Last year I studied music psychology. This particular stream was part of the reason I pursued music at tertiary level, yet I left its exploration until the very end of my degree. With subject matter so close to home, I was concerned about opening up wounds that I had worked so hard to heal. I desperately wanted to understand why grief affects us as it does and to source a paradigm for music healing that occurred for me, organically.
The subject's main assignment required us to disclose a personal situation in which music had made an impact, and to research therapeutic applications and possibilities for research expansion. I must admit, I initially toyed with the idea of making something up but part of me wanted to celebrate the victory of transition. It was my last challenge in this season of life. My soul had transitioned from a heart broken, depressed, lonely and helpless little girl to a confident and free woman.
Without my mother's death, I would not have had cause to walk through this valley and would not know the freedom that is available in the promised land. As painful as this experience was, I am grateful for it. It has propelled me into a future that my heart longed for but my mind could not conceive. Even in death, my mother pushes me to achieve.
After years of vocal training that slowly repaired my heart and strengthened my soul, I honoured my mother by writing of the grief I experienced at her death in this assignment. It may not mean much to many, but this was extremely difficult to talk about, let alone write about, for an academic audience who's responsibility is to judge. If only I could adequately describe where I have come from to be here today. It is indeed a miracle.
Whilst the paper does make for some heavy academic reading, it highlights the incredible healing power of music and in particular, vocalisation as a means of expressing the inexpressible and to feel that which we are too afraid to feel. I hope that there is blessing in sharing this with you.
“The world rushes on over the strings of the lingering heart making the music of sadness”
Tagore, from Stray Birds, XLIV
Grieving the death of a loved one is a universal human experience. Whilst many people may successfully negotiate the stages of grief without treatment, others may experience grief with such intensity that leads them to seek professional support (Currier, Neimeyer & Berman, 2008). Kubler-Ross (1969) describes 5 stages of grief; (1) Denial and isolation, (2) Anger, (3) Bargaining, (4) Depression, and (5) Acceptance. Music as an intervention in grief therapy provides an opportunity for those who have difficulty finding words to express emotions felt during these stages and to feel understood and validated in ways that may otherwise be inaccessible (Bright 1999). The use of music to release intense emotion and negotiate the stages of grief is a process that I myself have undertaken, after the death of my beloved mother, Anita.
In 2004, at 52 years of age, my mother succumbed to Non-Hodgkins Lymphoma1. Diagnosed at only 34, she spent 18 years fighting for life, through innumerable rounds of chemotherapy, radiation treatment, bone marrow transplants and life prolonging surgeries. I was 28 when she passed away, and up to that time, my life had been very much tailored to facilitate her every need. I had only known illness in her life, and her death brought about deep feelings of helplessness, sorrow and anger.
From a very young age, my mother supported my creative endeavours. I began singing and dancing the moment I could walk, and joined the Johnny Young Talent School. Music and dancing was a natural expressive outlet for me and represented an obvious mode to assist with processing the immense grief I experienced at her passing. However, as much as I wanted to release myself from its bondage, grief was locked behind a veil of stoicism that refused to be penetrated. My elderly singing teacher encouraged me to continue singing through the grief, however, my heart was so heavy that I could barely speak let alone sing and any sound I made felt out of control. As a consequence, I barely uttered a word for the next five years.
After years of internal processing with little progress, I sought assistance from a counsellor, an elderly lady with whom I bonded immediately. I was encouraged to use my voice as a means of letting go of the destructive emotions that had taken hold of me. One of my tasks was to find a remote location and scream as loudly as I could. Honestly, I thought this very strange and my initial reaction was to be fearful of letting go, lest I could not regain composure. After much consideration, I did as instructed. I found a remote section of beach in my hometown and screamed until I was exhausted. The activation of this primal sound broke a stronghold within me that day.
This was the beginning of a pursuit of vocal expression that has seen me complete voice studies at Victorian College of the Arts and Melbourne Conservatorium of Music. The process of learning to use my voice again and to release emotion through singing, has at times been excruciatingly difficult, however, this very process has freed me from an emotional turmoil that threatened to devour me. This healing process has reacquainted me with the joy of music which is now my profession. The pursuit of vocal expression in an effort to move through the stages of grief has been of great benefit to me and is worthy of exploration as a means of restorative therapy for bereaved persons.
Several studies have demonstrated the effectiveness of music therapy in the treatment of bereaved persons. In particular, a qualitative study undertaken by Smeijsters and van den Hurk (1999) found that processing grief using music therapy held benefits as the “expression of deep feelings of sorrow by singing can…lead to an emotional shift” (para 4, p. 249). The music therapy interventions used in this study included improvisational piano playing and vocalising. This reflects my own experience. Regardless of my modest piano skills, the act of playing notes or chords that reflected internal emotions and vocalising to these sounds provided a powerful outlet and aided me in redefining those emotions.
