(Notes provided by Kathleen Dougherty as I was on vacation)
Our speaker was Melou Stewart Cline, Music therapist. Melou
has her NICU-MT, a national certification to practice Music Therapy in the
NICU. Melou also is a Neurologic Music Therapist, NMT.
Melou outlined a multimodal approach to NICU music therapy,
which included humming, singing, humming with harp, singing with harp, and
touch. The latter, as I understood, is only employed by NICU nurses and parents
(or other approved persons).
Provide music geared to the developmental stage of the NICU
infant. For instance, at six months gestation, singing and playing harp will stress
the child’s immature physiology. Proceed hierarchially: Start with gentle
humming (Brahm’s Lullaby has had good results) and pay attention to startle
responses. Keep sound levels below 70 dB.
Startle response: The Moro reflex is when an infant suddenly
extends arms and legs, arches the back, then curls everything in again. The
child may gasp. (Infants may startle not only to sound, but bright lights,
physical touch and other unfamiliar stressors in the NICU.)
Watch for improvements of oxygen saturation, heart rate, and
relaxed states. If humming is tolerated, move to singing, then humming with
instrument (harp), then singing with harp. All interactions at slow tempo and
low volume. Note: I can’t recall discussion about harp alone.
These MT interactions with NICU infants can also soothe the
medical staff and the parents.
NICU sessions are usually brief, 10 to 20 minutes, to avoid
overstimulating the baby.
Singing one specific song to an unborn child can help Mom
sooth the infant after birth. Perhaps Dad’s singing, too.(Generally in
gestation babies start to respond to sound at 18-20 weeks.)
Music therapy in NICU can decrease length of stay. NICU
nurses and parents may also employ gentle human touch to soothe preterm infants
along with gentle humming or singing.
Today we are celebrating and honoring our member, Tristan
Adair as she retires from 25 years of work as a Music Thanatologist. Before Tristan embarks on her next adventure
traveling the country in search of Sasquatch in her RV and teaching harp, we
wanted to hear more about Tristan’s journey as a Music Thanatologist and learn
from her vast experience.
Tristan was a music student of piano from the age of 3.
Lucky enough to be born into a family of talented musicians she was recruited
early to play in the family string quartet on violin and String Bass. Tristan attended BYU on a full music
scholarship and also trained at the Royal Academy of Music in London playing String
After graduation, Tristan was living in Oregon and was
recruited (voluntold) by her mother for the Bend Oregon Hospice, where her mom
was a volunteer. At that time, Tristan
had never played a harp or been interested in hospice work. As serendipity usually happens, while Tristan
was volunteering, Therese Shchroeder-Sheker
was invited as a keynote speaker to present at the hospice. She spoke
about her Chalice of Repose Music Thanatology training program and Tristan was
intrigued. Tristan and Therese had a
long conversation after the conference and Therese encouraged Tristan to apply
to the program. Even though Tristan did not play the harp at that time, she was
admitted to the program in Missoula Montana.
Tristan recounted that long ago she had had a memorable dream about a
harp which made no sense to her at the time but was obviously prophetic in
The Bend Oregon Hospice was so supportive of this training that they partially funded Tristan’s training at the Chalice of Repose. When she graduated Tristan came back to Bend and was hired to work as a Music Thanatologist for them. Even with Tristan’s vast musical background and experience, the Chalice of Repose experience was daunting and demanding, according to Tristan. Many applied, few were admitted to the program and of those, many were redirected to other occupations before graduation. (It sounds like Harvard Law School.)
Tristan met Ann Dowdy at Chalice of Repose and Ann recruited
Tristan to come to Salt Lake City where she said there was a great need and
opportunity for Music Thanatology. Tristan has worked for a number of different
hospices in Utah: Applegate, Care Source and CNS were the most memorable. Tristan
recommends working in an inpatient hospice with a clinical team who truly
understand the benefits of Therapeutic Music for the best experience in the
world, as she had at CareSource. The most difficult misconception hospice and
palliative care team members have is that music is a performance to entertain
patients, which of course, it is NOT.
Some of Tristan’s most memorable experiences playing harp at
the bedside occurred when she was privileged to play for patients who were
actively dying and passed in her presence.
One experience she remembers was a patient who seemed to generate a
golden spiral from the top of his head upward and as they took their last
breath, the spiral began to evaporate from the head moving upwards and then
totally disappeared. Tristan believes
that was when the patient’s soul took flight from their body. Another time she was playing for a young ALS
patient and she saw a golden tapestry hanging midair over the patient prior to
their passing. She has witnessed a glow
of patients who are on the verge of dying that is unexplainable.
Tristan wished to thank all the members and guest of UTHN
for their support and friendship over the last 2 years. As this work can be very solitary and most
people don’t really understand what we do and why we do it, having a support
network like UTHN is most valuable to share ideas, experiences and learn from
Cyndi Bowen wanted me to thank all of those involved in her
therapeutic harp healing experience last month.
She found it a profoundly healing experience and couldn’t adequately
express her gratitude at the time.
a followup to our discussion, the Music Thanatology Association International will
be holding their annual meeting in Portland Oregon September 13-15 at Still
Meadow Conference & Retreat Center
16561 SE Marna Road
Damascus, Oregon 97089
Potential presenters include Peter Roberts and Farshid Akhlaghi
All are welcome to attend. More information can be found on their
Our next meeting will be July 9, location to be determined. Peggy Cann is hosting and one of our Music
Thanatologist friends will be presenting on Music Therapy in the NICU.
