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Every Saturday morning, when R. Kurien’s family would gather for a meal, her father would play songs from his youth. The family enjoyed South Indian cuisine for breakfast, sharing stories and plans for the week. Music was played constantly in the background while they cleaned their house. It was integral to their morning ritual. Kurien experienced a profound shock after her dad’s death due to the pandemic. They were quarantined and hospital visits were prohibited, preventing her from seeing or talking to him in person.

Kurien is an international student at Toronto Metropolitan University. She started therapy in 2022, almost two and a half years after her father passed away. It wasn’t until she moved to Canada that she realized how much her father’s passing away affected her and still affects her to this day. “Therapy has been a great outlet for me to seek closure within myself but at the same time work on myself,” said Kurien.

“My first year of university, I was struggling to make friends; I couldn’t seem to concentrate during class, and my grades were affected horribly. I was severely depressed, barely eating or even leaving my room for whatever reason,” said Kurien.

Kurien also mentioned that music therapy has been a small portion of the psychotherapy sessions that she’s been to. Her therapist would ask her to create playlists based on music that she connects to not only with her dad but with her family and how certain songs evoke different emotions for her. “Music was a huge part of my life growing up and still is,” said Kurien.

The deep impressions that grief and trauma leaves on the human mind are profound. The loss of a loved one can trigger an overwhelming rush of emotions, making it hard for a person to cope with their death and emotions of sadness, anger, and profound emptiness. Music therapy offers a way for those dealing with loss to find consolation, guiding the way to healing when words fail.

“Music therapy is a goal-directed process where you focus on the individual, whether they are seen in a group or individually,” says Dr. Melanie Keyes, a music therapist and the Director of Key Music Therapy. “The emphasis in music therapy is not on the ‘beauty’ of the music,” she says. “It is a process that allows us to work on therapeutic goals that could be cognitive, physical, social, emotional or behavioral.”

Music therapy isn’t only used as part of therapy. It is also used in palliative care, where it can provide an approach to ease pain perception and improve the quality of life for patients battling terminal diseases or those with a chronic condition that has worsened. According to Keyes, music therapy aims to address cognitive, emotional, physical, social, and spiritual needs, acknowledging the deep influence music has on all dimensions of human life. Music therapists develop programs that are adapted to each patient’s needs, aiming to provide a safe space where patients can heal emotionally by expressing their feelings, going back to their memories of times past, finding comfort, and connecting with their loved ones.

Additionally, the effects of music therapy are not limited to the individual patient alone, but also positively impact other stakeholders such as the patient’s family members and caregivers. “Many times the family is present in the sessions too. The therapy space becomes one where families can connect and release their emotions,” says Keyes. In end of life care, it provides a way for patients and their loved ones to engage in therapeutic music tasks together, such as singing, music listening and reminiscing; providing important support and even moments of joy and laughter at an otherwise difficult time.

Music therapy not only provides help with language barriers but also helps overcome cultural one’s too. Jacqueline Seo, a music therapist, comments on how culture plays a part in music therapy. “I’ve observed that patients open up more and show increased engagement with the use of cultural songs. These songs have the power to connect individuals across diverse backgrounds, creating a sense of unity and shared experience,” Seo explains.

A black and white image of a person playing drums.
Keyes shared an experience of a therapy session that was held in a homeless shelter. With people from different ethnicities joining, they would sit in a circle and sing along to the beats of the drum. They would help each other in pronouncing the sentences and understanding the language. she described it to be an euphoric experience.
Photo by Stephen Niemeier via Pexels

“It’s not just activities; if we are working to improve functional skills (motor movements) in collaboration with the physiotherapist, we’re not just exercising—we’re doing it to your favorite songs. It’s a way to get people invested, and it’s enjoyable, while meeting therapeutic goals,” explained Keyes.

Keyes says that many therapists work with individuals with an array of cognitive impairments,  developmental disabilities, and also those with autism, brain injuries, Alzheimer’s disease or dementia, and neurological disorders. Often the first step is to establish a connection with these individuals. For example, in those with aphasia due to stroke, who struggle to speak, music can expedite communication by forging new neural pathways in the brain. Some patients who cannot hold a conversation, retain the ability to sing words and phrases in song.

A case study provided by Dr. Keyes, Brenda who is a patient with mild cognitive impairment, has formed a strong bond with a music therapist over the past five months. Despite her symptoms, Brenda still recognizes the therapist as someone she knows. The therapist noted that Brenda enjoys singing familiar songs and joking with the therapist, highlighting the positivity of the sessions. Listening to Christmas music brings back memories of her family’s life in Ohio, including her father’s construction work and her four children. Brenda is worried about her son’s life after her death and expresses deep longing for her family. Despite being in physical pain from her medical condition she would find comfort and support in music during the therapy sessions, elevating her mood, encouraging self-expression and social interaction.

That kind of positive effect is why more institutions are starting to incorporate music therapy into their practices. Aaron Lightstone, a music therapist and the founder of Music Therapy Toronto, integrates techniques and improvisation to enhance therapeutic experiences with music. “Music therapy is like one pillar of music care,” says Lightstone. He talks about Room 217, a hospice and palliative care foundation, which has a library of calming music for healthcare situations and aims to increase cultural diversity in recorded music. Aaron and his team collaborated with musicians from various cultures to create six new albums, including Indian relaxation music, African, indigenous, South American, and Middle Eastern totals. The goal is to provide a diverse range of music for patients.

A patient of Lightstone with a severe brain injury presents as quadriplegic, with limited movement. Music therapy techniques like Therapeutic Instrument Music Performance are used to improve the individual’s range of motion and grip. However, the individual struggles with participation in these activities due to their cognitive impairment; he thought those activities were juvenile. To overcome this, Lightstone introduced the patient to something called a ‘Theremin’, a noncontact electronic musical instrument invented in Russia in the 1920s. The Theremin has two antennas with a magnetic field around them, allowing for manipulation of pitch and volume. This patient, who previously worked as an engineer, got curious and was able to play the Theremin with hand-over-hand assistance from his caregiver. The patient then played independently, moving his hand through the magnetic field. The goal is to improve the individual’s residual functioning, rather than restoring their pre-accident baseline.

In this case, the patient’s rehabilitation focuses on getting them back into the habit of moving, restoring functional use of their limbs through repetitions of these exercises.

Music therapy, with its diverse approaches and tailored interventions, continues to provide support and healing for individuals navigating grief, trauma, and various medical conditions, enriching lives through the power of music.