Music Matters

Music therapy and its power to heal is slowly being recognised as a powerful component in rehabilitation. We meet some of the people instrumental in championing its cause and effect.

 

“Musical training is a more potent instrument than any other, because rhythm and harmony find their way into the inward places of the soul”

Cast your mind to a time when you felt particularly low. Is there a song, album or artist you associate with that moment? Perhaps you turned to Bob Dylan’s seething lyricism on Blood On The Tracks or turned your pain into pleasure to Robyn’s exuberant Dancing On My Own. Elsewhere, in the mid-2000s, Arcade Fire’s Funeral articulated the alienation of grief and Modest Mouse encouraged fans to stay afloat. Personally, I go straight to Radiohead or Scott Walker.

In 1970, John Lennon opened his debut solo album, Plastic Ono Band, with a song called Mother. The song morphs into a harrowing incantation; “Mama don’t go, Daddy come home.” Lennon screams so ferociously that you can almost feel the heat, brought on by his impassioned plea, emanating from his body coupled with the image of pulsating vocal cords on the cusp of eruption.

Produced by Phil Spector, the overall tone of the album was influenced by Lennon’s exploration into Primal Therapy under Arthur Janov. The extent to which Lennon reveals his childhood trauma can, at times, make for uncomfortable listening. It’s like we’re eavesdropping by a door left ajar or scanning the pages of someone’s diary.

There’s a long history of artists sharing their experiences and emotions through song; (“I hope you can hear, hear me singing through these tears,” Dylan intoned on You’re A Big Girl Now.) From those examples, we’re given an insight into how songwriting can enable unfiltered self-expression; to become in tune with one’s mental health, body, and heart. We may not always realise it, but music’s function reaches further than entertainment. Talking Heads’ frontman David Byrne prefaced his book, How Music Works with the proclamation that, “Music can get us through difficult patches in our lives by changing not only how we feel about ourselves, but also how we feel about everything outside ourselves. It’s powerful stuff.”

This is a befitting synopsis when we consider how music helped countless soldiers suffering from post-traumatic stress disorder, incurred from the harsh realities of combat, following the Second World War. Professional musicians performed in the hospital for the soldiers, providing an escape from remembered sounds of thundering explosions and the fuzzed drones of aircraft searing through the sky replacing them with beautiful melodies that evoked a calmness within the patients. In ‘Music and the Wounded of World War II’, an article by Margaret Ann Rorke, published in the 1996 edition of The Journal of Music Therapy, she reveals that, “The healing powers of music were witnessed on an unparalleled scale. For the first time in history, a military, the American Service Forces, officially recognized music as an agent capable of helping its mentally and physically wounded. This was, indeed, a major turning point in the longstanding partnership between music and medicine, and the beginning of the modern music therapy profession.”

From there, the practice experienced a surge in popularity across Western culture. Prior to that, there had been a few instances in the early 1900s where music therapy had been written about under clinical consideration. The actual practice of music therapy, however, is an ancient one. In mythology, Asclepius, son of Apollo, is said to have cured illness through song. Elsewhere, the philosophers Aristotle and Plato were advocates of music as a source of establishing an inward connection. In The Republic, written in 380 B.C., Plato professed that “Musical training is a more potent instrument than any other, because rhythm and harmony find their way into the inward places of the soul.”

In Ireland, music therapy’s journey has been a gradual one. While it has become increasingly popular since the turn of the millennium, music therapists are still waiting for statutory recognition of their profession. Until then, there’s little protection on the regulation of the practice which is worrying to many professionals within the field due to the sensitivity of the cases they treat. The Irish Association of Creative Arts Therapists (IACAT), a body formed in 1992, has been campaigning for the inclusion of Creative Arts Therapies  – music, dance, art, and drama – in the Health & Social Care Professional’s Act (2005). Hopefully, the current climate of open conversation about mental health will provide a catalyst for this much-needed change of legislation.

In Dublin’s music scene, there’s been a significant increase in artists speaking openly about their experiences with mental health. The correlation between mental health and musicians isn’t a recent or surprising occurrence due to the nature of the profession and lifestyle. Since 2014, First Fortnight has hosted a plethora of events, with a strong emphasis on music, with the intention of diminishing the stigma surrounding mental health. Outside of the annual two-week festival, the organisation provides services to support people suffering from a range of disorders.

