More fun with Remo Drums! The Aroma Drum!

Okay, you caught me!  I spent a lot of time at the Remo booth at the national conference for the American Music Therapy Association last week in Jacksonville!

The Aroma Drum is not new.  It has actually been around for several years.  But, recently, I began investigating essential oils like the ones used in the Aroma Drum.  The Aroma Drum comes with four different essential oil diffuser packs:  lavender, pink grapefruit, patchouli and eucalyptus.  You can see the drum up close in this video.  Although the video is a bit contrived, it does get the point across!



I used to think that the aromatherapy component of the drum was just a nice gimmick, but I have discovered that some of the essential oils may have statistically provable anxiolytic effects. My investigation so far has revealed that the lavender essential oil may be the most widely and historically used oil for stress relief. 

One randomized controlled study, by Sultani et al. (2013), found that post-tonsillectomy pediatric patients used significantly less acetaminophen (Tylenol) than a control group. In another study, dental patients spent time inhaling lavender while waiting for treatment (Kritsidima, Newton, & Asimakopoulou, 2010). The patients who waited under the influence of lavender aromatherapy had significantly lower state anxiety levels. 

These are just two of many studies relative to lavender essential oil. In light of the growing research base that confirms historical and anecdotal evidence of the effectiveness of essential oils, I find the combination of essential oils and drumming a wonderful partnership! 

Unlike the lady in the video,however, I think the Aroma Drum used in a drum circle setting might be more effective, especially inside, where the scent could be more concentrated. A drum circle setting where a drum leader or facilitator would be walking around and waving the drum might more easily diffuse the lavender aroma. 

In any case, I think this drum is worth checking out! It is sold by itself or as a set with an accompanying CD and stress management guide. You can also purchase refill packs of the essential oils. Let me know if anyone out there has used one for yourself or in therapy. I am interested to know your thoughts! 

Happy drumming!

 

Kritsidima, M., Newton, T., and Asimakopoulou, K. (2010).  The effects of lavender scent on dental patient anxiety levels: A cluster randomised-control trial.  Community Dentistry and Oral Epidemiology, 38, 83-87.

Soltani, R., Soheilipour, S., Hajhashemi V., Asghari, G., Bagheri, M., and Molavi, M. (2013).  Evaluation of the effect of aromatherapy with lavender essential oil on post-tonsillectomy pain in pediatric patients: A randomized controlled trial.  International Journal of Pediatric Otorhinolaryngology, 77, 1579-1581.

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The Mood-Music Conundrum

Judith Pinkerton is a music therapist who also hosts the Music 4 Life Radio Show on iTunes. She recently authored a blog post at Corporate Wellness Magazine highlighting music to help with anxiety and mood.  


I really liked her discussion about how people tend to reinforce their current mood, even if it is an unhealthy mood.  This makes sense, since we often tend to listen to music that matches our mood.  Pinkerton is advocating for more of a mood music "diet", where you intentionally listen to music that reflects different moods in order to expand your mood "palate."  This may help to break the cycle of reinforcing the way you feel with music and then listening to more of the same type of music because that is the way you feel!  

Free Music! Your Choice: Relax, Meditate or Soundscape

The Daily Muse  

 Welcome to the Daily Muse feature of Music Makes Sense!  This daily update brings you up to the minute news about music and music therapy as it relates to our professions, events and individual lives.  You can follow the daily entries by subscribing to Music Makes Sense on Twitter or by "Liking" the Facebook page for Music Makes Sense.  Enjoy, and thanks for reading!

Amazon has some free music today that might be good for relaxation, meditation or drumming soundscapes.  It is a sampler album with all different artists.  I thought the Moussorgsky-Meditation was very nice.  


You can listen and download here:

A Smorgasbord of Thoughtful Treats

The Daily Muse

 Welcome to the Daily Muse feature of Music Makes Sense!  This daily update brings you up to the minute news about music and music therapy as it relates to our professions, events and individual lives.  You can follow the daily entries by subscribing to Music Makes Sense on Twitter or by "Liking" the Facebook page for Music Makes Sense.  Enjoy, and thanks for reading!

There are close to 500 posts on Music Makes Sense, so I thought it might be a good idea to point out a few of the highlights!


Music For Relaxation: A Flowchart for Decision-Making
This post contains a decision-tree to help you find the most appropriate music to use for relaxation.  This chart took me a long time to formalize and I think it could be very useful.  I welcome any and all feedback about this chart.


6 Ways to Empower Your Music-Assisted Relaxation
This post is another discussion about music for relaxation, but it delves deeper into the exact relationship music has with a relaxation protocol.  The ideas in this article come from years of clinical practice using music to facilitate relaxation.  I really feel that music can be helpful in relaxation, but we can really squeeze out much more effectiveness from its use if we pay attention to the details!


