Promoting a positive response

Meadhbh Monahan discusses music therapy with two passionate therapists. Combining music and psychology, the alternative therapy shows positive results.

“I prefer to see people as people and not as a diagnosis,” says Eli Chourdaki, a music therapist specialising in profoundly disabled children and adolescents and in elderly care.

While people are becoming “a bit more open-minded” to alternative therapies “as opposed to just medication,” the University of Limerick masters course is the only one in Ireland and, despite its 12-year existence, Eli notes that some people still don’t know what music therapy is.
Music therapy originated in America during the First and Second World Wars when it was discovered that music helped to aid the psychological, cognitive, and emotional recovery of soldiers in hospital. Therapists now use music experiences such as free improvisation, singing, song-writing, listening to and discussing music, and moving to music to help clients improve their health. It is used to help treat disabilities (e.g. autism), mental health problems, physical pain, palliative patients, trauma (e.g. for some victims of the Troubles), school children and victims of stroke.

From Crete, Eli completed a music diploma which entailed reaching grade 12 in the piano. She also achieved a BA in philosophy and literature before doing the masters course in Limerick. She was “fascinated” by music therapy after taking a module from a teacher who had studied it in Cambridge University.

“I thought it was about music,” she remembers, “but it’s more about therapy.” Students are expected to study modules in children’s developmental stages and must undergo 52 hours of psychotherapy, complete placements, group psychotherapy and introversion: “All those things that expose yourself so, so much,” she explains.

Looking back, she admits that she “didn’t have a clue about what therapy was.” Her initial misconception about music therapy is one she meets daily.

“You might say to people that you’re a music therapist but they don’t fully understand and they say: ‘Oh, you play music to people with special needs? I can play the guitar, maybe we can arrange something.’” What differentiates music therapists is: “We had to undergo a lot of training as to how to deal with someone’s emotions and behavioural problems and how we manage our own issues.”

Rewarding

Since her graduation, Eli and two colleagues formed Music Therapy Ireland to promote knowledge of music therapy and create posts for music therapists. Recognition of their work has been building slowly. Nurses, special needs assistants and psychotherapists tend to be open to music therapy because it is a falls under psychotherapy. “I love the fact that it’s a profession that combines music, psychology and medical conditions. It’s greatly rewarding,” Eli explains.

Similarly, Clara Monahan became interested in music therapy as it combined her passion for music with a personal understanding of seeing her disabled brother use music as a means of communication.

“I have always loved music and have played music since an early age,” she tells eolas. “My younger brother was diagnosed with severe cerebral palsy at birth and growing up with him meant that I was exposed to what full-time care entailed for a family from the age of five. We were always looking for ways to help him communicate as his communication skills were very limited.”

Clara and her parents noticed that her brother had “a very significant response to music and it always had a profound effect on his mood, his responses and gave him this medium through which to communicate.”

While studying for her music degree in NUI Maynooth (from 2002 to 2005) she heard about music therapy and took a masters of Music Therapy in University of Limerick.” Following her graduation in 2008, Clara worked for the Northern Ireland Music Therapy Trust and now works on a freelance basis, mainly with adults with intellectual disabilities across Dublin and Kildare.

Both therapists explain that having to undergo therapy themselves has helped in the course of their work. While Clara often came across children with disabilities who reminded her of her brother, Eli recalls her first encounter with dealing with her own emotions while on placement in a hospice. “Whenever someone was dying they put a picture of a dove outside their door so you knew not to enter and let the family have the last few moments alone. Walking down that corridor with a dove on every second door, I realised how close death and life are.” More recently, three of her nursing home clients died during one week. “It makes me sad … but it’s also a delightful thought that I was probably one of the very few people who spent some time with them and they were always happy to see me and I felt so welcome there.”

Queries about how music therapy can help with depression are regular. “I don’t treat the client as a client with depression; it’s just a human being and it’s so interesting for me to find out what they are thinking, what they need as opposed to just prescribing medication,” Eli contends. “Mostly what people need is to feel understood, to feel heard, supported and that whatever they decide is grand. That’s why we try to encourage as much freedom of self-expression within the session, within boundaries of course.”

Structure is important to people with intellectual disabilities. Whilst working with their clients, Eli and Clara ensure that each session has a certain structure and that the room is as minimal as possible to avoid distraction.

“I will start with a hello song,” Eli explains. “Then I might move onto images such as a farmer or cow for ‘Old McDonald’ or a star for ‘Twinkle Twinkle Little Star’.” This encourages the child to become more confident in choosing the songs and instruments, which ultimately translates into their everyday lives.

“Interaction for vocalisation is very important,” Eli continues. “If the child makes a random vocalisation, I will imitate that sound so they know they are heard. I might play on the xylophone what they just sang.”

Clara explains that, alternatively, “a client may need a time where they have no structure, total freedom.” This could entail 20 minutes playing purely improvised music with and supported by the music therapist and 10 minutes talking about the performance. She emphasises: “The client does not have to have and musical background or skill to attend music therapy.”

Eli works with a two-year-old autistic boy who cannot speak. “This child wasn’t able to be out in crowded places like shopping malls, he couldn’t stand noises like the hairdryer, the hoover, and now he’s well able to be calm when things are happening in the household and his mum is delighted to bring him out.”

Clara works with a 25-year-old man with a physical and intellectual disability who lives in an independent supported living house by himself. He was referred to her after becoming withdrawn from society and using his verbal skills less and less. Following six weeks of music therapy, he completed a recording of 12 of his favourite songs and has shown “a marked increase in confidence and use of voice.” He has been able to use the sessions as “a stepping stone” to join a local music session with a community music group.

It is also important for elderly people to “feel that they can still sing and still dance,” Eli contends.

“They so look forward to the weekly sessions,” she says. The nurses in the nursing home have told her that the residents are sleeping better and their mood has improved. Eli noticed one lady who is wheelchair-bound but “comes back to life” when she sings ‘Oh Danny Boy’. “There is a response and that’s the beauty of music therapy; that you can promote that response from people.”