Music as Medicine: How Performing and Listening Treat Trauma

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In the summer of 2012, my father passed me a well-worn copy of New York magazine with a provocative cover story by Michael Wolff titled “A Life Worth Ending”. In the story, Wolff chronicles his mother’s steady decline through dementia. I still remember the quote on the cover: “Mom, I Love You. I Also Wish You Were Dead. And I Expect You Do, Too.”

My father and uncle—like many Americans—related to the author’s sentiment, and his dilemma: Modern science allows us to keep our loved ones “alive” far longer than ever before, even while diseases like Alzheimer’s can reduce them to empty vessels, imprisoned in their own flesh. What about the quality of their lives and the quality of the lives of those left to care for them?

When I saw my grandmother in her later years, she often seemed politely embarrassed by her Alzheimer’s, touching her cheek, smiling, shaking her head and apologizing when she couldn’t remember my name or my sister’s. I only saw her become very agitated a few times, closer to the end. She passed––peacefully, thankfully––in Florida at the beginning of last year.

Growing evidence suggests that music can play a significant and positive role in both rehabilitation and hospice care.

Growing evidence suggests that music can play a significant and positive role in rehabilitation and hospice care.

I thought about her recently as I watched the documentary Alive Inside. It is the story of Dan Cohen, founder of the nonprofit organization Music & Memory, and his quest to bring iPods into nursing homes nationwide as a form of personalized care for patients.

I remembered my grandma belting out golden-age jazz standards at the drop of a hat, and how once, while I was driving her home from dinner with the radio on, she tapped her finger along to the song, then looked me in the eye and said somewhat seriously “that’s what’s called ‘laying down a beat’”. Watching the movie, retroactive regret formed within me: I wish I had bought my grandmother an iPod.

Music & Memory

Dan Cohen has the accent of a New Yorker and the delivery to match: fast, bottom line-oriented, though not unfriendly. I get the sense he’s more pragmatic than overtly sentimental about the work he does.

“In 2006 I heard a journalist say iPods were ubiquitous,” Cohen tells me over the phone. “So I Googled ‘iPods and nursing homes’ and there are 16,000 nursing homes and nobody using iPods. From what I’ve seen of nursing homes in my life, it just doesn’t seem right. If I ever want to listen to my 60s music in a nursing home, will I be able to?”

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Dan Cohen’s Music and Memory program is beginning to be used in therapeutic settings in several states.

Cohen is a social worker, but when he first brought personalized iPods into a Long Island nursing home that year, it was as a volunteer, in order to earn trust in his methods. Initially, he set up three residents with iPods full of their favorite music and watched as their suffering from a variety of ailments––depression, diabetes––receded while they listened. He eventually began working with residents suffering from dementia, where he saw the kind of dramatic results on display in the Alive Inside documentary: confused, agitated, and nearly immobile nursing home residents suddenly singing, dancing, smiling and crying to their favorite music.

“I would go to different nursing homes and say ‘Give me your most disruptive resident’. One of them was cursing at nurses all the time, knocking food and drinks out of their hands. He didn’t have any family, but we knew he was a veteran, so we made him a playlist of some patriotic music, and he immediately snapped to attention and started humming to the music, and that was it for his disruptive behavior.”

Dan volunteered for eighteen months before receiving additional funding from the Shelley and Donald Rubin Foundation to build his Music and Memory program. Donald Rubin had seen firsthand the effect music had on his own mother and her mood before she passed from Alzheimer’s. These funds enabled Dan to roll his program out to two hundred nursing home residents in four different New York nursing homes, and to demonstrate that the impact of this was repeatable.

“An initial complaint was: ‘Dan, you can’t do this, you’re going to isolate these residents even more–– with headphones, sitting in a dark corner…’ What we found, though, is that the thirty-three professional staff interviewed said ‘We had no instances of further isolation, but boy were they more social’. People were less agitated, more cooperative, more engaged, and in less pain, because perception of pain is often reduced when you’re engaged with music… Then I thought it was just a matter of getting attention.”

To help ensure the new program would get the right kind of attention, Cohen asked The Donald and Shelley Rubin Foundation for recommendations on a filmmaker.

“When I was trying to tell people about this, my friends said ‘Ah Dan, how nice, you’re bringing old people music’ and I said ‘No no, you don’t get it’. I couldn’t communicate the extraordinary impact. I thought ‘If only I could get someone to film a few minutes of this…’ That turned out to be the Henry clip.”