Memory Booster!  Using Music to Memorize Lists and Facts
This is one of the most widely read posts on Music Makes Sense.  It really gets back to the fundamentals of music therapy.  I often had to break down the way music works when trying to help teachers and parents understand music therapy.  


5 Tips for Drumming With Individuals in Psychiatric Treatment
Much of my recent work as a music therapist has occurred in the psychiatric setting.  Much of my advice in this post was learned through real-world experience!  Drum at your own risk without reading these important considerations! 


I hope you enjoy looking back through some of these posts with me.  It truly has been a rewarding time putting "pen" to "paper" over these years.  And now we are less than 50 posts away from the  500th post!   

What Was the Question? Bedtime Music: Help or Hindrance?

The Daily Muse     


Welcome to the Daily Muse feature of Music Makes Sense!  This daily update brings you up to the minute news about music and music therapy as it relates to our professions, events and individual lives.  You can follow the daily entries by subscribing to Music Makes Sense on Twitter or by "Liking" the Facebook page for Music Makes Sense.  Enjoy, and thanks for reading!

I have noticed that I get a lot of traffic and page-views for my post on Bedtime music:


Bedtime Music: Help or Hindrance?


This post has skyrocketed to one of the most popular posts in the last three months!  The interesting thing is that I have had hardly any feedback at all from the questions and theories presented in the article.  So I am now determined to ask more questions! 


I am curious as to what people are seeking when they see the title?  What kind of information are you looking for that prompts you to click on the title?  Is the title misleading or does the article simply not provide the needed answers?


Perhaps people are just looking for examples of bedtime music?  Or, maybe nobody else has any answers to my questions either?  


Any thoughts are welcome.  Feedback will improve my efforts to provide interesting reading material and helpful information.   

Bedtime Music: Help or Hindrance?

As I was putting my little angel down to sleep last night, I thought about how strict we have been in keeping all music stimuli absent from the bedtime routine after lights are out. Some people might think that is strange coming from a music therapist!  But I think we have some sound reasoning to support this practice.  


I would like to know what you think and your different experiences.  


Music is not totally restricted from the bedtime routine, but we feel it does have its appropriate place.  We will usually sing one or two songs after brushing teeth, stories and prayer, but we limit the number of songs.  You can support me on this one - if you give a toddler an inch, they will take a mile!  We could be singing all night!


Our little one in particular is very attuned to music.  Most nights, she will sing herself to sleep, and that is perfectly okay.  But if we add any more music stimuli into the situation, she would never be able to stop!  When she chooses to sing to herself, then it is her own way to self-soothe and fall asleep.  


So, in my mind it, basically comes down to two issues:  


1. Don't introduce external sleep "crutches" into a baby's or toddler's routine (unless you have extenuating circumstances, i. e., your own sanity!)  
2. Don't stimulate a child with music when they are supposed to be falling asleep.


You might be thinking, "But Daniel, music can help people to relax!"  And you would be correct!  But, in my opinion, the relaxation needs to take place well before the child is in bed.  For example, find a time during reading stories or right before the bedtime routines start to listen to some soothing music and sing some songs.  This can be great bonding time with your little one and is an appropriate time to use music as a cue to relax as well as helping regulate and slow physiological parameters.


I think many people will have issues with my advice, but as with anything, every situation is different.  Children vary greatly and there might be children out there that can benefit from soft music playing as they go to sleep.  


Music might be used effectively as a masking agent.  Maybe there are loud noises outside or in the home that  need to be covered?  We also know that with some disabilities, such as ADD, music might help to focus the attention on a soothing stimulus or engage part of the mind in a way that lessens the pressure or anxiety caused by other variations and un-regulated environmental stimuli.


There is probably much more that can be said about this topic.  What do you think?  If you do/did use music to help a baby or toddler go to sleep, do you shut it off later or have it on a timer?  What kind of music has proven to be the best?


There is a lot of music out there that purports to be good for helping babies sleep.  But is this music best used in the birth to 3 month-old time when babies are often fussy and suffering colic?  Is it a good idea to then fade the music and help them develop their own self-soothing techniques?  


So many questions!  I hope you will join the discussion and share your thoughts on this issue.       

6 Ways to Empower Your Music Assisted Relaxation!

It is very popular to use music during relaxation, as evidenced by the thousands of "relaxation" music tracks available for sale and published on the internet.  Choosing from this vast resource of music is a challenge, but there are basic guidelines for finding effective sedative music.  You can read many of my suggestions about finding and using music for relaxation in related posts here.


