Thursday, January 1, 2009

Using Cultural-Specific Music
to Alleviate Symptoms of Anxiety and Depression


Pallimed Case Conferences (cases.pallimed.org) is closed to comments and new posts as of April 25, 2013.
This site will stay online as an archived source, but will no longer be updated.
For active posts on these cases and new cases go to www.pallimed.com. 


By Erin Hedden, Music Therapy Intern
Vol 8, No. 10 - November 2008

Case:

Ms. Z was a middle-aged Colombian woman with pulmonary hypertension and was awaiting a double lung transplant. Her presenting symptoms included extreme shortness of breath with minimal exertion, tiredness, and chest pain. A palliative care consult was requested for support and symptom management for anxiety and depression. She was also very concerned about her bills. She had trouble concentrating, was unable to watch TV or use her laptop, and was constantly tearful. Through palliative care, a consult was obtained for music therapy. In the context of music therapy, her anxious and depressive symptoms were significantly diminished by using music that was specific to her native culture.

Discussion
Music therapy has consistently been demonstrated to help alleviate symptoms of anxiety and depression, especially when the implemented music is a type of music that is preferred by the patient. In fact, a study researching the effects of subject-preferred music found that subjects who listened to their preferred music exhibited an increase in positive mood if their pre-music mood was negative. It also found that subjects listening to preferred music maintained a positive mood if the subjects’ pre-music mood was positive (Wheeler 1985).

Since Ms. Z was a Colombian immigrant, there were many times that she had family members and friends with her to both support her and translate some of the more difficult conversations that were in English. Though this author did know rudimentary Spanish, and did successfully implement short phrases, it was the music that became the common language throughout each session.

The first music therapy session was met with much enthusiasm and laughter from Ms. Z’s family and friends. Ms. Z was visibly anxious and nervous as she sat in the corner, but as she began to watch those around her enjoying themselves, her face softened and she smiled from behind her oxygen mask. The two attending interns closed the session having played some of the requested music, but with the momentous assignment to learn many more songs. Countless hours were spent learning songs by one of her favorite artists, Juanes, who is famous in Colombia and other South American and Spanish-speaking countries.

The second session was filled with a myriad of their favorite Spanish songs. They sang every song along with the attending interns, laughing and crying at the same time. Ms. Z was visibly relaxed and at peace. She continued to enjoy music therapy after she got her double lung transplant. Through the implementation of music therapy, her anxious and depressive symptoms were significantly diminished through singing, the use of percussion instruments, and by using her preference of cultural-specific music.

Through singing, she used her lungs—both before and after her double lung transplant. Even when Ms. Z was only able to whisper, she was still stretching her new lungs while “mouthing” the words she knew from memory. It distracted her from the monotony of being hospitalized, from the bills she couldn’t pay, and from her constant medical problems. It fostered a deeper and more meaningful socialization with her loved ones, and helped her to find cultural familiarity within someone else’s culture. Singing also gave her choices: she could participate or watch; she could choose which song she wanted to hear; she could choose which artist she wanted to hear; and she could choose the language with which she wanted to surround herself. It also gave her a sense of ownership and pride that the attending interns learned these songs specifically for her.

Using percussion instruments had its own benefits: it was a less threatening way to participate in the music-making experiences; it gave another series of choices for her to make; and because there was a wide array of South American instruments, it was a physical and tangible connection to her cultural heritage.

Music can help patients to appreciate the beauty and wisdom of their own cultural backgrounds and promote positive feelings within them that can be tapped into when celebrating and coping with life’s highs and lows (Chase 2003). By validating Ms. Z’s culture and bringing it into her hospitalization, music therapy fostered a sense of normalization and familiarity within the hospital walls which to her had previously represented feelings of anxiety and depression.

References:
1. Chase, Kristen M. "Multicultural Music Therapy: A Review of Literature." American Music Therapy Association Music Therapy Perspectives 21 (2003): 84-88.

2. Wheeler, Barbara L. "Relationship of Personal Characteristics to Mood and Enjoyment After Hearing Live and Recorded Music and to Musical Taste." Psychology of Music 13 (1985): 81-92.
Reblog this post [with Zemanta]

6 Responses to “Using Cultural-Specific Music
to Alleviate Symptoms of Anxiety and Depression”

Jessica Knapp said...
January 12, 2009 at 5:46 PM

This is such an uplifting and wonderful case study to read. I love that the singing even helped her exercise her lungs. Thank you for the post.


Christian Sinclair, MD said...
January 15, 2009 at 2:34 PM

I actually quoted this case in a lecture today on COPD and treatment of dyspnea. I am continually impressed what a energetic music therapist can add to a therapeutic regimen.

Thanks for the comment.


Cynthia said...
April 11, 2009 at 5:11 AM

This is a very innovative case and use of music therapy. We often forget about the humanities and arts in the setting of a life threatening illness, thus forgetting that the patient is actually a person. We also don't touch upon "culture" much. Would love to see more cultural issues in cases. Thank you.


Christian Sinclair, MD said...
April 11, 2009 at 1:00 PM

thanks for the comment Cynthia. I completely agree with you about the focus needed on the Arts & Humanities. I heard a lecture by Robert Potter who was a key force in the Bioethics movement in the 90's. He noted that the technological fascinations of medicine can be traced back to a reading of the Flexner Report. The Flexner Report was comissioned by the AMA in the early 1900's to unify and standardize all medical education. There is a vital statement about the need to have science as the basis for medicine which apparently was often quoted but the second part of the statement is that medicine is not science alone but the balance with the humanities.

If you have not seen the Arts & Humanities section of Pallimed, i would encourage you to click on the Arts button at the top of the Pallimed pages or go to arts.pallimed.org It is a weekly blog and was created expressly for the reason you wrote about.

As far as incorporating more culture into the cases series, I am using material from the University of Pittsburgh for the cases blog so I don't get any input into topics. But I guess I am the editor of the Cases blog so I could do whatever I wanted and publish my own!


Cynthia said...
March 13, 2011 at 4:30 AM

This is a very innovative case and use of music therapy. We often forget about the humanities and arts in the setting of a life threatening illness, thus forgetting that the patient is actually a person. We also don't touch upon "culture" much. Would love to see more cultural issues in cases. Thank you.


Jessica Knapp said...
March 13, 2011 at 4:30 AM

This is such an uplifting and wonderful case study to read. I love that the singing even helped her exercise her lungs. Thank you for the post.