents, bunks, on couches, and in the camper. I actually slept in, which was only until 8. I can’t believe 8 is sleeping in for me. Last summer, getting up early was 9 or 10. Oh, how I needed this weekend.

My internship director is on vacation this week so I am on my own except for part of Wednesday and all of Thursday. Today I am singing a couple songs in a short memorial service for a nursing home employee who was killed in a car accident. Our bereavement team worked with the nursing home to plan everything. Pretty cool that we offer support to the community, beyond our patients.

Music update:
Still struggling to learn bar chords.
Still play most everything in G, but playing much more in D now!
I am learning A LOT of Gaither music. Oh my, you should see some of the YouTube videos.
I’m warming up to country. I actually just said that.

Happy Monday!

Anecdotes

A few of the many amazing stories I have found myself in these past 6 weeks of my internship:

Dang my Rowdy Soul

My second week we visited a newly admitted patient in her home. Her quality of life was very low and she was unresponsive to us and our music therapy, but we knew the husband would benefit, which is perfectly appropriate in hospice. After we explained what music therapy was, the husband told us what his wife likes, and also mentioned a song that he was interested in hearing, called “Dang my Rowdy Soul”. He explained how he used to listen to this song on his grandparents’ Victrola but hadn’t heard it after they died. I took it upon myself to find the song, which I did thanks to Youtube, and I wrote it down and learned it.

The next time we visited, I played the song for the husband. He confirmed it was the right song and was a little flabbergasted that I had found it just for him. I asked him when he heard it last and he said 1951, right before he left for Korea. He was very appreciative of our visit and our music.

His wife died the next day. It may seem odd to hear, but sometimes death is a good thing, especially considering her quality of life was so poor and it was very hard on the husband. But what struck me was that we wouldn’t be going back to visit. If I hadn’t learned and sung the song for him on that second visit, he may never have heard it again.

The Old Rugged Cross

We went to do an assessment (first time visit) of a current patient with dementia. My supervisor was familiar with the patient and warned me that she may be agitated. We arrived to her room in the nursing home and looked in. The patient was small, and curled up in her bed. She was in the fetal position and laying sideways. She appeared to be sleeping. My supervisor knelt down next to her, touched her hand over the blanket, and spoke her name. Her immediate response was a jerky motion and “what do you want?” but didn’t open her eyes. When we said we were here to share music with her, she said “alright.” Knowing she was spiritual, we began singing hymns. The patient began singing along but never opened her eyes. After a period of singing, we said good-bye and that we would be back soon. The patient thanked us for coming and was very appreciative. She was pleasantly resting when we left.

Upon writing our note in the patient’s chart, we found several other notes stating that the patient was agitated, mean, and uncooperative, calling people names and telling them to leave her alone. My supervisor and I looked at each other in bewilderment. How interesting we didn’t get that response at all…

Precious and Few

On a Friday afternoon, the last patient of the week, we did an assessment of a gentleman who had been discharged from Hospice and recently re-admitted. Only in his 60s, he was rapidly declining due to Alzheimer’s disease. His wife was present and was coping well with her husband’s condition. Since my supervisor had done music therapy with this patient before he was initially discharged, she knew some of his preferred music, and also that he used to dance. Usually only able to hold attention for five seconds on one thing, the patient kept dancing with help from his wife while my supervisor played a blues progression on the guitar. When the music stopped, my supervisor talked to the wife about her husband’s care, while the husband wandered around the room, not really focusing on anything.

Knowing the song “Precious and Few” was a significant song for the couple, my supervisor pulled it up on her iPad and played the recording while the wife took her husbands hands and moved them in a circular motion while dancing. He complied and moved along with his wife.

As I was watching, I noticed the patient was moving, but not exhibiting any kind of affect (emotional response) and not acknowledging his wife. Then, for a brief moment, the husband put his left arm around his wife’s waist and pulled her in close, resting his chin on her shoulder. She laughed and “awww”ed and said, “See, you’re still in there somewhere.” But before she finished her sentence, he went back to his previous behavior. The moment brought tears to my eyes.

Going Home

I spent most of last week in orientation, so I was in the office and not out on visits. There’s a particular song I’ve introduced to my supervisor, called “Going Home.” It’s poignant and very appropriate for those last days and moments of a patient’s life. Just as my training was getting underway one morning, my supervisor texted me and asked me to call her so I could sing her the melody of the song, as she was about to visit a patient who was impending (very close to death) and she wasn’t completely comfortable with the song yet. I left her a voicemail of me singing the song and she also was aided by a Youtube clip.