These foundations provide a solid frame for Ireland’s music therapy model. What we’re seeing is the building of communities and natural source of healing through creative instincts that reside in everyone.

 

IVOR BROWNE – PSYCHIATRIST & AUTHOR

“You feel music in the heart”

“I was always a bit of a maverick,” says Ivor Browne as we sat facing each other in his bright living room. I asked him what inspired his alternative approach to psychiatry when he worked in Grangegorman Hospital. “I was never satisfied,” he continued, “I’m still not satisfied with the reliance of drugs throughout the profession. Early on, I took the direction of psychotherapy. The heart of becoming a therapist is to go through therapy yourself. I would be unusual in that sense, as a psychiatrist, by getting involved in that.”

As a newly qualified psychiatrist in 1950s Ireland, Browne witnessed patients receiving electroshock therapy and lobotomies to remedy mental illness. Horrified by these inhumane methods, Browne sought a natural form of healing that would call for patients to work through their experiences rather than sedate them. He arrived in Grangegorman in 1966, a handful of years before adopting a method called Holotropic Therapy. Based on a combination of music, breathing and bodywork, this mode of treatment was developed in the late 1960s by Stanislav Grof, a Czechoslovakian psychiatrist based in California, as a reaction to the suppression of legal LSD; a vital component in his other psychedelic therapy.

Using an abandoned Protestant Church on the hospital grounds, Browne formalised the practice of quadrophonic sound in weekly sessions. “We’d have maybe twelve patients, usually lying on a blanket. Each person had someone sitting with them to wipe their brow.” Browne recalled. Of the people he treated until he retired from the hospital in 1984, he noted that they came from the most disturbed units of the facility. Reflecting on the success of the therapy, Browne estimates that the equivalent of two of the most disturbed units were emptied over two decades.

The general consensus amongst his colleagues regarding holotropic therapy, however, was one of total disinterest. “Nobody was doing this in Ireland. None of the psychiatrists working there came near the sessions, Browne said. “Mostly, they wouldn’t want to know. I think it had to do with the fact that they hadn’t opened up to their own experiences. They shied away from anything that threatened their approach, so they chose to remain uninvolved.”

As a boy, Browne dreamt about becoming a musician, “I had visions of becoming Louis Armstrong. Someone said I should take up jazz and that put a bug in my head. I was feeling very lost, I didn’t know who or what I was, so I got addicted to that idea.” Today, the ninety-year-old with a statuesque figure drives a Honda Jazz and searches for compilations of his favourite New Orleans-based music. Consecutive bouts of tuberculosis struck Browne as a teenager, stealing his ambition to pursue music professionally. Instead, he studied psychiatry and has practiced for over six decades, his clients include Tommy Tiernan, Colm Tóibín, and Mary Coughlan.

Over his extensive career, Browne’s thesis has, fundamentally, been grounded by the influence of the heart. At one point during our afternoon together, he enquired how aware I am of my heart. Swiftly, the interview transformed into a therapy session. We spoke about trauma; how, as a teenager experiencing grief, I looked to lyrics from my favourite artists as a way to understand and articulate my feelings when I didn’t have the words. How music had, unbeknownst to me, provided a therapy.

In recent years, he has become heavily involved with heart-centered meditations. “The heart sends more messages to the brain than the reverse. It has its own neurons, something like twenty or forty thousand neurons. It has its own brain and communicates with the rest of the body. People think it’s just a pump, it’s so much more than that.”

I wanted to know why people form emotional connections to music, how it can provide relief. Without hesitation, Browne stated through a smile, “You feel music in the heart.”

 

CONSTANCE KEANE (FEARS) – PRODUCER & MUSICIAN

“When I entered St Patrick’s Hospital, I was so ill that I couldn’t go near music because I found it over-stimulating”

For Dublin-born producer and musician Constance Keane, music started with a bang on her ninth birthday; between opening presents and consuming cake, she had her first drum lesson.

Throughout adolescence, Keane continued in her percussive pursuit before taking advantage of her laptop which opened up a world of music production at her fingertips. In a golden-lit room in central Dublin, she reflected on the impact composing via technology had on her personal development, “The accessibility of software allowed me to create something in the moment. Documenting thoughts and ideas as they’re coming out is a fascinating way to get to know yourself. In that regard, music was hugely important in forming emotional intelligence.” As time progressed, more layers and textures appeared in her arrangements. Eventually, so did lyrics. “I put off writing lyrics until I was nineteen. It’s not how I instinctively express myself, which for me, is through sound,” she shared.

