I’m sorry to say that, because of some unforeseen issues in my personal life, Music Therapy/Music Musings will be on hiatus for a bit. I will send an update sometime in the coming weeks.

In the meantime, take good care and listen to some good music.

Best,

Ray

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

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This month celebrates three years on Substack for Music Therapy/Music Musings! First off, thank you for reading and supporting this blog/newsletter. When I sent out my first Substack post I had 32 subscribers. Now I am over 600! I never imagined that many of you would be interested in my writing and reflections on music therapy and the healing power of music. I am so grateful for this community. I am so grateful for you.

Here is what I know:

- Music therapy is an evidence based clinical practice. A music therapist is a clinician who uses music as a tool to help meet a need or a goal.

- Our bodies work like music. The foundation of music is rhythm, and our bodies function in rhythm – our hearts beat in rhythm, we breathe in rhythm, we walk in rhythm. And when the rhythm is off, just like in music, everything is off.

- Our brains work differently when music is involved. Music is the only entity we know that is a ‘whole brain’ activity. Just about everything that we do involves a very specific part of the brain, but when music is involved – playing an instrument, singing, even listening to music – multiple parts of the brain are active, in both hemispheres. We know this by fMRI imaging of brain activity within music experiences.

- Music therapy is a legitimate and viable supportive modality in healthcare, addressing both the physical and psychosocial needs of the patients that we work with.

Here is what I don’t know:

Why was music such a helpful and powerful means for a gentleman, in his 60s, who had been in the hospital for almost two weeks after multiple debilitating surgeries that caused pain and such depression that the patient seemed about to give up any hope of recovering?

The answer may be a combination of some of the points above, or it may be something unexplained:

When I walked into the room he was lying in bed staring at the ceiling. He barely saw me come in and when I quietly said, “Hello” he seemed a little startled. The nurse was apprehensive in sending me in as, “He’s a gruff man. And all of this seems to really have taken a toll. He barely wants to talk to us.”

I asked, “How are you doing?”

“Humph. Horrible.”

“Are you in pain?”

“My stomach has been ripped open three times. What do you think?”

I sat and gave him a minute. Then I said, “I’m Ray. The nurses asked me to visit because we know that you are having a really rough time.”

“Is that a guitar?”

“Yes. I’m a music therapist.”

“I used to play guitar.”

And there was the connection. We eased into a conversation about guitars and music. He mentioned doing some traveling around with a band some years ago and said, “Man, those were the days.” He mentioned loving playing his Gibson Les Paul, “I love 70s rock man”. We spoke about different types of guitars, and then I said, “I have to show you this guitar,” and I pulled out my Breedlove acoustic that I use at the hospital.

Suddenly, his focus seemed to move away from the pain, feeding tube and various ICU monitors. His voice became a little stronger. Perhaps, the conversation brought back a little renewed sense of self, something that you lose when you are in the hospital recovering from a major medical issue. Suddenly we were just two guys hanging out talking about guitars and music.

“Can I play something for you?”

“Sure.”

I went into an easy version of ‘Peaceful Easy Feeling’ (The Eagles).

During the music, he was again staring at the ceiling. But now, his face was different. There was color, and light in his eyes, he seemed to transform a bit. The tension in his jaw seemed to melt away. (And, I noticed on the monitor that his heart rate was decreasing.)

When the song concluded he said, “Man… that was great. Can you play another one?” I went through a few more songs with themes of comfort and reflection. Then I said, “Here’s a good song for you,” and I played an easy version of Tom Petty’s ‘I Won’t Back Down’.

“Man… this is so great. Can you play a Beatles song?”

“I have the perfect one for you. It’s about looking forward to brighter days ahead.” When I went into the opening riff of ‘Here Comes The Sun’ he smiled and said, “Yes…”

“Man… you don’t know. This is just… this really helped me. Really… I don’t know what to say.”

I said, “Sometimes we just need to get out of our head a little. We need something with beauty, some music. We need the Beatles.”

“You really made a difference man. This was so helpful. Thank you. Really. Please… please come back any time.”

Did I really make a difference? Well sure, I was there, I was the one providing the music. And yes, everything I played was purposeful. But what really made the difference was music. Why? How? Some songs? It was the music that brought him back into himself? What is going on here?

I got a note later from the physical therapist that said, “Thank you for seeing him! He’s been refusing to work with us, but after your visit, we were able to get him up and moving.”

It’s simple. It’s complicated. But something is happening. Music affects us both physically and emotionally. Music gives something different. Music gives something with beauty and aesthetics. Music gives us what we need when we need it.

Again, thanks for your support during these past three years!!

If you enjoy reading this newsletter, please share with someone you know who may enjoy it too.

The healing power of music…

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Here we are at the beginning of August… wow! I hope that you are having a good summer and finding some time to reset, refuel, and relax. Speaking of which, I have been away on vacation this week so I’ve pretty much shut it down to recharge the creative juices.

But, I give you my Ultimate Summer Playlist! It’s always a work in progress and would love suggestions to add.

Enjoy and I will be back at it next week…

Ray

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Ray Ultimate Summer Playlist:

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively on music and wellness

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Several years ago I worked for the independent record label Putumayo World Music. Putumayo specialized in putting together CD compilations of music from around the world. The idea was, if someone was interested in exploring music from Brazil, Mali, Cuba, the Middle East, these packages, with their vibrant folk-art covers and extended CD booklets with information about the regions and artists, were accessible. You didn’t have to go into a record store and flip through countless CDs in the world music section and guess on something to buy. Putumayo took care of curating the music, and the cultural experience, for you in one neat little package of music and art.

Putumayo considered itself more of a ‘lifestyle’ brand than a traditional record label. And even though you could find Putumayo CDs in the bins of traditional record stores, the main focus was selling in ‘non-traditional’ stores such as gift shops, bookstores, museum shops and even Whole Foods. Putumayo would supply the stores with hand-crafted counter displays and listening stations and, key to sales, CDs to play in the store. The idea was, you walk into a craft store, hear the music overhead that fit the vibe of the store, see the colorful CDs displayed on a counter near the register, and… impulse sale! Market research showed that once a customer purchased a Putumayo CD, they generally purchased many more, as gifts, and for themselves.

The music was great, the package was informative and appealing, and it offered up an ‘experience’. Putumayo’s tag line - “Guaranteed to make you feel good.”

While CDs have seen their day, Putumayo is still doing its thing, putting together ‘compilations’ (playlists) on various streaming outlets. Check it out here…

There are many ways to learn about other cultures. But nothing brings us closer than music. Music is universal. Music has been a part of virtually every culture, all over the world, since the beginning of time. And music is social. We all understand a beat, rhythm, and the desire to move when you hear conga drums. And research shows that we also have a physical reaction when we listen together. Our bodies ‘entrain’ to music, and each other – our heart rates sync, our breathing rhythms match up, and dopamine is released in our brains, which is ‘guaranteed to make you feel good’. Music brings people together.

In the hospital, one of the benefits of music therapy is that it can work around spoken language barriers. In fact, music therapy becomes more essential when hospital staff cannot communicate with patients who speak a foreign language. Being in the hospital is isolating, and not being able to communicate, or connect with staff, exacerbates feelings of being alone. Cue the music therapy…

“He speaks no English so we can’t really talk with him. And he’s had no visitors,” the nurse told me when she asked me to visit with him. He’d already been isolated in the hospital for some time receiving cancer treatment. I walked into his dark room, and it was so quiet I could hear the IV drip. He looked at me and I showed him the guitar and gestured to a chair as if to ask, “May I sit?” He tentatively shook his head “yes”. He was in bed with the covers pulled up. He looked weak. He looked lost. I just started playing something soothing, offering some soundscape for comfort. He was looking straight up but… seemed to be listening.

After a few moments I noticed his left foot slowly moving. I kept the rhythm solid. And then, some movement in his head. I followed him with the music, adding a little more straight structure to my improvisation. His eyes opened fully as his body seemed to ‘activate’. He transformed and the music purposefully followed. More rhythm. More intensity. More movement. Soon, it felt as though we were… grooving?

He looked at me and his smile lit up the gloomy room. It became a music and movement improvised jam-session. And the movement in his body seemed to give him some ‘life’.

Without thinking about it, I eventually worked my way to ‘One Love’ and started singing. He pointed at me, laughed, and said “Ahhh…” Of course he knew Bob Marley! He took it in. He could not stop smiling. No words were spoken for the half hour I was there. There was no need. We had music.

As I was waving goodbye and about to walk out – three words… “Come back again?”

Sometimes we don’t need words. Sometimes we need beauty and rhythm and soul and aesthetics. Sometimes we just need… music. Music gives you what you need, when you need it. No matter where you are from. After all… music is “guaranteed to make you feel good.”

“One love. One heart. Let’s get together and feel alright…”

The healing power of music…

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Thanks for reading and supporting this newsletter! If you enjoy today’s post… please share.

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“Rhythm is sound in motion. It is related to the pulse, the heartbeat, the way we breathe. It rises and falls. It takes us into ourselves; it takes us out of ourselves.” - Edward Hirsh

Rhythm. It is the most important element in music. It is the foundation of all music and is essential for creating structure and movement. Rhythm is the magic that holds the music together, the heartbeat that keeps the body of the song alive. Even though it pains me to say it (being a guitarist), the drummer is probably the most important part of the band. Why? The drummer keeps the rhythm. When the rhythm is off, everything is off.

Music and rhythm are rooted in every known culture. What parent does not use rhythmic rocking to soothe a crying baby? The repetitive sounds and silences that comprise rhythmic patterns make dancing possible, aid in memory, and facilitate group singing, playing, or drumming. Rhythm has been used for millennia as a social connector. The chants of a religious ceremony or the cadence calls of military ranks are just two examples. And there’s the rhythm of poetry and verse, the rhythm of language, circadian rhythms in sleep, and the rhythmic changes of the seasons.

Music Therapy in a Hospital Setting

Our bodies work ‘in rhythm’. We walk in rhythm, we breathe in rhythm, and our heart beats in rhythm. And just like in music, if the rhythm is off, everything is off. One of the main reasons music therapy works in a hospital setting is… rhythm.

Then there’s ‘entrainment’. Entrainment occurs when body rhythms synchronize with the music to produce a desired response. It’s like walking through Target, and Stayin’ Alive is playing overhead. Without realizing it, you are soon walking in sync with the rhythm. (You may even feel a little like a feverish Tony Manero walking through Manhattan on a Saturday night.) A music therapist may use entrainment, and rhythm, to work on gait issues with Parkinson’s patients. After assessing and finding the right tempo and song, the patient may soon walk more steadily with the music, entraining to the rhythm. (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. 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? 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 beats per minute (bpm), that may be an indication of anxiety or pain. [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 are given, the longer it could take to get them off the vent, which can then lead to more long-term issues.