She texted me later that the song was perfect for the moment and the family members were able to grieve openly with each other. My supervisor left the patient relaxed, though still showing signs of impending death, and the family, close together.

The patient died that afternoon.

Oh, how much have I seen the effects of music therapy in hospice care. It’s the soft cushion of care and support upon which our patients and families rest and breathe.

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Morning Hymn

A couple weeks ago I talked about the simplicity of my nephew’s prayer.

This week, I want to share a prayer written in 1673. It comes out of the book, A Manual of Prayers for the Use of the Scholars of Winchester College. This book, written by Thomas Ken, included “Morning Hymn,” “Evening Hymn,” and “Midnight Hymn.” So who’s Thomas Ken? Well, a guy who wrote hymns. But also…he

  • was born in 1637 in England
  • was put in the Tower of London by James II (he got out eventually)
  • was one of the first people to write hymns with words that were not straight from the Bible, which was extremely controversial at the time.

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Thomas Ken wrote the Doxology. Actually, what we know as the Doxology was the final refrain of the three hymns I listed above.

I was drawn to the beauty and practicality of Morning Hymn. It’s not as direct as my nephew’s, but it’s still a pretty simple prayer. To our 21st century language and ears it may seem flowery, but it’s actually quite succinct.

Perhaps this prayer will realign your perspective this morning, friend.

(Since the Doxology is the refrain, you can sing these words to the same tune.)

Morning Hymn

Awake, my soul, and with the sun

Thy daily course of duty run,

Shake off dull sloth, and early rise,

To pay thy morning sacrifice.

Direct, control, suggest, this day,

All I design, or do, or say;

That all my powers, with all their might

In Thy sole glory may unite.

The Versatility of Worship

Thank heaven God is creative.

Did you ever wonder what it would be like if He wasn’t? And not only is He creative, but He made us all creative. If this weren’t so, we wouldn’t know color. We wouldn’t know beauty, or a melody, or what an idea was.

One thing I love about God giving us creativity is we have come up with so many different ways to worship Him. And the cool thing is, there’s no wrong way to do it, if you have a genuine heart. He doesn’t care what songs you sing or what you say or what symbols you use, as long as it’s real and you mean it. I’m reminded of the time I took communion on a spring break mission trip. It was impromptu, on the way home, in the van. The elements? A cheez-it and a swig of someone’s bottled fruit juice that we passed around.

Lately, I’ve had the amazing opportunity to worship God in vastly different environments.

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Two weeks ago, invited by dear friends, I attended a choir rehearsal at a church where I was absolutely the whitest white person there. I sat in between my friends and sang gospel songs, going over them by rote, with no music, and actually very few words. Unlike other church choir rehearsals I’ve been in, where our noses are in the music and we work on diction and where to breath, this rehearsal was simply about praising God. I can’t describe the feeling of having my voice drowned out by a group of people who not only sounded great, but meant it. I was almost overwhelmed to tears with the sense of God’s presence in this community. And this was a choir rehearsal. It was so what I needed at the time. I had one word for my friend when she asked me what I thought: cathartic. They didn’t even care that I could’t attend the performance we were rehearsing for. It was an incredible experience.

Five days later, on the Wednesday before Easter, I attended a Seder at school. A local Rabbi led the meal and about 25 faculty and students attended. The Seder (Hebrew for “order”) is the Jewish feast that marks the beginning of Passover. There is very specific food and drink that is presented, some as symbols, and some to eat. Participants read from a text called the Haggadah. In it is the story of the Passover and the exodus from Egypt, along with prayers and songs. It was really humbling and insightful to be a part of this service. I love the tradition of Jewish culture, how old everything is. I really value the history, and it definitely puts Christianity in a more tangible and savory context. But that’s a whole other post…

On Good Friday, I attended a Tenebrae Service at the church I normally go to. (Tenebrae is Latin for shadow.) It was very dark, somber, quiet. I’m fortunate to know the man who led the service. His story alone is incredible and to be able to participate in this experience with him leading was quite impactful. He spoke slowly and his voice was fluid and resonant. He wasn’t afraid of silence. The music was stripped of its complexity, just acoustic guitar and voice. These are my favorite types of services because this is how I operate inside. Dark, somber, quiet. Processing. This service enabled people to simply process Jesus’ death. Good for the soul.

