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Control… Connection… ‘Daylight come and we want go home…’

Control -

When you get admitted into the hospital, especially into critical care, you lose all sense of control. Disease has taken over your body and you soul. And you have to rely on others for everything. You lose all sense of control. And not just the patients. I recently got a music therapy referral to visit a woman in the ICU to help with comfort. She had been on a ventilator for several days… and it was starting to look as though things may not turn around. Her adult daughter was with her around the clock, trying to put on a good face. She was not very successful. I introduced myself and told her why I was there. She smiled and said, “Music… she loves music.” Then after being lost in a thought for a moment, “She loves Harry Belafonte. She actually met him once. And she loves to tell that story. She’ll tell anyone…” Then she started to cry. She has no control over anything right now. I took out the guitar and just started offering some soothing soundscape (for both). She held her mother’s hand and then rested her head on her shoulder, seeming to allow the music in. Eventually I added some soft vocals – “Day-O. Day-A-O. Daylight come and we want go home.” She looked at me with a soft smile through her tears. I kept the music slow… grounded… drone-like. I sang the phrase again. “Day-O. Day-A-O. Daylight come and we want go home.”

Connection -

When music is introduced in the hospital, it creates connection… Then, I asked her to join me, “Daylight come and we want go home.” It became like a mantra, cycling around within the musical underscore. We sang it together again… and again... and again. She sang to her and suddenly seemed to have some purpose—suddenly, some sense of control. She was singing to her. She was comforting her. She was connecting with her mother… through a simple lyric. A simple meaningful song that was shared. Music is the great connector. 

She has hard decisions to make in the coming days, but the music… It gave her some sense of control and it gave her some sense of connection… to her mother and to herself. And, perhaps, the music also started to help with some sense of resolve.

“Daylight come and we want go home.”

The healing power of music…

(*The stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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But… she sang

She was having trouble breathing, trying to find the right position in her hospital bed.

(But… she sang.)

She really couldn’t speak more than a few words without losing her breath.

(But… she sang.)

She was very anxious.

(But… she sang.)

In our initial conversation, when I asked her about music in her life, she told me that she used to sing in the church choir, “…it’s been a long time…” and that she loved the old hymns. “Well then,” I said, “we should sing.” “But… I can’t breathe.” I asked her, “What is your favorite hymn?” “In The Garden.” “Okay, just follow me, nice and easy.” I kept the rhythm solid and steady on the guitar but with an easy feel, and the tempo a bit slower than her shallow breathing rhythms. And… we sang. Her breathing started to naturally follow the phrasing of the song… and gradually became slower and deeper. [When we sing, we naturally breathe in rhythm, drawing in breath fully for the next phrase, which increases our lung capacity. Our breathing “entrains” to the rhythm of the song. And when we breathe a bit slower and deeper, it naturally relaxes our bodies. And yes, I did purposefully slow the tempo as we went along (helping to slow and deepen her breathing). Singing—and all music making—can also trigger the release of Dopamine in our brains, the “pleasure” neurotransmitter, and can brighten our mood. Singing helps both physically and psychologically.] After the song, she recalled a memory of an Easter concert she sang in when she was younger. Then, I asked, “How’s your breathing now?” “Oh… I wasn’t even thinking about it.” 

Because… she sang.

Singing is powerful. Singing is healing. Singing connects us to our breathing and is an outlet for expression. Singing connects us to our soul. We ‘sing’ when our emotions or feelings warrant more than just speech. Singing activates multiple parts of our brains. Singing is a mind/body/spirit experience. And… singing brings joy.

So…

‘Sing… sing a song

Sing out loud, sing out strong

Sing of good things, not bad

Sing of happy, not sad

Don’t worry if it’s not good enough, for anyone else to hear

Just sing… sing a song!

The healing power of music…

(*The stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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In The Hospital… Music Therapy Is For Everyone

Here’s the scenario: In the hospital where I work as a music therapist, I get a referral from the bedside nurse to visit with her patient in the ICU, who is on a ventilator, to help reduce anxiety. I arrive, I confer with the nurse to see if there is anything I need to know, and then I enter the room and start to facilitate a music experience. And then, five minutes in, the nurse quietly enters the room to… take care of stuff. She checks IV lines, she checks the computer, she checks… stuff. And she stays in the room doing what appears to be ‘checking stuff’ for most of the remainder of the session. Perhaps that ‘stuff’ is timely. (And I am certainly not minimizing what these nurses do. The critical care nurses I work with are incredibly skilled, compassionate and take great care of their patients.) But here is what I think – she wanted (needed) the music experience as well. This happens often. And why not? Being a critical care nurse is extremely stressful. I see what they are dealing with on a daily basis. Perhaps she needed… something in that moment. Perhaps she needed some music. When nurses, or any medical professional, are in the room… the music is also for them. Not long ago, a nurse came into my session where I was singing with an older woman who was anxious and a bit confused. We were singing Blue Moon. After she checked the IV lines, took care of stuff, etc., she sat on the bed next to the patient and sang along for the duration of the session. And like the patient, her affect softened. Her anxiety appeared to subside. Perhaps she needed… something in that moment. Perhaps she needed some music. I have had a few nurses ‘come clean’, telling me that they sit outside the room I’m in so they can listen to the music while charting medical notes. And yes, a few have told me that they wait to do their in-room rounds (stuff) until I am there, providing music. Perhaps they needed… something in that moment. Perhaps they needed some music. Music therapy is also for medical staff.

When there are visitors or family members in the room of patients I’m visiting, the session (the music) is always for them as well. (Sometimes more so.) And like clockwork, there are so many times that music brings out sudden emotion in the visitors. It makes sense. They are holding it all in, trying to navigate their own feelings while often putting on a good face for the patient. The music seems to prompt a release… a release of held in tension. It creates an opportunity for emotional outlet. Perhaps they needed… something in that moment. Perhaps they needed some music. When this happens, I always tell them that it’s okay. That it’s actually a good thing. They need to release that tension. It can be a cathartic experience for them. It can be so needed.

Also…

Music creates connections and brings people together. There are many times when I walk into a room and the family members are sitting on the outskirts, maybe on their phones, watching the TV or just staring off. But when the music starts something happens. Movement. Connection. Suddenly everyone gravitates bedside (especially if a favorite or meaningful song is presented). They make eye contact with each other. They hold the patient’s hand or stroke their head. Music prompts togetherness. Music creates connections. Music therapy is also for family and visitors.

