Publication: Inside Scripps
“Ah, music. A magic beyond all we do here!” –J.K. Rowling
Margaret Speyer is an oncology patient at Scripps La Jolla and has been in the hospital for almost three weeks. On this day, she is recovering from recent chemotherapy treatment and is feeling fatigued. However, when music therapist Mary Owenby enters the room with her guitar, Speyer rallies, sits up in bed and prepares for a more enjoyable treatment.
Owenby pulls out her guitar and song list and two confer on selections before deciding on the Beatles’ Let it Be. Owenby sings while Speyer nods along and a smile spreads over her face. Later, both Owenby and Speyer use a quartz toning bowl, which produces a soothing note often used in meditation.
“It’s extremely uplifting,” says Speyer. “When you’re in the hospital, one of the things you fight is depression. When Mary plays, you forget your problems for a few moment.”
The Science of Music Therapy
While many would say all music is therapeutic, music therapy involves more than simply playing an instrument for patients. Therapists complete a four-year degree program in which they are trained to respond to depression, sleeplessness, pain and other conditions. Like any other treatment, music therapy contributes to the patient’s overall quality of care and is provided only when ordered by a caregiver for a specific medical need.
“Music therapists are professional therapists, as well as professional musicians,” says Barbara Reuer, Ph.D., who directs music therapy at Scripps La Jolla. “We need to recognize the patient’s condition and adjust our treatments accordingly.”
Dr. Reuer and her colleagues keep copious records of their therapy sessions, including the patient’s symptoms, the types of interventions and patient comments. Most importantly, they track the outcomes, noting if the patient experiences relaxation, reduced pain, a spiritual response or other benefit. Music therapy patients report an average 30 percent reduction in symptoms like pain, anxiety and nausea. Another sign of success is when the patient falls asleep, as sleep is often elusive for people experiencing pain or other discomfort.
Through these statistics are powerful, the program’s case studies are even more impressive. During one session, a patient who had been non-responsive for days sat up in bed and thanked the therapist. Another requested a song she often sang for her granddaughter and reported her pain as zero. Yet another told his doctor that “the music is better than Wellbutrin,” a commonly prescribed antidepressant. A wife, overcome by an emotional memory, crawled into bed with her terminally-ill husband.
Occasionally, the music therapy team is called on to play for family members as life support is being removed. These moments are intensely emotional and the therapists must read mood in the room and play accordingly. And like other caregivers, they must maintain their detachment.
“We take a lot of deep breaths,” says Dr. Reuer.
Neurologic Music Therapy
At Scripps La Jolla and Scripps Encinitas, music is being used to help patients overcome neurological deficits. Neurologic music therapy can help people who have been debilitated by a stroke, Parkinson’s, Alzheimer’s or other conditions.
“The brain can repair itself from learning and training,” says Michael Thaut, Ph.D., director, Center for Biomedical Research in Music at Colorado State University and a leader in the field. “Auditory rhythm is an extremely powerful tool.”
Peggy Groves, a neurologic music therapist who works at Scripps Encinitas, uses this information to help patients with their speech, cognition and movement. Because there is no musical center in the brain, music is very helpful when retraining patients who have lost the ability to speak. “People who have trouble speaking can often singing to their speech needs.”
Rhythmic sounds can also profoundly help people who have trouble walking due to stroke, Parkinson’s or brain injury. Often patients are weak on one side, leading to an uneven gait. Groves uses rhythm to help patients improve their walking cadence, velocity and stride length. One of the advantages of neurologic music therapy is that people can take the music with them. “Patients can transfer the rhythmic skills by singing in their heads,” says Groves.
Dr. Michael Lobatz, hospital chief of staff and medical director for the Encinitas Rehabilitation Center, likens the treatments to listening to music while exercising—jogging a mile seems easier with music—but acknowledges that we don’t completely understand the mechanism. “We need to learn what is going on in your brain cells and circuits when you’re listening to music,” says Dr. Lobatz. He may have the opportunity to find out. Scripps Encinitas is working with Dr. Thaut to develop research to better understand how neurologic music therapy affects the brain. The proposed research projects include using rhythmic auditory stimulation to reduce the risk of falling for Parkinson’s patients and improve upper extremity function in stroke patients. The research is planned to begin this year, with the results presented to the World Congress of Rehabilitation in 2008. [ end ]