Fortunately, medical teams are now looking at more ‘non-pharmacological’ means to help their patients, such as music therapy. How can music therapy help? Again, by using the inherent elements in music to work with the body - rhythm and entrainment.

When working in this forum, the patient’s heart rate monitor becomes my metronome [a tool that produces a rhythmic, steady beat.] So, when I initiate a music experience to help reduce anxiety in these vented patients, their heart rate is my starting tempo; I match the music’s tempo to their heart rate [and, in other cases, to their respiratory rate]. Once the music and their heart rate are in sync, or entrained, I will gradually start decreasing the tempo of the music. And often, the heart rate will follow. Over 30 minutes, give or take, I may reduce a heart rate from somewhere over 100 bpm down into the 80s – entrainment.

The Music

Mainly I improvise and create the music, in the moment, on the guitar. Why? So I can change and manipulate the music as needed based on the ‘feel’ I get in return from the patient. Music therapy is a dynamic process. [This is why music therapists mainly use ‘live’ music in practice.] I may include some light, purposeful tension to start. Then, as the tempo decreases, the tension gradually moves to more soothing and harmonic themes to help prompt a relaxation response. I may also incorporate structured songs if I can find out from family members what the patients’ music preferences are. I’ve used Elvis, Frank Sinatra, Green Day, Adele, occasionally adding humming or singing, all working within entrainment, rhythm, and heart rate. [I never assume music preferences. If I don’t know, I will stay with improvisation.]

Entrainment and Breathing

We can do the same with breathing. If someone is having breathing issues, they are often anxious, and when we are anxious, we tend to tighten up, and our breathing becomes shallower. Here’s a story of an older woman I recently worked with:

She was having trouble breathing and trying to find the right position in her hospital bed. She couldn’t speak more than a few words without losing her breath. She was very anxious. 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, but I love the old hymns.”

“Well then, I said, “We should sing.”

She looked at me with apprehension. “But I can’t breathe.”

“What’s your favorite hymn?”

“In The Garden.”

“Okay, just follow me. Nice and easy…”

I kept the rhythm solid and steady but with an easy feel, and the tempo just a bit slower than her shallow breathing rhythms. And we sang. Then… her breathing started to follow the song’s natural phrasing — the rhythm — and gradually became slower and deeper.

[When you sing, you naturally breathe within the rhythm of the music, drawing in breath fully for the next phrase, which opens up your airways. Singing is great for breath maintenance. Our breathing ‘entrains’ to the rhythm of the song. And yes, I purposefully slowed the tempo as we went along. Her breathing rhythm followed.]

After the song, she recalled 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.”

We walk in rhythm, breathe in rhythm, and our hearts beat in rhythm. And if the rhythm is off, everything is off. Fortunately, we have music (and rhythm and entrainment).

“The art of healing, the art of ecstasy, the art of God-consciousness has millions of names in mystic terms. It has to do with rhythm and reality. When the body is in rhythm, there is ease. When the body, or any part of the body, goes out of rhythm, there is dis-ease.” – Harbhajan Singh Yogi

The healing power of music (and rhythm)…

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Thanks for reading and supporting this newsletter! If you enjoy today’s post… please share.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Good sleep is one of the most important ways to reset, refocus, and replenish. And 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, I love helping patients relax and, well, get some sleep. I may even say… it’s one of my superpowers.

Music therapy in the hospital is a clinical practice, facilitated by a trained music therapist who creates music interventions, in the moment, to address and meet the immediate needs of the patients they work with. Music therapy in the hospital can help in many ways, and one of the most effective and important is to help promote… sleep.

Over the past several days I was able to help three patients move towards a sleep state — with music, and some relaxation techniques.

First there was the woman, in her 30s, who was experiencing anxiety and pain after a recent surgery. “She needs something,” the nurse said, “I can’t give her more meds for a few hours. Can you help?” This patient also has cerebral palsy and has limited movement capacity, which may exacerbate her pain. When I entered her room, her face told the entire story. I simply introduced myself, got out my guitar, and started with a meditative soundscape. After the music was established, I simply said, “Focus on the music… the sound of the guitar.” I was imagining the music enveloping her, like a big blanket. It took her a while for her to settle but soon… she was asleep.

Next there was the woman, in her 50s, with serious stomach issues. She was dealing with significant pain as well as some 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 “so much pain.” She looked anxious and exhausted. 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 the music started to progress, the minor modes slowly modulated to major, the dissonance moved towards 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 sleeping.

Finally, the gentleman, in his 60s, also dealing with pain as a result of an advanced form of cancer. He and his wife were both very pleasant and welcoming, but they looked exhausted. In conversation there seemed to be a real fear of the unknown (for both) which seemed to add to their 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 softened. His breathing became a little deeper; a little slower — matching the gradual purposeful decreasing tempo of the music. He seemed to fall asleep.

The constant here was music. Live, improvised music, on the guitar, that I was changing and manipulating to help bring them towards a more comfortable place. When the pain and the anxiety are this heightened, I’m not sure recorded music would be as effective. Sure, listening to soothing music, or whatever music works for you, certainly can help you relax after a long day, or help you fall asleep. But in the hospital, another level is needed.

He and his wife were holding hands, and his relief seemed to help her too as she closed her eyes. When the music concluded, after a moment he 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… “When will you be able to come back?”

“We are such stuff as dreams are made on; and our little life is rounded with a sleep.” – William Shakespeare

The healing power of music (and sleep)…

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Thanks for reading and supporting this newsletter! If you enjoy today’s post… please share.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

It’s hot… and it’s a holiday weekend. I don’t know about you but that is the perfect combination to make me lazy. I just want to lie down, on the couch… by the pool… in the tub… anywhere really. So something a little different this week. A little curation of a few things to help embrace the heat and keep you cool. And… to celebrate the July 4th holiday. You don’t have to think too much. And you can lie down to consume it all! (After all, I was lying down while compiling.)

It’s hot! Here’s your HOT HOT HOT playlist, hot music to keep you cool. Grab some lemonade, or a cold beer, hit play and lie down and enjoy!

Jon Batiste is a national treasure. And here he is covering a national icon. This has it all - great song, great performance, full commitment, and all of the emotion that great music brings. It simply does not get any better than this…

Jon Batiste is from New Orleans, and what is more ‘American’ than New Orleans jazz. And you can get your fill, and some, from this great public radio station based out of New Orleans, WWOZ. Talk about curation! When you want to feel the vibes of ‘The Big Easy’, and hear some great true ‘American’ music, here is where to start.

Speaking of American icons, I have always been a big fan of Tom Petty. And over the years, have become more and more appreciative of TP’s right hand man, guitar hero, and number one Heartbreaker, Mike Campbell. This is the man behind the great rifts (and co-writing, producing, holding the band together) that set the tone for American Girl, Breakdown, Mary Jane’s Last Dance, and many more. He’s the unsung hero to the machine that is Tom Petty and the Heartbreakers. He’s Robin to TP’s Batman. And, perhaps, the most influential side-man in the history of rock & roll. Finally, he takes the spotlight in his memoir Heartbreaker. If you are into TP and the Heartbreakers, or simply interested in the workings of an American rock & roll band, you will love this book. And, you can read it while lying down!

And speaking of America and rock & roll, what’s more American than a good protest song. There are many (I wrote a whole post on it here) but this is the one that keeps coming back to me. These days I keep hearing Green Day in my head. Over and over and over again. I hear the opening chordal strands of American Idiot. I sympathize with the frustrated angst of the soliloquist. I feel the driving force of the collective trio’s musical anarchy. I probably don’t have to say anything more as to why:

“Welcome to a new kind of tension. All across the alienation. Where everything isn’t meant to be okay.”

And finally, a photo. Some photos need no caption as we think about heat, and iconic American music.

So there you have it! Some music (and a little reading material) to help keep you cool and celebrate the holiday weekend. Let me know what you think in the comments below. I love hearing from you!

Enjoy!

Ray

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Thanks for reading and supporting this newsletter! If you enjoy today’s post… please share.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Shared music experiences are dynamic. Or at least they are supposed to be. When we experience music there is a connection between the music source and ourselves. This is especially true in ‘live’ music experiences. There is interaction between the one providing the music and the one receiving it. The audience is just as important as the performer with energy going back and forth. The performer thrives on the energy from the audience and in return, the audience experiences a full mind, body, and soul aesthetic experience.

Any musician will tell you that they are ‘fueled’ by the audience; not just the response of applause but the ‘feeling’, the connection, that the music creates between both entities. The musician and the audience are in concert (pun intended) with each other within the aesthetic experience.

I’m sure you can recall a time when you were at a concert, or a music performance, and felt it. Some even relate it to a ‘religious’ experience. (And this is felt in all art, including visual art, photography, poetry, theater, etc.)

I can easily recall a moment, about six years ago, when I went to see Sara Bareilles at The Anthem in Washington D.C. I was about halfway back on the floor. She had a great band and she, and they, sounded great as she went through some of her back catalog and new work. About halfway through, the band left the stage and Sara sat at the piano, alone, and sang She Used to be Mine, a song that she wrote for the musical Waitress. In that moment, I had an aesthetic ‘religious’ experience. First off, the song is amazing, sung by the lead character when she hits rock bottom, is lost, and mourning her lost former self. And Sara’s performance was nothing more than magical. The audience was completely silent, and totally at her command. It was one of the most amazing live music moments that I’ve ever experienced as, while listening, I felt chills and became emotional. Like many in the audience. I experienced the true power of music as connection, in my mind, body, and soul.

And she had to feel that coming back to her, which, I’m sure, added to her performance and experience of the music. You cannot get this from listening to recorded music.

However, as we continue to move through this Insta-TikTok-social media fueled world, what do you see at virtually every live music performance? People with their phones out, filming the concert, essentially watching and experiencing the performance, the art, through a screen. The ‘connection’ is broken.

A live music experience should be a more pure form of aesthetic exchange where one is not trying to capture a moment but experience it. If you are going to try and experience a live music concert through your phone, why not just stay home and listen to the recording? It’s much cheaper.

Music therapy experiences in the hospital are all about connection. Connection between the therapist and the patient, the patient and the music, and the patient and themselves. In all of my experiences – from performer, to audience member, to now music therapist – this is the most ‘pure’ form of aesthetic connection.

What I really do is work in human connection.

