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Musical Community: Music Therapy at Northeast Center for
Special Care
By Rick Soshensky, MA, MT-BC, NRMT
| The Community Music Therapy
Program at Northeast Center for Special Care utilizes potentials
inherent in musical involvement to assist our Resident-Neighbors in
developing adaptive coping strategies and social skills necessary to
re-enter the community.
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A
group of Resident-Neighbors participate
in one of the many music groups held
daily at Northeast Center for Special
Care. |
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Following a traumatic brain injury, impairments to
self-awareness, cognition, judgment, social behavior and communication
may complicate an patient’s ability to take an active and self-motivated
role in rehabilitation. The “ripple effect,” (a term coined by music
therapists, Mercedes Pavlicevic and Gary Ansdell), refers to music’s
tendency to spread outward, naturally attract people and move them into
increasingly wider social contexts.
Employed clinically, music’s dynamic
capacity for interaction, self-expression and community-building provides
an experiential ground to engage our Resident-Neighbors in a process of
rehabilitation.
Consider these scenarios occurring within the diverse musical contexts of
the music therapy program:
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- Two talented
Resident-Neighbor musicians - a high-decibel rock
guitarist, prone to paranoia and rapid escalation into rage
collaborates seamlessly with a former professional pianist in her late 70’s who loves nostalgic music from the 20’s,
30’s and 40’s while performing background music for facility
art shows and other events.
- A severely
injured, disoriented former country music band leader gets up
before a large audience at a facility concert to front his old
band for several numbers, performing flawlessly, making
announcements and introductions, astonishing staff and bringing
friends and family to tears.
- A shy jazz
musician, whose career and self-esteem were shattered following
his brain injury, begins to regain his confidence and love for
making music by jamming in the community.
- An
administrative staff member, also a humble, private musician,
takes time out from his busy schedule to join music sessions and
participate in the same vulnerable process of growth,
self-discovery and collaboration as the Resident-Neighbors.
- An easily
frustrated and agitated, yet talented musician comes to accept,
appreciate, and even assist, the collaborative efforts of far
more impaired Resident-Neighbors during music sessions.
- Resident-Neighbors
rehearse and perform in community concerts, music videos and
other music related projects within the facility.
- A previously
non-musical Resident-Neighbor works hard to complete an original
biographical song and then sings it publicly in a music session.
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These seemingly modest
accomplishments represent significant achievements for the individuals
involved. Music therapist, Stuart Wood (2004), also compared music’s
power to connect people with an impact that extends far into a
participants life, as akin to “ripples in a pond” (p.61). Waves of
music flow out of rooms, permeating the environment, affecting people.
The
music community grows and evolves. Identities, individual roles and
self-perceptions begin to shift. Social boundaries and distance diminish
through shared experiences, the establishment of collective identity,
deepening musical involvement and the emergence of common goals. Projects
develop. Pathology is transcended.
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| Music
moves people to go outward. People begin to interact in a
wider social context. |
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Motivation is strengthened and range of
expression is broadened through participation in a creative music process
(Turry & Marcus, 2004). Isolated individuals find a place where
they are safe and accepted for who they are. More importantly, in music
they find increased freedom from the impairments that restrict their
lives.
Music’s unique communication functions have stimulated a growing body of
literature related to its inseparability from the evolution of our
species. Cognitive scientist and jazz musician, William Benzon (2001) has
proposed that the brain and music evolved together and that music
continues to play the role it did in humankind’s beginning: “the forge
in which the new forms of social being emerge” (p.238). That our
prehistoric ancestors made music is clear as evidenced by the discovery of
bone flutes more than 50,000 years old. It would seem likely that
percussion instruments predated melodic instruments by hundreds of
thousands of years. The fact that the limbic system, an ancient part of
the brain in evolutionary terms, has been demonstrated to be strongly
responsive to music has led some researchers to conclude that music
predates spoken language. Neuroscientist, Steven Brown (2001) proposes
that very early “pre-language” humans utilized a music-language that
conveyed information as well as emotional meaning using discrete pitch
levels and expressive phrasing. Eventually, what Brown terms “Musilanguage,”
would split into two specialties.
In more modern times, music has reflected its period as much as it has
illuminated the future and stretched social boundaries. In the Middle
Ages, the Church restricted some uses of harmony that are now common. In
the 19th century, the Waltz was considered immoral. In the 20th
century, Stravinsky’s music, avant-garde experimentation, Jazz, Rock, and Rap idioms were all met with resistance,
only to be absorbed into the prevailing musical vocabulary and social
culture. As such, communal music making in a clinical setting can also
contain a socio-political impetus that encourages cultural movement (Ansdell,
2002). Musicologist, Christopher Small (1998) claims that all music is
ultimately a political act and music therapist, Oksana Zharinova-Sanderson
(2005), refers to the music therapist as a “campaigner for music as a
force for change in the community” (p. 245).
Beyond music’s social impact, researchers have uncovered music’s
effect on neural activity at almost every level from the most primitive
regions of the brain common to all animals to the more evolved regions
thought to be distinctly human. In fact, no specific music center, as
such, has been identified in the brain (Tramo, 2001).
Studies indicate
that music perception emerges from a complex interplay of activity in both
sides of the brain and that playing music powerfully influences synaptic
reorganization throughout the brain (Pascual-Leone, 2001). Neuroscientist,
Dr. Paul Aravich (2005) points to this unrelenting neural plasticity in
the brain as an endless source of hope for brain injury survivors.
