When a person gets older, they gradually, or in some cases instantly, lose control over certain things. Mobility, memory, independence, and decision making are just a few. Something else they lose which might not be obvious to many is the right to be heard. A man is admitted to hospice and the team does their job getting everything in order to care for this man the best way they know how. Often by this point, the family is already making most of the decisions. The patient may be in hospice care against his will. And many of our patients are stubborn, as we all are.
Everyone is bustling around and fussing over the patient and he is too tired or confused to put a fight so he just gives up and gives in. However, this isn’t usually the case. A majority of our patients are accepting of hospice care and appreciate all that we do. Others are so far gone in their dementia or Alzheimer’s they only have a vague notion that lots of people are taking care of them.
Whether the patient is docile or not, they will still go through a cornucopia of feelings throughout their dying journey. Family matters invariably may complicate things. Sometimes the family is healthy and coping well, getting along, and prepared for their loved one to die. Other times…I’ve seen denial, dysfunction, estrangement, insecurity, guilt, and simply poverty, significantly affect the experience of the patient.
It is in this context that I arrive for music therapy. The patient may be dealing with the new routine of nurse and aide visits, new medication, family members coming and going with their own emotions, and death waiting before them. They might have just had a bath, or a phone call, or a handful of pills, or a visit from a tearful son or daughter.
Upon being asked what song he would like to hear next, a patient of mine once said, “I don’t care what you sing, just don’t cry.”
I thought that was a very interesting statement. And this is where validation comes in. I could have said, “Oh, people are crying because they love you and are sad to see you sick,” or, “Sometimes people can’t help crying,” or, “Well, emotions are hard to control.” Or I could have ignored his statement. But none of these validate the patient.
1. To declare or make legally valid.
2. To mark with an indication of official sanction.
3. To establish the soundness of; corroborate.
This third definition describes my use of validation in music therapy. To be clear (also I had look it up), corroborate means “to strengthen or support with other evidence; make more certain.” In this case, I corroborate with my patients by listening to and believing them.
Validation is the most common support I provide to my patients next to singing and playing songs. I said to the man, “You don’t like it when people cry?” He said, “No.” I said, “It’s hard to see people cry, isn’t it? Sometimes it might make you uncomfortable or you don’t know what to say. I can understand why you don’t want people to cry around you.” I can’t quite remember what he said after that, but I recall it was insightful and strengthened the rapport between us.
And then I sang a song. Probably “Ring of Fire” because he likes Johnny Cash.
Validation doesn’t come easily for me. I’m usually one of those people who is thinking of what I’m going to say while you’re talking. But in this internship I’ve learned to actually listen to people who are talking to me. It’s a lot less work because I don’t have to think of something witty to say or try to 1-up the person. Instead, I simply let them know they’ve been heard. It takes a lot of pressure off to be interesting, and the person appreciates the undivided attention. Charismatic people are experts at this, which is why we’re drawn to them.
Validation and music therapy naturally go together. Unlike the medical team in hospice, music therapists come to the patient to sit with them but not do anything to them. Music therapy is music, but it’s also talking. Partially because it’s a naturally social thing, and partially because music builds rapport and trust, and music will uniquely draw out conversation that may otherwise be suppressed or hidden behind barriers.
Two significant outcomes have resulted from my learning to validate. First, I’ve begun to validate my friends and family way more than I used to. The skill naturally spread into my whole life. I find myself talking less and listening more, and finding out more about the people I love.
Second, I’ve begun to validate myself. Part of this came from my therapist. Before, when I would have an emotion I didn’t like, I would be hard on myself and try to dismiss the feeling, which made me feel worse and like I was a terrible human being. Once I began validating my own feelings I gained a healthy confidence and respect for myself, and I didn’t feel like a weirdo all the time.
Now, when I experience an emotion, I acknowledge it instead of dismissing it. And in the times I’m really smart, I include God in the conversation. It usually goes something like this:
Me: God, I feel [emotion] because [of this situation], and….I don’t know what to do with it, so….here….I can’t – so….you.
God: Beloved, thank you for trusting me with this, let me take it from you and replace it with peace and a little clarity.
It’s amazing. It really is. And it works perfectly because God is really good with handling the stuff that doesn’t make sense. Guess who isn’t? Yah. And He gave us empathy and compassion and communication to validate each other so that we can support each other and grow through shared experiences.
So go forth and validate! Huzzah!