Once you have chosen some sedative music that you would like to use, there are ways to increase the symbiotic effectiveness of voiced dialogue and music when used together.  Some of the different approaches to using scripts or verbal guidance to facilitate relaxation are: simple stretch routines, guided progressive muscle relaxation, structured breathing and describing simple imagery.  No matter what your verbal instructions entail, there are some strategies you can use to connect the verbal dialogue more strongly to the music stimulus.  This will be easier with some music selections, but the following suggestions may still be useful in concept even when they are not possible with a certain song selection.  


1. Using ascending and descending musical ideas - Some music may have repetitive up and down motion, either in volume, melody or even patterned chord changes.  These ideas are very useful in structuring stretching routines and breathing.  Enya's song, "Watermark" always reminds me of this up and down motion.


2. Breathing - I like to encourage participants in relaxation to find their own natural rhythm of breathing.  Everyone has a different respiration rate, especially at the beginning of a relaxation session.  I am happy if the participants are simply becoming more aware of their own bodies, so I think it is important sometimes not to force breathing into a certain time frame or count sequence.  When I verbally facilitate relaxation, I will often come back to instructions about breathing as one song fades into another.  This helps to maintain focus during the short lack of musical stimulus.


3. Descending arpeggios - There is something about a descending melodic line that cues people to relax.  This is even more profound if the motif is repetitive.  Use this downward idea to pattern your voice and vocal tone so that as the relaxation session progresses, your voice is gradually getting lower in tone and slowing down.  I also really like it when a repetitive background of descending tones supports a solo instrument on a more varied melody line.  This melody helps the participants maintain interest and focus in the music as long as it is not too distracting. 


4. Phrasing - As a facilitator, you really need to know your music stimulus.  It is very important to try and match the start of a verbal phrase or imagery idea to the musical phrasing.  Sometimes you can even introduce a new part of the relaxation sequence (i.e., muscle group in progressive muscle relaxation) or new imagery idea with a new melodic theme or instrumentation in the music.  


5. Cadence - The music can be your guide for the tempo of your speech as well as the rise and fall of your syllables.  Allow your speaking to match and blend with the rhythm (or lack of rhythm, in some cases) of the music.  


6. Take a break! - One of the most difficult things to do as the verbal facilitator is to stop talking!  I think that this concept and the challenge to talk more slowly than you think you are talking are two very important things to remember.  Sometime during the guided relaxation it may be appropriate to allow the participants to simply relax and listen to the music for one or two minutes.  As the facilitator, these two minutes can seem like two hours!  This is a natural feeling until you get used to it and give yourself permission to be quiet for a bit.  One way to help is to find a place in the music that might lend itself to this concept.  Perhaps a section of the music with a new motif or an instrumental break or bridge can be the natural place to stop talking for a minute and encourage the participants to enjoy the moment and try to remember how they feel being relaxed.


Facilitating a relaxation session with music is an important skill for music therapists.  It does take practice and some attention to detail, but is incredibly useful in a variety of clinical settings.               

Mixing It Up With Stereo Mood

The Daily Muse     


Welcome to the Daily Muse feature of Music Makes Sense!  This daily update brings you up to the minute news about music and music therapy as it relates to our professions, events and individual lives.  You can follow the daily entries by subscribing to Music Makes Sense on Twitter or by "Liking" the Facebook page for Music Makes Sense.  Enjoy, and thanks for reading!

Here is another great website to add to the growing list of music and mood mixers. I like Stereo Mood because it plays so much new music that I have never heard before. They also have many pre-labeled mood categories and I have always been able to find one that matches what I am doing or how I feel. This site is definitely worth checking out! I currently listening to "tired" because it has been a long workday. The music fits my mood perfectly! 

  Stereo Mood.

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Dreams of Somatron

The Daily Muse     


Welcome to the Daily Muse feature of Music Makes Sense!  This daily update brings you up to the minute news about music and music therapy as it relates to our professions, events and individual lives.  You can follow the daily entries by subscribing to Music Makes Sense on Twitter or by "Liking" the Facebook page for Music Makes Sense.  Enjoy, and thanks for reading!

A few months ago I was able to try out a Somatron chair, very similar to the one in the picture. I remembered the experience today as I thought about some stiffness and soreness in my back and shoulders! The chair was amazing! I had been in one before at a conference, but it was for a short time, and the environment was very distracting. Sitting in one for twenty minutes or longer in a quiet space can be a completely different experience. I have always loved the feeling of sitting at a live orchestra concert or being very close to the fireworks going off at the fourth of July, so I was not surprised that I enjoyed the Somatron chair. It was definitely therapeutic and relaxing for me, although I think it would be the same as with anything else, subject to personal preference. Somatron has some encouraging research on their website about the clinical use of the Somatron technology, but I think there is much research yet to be done to verify the true effects of this type of intervention. Personally, I loved it, and wish that I had a chair in my living room! 


-- Just thought I would share my Somatron chair wish with you today. If you ever get the chance, try one out and let me know what you think!