In a world of social media, the isolation of smartphones, and A.I., presence and human connection are needed more than ever. Especially for someone who is in the hospital and challenged with a life-threatening illness.

Music is a great connector. We can communicate through music in a way that we cannot through words. Music transcends spoken language. Music expresses emotion and provides validation and empathy. And music creates an aesthetic connection.

“The morning mist…” He was in pain. Three weeks in the hospital with complications from brain surgery. He could only lie in bed and stare at the ceiling. A journey. A grind. When will it end? But now… something different. Something aesthetic. I offered some soundscape on the guitar. Something to help refocus, and ‘hold’ him in the space. After 30 minutes, as the music was winding down, I noticed that his face was ‘softer’. Then he said… “The morning mist. That is what I’m seeing and feeling with the music. The morning mist.”

So… the next time you go to a concert, experience it, don’t try to ‘capture’ it. Experience it fully, with your mind, body, and soul. Live in the moment and create the memory. My memory of Sara Bareilles’s performance of She Used to be Mine is captured in my brain, and I will always have that memory. And when I recall that memory, I feel it all again.

The healing power of music…

Can you recall a ‘live’ aesthetic experience that has stayed with you? Something where the experience took over your mind, body, and soul? Let me know in the comments below. I love hearing from you.

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Thanks for reading and supporting this newsletter! If you enjoy today’s post… please share.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

A few weeks back, at one of the hospitals where I work as a music therapist, I was asked to visit with a woman, in her 70s, in the oncology unit. She was having some complications with treatment and was feeling down. The referral was to help with emotional support, and coping with hospitalization.

When I entered the room, she was sitting in the chair and peering out the window, not really looking at anything in particular. When she finally saw me, she welcomed me in with a soft smile. I asked how she was doing and she gave a little chuckle. “I’m sitting here, so…” I sat and we had a chat, about her illness, her hospitalization, and how she was generally feeling defeated. I offered my ear and gave her my presence. After a bit she said, “Enough of that. What about you?” I gave her my elevator pitch on music therapy and she was happy to get to some music. “I need something positive. Let’s do it.”

She told me that she was a ‘folkie’, played a little guitar, and loved the folk artists of the 70s, especially Harry Chapin. “I saw him once, walking down the street in Greenwich Village! And I was a fan-girl.” She gave a little laugh as she recalled the memory. “Can you play Cat’s in the Cradle? I love that song.”

I got to the second chorus. Then the song took me down.

You see, my dad passed away in February after suffering through dementia for the past few years. It had been hard watching his decline. He was always a vibrant and happy-go-lucky guy who enjoyed his simple life as a neighborhood barber. He was a jokester and always made everyone laugh. But he became a shell of his former self and had become lost, angry, and agitated (understandably so) as he slowly faded away. He passed peacefully in the hospital and we were all there with him when he finally let go.

At the same time, like many young adult men these days, my son has been struggling. For the past year he had become more and more lost, also a shell of his former self. It’s been hard to watch and it feels as though none of us have any control over the situation. Especially him. The hardest part for me is that I don’t know how to help him. And I feel bad about that. You want your children, no matter the age, to thrive and have joy in their lives. Right now there is not much joy.

So there I was, the therapist sitting with the cancer patient, half way through Cat’s in the Cradle, becoming overcome with emotion. (That song really isn’t fair.)

The patient put her hand on my knee and said, “What is it dear?” I said, “Well… I recently lost my dad. And my son is struggling.” It was weird how freely I blurted that out, considering the circumstance. And it was also weird how normal it felt. She said, “I’m so sorry. It must be hard for you.” [The technical term may be countertransference, but what we had here was role-reversal.] After sitting in the silence with me, giving me her presence, she got up, and gave me a hug as my tears flowed. Then, we chatted some more, almost as equals now, or two people helping each other through the throes of life. She was empathic. And I actually felt better after I left her room. (And somehow, I feel as though she felt better too. She was obviously comfortable in the ‘caring’ role. Perhaps it gave her a sense of control and a renewed sense of self.)

A simple song

Songs are powerful. Songs bring us to places and to people from our past and our present. Music prompts emotion – music is emotion – and when the right song connects with the right emotion… you have release. This is one of the reasons that music works as therapy. This was the perfect storm, the ‘perfect’ song to prompt a much needed release for me. Although the timing and place may not have been the best.

Songs seem to hit the hardest when we are least expecting it. When we are holding things in that need to come out. When we can’t find the words to express our feelings. Songs find us. Music gives us what we need when we need it. I see it every day. Usually in the patients that I work with… not myself.

And the patient. The woman. I needed her too. She was perfect for me in that situation. Sometimes people find us too when we least expect it.

So this Father’s day, I’m feeling a bit melancholy, and working through a lot of emotions. I’m feeling right in the middle. I miss my dad. I ‘miss’ my son. For those who read this newsletter regularly, you know how I feel about sitting in the melancholy. It’s okay. It can be good. Therapeutic, if you will. And we have music (and art) to help us experience and navigate it all. (Maybe just not Cat’s in the Cradle.)

I do have the memory of my dad. He was a good dad. I feel him whenever I’m watching baseball, see someone fishing, or hear some humor that matches his. Sometimes I laugh out loud when I recall one of his pranks. And my son? He’s still my son. I do see ‘him’ in there occasionally, and I love his dry humor – which I think he got from his grandfather – that occasionally breaks through. Or his smile when he sees our cats doing crazy things. He’s stubborn, but he’s kind. He’s my son. And I love him unconditionally. We are working on getting him some help.

For all the fathers out there, enjoy your day, regardless of how it hits you. Hug your dad. Hug your son. Remember, they need you. And they love you. Whether they are still here or gone, hold them in your heart. They are forever yours.

The healing power of music…

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

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Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Suburban Baltimore. Senior year. When school was winding down and the opening riffs of summer were tickling the air, everything was in the air. The yearning and desire to just go, wanting to be free and letting it all out – testosterone… hormones… whatever you want to call it – we were ready to explode. The flowers were blooming. The girls were blooming! We wanted (needed?) to just go. And the music! The vibrant soundtrack of burgeoning adolescence blaring through newly installed cassette decks through speakers that were way-too-big for sedan square footage. (Did we really know what woofers were?) By 6th period on the last day of school you could start to collectively feel it… subtle movement like a wasp’s nest slowly awakening. Your feet could not stay still during algebra. You couldn’t stop looking at Angela’s Jordache jeans during study hall. The day dragged on and on and on and on. Finally… the bell rings. The halls fill like a hundred rush hour subway cars just opened their doors. Suddenly, high schoolers with purpose! And through the crowd I see Ricky. As we merge together and head for the student parking lot, his eyes focused, his heart beating through his ‘I Want My MTV’ t-shirt, he says to no one in particular… “It’s Van Halen weather!” Windows down… Volume up... We go!

As schools are letting out and I see kids with backpacks smiling and bouncing down the street, I can still recall that feeling. There was nothing like the end of school and the beginning of summer, right? I bet you can still recall that feeling, regardless of how many 10s of high-school reunions have passed. (Anyone of a certain age still feels that rush when you hear the opening guitar riff from Alice Cooper’s School’s Out.) And what else takes me back to the carefree days of summer? The music!

Music prompts memories, takes us back, and makes us feel something. Listening to Van Halen takes me right back to those important people and the times we shared. And every early summer, to this day, when the sun is out, and the windows are down, I think… it’s Van Halen weather! and I pull up my playlist and go. I think of Ricky. I think of my youth. And I think about the good times. And I feel sooooo good!

As I ease out of the cul de sac, and EVH’s guitar kicks off ‘Ain’t Talkin Bout Love’, I accelerate onto the highway and the shot of dopamine explodes in my brain. I feel youthful. I feel carefree. I feel the wind running through my… uh… over my head. As I hit 4th gear and pump up the volume I feel like I’m ‘Running With The Devil’...

Bonus! - Here’s my ultimate Van Halen Playlist!

What music brings you back to your carefree days when the windows are down and the volume is up? Let me know in the comments below. I love hearing from you!

The healing power of music…

(The stories presented in this newsletter ARE based on actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

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Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

We need beauty in our lives. Living, working, simply ‘being’ in beauty makes everything a little better. As I’m writing this I’m sitting in a library looking out the window at a beautiful azalea bush. Vibrant pink bursting out against the rich green leaves. The pink is even more pronounced within the backdrop of the cloudy day, almost as if saying, “I’m here, no matter what.” Beauty transcends the gloom. As I continue to focus on it, it almost feels as though it’s reaching for me. Calling me. I start to sense a higher power. It settles me and it fuels my soul. And it’s right there. On a suburban street right under my nose. I noticed it by simply looking up. I wonder how many people walk or drive by without noticing it, getting some inspiration from it. If we look up, no matter where we are, we will see beauty. Beauty is everywhere. And it will fuel your soul.

Now… imagine being in a hospital and seriously ill. Feeling the dark and gloom that settles in your mind when you have nothing to do but lie in a hospital bed perseverating on your fate. Where’s the beauty now? Medicine works to heal the body. But what works to heal the soul? I think we all realize the connection between the body and the soul. And yes, the body needs medicine. But what heals the soul?

“That was beautiful.” - On a recent day, working as a music therapist in the hospital’s intensive care unit, this is what two patients said to me after experiencing music.

She was experiencing intense respiratory issues, needing help to simply breathe. Machines… hoses… oxygen… When I walked into the room she was lying in the bed seemingly so focused on her labored breathing that I could ‘feel’ her anxiety emanating from her. I suggested that, for a few moments, she try to focus on some music. She likes the 50s so I provided some songs (Elvis, The Everly Brothers, The Coasters, and a little Sinatra) in a relaxed, soothing style. Her face slowly softened. Her eyes gradually brightened and the anxiety seemed to melt from her body. And… her breathing slowed and deepened, entraining with the music’s tempos. When I finished, she looked at me with wide eyes and said, “That was beautiful.”

[When I started the music, I purposely set the tempo to match her breathing rhythms, and then gradually decreased it to help slow her breathing. It’s called entrainment. Our breathing will ‘entrain’ to the tempo of the music.]

Next…

She had a recent stroke. Her face looked hard and her body tense. Just a few days ago she was living her life, but now here she was in an ICU bed having trouble speaking as a result of the left-sided brain injury. But when she saw me with my guitar… she gave a slight smile, looking almost as if she were in a dream. Again, “focus on the music.” I had heard from the nurse that she loved John Denver.

