When Thomas* entered the short-term assessment centre for children where Debbie Carroll was working as a music therapist, he was emotionally distressed. He had been removed from a second foster home due to his aggressive and threatening nature and was unable to contain or control his emotions. Carroll was initially at a loss. Thomas refused to engage in playing any instruments, and would not respond to any therapy. After multiple failed attempts, Carroll decided to go to the local library, where she discovered a Persian lullaby titled “Bird Without Nest.” When she played this song at a therapy session, Thomas had an immediate response. For the first time in four months, he paused – and turned to look at the record turning around and around. His whole body relaxed and a smile slowly crept onto his face. He opened his mouth to utter his first word since entering the centre: “Again.”
Carroll is one of the many practicing music therapists in Montreal. Music therapists are trained to utilize the therapeutic qualities of music and musical elements to restore, preserve, and improve individuals’ well-being in the physical, emotional, and social domains. From neonatal care to mental health, music therapy’s applications are incredibly wide-ranging and can help people across all age groups with any level of musical aptitude.
Though documentation of music’s healing power has existed for thousands of years, formal training for music therapy only began after the Second World War. It was realized at the time that music could alleviate pain and some of the psychological symptoms of brain injuries and shell shock in soldiers (known today as post-traumatic stress disorder). As a result of this breakthrough, musicians were recruited into military hospitals in order to provide this new form of treatment. It was soon recognized that a system was needed to train these musicians to assess and establish treatment goals, giving birth to professional music therapy programs.
“We have a lot to teach people about the human condition. We need to work with people as human beings and understand what they bring as individuals rather than [giving them] pills,” described Curtis.
“[Music therapists use] the aspects of music that are inherently therapeutic … [Music] can be relaxing or stimulating, can mirror emotions, and allow us to reflect [on] how we feel,” Carroll told The Daily. Music therapy tries to improve an individual’s quality of life by using music’s ability to reflect the whole range of human emotions, allow nonverbal communication, and foster social interactions through shared musical experiences.
In today’s healthcare system, the go-to response for mental health issues is often drug prescription. This model has been criticized in the field of psychiatry, where piling prescriptions and diagnoses can become an endless loop. Sandi Curtis, a professor of music therapy at Concordia University, is hopeful for music therapy’s future integration into the medical institution. While music therapy would not act as replacement for current types of medical care, the hope is to reach an understanding of the roles of each profession.
“There is some research that shows that in certain circumstances, music is more cost effective in comparison to some medication – and free of the side effects,” described Curtis. “We have a lot to teach people about the human condition. We need to work with people as human beings and understand what they bring as individuals rather than [giving them] pills.”
In some areas such as palliative care, music is being used in lieu of medications. Collins reflected on her time working in palliative care, where patients whose medication was no longer helping them would be referred to her in order to be treated with music therapy. “Clearly, there is more than just the pain [to take into account]. There is the patient’s response – the fear of dying and family difficulties that come with having a life-threatening illness,” reflected Curtis.
Pascal Comeau, a music therapist at the Montreal Children’s Hospital (MCH), uses music to help children of all ages. Comeau recalls an incident with a 19-month-old child, who, despite all efforts made by hospital staff, would not stop crying. The staff did not want to medicate the child, and decided to call on Comeau to alleviate that child’s anxiety using music. Comeau used a drum to match the level of anxiety the child was feeling. Within 30 seconds of the drumming, the infant had stopped crying.
“Music can be used for good, but it can also be used to create a barrier between oneself and the world. We need to be vigilant in how to bring out the healthy and positive aspects of a person,” Carroll explained to The Daily.
An important principle of music therapy involves reaching the emotional level of the person in question. By matching that, it allows the person to feel supported and heard at the level of their experience. Similarly to Thomas’ case, it is often a specific piece or type of music that can help an individual out of their distress or anxiety.
Though music therapy has recently gained momentum in the public spotlight, a number of misconceptions still surround it. “It’s part of our mandate [at the MCH] to tell people about music therapy. Even staff who have been here for many years don’t fully understand,” Comeau told The Daily. A common misconception is that music therapy is about listening to recreational music. However, this is not the case – a huge portion of a music therapist’s work involves trying to actively engage individuals in music.
An integral part of music therapy is the relationship between music, the individual, and the therapist. Music therapy is not simply about the individual and the music. “We all more or less intuitively know that music moves us – but music therapists have the [skills and training] to take this a huge step further […] to handle it and control it,” explained Curtis. “As much as music can move us tremendously emotionally [and] open a door for growth, it can also open a door for danger if the person is not prepared for what will come out of it.”
Because music has the power to unleash very strong emotional responses, without the proper training to be able to handle these effects, using music as therapy might not be a good thing. An ongoing challenge for music therapy is that there are still a number of individuals using music as treatment without being properly trained.
“Music can be used for good, but it can also be used to create a barrier between oneself and the world. We need to be vigilant in how to bring out the healthy and positive aspects of a person,” Carroll explained to The Daily.
In Thomas’ case, it was later found that his mother was of Iranian descent, and the song was almost able to reflect the act of his mother nurturing and caring for him. After his experience with the lullaby, Thomas experienced a dramatic change in the unit. He would sing and hum that song, and after a few weeks, finally started to speak to the staff about the feelings of being abandoned by his mother. The song, for Thomas, marked the beginning of a healing journey.
*Name has been changed