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Music For Relaxation: A Flowchart for Decision-Making

There are many situations where a people or music therapy clients may want to use some music to help them relax.  I have often found that most people not familiar with music therapy interventions have a very simplistic view of using music to relax.  They may often say, "Oh, do you just put on some Mozart for people?"  It is important, however to determine the real purpose of the music and what kind of music would be appropriate given the conditions.

Key Ideas For Facilitating Relaxation

Concepts For Drumming & Relaxation

People don't usually associate drumming and relaxation, but slow rhythmic drumming in a group setting with some added ambient instruments like ocean drums and rainsticks can be a great way to relieve stress! In order for a music therapist to facilitate an effective drumming session for relaxation, there are a few ideas that should be considered. These ideas will remain fairly constant with or without drums as part of the experience and will be useful for many different kinds of facilitated group relaxation.

• Facilitated dialogue - Keep your verbal directions as soft as possible with a relaxed tone of voice. Your speaking tempo should be "Adagio" while leaving some space and time between words and phrases. Start off the relaxation script in a higher pitch of voice and gradually lower the pitch of your voice as the relaxation deepens. Try to follow cues in the music and speak each sentence or idea with a rise and fall of expression as with a musical phrase.

• Word choice - Use words like "stress" and "discomfort" instead of "pain." Active words also work better than phrases beginning with, "try," "I would like," or "do not think."

• Music - Client preferred music is always best if you can find appropriate sedative music. Try music that is slow, 60 -70 beats per minute as a pulse. Music without words will be more sedative than music with lyrics. The music should have some melody, but it should be mainly repetitive and predictable. "Elevator" music (e.g., strings versions of rock songs) is not recommended.

• Breathing is very important. - Direct the group to, "allow your body to find its own natural rhythm." Breathing should be slow; in through the nose and out through the mouth. Deep breathing is aided by obtaining a good exhale. Think of breathing out as a "cleansing" breath.
  

• Remind people to relax - Focus the session on feeling relaxed, heavy and/or drowsy. Each body part can be tensed and then relaxed. Each exhale should bring a deeper sense of relaxation, clearing stress from the body.

• Imagery - It is helpful to imagine breathing in "life" and "vitality." Cool, calm air comes in and stress and discomfort are breathed out.
  

Remember to practice relaxing! It can become a conditioned response, especially when paired with the same music for several sessions. There is one album by Kevin Kern that I can't listen to anymore because it is such a powerful cue for me to relax!

What Stress Can Do For You!

Stress. It really can cause heart attacks researchers say!

There is mounting evidence of the role of stress and the increased risk of heart attack. A new research study in the European Heart Journal links elevated salivary cortisol levels as a result of mental stress to increased coronary artery calcification, a risk factor for coronary heart disease (CHD). This study is important because it used subjects who were not already diagnosed with CHD. The research is also emphasizes how important it is for everyone, not just people who already have heart problems, to recognize and address stress in their lives.

I have written several posts about using music as an aid for relaxation and stress management. I think music continues to offer a powerful tool as part of a lifestyle that includes managing stress. One of the comments on the webpage that introduced the story was from Tony in Essex who quite correctly stated, "Let's get it straight, how the h--- does anyone avoid being stressed constantly in this insane society?"

This past week in my drumming in therapy class we have started each class with a facilitated drum circle. After the drum circle I asked the participants what they had been thinking about while they were drumming. I found it interesting that everybody seemed to have had a clear mind. They had not been thinking about their "to-do" lists or where they needed to go after class, or any number of different mental stressors that clutter up our everyday lives. Christine Stevens, a pioneer in community drum circles, often talks about the power drumming has on our mind, body and soul. I have heard her mention the fact that drumming is powerful because while you are engaged in a group drumming event your mind is more at peace and temporarily free of many of the mental stressors that usually take up our thought space. (For more information about Christine see my post here.)

Stress is a problem for all of us in the modern world. It obviously becomes more serious after a heart attack or diagnosis of Coronary Artery Disease, but it looks like any of us could end up in those situations if the new research holds true. Finding some time to relax and listen to some favorite music or scheduling a few times a week to play a musical instrument as a leisure skill are some healthy suggestions in developing a good way to cope with modern life. Music makes sense!

The abstract to the original research in the European Heart Journal can be found here.

Book Review: Tataku: The Use of Percussion in Music Therapy

Wow! This is really a terrific book! Bill Matney actually used to work for Music Therapy Services of Texas when I was Director of Client Services several years ago. We were pleased to have him as one of our therapists, primarily serving clients in the public schools. He continued in his career by taking a position with Lewisville Independent School District and also lecturing at Texas Womens University.