As I started Leaving on a Jet Plane, her face softened, and her body seemed to melt into the bed. It was like an ‘aural’ blanket was now comforting her. As I moved into the second chorus, I paused and said, “You must know the words. How about singing along with me?” It took a few moments, but then… a few words. She seemed surprised. Life (beauty?) had come back into her eyes. Then, when I played and sang Annie’s Song (her favorite), a few tears sparkled on her soft face, creating an angelic glow as she took it in fully – seemingly listening with her entire being. When I finished, she looked at me, almost childlike, and said one word, “Beautiful.”

[Even though she was having issues speaking, she could ‘sing’. Speech comes from a specific part of our brains in the left hemisphere but singing activates multiple parts of our brains, in both hemispheres. That may be why she was able to sing.]

Beauty soothes the soul. (Music soothes the soul.)

Maybe we take beauty for granted. It’s all around us, yet, we don’t often see it. Maybe we take beauty for granted until we really ‘need’ it, like when we are sick or hurting or suffering (or dying); when all beauty seems to have been taken away.

Maybe life would be better if we simply looked up to see and experience the beauty around us more often. I mean… it’s right there!

Maybe give yourself a chance to notice the everyday wonders that are right in front of you, that you’ve been too distracted to see. We spend a good part of our day looking down – at the ground, at our phones, at nothing – lost in the thoughts of work and dread, of yesterday and tomorrow. But… if we just look up, you’ll see the beauty of the real world. Nature’s art. An eternal sketch of vibrant hues. The sacred and the miraculous are everywhere. A flower, or even a weed in the rich earth on the side of a path. A bird song. A clear blue sky that you can look right through towards something divine. The distant sound of someone practicing the cello. A vibrant pink bush outside the library window. You will see Shakespeare, Monet, and Chopin in nature’s art if you just look up. You will see beauty all around. And maybe things will be a little bit better.

The healing power of beauty… (and music)

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Thanks for reading and supporting this newsletter! If you enjoy today’s post… please share.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Music therapy is a clinical process.

“Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.” - American Music Therapy Association

Music therapists are clinicians.

“Music Therapy requires a board-certified music therapist who has been trained to use very specific, research based, individualized music interventions to help meet the immediate needs of the patients they are working with.” - American Music Therapy Association

As a music therapist working in a hospital setting, my job is to deliver evidence-based music interventions as an addendum to, and in concert with, patients’ medical goals. I assess the patient’s needs based on the medical plan, work interdisciplinarily with medical staff, and design and deliver researched and practiced music interventions to address said needs. I then ‘chart’ their progress in the medical records and recommend ‘next steps’ based on my overall assessment of the session’s outcomes.

That is the job of a music therapist working in a hospital setting.

But what is my job, really?

In a world of social media, the isolation of smartphones, A.I., and political division, presence and human connection are needed more than ever. Especially for someone who is in the hospital and challenged with a life-threatening illness.

Music (or any art form) is a great connector. We can communicate through music (and art) in a way that we cannot through words. Music transcends spoken language. Music expresses emotion and provides validation and empathy. And we can be present with each other within a music experience.

Oftentimes, those who are in the hospital and debilitated by disease are dealing with extreme isolation. (Sometimes literally depending on diagnosis.) Medical staff are focusing on the patient’s physical needs. That’s their job. But no one is really focusing on the emotional and psychosocial needs of patients.

Conversations with medical staff mainly involve treatment plans, medication schedules, physical therapy goals, and monitoring ‘numbers’, but what seems to be missing is real connection on a human level. What’s missing is presence. Music is presence. And music (and art, and poetry, and creativity) is connection on an emotional level.

So… my job, at the most basic human level, is to give presence. My presence. (And music.) That is the most important thing that I can do to help. It really is as simple as that.

My job is to give my presence through music.

This week a memory came up from a few years ago that hit me hard. A memory of a young woman that I worked with on a regular basis for over a year as she was battling cancer.

Here is what I wrote:

So young and so unfair that cancer riddled your body. And I know it was hard for you to speak with anyone about the emotional strain, considering the cultural differences and language barriers. I remember when we met. I was unsure if I could help. But when I brought in my guitar and asked if I could sit, you gave me a welcoming, warm smile – a smile that I will not soon forget – even though I could see the pain underneath. When I played, you closed your eyes and your face softened, almost trance-like. As it did every time I gave you music. I could see the real you. That was over a year ago. And since, we shared many moments as you went through treatment that also riddled your body. Lots of tears, pain, smiles, music… connection. And presence. You always said that the music made you “feel soft.” Your way of saying it was comforting, I think. And it’s not lost on me that you always asked me how I was doing. As things really started turning, you once asked me if I would hold your hand. I was unsure… but I took it and we just sat together in silence for some time. I could see how hard, and painful, the last few months were. I only hope that I was able to bring you a little comfort. Now… no more pain. Now… no more suffering. Now… peace – finally. I’ll miss our time together. And your smile. Rest easy. Maybe you can still hear my music. Rest easy…

Christy* was young, in her 30s, and was from a country in the Middle East. She had not been in the U.S. for more than a year when she was diagnosed. Her English was limited, and it was hard for staff to communicate with her, including social workers and therapists. I do remember the apprehension I had when I was first asked to visit with her when she was in for out-patient chemotherapy treatment. I wondered if I would connect with her. How we would communicate? I wondered what to do.

But we did connect. We connected because I gave her my presence. (And she gave me hers.)

I remember the first time I visited her. Her big brown eyes looked at me, perhaps wondering why I was there with a guitar. But she smiled when I introduced myself. A smile that lit up more than just her face. A smile that was there until the end, even when the pain was unbearable. A smile I can still recall.

I also remember how, from that very first day, she took in the music. I would improvise on the guitar, providing music for comfort. It seemed to completely consume her. Take her away from everything that was so uncertain. Take away the pain for a bit. I would watch her as I played. And sometimes, (most times) it felt as though the music was just ‘coming out’ without my control – just taking over and creating a connection between us beyond language.

For many months I saw her regularly when she was in for treatment. And then, in the hospital, when treatment could no longer keep up. There is no other patient that I’ve worked with, and spent time with, more than her. We formed a special bond that sometimes felt too much outside of the therapeutic relationship. Outside of my ‘job’ as a therapist. But, considering her isolation, including some challenges in her personal life, our bond seemed to help her throughout that trying time.

When the end was near – and I obviously knew what was coming – I braced for the day that I would find out that she was gone. And when I did, it hit me hard. I felt as though I had lost a friend. But I took solace in being able to give her something that was, perhaps, more important than anything she needed during that time. My presence. And, of course, music.

Is there anything else so powerful as presence when someone needs ‘something’ more?

I wonder if some of the division, anxiety, and anger in the world today could be alleviated simply by being more present with each other. It’s so easy to rant on Facebook about the issues of the day, but no one seems to actually talk to each other on a human level. Everyone seems so ‘connected’, yet so isolated.

Maybe something as simple as giving a smile, or a nod, to someone you pass walking down the street (if they are not looking down at their phones) or putting your devices away when having lunch with a friend, would help. Maybe what we need is a little more human connection… a little more presence with each other.

There is something so valuable in giving someone your presence. And it takes very little effort, and it doesn’t cost a cent. And in doing so, you will benefit too. I’m so honored that I got to meet and get to know Christy. I’m glad that I could give her something that may have helped when she was hurting. And she gave me something too. She gave me her presence. And that has left an impression on my life… one I can still feel to this day.

The healing power of music (and presence)...

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

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Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

It’s Memorial Day weekend, the ‘unofficial’ start of summer! So it’s time to get into ‘summer music’ mode.

Summer (in my opinion) is the best ‘season’ for music – It’s the beach, outdoor parties, cook outs, summer concerts, and windows down and volume up. We don’t generally have a Fall or Winter ‘anthem’, but summer? Well… music enhances the lazy, hazy days.

We know that songs bring us back – to people, to places – and prompt memories, (our music memories are some of our strongest memories) and the songs of summer, the soundtrack of sun and fun and all that goes with it, is where most of the best memories reside…

The summer of 1980: Frank Della Noce was the first of our crew to get his license. And… he had a car! A beat up, 12-year-old VW Bug that we sometimes had to push to get started. We had just finished sophomore year and things were happening. Things started popping, (I’m talking about our acne pocked faces), and things started stirring inside us – especially when the summer heat arrived. (And when Donna Benoitt started wearing tank tops.) Like I said… things started popping.

In the evenings, after our summer jobs as dish washers, or mowing lawns, we’d all pile into Frank’s beat-up bug. (Glad he didn’t bring the ‘other’ car. Frank’s family was in the funeral business and he would occasionally drive the hearse to school. Once we even sat in it and listened to a brand new Rush cassette. But that’s a story for another day.) We had little money. We had nowhere to go. But we would drive. And… we would ‘look’ for girls. (I don’t think we ever found any, and not sure what we would have done if we had, but it was all about the possibilities.)

The testosterone level in the car was as high as the volume crunching out of a speaker in the trunk that belonged in a 1970s den. Frank couldn’t afford oil or spark plugs, and sometimes we had to crawl out of the window on the passenger side because the door wouldn’t open, but he had a killer sound system! Someone just got the new Foreigner cassette, ‘Double Vision’, and as we started our evening journey, we popped it in (a lot of things were popping then) and Track 1 – ‘Hot Blooded’ started the soundtrack of the summer of our pent up teenage angst.

The Summer Anthem

It may be a collective song of a particular summer, a song from a summer blockbuster, or a song that simply hits home and is stamped with a summer memory that when you hear it, it brings you right back to Frank’s beat up VW Bug.

We all have our favorite summer anthems. And for me, no song in the history of music represents the transformation of my youth into adolescence than what I felt then and there… that summer – hot blooded, desire, the need for release, the pursuit of Donna Benoitt in a tank top – while driving around in an old VW Bug. That song represents the summer when things, well, started popping.

My ultimate summer anthem is… Hot Blooded.

“Well I’m hot blooded, check it and see

I got a fever of a hundred and three

C’mon baby do you do more that dance?

I’m hot blooded, I’m hot blooded…

When I hear this song now, I feel it all again… I’m right back there, in the suburbs of Baltimore, without a worry to be found.

That’s what great songs, meaningful music, does. It gives us that kick, and for 4 minutes and 28 seconds takes the weight of the world away. I’ll be listening to Foreigner (and Van Halen, Rush, Boston) this weekend to get into summer mode. How about you?

(I wonder what Donna Benoitt is up to these days? Frank too I suppose. Windows down… volume up… let’s go!)

What is your ultimate summer anthem? What is the one song that takes you back? Brings out the best summer memories for you? Makes you feel like something is popping? Let me know in the comments below. I love hearing from you!