Research suggests that this adaptability of the brain is most potently
affected by sensual/emotional experiences (as opposed to
cognitive/analytical ones) that stimulate behavioral patterns relevant to
physical and/or social survival (Tucek, 2005). This would seem to indicate
music therapy, with its potential for deeply charged interaction, memory
stimulation and emotional response, as an essential component in brain
injury rehabilitation.
According to Dr. Yehuda Ben-Yishay (1985), in a pioneering article on
neurorehabilitation, optimal and stable outcomes are realizable only if
the patient proves successful in reconstituting, to some degree at least,
his “ego identity.” Music therapist, David Aldridge (2005) suggests
that identity can be regarded as a performance of sorts, achievable only
through feedback and dialogue with others. Traumatic brain injury can
cause restrictions in performance of movement, of communication, of
thinking and, for some, a sense of becoming lessened as a whole person.
Aldridge contends, “we are performed beings; that is we realize
ourselves in the world - mentally, physically and socially - as
performances” (p.27).
Communication, attention, arousal and action all
occur within musical performance, allowing our Resident-Neighbors to
experience themselves and contact others in ways that have been reduced or
denied due to the nature of their injury. Clinical problems are addressed
as musical participation creates opportunities to practice and internalize
community transferable skills, as illustrated by the chart below:
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| Clinical
Problem |
Musical
Participation |
Community
Transferable Skills |
Social
Isolation
Communication Deficit
Adynamia
Short Attention Span
Poor Frustration Tolerance
Disorientation
Memory Impairment
Disorganization
Unstable Mood
(Agitation, Anger, Aggression, Depression)
Low Self-Esteem
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Inclusion/Collaboration
Musical Interaction
Self-Initiation
Vitalization
Sustained Attention
Rehearsal/Repetition
Deep Engagement
Clarity of Situation/Role/Others
Recognition/Organization in Song, Idiom, Rhythm, etc
Emotional Expression and Regulation
Acceptance by Others
Dignity
Leadership Opportunities
Risk-Taking
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Social
Integration
Cooperation
Improved Listening/Responding
Improved Motivation
Independence
Improved Concentration
Work Ethic
Alertness
Improved Self-Awareness
Improved Executive Function
Improved Mood Management
Identity Recovery
Confidence
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Regardless of the nature or
degree of impairment, we proceed with the assumption that a
Resident-Neighbor possesses receptive capacities and a developed
personality; that there is an active inner life and a motivation to
communicate with those around them. We search for the music, the
instrument, the form of expression that will activate response and
participation.
Once a seed of creative engagement has been generated
further development is possible as relationships, skills and creative
vision continues to mature. From this perspective, there is no
differentiation between a Resident-Neighbor’s changing music over time
and clinical progress. When music indicates improvement in problem areas,
it can almost invariably be observed to generalize to related growth
outside of music. In this way, outcomes are improved.
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Clinical
problems are addressed as musical
participation creates opportunities to
practice and internalize community
transferable skills. |
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References
Aldridge, D. (2005). Music therapy and neurological rehabilitation:
performing health. London, UK: Jessica Kingsley Publishers.
Aigen, K. (2005). Music-centered music therapy. Gilsum, NH:
Barcelona Publishers.
Ansdell, G. (2002). Community music therapy and the winds of change - a
discussion paper. In C. Kenny & B. Stige. (eds.). Contemporary
voices in music therapy: communication, culture and community (pp. 109
- 143). Oslo, Norway: Unipub Forlag.
Aravich, P. & McDonnell, A. (2005). Successful aging of individuals
with brain injury. Brain injury professional. Vol. 2 (2).
Ben-Yishay, Y. et al. (1985).Neuropsychologic rehabilitation: Quest for a
holistic approach. Seminars in neurobiology: 5(3) 252-259.
Benzon, W. (2001). Beethoven’s anvil: Music in mind and culture.
New York, NY: Basic Books.
Brown, S. (2001). Are music and language homologues? Annals of the New
York Academy of sciences: The biological foundations of music. Vol.
930: 372-374.
Pascual-Leone, A. (2001). The brain that plays music is changed by it. Annals
of the New York Academy of sciences: The biological foundations of music.
Vol. 930: 315-329.
Pavlicevic, M. & Ansdell, G, (eds.) (2005). Community music therapy.
London, England: Jessica Kingsley Publishers.
Small, C. (1998). Musicking. Hanover, NH: Wesleyan University
Press.
Tramo, M. (2001). Biology of music: Music of the hemispheres. Science
Magazine. Vol 29/No. 5510: p.1920.
Tucek, G. (2005). Traditional oriental music in neurological
rehabilitation. In Aldridge, D., (ed). Music therapy and neurological
rehabilitation: performing health. London, UK: Jessica Kingsley
Publishers.
Turry, A. & Marcus, D. (2001). Using the Nordoff-Robbins approach to
music therapy with adults diagnosed with autism. In Oxford, L. &
Wiener, D., (eds). Action therapy with families and groups: Using
creative arts improvisations in clinical practice. Washington, D.C.:
American Psychological Association.
Wood, S. et. al. (2005). From therapy to community: Making music in neurological
rehabilitation. In Pavlicevic, M. & Ansdell, G, (eds). Community
music therapy. London, England: Jessica Kingsley Publishers.
Zharinova-Sanderson, O. (2005). Promoting integration and socio-cultural
change. In Pavlicevic, M. & Ansdell, G, (eds). Community music
therapy. London, England: Jessica Kingsley Publishers.
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Fine
and Performing Arts Program Video - In this video you can view the
author Rick Soshensky and Northeast Center Resident-Neighbors as they make
music.
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