Mr. Matney's book is a wonderful compilation of many of the different applications of drumming that have been used in therapy settings. Bill is a trained percussionist and I can attest to his professional ability as a drummer. In this book, he has synthesized theory and practice from the leaders in drum circle facilitation and drumming and wellness like Kalani and Christine Stevens. This book can serve as a handbook and manual for music therapists and teachers in implementing much more effective use of drumming in the classroom. Matney's discussion of drum circle facilitation along with his nice illustrations and picture examples provide an excellent reference source that is easy to use.

Before this book, much of the literature was either about drumming instruction or intended for specific types of therapeutic drumming. Christine Steven's, Healing Drum Kit, was groundbreaking in its way of teaching some simple drum techniques, but also promoting drumming for relaxation and wellness. Mr. Matney has now provided us with a much more comprehensive manual for learning to play many different types of percussion instruments from around the world. He has provided traditional rhythmic patterns that can be used for each instrument and ideas for group activities. In each case he has also provided links to therapeutic goals and adaptations for people with disabilities or people using drumming to address wellness and psychological objectives. The final chapters provide a thorough and easy to follow description about facilitating drum circles.

The bottom line: This book makes sense for the music therapist who wants to use drumming in a variety of settings. The teacher in special education could also use this book to provide ideas for group drumming in the classroom. The music education teacher could use many of the more advanced ideas for regular education group activities and information for teaching multicultural ideas.

The book at Amazon:
Tataku: The Use of Percussion in Music Therapy

Brain Music! Food for Thought...

What in the world is our government up to now!? While I am glad that there is much research out there about using music for wellness, like many government projects, they may have missed seeing the forest for the trees. The article from the Department of Homeland Security can be found here.

The article describes how Homeland Security is allowing researchers to test the effectiveness of "brain music therapy" on reducing the anxiety in first responders. The concept is interesting, but the implementation is neither traditional music nor music therapy. Somehow, from a method I have yet to find in detail, music has been created from brain waves. The music has been "composed" in both alert and relaxed styles from actual people in those states of being. The research that this project is based on indicated that four weeks of daily listening to brain music decreased the anxiety of patients with insomnia.

You can listen to a sample of the "alert" type of brain music here. The music is not unpleasant, but it is definitely repetitive. The music lacks feeling and direction and does not have a memorable quality. My main concern is that even if there is some effectiveness to the treatment after four weeks of daily listening, I can't believe that anyone would voluntarily listen to this music day after day if they were not part of the research study! I have found that using a client's preferred music is much more effective than forcing people to use music that has been "proven" to be relaxing. Careful selection of relaxing or comforting music within many different musical styles is possible. People are much more likely to continue using music as a tool for relaxation if it is music that they prefer.

One of the interesting findings in one of the research studies about brain music therapy was that anxiety was decreased in patients using their own brain music as well as generic brain music. I can see some good applications for brain music for waiting rooms, office building elevators or schools before final exams, being played as background music! Eat your heart out Muzak!

Music for the Heart: Changing the Course of Depression and Heart Failure

FOXNews.com - Depression Raises Heart Failure Risks, Study Finds - Health News | Current Health News | Medical News

Posted using ShareThis

The research, based out of Intermountain Medical Center in Utah, studied a large population of 14,000 heart patients. This new research contributes to a growing body of evidence that indicates how heart patients should change their lifestyle after having a heart attack. Previous research has already linked depressed mood and depression to increasing the risk of a recurring heart attack. Stress-induced anxiety can be a major cause of depression and negative mood so it is very important to find stress-management techniques after having a heart attack. One of the most interesting findings in this new research study is that patients taking antidepressants did not reduce their risk of heart failure. This finding emphasizes the need for alternative ways to manage stress and elevate mood.

Music can be an important component of a full rehabilitation program after a patient has heart trouble. Music as an aid to relaxation is a powerful tool in developing a routine of daily relaxation. Most people listen to some kind of music, even if it is just in the car. I have found that most people are able to implement more successful and more consistent relaxation times into their busy schedules when they use music as an aid. A person's preferred music makes the time pass faster and allows the person trying to relax to take their mind off of stress-related thoughts or in getting too caught up in the process of trying to relax a tense body. Careful selection of music as an aid in relaxation can also provide musical cues that help the body gradually relax.

Music is also invaluable in effecting mood. Mood is the state or feeling you have at a particular time. We often use music to reflect our mood state. Music may reflect mood through the tempo, style and genre as well as through the lyrics. In my experience, most people automatically match their music to their current mood without thinking about it. Sometimes it is simply the lack of music that may indicate a more depressed mood if music is normally played during a happier or more relaxed state of mind. People who need to change their mood for health reasons can use music to influence their state of mind. As they examine how they have personally used music in their lives, they may discover certain times that they use music in relation to their mood . With some cognitive effort, it is then possible to match music to a current mood and then gradually change it in the direction you want your mood to follow.