Bonus! - Here’s my current Ultimate Summer playlist. Enjoy! (What songs can I add?)

Have a great Memorial Day weekend!

The healing power of music.

(The story presented in this newsletter is based on actual accounts or experiences.)

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Thanks for reading and supporting this newsletter! If you enjoy today’s post… please share.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

There are two ways that we listen to music, passively–which is most of the time–and purposefully. Listening passively is when we have music on ‘in the background’ while doing something, listening while cleaning, driving, going for a walk, working, reading, you name it.

But purposeful listening is when the music is the main attraction, the focus. When we listen to music with purpose, we ‘get’ more from it; the textures, the lyrical connotation, the underlying nuance. We may focus on the cool bass line (one of the coolest is John Deacon’s bass line in Queen’s You’re My Best Friend), the interesting drum fills (obviously anything by Rush), the background vocals (Did you know that the whispering background vocal on the chorus of Carly Simon’s You’re So Vain is none other than Mick Jagger? Could the song be about him?), or the mix (how Sting’s vocals on the Police’s Every Little Thing She Does Is Magic feels ‘way in the back’).

Also, purposeful listening invites us to pay more attention to the lyrics, the interesting meter, or how the vibe of the music connects with our emotions at the time — and when we do, we get something more from the music, such as validation of our feelings, empathic connection (Think Everybody Hurts by R.E.M.), or more of an aesthetic experience. This is where music gives us what we need when we need it. Sometimes we need to wallow in the melancholy of Leonard Cohen, the reflective profoundness of Joni Mitchell, or the empowerment of Lizzo.

When we listen to music with purpose, we experience the entire aural and emotional profile that connects our mind… body… and soul.

Music therapy

In music therapy, the music is always purposeful. The music is a tool to help work towards a need or a goal. It’s where the inherent elements in music work with the body as we ‘entrain’ to rhythm, tempo, and timbre. Great music builds tension, and then when it resolves, we actually feel it in our bodies — the goosebumps we get, the ‘awe’ factor. Think Beethoven’s Fifth. The entire four-movement piece builds from the famous, dark motif until the breathtaking explosion of relief and joy when we hit the final movement. We physically ‘feel’ the resolve.

As a music therapist working in a hospital setting, when working with someone who is in pain, I may use tension and release in the music to help guide them through their discomfort. I may start by having them focus on their pain as they breathe into it while I’m holding on a minor chord (Em) on the guitar. Then, when I prompt them to exhale, I’ll resolve the minor chord (Em) to the major equivalent (Emaj); the resolve. Then we may go to Am - Amaj, Dm - Dmaj, etc., to hold the tension on the breath in (the minor chord)… then let it all go, or release, on the exhale (the major chord). This can help ‘move’ some of the pain out of the body, which decreases pain perception.

Or… If someone is extremely anxious I may use ‘clinical’ improvisation on the guitar. Clinical improvisation is creating the music in the moment, purposefully, to ‘meet’ the patient where they are, and then gradually changing and manipulating the music to help bring them to where we want them to be; to help prompt a relaxation response. When I initiate the music, it sounds like how I imagine they are feeling. There’s dissonance, minor modes, and tension. The music connects to their deepest fears and entrains with their anxious feelings. In doing so, the music also provides validation and empathy. Then, once we are fully aesthetically connected, I’ll start moving the dissonance to more harmonic themes, the minor modes to major foundations, the tension to resolve. This prompts a relaxation response in the body. There have been many times when someone is so anxious when we start that they are rolled up in a ball in the bed and shaking. Then after 30 minutes of this type of intervention, they are sleeping. Again, the music purposefully meets them where they are, then helps take them to a more comforting place.

The purposeful use of songs in music therapy

Songs give us so much. Especially for someone who is coping with being in the hospital, dealing with the emotional pain of a life-threatening illness, or navigating a new cancer diagnosis. Songs connect us to others and to ourselves. Songs speak for us when we can’t find the words. And songs help us reflect on life, and our mortality, say, when a doctor suggests stopping treatment because it’s no longer working and it’s time to look towards a more palliative plan. Songs can help process it all. When we are working through a myriad of medical challenges, we can find profound connection in music, specifically the lyrics of meaningful songs.

She’s in her 60’s, with a new cancer diagnosis, and is in the hospital going through treatment. Her doctor said to me, “Her body is wrecked, her mind is wrecked, can you please visit?”

I sat with her for a few moments, just trying to be present as she looked exhausted and pained and anxious and... all of it. I played some ‘soundscape’ on the guitar, just to hold her in the space. She closed her eyes. Then I moved into some songs that were, perhaps, meaningful for her. I started with Stand By Me.

My tempo and arpeggiated accompaniment were pensive against the somewhat positive lyrics. Her face softened with the music and after the song, without opening her eyes, she said, “Yesss...” I moved through a few additional songs, and she really seemed to fully take the music in. She was languidly moving her arms and occasionally sang a few familiar lyrics with me. I kept the mood reflective but started adding a little energy, for some movement. I closed it out with a relaxed, yet uplifting, version of I Can See Clearly Now. When the music concluded, after a moment she slowly opened her eyes and said:

“These songs make me happy and sad at the same time. It’s just what I need.”

That statement. It almost sums up what music therapy is. And what purposeful music can do. Music brings, prompts, and releases held in emotions, but music also has an inherent underlying beauty in it that we connect with. It’s the perfect dichotomy of projecting what is being felt against what wants to be felt. It’s all the emotions, together in the moment, funneled through the aesthetic experience.

In the hospital, and in life, purposeful music has the capacity to engage multiple physiological and neural systems that not only help the body, but mend the mind, and lift the soul.

Purposeful music can give reprieve and release, prompt a relaxation response, bring connection and a sense of control — and offer comfort during the very last moments of life.

Purposeful music gives us what we need when we need it. When you are finding yourself in times of trouble. Listen to some music… purposefully.

The healing power of music.

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

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I asked the Internet how many songs have been written in the history of popular music. The answer? Somewhere between 50 and 200 million. That’s a lot of songs. I’ve certainly not listened to anywhere near all of them, nor have I conducted any lavish research study or worldwide poll. Nevertheless, in my opinion, there are two songs that stand above and beyond the rest. This may be a bold statement, but because I have (given myself) the authority to make such statements, I declare that the two greatest songs ever written are:

Both Sides Now (Joni Mitchell)

In My Life (The Beatles)

Both Sides Now was written in 1967 and released in 1969 on Joni Mitchell’s album ‘Clouds’. [Although, an early version of the song by Judy Collins appeared on the singles charts in 1968.] Joni Mitchell has said that Both Sides Now was inspired by a passage in the 1959 novel Henderson The Rain King by Saul Bellow:

“I was reading Henderson The Rain King on a plane and early in the book Henderson is also up in a plane. He’s on his way to Africa and he looks down and sees these clouds. I put down the book, looked out the window and saw clouds too, and I immediately started writing the song. I had no idea that the song would become as popular as it did”.

What makes it so poignant, so iconic, is that the song somehow captures the universal experience of gaining wisdom through life experience; using clouds, love, and life as metaphors for this journey. There’s loss of innocence, the complexity of love, the mystery of existence, and resolved wisdom. It seems to capture that moment when we realize life isn’t the fairy tale we imagined, and does so with grace rather than cynicism. It’s very ‘matter of fact’. That, along with its musical simplicity, seems to give it its power. Oh… Joni Mitchell was just 23 years old when she wrote it.

Written by John Lennon (although credited to Lennon-McCartney), In My Life first appeared on the ‘Rubber Soul’ album, released in 1965. John Lennon has said of the song that it was his “first real major piece of work” as it was the first time he had written “personal lyrics” about his own life. Many reports suggest that he wrote the lyrics of the song while riding a bus through his hometown of Liverpool, seemingly reflecting on when life was simpler. ‘Beatlemania’ had recently exploded and life for John and his bandmates would never be the same.

In My Life is profound, filled with perspective and wisdom; a reflection on a life fully lived—of what once was and reminiscing about those who had an impact in shaping one’s life. Perhaps even now pondering mortality… In my life I’ve loved them all. It’s one of those rare songs that feels both deeply personal and completely universal at the same time. Oh… John Lennon was just 25 years old when he wrote it.

The reason I make such a statement is because of how effective and powerful these songs are when used in the context of music therapy practice in a hospital setting. These are the two songs I keep coming back to and have used hundreds of times with patients who are in pain, experiencing anxiety, coping with illness or a new diagnosis, searching for their voice and particularly, when medical staff are recommending moving to a more ‘palliative’, or even hospice approach.

Music therapy, and songs in particular, helps us experience and understand what we are feeling inside and reflect on what we are going through emotionally. Especially when we can’t find the words. Songs also provide validation and empathy. When we are struggling, there can be profound empowerment found in a simple song. And for me, these two songs continue to provide insight and discovery. Every time I share these songs I also find something new - a new idea, a new thought, a new feeling prompted, a new reflection.

No other songs lead to a more open, and meditative process of feelings, of contemplating life or mortality, than Both Sides Now and In My Life.

I was recently asked to visit with a woman, in her 60s, in the oncology unit, as she was struggling with some difficult decisions. After months of treatment, and not much movement, her doctors were now suggesting a more ‘palliative’ treatment approach.

When I walked in, she looked tired, and defeated, sitting in a chair and staring out the window. When I said, “hello”, she came out of her ‘trance’ and gave me a soft smile, welcoming me in.

In our chat she was reflective, mainly about her life; mentioning her family and the memories that she holds onto, but also wondering if they were going to be okay. She was thinking about what it may be like for them when she is gone. She was also struggling with her sense of self—trying to connect her former self (young and healthy) to her current self (terminal cancer patient). After a pause in the conversation, I said that I had a song that I would like to play for her.

“I’ve looked at life from both sides now
From win and lose and still somehow
It’s life’s illusions I recall
I really don’t know life at all…”

As she was listening, she looked pensive. She became tearful. When the song finished, after a pause she said, “I’ve looked at life from both sides now. Well… here I am.” I gave her some space to reflect. Then she said, “Wow… that song really brings it out. That is truly what I’m struggling with, both sides... feeling like I’m on both sides, or trying to be on one side? I don’t know. Maybe I need both sides. Maybe that’s the point. Maybe all of it is what I am or what I have to embrace.”

We chatted a bit more, about her life, the happy times that made her smile, and the struggle to let go. And also thinking about working towards some sort of resolve. Not necessarily giving in… accepting.