Just this past week I was asked to visit with an older woman, in her early 90s, who had been in the hospital for several days. She was a bit confused and just feeling all the stresses of being in an unfamiliar place dealing with illness. Her daughter, grandson and his significant other were all there… sitting on the outskirts. When the music started, they focused… they connected to it. I could feel them start to lean in. I sensed something happening. When I transitioned into a relaxed version of Somewhere Over the Rainbow, they all moved closer to the bed. Then… without prompting… they all joined in singing along. And they really sang! With some lovely harmonies! It was such a beautiful moment… a real moment… in a hospital room. The picture that still lingers in my mind is the face of the patient, her beautiful smile as she gazed at her grandson singing to her. Tears started running down her face. (Tears started running down his face too.) Suddenly it wasn’t ‘patient’ and ‘visitors’, it was family. It was family connecting on a real and human level. It brought comfort into a place where comfort is hard to find. I felt honored that I got to be a part of it.

What else can bring that kind of connection in the hospital? What other modality brings nurses into the room to have a moment where the aesthetics can help them get through their shift? What other practice can bring family members together in harmony and tears of joy?

In the hospital… music therapy is for everyone.

The healing power of music…

(*The stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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Did He Say… Journey? The Power Of A Favorite Song

Recently, at one of the hospitals where I work as a music therapist, I was asked to see a gentleman in his early 80s, currently undergoing chemotherapy treatment for a form of brain cancer. He was brought into the hospital as a result of some disorientation issues. When I entered the room, he was lying back in a chair receiving treatment. He looked very weak, eyes closed and with a bit of a pained look on his face. His wife was with him and appeared quite anxious. However, she did say that he loved music and when I suggested offering something for relaxation and comfort, she was very accepting. I sat and simply started playing on the guitar, providing something soothing—a soundscape for relaxation and comfort… for both. After a few moments, he opened his eyes, looked at me briefly and quietly said, "That's nice." She put her head down and started to cry. I kept watch over her and after a few moments, she looked at me and said, "That is beautiful". Then she closed her eyes, and both appeared to be taking the music in. After about 20 minutes, she went to him and stroked his head. He looked at her, still looking pained, and she asked if he was enjoying the music. He slowly nodded "Yes". He then seemed to ‘wake up’ a bit and was looking at the guitar as I continued playing. So, after a moment I quietly said to him, "So tell me, what music do you like? What makes you feel good?"

It sounded like he said... "Journey?"

"What?" I said, looking at her thinking I wasn't hearing him right.

She said, a bit coyly… "He likes Journey."

Okay... after a breath and a bit of a reset I started into a down-tempo version of Don't Stop Believin’. Both of their faces suddenly lit up. She said, "Oh my gosh... that's his favorite song!" And now, his eyes were opened all the way. She took his hand and was slowly moving to the music a bit next to him, with interspersed kisses on his head. He smiled and suddenly looked less pained. And for a moment it appeared as though he was... feeling okay? When I finished the song, she took his face in her hands, looked at him and sternly said "That's right dear, don't stop believing, don't. Never ever stop believing." They hugged. I just sat and enjoyed the moment.

Even when you are feeling so compromised - Music… A favorite song… Some joy… Something aesthetic... Some comfort…

The healing power of music…

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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Therapeutic Songwriting and… Foo Fighters

After a little over a year’s hiatus, and the tragic untimely death of drummer Taylor Hawkins last March, the Foo Fighters have made a comeback with a brand-new record, ‘But Here We Are’ (released on June 2, 2023). It’s a full-on rock record as only the Foos can deliver. But there’s something more about this one. It also seems to be front man and songwriter Dave Grohl’s full-on therapy session. As often is the case after tragedy, pain and loss… music. Most great music, art, creative outlet, often stems from pain and loss. Creativity is the ultimate form of coming to terms with grief, a release, an expression when words are just not enough. “We are creatures who are born to transform pain into beauty. Creativity is one way we respond to pain, by acknowledging it and attempting to turn it into art.” (Author Susan Cain in her great book ‘Bittersweet: How Sorrow and Longing Make Us Whole’ - which I seem to reference in every post or essay I write these days.)

Dave Grohl has now gone through this type of trauma and loss twice—previously as drummer of Nirvana when Kurt Cobain took his own life in 1994. Grohl has said that he thought, after Cobain’s death, that he would give up music entirely, however, after struggling for some time, he eventually found solace and healing in… music and songwriting. That is when Foo Fighters was born. So here he is again, using music and songwriting to heal. His previous artistic revelations about Cobain were rather subtle. Hidden phrases buried in songs, or a nod to his old pal that seemed to be more of an artistic aside. Not this time. On this new record, he lays it all out there front and center, bares his soul completely, almost as if the record were a recap of many therapy sessions. (Perhaps?) He seems to revel in the obvious and invites the world to share in his grief and healing process. It's almost as if this obvious expression keeps Taylor Hawkins’ spirit alive—a forever part of Foo Fighters. Forever close to Grohl. With the release of the new record, the band also introduced a new drummer (Josh Freese) and this summer are starting to tour again extensively. A tour that, no doubt, continues expressing feelings of grief and loss every night that these songs are performed. One song in particular, Under You, sets the entire tone.

I woke up and walked a million miles today I've been looking up and down for you All this time it still feels just like yesterday That I walked a million miles with you

Over it Think I'm gettin' over it There's no gettin' over it

There are times that I need someone There are times I feel like no one Sometimes I just don't know what to do There are days I can't remember There are days that last forever Someday I'll come out from under you Out from under you

Someone said I'll never see your face again Part of me just can't believe it's true Pictures of us sharing songs and cigarettes This is how I'll always picture you

Over it Think I'm gettin' over it There's no gettin' over it

There are times that I need someone There are times I feel like no one Sometimes I just don't know what to do There are days I can't remember There are days that last forever Someday I'll come out from under you Out from under you Out from under you

There are times I think it's over There are times I can't recover Sometimes I just don't know what to do There are days I can't remember There are days that last forever Someday I'll come out from under you Out from under you

Out from under you Out from under you Out from under you Out from under you

This is also why music, and songwriting in particular, can be so powerful in music therapy practice. The songwriting process lends itself to exploring what we are truly feeling inside, feelings that are buried and that we often cannot express with just words. Feelings we want to (need to) release. In the hospitals where I work as a music therapist, I’ve worked with many patients, in cancer care in particular, where songwriting helped them express and come to terms with their dark, inner feelings about a new diagnosis, going through grueling treatment, or coming to terms with their mortality. I’ve worked with groups of young adults at in-patient psychiatric units who were able to collectively write songs to help discover that they were not alone in what they were feeling and going through—an opening to moving forward and feeling less isolated. Songwriting is an ideal way to explore and release inner thoughts and feelings for either those who are suffering or those who are holding onto something that may ultimately need to be released. It’s the ultimate form of creative emotional expression.

