By Evangeline Majawat
A MAN lies on a hospital bed. Once a talented musician, a stroke left him confined to a wheelchair and unable to speak. His disabilities frustrate him as he is incapable of performing daily activities, let alone play any musical instruments.
He sinks into depression and refuses to have anything to do with music. But slowly, with the help of his music therapist, he regains his confidence, pulls himself out of depression and learns to talk again.
“It was very frustrating for him,” music therapist Gurpreet Kaur Kalsi recalls of that patient, one of her earlier cases when she first practised in London. “It’s hard when you’re a musician and you find that you cannot play again. He kept saying ‘I can’t do it. I can’t play the way I used to and I’m not going to play.’”
At first, all he did was listen to his favourite music by American musician Santana. In time, he opened up and talked about his feelings. Slowly, he learnt to talk and his speech became clearer.
It was on his last session with now Kota Kinabalu-based Gurpreet that he picked up a small drum.
“He picked up this drum with his good hand, played and said ‘yeah, I’ve still got it,’” Gurpreet says proudly.
LITTLE KNOWN THERAPY
Not many in Malaysia are aware of music therapy (MT) and its benefits. Whilst MT is lumped into the same category as massage and acupuncture under Traditional and Complementary Medicine (TCM), it is much more low profile and lesser known.
MT can be defined as the art of using music to treat people who find it difficult or who cannot communicate normally because of injury, illnesses or disability. Music therapists see patients ranging from newborns to the elderly.
The patients could be facing learning difficulties, substance abuse problems, brain injuries, physical disabilities, acute and chronic pain, psychological trauma or special needs.
“It works. The whole idea of music therapy is that you’re working with a therapist to help you. It contributes to the patient’s wellbeing,” Gurpreet explains.
MT is a recognised allied healthcare. In countries such as the United Kingdom, United States and Australia, MT features notably as part of the government’s healthcare system.
One point that Gurpreet is keen to highlight is that MT is in no way music education. She stresses that music education is focused on learning and mastering a musical instrument.
MT, on the other hand, is a clinical treatment.
MUSIC THERAPY AS PAIN RELIEF
Various studies have showed that MT helps to ease acute and chronic pain experienced by patients through the reduction of anxiety and stress, which eventually leads to positive physiological changes.
Doctors and researchers have recorded improved respiration, lower blood pressure, reduced heart rate and relaxed muscle tension. Patients report better pain tolerance.
The American Music Therapy Association quotes Professor Suzanne Hanser of Berklee College of Music as stating that comforting music acts as a distraction, inducing relaxation and changes the patient’s mood to focus on the positive.
In his research of MT in hospice and palliative care, Dr. Russell Hilliard, the National Director of Supportive Care, Research, and Ethics of Seasons Hospice & Palliative Care found that MT patients recorded significant differences in physical comfort before and after therapy.
“From the patients’ point of view, they feel better. While you can’t remove the physical pain, you find ways for them to cope with it,” Gurpreet says. “From the nurses and doctors’ point of view, they notice how patients respond better to their medical treatments.”
Gurpreet, who has worked with palliative care patients, saw for herself how MT eased their pain both physically and mentally.
“It gives them insight to how they feel, to be emotionally aware and to make them realise that even when they feel down (or in pain), life isn’t that bad and that life goes on,” she shares.
“It is cathartic for them.”
HOW IT WORKS
There are two approaches to MT, says Gurpreet. The first is the active approach. Patients are encouraged to use different musical instruments to express their emotions, “spontaneously creating music”.
Songwriting is also part of the active approach. Patients usually start off writing poetry then lyrics. Again, it is about self-expression that usually reflects any psychosocial issues within.
At times, the patients are given a theme (an emotion that could be prompted by a photo or memory) and play the instruments to reflect that emotion.
The second approach is receptive whereby the patients listen to music played out loud or through headphones. The music that is used could be the therapist’s choice or selected by the patients.
MT sessions could be as short as one day or go on for years, depending on the gravity of the problem. Each one-on-one session lasts for half an hour for children or about an hour for adults. Group sessions go on longer ¾ generally for an hour and a half.
LEARNING TO LEARN WITH MUSIC THERAPY
For general practitioner Dr. Ho Siang Boon, music is a precious medium for those who find it difficult to communicate normally. He says MT sessions allow people with special needs or autism to express themselves.
Dr. Ho, who is also the technical adviser for Handprints the country’s first and only toy library for children with special needs, says music creates a bridge for the kids to pick up the necessary social skills for them to integrate into society.
“They do respond positively. Once they open up and are more expressive, we’re able to reach out and teach them social communication,” he explains.
In Gurpreet’s patient, music stimulated his brain allowing him to learn to speak again over time. Similarly, former US Congresswoman Gabrielle Giffords also relied on MT to relearn to speak after being shot in the head two years ago.
ABC News quotes Meaghan Morrow, Giffords’ music therapist and a certified brain injury specialist at TIRR Memorial Hermann Rehabilitation Hospital in Houston, Texas explaining that by layering words on top of melody and rhythm, her patient was opening new ‘pathways’ around the damaged areas of her brain. This ability is called neuroplasticity.
Despite the glowing and proven case studies, MT remains low profile in Malaysia. A contributing factor could be because there is no MT board here. Gurpreet says she and a few of her peers tried to set up a national association for music therapists but was turned down by the Registrar of Society.
“We don’t meet the first requirement, which is the number of professionals in minimum seven states. We only managed to come up with (a list of therapists in) five states,” she says. This has remained a status quo for the past 13 years when she first got back from the UK.
But she says awareness is spreading slowly through word-of-mouth and with referrals from supportive doctors such as Dr. Ho.
Dr. Ho believes that MT should eventually be a part of our public healthcare system. “Right now, I recommend MT and arts therapy to my patients. I tell them it’s worth giving it a try because it does improve your wellbeing,” he says.
“Afterall, there are no side effects (to MT) so why not try it.”
To contact Gurpreet Kaur Kalsi please email email@example.com. Handsprint Toy Library is located at Lot 29B & 29C, 1st floor, Likas Square, Kota Kinabalu, Sabah. For more information, please contact Christina Poong at 016 417 2298