Individual Music Therapy and Brain Health
When we think about receiving a diagnosis of a dementia and the possible impact of that on our brain health, many of us would assume that it could be catastrophic. What if we knew that music could be used therapeutically to help restore optimal functioning, despite significant structural damage to the brain?
The current World Health Organization (WHO) definition of brain health refers to ‘the state of brain functioning that allows... individuals to reach their full potential throughout their lives, regardless of the presence or absence of disorders.’ By this definition, brain health is not just the absence of disease, but a state of optimal functioning across ’cognitive, sensory, socio-emotional, behavioural and motor domains’.
This is the story of Frank who can perform, experience creative freedom and contribute to the life of his community through the interactive use of music, despite living with an advanced stage dementia.
Frank has a diagnosis of Alzheimers disease and has been a care home resident for nearly two years. Frank receives regular, weekly, individual music therapy sessions and attends a large, music therapy group within the home.
Music Therapy is a clinical intervention in the UK, delivered by trained and registered therapists. Both client and therapist can actively make music together, using music as the primary means of expression, communication and change.
Music and singing had always been a great hobby of Frank’s. His voice was much admired and he used to perform at functions in bands with friends.
Since his diagnosis, Frank has become increasingly confused with long periods of disorientation and frustration. His mood can dip in the late afternoon, becoming very restless, sometimes unable to have his evening meal or interact positively with others.
Due to the role that music had previously played in Frank’s life and to observed positive responses to music, it seemed that music therapy might be an appropriate intervention for him.
In session one, Frank expressed interest in playing the guitar- a lifelong ambition. He was offered one to explore straightaway. This seemed to provide a focus, where concentration had previously been difficult and he took it seriously, asking for feedback on how to hold and play it.
The guitar was tuned so it sounded satisfying for him to play and he now uses it in creative ways: strumming with a plectrum, creating different rhythms and picking out strings individually with his fingers to produce different effects.
I often accompany him on keyboard and we sing together, taking turns to sing different lines. Frank can create his own song-words, expressing thoughts, feelings and his love of blues music. He seems to find a freedom in this and his previous experience of music seems to come to the fore.
Frank plays a starring role in the weekly group, taking requests from others and performing solos. He looks happy when he sings and to be absorbed in the music. In that moment, he is healthy, he is well and there are no outward, observable signs that he is living with any debilitating neurological disorder. He is performing using his whole self, he and the music are as one in what the neuroscientist Daniel Levitin describes as ‘flow state’.
Frank
How is this possible? It seems to be largely due to the neuroanatomy of music, where music is represented throughout the brain in all its main areas, creating expansive networks which can continue to function despite more localised damage elsewhere.
The person-led use of music, utilising a person’s previous life experiences, their preferences, current wishes and support needs, can positively impact observed brain health in a transformative way. Music therapy helps to support Frank’s mood, his dexterity and global functioning. It has facilitated the learning of a new skill plus positive and creative interactions with others. This may help to reinforce his sense of identity, his self-esteem and his role in his current environment.
~ Laura Bolton, Music Therapist with Nazareth Care Charitable Trust.