Surely this process, writing and recording this record, has been a form of therapy for Dave Grohl. And for us, the audience, we get a real, organic expression of art (that also rocks) and a perfect example as to why art is the ultimate form of expression and release. This is why music, art, any creative outlet, works so well as therapy.

“The quest to transform pain into beauty is one of the great catalysts of artistic expression.” Leonard Cohen.

The healing power of music…

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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Music (art, aesthetics)… belongs

The scene: A hospital room in the intensive care unit. The patient is in the bed and on a ventilator, multiple IV lines connected to him, and all the bags of fluids and medications on a ‘tree’ next to the bed. He is being fed through a tube inserted into his nose. There is a large monitor with readings of his heart rate, respiratory rate and blood pressure… the beeping is soft, but you feel at the base of your brain. A white board on the wall lists medications and times and other charted numbers in bold back and bright red marker. Also present is a technician performing an echocardiogram, sitting at a mobile desk with a big monitor with various displays. The patient’s wife is quietly sitting in the corner in an industrial type chair… just staring off. The room is somewhat dark, gloomy, quiet with only sounds of mechanical ‘breathing’, the beeping from the monitor, and muffled and eerie ultrasound tones coming from the echo machine. There was one other element (seemingly out of place?)… Me and my guitar.

From the first strum, the mood of the room started transforming. As the music started progressing, it gradually overtook the dreary antiseptic feel of the surroundings. The tones of the machines were now (purposefully) within the melodic structure, the key, of the music. And the heart rate rhythm acted as a metronome, syncing with the music’s tempo (again, purposefully). – The music changed everything.

Now: The nurse frantically came in to check on meds but slowed to give me a soft smile. You could see her shoulders drop as she let out a breath and subtly rolled her head from side to side. The technician occasionally glanced over at me and smiled while performing his task. The patient’s wife sat back in her chair and closed her eyes. She let out a sigh as her face softened. And… the patient’s heart rate slowly decreased, perhaps following the (purposeful) ‘ritardando’ (gradual slowing) of the music. [The heart rate and/or the respiratory rate will often sync or entrain with the rhythm of the music. When the music is slowly decreased in tempo, the heart rate and/or the respiratory rate will often follow, prompting a relaxation response.] The entire mood of the room changed.

From the outside, it may have looked as if something in this scenario did not belong. But on the inside, it (the music) made a difference for all involved. Music (art, aesthetics)… makes a difference. Music (art, aesthetics)… belongs.

The healing power of music…

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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Music Therapy and… Sleep

We all know how important sleep is in healing, recovery and wellness. Good sleep is one of the most important ways to reset, refocus and replenish. With sleep being so important in every aspect of good health and healing, why is it so hard to get good sleep in the hospital? The noise from the monitors, various hospital staff interrupting sleep at all hours (although, for good reasons) and just being out of sorts from the environment all lead to interrupted sleep. Sleep is essential, yet when we need it most, while in the hospital, it can be very difficult. As a music therapist working in a medical setting, when I can help patients sleep, that’s a good thing. Recently, throughout a few hours on the oncology unit, I was able to help 3 patients move towards a sleep state… with music (and some relaxation techniques).

First there was the woman, in her 30s, who’s nurse asked me to visit because of anxiety and pain (she could not give more meds for some time). This patient also has cerebral palsy and has very limited movement capacity, which may exacerbate her pain. When I entered her room, her face told the entire story… pain—in her abdomen area as a result of surgery. As I started in on the guitar with a meditative soundscape, I simply said, “Focus on the music… let the music take you away for a bit.” I was imagining the music enveloping her, like a big blanket. It took her a while to settle but soon… she was sleeping.

Next there was the woman, in her 40s, with throat cancer. She was dealing with significant pain and some issues with confusion, seemingly from powerful medications. She was aware of my presence when I greeted her and was able to tell me that she was in “constant pain” (the kind that you can’t imagine unless you experience it.) She also looked exhausted and quite anxious. I told her I was going to give her some music and she gave a slight nod. I started with some dissonance and tension on the guitar, trying to match the music to what her pain and anxiety may have felt like… entraining to her overall aura. As we started to progress, the minor modes slowly modulated to major, the dissonance moved to more harmonic themes. I was working to guide her with the music… guide her towards some relief. When she started to seemingly come along, I occasionally coached her on some focused and deeper breathing. After about 45 minutes… she was soundly sleeping.

Finally, the gentleman, in his 60s, also dealing with pain as a result of advanced stomach cancer. He and his wife were both very pleasant and welcoming, but both looked exhausted. In conversation there appeared to be a real fear of the unknown (for both) which seemed to add some anxiety. Again, “Let the music take you away for a bit… give you a little break.” Over the soundscape, which incorporated some elements of Beatles songs (his favorite) I introduced some guided imagery, encouraging him to “think of a place in your mind where you feel very comfortable and at ease… Any place… A beach? The mountains? Someplace at home?... Focus… Go there in your mind…” His affect slowly softened. His breathing became a little deeper. And he seemed to fall asleep. He and his wife were holding hands and his relief seemed to help her too. As the music concluded, after a few moments he slowly opened his eyes. “I felt like I was in a big open field. It was warm. It was open. In here, sometimes it all feels closed in. But everything was open.” Then… “Will you be able to come back again?”

The constant here was music. Live, improvised and purposeful music that I was providing on the guitar. When the pain and the anxiety are this heighted, I’m not sure recorded music would have been as effective. (Sure, at home listening to soothing music, or whatever music works for you, certainly can help you relax after a long day, or help you fall asleep. I listen to classical music every night at bedtime. But in the oncology unit, another level is needed.) The music was unique and different for each situation—soothing soundscape, tension and release, the incorporation of music preferences—all working towards the same goals… relaxation and comfort. The music was dynamic, it was fluid, it changed in mode and feel and tempo and rhythm, providing what was needed in the moment. (This can’t be done with recorded music.) The music helped meet them where they were, and then guided them towards a more comfortable place.

And yes, there was some occasional verbal guidance, but… the driving force was the music, live and individualized in the moment. Music therapy in the hospital, as a clinical practice, can help in many ways, and one of the most effective and important is to help promote… sleep.

The healing power of music…

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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Music changes everything

She’s in her 50s and just had a stroke. She was sitting in the chair just staring at the floor. Her daughter was sitting on the other side of the room. When I introduced myself and told her why I was there (the music therapy referral was to help with her anxiety and concerns of her being withdrawn), she looked very apprehensive. “I’m… just… not feeling well. I’m… tired.” “Let’s just try,” I said. “Let’s just try some music. Just something different to focus on. Just listen… and breathe.” She continued to stare off. But her daughter said, “Yes, let’s try. That sounds nice.” When I started to play, something soothing on guitar, her daughter went to her, took some lotion and started massaging her hands, her arms… slowly… gently. She rubbed her neck and shoulders. Her face softened and she looked at her daughter so lovingly. It was a beautiful shared moment between mother and daughter—and music. Music creates connections.

