Music Therapy and Bereavement

Presenter: Sara Klinck, MMT, RP, MTA

A Little About Me

Training and background•

BMT, MMT–

Registered Psychotherapist (RP) –

Music Therapist Accredited (MTA)–

Current work and practice•

End– -of-life, hospice, LTC, bereavement care

MT instructor (WLU) and clinical supervisor–

Personal loss history•

Webinar Outline

• Brief background of MT

• Emergent themes in MT research/practice in bereavement

• Music Therapy Bereavement Group Model

• Case examples and research findings

What is Music Therapy?

• “Music therapy is a discipline in which credentialed professionals (MTA*) use music purposefully within therapeutic relationships to support development, health, and well-being. Music therapists use music safely and ethically to address human needs within cognitive, communicative, emotional, musical, physical, social, and spiritual domains.”

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How do we define loss?…

“Grief”

“Mourning”

“Bereavement”

Variations of Grief• Anticipatory Grief

• Complicated or Disenfranchised Grief

• Grief process affected by variety of factors:– Nature of relationship

– Mode of death

– Personality characteristics

– Social and cultural factors

Grief TheoriesTasks of mourning • (Lindemann; Worden)

Stages of grief • (Kubler-Ross)

Attachment Theory and phases of grief/mourning•(Bowlby; Rando)

Meaning reconstruction • (Neimeyer)

Dual process model• – loss/restoration focus (Stroebe & Shut)

Expressing grief + relearning the world • (Attig; Bertman;

Neimeyer; Stroebe & Shut)

Bereavement Support Groups

• Group support + creative activities = acceptance and nonjudgmental listening (Rando)

• Group = safe place, container, “sacred” witness (Jeffreys)

• “Healthy healing workplaces of mourning” (Wolfelt)

• V.I.N.E. (Teahan)

• Bereavement Support Group resources (Dyregov & Dyregov;

Graves; Humphrey & Zimpfer; Wilson; Wilson)

Grieving and Creating Together

• Forms of creative expression tell our stories of loss and suffering (Neimeyer)

• Paths for representation of loss and grief (Neimeyer)

• Various creative forms bring our stories from the past into the present (Rogers)

Music Therapy and Bereavement:Emergent Themes in the Literature

• MT in palliative care and anticipatory grief

• MT with grieving children and adolescents

• Specific MT techniques:

– Clinical improvisation

– Songwriting

– Culture-specific songs/approaches

Music Therapy in Bereavement Contexts:Provides sense of community, connection, and •belonging

Creates a pathway to access feelings; facilitates •emotional expression

Use of metaphor and symbolism in song material•

Positive changes in mood•

Synthesis of physical, sensory, emotional responses•(Albergato-Muterspaw, 2009; Bright, 1995 ; Creagh, 2005; Clements-Cortés & Klinck, 2016; DiMaio, 2015; Krout, 2005; Heath & Lings, 2012; Klinck, 2013; Sekeles, 2007; Smeijsters & van den Hurk, 1999)

Music Therapy Bereavement Group

Tapestry of Our SongSharing our stories, sharing our lives, hearing the music of our hearts

Thank you for bringing who you are to the tapestry of our song

Healing can come as we share, as we walk this road together

Each in our unique journey of tears, and in the tapestry of our song

There are times to listen, and times to cry, times to share our memories

Times to feel, sharing laughter and fears, in the tapestry of our song

(Klinck, 2008)

Group Elements

Eight• -session program

Topic• -based, music-centered

Participant registration•

Group • norms

GOALS:

• To use music and its emotive/expressive qualities in a supportive environment to:

– Identify and express loss

– Meet and support one another

– Learn and develop coping skills and resources

Topics of the Program

• Week 1: Introduction (Opening Session)• Week 2: Telling Your Story• Week 3: Changes, Challenges, and Coping• Week 4: What You Feel• Week 5: How You Express• Week 6: Supports and Relationships• Week 7: Finding Meaning• Week 8: Moving Forward (Closing Session)

Weekly Session Outlines:• Transition into the session:

• Light a candle

• Opening music

• Check-in (musical and/or verbal)

• Music-sharing

• Reflection or Lyric Analysis on the theme/topic

• Music therapy experiences and verbal processing

• Closing music

Music Therapy Experiences:Musical • / Instrumental / Verbal check-inClinical Improvisation (instrumental, vocal)•

Songwriting•

Music• -sharingLyric • AnalysisMusic and • Art/drawing/writingGroup • SingingListening Journal •

CD Compilations•

• Songwriting• Writing thoughts to improvised music

–What would you like to tell your loved one?