Having honed her style – sparse ambient melodies harnessed with harrowing, reverb-laden vocals – Constance Keane began releasing music as Fears in 2016. Shortly after the release of her debut single, Keane spent six weeks in St Patrick’s Mental Health Service having suffered a mental breakdown catalysed by a traumatic experience. She was acutely suicidal upon admission.

A report regarding mental health published by the OECD in November 2018, detailed the rapid increase of mental illness across Europe. It documented that, in 2016, one in six people (approximately eighty-four million individuals) suffered from poor mental health. Amongst the disorders affecting people, anxiety was classed as the most common. Since the age of sixteen, Keane has dealt with both anxiety and panic attacks. Shrouded by the disorders, Keane was unable to find solace in anything during this period. Not even music. “I couldn’t make music because I felt I had completely lost myself,” she said, “Not being able to do something I care about so much was terrifying because I thought I’d always have it in my life. When I entered St Patrick’s Hospital, I was so ill that I couldn’t go near music because I found it over-stimulating. I mostly listened to Headache by Grouper. That got me to sleep when nothing else would.”

Ironically then, Keane cites the hospital’s music room as an integral resource in her recovery. “Initially, I went to the music room to cry because I was surrounded by things that gave me a lot of comfort. I felt safe crying surrounded by instruments. It took me a while to actually use them, though. When I did, it was an entirely new experience for me because I had zero expectations or intention for the songs to be released. The freedom to create for the sake of creating was a game-changer for me. It was through music, banging away at the drums, that made me feel like my nine-year-old self, again.”

Days and evenings in the hospital were spent in the music room. It was there where, with a friend from her ward, Keane played the drums (“We had a punk band together”) and even gave another patient impromptu drum lessons. A particularly poignant half-an-hour in the music room oversaw the writing and recording of h_always. The song would be Fears’ third single, released in April 2018. Speaking about the importance of that song, Keane said, “There were so many aspects of my situation that I needed to validate for myself. I spent so long telling myself that I was unreasonable for having certain feelings. I slowly learned, during my treatment, that I was entitled to those feelings. I wrote about them because when you write a song about something, it exists permanently. For me to go back to my ward and listen to the song in my bed and think, ‘This isn’t half-bad!’ was really good for me because it helped rebuild my self-esteem.”

Having experienced the benefits of incorporating music into her recovery, Keane fully endorses the unifying nature of creative arts in therapy. “I think it’s great because of the sense of community that comes out of it. Musicians are susceptible to suffer from mental health issues, in part, because of the lifestyle that goes with it; financial struggles, housing issues, working alone. I think to build a network is so important to develop a support system. Even for non-musicians, I think it’s amazing to hand someone an instrument, even a small shaker! There’s a fun element to it and to bring as much fun to life as possible when you’re feeling low is so important.”

 

BRENDAN BRESLIN – FOUNDER OF LE CHÉILE PROJECT & MEMBER OF THE ROYAL IRISH ACADEMY

“The ensemble members are developing their respective voices by engaging in an art form which is substantially improving their wellbeing”

Since December 2018, Brendan Breslin, Head of Connect at The Royal Irish Academy of Music situated on Pearse Street, has been working on a unique initiative which marks an exciting first for Ireland. Our island has a rich tradition of fostering exceptional symphony and chamber orchestras. However, there has never been an ensemble comprised exclusively of disabled musicians. “Ireland is groundbreaking in researching the relationship between neuroscience and music,” Breslin proclaimed. “I was shocked, then, to discover that there wasn’t a fully integrated ensemble formed for musicians with physical or intellectual challenges.”

Community music has played a significant role in Breslin’s life having played in numerous wind and brass bands before entering professional musicianship with The Band of An Garda Síochána, fifteen years ago. It was around that time when he entered The Academy to study, specialising in community music across the country, focusing on orchestras and choirs. Fortunately for Breslin, The Academy was extremely supportive of the ensemble projects he established which emphasised community development, diversity, and inclusivity.