Music as an aid to relaxation and as an influence on mood are two very powerful tools for helping people after a heart attack or other heart problems. Since drug therapy is not always successful in combating depression or at least decreasing the risk of recurrent heart failure, it is becoming more important that we look for alternative ways to help in rehabilitation. The following articles contain related information about music and relaxation and music for a healthy heart:



Patient Resource Page: Music Strategies for Relaxation and Wellness

Nuts and Bolts: How Music Works for Relaxation

American Heart Month: Music for the Heart

American heart month is sponsored every year in February by the American Heart Association. In order to highlight their efforts I wanted to promote the Music for the Heart website. I developed this web resource for people looking for specific connections to music and how it can benefit heart health. My personal experience is with helping people manage stress and anxiety before surgery and as well as using music to build a new heart healthy lifestyle after experiencing heart problems. I have included many of my ideas and suggestions on the website, but also have links to much more. In addition to a section about recent research studies regarding music therapy and heart health, there are links to stories in the news and reference materials like books and music. One of the most effective ways for people to improve their cardiovascular system and heart muscle is to learn how to relax. I have provided many suggestions about how to use music more effectively as an aid to relaxation.

Please consider helping support the American Heart Association by purchasing "Music for the Heart" logo merchandise. Not only does 5% of all royalties go to the American Heart Association, but we can all promote the connection between music and the heart by spreading the message!

Thank you!

Music for Birth and Labor: Lessons From the Labor and Delivery Floor

There are music therapists who specialize in using music for childbirth and for babies in neonatal intensive care. Although I have extensive experience working in hospitals, I had not specifically used music strategies as part of a birthing plan. I have read that some women develop detailed descriptions of what they would like to happen as labor progresses and delivery occurs. Medical details are often highlighted, such as when and if they wish to receive an epidural block or whether or not certain drugs should be used. From my understanding of what some music therapists do as part of the birthing plan, music can be integrated as a motivator or relaxation cue for different parts of the laboring process. As I proceeded to develop ideas for my part in a birth, the idea of making a detailed plan was beyond my expertise since I had only watched two previous deliveries many years ago. I did, however, identify some key moments when I thought music therapy strategies might be effective.

"The best-laid plans of mice and men..."
~John Steinbeck

I had diligently worked with the expectant mother to make two different play-lists on an ipod. One play list included her preferred songs for relaxing. Another play list titled, "Push it!", contained motivating music with fast tempos and an invigorating beat. I had envisioned that the relaxing music could be used with deep breathing and muscle relaxation techniques during needle sticks and the introduction of an epidural. The motivating music would be available for late in the labor process in the event that physical or mental fatigue presented itself. I should have heeded Steinbeck and thrown most of this limited birthing plan out the window!

The bright spot in the plan was that the relaxation music for needle sticks worked very well. Key elements for this success were that the patient did not need to listen to instructions given by the medical professional during the procedure. I was able to hold the patient's hand and encourage her to close her eyes and breathe in and out in slow, regular breaths that fell into her own comfortable rhythm. The patient listened to music through headphones to help mask environmental sounds and encourage mental visualization of a relaxing, comfortable scene. I further guided the patient in slightly tensing and releasing various muscle groups to help her feel the difference between tense and relaxed. She squeezed my hand and relaxed, tightened her face muscles and then let them feel loose, and released her jaw muscles so that her jaw and tongue were relaxed. Relaxing the jaw is a very good way to force the body to relax since it signals many other muscle groups in the body to either tense or relax.

There were many instances where shots, blood draws and an I.V. placement were necessary. In all these cases the patient was visibly more relaxed during the procedures and has not talked as much about the incidents afterwards as she had for previous needle sticks given without music and relaxation.

The epidural procedure involves introducing a long needle near the base of the spine and then placing a flexible tube over the needle. The anesthesiologist must use touch to guide the needle and catheter into the correct position since every person has slightly different anatomy. My client was highly anxious about potential pain and concern over complications that could occur during the procedure. She began by wearing headphones and listening to her selected relaxing music, but soon had to remove one earbud in order to listen to instructions from the nurse and anesthetist. My client lost the masking effect of the music by having to remove one ear piece, but also lost a strong focal point to help her focus her attention on something else besides the needle stick. The procedure requires a patient to arch her back and drop her head and arms forward and allow them to hang. Progressive muscle relaxation was therefore contraindicated since the patient must not move and should stay in a loose and relaxed state. The anesthetist continually provided instructions and asked questions, while requiring the patient to stay alert and verbally respond to the questions when appropriate. This arrangement precluded me from being able to provide verbal coaching or instructions to the patient in hopes of establishing relaxed breathing or facilitating relaxing visualization.