She’s in her 60s and was just moved to in-patient hospice care. When I walked into the room, she was in bed, looking very weak and seemingly close to the end. She was surrounded by her two daughters and her granddaughter. They were all very welcoming of having me there to provide some music for comfort. As I usually do, I gave some soothing soundscape, some comfort, on the guitar. As I played, they all seemed to be using the music for both comfort and reflection, as there was also some light emotion expressed. After about 20 minutes, at a natural break in the music, one of her daughters asked if I knew “any Elton John. It’s her favorite.” I played and sang Your Song. During the song, (which they told me afterwards is her favorite) the granddaughter became very emotional. She was comforted by her mother, who indicated to me that it was okay to keep going with the song. It was… a very emotional and powerful moment for all of us. Obviously, she is very close to her grandmother. When the song ended, there was a few moments of silence (other than the granddaughter’s crying.) But then, the granddaughter suddenly got up, went over to a vase of flowers that was on the windowsill, and took out a single rose. She walked over and handed it to me. She said, through her tears, “I want you to have this because now I know that everything is going to be okay.” Music comforts and helps bring resolve.

Music changes everything. 

The healing power of music…

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

[rleonemusic]

When there is nothing left… we still have music

When there is nothing left… we still have music.

When there are no more words… we have music.

When we can’t figure out what we are feeling inside… we have music to help.

When we are sad, melancholy or feeling alone… we have music to support and to empathize.

When we need a boost… we have music.

When we lose love/When we find love… we have music.

When the mind deteriorates, and we begin to lose ourselves… music can help bring us back.

When we need peace/When we need chaos… we have music.

When her nurse felt as though her hands were tied and didn’t know what else to do, she called me. She’s in her 90s. On ‘in-patient’ hospice care and very close to the end. She is alone. “Can you help? Can you give her some music?” And like I’ve done many times, I went into the quiet, dark room, sat next to the bed, and gave her… music. She looked… ready. Her eyes were closed and her breathing was very shallow. She did not look like she was in pain. I took out my guitar… and I played. I gave some soothing soundscape to start. Comfort. Music to hold her in this moment, like a warm blanket. And as I played, although I hadn’t met her prior—we had never spoken a word to each other—I felt connected to her. I felt close to her. The moment was very intimate… her in the bed (almost ready) and me sitting there with her, providing music. I eventually worked my way to Somewhere Over the Rainbow, and softly sang… like a lullaby. And then it happened. I sensed it. I felt it. She took her final breath. At first, I didn’t know what to do. But lucky for me… I had music. So I finished the song. A final encore. The closing credits. Before I went to get her nurse, I just sat for a moment… in an unusual solitude. The room felt… peaceful. I felt a little sad. I felt a little overwhelmed. I felt very honored. I was glad that she did not die alone. I was glad that there was music… for both of us.

When there is nothing left… we still have music.

“If happy little bluebirds fly

Beyond the rainbow

Why, oh why can’t I.”

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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Yep… your body is like a symphony orchestra

Why music? Why music therapy in a hospital setting? Well... our bodies work like music—our heart beats in rhythm, we breathe in rhythm, we walk in rhythm—and, just like in music, if the rhythm is off, everything is off. We want to feel ‘in-tune’. We want ‘harmony’ in our lives. Just like music. And if one part of our body is off, or ‘out of tune’ (pain or an injury, an ailment or disease, psychological distress) our entire body is off. It’s just like, if one oboe is out of tune, the entire symphony orchestra is off. Yep… your body is like a symphony orchestra.

In music therapy, we use the inherent elements in music to work with the body and the mind.

Great music creates tension and release. The orchestra swells in crescendoing dissonance, taking you to the breaking point, only to finally collectively resolve in harmonic bliss. Or, a powerful song just brings you to the edge, encasing you in its grips—holding onto the dominant chord… holding… pushing… and then finally… resolving on the tonic (the foundation). And when the tension resolves, that’s when you get the “chill factor”, when you literally feel the music and the hairs on your arms stand on end. Oftentimes, minor chords (darker sounding) creates the tension and major chords (brighter sounding) brings the release. When working with pain, I may use minor/major patterns to help create tension and prompt release in the body. I may have the patient breathe in on the minor chord (Em), imagining the breath going into the body and washing over the pain, and then exhale on the major chord (E), imagining the release, or some of the pain floating away with the exhale. The music purposefully creates tension, but more importantly… release in the body. Using the inherent elements in music to help release the pain.

Then there’s ‘entrainment’. Entrainment occurs when body rhythms synchronize with the music to produce a desired response. It’s like, when you are walking through Target and Stayin’ Alive is playing overhead. Without realizing it, you are soon walking right in sync with the rhythm. (And you may even feel a little like Tony Manero walking through Manhattan on a Saturday night.) A music therapist may use entrainment and rhythm to work on gait issues with a Parkinson’s patient. After assessing and finding the right tempo and song, the patient may soon be walking more steadily with the music, entraining to the rhythms. (And, perhaps also feeling a little like Tony Manero.)

I do a lot of work in critical care in the hospitals where I work as a music therapist. And I work with patients on mechanical ventilation, using music to help reduce their anxiety and pain. Since the patient on the vent cannot speak, (because of the breathing tube inserted in their windpipe) how can we tell if they are anxious? Again, we can look at the rhythms of the body. One indication may be their heart rate. If their heart rate is high, something over 100 bpm, that may be an indication. (There are also scales and tools that critical care nurses use to assess pain and anxiety in vented patients.) One way to help reduce their anxiety and pain is to give more medications. But they are usually already quite medicated, with strong sedating drugs. And we know that the more drugs given, the longer it could take to get them off of the vent, which can then cause more long-term issues. Fortunately, medical teams are now looking at more non-pharmacological means to help their patients… like music therapy. How can music therapy help? Again - using the inherent elements in music to work with the body. Rhythm. Entrainment. The patient’s heart rate monitor becomes like a metronome (a tool that produces a steady beat.) So, when I initiate a music experience to help reduce anxiety, their heart rate is my starting tempo. I match the music’s tempo to their heart rate (or, in some cases their respiratory rate.) Once the music and their heart rate are in sync, or entrained, I will gradually start to decrease the tempo of the music. And oftentimes… the heart rate will follow. Over 30 minutes, give or take, we can often take a heart rate from somewhere over 100 bpm down into the 80s. [And the music… Sometimes I’m just improvising and creating on the guitar. I may even include some light, purposeful tension to start and as the tempo decreases, the tension gradually moves to more soothing and harmonic themes. I may also incorporate structured songs if I can find out from family members what the patient’s music preferences are. I’ve used Elvis, Frank Sinatra, Green Day, (adding humming or singing) all working with entrainment and rhythm and heart rate and respiratory rate. And I never assume music preferences. If I don’t know, I will stay with improvisation.] This is entrainment. This cannot be done with recorded music, and this is why music therapists use ‘live’ music. [Although, there are many other times that music therapists will and do use recorded music.] The music can be changed and manipulated, in the moment, to help meet the immediate needs of the patient.

