By Maggie Finley, MAPS, BCC
Plato tells us, “Music gives … soul to the universe, wings to the mind, light to the imagination and life to everything.” Visionary poet John O’ Donohue strikes a similar note in his elaborate meditation on Beauty, celebrating its capacity to call us to new ways of seeing and being in the world. So for me any discussion about art and music is to be understood within the realm of the Christian aesthetic, considering its natural trajectory toward wholesomeness, balance and beauty, and bordering as it does on perfection and the symbolic. I’m indebted to the spiritual teachers who encouraged me to integrate my arts experience into the practice of pastoral care not only because it’s a significant lens through which I see the world and make meaning, but because they recognized the power of art to propel us toward the thresholds of mystery and spiritual imagination — places where words fail — the thin places where we humans move in dialogue with “the real and the ideal.”
Not everyone is born into a musical family or theatrically trained as I was; nevertheless, this should not discourage exploration of the territory. The first artistic venture that ultimately led to my performing for therapeutic efficacy, was to bring (live) music inside the Missouri Department of Corrections. Invited by a personal friend, I performed a one woman biographical sketch for the inmates of the maximum security prison in Jefferson City to complement her therapeutic writing seminar.
A few inmates wrote testimonies about how much they appreciated my coming inside as well as the vulnerability it took to share my story. But several more wrote that they were reminded of all the women — mothers, wives, significant others and daughters — who endured hardships on the outside. I believe the contemplative dynamic inherent in the theatrical experience created sacred, non-threatening psychic space that drew these lifers beyond the bars of an iron cage, giving them permission and freedom to express their feelings.
Fast forward to my CPE residency in mental health, followed by seven years in hospice ministry, where I was exposed to further education in those arts within the domain of thanatology. Through the Anam Cara Project, Richard Groves provides a weekend immersion into transhistorical and transculturo-religious realities. The name Anam Cara itself speaks to the artful care of the sick and dying. Groves’s own professional and personal journey as an Air Force chaplain led him to key questions about how caregivers address spiritual pain to “ease the pain of dying through prayer, music and ritual.” Further inquiry generated during doctoral work drew him into the field of holistic medicine, and tangentially toward a path of rediscovering the wisdom of Medieval Celtic monks whose illuminated manuscripts on “Ars Bene Moriendi” formed the basis of the original hospice movement. Fortunately, we have only to look at church history for the exhortation to act artfully within the ministry of care.
Music thanatology carries forward this tradition as a clinical healing modality and subspecialty of palliative medicine in end-of-life care. As much as Campbell’s Mozart effect, “an inclusive term signifying the transformational powers of music in health, education and well-being,” piqued my interest, surveying thanatology rounded out my understanding of the physics of sound and the fact that musical tonality actually plays on the human body. Music thanatologist Lyn Miletich sums it up this way: “Music resonates with both the physiological and existential needs of a patient to create a palpable atmosphere of calm, serenity and comfort. It is through the prescriptive delivery of live music via voice and instrument (usually harp) that patients and families are opened to an experience at once unique and intimate, in a safe and sacred place where words are often absent. And if words are elicited by the music, they come from a place of depth.”
Sacred and classical music stem from the same roots so lend themselves to ritual. Patients and families often appreciate the addition of familiar musical motifs to communion and other visitation rituals. Because we now know in the dying process, hearing is the last of our senses to shut down, it was not unusual for me to sing or play recorded music by the bedside of a dying person when suitable, to underscore the patient’s transition, aiding relaxation and easier breathing, reducing pain, fear and anxiety.
Mozart’s music helped me build rapport with a 99-year-old Holocaust survivor who was deaf and without short-term memory. My assessment visit played out in an aura of old-world charm on the porch of her massive Victorian, over a cup of tea, as I made a concerted effort to be heard and understood. The patient, in her still Austrian-accented English, disclosed she was born and raised in Vienna, the city of Mozart. But it was only after I mentioned Strauss, whom she thought a hack, that she laughed and went on at length, painting lively word pictures of what her beloved city had been before she and her husband were forced to flee the impending Nazi occupation. This first connection became the thread to follow during visits when her hearing, mentation and low energy conspired against us. On the days when she couldn’t engage, I thought maybe she’d benefit from presence and resting in the music she loved. I knew that in some cases of aural deficit, bone hearing might be possible, so I started bringing Mozart
CDs. Rather remarkably, she heard and responded. (I suspect even though she may not have heard every note, aural memory probably filled in.) Caregivers were also excited about potentially having another way to communicate and care for her, so I encouraged them to use it.
The patient ultimately took ownership of the music, deciding when or when not to play it. Eventually, the music evoked her grief around having outlived her family and friends. In steady decline a couple of months preceding her death, she began to imagine I was a friend with whom she enjoyed the coffee house culture of Vienna. She held forth about much of her life: before and after her escape, ultimately landing in Seattle in the midst of a vibrant Jewish arts community. I wasn’t there when she died, but the caregivers reported Mozart’s music accompanied her last breath.
Patient encounters like these only strengthen my conviction of the power of word, music and movement to convey feeling and tell stories. As corny as it sounds, I subscribe to the theory that “music is the soundtrack of our lives.” I used music with art modalities regularly in my facilitation of spirituality groups as chaplain consult to the Psych Department at Seattle’s Harborview Medical Center. Spirituality Group was offered as a more relaxed and recreational alternative to Dialectical Behavioral Therapy (DBT). A majority of substance users and/ or survivors of abuse responded well to expressive arts and music (usually contemporary). I chose dynamics with an underlying spiritual theme and hopeful message, aimed at creating a safe environment, charged with playful energy, opening participants up to some sense of community, to share stories, to laugh or to shed tears.
The environment provided an unspoken invitation to be: to be themselves as well as to be vulnerable without being judged. Film clips were another useful intervention, especially for those patients whose crisis was beyond the reach of speech or self-disclosure. Film gave them room in which to center or emote. I can report that the arts also allowed persons with special needs to benefit from the group. I remember a blind woman who asked someone to guide her hand in choosing more tactile materials as well as drawing, which succeeded in engaging the whole group. More than one patient who spoke no English was able to fully participate, enjoying the activity and the company even when translators were not available.
While music and art may not be a chaplain’s primary mode of patient encounter, both have a proven track record in ministering to persons in memory care via reminiscence therapies. I accompanied elders with various forms of dementia in acute care and hospice, where being able to share my vocal music spontaneously was another way of being present to individuals with profound memory or speech loss. In ambient groups, others with similar symptoms could also engage and be “socialized” by the music. The music itself facilitated a patient’s awareness of presence, some orientation to time and place even if in the past, or their own story. Significantly, songs occasionally elicited what I call “camelot moments” — crystalline moments of clarity and/or vocalizations from those who were otherwise non-verbal or minimally responsive.
Maggie Finley, retired hospice chaplain, ministered for seven years at Providence Hospice of Seattle in Seattle, WA. She served patients throughout King and parts of Snohomish Counties. Providence is a non-residential hospice, so she visited patients and families in their homes, skilled nursing facilities, assisted living residences, and occasionally in hospital settings.