Yesterday for Easter, a friend invited me to her church for the sunrise service, free breakfast (amen) and the regular church service. I was (to steal a term from a dear friend) on the “strugglebus” emotionally and physically, so I didn’t mind getting lost in the extra mile of spectacle that an Easter service is. I hadn’t been to a service like this in a long time. A usual house band complete with piano, keyboard, AND organ (it was amusing to see an organist with an in-ear monitor), singers strewn across the front and a choir in the back, complete with the season’s best outfits, some even with hats. The pastor had that old school authoritative presence and in his sermon I realized he sounded just like Tommy Lee Jones. The atmosphere really was great and while I wasn’t feeling all “Praaaaaaise Jeezuz” I appreciated all those who were.

God is creative. And he knows that even some of the most creative people don’t feel creative sometimes, that’s why there is liturgy. Sometimes the uncreative get a burst of whimsy and need unorganization – that’s what repeating choruses are for. Sometimes we just need to be still. Sometimes we just need to be loud. Sometimes we don’t know what we need, and that’s okay too.

As long as it’s genuine, God is pleased.

Why the National Anthem Makes Athletes Cry

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When one studies music therapy, one begins to notice the role of music in all aspects of society. From the evening news opening theme to the ice cream truck. I went to a baseball game a few months ago and was completely distracted the whole time by the use of music. There’s the 7 second clip of a song for each home team player as they step out to the plate. The “charge!” trumpet fanfare. The “we will rock you” rhythm. Not to mention Harry Carey’s tune. It’s fascinating to me, and now, thanks to my music psychology class and A&P, I know exactly why music does its job in athletic events. A role nothing else but music can fulfill.

The Olympics only enhances this phenomenon. The hype, prestige, and pressure that comes from the Olympics makes music’s role even more significant and crucial. John Williams knew that. Which is why you get goosebumps when you hear the low triad of the trumpet in his opening fanfare.

I love the Olympics. Probably because I’m so terrible at sports. I’m completely in awe of what these people can do. But one area of the Olympics that I have some knowledge of is what happens when a national anthem is played at a medals ceremony. You all know music affects emotions. Here’s a thorough explanation of why:

When sound hits your ear and goes into your inner ear, it is converted to an electrical impulse that can be translated in the brain. The cranial nerve that this impulse travels to is called the vestibulocochlear nerve. It’s the 8th cranial nerve (out of 12) that your brain contains to receive information about your senses. The impulse travels to the auditory cortex in your brain so that your brain can interpret what you are hearing. It is in this that you can tell the difference between a garbage truck and a piano. Also, the difference between your mother’s voice and anybody else’s.

First, though, the impulse travels to the medulla oblongata, part of the brain stem. It eventually send the signal to the cerebral cortex. The medulla oblongata includes the diencephalon which includes the thalamus and hypothalamus. Here is where it all happens! The hypothalamus is the control center for your emotions. It is also connected to the limbic system, which controls your hormones. And it’s connected to memory.

Still with me? Ok.

An Olympic athlete performs under massive amounts of emotional pressure, both outside and internal. He also is putting his physical body under and enormous amount of pressure and stress. And the anticipation only adds to it. This heightened awareness and focus takes a lot of energy.

When the race is over, and the athlete has won gold, all of the emotions that have been held back by this heightened focus are free to surface. The first display is usually a fist pump, a yell, or a smile. The initial shock of it all puts the athlete in a daze. And they are emotionally vulnerable because they are physically exhausted.

But the athlete has no defense against the power of music! When they’ve gotten their medal, and are standing in silence, the music starts. The music hits the athlete’s ear and it instantaneously travels to the hypothalamus, activating his memory and limbic system. Music is time-based, so the athlete is finally grounded in reality: Music has duration, one must be “present” to experience it. The music is actively engaging the person’s memory and emotions. Forms of this engagement are things like the familiarity of the tune, there are no words being sung in the recording so he must provide them, the tune gives the athlete a sense of identity and pride, and it is combined with the flag of his nation, which is rising before his eyes. Also, the anticipation of the tune and the memory of what’s happened before when listening to it in this context is a factor. All of this combined triggers an overflow of chemical reactions (remember the limbic system and hormones), which must be disposed of to maintain equilibrium inside the body. Read: tears.

Suckers! This is the part I revel in. The toughest athlete is no match for the intense reaction music causes. Music has such a unique power. It can break down barriers like nothing else. It is absolutely no coincidence that the tears don’t flow until the music starts playing.

As music therapists, we harness this power and use it as a therapeutic tool. We make it our job to know how to use someone’s personal experiences with music to help them with whatever problem they are facing. How cool is that??