Music therapy is an evidenced based practice, meaning that there is research showing and backing up these (and many other) techniques and interventions. Music therapists are trained clinicians. There is education, field training and board certification. Music therapists are clinicians first, who happen to use music as their tool to help prompt or promote change.

Speaking of research, I was part of a music therapy study that was just published in the American Journal of Critical Care, a prominent medical journal. This study took place in the ICU at one of the hospitals where I work. The study was a randomized control trial that looked at the effects of music therapy on pain, agitation and vital signs in mechanically ventilated patients. The study showed a significant reduction in pain, agitation and heart rate in the music therapy group compared to the non-music therapy group. You can find more information here:

https://aacnjournals.org/ajcconline/article-abstract/32/2/109/31983/Receptive-Music-Therapy-for-Patients-Receiving?redirectedFrom=fulltext&fbclid=IwAR2GKS9oHP3ceicNJ9mpIPsRec7Dbs7bG4AzQJIGV5QkG5Bjrd8Vq1JT5qA

So… why music therapy? Our bodies work like music. Our bodies entrain to music. Music therapy uses the inherent elements in music to work with the body and the mind. Your body is like a symphony orchestra. And when every instrument is in sync and in tune… there is harmony. You can literally feel it. And don’t we all want more harmony in our lives?

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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Music to say “hello” again… and music to say “goodbye”

One of the most interesting aspects of working as a music therapist in a medical setting is not knowing who I am going to see, or what I may face on any given day. What I do know is that music can be a very powerful experience in the hospital... on any given day. Music can help reduce stress and anxiety, music can be a voice for emotional expression, music can create a soundscape of comfort at the end of life and music can empower and help celebrate the small steps towards healing. On a recent morning I saw two patients that covered the opposite ends of the spectrum.

The first patient I saw was a woman in her early 60s who was in the ICU recovering from a recent cardiac event. I had seen her a few days prior, providing music for stress reduction and relaxation, as she was working to recover. But now she was sitting up in a chair and she smiled warmly when I peeked in to say “hello” and check in on her. When I asked her how she was doing she said, “Much better! I’m getting stronger and I’m ready to move on!” She was smiling and happy and we used music to celebrate her new lease on life. We jubilantly sang, Don’t Stop (Fleetwood Mac) and I Won’t Back Down (Tom Petty) among a few others. She was smiling, singing and her face showed relief and exhilaration. How great it is to celebrate “feeling better” with someone in the hospital! This story had a happy ending.

After seeing her I was asked to visit with a woman, and her husband, in the oncology unit--a case with a very different feel. She was in her late 40s and had battled ovarian cancer several years ago. But she got through it, and everything was going well. However, suddenly out of the blue she started to feel increasing unbearable pain. When she came to the hospital earlier in the week, she was told that the cancer had returned and was now spreading rapidly all over her body. She was declining fast. This all happened within a few days and her prognosis was not good. This week changed everything for her. They were now suggesting “home hospice”. She was very afraid and worried about her children. And the look on her husband’s face showed how blindsided he was with all of this. I was asked to visit with her and husband while they were waiting to take her home. When I entered the room, it was dark and quiet. He was sitting next to the bed holding her hand. I told them why I was there and offered some music… for comfort. He shook his head, “yes.” When I started on the guitar… he started weeping. [When there is so much tension, music can prompt a release, a cathartic moment.] I gave them some music for emotional outlet, adding dissonance into my playing, working to create tension and then release within the soundscape. And I also gave some music to ‘hold’ them, like a comforting blanket, now with some grounding and resolve. After several minutes, she looked directly into my eyes (for the first time) and as I held her gaze, without even thinking I started humming along with the guitar accompaniment, trying to soothe and comfort, like what you may do with a frightened child. And for a few moments it felt oddly… peaceful. When I finished, I stood to leave and nodded “goodbye.” Her husband walked right over and embraced me and he whispered in my ear, “thank you so much.” I was honored to have been able to share music and spend some time with them.

In just a few hours, music celebrated life and music supported an unexpected impending loss. As the day went on, many other situations arose, and it just goes to show--music can be whatever is needed in the moment. And that is why music therapy can be so profound and powerful in a hospital setting.

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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Craft vs. Creativity

Classical musicians, more than any others (imo) strive for perfection. They work long and hard on their craft. When you listen to a top-notch symphony orchestra perform the great works of the classical repertoire, it’s as close to perfection as you can get. Every note, every run, every dynamic, every silence—perfection. When I hear a solo line, during a symphonic performance, say, an oboe or trumpet, the player so exposed, I can almost feel my own stress level and blood pressure rising, wondering what they must be going through, and the pressure involved, to be… perfect. It’s kind of like Lebron James, at the free-throw line during the NBA finals, his team down by one point with one second left. Thousands of screaming fans. Millions more watching on TV… he cold-bloodily sinks both shots. Lakers win! Practice. Dedication. Mental toughness. (Athleticism.) Thousands of free-throws in the gym after practice. Hours and years of practicing and perfecting Bach note for note. Honing… craft. (And let me just say… I can’t do that.)

Is that ‘creativity’?

The definition of creativity: “The use of the imagination or original ideas, especially in the production of artistic work.”

Well… Bach certainly used his imagination and had an original idea when he composed his infamous Cello Suites. Creativity… right? Yo Yo Ma can play them to near perfection. I imagine that he spent many, many hours practicing those pieces, let alone a lifetime of practicing and honing his skills on his instrument. Craft? Well, there’s certainly interpretation, passion, feeling, emotion and expression in his performance of that work. You can feel it. And that is what separates him from all of the others working to perfect that music. Creativity? Is Yo Yo Ma’s command of the Bach cello suites more craft than creativity? Equal parts? Some combination?

And then there’s Eric Alexander, a monster jazz saxophonist with mad improvisational skills. I saw him perform a while back at a small jazz club in NYC. And to watch, listen and experience him create, improvise organically, in the moment was mind blowing. Creativity? For sure.