Not all bereaved persons can avail themselves of musical ability to express their grief. Fortunately, musical aptitude is not imperative in order to benefit from the effects of music therapy. Merely listening to music may provide similar positive outcomes. This was demonstrated in a study undertaken by Yun and Gallant (2010) in which music-listening interventions were introduced to grief counselling sessions. The interventions did not require active participation in music making or vocalisations and yet the results of the analysis showed a significant decrease in grief measures post intervention (Yun & Gallant, 2010).
A listener’s choice of music may induce significant emotions in music listening (Juslin & Laukka, 2004). During the period of relative silence, I continued to listen to music, particularly that which represented an external expression of my internal emotional state. Minor tonalities, reflective lyrics and slow tempi were often sought and found in the music of Sarah McLachlan and Tori Amos. When I couldn’t make a sound, I received validation from musicians who expressed lyrics with themes of loss and I grieved vicariously through their song.
Music is important for emotional expression and for recalling memories, which may lessen the emotional pain experienced by the bereaved person. Vale-Taylor (2009), conducted a study of post funeral “remembrance activities” and found that listening, composing and playing music can support the bereaved person’s grief expression and powerfully promote their connection with the deceased. Additionally, music was found to positively affect a bereaved persons mood, allowing for simultaneous feelings of positivity and sadness (Vale-Taylor, 2009; O’Callaghan, McDermott, Hudson & Zalcberg, 2013.).
Interestingly, Vale-Taylor (2009) reported that a person’s reaction to music therapy largely depended upon their feelings at the time and whether they connected with the deceased through music or thought of them upon hearing certain music. During my own bereavement, a song calledwas particularly poignant and invoked strong emotions associated with the last moments of my mother’s life. To this day I find this song difficult to listen to. The process of evaluative conditioning, which is resistant to extinction, conjures up strong emotion induced upon hearing the music that I have paired with the experience of losing my mother (Juslin & Laukka, 2004).
Listening to music that holds a strong connection with the deceased may cause distress and difficulty in controlling one’s emotions. In O’Callaghan et al’s., (2013) study, participants carefully selected music that reflected attempts to manage their emotions. Music that reminded the listener of the deceased in a comforting way, enabled the listener to rise above the distress of their loss whilst some music was not used due to fear of inciting intense sadness. O’Callaghan et al., (2009) reports that avoidance of specific music is not necessarily an indication that one is avoiding grief, rather, listeners exercised control over how and when they connected with the distress of their loss (O’Callaghan et al., 2013). In the right time and in the right context, music provides a safe place to mourn and to let go of control over their emotions.
People, myself included, who experience bereavement-related major depressive disorders may also suffer from a construct known as ‘complicated grief’. The key features of complicated grief as described by Shear, Frank, Houck and Reynolds (2005) include (1) a sense of disbelief regarding the death; (2) anger and bitterness over the death; (3) recurrent pangs of painful emotions with intense yearning and longing for the deceased; (4) preoccupation with thoughts of the loved one including distressing intrusive thoughts relating to the death. A study by Iliya (2015) supported the theory that vocal interventions in the form of singing in music therapy were most helpful to participants dealing with complicated grief.
As a singer, I was particularly interested in the way in which vocalisations could assist bereaved persons. Austin (2008) developed a model of vocal psychotherapy and describes the benefits of singing as a connection to the source of sound vibrations. Our voices resonate inward and help us to connect with our bodies and express our emotions. Singing is a neuromuscular activity known to be closely linked to psychological patterns and emotional response (Newham 1998). Austin describes the theory of vocal psychotherapy and argues that the voice holds immense therapeutic potential, exercised through breathing techniques, primal sound exploration or improvisation.
Finally, music provides a vehicle for bereaved persons to continue and evolve a relationship with the deceased, through engagement with music associated memories, ascribing new meanings to music related to that person and through finding or creating music that allows a sense of communication with the deceased (O’Callaghan 2013). Music can function as a transitional phenomenon through the harsh reality of loss and can effectively be used with bereaved persons when the practitioner is process-oriented, emotionally sensitive, socially directed and awareness focused (Gallant & Holosko, 2001; Yun and Gallant 2010).
The literature reviewed has reinforced my own experiences with music as an alternative intervention for dealing with bereavement and complicated grief, and has highlighted opportunities for replication and expansion of existing research.