As I was packing up to leave, she looked at me and smiled. “Thank you. Maybe it doesn’t have to be just one side. Maybe I can sleep easy tonight.”

I was recently asked to visit with a woman, in her 70s, who, after recommendations by her doctors, just made the decision to discontinue treatment for her cancer. When I entered her room, she was sitting quietly, looked tired, and was just staring off, seemingly in thought. But, she also seemed oddly peaceful. At first she didn’t notice me, but after a moment, she came out of her ‘trance’ and said, “Oh… hello.”

I introduced myself, told her the nurse asked me to visit, and I asked if she minded if I sat down. She gestured to the open chair. After a few moments of silence, I asked, “How are you doing?” She looked at me and I could see that she was really pondering the question. Finally, “I’m… okay.” I gave her some space. Then she said, “I don’t really know what I’m feeling. I don’t really feel sad. I do worry about others…” More silence. “I really can’t go on like this anymore. I’m so tired. But…” More silence. Finally, I said, “I’m sure there’s a lot to process.” After a pause she said, “I’ve had a good life. I really have. I have a good family… friends… I just can’t…” She couldn’t seem to find the right word. Fortunately, when the words become hard to find, I have music. “Can I play a song for you?” “Sure,” she said. “That would be nice.”

“There are places I’ll remember
All my life, though some have changed
Some forever, not for better
Some have gone and some remain

All these places had their moments
With lovers and friends I still can recall
Some are dead and some are living
In my life I’ve loved them all…”

After the song, her face was soft. She looked calm and she looked peaceful. There would certainly be a lot more processing and emotion to come, but for the moment, she seemed okay. We again sat in silence. Then… “I’ve had a good life… (pause)… I’m… okay.” She looked at me and gave a soft smile. And I could see in her eyes that she really was ultimately going to be ‘okay’.

Music helped in these moments. A song, a meaningful song, seemed to help. Not just any song, songs that give so much that they seem to have come from someplace far beyond consciousness, perhaps penned with help from the hand of God. (Or, at least, Joni Mitchell and John Lennon.)

When there is nothing else left, we have music. And when we need something more, something profound beyond words, we have Both Sides Now and In My Life. The two greatest songs ever written.

The healing power of music…

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

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Recently, at one of the hospitals where I work as a music therapist, I got a referral from Dr. L. in the ICU. This is not unusual as Dr. L. sends me many referrals for her patients. But this particular referral was unusual as it read, “For me and my staff. Please come now.”

When I got to the ICU, she gathered everyone (nurses, clinical techs) and said, “It’s been a heavy couple of days, we need you to lift us up please.”

So, I sat in the middle of the unit and gave them a song (an engaging, yet relaxed, version of I Can See Clearly Now). It’s amazing how music, a simple song, can bring some much-needed release – some tears started flowing through the smiles – and a little reprieve. Even for staff. Dr. L. and the team were most appreciative. Then they all went off in different directions to attend to their patients. I’m so glad that I could offer them ‘something’ to help.

While this was an unusual referral, it was not an unusual request. On any given day, as I’m walking through the hospital, I will hear: “We need music therapy!” “How about some music for us!” “Would you sing me a song?” These quips are often jovial and light-hearted, however, there’s always an underlying tone that I hear… “We need ‘something’ too.”

I’ve noticed a few things over the years:

• Nurses or Clinical Techs, coming in to ‘check’ IV lines and monitors, administer meds, etc., while I’m in the room providing music for a patient.

• Nurses opening a door, that I just closed, while I’m in a room providing music for a patient.

• Nurses charting on a computer, sitting right outside the door of a room that I’m in providing music for a patient. (A few have come clean that they do that on purpose.)

They all think that they are so sly. But I’m on to them.

Not long ago, for a few weeks a nursing student, whose class was doing rounds for the semester in the oncology unit, had been jokingly saying to me, “Yeah, you play everyone else a song, but what about us?” So one day when she asked, seemingly in jest, “Hey… Would you sing me a song?” I said, “Okay”, and behind the nurses’ station I took out my guitar and sang Count on Me (Bruno Mars). Her classmates also came over to listen. She was in tears. After I finished, and we all started going about our business, she came over and gave me a hug.

There was the time when I was in a room doing a session with an older woman when her nurse came in to ‘check on some things’. And lingered. This patient had been in the hospital for several days, was frail, and was just placed on in-patient hospice care. The nurse asked me to see her because “She has no one, no visitors. She’s all alone.” I could tell that the nurse was really feeling something with this patient. When I started singing and playing Bicycle Built for Two, the patient smiled. I looked at the nurse and she smiled too. I could see on her face that there was some emotion building. Then… when the patient started singing along – “Daisy, Daisy, give me your answer do. I’m half crazy, all for the love of you…” – the nurse went to the bed, sat next to her and held her hand, and the three of us sang the rest of the song together. After we were finished, and we left the room together, the nurse gave me a hug and cried on my shoulder.

The nurses (and doctors, clinical technicians, nurse practitioners, rehab therapists) that I know are all compassionate and caring. They give so much. They see pain and sorrow and hurt every day, and try to bring comfort for those who are suffering. They try, I’m sure, to not ‘let things get to them’, ‘get too involved emotionally’, but they do. How can you not? This is human connection. This is hard work. And everybody needs ‘something’ sometimes. Perhaps some music. Something aesthetic and with beauty. A simple song.

Music therapy, in the hospital, is for everyone. When I’m working with a patient, if a nurse or tech is in the room, it’s for them too. If family members are in the room, it’s for them too.

And these nurses… they get it! They ‘get’ music therapy! They see that music therapy can help their patients and they know that music therapy is a legitimate clinical practice that belongs in the hospital. I get a lot of referrals when nurses feel as though their hands are tied, and are, perhaps, unsure what to do next – when a patient is in pain and they can’t give any more meds, when a patient is anxious because they have a biopsy scheduled for later in the day, when a patient was told of a new diagnosis, after a conversation when a doctor just suggests moving to a more palliative plan as treatment is not working. – This is when they call me. This is when music therapy can help as an adjunct to traditional medical care, helping with both the physical and psychosocial needs of their patients.

Just this past week I overheard this from an ICU nurse at one of the hospitals where I work:

“Y’know, there’s research and scientific evidence showing that music therapy can reduce anxiety and help people cope with being in the hospital. Can I have Ray come and see your dad?”

Of course, when I went into the room and got out my guitar, this nurse came in to ‘check’ on IV lines and monitors, fix the sheets on the bed, made sure the lights were right, checked the shade, water the plants, re-calk the bathroom…

After all, can’t we all use a little music to help us get through a hard day?

Next week is National Nurses Week. If you know a nurse, or see a nurse, thank them for what they do. Thank them for being there whenever your mom, dad, daughter, son, grandmother, uncle, friend is in the hospital and needs some loving and compassionate care.

I personally want to say that I am honored to work with all the nurses that I have had the pleasure of working with. They are the real deal. They truly make a difference for their patients. And they make a difference for me. Thank you. (And anytime you need a song, just let me know.)

The healing power of music…

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Thanks for reading and supporting this newsletter! If you enjoy today’s post… please share.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

Music is emotion.

Music creates and prompts an emotional response.

And when emotions are heightened, especially when someone is hurting, or anxious, or ill, there is a lot of tension held in; it’s a natural response to not overly show emotion. But some things can only be held in for so long and need prompting for release.

Cue the music.

This could be a meaningful song, a soothing soundscape, an anthem of empowerment, or a melancholy string quartet that connects to inner feelings.

Or…

When purposeful tension is included in the music that is being created, in the moment, by a music therapist—initially matching the patient’s anxiety or pain—then gradually moving towards resolution.

When the minor moves to major, the dissonance to harmony, the tension to resolve…

Tension.

Emotion.

Release.

Often, we don’t realize that we are holding onto such tension. And, more often than not, it’s hard to find the words to express these repressed emotions. Then something happens… we hear a beautiful piece of music, see a work of art that we connect with, read a poem that sums it up and touches our soul beyond comprehension.

And there is a release.

A cathartic experience.

And this is a good thing.

This is one of the many reasons music therapy is beneficial in a hospital setting. In fact, facilitating this ‘release’ is a big part of my job.

When I entered the room he looked at me and glanced off-puttingly at my guitar. He looked ‘stoic’, but I could see through it. I introduced myself and told him that the nurses asked me to come in and maybe play a little music - “Just to help you relax, give you something else to focus on.” He dismissively said, “I don’t care. If you want to.” I asked him, “What kind of music do you like to listen to?” “I like anything from the Beatles to Radiohead. I like Foo Fighters.” So, I went into an easy version of ‘Times Like These’:

“It’s times like these you learn to live again.

It’s times like these you give and give again.

It’s times like these you learn to love again…”

Before I could get through the first verse… there were tears. As I always do when this happens, I paused and asked, “Should I keep going?” And as they always say when I ask, he said… “Yes please.”

It’s not just the patients.

I went to visit an older woman in the ICU who had a stroke. She was minimally responsive and unable to focus or answer questions. I was asked to provide some music for orientation. Her daughter was sitting in the corner of the room and looking at her phone. After telling her why I was there, I started to bring some music in. Initially I was just giving some soft soundscape on the guitar, just to set the tone. I noticed that the patient’s heart rate gradually increased, perhaps showing an awareness of the sound stimuli. I continued, following her body-rhythms with the tempo and feel of the music. After a bit, I merged into a ‘lullaby’ version of ‘Edelweiss’ (from The Sound of Music). As I started singing, her daughter got up from her chair, went to the bed and took her hand… and started to cry.

Tension.

Emotion.

Release.

I facilitate a weekly music therapy group for the organization Life With Cancer. Members are at various stages of their cancer journey. This past week we had a very emotional session. A few members of the group shared that over the past few days they found out that their cancer has recurred. This, I imagine, is the biggest fear for someone who’s had cancer, even if they have been ‘cancer-free’ for years.

[I’ve heard the term scanxiety many times. This is the intense stress, anxiety, or fear patients experience before going in for imaging scans, commonly associated with cancer check-ups. Once you’ve been there, you are always there.]

This news really shook everyone in the group. Mainly, they all realized that this could be any one of them at any time. Some were offering comforting words, or a quick “I’m so sorry.” But mostly we were sitting in the silence, and weight, of the moment. This is a virtual group, but I could feel the tension everyone was holding in bleeding through the screen.

I turned to music.

I asked, “What do we need right now? Is there a song that speaks to what we are all feeling?” After a pause, someone quietly said, Everybody Hurts (R.E.M.)

I played the recording of the song and we all just listened.