So… is jazz more ‘creativity’ and classical music more ‘craft’? Don’t come at me classical musicians (or jazz musicians)… I’m just throwing this question out there. Food for thought.

Obviously, it’s not that simple. And just like the Nature vs. Nurture debate, it’s really some combination of both. I’m certain that Eric Alexander has spent hours and years practicing and perfecting the ‘craft’ of his instrument. And I don’t think Yo Yo Ma became who he is just because he practiced more than everyone else. But, creating in the moment is certainly different than, say, playing Bach note for note, as written. There is no room for error in playing the Bach cello suites. Is there more room for error in jazz? Miles Davis famously once said “If I play a wrong note, I’ll just play it again and then it’s not wrong anymore.” Well… I don’t think you can do that when performing Elgar’s Cello Concerto in E minor.

What I think is, you need both. The creativity fuels the craft. And the craft is needed to express the creativity at a high level. A professional level. There is always some of both involved. And ultimately, it’s those who are most creative AND most dedicated to the craft that are the most successful.

I also believe that everyone is creative in some way. It’s just, how much do you allow yourself to tap into it? And really, how much do you believe it? And I also believe that you can be creative without the craft.

When we look at music therapy, or any arts-based therapy, it’s all about the creative element. The work of the music therapist is to help one tap into their own creativity, regardless of skill or ability, to help promote change. To use music (or art) to help express feelings that words can’t describe. Or to communicate with others, through drumming or instrument play. In the right environment, you can certainly understand what a non-verbal, autistic person is feeling by how they are creatively improvising on a piano (or other instruments) with their music therapist. It’s the innate creativity in all of us that makes music therapy (and all the creative arts therapies) work. Part of the music therapists’ job is to bring the craft, and show that you are creative, as well as providing a safe space for expressing oneself creatively. And sometimes (more than not) the music is really good!

So, back to the question… How much craft and how much creativity? Does one artform or genre skew more one way than another? Did Miles Davis really play ‘wrong’ notes? Can Eric Alexander play Bach and can Yo Yo Ma improvise over jazz progressions? Who would win a one-on-one basketball game between Eric Alexander and Yo Yo Ma? And where does screamo metal fit in?

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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Performing CCR

When being hospitalized as a result of a debilitating disease, or an admission to an Intensive Care Unit (ICU) and being put on a ventilator, you immediately lose all ‘sense of self’. You lose a sense of one’s own humanity. Every part of you is immediately given over to the medical team. I, fortunately, haven’t experienced this first-hand but I see it (and indirectly feel it) every day in the patients I work with as a music therapist. There is so much work being done on the body—well, after all, the body is broken (and the medical teams that I work with are unbelievably gifted at what they do.) But there is not a lot of work on the emotional toll, the ‘sense of self’ or sense of restoring one’s humanity. When I share music with someone who is suffering in the hospital—and mourning a loss of humanity—after all this time I still can’t really explain what it is about music. Is it the feelings and emotions elicited? The connections created? Or simply the aesthetic experience that helps bring back a sense of self, a restoration of humanity. And, as I’ve said before, I’m really just a conduit, a facilitator that helps prompt the music to take over and connect the body, the mind, and the soul.

The gentleman that I visited recently, who had an ‘unexplained cardiac incident’, had been on a ventilator for several days and was now continuing being monitored in the ICU—still very weak. He still needed help with his breathing. When I walked in to see him, he just seemed lost. His body was frail, but worse, his eyes showed an uncertainty... a loss of any sense of self. He was, in the moment, a ‘critical care patient’, hooked up to beeping monitors, oxygen flow, and at the mercy of the staff to do anything. A total loss of his humanity. And then there’s me. When I’m about to walk into an ICU room with a guitar, I still have an underlying feeling of apprehension. A feeling of… ‘What can I do? How can I possibly help this person?’ Well… I gave him CCR. (Creedence Clearwater Revival)

After he quietly told me about his hospital stay—the vent… the pain… contemplating mortality—I just simply started to ‘talk’ with him. “So, where are you from? Where did you grow up?” At first, he looked at me strangely, like, ‘No one’s asked me that since I’ve been here. What does that have to do with my oxygenation levels or EKG scans?’ And when the conversation turned to music… a change. I could now start to see the real person behind the gown, the nasal cannula, and the IV lines. I could start to see… him. “Ahh… music,” he said. And suddenly his face didn’t look so hard. Suddenly, he looked like… a real person. And as he reminisced, his eyes kind of brightened from the inside (like ‘life’ was coming back.) “Oh man… we used to drive around in my friend’s old beat-up VW bug, a real clunker, after school, roll down the windows and crank up CCR.” Then he told me about meeting his wife, making her go to a CCR concert with him and his friends, worrying that was going to be their first and only date. He laughed… (in an ICU room.) And I noticed that his voice was a little stronger and his breathing a little less labored. When I took out the guitar and played and sang Have You Ever Seen Rain (Creedence Clearwater Revival), he seemed to drift further into a world of memories. He seemed to drift further into his real self.

https://youtu.be/phBBeD5Pxb0

After a few more songs and a little more conversation, as I was packing up to leave, he took my hand and said, “Thank you for coming… really, thank you for…” He couldn’t find the words, but I knew what he was saying. I knew what he meant. [Humanity.]

Like nothing else, music connects. Music connects us to others, to memories, to feelings and emotions, but most importantly, music connects us to ourselves. We are all defined by the music we love. Music therapy in a hospital setting, above all else, helps to restore our true sense of self. Our true feelings of humanity. And I’m always honored to be a part of it. Especially when it’s CCR…

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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“You realize, that is the last music she will ever hear.”

“You realize, that is the last music she will ever hear.” That is what a gentleman said to me after a music therapy session with his mother… who was actively dying. That was 5 years ago. And it stuck with me. I often get music therapy referrals, at the hospitals where I work, for patients at the end of life. And when I am alone with a dying patient, providing music for comfort and transition, it is so intimate and, perhaps, the most organically powerful of all the work I do. And even though they are ‘non-respondent’ [perhaps with labored breathing but comfortable. When patients are put on ‘comfort-care’, the medical team’s goal is than to make sure they are not in pain or suffering] I feel so connected to them. And I always assume that they are ‘experiencing’ the music in some way. Always. And I believe it. Always. Occasionally there are little signs that they are (see below.)

The music -  Many times, I’m simply providing a comforting soundscape. If I know music preferences or favorite or meaningful songs, I will incorporate them into the continuum of music, sometimes humming the melody, sometimes softly singing. Again, I feel the connection… I just ‘know’ what to provide in the moment.