Our UTHN meeting was followed by the Heartland harp trunk show featuring the Serenity, their newest addition to their line of carbon fiber harps. Dave Woodworth was present and incredibly generous as he hauled one of each model into my house for us all to try. The Serenity weighs 5 lbs, fully levered and has 25 strings. It is retailing for approx.. $2500. If I was in the market for a new therapy harp, this would be the one I’d buy. While Dave was here he fixed a chronic intermittent buzzing problem I have been having with my Lewis Creek Jessie harp. I can’t believe how great it sounds now. 10 years old and still serving me and my hospice patients well. We all enjoyed playing them and lifting them and envying the built in light system. Safe travel wishes for Dave as he continues on his cross country show of harps.
Today was Tristan’s and Chris’s birthday which we celebrated
with good food and a potluck lunch.
I: Heidi Reviewed the Generations 2019 conference Music Therapy Track held 4/16/19 at the Salt Palace Convention Center; Peggy, Tamara, Pam and Heidi attended and Peggy presented:
Conference Session I: A Continuum of Music in Healthcare: From Music Listening to Music therapy
Presenters: E. Christensen, SCMT, MT-BC; P Cann, CMP; S
Cheek-O’Donnell, PhD; M. Frani, PhD; M , Hearns, PhD
Massamiliano Frani, PhD is the CEO of Genote see www.genotelab.com, recorded music to achieve various outcomes working with specific populations. He graciously offered attendees a 2 month free trial if we email him and mention his offer at this conference. He discussed his research using his product with long distance runners and the effect it had on their Ck, Hb, Cortisol, and Testosterone levels. Statistically significant results include an decrease of Ck and increase of testosterone and better motivational and coping skills. See Youtube videos for more information https://www.youtube.com/channel/UCm4tiXyX_axzIq1Ty9q7eYA
Sydney Cheek-O’Donnell, PhD, Assoc Dean for Research at UU
Discussed Time Slips, a storytelling method to work with
Dementia patients. TimeSlips opens storytelling
to everyone by replacing the pressure to remember with the freedom to imagine.
The open, poetic language of improvisational storytelling invites people with
dementia to express themselves and connect with others. https://www.youtube.com/watch?v=9yxxbw7YIys
The UU has an Arts In Health Innovation lab, free yoga at
the UMFA for the public and recently produced a play about a blind woman called
Maureen Hearns, PhD, Chair of the Music Therapy Dept. at
Utah State University, Logan
Music therapy In Dementia Care:
Music therapy provides opportunities for:
Memory Recall which contributes to reminiscence
and satisfaction with life
Positive Changes in Mood and emotional states
Sense of Control Over Life through successful
Awareness of self and environment which
accompanies increased attention to music
Anxiety and stress reduction for older adults
Nonpharmacological management of pain and
Stimulation which provokes interest even when no
other approach is effective
Structure which promotes rhythmic and continuous
movement or vocal fluency as an adjunct to physical rehabilitation
Emotional intimacy when spouses and families
share creative music experiences
Social interaction with caregivers and families
Peggy Cann, CMP gave a great presentation on what Therapeutic Musicians do and demonstrated by playing the harp for the group as she would for the NICU patients she plays for. She discussed the differences between Music Therapists and Therapeutic Musicians training and scope of practice.
II: Music therapy in Utah: Current
Trends, Reimbursement and More
Presenter: Emily Polichette, MM, SCMT,
MTs can bill for restorative care if their
work is in support of other outcomes.
They need an MD to sign off on this.
If insurance companies deny billing, ask to
see their exclusion policies.
Utah Association of Music Therapists has a group devoted to legislative lobbying and they are always trying to get more billable services approved by Medicare/Medicaid See Utah State HB 277 which created the designation of State Certified Music therapist (SCMT). Only MT-BC people can apply for SCMT certification.
The term “Music Therapist” is not owned exclusively by BC-MTs which is one reason why they pushed for HB 277. It is important for the public to understand the difference between music therapists and Board Certified Music Therapists. One difference is in the amount of training and internship hours BC-MTs receive versus other certification programs.
III: Music and Mental Health in the
Presenter: Heather Fellows, SCMT, MT-BC
An experiential session. We all took up instruments, drums, guitars, and played together. Heather and some of the other Music Therapists present sang. Heather provided stories of her 20 years of practice as BC-MT working with all kinds of patients and how she used music, usually guitar and voice, to hold space for patients.
Group Music Listening with Adolescents for Self-Expression
in Grief Recovery (McFerran, 2011)
Active music making, songwriting and analysis,
and music assisted grief rituals with hospice workers (Wiodarczk, 2010)
Singing and vocal improvisation with adults with
mental illness in complicated grief (IIliya, 2015)
Live Music Based experiences improved pain
control, physical comfort and relaxation in terminally ill hospice patients
Heather told a story about a family member of
a terminally ill patient who requested she play and sing Charley Puth’s song,
See You Again.
IV: the Power of Your Individual Voice: Songwriting and Voice in Music therapy
Presenter: Brandtley Henderson, MM, MT-BC
Why we sing: Everybody can do it!
Muisc can create and reinforce neural
Singing is a way to create a shortcut from
the prefrontal cortex (decision making) to the amygdala (emotional processing).
Singing permits the individual to
acknowledge and process emotion in a way that is engaging, accessible, and
Another experiential session. Everybody can
sing who can breath and make any sort of vibrational noise from their throat.