”The Henry Clip” is a now-viral video captured by filmmaker Michael Rossato-Bennett on his first day following Cohen. (This clip would be included in Rossato-Bennett’s Alive Inside.) “Henry” is the subject: a nearly-catatonic nursing home resident in his 90s, suffering from dementia. When Henry listens to his favorite gospel music, however, he sings, begins to move, and for a period afterward, reflects on the music and his remembered experiences in poignant––even poetic––terms. As neurologist and author Oliver Sacks comments during the video, Henry “has reacquired his identity through the power of music.”

Cohen was right: the power of stories like Henry’s were undeniable. Based on the clip of Henry alone, the Wisconsin State Department of Health called Cohen, asking how they could begin to implement a statewide iPod program for nursing homes.

Today, more than 1,000 nursing homes, assisted living facilities, hospices, hospitals, and home care programs actively participate in Music & Memory’s program to provide personalized music playlists to those they serve. In addition to Wisconsin, Utah and Ohio have made commitments to initiate statewide programs, with more states in the queue. In early 2013, The Alzheimer Society of Toronto began a Music and Memory project with the goal of bringing iPods to over 10,000 patients suffering from Alzheimer’s. Early evaluations of the project note decreased levels of agitation in patients and decreased levels of stress in caregivers.

“That’s still my challenge—just getting adoption,” Cohen says. “It’s going to happen. It’s just a matter of when people want to jump in. Because it works.”

Sounds of Science

iPod Shuffles in nursing homes may provide a new context for music as medicine, but music therapy is not a new idea. It was a popular form of treatment for soldiers returning home from both World Wars, and in fact, as recently as 2010, the U.S. Department of Veterans Affairs created its own music therapy program for veterans, documenting the results in a report titled “Guitars for Vets: Evaluating psychological outcome of a novel music therapy”.

A wounded soldier participates in music therapy (Photo by flickr user Lori Newman)

A wounded soldier participates in music therapy (Photo by flickr user Lori Newman)

The Guitars for Vets program recruited forty veterans with significant PTSD symptoms as subjects. Each subject received a guitar and an hour of individual musical training each week, as well as a weekly group instruction session. After the study, they kept their music, supplies and instructions. The study reported significant decreases in prominent PTSD symptoms, as well as overall decreases in symptoms of depression, and increases in health-related quality of life.

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  • Pranasound

    Very good read! Thanks. Sound healing goes a bit further than just song. Using frequency, vibration, binaural beats with a lot of new scientific backing will be the future ! I’m an engineer who got into conducting sound healing for many people which aside from doing in person I also record music as well made for specific healing functions.
    http://Www.pranasoundstudio.com

  • pressurized yogourt

    i really enjoyed this article ! thank you, this is very important to me. shared.

  • Stevie

    I think we need to get everyone with illnesses there lives filled with music.I know understand a little more about my grandmother back in 1968 when I was 10.My grandmother was in a nursing home.She probably had Alzheimer’s but back then we called it getting old but I remember my mother buying a little transiter radio for my grandmother.Well when we would visit her,my Mother and I.I would be allowed to listen to the radio,Grandma never new anymore who Mom was but she always brighten up when she saw me and called me stevie,My name was stephen but while listening to the radio.I didn’t really pay any attention to what it was doing for my grandmother but I do know that she would remember my Mother the longer we were there and the more I would listen to all kinds of music and when we left I always left the radio on because grandma would ask me to so mom left it on low but when we would leave she always said of coarse goodbye to me(stevie) but she started saying goodbye to my mom saying goodbye Mary Ann.I never put the two together.I was to young to even think of that kind of stuff but I thought about it after reading this article and putting the two together and look at how long ago that was,Almost 50 years.So I truely believe there is something to this and I know there is.I know when I am down I play my country music and I start feeling much better and singing with the music and on some songs getting very emotional.I hope if I ever go to assitive living or anything like that we will have this a standard by then.I am definately going to see what I can do to help the cause.Thank you so much for this article.We need to get this on the world news and in congresses hands,Although who knows what they would do with it but I think money should be given from our government for a program made for all kinds of illnesses and injury’s.It would prabably save money instead of drugging our seniors all up on drugs they don’t even need.That would save billions of dollars,That is just what I think.Thanks again!!!!