During this labor, the patient did not require motivating music. Although it was a long labor (34 hours), she did not lose energy to push at the request of the nurse or doctor. I believe that music would have been problematic since it was necessary for the nurse to count out loud and provide verbal instructions throughout the birthing process. The patient also had a spouse acting as verbal coach so there were already competing focal points.

There was one point during labor when the patient was instructed to breathe through the contractions and not push. In retrospect, this may have been another opportunity for the relaxation music and protocols. The main thing to remember is that assistance through music can be available as a strategy when needed, but it should not be forced into situations just because it is part of a "birthing plan."

The result of my short foray into music assisted childbirth was holding a beautiful newborn baby.

Related Posts:

Relaxation Strategies for Pre-operative Settings
A Guide to Sedative Music

Patient Resource Page: Music Strategies for Relaxation and Wellness

*This page is actively updated*

Music Therapy:

• American Music Therapy Association - The official site for music therapy as a profession. This site includes a very informative FAQ section describing music therapy and its applications.
• Music as Part of Rehab - How music as therapy fits into the lifestyle changes that must happen after a major cardiac event or surgery. Improving your mood and reducing stress are key elements in maintaining a healthy future.
• How Music Works to Help Relaxation - Breaking down the elements of music to find out why music can be so powerful as an aid to relaxation.
  
• Abstract: The Effect of Preferred Sedative Music on Anxiety - The purpose of this study was to examine the effect of patient preferred, sedative music on the state anxiety level of patients undergoing heart catheterization or pacemaker implant.

Music Strategies:

• Using Music Effectively to Manage Pain - Theories and strategies for pain management and distraction from pain.
  
• Relaxation Strategies for Pre-Operative Settings - Three suggestions about how to relax before surgery.
• A Guide to Sedative Music - Tips for choosing the right kinds of music to aid in relaxation.
  
• Self-Guided Relaxation to Music - A relaxation script and guide for relaxing on your own.
  

Tools on the Web:

• Music for the Heart - A website that will present strategies to address the specific stress-inducing events that surround cardiovascular health problems. Recent research has emphasized the need for a holistic approach to health after heart attacks and cardiovascular surgery. This site will present tools and guidance to help patients elevate their mood, learn to relax and introduce music as a leisure-time tool to help them make the post-cardiac event lifestyle change.
• The Mind-Body Wellness Center - This center features cutting edge research about wellness by Dr. Barry Bittman.
  
• Music Makes Sense store at Amazon - A collection of books, music and instruments that I use in music therapy.
  

Relax! How to Use Music and Relaxation to Help Your Students With Disabilities.

I have had the opportunity to lead several music assisted relaxation groups in public school special education classrooms. These groups have included a range of ages and types of disabilities including Down Syndrome, autism, mental retardation and Cerebral Palsy. One of the key points I like to emphasize with my clients and their instructors is that learning to relax can become a conditioned response. This means that relaxing can be practiced so that it is more effective and useful in the future.

Generally the clients that I work with in the special education classrooms do not have typical life stressors that would induce anxiety and require relaxation, but there are other reasons that relaxation can be an important tool for them and their teachers. I have found that many of the special education students are easily overwhelmed with environmental stimuli in their daily environment. Most teachers recognize this situation and have created quiet areas of their room that have been somewhat sectioned off and made comfortable for students to experience some quiet time without so much of the distractions of the classroom.

In other situations, students sometimes become agitated or emotionally upset without apparent cause. When this happens, it has been helpful to have a familiar music relaxation or music listening strategy already in place as part of the behavior intervention plan. In addition, the students may also benefit from social interaction, gross motor movement, stretching and opportunities to become peer models or leaders as they participate in small group relaxation activities.

I have used various music assisted relaxation activities with school-age students. There is not a specific protocol that must be followed, but rather some general suggestions and ideas to reference as you implement relaxation activities into your classroom:

1. Music choice - Music for relaxation should be chosen according to several criteria. The most important quality of the music is a slow tempo with a predictable underlying rhythmic pulse. I recommend a tempo of about 60 - 80 beats per minute. Music without lyrics is recommended, but there may be some singing if it does not distract too much attention from the experience. The melody should be pleasant and part of traditional music and not atonal or experimental. Try to use songs that do not have sudden changes in tempo, dynamics or unexpected starts or stops. The melody should also stay in the mid-range and not sound extremely low or high. There are some very good songs by Enya, Kevin Kern and Daniel Kobialka that I have used in my groups.

2. Facilitator - The person doing the relaxation facilitating, either a teacher or student, should use a calm, steady voice. Practice speaking slowly and clearly, pausing often to listen to the music. The music should be loud enough to mask unwanted environmental sounds, but not so loud that the facilitator has to speak any louder than he or she would in a normal conversation. The facilitator should sit in a chair and demonstrate the breathing or stretching movements.

