The Impact of Music

When it comes to music, there are no boundaries to the impact it  may have on people. To me, music can break through the strongest barriers and connect people of different cultures; although their understanding and their perception may be different, the presentation of music is the same. As a student music therapist, this has been my foundation while facilitating sessions here in Thailand. I have had to communicate  through music and let it be the common denominator. 

Because I cannot speak or understand the language it limits the therapeutic effect of verbal communication with my clients. Therefore I depend solely on non-verbal communication and musical elements to promote success in my sessions. I have discovered that these strategies can carry you a long way.

My first individual session that occurred on the Pediatric Palliative Care Unit at Siriraj Hospital, a two wing, 20+ bed unit of fragile children age 0-18 with a terminal illness. In our sessions here, there are four student music therapist on the unit to facilitate group sessions, and two to facilitate individual sessions. After co-facilitating three group sessions my first day; a seven year old girl came to her bed weeping. She had just been released from surgery, and as you could imagine, she was in a tremendous amount of pain. The child’s mother contacted the music therapy supervisor to request services and the supervisor happily agreed to see her. 

I volunteered to facilitate the session because I wanted to try some of the different techniques that I learned in my pediatric class last semester as it related to pain with children. I had not planned for this session and was unprepared, but I knew I could be effective if I followed the energy my client was giving me. There was no formal introduction needed; I said hello and started singing and playing very softly by her bedside. During the first few minutes she was still crying and seemed apprehensive to participate. I continued to sing softly as I reached in the bag to bring out a few puppets and instruments. I set them in front of her, giving her an opportunity to choose. As I watched her response to the options I provided, I realized that this stopped her from crying. 

At that moment, I knew it was time to sing a song that she was familiar with, since she was making eye contact with me and seemed receptive to interaction. I decided to sing “Chang Chang Chang”, a traditional Thai children’s song about the parts of the elephant/chang. I used a chang puppet to motivate her and help her participate in the session. I asked the music therapist supervisor, who speaks Thai, to help me say “chang, take the pain away in Thai.” I then moved the chang over her left arm where the procedure took place as the mother helped us say “take the pain away”.  Once the child noticed her mother’s engagement in the session, her affect changed tremendously. She began to release the tension in her body and her grimaces turned to a pleasant smile. Not once did I have to depend on language as a mean for communication, I used non-verbal communication and music elements to enhance and carry-out this session.

We continued singing together and I incorporated instruments into the session. With the few Thai words I know, I was able to give her directives to extend her arm over her head, to the left and right, and below her waist. This was beneficial for the child because it allowed her to use her arm and hand muscles, improving blood-flow, preventing potential pain. The most important application used in this session were interventions to distract the child from the pain she was experiencing.

This short, 45 minute session, impacted me in so many ways. It was challenging, but it helped me work through my insecurities about facilitating a session with fragile children as a music therapist, which is much different than my experience with this age group when working as a music educator. As a music therapist, we see clients of all ages and of varying illnesses. When it comes to working with infants, toddlers, school age, and adolescents with IV’s, bruises, and scars from operations, it is hard to maintain a poker face. Although it is very sad and difficult to see, I knew that it was my duty to try and bring a positive and professional attitude to my these kiddos. Therefore, I set my emotions aside and worked to be the best for this patient. 

The techniques I learned in class were successful because I followed my client’s lead by adjusting to what she needed, used non-verbal communication, and used strategies that were conducive to children. For instance, using a stuff puppet, implementing rhythm sticks and eggs shakers as instrument play, and using music elements such as dynamics and tempo changes to the calm her down were strategies and techniques I learned from my pediatric class. The techniques used were not hindered because of our cultural differences. In fact, our therapeutic relationship was initiated and successful because of the music. The outcomes of this session demonstrates that music can impact anyone no matter what the barriers may be. How does music impact your life?

Music can connect us and affect us in different ways!!!