You don’t have to be a trained singer. Brandtley played guitar and sang songs and had us all
write a song in 15 minutes as a group which we then sang. It was pretty easy to do actually: pick a rhythm, create a phrase about a
preselected topic, attach the phrase to a melody. Sing. Brandtley works with the Utah State Hospital
II. We were all requested to watch the TED
talk You Are Contagious by Vanessa Van Edwards
End of Life University Dr Karen Wyatt Mortal Wisdom
183 How to let go of
what you thought should happen
167 Kathryn De Longi and
Music Thanatology (Kathryn is Kristen’s cousin and inspiration).
Using these sources as
inspiration we talked about our own experiences when we were not centered and
focused on our patients and the effect that had (or did not have) lending
support to the concept that our intention and mindfulness is critical to the
work we do.
We discussed the importance
of focusing on gratitude as a way of improving not only our own emotional and
physical health but that of others around us and how HeartMath measures and
encourages this practice of cardiac coherence.
Tristan shared an experience she had recently of an estranged family coming together at the bedside of their dying loved one and how the music helped them heal at this critical time before their loved one passed.
We also shared experiences of how times of brokenness can allow us to utilize other gifts we have to make a positive impact on the world in spite of our own disabilities and limitations. Laurel shared her experience from living with a chronic illness for the last 25 years and finding gratitude for all the blessings of her life.
We finished with lunch together and a healing ritual for one of our members using harp, intention and holding space for support.
Attendees: Kate, Heidi, Angela, Kristen, Laurel, Peggy,
Tamara, Chris and guest, Cindy Bowen
We each introduced ourselves, told where we got
certified (or are in process of
certification) and where we currently work.
Cindy is enrolled in the CMCP
program that Pam, Kate, and Tamara went through. Cindy will be added to
our email distribution list and can be reached at email@example.com.
Chris Watts shared with us her presentation that
she uses with Senior Centers, Sir Gwain and the Loathly Lady, a story of
chivalry, romance, honor, overcoming fear, and the answer to the ultimate
riddle, “What does a woman really want?” Chris uses storytelling, harp playing
and visual aids to facilitate the telling of this tale which was charming and
had us all engaged. Chris said that she
has a different presentation for almost every month. March would be Irish
stories, April Jewish stories, May Mothers Day stories, etc.
Chris asked us each to bring or play a happy
song. Everybody either discussed, sang
or played the harp for their piece:
I’ve Being Eaten by a Boa Constrictor (Kate)
Oh What a Beautiful Morning (Heidi)
Wo Betyd thy Wearie Bodie –an Irish melody for
the wire strung harp c.1627 (Angela)
Kristen reminded us all that happy songs are
very personal and depending on the circumstances she has used What A Wonderful
World, Frere Jacques, You Are My Sunshine, There is Sunshine in my Soul Today
Dark Gaick of the Wandering Stream, a Scottish
piece from the 1800s for the wire strung harp was played by Laurel
Tamara played Petite Waltz combined with My Sun
and Shield. She recommended Lorinda Jones Harp Concert Book which is full of
popular happy pieces and Carolyn Bame’s book of waltzes which had the pieces
that she played for us.
Peggy played and sang: How Much is that Doggie in the Window.
Chris shared with us the lyrics and chords for I
Love You A Bushel and a Peck and The Whale.
Other topics of interest
Peggy is presenting on a panel at the Generations
2019 Conference April 16 on A Continuum of Music in Healthcare from Music
Listening to Music Therapy. The music Therapy track runs all day long and
anyone can register and attend that track for a fee. If you want to attend just
the panel presentation from 9:15 am to 10:30 email Peggy and you can attend
that session only, free as her
Peggy will be hosting our next UTHN meeting at her house in Orem April 24 (date and location to be confirmed later)
The UTHN is a professional development network of practicing Therapeutic Musicians living in Northern Utah. All members have graduated or are currently enrolled in a Therapeutic Music Certification program approved by the National Standards Board of Therapeutic Musicians (NSBTM) Or Music Thanatologists. Visitors to our monthly meetings are always welcome. Please contact me if you would like more information about this organization.
The Osher Lifelong Learning Institute at the University of Utah offers a rich and evolving array of courses, lectures, and special activities for people who are 50 years of age and older. On 12/13/17 I was fortunate to be attending an Osher LLI Lunch and Learn. The keynote speaker was Dr. Greg Bulaj of the Medicinal Chemistry Department at the University of Utah. I was especially interested in his talk and had reserved a space well in advance as I expected the lecture to be pertinent to Therapeutic Harp work.
It was titled: Digital Medicine and Music for Epilepsy, Pain, Depression, and Cancer: How Mobile Apps and the Internet Deliver Non-pharmacological Therapies for Chronic Disorders.
Dr. Bulaj has been conducting research combining drug therapies with music and digital apps to improve the outcome for patients. As he began his lecture he informed us that one of the biggest healthcare challenges today is the fact that patients do not take their prescribed medications either at all, or sporadically, or incorrectly. According to research in the area of Medication Non-adherence, 50% of people with chronic diseases to not take their medications as prescribed. This can result in increased mortality and morbidity rates, reduced quality of life and shortened lifespans. The reasons for non-adherence vary including medications being too expensive, regimens too difficult to follow, patient denial of disease and need for treatment, discontinuing medication due to patients feeling well, and unpleasant medication side effects.
In the case of epilepsy, if meds are taken incorrectly seizure activity increases.
Mobile Medical Apps
Medical Mobile Apps are considered medical devices and require FDA approval and clearance. Examples include:
Epicadence: mobile software for the treatment of epileptic seizures (under development)
Blue Star: prescription digital intervention to treat Diabetes Type II. In clinical trials it was shown to be just as effective as medication. It is an FDA cleared mobile medical app and delivers behavioral self-management content.