Eighteen months ago, a grant application released by Creative Ireland caught Breslin’s attention. “We had been intrigued by a pilot programme developed by Dr. Denise White at Ulster University called Inclusive Creativity,” Breslin explained. This scheme looked at assisted music technology where laptops, iPads, and launchpads facilitated people with various intellectual or physical challenges to access their creativity through ensemble activity. By pressing a button or lightly touching the surface of an iPad people with minimal motor abilities were able to create sound. “We’re trying to show how technology can break down barriers that may have prevented people from being creative in this way,” Breslin proffered enthusiastically.

With funding behind the initiative, the Le Chéile Project was born in January of this year with ensembles formed in Athlone, Cork, Derry, and Dublin. The individual groups have been rehearsing on a weekly basis, working towards a large-scale performance where the musicians will come together to create the Open Youth Orchestra of Ireland, this September. This stage of the project will mark another first as the four groups will have a residential stay at Athlone Institute of Technology. A regular occurrence for orchestras across the country, this hasn’t happened with a group of disabled people within the arts.

What is involved in the preparation for this performance? Each group (varying from seven to twelve members) has a facilitator who is required to have a number of strings to their bow. They need to have a heightened awareness of the nature of the technology being used in this form of therapy. Furthermore, they’re trained in a gesture-based language called Conductology, as a way to communicate with the ensemble. “The facilitators use their face or arms to give signals for the musicians to respond to. They could wave their hand in a circular motion to indicate to continue playing or point to the ceiling to indicate a point where the melody is going up a note,” explained Breslin.

It’s an all-encompassing project that touches on culture, education, and health because, as Breslin attests, “The ensemble members are developing their respective voices by engaging in an art form which is substantially improving their wellbeing. In the Derry group, there’s a gentleman who was almost completely non-verbal when we met at the start of the project. Now, not only talking to colleagues within the ensemble, but he’s presenting in concerts and talking to the audience.”

The progress and positivity surrounding the Le Chéile project has been a defining moment for The Academy. Looking towards the future of Le Chéile, Breslin is eager to continue developing the programme. “We’re looking to create a handbook to guide anybody from a music therapy or education background to establish a Le Chéile group in their region. It’s so important to recognise the need and want of people who have been disenfranchised and help them reclaim their voice through music and performance.”

 

BILL AHESSY – MUSIC THERAPIST & CHOIR FACILITATOR WITH THE MEATH COMMUNITY UNIT

“Music therapy has the ability to work on many different domains because it’s a very adaptable mode of treatment”

In my conversations regarding music therapy, a recurring theme was the creation of community. As a teenager, Bill Ahessy witnessed first-hand how creativity afforded people the opportunity for self-expression when he assisted his father, a primary school teacher who organised community dramas, with various stage productions in a small village in County Tipperary.

In 1996, as the last weeks of secondary school drew closer, Ahessy heard about the Nordoff Robbins training course and its approach to music therapy. The concept of this innovative practice remained in the back of his head throughout his tenure in University College Cork, where he studied music. “We were offered an introductory module to music therapy but I didn’t get into that class,” Ahessy recalled. “I bought a book instead. It was the first book I bought online, The Music Therapist’s Handbook. I remember being very excited about it.”

Leaving Cork, Ahessy traveled to Sydney where, fifteen-thousand kilometers from home, he fulfilled his clinical training and obtained a post-grad diploma in music therapy. Before returning to Ireland in 2009, he completed a Masters in Spain and worked in mental health facilities whilst living in London. Immediately, Ahessy noticed a marked increase in both posts created and media coverage of music therapy at home. It wasn’t long after he’d settled into his new routine when, following a conversation with Tallaght Hospital, he was approached with an exciting proposal. “The Meath Community Unit was offering to fund a research project to examine the effects of a music therapy choir on older adults. Over the course of a year, we had a control group and a choir group with twenty members in each. They were mixed groups comprised of people from the local community and from residential care,” Ahessy explained. Having previously worked with a music therapy choir in Australia, Ahessy was the ideal candidate to carry out the research.

Over the course of the twelve-week programme, known as The Meath Community Project, Ahessy assessed participants through a number of intake interviews. The project was bookended with a series of identical tests, the final results presented remarkable changes across the choir group with over 54% of them experiencing an improved quality of life and a statistically significant change in cognitive function and depressive symptoms. Following on from the initial research programme, Ahessy kept the service going. Today, there’s a weekly choir session held every Friday featuring three members from the original group from the 2009 project.