3. Breathing - Breathing is the foundation for these relaxation groups. Start out the group with several deep cleansing breaths by breathing in through the nose and out through the mouth. Continue the relaxation by practicing some deep breathing in and out using slow eight or ten count intervals. Breathing can be verbally reinforced by describing the "revitalizing," "fresh," "relaxing," air going in and the "discomfort," "anxiety," and "stress," leaving the body. After a few minutes of breathing, the facilitator should encourage the group to get more comfortable in their chairs, close their eyes if desired, and breathe normally. Breathing should fall into a steady, relaxed rhythm.

4. Stretching - I encourage breathing and "stretching" as the main components of the relaxation sessions for these groups with students who have disabilities. Simple gross motor movements demonstrated by the facilitator provide "concrete" actions for the group to follow. I usually do shoulder rolls forward and backward, reaching for the ceiling and the floor and slowly tilting the head from side to side and forward as the basic movements. Other stretches can be done by reaching forward or sweeping the arms up and down as if doing very slow jumping jacks. Combine some breathing in and out on selected motions for added effect.

5. Imagery - For groups that do not have people with disabilities it is very effective to use some kind of imagery to facilitate the relaxation. Suggestions include imagining a warm light that slowly warms and relaxes each part of the body or being guided to a restful place in nature where comforting sounds and worry free relaxation can take place. Most of my clients in special education do not respond well to abstract imaginations and descriptions, but music that has environmental sounds or large pictures with client preferred settings may be possible applications after a relaxation routine is familiar and established.

The relaxation experience should begin and end with similar breathing and gross motor movements. Between these times the facilitator is free to try different stretches or breathing as they wish. This allows for leadership and choice-making opportunities for the students. Picture cards that illustrate the gross motor movements can be made so that students can make a choice between pictures and then present their choice to the group. The facilitator may also pass out supportive instruments such as an ocean drum to add to the atmosphere of the experience. An 6'-10' parachute shared by the group is a wonderful way to practice slow breathing and movements!

The relaxation session should last about 5-10 minutes depending on the attention span of the participants. If this group relaxation is practiced on a regular basis, you will notice that the students will tone down their activity simply in anticipation of the experience and even more when the music begins playing. Teachers will find that just by playing the music that they regularly use for relaxation they may be able to aid a student who is upset or agitated and help them regain some self-control. The relaxation protocol may also be helpful to use on days when an unplanned change of the school schedule has disrupted the regular routine and the students are unusually off-task.

There are many applications for the use of music assisted relaxation activity in relation to objectives in a student's Individual Education Plan. Following directions, making choices, gross motor movement, counting skills, focus of attention, gesturing and verbalizing are all specific objectives that can be tracked for progress during music facilitated group relaxation.

Now...take a deep breath....exhale.....

(For teachers after a long day, take a look at this article: Instructions For Self-Guided Relaxation
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Pain - Forget About It! Using Music Effectively to Manage Pain.

Everyone dreads the dentist chair when they know they have a cavity. Sometimes even a sound that reminds you of a dentist's drill can cause perceived pain! I have worked with clients at the doctor's office, in hospital rooms, and at home to help them with pain management. These patients have been dealing with everything from needle sticks to chronic pain from disease and in many cases using music to help them relax and ignore the pain has been very effective.

The main theory behind using music to help with pain management is centered around the "Gate Control Theory of Pain." This theory establishes that a person cannot actively think about two different information streams at the same time. Pain is a perceived idea in our cognitive thought process. Without cognitively focusing on the pain, the sensation can be greatly diminished. The Gate Control Theory is useful in that it promotes using focus of attention to distract from pain. Active music listening or music used for relaxation are very effective ways to focus attention.

Music provides a preferred and pleasant stimulus for focus of attention. The sound of music can mask unwanted environmental sounds such as medical staff talking about procedures or the clanking of surgical equipment. Music may also act as a trigger for positive memories and associations. The choice of music, therefore, is key to successfully utilizing it as a tool for distraction from pain. In order to further enhance the success of using music to distract from pain, a person may also choose whether they want to use upbeat and highly preferred music or sedative music to use for pain management.

Upbeat or stylized music may be a better choice for masking environmental sounds and promoting active listening. Familiar lyrics and memories associated with favorite songs may more easily hold active thought patterns and form "trains of thought" to other memories. Sedative music may be recommended for highly stressful situations where anxiety and tension are contributors to pain. In most cases, muscle tension will increase pain sensations by heightening physical awareness and pulling the thought pattern towards thinking about environmental sensations. Tightening the muscle fibers can also cause more painful procedures such as needle sticks or shots into the muscle tissue. Music facilitated relaxation provides a distraction as well as helping to relax the muscles.

I suggest using music listening during dental procedures, blood draws and before surgery to help with a variety of issues, including pain management. All of these settings easily accommodate headphones and family, friends or a therapist who can be there to help.