Pear Therapeutics: mobile app to treat substance abuse (FDA cleared prescription digital therapeutic)
MusicGlove used to treat stroke and traumatic brain injury, and Cerebral Palsy.
Project EVO videogame by Akili Interactive treats ADHD and Autism.
NeuroRacer videogame to treat and monitor cognitive decline.
Pain RelieVR: Virtual Reality device and software to manage pain.
ReMission: videogame for pediatric cancer patients.
Intellicare: A suite of apps for the mobile phone to treat depression and anxiety from the molecular level to the behavioral level. ‘A novel suite of 13 speedy mini-apps called IntelliCare significantly reduced depression and anxiety in study participants, who used the apps on their smartphones up to four times a day. The reductions of 50 percent in anxiety and depression are comparable to results expected in clinical practice using psychotherapy or with antidepressant medication.” https://www.sciencedaily.com/releases/2017/01/170105123102.htm
Patient Empowerment Exercise Video game, called PE Game, for pediatric oncology patients. Similar to Wii.
Combination therapy for cancer patients includes cancer drugs and the PE Game. Builds strength and improves positive attitude which can improve the immune system. The mobile game is loaded on a tablet and improves physical and mental empowerment and becomes an exercise device for patients.
Packaging music into music streaming software to be used as a medical treatment. See published research paper below:
See UpMusing.net for use of music in treatment of depression and pain. upmusing.net/
Music and Physical Exercise are very effective in treating pain. Recommended treatment for chronic low back pain now is physical exercise, tai chi, or yoga. If no relief from this regimen after several months, then physicians may prescribe meds.
Fish oil (omega 3) can also be useful for pain management in combination with other modalities.
Mozart Sonata K448 has been shown to reduce seizure activity in humans and rodents if performed per the original composition. 10 min/day seems to be an adequate amount of time for listening to be effective. It can also improve sleep and reduces stress. OK to listen to the music while sleeping.
If music is packaged in a mobile app, and approved by the FDA as a medical device, it can be reimbursable by third party payers
Dr. Bulaj’s final thoughts and comments:
“Alone we can do so little. Together we can do so much.” Helen Keller.
Digital Medicine may be efficacious as a preventive treatment because this is where behavior changes can most influence the disease outcome.
Challenges to Acceptance:
Cyber security fears
Patients willingness to be actively engaged in their own therapy
After an enlightening discussion with Dr. Bulaj earlier this week he sent the following links for additional information related to his projects including harnessing medicinal properties of Mozart music for people with epilepsy.
Playing music for the hearing-impaired is a challenge. Unfortunately, a large number of hospice patients have lost much of their ability to hear well due to their advanced age. Until I can sit with the patient and try different sounds and gauge their response, I don’t know if therapeutic harp will benefit them or not. Sometimes, just the experience of trying to hear, agitates and frustrates the patient because it is a painful reminder that they’ve lost the joy of sound along with so many other deep losses. I have been dismissed by some with little regard for social graces and a lot of anger focused in my direction. In contrast, some profoundly deaf patients delight in the experience that someone went to the effort to lug a harp into their space and sit with them for awhile even though they will never hear a single note that is played. Intention and presence are gift enough for these people. One of my profoundly deaf patients once said to me, “Honey, I can’t hear at all anymore so you just play whatever you like. My wife enjoys the music and that makes me happy. Come back anytime.”
Yesterday I met a new hospice patient for the first time. John is in his 90’s, and when I arrived, he was quite agitated about something he thought was on his pants that needed to be removed. He was bent over double in his chair in his living room trying to pluck the offending substance off his pants. The printed pattern on the pants looked like something that didn’t belong there to him. His caregiver, a family member, was present and was concerned that John was not behaving appropriately for his “private concert”. He tried to reassure John that nothing was on his pants; John was not reassured in the slightest.
I had been informed before I arrived that John had 2 favorite songs that I should play which I practiced before I went. One, a traditional American song, the other a hymn. I introduced myself to John and shook his hand. He looked confused and asked, “Do I know you?” “Not yet” I assured him, “But you will.” I had to get very close and shout and it wasn’t clear if I was being heard at all. Initially, I sat about 6 feet back from the chair John occupied and began playing the songs a family member had told me he loved. I got no response. John had stopped fussing about whatever he thought was on his pant leg and now was agitated over the towel that he was sitting on to protect the chair. He wanted it removed. He kept trying to stand up so he could pull the towel out, which he wasn’t able to do without risking a fall. His caregiver kept jumping up and trying to calm John, encouraging him to just sit and listen to the music. John was having none of it and the caregiver appeared to be getting frustrated with John’s behavior. No matter how loudly I played, John was paying no attention to me at all. I was invisible to him. I suddenly realized John couldn’t see me or hear me. Clearly, this encounter was not producing the desired effect of soothing peace and calm for either John or his caregiver.
I stopped playing and told the caregiver I wanted to try something a little different. I moved as close as I could get to John with the harp and managed to get his visual attention. He did not seem to remember me and acted surprised that I was there. I placed his hands on the harp pillar and began to play scales, arpeggios, and glissandos. John’s face lit up. He could feel the vibrations. He began to comment on the size of the harp and the strings. He tentatively plucked a string and beamed his delight at me. He asked questions about the harp and told me about someone he knew long ago who played the harp. I was getting a glimpse of the charming, intelligent and caring man John was inside. He stopped perseverating on the chair and his pant legs. I tried again to play his favorite songs but there was no visible recognition to any melody from him. I continued to play familiar tunes, more to calm the caregiver than John. John appeared to find joy in the closeness and novelty of my presence and the harp vibrations he could feel. The caregiver found peace in the music and ability to relax, momentarily, from his demanding job. The tension in the room began to dissipate quickly as the calm settled. John kept his hand on the harp pillar and continued talking to me, quietly. I couldn’t understand his words so I just kept playing, looking at him, smiling and nodding. When it felt like the right time to leave, I bid John and his caregiver goodbye and was encouraged to return anytime, any day.