–Write about your loved one

–Write about your own process

• Lyric discussion

• Choosing chord progression

• Workshop-ing songs within the group

“Pilgrim” (Enya)

Pilgrim how you journey on the road you choose

To find out why the winds die, and where the stories go

All days come from one day that much you must know

You cannot change what’s over but only where you go

One way leads to diamonds, one way leads to gold

Another leads you only to everything you’re told

In your heart you wonder which of these is true

The road that leads to nowhere, the road that leads to you

Will you find the answer in all you say and do? Will you find the answer in you?

Each heart is a pilgrim, each one wants to know

The reason why the winds die, and where the stories go

Pilgrim in your journey, you may travel far, for pilgrim it’s a long way to find out who you are…

Music Therapy Strategies:• Musical / Instrumental / Verbal check-in• Clinical Improvisation (instrumental, vocal)• Songwriting• Music-sharing• Lyric Analysis• Music and Art/drawing/writing• Group Singing• Listening Journal • CD Compilations / Playlists

Henrietta’s Drawing

Wendy’s Drawing

When you’re weary, feeling small. When tears are in your eyes, I will dry them all.

I’m on your side, oh when times get rough, and friends just can’t be found

Like a bridge over troubled waters, I will lay me down (repeat).

When you’re down and out, when you’re on the street.

When evening falls so hard I will comfort you.

I’ll take your part when darkness comes, and pain is all around

Like a bridge over troubled waters, I will lay me down (repeat).

Sail on silver friend, sail on by,

Your time has come to shine, all your dreams are on their way.

See how they shine, and if you need a friend, I’m sailing right behind.

Like a bridge over troubled waters, I will ease your mind (repeat).

Bridge Over Troubled Waters By: Simon and Garfunkel

Group Lyric Improvisation

Meaning, you are here…meaning, you are here

We see you in _______________

Research Study (Klinck, 2013)

“Grief Journeys in Music: The experience of a music therapy

bereavement group”

Primary Research Questions:

1. What is the experience?

2. How is grieving enabled by music therapy in terms of expression and coping?

Structure of the Study

Phenomenological Inquiry•Modified Grounded Theory for coding themes–

3 • courageous participants: Evelyn, Nancy, Henrietta

• 6-week group followed

Semi• -structured interviews

Findings

Sub-themes

Main themes

Bigger PictureHolistic Shared Experience:

A Mutual Search for Connection

ValidationSimilarly Unique Journeys

Honouring the Relationship

Musical Memories

Bring Comfort

Relationship Continuation

Apprehension to

Discovery

Normalizing the Roller Coaster

Projection and Relating

Honest Self-Expression

Findings: Experience

What was the essence of the experience for participants?:

Holistic, Shared, Search for Connection

“Mutual sharing and learning about each others’ journey…when you’re with people in the same boat, you’re not the only one,

and the music sort of supports that. At the end there was a real bond formed…and a mutual strengthening all around the

circle…” (Henrietta)

Findings: Expression

Music Therapy affects expressions of grief and loss through:

Externalizing inner state through projective methods

“Sometimes when you don’t have words of your own, you find them in a song.” (Henrietta)

Findings: Expression

Music Therapy affects expressions of grief and loss:

“You go back and you go forward…waves, roller coaster…up and down…it’s a journey”

(Nancy)

Findings: ExpressionMusic Therapy affects expressions of grief

and loss through:

Inviting honest self-expression

“I felt as if I was sort of pushing the buttons when I was bringing up anger, but it’s very much a part of me. I think the instrument thing was very good because you could show your emotions.” (Evelyn)

Findings: CopingMusic Therapy provides opportunities for

developing coping resources:

Music -listening as a tool for continued coping

Comforting memories:

“Memories, music can help remember them…” (Nancy)

Validation through song lyrics:

“I listen to the words more, and kinda try to relate to it… it confirms what you feel and how things are…” (Nancy)

Findings: CopingMusic Therapy provides opportunities for

developing coping resources:

Discovering creativity within

Evelyn: “I might get a career in music, I keep saying we have to be a band”…Nancy: “this is the most musical instruments I’ve

ever played in my life…Evelyn: “better than the first night”

(all laugh)

Wider Implications?

Group music therapy for bereaved/grieving adults is beneficial

Offering a variety of music therapy techniques/strategies can be beneficial for grief work

Structure provided by a topic-based program proved helpful and comforting

Future Research???

• Comparative research (different MT experiences: songwriting vs. improvisation)

• Effects of bereavement length on experience of MT

• How previous experience with MT affect use of music and/or MT in bereavement

“Music has a unique power to express inner states and feelings….and there is, finally, a deep mysterious paradox here, for while music makes one experience pain and grief more intensely, it brings solace and consolation at the same time.”

(Sacks, 2007, pp.300-301)

QUESTIONS?

Thank you for your time, interest, and attention!

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