My thanks to Christina Shocklee, MT Intern for allowing me to post her thoughts on a recent visit with one of our hospice patients.
M was clearly not having a good day. As the facility caregiver wheeled her to our meeting spot for the morning, M’s eyes were fixed firmly on the floor. Her mouth was drawn into a tight, thin line and her brow was deeply furrowed. M was holding so much tension in her arms and upper body that she was practically vibrating. She was far beyond her usual anxious chatter - M sat in steely, seething silence.
Karen, the MT-BC, gently addressed M as the MT Team pulled out their guitars. M sharply turned her gaze up. She trembled and began to chatter. Her tone was harsh and as tense as her body. She paused for a moment, breathing quickly in her distress. And this gave the MT Team an idea.
There is a music therapy technique called the Iso Principle, which is where the MT-BC matches the tempo and energy level of a patient’s breathing or vocalizations and then gradually adjusts their music to influence the patient’s affect. In this situation, M was extremely agitated and our goal was to get her to take some deep breaths and release her anxiety and agitation.
The MT Team began with a fast-paced song with a lot of syncopated rhythms and a complicated strum to match M’s energy and chattering. Each song was progressively slower and less rhythmically involved, and the MT Team utilized spaces between musical phrases to encourage M to take deep, calming breaths. M took a shaky breath in and her syllabic speech finally paused. Her face, which had been so taut, began to soften; her brow relaxed and a small smile crept up. She began to move her body to the music, silently audiating and swaying, her smile broadening. She made eye contact with the MT Team, eyes locked on whoever was singing the melody. M was finally relaxing.
However, now the MT Team had a new challenge: lunchtime. Noon was approaching fast, and if M was wheeled into the chaos and clatter of the lunchroom right after getting to this relaxed state, it could easily reignite her agitation. So, the MT Team carefully upped the energy in the music, keeping it lightly perky and pleasant.
And then, all at once, we heard it. M was humming!! It had been weeks since we’d heard her hum, but M was humming enthusiastically with everything she had, swaying and smiling all the while. It was honestly an emotional moment for the MT Team. As the music ended, M’s chattering began again, but we could hear words now - “thank you, that was wonderful, I needed that,” all pouring out of her as quickly as she could take a breath.
Karen wheeled M into the dining hall, softly singing “You Are My Sunshine” as M excitedly expressed her gratitude and pleasure with the music. It was a beautiful, successful, and personally gratifying session for the MT Team, one I’ll carry with me for a long time.
-Christina Shocklee, MT Intern