I was asked to present some Self-healing practices at our most recent Utah Therapeutic Harp Network (UTHN) gathering (a sacred circle). I have taken so many workshops and classes on the following list but can not claim any expertise. I’ve tried them all and to some extent they are all useful and easy to do. We did some of the exercises at our meeting and I think everybody felt more open and less stressed at the end. I know I did. Then, of course, we ate a fabulous lunch prepared by our awesome hostess, Peggy. Felt like a day at the spa.
What makes all of these practices most beneficial is habit. They should be practiced on a daily basis, not just when you’re depressed or stressed, in order to build resilience. Yeah, right. Do what I say, not what I do. Youtube video references are included for more in-depth explanations and demonstrations. I tried to find the best for you.
Self-Healing Practices to Stay Healthy and Creative
1. MUSIC: Listen, play, sing and tone your chakras
If you’re feeling overwhelmed by a stressful situation, try taking a break and listening to relaxing music. Playing calm music has a positive effect on the brain and body, can lower blood pressure, and reduce cortisol, a hormone linked to stress. (Did I really need to remind a roomful of Therapeutic Musicians this?) Ocean or nature sounds have similar relaxing effects as music. So does singing and it improves your oxygenation levels if you do it right. Exercise: Tone your Chakras. As you sing the vowel sounds, hold the place where that chakra resides in the body and see if you can feel the vibration there. https://www.youtube.com/watch?v=F8kwc1lkiAQ every video has different vowel sounds. If the following don’t work for you, try another one.
Root chakra: uh sound (C)
Sacral chakra: uuuu (like Moo) (D)
Solar chakra: long o (like low) (E)
Heart chakra: Ahhhhhhhhh (F)
Throat Chakra: long I (like lie) (G)
3rd Eye chakra: long A (like hay) (A)
Crown chakra: long E (like she) (B)
2. Call a friend (another UTHN member)
When you’re feeling stressed, take a break to call a supportive friend and talk about your problems. Good relationships with friends and loved ones are important to any healthy lifestyle, and they’re especially important when you’re under a lot of stress.
3. Talk yourself through it (EFT)
Sometimes calling a friend is not an option. If this is the case, talking calmly to yourself can be the next best thing. Don’t worry about seeming crazy — just tell yourself why you’re stressed out, what you have to do to complete the task at hand, and most importantly, that everything will be okay. Remind yourself of all the challenges in life you have already overcome successfully. Or try the
Emotional Freedom Technique technique https://www.youtube.com/watch?v=XyHxuTG6jRk with self talk and tapping.
4. Eat Right
Stress levels and a proper diet are closely related. When we’re overwhelmed, we often forget to eat well and resort to using sugary, fatty snack foods as a pick-me-up. Try to avoid sugary snacks and plan ahead. Fruits and vegetables are always good, and fish with high levels of omega-3 fatty acids have been shown to reduce the symptoms of stress. A tuna sandwich really is brain food.
Drink Green tea rather than caffeinated drinks A large dose of caffeine causes a short-term spike in blood pressure. It may also cause your hypothalamic-pituitary-adrenal axis to go into overdrive. Instead of coffee or energy drinks, try green tea. It has less than half the caffeine of coffee and contains healthy antioxidants, as well as theanine, an amino acid that has a calming effect on the nervous system.
5. Laugh it off—yoga laughing
Laughter releases endorphins that improve mood and decrease levels of the stress-causing hormones cortisol and adrenaline. Laughing tricks your nervous system into making you happy.
Can’t think of anything funny? Go to Youtube and look for Monty Python, Robin Williams, Carol Burnett or whoever has made you laugh in the past.
Fake it. Just start belly laughing. This will be enough for your body to respond biochemically. And you will soon be laughing for real at how silly you sound. Did you know there are Laughing Yoga clubs all over the planet? https://www.youtube.com/watch?v=5hf2umYCKr8
6. Exercise (even for a minute) Qi Gong and Qi Self Care
Exercise doesn’t necessarily mean power lifting at the gym or training for a marathon. A short walk around the clinic or neighborhood, or simply standing up to stretch during a break at work can offer immediate relief in a stressful situation. Getting your blood moving releases endorphins and can improve your mood almost instantaneously.