There is substantial literature, which discusses the effect of music on mood and emotions of participants. This directional relationship is explored in Juslin (2010) who reports that music usually invokes a positive emotional response, resulting in physical health benefits. Using the psychological mechanism, Appraisal in Music and Emotion, listener’s responses to music were measured through episodic memory, brain stem reflex, rhythmic entrainment, evaluative conditioning, emotional contagion and visual imagery (Juslin 2010: 622). What can be learned from this directional relationship that may be used inversely to benefit bereaved persons? Can music that invokes happiness, be used to combat sadness or depression associated with grief? Is it possible to design a standardised suite of musical stimuli that can predictably be used to relieve the effects of complicated grief? These questions provide further opportunities for researchers to explore.
Music reaches into a persons inner depths more easily than words (Bright 1999) and provides a safe mode to release suppressed feelings of bereavement that create tension. The act of singing and actively participating in making music requires an energy that can only come from within. This allows access to those suppressed feelings and provides an outlet for their expression. Music has been integral to the healing and relief from the pain of loss, and has helped me to redefine the memories associated with my mother’s death. It serves as a transitional phenomenon (Winnicott 1971) to a happy, well adjusted life.
Austin, D. (2008). The Theory and Practice of Vocal Psychotherapy: Songs of the Self. Great Britain. Jessica Kingsley Publisher. Retrieved from http://eds.a.ebscohost.com.ezproxyf.deakin.edu.au/eds/ebookviewer/ebook/ZTAwMHh3d19fMjkxOTExX19BTg2?sid=a24b182e-0a4e-441b-ad5e-11fd12c3467a@sessionmgr4003&vid=4&format=EB&lpid=lp_7&rid=0
Bright, R. (1999). Music therapy in grief resolution. Bulletin of the Menninger Clinic, 63, 481- 498.
Currier, J.M., Neimeyer, R.A., & Berman, J.S. (2008). The effectiveness of psychotherapeutic interventions for bereaved persons: A comprehensive quantitative review. Psychological Bulletin, 134, 648-661.
Gallant, W., & Holosko, M. (2001). Music intervention in grief work with clients experiencing loss and bereavement. Guidance & Counseling, 16, 115-121. Retrieved June 6, 2015, from http://web.a.ebscohost.com.ezproxy-f.deakin.edu.au/ehost/detail/detail?vid=3&sid=83a8f517-8c6f-4e51-87fc-d36879aa83a8%40sessionmgr4002&hid=4109&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=7272824
Iliya, Y.A. (2015) Music therapy as grief therapy for adults with mental illness and complicated grief: A pilot study. Death Studies, 39, 173-184.
Juslin, P.N., & Laukka, P. (2004) Expression, perception, and induction of musical emotions: A review and a questionnaire study of everyday listening. Journal of New Music Research, 33,217-238.
Kubler-Ross, E. (1973). On Death and Dying. Great Britain. Rutledge Publications. Retrieved from http://site.ebrary.com.ezproxy-f.deakin.edu.au/lib/deakin/reader.action?docID=10094212&ppg=4
Newham, P. (1998). Therapeutic Voicework: Principles and Practice for the Use of Singing as a Therapy. London: Jessica Kingsley Publishers
O'Callaghan, C.C., McDermott, F., Hudson,P., & Zalcberg , J.R. (2013) Sound continuing bonds with the deceased: The relevance of music, including Preloss Music Therapy, for eight bereaved caregivers, Death Studies, 37, 101-125.
Saresma, T. (2003). ‘‘Art as a way to life": bereavement and the healing power of arts and writing. Qualitative Inquiry, 9, 603–620.
Shear, K., Frank, E., Houck, P.R., & Reynolds, CF. (2005). Treatment of complicated grief: A randomized Controlled Trail. Journal of American Medical Association, 293, 2601-2608
Smeijsters, H., & van den Hurk, J. (1999). Music therapy helping to work through grief and finding a personal identity. Journal of Music Therapy, 36 , 222-252.
Vale-Taylor, P. (2009) . “We will remember them”: A mixed-method study to explore which post-funeral remembrance activities are most significant and important to bereaved people living with loss, and why those particular activities are chosen. Palliative Medicine, 23, 537–544
Yun, S.H. & Gallant, W. (2010) Evidence-Based clinical practice: The effectiveness of music-based intervention for women experiencing forgiveness/grief issues. Journal of Evidence-Based Social Work, 7, 361-376
Zisook, S., & Shuchter, S. (2001). Treatment of the depressions of bereavement.American Behavioral Scientist, 44(5), 782–797.
1 A diverse group of blood cancers.
Dannielle O'Keefe profile photo credit: Peta Jolley @ bypeta.com