Music Therapy and Bone Marrow Transplants

In some medical settings, such as mental health services, music therapy has been used widely to decrease patients' perception of pain, anxiety and depression, and boost their feelings of relaxation. It's also used in hospice to comfort terminally ill patients. But it's not commonly used with bone marrow transplant patients, who are often hospitalized for a month or more. Because their immune systems have been wiped out, visits are kept to a minimum to avoid infections, and feelings of isolation often set in. Patients can have a variety of side effects, including pain, nausea, fatigue, anemia and dehydration. 'One reason we began this study was because patients were requesting new ways of treatment,' says Sahler, a behavioral pediatrician who works with children who have chronic and terminal illnesses. 'The patients told the staff, 'I know I'm about to go through a major challenge that will be very painful and isolating. What do you have to offer me to help me get through this?' Music therapy was one answer. We originally began the study with children but quickly decided to enroll adults as well.' Sahler teamed up with Bryan Hunter, Ph.D., an associate professor of music and the coordinator of music therapy at Nazareth College and adjunct associate professor of pediatrics at the Golisano Children's Hospital at Strong, who has established music therapy programs in several hospitals. Hunter's students visited patients at the Wilmot Center's Samuel E. Durand Blood and Marrow Transplant Center, providing a range of music-therapy services. Sometimes students simply brought and played music the patients requested; other times they helped the patients play music themselves, or write their own songs, or talk about a favorite set of lyrics. Patients were also encouraged to visualize a peaceful and joyful setting during each session. 'The program has been very well received,' says Hunter. 'When a program like this is first introduced, typically we get mixed reactions. Some in the health care field are skeptical at first. But when they see the positive effects on patients, they usually change their mind. And other doctors and nurses are excited when it's introduced - they think it's a great idea right from the beginning.' An early problem with the study, Sahler says, was that staff members frequently turned the music therapists away, saying the patients were too ill. 'It's taken awhile for staff members to recognize that music therapy can be very helpful to people when they feel most distressed,' Sahler says. 'Nurses and doctors originally thought that the patient had to be playing an instrument or singing along, but passive listening or simply the presence of the therapist providing music itself can be therapeutic.' Now with funding from the National Institutes of Health, the team is conducting a larger study to check its results. In the current study, scientists will also measure the amount of medicine that patients receive for pain and nausea, and they'll monitor levels of the patients' cytokines - molecules in the body that are key to helping a patient's immune system establish itself after a transplant. In addition to Sahler and Hunter, immunologist Jane Liesveld, M.D., medical director of the bone marrow transplant unit, helped direct the study.Contact: Tom Rickeytrickey@admin.rochester.edu585-275-7954University of Rochester Medical Center

Music Therapy, Autism, and Dr. Tomatis

The fields of music therapy, music healing, and music medicine have been around for centuries. But I don't know exactly when therapists discovered the power of music with autistic children. Autistic children have, among other things, a great difficulty or even an absence of speech. Typically these children rarely make eye contact but miraculously they respond powerfully to music! Dr. Alfred Tomatis, with whom I studied in 1991 was one of the first therapists of our time to focus extensively on working with autistic children as well as children with PDD, and other learning disabilities. Enjoy the following story:

"By the time Debbie Clark took Adam, her autistic three year-old son, to a music therapist, he could barely speak. At the music-therapy clinic at California State University in Northridge, USA, therapists encouraged the autistic child to express himself by playing instruments and beating out rhythms on drums. They put conversations to song in order to get Adam talking."In tree months, the change was phenomenal," says Clark. "Before, Adam would never look a stranger in the eye, let alone speak. Now, after his music therapy session, he waves to the therapists and says, "Bye, Jim. Bye, Ron. See you next week." Believe me, that's music to my ears."Music, researchers around the world are discovering, can help healing in a variety of ways. Burn victims encouraged to sing while having their dressing changed experience less pain. Cancer patients who listen to music and practice improvising on instruments, for example, see their levels of stress hormones drop and their immune systems get stronger. Part of music's power comes from ability to relieve anxiety, which can suppress immune defenses as well as intensify the experience of pain. Music, especially singing, takes a person's mind off the suffering and soothes tension. "By helping patients relax, music eases pain and may even speed recovery," says Richard Fratianne, a noted professor of surgery. The experiences of autistic children like Adam Clark suggest that music's effects reach deeper, even influencing brain development. The therapeutic use of music seems to activate different parts of the brain, including networks associated with motor control, memory, emotion and speech, explains neuroscientist and musician Michael Thaut. In his own work, Thaut is using the close link between music and movement to help people slowed by strokes, cerebral palsy, muscular dystrophy and Parkinson's disease.Says Northridge music therapist Ron Borczon: "Traditional healers have used songs and drumming for centuries. We're simply rediscovering what they always knew -- that music, through its profound effect on mind and body, can be a potent way to help people get well."