Open the Meridians with tapping and movement https://www.youtube.com/watch?v=FjQJYAk97ns
7. Sleep better (banana tea)
Everyone knows stress can cause you to lose sleep. Unfortunately, lack of sleep is also a key cause of stress. This vicious cycle causes the brain and body to get out of whack and only gets worse with time. If sleep is a problem, try turning the TV off earlier, dim the lights, and give yourself time to relax before going to bed. It may be the most effective stress buster on our list. Kristen shared a recipe for insomnia, make banana tea: cut off the ends of a ripe banana and boil it for 10 minutes. Drink the water as tea with some cinnamon. : https://www.davidwolfe.com/banana-cinnamon-tea-deep-sleep/
8. Breathe deep and think of things you are grateful for
For centuries, Buddhist monks have been conscious of deliberate breathing during meditation. This is also the foundation of HeartMath’s formula for improving Heart Rate Variability and increasing resilience. Sit up in your chair with your feet flat on the floor and hands on top of your knees. Breathe in and out slowly and deeply, concentrating on your lungs as they expand fully in your chest. While shallow breathing causes stress, deep breathing oxygenates your blood, helps center your body, and clears your mind. While you’re breathing, focus your mind on the things in your life you are grateful for. 3-5 minutes every day, longer if you don’t think you have time to do this. https://www.youtube.com/watch?v=d4QtkV3UgDY and a guided meditation:
9. Morning Pages, The Artist’s Date, Sacred Circles: Purpose: to declutter your brain and banish blocks to creativity and living a full and abundant life. All of this is from the book, The Artist’s Way by Julia Cameron. If you read this 20 years ago, like me, read it again. I got so much more out of it the second time. Morning pages: Every morning before anything else, sit and fill 3 pages of handwritten stream of consciousness. Do not review it, do not edit it. Just brain dump onto the paper. https://www.youtube.com/watch?v=oxtEo4yCOh4 Artists Date: Make a date with yourself to do something that you really enjoy, honoring yourself and what it is you do that makes you unique on a regular basis. What is fun? Can you do it alone? Do it. Is there someone who would enjoy doing it with you not just out of obligation? Invite them. Forming a Sacred Circle—”Success occurs in clusters and is born in generosity. Let us form constellations of believing mirrors and move into our powers.” J. Cameron. This is what UTHN is, our sacred circle.
I returned recently from the International Harp Therapy Program workshop in Cedar Falls, Iowa and the follow up experiential workshop on Resonant Tone in Albert Lea, Minnesota. While I wasn’t looking forward to traveling to the mid-west in August from all I had been warned about: sweltering heat, oppressive humidity and bugs; none of that proved to be the case, at least while I was there. The weather was agreeable, even cool and rainy and the bugs stayed home. It is always inspirational and validating to come together with the IHTP tribe of Therapeutic Harpists, including new students, former teachers, experienced practitioners, and old friends. We speak the same language and have shared experiences. While all presentations at this weekend conference were valuable and informative, my favorite takeaway from this session was the Aromatherapy Workshop. I use aromatherapy with patients by dabbing it on my wrists. The movement of my arms while playing harp sitting close to the bedside then sends it subtly into the room. My favorite blend is from Young Living Farms called Forgiveness. It includes sesame seed, melissa, geranium, frankincense, sandalwood, coriander, angelica root, lavender, bergamot, lemon, ylang ylang, jasmine, Helichrysum italicum oil, Roman chamomile, and rose.
It is useful when people are at the end of life and can’t seem to let go because of anger, bitterness, resentment, guilt and fear. And I love the smell.
Pamela, my new IHTP sister, friend, and roommate for both workshops, acquired a room spray of Frankincense to help us sleep and ground us while we were there from Rodney Schwan, which she liberally spritzed every night before bedtime. It seemed to do the trick. Rodney is a Massage Therapist and Aromatherapist who works in the field of palliative care. The knowledge and personal experience he shared about using various scents in palliative care use was extremely valuable and which I intend to include more of in my own practice.
On Saturday night, Gaylord Stauffer, Cedar Falls host, harpist and gardener extraordinaire, invited us all to his home. The following pictures are from his incredible gardenscape, where we were able to wander and wonder at our leisure while our friends played harp and sang into the evening. Good food, good company, and incredible creative landscape artistry created a magical environment for us all to refresh and relax.
Albert Lea and ESM Workshop
“ESM – Experiential Specialty Module – The Experiential Specialty Module requires in-person attendance for all students. This is a week long Module. The ESM is scheduled at venues in many countries, and you can take it anywhere it is offered. This allows the program to be quite flexible and moderately paced for all students. The Experiential module (which is an extension of Unit 4) enables the student to be ‘recommended for Hospice work,’ as opposed to those who only take the theoretical Unit 4 about Resonance.” (http://harptherapycampus.com/campus-2/faqs/).
There were four of us in this training:
From left to right: Diane from Idaho, Pamela from New York, Sharon from Edmonton, CA, and me. Included is Sharon’s Stony End harp which we all got to play one evening in the hotel lobby for our own amusement and that of the hotel staff and guests while it poured rain outside.
Being such a small group with 2 fabulous instructors: Christina Tourin and Judith Hitt, allowed us to really go deep into the training which was so appreciated by us all.
Having gone through the theoretical ESM training seven years ago, much was review for me but the experiential resonant tone was practice-changing for me.
The concept of resonant tone is based on the fact that we all vibrate, and that which vibrates, produces sound. As Therapeutic Harp Practitioners, we must be centered, focused and attentive to our patients and their surroundings, integrate that information and meet the patient where they are at within that moment vibrationally, emotionally, and mentally. Any vocalizations produced by the patient provide a clue as to their resonant tone which we try to match with our musical selections. Items in the room provide clues to their interests and personality and whatever they are willing to share with us in that space also helps. Being open to all of this and completely focused on the patient allows intuition to assist with the choices. Some of my colleagues refer to this as “the voice”, “Creator”, spirit guides” “universal intelligence” and “pure coincidence”. Whatever the source for an idea that comes to us to play a particular tune or improvisational mode for a patient that is absolutely perfect, it will come to us if we are open to it, paying attention, and grounded in our intention to do the best we can for the person we are with.
Watching the response of the patient to our musical selections, key, rhythm, genre, allows for opportunities to change and select a more appropriate choice to connect with the patient as needed.