The benefits of music therapy choirs, as shown with the Dublin 8 participants, include enhanced physiological and emotional function. “There are many aspects to how singing can affect us,” Ahessy suggests. “Throughout the body, it can improve breath-control and create new neural pathways, which is particularly important for people with Alzheimer’s Disease. When someone sings a lyric that resonates with their biography it can enable them to revisit a particular memory. This shows us that there’s also an emotional strand to this practice. Another very important element is the social nature of singing in a choir. A lot of the feedback we received from the project was that the participants found a new sense of community through the sessions. From all this, we can see that music therapy has the ability to work on many different domains because it’s a very adaptable mode of treatment.”

As well as facilitating the choir, Ahessy is a guest lecturer and supervisor at the University of Limerick. The institute is renowned, throughout the country, for its training in music therapy. A relatively small course with under twenty students choosing it, per annum, it’s heartening to know that there’s an interest in creative arts therapy amongst today’s students, ensuring its growth amongst future generations.

 

REBECCA O’CONNOR – SENIOR MUSIC THERAPIST AT THE NATIONAL REHABILITATION HOSPITAL, DÚN LAOGHAIRE

“There are so many ways that you can facilitate treatment through music”

Thirty years ago, when Rebecca O’Connor graduated with a degree in Nursing from a London-based University, music therapy was finally registered as a profession in the United Kingdom by the Health and Care Professionals Council. Ireland is still awaiting the same statutory recognition from CORU, our own health regulator. Shortly after, O’Connor combined her passion for music – she sang in choirs and played piano and flute from a young age – with a qualification in nursing. Before moving to Ireland eleven years ago to introduce a music therapy pilot programme in the National Rehabilitation Hospital (NRH) in Dún Laoghaire, where O’Connor holds the position of Senior Music Therapist, her patients ranged from premature babies to end of life patients. She also worked extensively as a researcher and lecturer in the field.

Throughout our conversation, O’Connor enthusiastically detailed the work she does with patients at the NRH. We discussed the effects of music therapy and how this is a particularly fruitful time with a number of exciting research projects proving how it works. Since O’Connor began practicing as a music therapist, she has noticed a positive response to music therapy across her patients. “Music stimulates everything,” she told me. “As you’re playing an instrument, the motor-side of the brain is engaged with the cognitive part because you need to think about what you’re playing. Concurrent to that, the communications side of the brain is stimulated, too. It’s powerful because all of these areas are impacted.”

Before O’Connor arrived at the NRH, the only rehabilitation resource of its kind in Ireland, there were no music therapy services available. For over half-a-century, the hospital has treated a wide range of patients. There’s a pediatric unit for children with brain and spinal injuries, limb absence units for adults, a facility for people in a disorder of consciousness, as well as brain and spinal injuries amongst adults. Due to the highly adaptive nature of this form of therapy, O’Connor is able to work with all of these patients. Each session is catered to the specific needs and recovery goals of the patient. O’Connor and a revolving cast of clinical professionals – music therapist, occupational therapist, physiotherapist, speech therapist, psychologist, and nurse – work together with music acting as a glue.

The reaction music elicits in someone suffering from a disorder of consciousness, as described by O’Connor, is astounding. “Through clinical improvisation, – where you make a connection through spontaneous play – I’ll match the rhythm of their breathing with a melody on the flute. Sometimes, they realise that there’s a connection between their breathing and my playing. They might stop breathing and then the music will pause briefly before they take a deep breathe and the tune starts again. That’s the beginning of them understanding that they’ve formed a connection with somebody through breathing.”

Lyric writing is another useful method of using music to enhance a patient’s recovery. As children in school, we’re taught the alphabet and the number of days in a month through rhyme and song; reeling off information without consideration. The same process is hugely beneficial for patients with memory loss resulting from a brain injury. “There was a young girl who struggled to remember directions because the memory-part of the brain had been severely damaged. However, she could easily recall words of songs. We wrote a song full of directions to help her make her way from the music room to the coffee shop, for example. It shows us that there are so many ways that you can facilitate treatment through music.”

Words: Zara Hedderman

Photos: Molly Keane