Just this week I was asked to visit with a dying patient, an older woman. Her nurse was so concerned (and a little emotional, yes, nurses, certainly the one’s I know, are unbelievably compassionate) that she was alone. And the scenario is constant. Dark room, patient in bed under a blanket that either a family member brought or was donated. Quiet, with just the slight sound of shallow, stagnate breathing. I always sit for a moment before I take out my guitar. And then… I played. I started with some comforting soundscape and eventually moved to some structured songs. I immediately felt connected to her (even though she didn’t move or show any change in facial expression.) Because of her age, and just a feeling I got, I eventually merged into a down-tempo, ‘lullaby’ version of Can’t Help Falling in Love, humming the first verse, then softly singing the rest. Suddenly… she opened her eyes very briefly and lifted her hand up towards the ceiling, as if reaching for something. (Or someone?) And then, back to where she was, eyes closed, non-respondent. I almost froze (but fortunately, kept the music going.) It was so quick that, in the moment, I wasn’t sure if I was imaging it. I wasn’t. And I felt, even more so, that this was a dynamic scenario. (Something like this doesn’t usually happen. But this wasn’t the first time.) As my heart rate settled back a bit, I continued…

Yes, there is sadness. Someone is dying after all. And yes, this is emotional work. But what helps me is the honor that I feel after these sessions. (“You realize, that is the last music she will ever hear.”) And the connection and intimacy that is like nothing else I experience. This is a whole other level. And in a weird way, I’m comforted after I leave as well. Comforted that I could provide music (and yes, here I really do just feel like a conduit)… music that I know gets through, to comfort, to help honor life and to help transition to what comes next. This is the most meaningful work I do. When else is music this powerful? And as I often say… when there is nothing left, we still have music.

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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A New Year - Could be. Who knows…

Here we are… a new year! So much to look forward to. To change. To make better. A time for new beginnings… a time for hope! Yeah, I know. A lot of pressure. No one keeps resolutions. No one can live up to the idea of reinventing oneself on a yearly basis. No one transforms into The Rock (well…) or becomes vegan into February when there is barbeque at the Super Bowl party. And Dry January? Right… And while there are lots of songs about new beginnings (I Can See Clearly Now, Here Comes the Sun, Brand New Day) and about hope (Don’t Stop, Imagine, Man in the Mirror), maybe sometimes we just have to embrace the unknown. Embrace what may be coming--whatever that may be. So, my song as I prep for 2023 is Something’s Coming (West Side Story).

How did I get here? How did I get to the idea of embracing the unknown? Let me tell you about Maria*. Maria is one of the last patients I visited this year and shared music with at the hospital where I work as a music therapist. Maria is quite ill, but she had this interesting air about her. She wasn’t fully down. She wasn’t really “hopeful” or showing an ‘I’ll fight to the end’ attitude. She was a little gruff but not in a bad way. She just seemed to embrace the unknown. When I asked her how she was doing she said, “Right now… good. I’m sitting here talking to you.” When I asked her how she was handling things she matter-of-factly said, “It is what it is. Maybe I’ll live to be 100 or maybe I’ll die tomorrow. One thing I do know is, something will happen. I don’t know what. And whatever it is… is what it is.” She wasn’t too up and she wasn’t too down. And for right now, just like she said, she seemed… good. There was a unique, unpretentious calm about her that I immediately admired. After some silence, she said, “Well, you brought a guitar. It won’t play itself now will it.” (Did I mention, a little gruff?) So, I asked her about music. What she liked, or better yet, what she was feeling right now in this moment. She thought for a moment and then she said, “You know that song from ‘West Side Story’ about who knows? Could be? I thought for a moment… “Something’s Coming?” She pointed at me and said, “That’s what I’m feeling.” I pulled it up and gave her perhaps the first acoustic rock version of Tony’s soliloquy:

Could be, who knows? There's something due any day I will know right away, soon as it shows It may come cannonballing down through the sky Gleam in its eye, bright as a rose

Who knows? It's only just out of reach Down the block, on a beach, under a tree I got a feeling there's a miracle due Gonna come true, coming to me

Could it be? Yes, it could Something’s coming, something good, if I can wait Something’s coming, I don't know what it is But it is gonna be great

With a click, with a shock Phone'll jingle, door'll knock, open the latch Something’s coming, don't know when But it's soon, catch the moon, one-handed catch

Around the corner Or whistling down the river Come on, deliver to me Will it be? Yes, it will Maybe just by holding still, it'll be there

Come on, something, come on in, don't be shy Meet a guy, pull up a chair, the air is humming And something great is coming Who knows? It's only just out of reach Down the block, on a beach, maybe tonight

Maybe tonight, maybe tonight

After I finished, she looked like she was in thought, or pondering something. Finally, I asked, “What are you thinking about?” She immediately said… “You.” With surprise I said, “Me? What about me?” “That’s your song too. That is your song for the new year coming. I sense something about you. Seems like you need… something. Something’s coming for you. I don’t know what it is but… then she sang the first line – “Could be. Who knows?” and smiled. I think it was the first time that she smiled. I was, admittedly a little thrown (It’s no real secret that I’ve had some challenges in my life recently) and didn’t really know what to say. It usually takes a lot to throw me off my game when working with patients in the hospital. So, after a long pause I finally just said. “You okay?” This time she smiled a very nurturing smile when she said, “Right now… good. I’m sitting here talking to you.”

There’s no doubt that I connect with people on another level when sharing music with them in the hospital. And even take on some of their feelings, sorrow and joy. Everything is ‘heightened’ in the music--the emotion of the moment. Music does that, it connects us as we share on another level. But this was… different. This was her, perhaps, ‘reading’ me on some other level? I’m not one to embrace fate of ‘meeting someone’ or being ‘put in a place at the right time’ when needed, but her words stuck with me. And still do as I’m sitting here writing this. And now I just cannot get this song, these lyrics, out of my head. If someone would have asked me a few days ago, “What is your song for the new year?” there would have been about a thousand that I would have said before this one. But here I am…

No resolutions for me this year. No radical changes. (I’m not becoming vegan until the Super Bowl.) I’m just embracing what may be coming. Whatever that may be. Okay 2023, I’m ready to see what you’ve got for me! Could be. Who knows? There’s something due any day, I will know right away, soon as it shows…

Happy New Year!! Will you simply embrace the unknown when the clock strikes midnight? Whatever it may be? What is your song for 2023?

