Wednesday, October 19, 2005

Sonic Rejuvenation

The last few weeks have been held together by wonderful and deeply synchronistic threads. (I've also seen some wicked shows - big up to the Al-Haca Soundsystem for a killer set, featuring mad poetry by the mc and thundering basslines that would make Shaka proud). Much of these interwoven experiences have related to creativity and music. As part of this, I've been reflecting a bit on the nourishing, restorative effects of music and on the various shades of our psychological response to sound and rhythm...

Let me set a bit of context. As part of my UCSF faculty appointment, I work as a psychiatrist in an outpatient program serving a population that is primarily homeless. These individuals are pretty much considered among the most challenging to engage with - beyond the destabilizing effects of homelessness itself (and as part of its etiology), many of them struggle with severe trauma histories, multiple major losses, major psychiatric conditions, drug addictions and years of being unemployed...

The program itself is person-centered and offers medical care, psychotherapy, psychopharmacology, help with housing and financial entitlements (as well as meaningful relationships). It's nice to actually look forward to work (not that I don't ever get weekend blues on a monday morning!) - I feel rather blessed with this opportunity to work with this population (and also with a spectacular group of social workers and other providers). In the midst of this program, we've started a weekly Music Therapy group, which has evolved into the program's most popular group (which more than anything, seems a testiment to a central role of music in our lives, even when we've forgotten this)...

Let me circumabulate a bit, starting with a quote:

Pythagorus considered that music contributed greatly to health if used in the right way... He called the method musical medicine... In the spring he would sit in the middle of his disciples who were able to sing melodies and play his lyre... His followers would sing in unison certain chants which were melodious and rhythmical... At other times his disciples employed music as medicine, with certain melodies composed to cure the passion of the psyche, as well as ones for despondency and mental anguish. There were melodies for anger and aggression and all the psychic disturbances...

As quoted from Iamblichus, 4th century Greek philosopher

My tabla ustaadji was in town recently, another wonderful thread in the mix. I've been studying with Vishal for some years, he's a virtuosic player who even dreams in tabla bhols (the object-relations of tabla playing will be the subject of another post!)... He lives in New Delhi for most of the year, but comes to Seattle for 2-3 months to teach and perform across the US (check a stream of our own non-classical soundsystem collaboration here!). In resonance with the quotation above, Vishal told me the older generation of Indian classical musicians would share stories of specific raga's being used to treat specific physical diseases and psychological conditions!

Even in contemporary scientific literature, Music has been shown to have multiple positive effects - it's been shown to improve a variety of psysiological parameters (blood pressure, heart rate, etc...), enhance immune functioning, reduce anxiety, improve mood and it's even been shown useful in a spectrum of psychiatric illness. Of course, these studies miss the more nuanced, personal ways in which music can effect us - including the capacity of music to connect us with repressed or dissociated affect and even as a pathway to communicate with some core aspect of our Being or Nature (check this great article for a Jungian perspective - "The Goal as Process: Music and the Search for Self").

This may be a bit hard for some to digest, but let me share a few examples from the literature (with links to abstracts): In one study, music was shown effective in augmenting conventional treatment for people hospitalized for depression. There is a study which has demonstrated improved outcomes for individuals with Alzheimer's Dementia treated with Music Therapy, with decreased agitation and even improved cognitive measures. If you're interested in reading more along these lines, I would definitely recommend "Sounds of Healing," written by the Cornell Oncologist, Mitchell Gaynor.

Now back to the Music Group... Though each person (I don't like either "client" or "patient" when referring to the individuals engaged with our program) relates and draws from the group in their own way, an overarching goal has been to cultivate a mindful awareness of how different sounds, rhythms and music effect us. We've also aspired to create a space where participants can cultivate a sense of play, as well as nurture their creative aspects. We've also attempted to cultivate the idea of music as active imagination, or a means of dialogue with our Self, or Soul.

The format has been pretty improvisational, initiated by a few brainstorming sessions, and then drawing from ideas and inspiration that find us through various avenues (an overall process that is not too unlike the approach to jazz and indian classical music performance). Over the 10-12 sessions we've had, some structure has evolved and now we usually start each group with an open invitation to share experiences with sound and rhythm in the prior week. This is followed by a mindfulness meditation, which focuses on the breath and also incorporates humming/toning.

The remainder of the group varies. We've done a good amount of listening - covering Soul, Jazz, Delta Blues, Indian Classical, Western Classical, Roots and Dub Reggae, Hip-Hop, Afrojazz, and even Breakbeats and Ragga Jungle! We've done visualization and toning meditations that focus on compassion and forgiveness. We've held rhythm circles with found objects (as there is potential for sound in most everything - as well, most of the client's can't afford actual instruments). People have been invited to put music or emotional responses into movement - with a hope of bringing soma, or body, back in from the margins.

Overall it's been moving. I've been blessed to learn from my fiance, who is studying expressive arts therapy! I certainly don't feel that we received much exposure to the incorporation of expressive arts modalities (such as music and movement) in my residency training. I feel pretty empassioned about integrating these into my work and have fantasies of playing some small part in integrating these approaches more and more into our public mental health system. I feel the same way about Jungian and contemporary psychodynamic work, which doesn't have as much presence in this public setting (in contrast to cognitive behavioral psychotherapy and psychopharmacology) - this will be the subject of a future post (and a paper I'm working on - "Jungian Dream Work in a Public Mental Health Clinic")!

- Khenu


1 comment:

Cre said...

Yo Khenu. Glad to see your blog. Look forward to reading it. Peace.