And we all (including me) let it out.

Tension.

Emotion.

Release.

In music therapy, we often start by using music to meet where we are. To speak for us when we can’t find words. To match our emotions. We first have to experience what we are feeling, even honor it, before we can move on. The aesthetics and beauty of music makes it a perfect vehicle for holding us in the moment. This was the perfect song.

We moved on to a few more songs, including The Long And Winding Road (The Beatles), and ended with some uplifting instrumental music (by an artist named Farid Farjad, who someone in the group suggested). The mood was still contemplative, but things shifted a bit. We all seemed to leave at the best place we could be.

The music met us where we were, allowed us to release tension, and moved things forward.

A few days later I got an email from one of the members of the group, reflecting on the experience, “During the session, you and others used the words “peaks, valleys and curves” to discuss the cancer journey. My mind grabbed on to that and would not let it go until I created a Zentangle design called Peaks, Valleys and Curves”.

Zentangle is an easy-to-learn, meditative art method that uses structured patterns (tangles) to create intricate, non-representational images. Here is what she came up with and shared with me. (Shared here with permission):

Another way to release held-in emotion and tension is to create something: art, music, poetry, dance, sculpture, photography. Creativity turns pain into beauty.

“The quest to transform pain into beauty is one of the great catalysts of artistic expression.” - Susan Cain (from her book Bittersweet: How Sorrow and Longing Make Us Whole)

Again, when we can’t find words, we have the arts, creativity, as a means of expression. And isn’t this what art truly is? Expression when we can’t find the words?

There is so much emotion bottled up inside, for patients, caregivers, or anyone working through challenges. Music (and art) prompt release. It’s cathartic. Beauty and aesthetics prompt emotion. It’s needed. And that is a good thing.

Tension.

Emotion.

Release.

The healing power of music (and art)...

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

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Since the beginning of time, and virtually within every culture, music has been a part of the fabric of life. Music is part of ceremony, religious celebration, military ordnance, weddings, funerals, sporting events, and, of course, entertainment. For centuries, Shamans and Medicine Men have been using music for ritual and healing. Then, after WWI when musicians played in veterans hospitals for returning soldiers, the first official music therapy program was initiated in 1944. Now, many hospitals and healing centers house music therapy and arts and healing programs, with music therapists working clinically, and volunteer musicians filling waiting areas and atriums with music. It’s hard to imagine a venue where music is not enhancing general well being.

Why music and healing?

We want ‘harmony’ in our lives. We want to feel ‘in tune’ or ‘in sync’. All musical terms. Music is emotion… and prompts emotion. We use music to reduce stress or to give us a lift, as needed. We listen to music to match our mood, or to change our disposition. Sometimes we may want to dance around the kitchen while making dinner, and sometimes we may want to sit under the covers and enjoy the down-tempo melancholy of a rainy Saturday afternoon. There’s music to support all of our emotional needs.

Our bodies work like music

The foundation of music is rhythm, and our bodies work in rhythm. Our heart beats in rhythm, we breathe in rhythm, we walk in rhythm, and when the rhythm is off, just like in music, everything is off. Our bodies ‘entrain’ to rhythm. When walking through Target, we find ourselves ‘in step’ with the overhead song being played. Or at the gym, or on a walk.

Our heart rate entrains to music’s tempos. This concept is very beneficial in music therapy practice. When working with patients on mechanical ventilation in the ICU, who are anxious or agitated (which we know because their heart rate is high), I will initially match the music that I’m offering (mainly improvised on guitar) to their current heart rate’s beats per minute (bpm), which I can see on the monitor. Then, as I gradually decrease the rhythm of the music, the heart rate will often follow and decrease. Over a 30-minute music therapy session a patient’s heart rate may decrease by 10, 20, 30 bpm or more, therefore prompting a relaxation response.

Our brain activity changes when music is involved

Research shows that our brains work differently when we play music, sing, and even listen to music. We can see, through fMRI imagery, that when music is involved, multiple parts of our brain activate in both hemispheres. This, as far as we know, is exclusive to music association. When there is activity in both hemispheres, powerful neural pathways connect both sides of the brain, and, since our brains are ‘plastic’ (they can heal) this too can be highly beneficial in music therapy practice.

When someone has a stroke involving a left-sided brain injury, their speech is often affected as speech comes from a specific part of our brain, Broca’s area, which is housed in the left frontal lobe. This disorder is called ‘aphasia’.

In music therapy practice, when working with someone who’s had a recent stroke, we may use singing to help get their speaking voice back. Why? Because when we sing, multiple parts of our brain activate in both hemispheres (unlike when we speak, which comes from the specific Broca’s area), and those neural pathways connecting the functioning part of the brain to the compromised area help in the rehabilitation process. Therefore, we can often get a stroke patient to sing first, which can then lead to rebuilding their speech.

All of these music therapy techniques are a result of extensive research, which music therapists learn through intensive university training and clinical practice.

Music is powerful. And music is healing. Especially when used clinically.

However…

Music is powerful. Our bodies work, and entrain, to music. As a result, for compromised patients in a hospital setting, music intervention needs to be monitored by a trained music therapist.

Many hospitals, in addition to programs that employ trained music therapists, also house various ‘music and healing’ programs with volunteer musicians filling hospitals with music. Imagine sitting in a waiting room with anxiety about an upcoming appointment. Would you rather have a TV blabbering some random noise, or music provided by a classical guitarist or harpist? When you walk into a hospital to visit a patient, would it be better to be antiseptic and quiet, or would piano music filling the aural void help lower your anxiety while getting your bearings as you figure out where to go and prepare to see a loved one? I fully support these programs.

However…

Some hospitals–particularly those without a trained music therapist on staff–allow volunteer musicians to wander into patient rooms to ‘play’ for them bedside. Now, if someone is there recovering from a broken leg and needs to have their spirits lifted, okay, but some musicians are also randomly going into ICU rooms to play for patients. This can be problematic.

Let’s say there’s a patient in the ICU as a result of hypotension (low blood pressure) which can limit blood to vital organs. Let’s also say that a volunteer musician goes into that room and plays a nice, relaxing acoustic guitar song. Remember entrainment? Now, they don’t have access to the patient’s chart, or round with doctors like music therapists do so they may not know that the patient is hypotensive, or even know what that means. And they may not be familiar with the monitor readings, so may not know that the BP levels are lowering. Well… the music can cause a relaxation response, which can lower blood pressure. And in this situation, that can be harmful.

Then there may be the patient in Afib (Atrial fibrillation). These patients experience an irregular, often rapid heart rate–the upper chambers beating chaotically, out of sync with the lower chambers, the ventricles, so each is working against the other. Now, suppose a volunteer musician goes into the room and plays a nice song on the guitar that has a solid, pronounced rhythm (One Love - Bob Marley). The heart rate may try to entrain to the rhythm of the music. And that may cause the ventricles to work even harder as they are now not only competing with each other, but also with the music. Music and rhythm are very powerful in working with the rhythms of our bodies, especially when someone is compromised. And in this situation, that can be harmful.

I’ve seen both of these scenarios happen.

I’ve also been in situations myself where the music is not working. I recall a time when I was asked to visit a patient in the ICU, who was on a ventilator, who had high state anxiety. How did they know? For one, their heart rate was high; nearly 130 bpm. This is a typical music therapy referral for me. And this is where I use entrainment, as a tool, to help reduce the heart rate, and therefore, prompt a relaxation response. I set the tempo of the music I was offering to ‘match’ their heart rate (130 bpm). Once we were in sync, I gradually decreased the tempo so the heart rate would follow. This happens in about 55% - 60% of the patients that I work with. [A research study that we conducted at one of the hospitals where I work, published in the American Journal of Critical Care, shows the effectiveness of this approach.]

However…

When I introduced the music, I noticed on the monitor that this patient’s heart rate started to increase. Not the norm, but it happens. (Remember, the heart rate stated at 130 bpm.) I stopped. Gave it a moment. And tried again. When I reintroduced the music, the same thing happened. I stopped. I left the room. And I reported it to the patient’s nurse.

One of the most important things I can do as a music therapist is to know when to stop. To know when the music intervention is not working. To know when the music may be doing harm.

Music can be powerful. Especially in a hospital setting when patients are compromised. This is why music therapy, as a clinical practice, works. But there are times when it may not work, and can even be harmful. This is why a trained music therapist is needed.

It may seem as though I’m against volunteer musicians lending their talents in hospitals. Not at all. I wish there were more music and art in hospital settings. But when working with patients directly it needs to be monitored. There are instances where volunteer musicians can play music for patients, give them a lift, and brighten their day when they are feeling down. But someone, like a music therapist or creative arts therapist, needs to guide these programs. And some do. But there are many hospitals that do not have a budget for music therapy, yet they know that music, art, and something aesthetic, can be helpful (we have a growing body of published research) so they bring in volunteer musicians to fill this void.

Again, I am not against it. Music therapists don’t ‘own’ music in hospitals. But it needs to be moderated by someone who understands the intricacies of how music can have a significant impact on physiological and psychological outcomes.

Music therapists go to school, train, study, spend hours in internships and sit for board certification exams before becoming a board-certified music therapist (MT-BC). We rely on evidence-based research and clinical supervision to work in these settings. We work interdisciplinary with the medical team to understand and design interventions that are in line with medical treatment plans and goals. We also know when music can be contraindicated and… perhaps, cause harm. Music therapists are trained clinicians. Music therapists should be guiding these programs.

The healing power of music…

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

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Music has always been a big part of my life. From buying my first record as a young teen (Destroyer, Kiss) and selling my soul for rock & roll, to discovering new styles and genres through the years on vinyl, cassette, CD, MP3, streaming, and vinyl again, I listen to most anything depending on my mood.

I’ve also played music for most of my life. Trumpet through middle and high school, and I got my first guitar after listening to that Kiss record referenced above. I’ve worked as a professional musician (and fronted The Greatest Rock Band In The World… for Kids! - StarFish), worked as a professional actor, played in pit bands, worked for record labels, and now work as a board-certified music therapist. I also write extensively about music and wellness.

To me… music is life.

Everyday I listen to music

As a music therapist working in a hospital setting, listening to and researching music is a part of my job. I would argue, the best part of my job. I get to be a part of everyone’s music. On any given day I may share music experiences that include: Green Day, Gershwin, Sinatra and the Great American Songbook, Elvis, Dylan, country gospel, 50s, 60s, 70s, 80s, 90s, Foo Fighters, Petula Clark, John Denver, Patsy Cline, Merle Haggard, Spanish guitar, jazz, classical, Metallica and The Muppets. (Just to name a few.) I love it all!