The healing power of music…

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

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What I want for Christmas (A personal reflection)

Well… here we are. The holiday season. The “most wonderful time of the year.” As we take it all in, embrace the festive atmosphere or just go through the motions, we all seem to reflect a bit on where we are and where we are going. It’s certainly a time for gratitude and to be thankful for those that we hold close to us in our lives as we anticipate the excitement of the season. But there are also feelings of loneliness, sadness, sorrow for what may be lost, or longing for what may be just out of reach. Working as a music therapist in a hospital setting, I see (and experience) the full spectrum of emotions this time of year. It's never a good time to be in the hospital, but during the holiday season emotions are enhanced ten-fold. Music can be a great salve, bringing comfort, joy, a renewed sense of self and connection to those who need it. But it (especially Christmas music) can also remind us of our sadness or loss or longing. [I never play Christmas music when working with patients in the hospital unless they specifically request it.] Just this week an older woman in the ICU asked if I would play and sing Rockin’ Around the Christmas Tree because “Christmas music makes me happy regardless of what is happening.” It brought her comfort during a trying time. In visiting another patient later in the day in the oncology unit, as I took out my guitar her face looked pained as she said, “Please, no Christmas music. I just can’t…” I understand both sides. I always feel, in some way, all of the emotions that the people I work with feel when we share music together so this time of year, my emotions are always heightened a bit too.

However, this year, like so many of the patients that I work with, a few people in my life have become the ‘patient’, dealing with medical and possibly life-changing challenges. And I now find myself somewhat in the role of ‘caregiver’, now experiencing all of the emotions from the other side. So, I too am certainly feeling the dichotomy of the season. And the music… even more powerful from this perspective. Sometimes I will hear a holiday song and feel comforted as a nice memory was prompted, but other times, well, I just want to scream and run away. But mostly what I’m feeling more of, as I’m navigating all of my current challenges, is loneliness. Like… I’m on an island. Alone. (And not for lack of the support that I have from family and friends.)

But in reflecting on it all as I write this, there are two things I’m realizing:

- We need each other. It sounds so cliché, (and so obvious, I know) but you just don’t know what people are going through, if they are hurting, or are lonely. I’m seeing it all through a different lens right now. We really do need each other. I thought I could tough all of this out on my own, not be a burden to others, but after sitting with a dear friend the other night I realized what I really need is connection. Some connection. More human connection. (And how much I cherish this dear friend.)

- How much we need--and the unbelievable power of--music and the arts when we are hurting. (What I, obviously, already know as I am literally practicing what I preach.) Like nothing else, music gives us what we need when we need it. When I need to sit in solitude and just feel what I’m feeling, I can sit with Samuel Barber’s Adagio for Strings or when I need some escape, empowerment or the attitude of f*ck it all, there’s Foo Fighters Wasting Light album (full volume.) Music is always there for me and always gives me what I need. I’ve also realized how little I actually ‘use’ music for myself, for my own self-care and well-being. Again, practice what you preach Ray.

And there is no doubt that we naturally turn to music (and the arts) when we are hurting, or in need. That is how most of the greatest works have been created. Think Beethoven, Billie Holiday, Leonard Cohen, Green Day, Lucinda Williams, Charlie Parker, the list goes on and on and on. In her book Bittersweet: How Sorrow and Longing Make Us Whole (one of my new favorite books that I keep going back to) author Susan Cain talks a lot about music and art as a means of embracing our sorrows and feelings of longing. And that we should embrace and not ignore those feelings.

“Bittersweetness shows us how to respond to pain: by acknowledging it, and attempting to turn it into art, the way musicians do, or healing, or innovation, or anything else that nourishes the soul. A moonlit sonata can be therapeutic for people experiencing loss or depression; it can help us to accept negative emotions rather than ignoring or repressing them; it can show us that we’re not alone in our sorrows.”

So… what do I want for Christmas this year? Certainly, peace and comfort for my loved ones who are suffering right now. But what I really want is to not feel like I’m alone. I want connection. Or more connection. (Not easy for me to admit but there… I said it.) I want to be a part of something more, something bigger, and to get off of the ‘island’ that I’ve been feeling like I’m stranded on lately. I want music and art for myself (which will ultimately help me help others.) This time of year can certainly be challenging. How can we help each other? Maybe a quick call or text just to check in and say, “How are you doing?” It can do wonders. (I know. It did for me today.) I’m okay. I will get through it (because I have support.) I am also grateful, for my family and for my friends, for my job and the music that I get to share with others that hopefully brings them some comfort. I will admit, I do like seeing holiday lights (and don’t mind when people keep them up until March!) Christmas cookies. Christmas ale! Gifts! And speaking of gifts, I also want a set of nice martini glasses, Miles Davis’ Sketches of Spain on vinyl, Books and more books. Oh… and for Norah Jones to sing me a song.

Happy holidays to you and yours (and I’m here for you if you need me.)

Ray

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System

[rleonemusic]

I am thankful for music...

I am thankful for music.

I am thankful that music heals.

I am thankful for the human connection that music creates.

I am thankful that music can help bring some comfort to those who are hurting.

I am thankful for all of those whom I’ve gotten to meet and share music with.

I am thankful that I’ve been able to share music with those who are no longer here. Especially Christy*, whom I had the privilege to have gotten to know and work with. Through all of the tears and pain you always said that the music made you “feel soft.” (Your way of saying it was comforting, I think.) I could see how hard and painful the last few months were for you. I only hope that I was able to bring you a little comfort. I’ll miss our time together but am thankful for it too.

I am thankful that music can bring hope and a sense of joy.

I am thankful that music can empower and motivate.

I am thankful that music can “heal my soul.”

From a woman who had been in the hospital for several weeks whom I was honored to work with:

“I really needed that today. I really needed something… different. Here in the hospital, it’s just not like being a whole person. The music… I feel it deep inside. It heals my soul. I realized that nothing is healing my soul when I’m here. And when my soul is healed, my body will be ready to heal too.”

I am thankful for my Van Halen records, Foo Fighters playlists, the classical music I listen to when falling asleep, discovering new artists such as Ibrahim Maalouf, that I can stream WXPN (especially in the mornings) and WFUV, the clips that Emma sends me of her singing, going to see the National Symphony Orchestra and Green Day with my son, listening to Miles Davis when needing inspiration and listening to Metallica when I need to let it all go, that I finally got to see a Beatle (Paul McCartney) live in concert, Sara Bareilles, that I can still sing Che (Evita), that my videos on Facebook makes my mom smile, for all of my guitars and the ones I’ve yet to get! (Hello Gretsch!) And, that I get to bring music--and a little relief--to help those who are hurting and suffering. I learn so much from those with whom I work, not just about music, but also about living for today. Oh… and for Norah Jones (and that one day she will sing me a song.)

I am thankful that music heals.

I am thankful for music.

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is director of Medical Music Therapy at A Place To Be and the Inova Health System