At the end of the week we gave a performance for the residents of the facility which had provided a beautiful space for us all week. Then we traveled to a different facility where we were allowed to shadow Christina and Rachel Christianson, IHTP graduate, amazing harpist, and local host for our training, as they provided Therapeutic Harp music for selected patients. They used harp, voice, conversation, shared experiences to establish that special connection for the patient and their families within a limited amount of time. There is no way to glean the benefits of this level of training without being present and experiencing it first hand.
Another dinner party, this time hosted by Rachel and Dave Christiansen of Albert Lea, MN at their lovely home on the lake. From L to R: Tina, Judith, Pamela, Sharon and Diane.
I have been able to develop a new depth to my own practice of bedside playing for hospice patients because of what I learned in both of these workshops. It was well worth the time and money to participate, expand my skills and work outside my comfort zone with such incredibly talented and dedicated professionals.
Sometimes I don’t arrive in time to play for the actively dying patients before they pass. If the mortuary has not come yet, I may sit with the body in a low-lit room and play for the newly departed. My personal belief is that the newly dead remain in the former space for a short period of time. Like birth, the end of life transition from mortal to spiritual being can be traumatic and confusing, initially. I imagine the abrupt cessation of pain, gravity, and fear when the spirit finally releases the physical shell, combined with the impending launch into the light of unconditional love with the soul family and Creator, may cause some momentary resistance, at least for some. So, I play for that spirit who may remain, encouraging it to take flight. I play for the hospice staff and family members who remain in the room grieving their loss. I play for the facility staff who clean and prepare the body for the mortuary to pick up and are mourning, as they complete this final service for a patient they have come to know and love. This is a sacred space and time and I feel a responsibility to hold and preserve that sacredness for just a bit longer with music if I can.
Rudy was a patient who was loved by everyone he met throughout his life. He came to America as a poor Russian immigrant when the Soviet bloc collapsed in the 1980s and he could leave Mother Russia. He brought his family with him including his wife and several small children and was a man who made friends wherever he went. According to one son, Rudy never forgot his old acquaintances while continuing to make new friends his entire life. How he remembered all those people, their names, the details about their families and lives was a mystery to everyone, including Rudy’s own family.
Rudy’s final days were spent on hospice in an assisted care facility he had been living in for a while. Even before Rudy was admitted to hospice, I knew him. He had met me when I came to play for our hospice patients at the facility and we had spoken in the lobby while I tuned the harp and he was waiting for his daughter to come and visit.
When I first entered Rudy’s room with the harp, he looked up and smiled. “Well, I guess it must be my time, the angel has come for me, now”, he said. He remembered who I was from our prior brief meeting. I told him I hoped we would have many therapeutic music sessions together. He just shrugged, leaned back in his wheelchair, closed his eyes and let the music envelop him. We did get to have many sessions together but not as many as either of us would have liked. I remember him always smiling and welcoming me into his room even as his diminished health steadily declined.
I was unable to be there with him while he was actively dying but I was told he was surrounded by his loving family and friends. By the time I arrived at the facility to play for him, Rudy had passed and his family had left so I sat in his room with his body and played some of his favorite songs. Soon the Nursing staff came in to prepare Rudy’s body for the mortuary. I asked them if I could stay and continue playing while they worked. The two Aides agreed although my request seem to surprise them. Both were tearful while they lovingly bathed Rudy and covered his body. Rudy’s departure would leave a large hole in the world for all the people whose lives he had touched.
When the mortuary came for Rudy, his body was carefully transferred to the gurney and his face covered with a drape. A rose was placed on his body and the processional to the waiting van began with the hospice nurse, the 2 mortuary staff people, and the gurney with Rudy. The nursing assistants and I walked behind out to the waiting car. I believe Rudy’s spirit had already departed by then. I played only for his memory and for the people he had left behind to comfort us all in our grief.
I had been alerted through encrypted email that one of my favorite VA patients had passed after a long time on hospice. I had gotten to know Joe well during our sessions together as he did not suffer from dementia and loved music. Usually welcoming and greeting me with a big smile, the last time I visited he asked me to leave as he just wanted to sleep. I knew he wouldn’t be with us much longer.
The next time I saw him, he had passed. He was still in his facility bed and room and his family wanted to provide a memorial for him there and dispense with a funeral service. They planned a bigger family and friend memorial much later in his home. Joe would be cremated. A rose was placed on his body and I sat next to the bed as far back as I could get in very tight quarters to accommodate family who wanted to say “Farewell” and touch him. As they slowly filed in, I played hymns and music he had enjoyed. Although no program had been formally planned, at one point a son began telling stories about his dad from a happier time. In addition to being a kind, generous, adventurous man who loved the outdoors and his family, he had also been a Gin and Tonic drinker. Neat, no ice. As the family stories began to unfold of trips to Moab and Lake Powell and skiing, there was equal laughter and tears. Everybody, including teenage grandchildren at the time, had been encouraged by Joe to join him in his favorite drink. As they told it, mostly gin, little tonic, warm and disgusting but they drank with him anyway to please him. And to honor him, an adult grandchild pulled out of his pocket a flask of gin and a small bottle of tonic water. Paper cups were gathered and a toast was drunk to Joe, beloved husband, father, grandfather and friend. After everyone was done speaking I played some more and stayed until the mortuary arrive. I finished with You Raise Me Up, Wind Beneath My Wings, and Somewhere Over the Rainbow. I waited outside the room while the mortuary transferred Joe to their guerney, draped his body with the American flag and began the processional out to the waiting van.