My daily listening includes a combination of my staples—the music that I grew up with, and the music that has become a part of me over the years—and new stuff that I’m constantly searching for.

Here is how I listen to and enjoy music on a daily basis. (Maybe you can take something from this.)

Vinyl

I love my vinyl. About 10 years ago, after picking up a few records at a yard sale, I went down a rabbit hole and started buying vinyl records. Mostly used. And lots of it. Then, I basically recreated my stereo set up from when I was in high school. (I still have, and use, my original Panasonic receiver!) I must say, I have quite a collection.

I have a lot of my staples, mainly classic rock from the 70s and 80s (I recently completed my Van Halen–the Dave and Sammy years–catalog!), but I’ve also acquired lots of other stuff too. I love classic jazz on vinyl (Coltrane, Miles, Ella and Frank.) And because I live in a ‘musical theater centric’ house, there’s an extensive collection of Broadway cast recordings. (I recently found a copy of the original Broadway cast album of Bye Bye Birdie from 1960!)

I also buy new stuff. I love Norah Jones’s new record (Sing to me Norah!) and new Foo Fighters is on the way! But I really have a soft spot for eclectic stuff. (The Ventures, Andreas Vollenweider, Herb Albert and The Tijuana Brass, Captain & Tennille, England Dan & John Ford Coley, Irish Drinking Songs, and one of my prized records, Lavern & Shirley Sing.) I listen to all of them. Sometimes I pick out something with purpose, (Van Halen) and sometimes I just randomly pick something from the shelf (Barry Manilow Live on 2-LPs from 1977). And I love it.

Playlists

I also love putting together playlists. [I use Spotify.] And I have created a bunch. And like my vinyl collection, my playlists are eclectic, generally with a mix of ‘my’ music (Rush, Foreigner, Styx, Journey, have I mentioned Van Halen) and stuff I randomly discover. [More on how later.] How I do this, and what makes it fun for me, is that I set up playlists with various ‘themes’. Of course I have my seasonal themes (My Ultimate Summer Playlist is a fav) and then ‘other’ types of themes. I totally dig my The Sun and The Moon playlist that I put together a few years back for the eclipse. And I just listened to my April Fools Day Rocks! playlist, (I basically listen to it once a year. But I dig it!) Then there are various themes such as About A Girl (all songs with girls names in the title), A Colorful Playlist (all songs with a color in the title), and I’ve Got Your Number (All songs with… well, you get the idea.) A few others include Cocktail Hour, Brunch/Dinner with Friends, and It’s Van Halen Weather. (I know, sometimes I’m so predictable.)

Again, all of these playlists have a mix of songs that I know and love, and stuff that I discover. These are continually evolving playlists. As I listen to music on a daily basis, whenever I hear, or discover, a song that fits one of my themes, I add them. It keeps the music both nostalgic and fresh for me. It’s a fun, on-going project. And I love it.

[Click on any of the links above to check them out!]

Speaking of nostalgia, we get so much from listening to the music we grew up with. This music is part of our identity and when we hear it, we think of happy times and the important people in our lives. We generally feel uplifted, euphoric, and even youthful. And… when we listen to this music, ‘our music’, dopamine, the ‘pleasure’ neurotransmitter, is released in our brains. And that makes us feel good!

Discovering and listening to new music stimulates the brain by activating widespread neural networks, including the auditory cortex, hippocampus, and limbic system, enhancing cognitive flexibility and emotional engagement. And… releases dopamine in our brains. And that makes us feel good!

Listening to all of this music is good for our brains! There have been recent studies showing that listening to music every day may lower the risk of acquiring dementia later in life.

Listening To Music May Cut Dementia Risk

Public radio and discovering new music

First off, when I say ‘new’ music, I don’t just mean new music that was recently released. It could be, but it’s also new music to you. And that can be anything. (Maybe you’ve just recently discovered Tennessee Ernie Ford and went down that rabbit hole.)

The third way I generally listen to music is streaming music-centric public radio stations. My favorite is WXPN based at the University of Pennsylvania in Philadelphia. This station, while living in the pop/rock/Americana world, plays everything. You can hear new singer/songwriters like Maggie Rogers and Courtney Barnett next to Ella Fitzgerald and Nina Simone. Wilco and The Hold Steady next to a song from a classic movie soundtrack. Classic rock, hip-hop, Billie Holiday, Burl Ives (yep) Dr Dre, The Bee Gees, new artists and everything in between. This is curation, not algorithms.

And, like my playlists, they do a lot of ‘themed’ programming. The morning show (which I listen to almost every day) has The Friday Morning Mix Tape, curated by listener suggestions based on a theme. (Some recents have included: Songs recorded by siblings. Songs with no bridge. Songs that don’t mention the title. All songs in 6/8 time.) Every evening from 6:00 - 7:00 is Highs In The 70s (Van Halen!). There’s Funky Fridays, 90s at 9, Lost In The Aughts, an 80s underground show, The New Music Spotlight, and even Kid’s Corner. (They’ve played StarFish!) Some days the entire programing will be all from the same year, anywhere from the 60s to today, or all covers, or all female fronted bands. This is serious programming bordering on musicology! Listening to this station, I hear artists that I love (I won’t say it again) and discover new music. This is the ‘sweet spot’ combination, the mix of music I know, and new stuff for me.

Then, from my listening, I put songs that I discover (or just didn’t think of) into my themed Spotify playlists as is fitting. It’s fun! And I love it.

I also love WFUV (out of Fordham University in New York), which is similar to WXPN.

WBGO (the greatest jazz station in the world from Newark, NJ. I particularly love their Singers Unlimited show that includes classics like Etta James and Nat King Cole, and new voices like Kurt Elling and Laufey.)

WWOZ (from New Orleans, playing New Orleans jazz, Zydeco, and heritage music.)

WETA (classical out of Washington DC, which I listen to every night while falling asleep.)

So… that’s my jam. Maybe you can take something from this. Or maybe you have your own jam on how you listen to and discover music. If so, PLEASE let me know in the comments below. I’m so interested (obsessed really) in what and how everyone listens to music!

Also for the comments below:

What song suggestions do you have for my playlists?

What themed playlists do you curate?

What radio stations, or music outlets, do you listen to and love?

Music, and all of the arts, is essential in navigating this crazy world. Sometimes we need a boost. And sometimes we just need to live in the melancholy of our mood. For all of it, we have music. Music gives us what we need, when we need it. Music is part of our identity. And music helps our brains stay active and fresh. So listen to music! And listen to what you like. (Even if it’s Kenny G.) No one should tell you what you should listen to. (Not even me.)

The healing power of music…

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

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Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!

It’s been a long, cold, lonely winter. There’s wars and global strife. People are worried about the economy. There seems to be a general sense of malaise when you walk around… everyone doomscrolling.

But April has arrived! Bursts of light and luster seep into the gray and gloom as color returns. Buttercups and bellflower and butterflies blossom and are resurrected. And when I walked into the coffee shop this morning, the young woman behind the counter smiled and said, “Good morning! How can we make your day better?”

It’s Easter weekend. It’s Passover. Baseball is back. And spring is in the air! And with the start of spring… there is a renewed sense of hope.

“Hope springs eternal in the human breast; Man never Is, but always To be blest…” Alexander Pope (1733)

Stories of hope (And music)

“What is that song about?” —I asked the group at an in-patient behavioral health facility where I facilitate music therapy sessions— after listening to Don’t Stop (Fleetwood Mac.) There was silence. Many looked down with flat, tired faces. No eye contact between anyone. But then, a quiet voice from a young woman sitting to the side, “Maybe that things will be different tomorrow? Maybe it won’t be the same as it was before?” Then, with tears in her eyes, she looked up, - “The song is about hope.” I played the song again and one of the older women, who was sitting on the other side, got up, walked over to her and took her hand… and they started to dance. Soon the flat, tired faces showed some smiles. Soon… more got up to dance. One of the nurses joined in. Suddenly there was laughter, connection, and some sense of joy in a joyless place. Suddenly - a feeling of hope. Music for reflection. Music for empowerment. Music to create hope for a better tomorrow…

“You made her smile!” her son said as I was playing and singing some of her favorite classic rock songs. Three months prior she had a stroke and her road to recovery has been challenging. Her body is weak, and she’s been minimally responsive. But today… a smile. And when she did, her son’s face lit up, “I haven’t seen you smile in so long mom!” And, through tears, he smiled too as he took her hand. Then… his eyes lit up as he pointed to her feet, which were pulsating to the beat of Tom Petty’s I Won’t Back Down. (I mean, how can you not move your feet to your favorite T.P. song?) It’s been a long road, but today… a smile. Today… a connection - a connection to the music, to her memories, and to the rhythms of her body. (And, perhaps, the start of reconnecting with herself.) But most importantly, a shared moment, and a smile, with her son. When we finished, she reached for my hand, and as I took it, she squeezed and tried to speak. No words yet… but a smile.

“Just when I start to feel the most down, the music brings me back up. Now I can handle another day.” I’ve gotten to know her now that she’s been in the hospital for nearly 50 days, working through treatment for a form of cancer. She endures. She’s tired… but she endures. She has bouts of pain… but she endures. Many times, when I arrive on the unit, she is walking her ‘laps’, cane in one hand and pushing a tree of IV liquids with the other. “What are we going to sing today?” she yells out while keeping stride. Some days she is feeling it all, so the music is soothing. Some days she has more energy, time for Neil Diamond. And sometimes we use songs for reflection, especially during moments of uncertainty when she is trying to come to terms with where this all may be going. Music gives her what she needs at a particular moment. Music is a safe way to explore her feelings. And music prompts reminiscence. I love hearing her stories that various songs prompt, and I particularly enjoy seeing her face light up when telling, and reliving, these memories. And when she laughs… the room shakes. And yes, there was a time when we were laughing so whole-heartedly that the nurse came running in to make sure she was okay. Music won’t cure her cancer. But it helps.

“The morning mist…” He was in pain. Three weeks in the hospital with complications from brain surgery. He could only lie in bed and stare at the ceiling. A journey. A grind. When will it end? But now… something different. Something aesthetic. I offered some soundscape on the guitar. Something to help refocus, and ‘hold’ him in the space. After 30 minutes, as the music was winding down, I noticed that his face was ‘softer’. Then he said… “The morning mist. That is what I’m seeing and feeling with the music. The morning mist.” A new day is coming…

“Little darlin’

The smile’s returning to the faces

Little darlin’

It seems like years since it’s been here…”

The healing power of music…

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

Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.

Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!