pathway

Playing Your Song: The Use of Music Therapy for Self-expression with Individuals Who Have Experienced ABI

© Cheryl Jones
Published in OBIA Review Vol. 18, Issue 4

Self-expression is important. It allows us to describe how we feel and our thoughts about issues; it highlights our individuality and provides opportunity for release of emotions.

The Importance of Self-expression

We all have the need to feel heard. Sharing who we are, or what we are going through, with another person provides opportunity to receive support. Expression allows for another to respond with empathy, understanding, and encouragement. Feeling heard is validating and can prevent feelings of isolation or loneliness.

Self-expression is important for everyone and can be especially important for the individual who has experienced ABI. S/he may be developing a new sense of self, experiencing significant changes in ability, or adapting to adjustments in their role at home, work, or school. Being able to express who they are and how they feel enables them to experience support and affirmation as they journey through these changes. Self-expression can help articulate their individuality and identify their sense of self.

An individual may experience a range of emotions following ABI. Expressing these emotions provides release and is an important aspect of mental health.

Although self-expression is important for the individual who has experienced ABI, the ABI itself may have resulted in impairment to self-expression. Possible challenges to self-expression following ABI include: word-finding problems, word pacing (delay of verbal response, stuttering, or acceleration of words), oral motor issues (which can impact articulation and the ability to be understood), attention span (affecting the ability to stay on topic or follow a conversation), initiation, and depending on the location of the brain injury, the total loss of the ability to speak. Challenges in self-expression can lead to feelings of frustration, depression, and loneliness.

Why Music?

Music has proven to be an effective tool in providing opportunity for self-expression. Because of music's unique characteristics and its strong emotional qualities, it can be a powerful form of self-expression: both verbal and non-verbal. Musical elements such as melody, dynamics (range of soft and loud), harmonic qualities, and tempo all serve as expressive tools. For an individual with speech related challenges, music can be an effective form of non-verbal expression.

In addition to its expressive qualities, music is also an effective tool due to its neural stimulation. Research evidence demonstrates that music is processed within a number of locations in the brain. When music is used, it is a multi-site stimulation allowing for increased neural recruitment and creates potential for new neural networking.

What is Music Therapy?

Music therapy uses music to work towards non-musical goals. Goals are individually established for each client following an assessment. A music therapist is a qualified individual with a university degree in music therapy, has completed a 1000- hour internship, and has received accreditation from the Canadian Association for Music Therapy. This is indicated with the professional designation MTA.

Examples of Music Therapy Techniques for Self-expression

Improvised Instrumental Music
During improvised instrumental music a number of instruments, suited to the client's ability, are made available. A range of instruments also allows for a range of expressive qualities. The music therapist may accompany the client on a second instrument or the client may play solo. An improvisation may have a theme such as "let's play about how school went today" or may not have a theme and the music simply unfolds.

Some individuals with speech related challenges enjoy the non-verbal aspects of musical expression and find it easier to flow in their expression when they are not dealing with "finding the right word".

Instrumental music can also serve as a cathartic release of emotion. Music creation can allow for a healthy outpouring of feelings and can serve as an appropriate release for negative emotion such as anger.

During a music therapy session a non-verbal client was demonstrating frustration due to challenges with her feeding-tube. When offered a large buffalo drum to express how she felt, she struck the drum loudly several times. This was followed with a smile, having released her frustration effectively and feeling that those present now understood just how frustrated she was.

Composition

Composition allows for an individual to take the time to create the lyrics, to find the words, in order to express what they would like to convey. With the help of the music therapist, the client makes musical decisions such as the use of one chord vs another, melodic direction, harmonic quality, tempo, and dynamics. The completed song provides the message the client wishes to convey, plus the emotional qualities to reflect it. It also is a wonderful experience of empowerment, affirmation, and creativity. It is a concrete example of accomplishment and success. Following the completion of a song on a theme of personal significance an individual stated, "Wow! I did not know I could do that! I have accomplished something and I loved being creative". Another individual, who was non-verbal signed to the music therapist, "now they not only know my words, but they also know how I feel". For her the use of sign language and technology allow her to state herself, but the addition of the emotional qualities of music to her message gave her increased personal satisfaction.

Sharing of Personally Significant Music

The sharing of personally significant music with the music therapist can provide opportunity for an individual to express a theme or memory of importance. It can serve as an "ice-breaker" or springboard for further exploration.

Singing

Singing can provide opportunity for an individual to be verbally expressive while being supported by music's characteristics and neural stimulus. Singing personally significant music can celebrate individuality.

An individual does not need to have a musical background in order to participate in music therapy. Music therapy techniques are determined based on the client's need, abilities, and interests.

Conclusion

The need to be self-expressive and feel heard is experienced by us all. Because ABI may result in limitations to self-expression, it is particularly important to provide these individuals with expressive opportunities. Due to music's characteristics, emotional qualities, and neural stimulus, music therapy can be an effective tool to use for self- expression, both verbal and non-verbal. In addition, it provides opportunity for empowerment and creativity, celebrating success and the individuality of the person. As one individual stated following an instrumental improvisation, "It's wonderful to discover new things that I can do".

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Cheryl Jones MMT, NMT-F, MTA holds her Masters of Music Therapy from Wilfrid Laurier University. She has advanced training in Neurologic Music Therapy from the Bio-medical Research Centre at Colorado State University. Cheryl is a researcher for the Conrad Institute for Music Therapy Research. She is a fellow of the Robert F. Unkefer Academy of Neurologic Music Therapy, is a member of the Network of Neurologic Music Therapists, and of the International Society of Clinical Neuromusicology.
She currently resides in Ottawa where she maintains a private practice Con Brio Music Therapy.
She may be contacted at: con.brio.piano@gmail.com.