At this VA long term care facility, the dead are acknowledged and honored. As they are slowly moved out in a great processional with the nurse, chaplain and family following the departed, over the loudspeaker everyone in the building is informed of their passing, their military service and a recording of Taps is played. All who can, stand and either salute or place their hand over their heart until the veteran moves out the door. All work and conversation that is not essential stops. It is a very moving experience just to be part of this loving and final tribute to people who selflessly served their country.
I realized that I might have overdone it that day when I pulled into the grocery store on my way home from work at 7:30 pm on a Friday night. Instead of buying some nice, sensible salad fixings for dinner, or even a pre-made comfort meal from the deli, I bought a pint of cookie caramel crunch gelato and a tiny little jar of Nutella. Oh, and some salty, crunchy, calorie-dense, nutrient-poor condiments and side dishes to enhance the main course. This is what I ate for dinner while I binge-watched Glee reruns on Netflix. Predictably, by bedtime I was suffering from bloat remorse and a bit of queasiness. I confess, this is how I self-medicate.
The day started with me getting a late start on a one hour drive for a Mother’s Day lunch harp gig, only to discover when I arrived (after breaking speed limits without getting caught) that the lunch actually started an hour later. Since I was at a long term care facility, I had patients there to see anyway. I went first to the one patient who I had read via email was probably transitioning. I sat by his bed and played ionic, rhythmic improvisations in mostly major keys. I threw a couple of hymns in as well. I could not detect any sort of outward physical response to the music. For all intents and purposes, the patient appeared relaxed, calm and sleeping like a baby. I moved on to patient number 2 who was sitting in the dining room waiting for lunch. I played for him until it was time to gravitate to the Mother’s Day lunch celebration. I was put on the stage with a spotlight and microphone and played my heart out for an hour and 15 minutes. That is about my limit, without a break. When I reach that point of “so-done”, I start making a lot of mistakes. The brain begins to go first, and the fingers aren’t far behind, similar to hypothermia effect. It’s best to stop while people still think I’m a fairly good harp player. Fortunately, the facility staff in their gratitude for my serenade offered me lunch which was reviving as only lasagna, salad with raspberries and cupcakes frosted to look like flowers can be. I proceeded to see and play for another 4 patients at the facility.
My email alerted me as I was finishing up that there were no less than 3 patients I knew well who were transitioning to actively dying at a facility I would be driving right past on my way home. I felt compelled to stop and play for them and their families, if there were any family members present.
Before I got to anyone’s room, I ran into one of our hospice chaplains. He confirmed that there were three of our patients in various stages of dying, none of whom were expected to last the weekend. I assured him I intended to see them all before I went home.
The first patient I saw at the facility, patient #7 for the day, was lying in bed with open, unseeing glazed eyes and death rattle breathing. Her roommate had not gone to dinner and was lying in bed watching TV, which she blessedly turned off after I arrived and began to play. I am always so grateful for this thoughtfulness in shared space. No matter what someone’s financial situation is, they should be allowed to die in peace and not have to listen to the dreadful evening news or Jeopardy blasting 10 feet from their bed. So often though, they are left in a shared room where the roommates are doing their best to ignore the fact that one of their own is dying, while family and friends are present and grieving around the bedside. If there is space available, sometimes the nearly departed and entourage are moved to a private room but often, there is no space available and everybody must suffer together.
I played chord progressions with right hand improvisations, including both major and minor keys, the Kyrie Eleison from Hildegard Von Bingen’s Missa De Angeles written in the 11th century and pentatonic improvisation with some standard hymns thrown in. Finally, the patient closed her eyes and appeared to fall into a deep sleep. Her breathing was still audible and wet sounding but not so loud and labored as before. I left her quietly and went to see my next patient.
Patient #8 was surrounded by children, grandchildren and a young great grand-child. This room was also shared with another patient hiding behind a thin curtain surrounding her bed. A son told me that his mother loved music and came from a musical family. I had been playing for the patient for a couple of years as she slowly declined but she had never been able to communicate with me beyond gibberish, moans and cries. She had severe dementia in addition to co-morbidities so while I knew her, I never really knew her at all or who she had been before she became a hospice patient. The patient was sleeping peacefully and I didn’t know that I had much to offer her. However, the family was in the throes of grief and their pain and agitation was very real. I find that familiar music and hymns seem to help in those situations. I extended the repertoire with improvisations but I focused on standard hymns, finishing with Somewhere over the Rainbow, You Raise Me Up and Wind Beneath my Wings. More family arrived and I departed to make space for them and to see my third patient.
Patient #9 was a dementia patient who was blissfully alone in her room. There were no other patients or family with her at that time. Prior to her recent health decline, she used to love to sing along when I played harp for her. Even in her current state, she was still humming, very quietly, while she lay in bed with her eyes closed. I began with her favorite songs and then shifted to unfamiliar music and then improvisations. She continued to hum along anyway. When I left, she was still humming some favorite tune only she could recognize. She did not appear agitated or uncomfortable, which had been the case earlier, according to the nurse’s report.
I did not notice my own exhaustion while I played for our patients but after I finished it hit me. As did the pulsating neck pain radiating up into my head. I still had an hour drive home after seeing the last patient but at least the commuter gridlock traffic had abated by then. Good thing, because I think I drove on autopilot most of the way. That is, until I got close to the grocery store and began obsessing about ice cream and Nutella. Eight hours of Therapeutic Harp playing is too much, at least for me. But sometimes things happen and there is no real choice in the matter. You do what needs to be done; then go home, eat ice cream, watch Glee reruns, and hope tomorrow is better.