music for the soul

The (Therapeutic) Sound Of Music

Listening to your favourite playlist may be a by-the-way thing on a jog or in your car. But there is an industry that uses songs, instruments and beats to heal and rehabilitate.

The (Therapeutic) Sound Of Music

One Japanese song by the late songbird Teresa Teng was all it took to bring back bittersweet memories for “Ms A” who had end-stage renal failure.

“There were always tears in her eyes when she sang this,” recalls Michelle Low Yin Yin. “Towards the end of her life, it was evident that music helped soothe her well-being. She was able to talk about death more readily than before.”

In her job, Low works with music 24/7 to help people like Ms A. But she is not a music teacher or a radio DJ.

For five years, Low has been a music therapist at the Singapore General Hospital (SGH), and it is a relatively little-known occupation in Singapore.

According to the American Music Therapy Association, music therapists are professionally trained to “assess emotional well-being, physical health, social functioning, communication abilities and cognitive skills through music responses”.

They then conceptualise therapy sessions using music improvisation, songwriting, lyric discussion and other techniques to help a wide range of individuals, from young children and adolescents with developmental and learning disabilities, to the elderly with ageing-related conditions as well as those dealing with acute and chronic pain.

In Singapore, the Association for Music Therapy (Singapore), founded in 2007 to provide equal access to music therapy for all, now counts 26 professional accredited music therapists among its members, most of whom are hired in nursing homes and hospitals like Ren Ci and St Luke’s Hospital.

At KK Women’s and Children’s Hospital (KKH), music therapy is part of its CHAMPs (Child Life, Art and Music Therapy Programmes), which helps patients of any age group cope better with medical treatments, manage pain, express emotions and achieve rehabilitation goals.

In 2010, the hospital launched the Alpine Blossoms Breast Cancer Support Group Choir. Facilitated by its music therapists, the choir performs short gigs in the women’s wards to give patients and caregivers a chance to relax, socialise and heal through music appreciation.

With 2020 being mainly about new norms, job cuts, border closures and social distancing rules, music can play an important role in enhancing one’s mood and well-being.

As KKH’s music therapist Kayla Wong says: “This year has certainly been tough for many of us, with plans being disrupted. In a time of such uncertainty, music can be used to bring comfort. A music therapist is trained to guide the client through exploring and experiencing music in a way that can bring forth insight to understand how to navigate

challenges, and provide some psychoeducation as to how they may use music strategies towards their health and wellness goals.”

At SGH, music therapy was first introduced in 2005 as the Music to the Ears programme for children with hearing impairment at what is now the Department of Otorhinolaryngology — Head & Neck Surgery.

In 2011, the hospital expanded its music therapy programme to the inpatient rehabilitation wards for those undergoing rehabilitation for such conditions as post- stroke care, traumatic brain injury and Parkinson’s disease. SGH now uses music therapy to help these patients, as well as those with dementia or who are undergoing oncology treatments and palliative care, to help them regain their speech, cognitive and motor coordination, and address their psychological needs.

Even then, SGH’s Low acknowledges that music therapy is still “fairly novel” here (fun fact: pre-independence Singapore actually had its first music therapist, Louise Cheng, back in 1963).

One reason: the perception that music is abstract and that only the musically inclined can attend music therapy sessions.

The truth? Patients do not have to be musically inclined as music therapy is not “about playing the right notes on the keyboard or guitar”, she explains.

KKH’s Wong reasons: “Music is very much embedded in our everyday lives, be it nursery rhymes sung at kindergarten or music from our favourite movies.”

It’s also not just about songs, anthems and tunes.

“Then there is the aspect of our internal rhythms — our heartbeat can be seen as our personal tempo, the tone of our voice, the speed of our speech — music is all around us.”

She adds that as a music therapist, she has been trained to recognise all these components of music and “as long as the patients are open to music”, they can benefit from music therapy.

Sessions at SGH are designed to address every patient’s specific condition and needs, and even then, therapists use music that the patient prefers or is more familiar with — which means it’s not about only using classical music, as people might assume. Instruments like drums, maracas and guitars may also be used during a session, which typically lasts about 30 to 45 minutes.

On the contrary, the music therapist has to be musically inclined and be proficient in using at least one instrument, says Low. To get accredited, music therapists have a Bachelor’s degree or a Master’s degree in music therapy, plus they must complete hours of practicums and internships to be accredited.

This allows the music therapist to perform an assessment of the patient, determine baseline functional and psycho-emotional levels, come up with goals and objectives, and customise a treatment plan.

For instance, she gives the example of how a music therapist may use singing to improve a patient’s breath control and articulation. To help those with physical conditions, the rhythm in music is used to regulate their movements, while the tempo is gradually altered as the sessions progress.

She elaborates: “To help a patient shift the (body) weight sideways to improve balance, we may use a 6/8 tempo to initiate and sync movement coordination. If it is (to encourage) walking, we may use a 2/4 tempo with strong beats to help the patient take bigger steps. This also motivates the patient to have better endurance during therapy.”

For patients with psycho-emotional needs, a mix of interventions like improvisation, song discussion and instrumental play is used. This doubles up as a safe, non-verbal outlet for them to express their feelings.

Sometimes, Low meets patients who require a combination of treatment methods. She once had a music-loving patient who had suffered speech and mood changes due to a brain tumour. To retrain his speech and to lift his mood, she used singing, rhythm training and song discussion.

The result: he became happier and started smiling and chatting more with others.

So, can just about anyone listen to music at home and consider it self-therapy?

That would work as a music strategy, not therapy, because there is “no active therapeutic relationship involved using music to guide and address needs”, says Low.

But if you must, creating different playlists to complement your various moods can help to validate your feelings as you tune in to the song’s lyrics or melody.

“This is why some people cry when they hear a certain song but feel better after doing that.”

This story first appeared in the December 2020 issue of A Magazine.

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