Dealing with Symptoms of Loss and Depression
Many adults experience depressive symptoms when they mourn the loss of life opportunities, goals, and loved ones (Jochims, 1992). Familiar vocal or instrumental music can help individuals to explore new life possibilities and reduce depressive symptoms. Music can stimulate creativity, build independence, enhance self-confidence, and provide a sense of accomplishment (Johnson, 1985). Through musical improvisation, the therapist and client can echo one another and creatively reshape themselves psychologically and emotionally (Kenny, 1985).
The theme of loss can be both filtered and processed through clients' own creations. In our experience, several clients have written therapeutic prose, poems, and narratives (Gallant, Holosko, & Siegel, 1997). Without much encouragement, these clients were able to identify major themes and insights that captured the substance of their loss and the gruelling ordeals they sometimes had to endure. Music intervention helps to mobilize ego strengths and coping abilities and facilitates the expression of emotional content. Unkefer (1990) encouraged clients to reflect creatively on their experiences and to write imaginatively as a way to express the deeper feelings they could not express verbally.
The Final Moments of Life
Amid the pain and confusion that surrounds those who grieve an imminent death a moment occurs when one is able to let go and let God do his work. Such a breakthrough provides yet another way to resolve grief. The song in Appendix D written for clients of the Judeo/Christian tradition offers an opportunity to see a light at the end of the tunnel, bringing with it peace and consolation.
Illustrating such peace is the story of Josie. Drifting in and out of consciousness, Josie was in the final stages of dying. She had a strong belief in extrasensory perception, parapsychology, and the occult. She had once vividly recounted a story in which she heard a knock at the door in the middle of the night. Startled, she asked her husband to see who was there. To his amazement, he saw the hallowed image of a person wearing a captain's hat. He was later notified that his father had died around the same time that morning. Josie often communicated to her worker about her own demise and using the image of the captain, she reassured the worker that she was at peace and that after her death she would wait for her friends and relatives to join her in "her place of peace and bliss." She lived her final days with a tremendous degree of faith, hope, and courage. She found consolation in the belief that those dear to her would eventually be reunited in a joyful feast in "a land full of bliss." Reflecting Josie's attitude, the song in Appendix D contains images of a calling, a ship and its captain in a storm, a journey home, and a bonding wish for friends and relatives to reunite.
A Sense of Celebration after Life
While some people have difficulty accepting their impending death and others vacillate between acceptance and resignation, some people who have lived a reasonably satisfying life are prepared to die. Such individuals are often a source of support to family members because they generally do not project guilt, remorse, or unresolved conflict during their last days of life. Their presence often conveys acceptance and peacefulness and has a positive impact on significant others. The song in Appendix E was inspired by an 83-year-old woman dying of colon cancer. In her most agonizing moments, she invited the worker to pray with her, a spiritual devotion that was accompanied by much comfort, joy, peace, and consolation. Within the strength and courage of her own faith, she confided that she was not afraid to die and that she was content with the quality of her life and the things that she had accomplished on her journey. Her only wish was that her close relatives be by her side, holding her hand as she crossed into God's kingdom to finally be reunited with her husband. The song reflects a deep sense of celebration of a fulfilled life and a family that felt very blessed to have been in Aunt Judy's presence. It conveys a transition from mourning to rejoicing in a new life.
Implications for Counselors and Therapists
It has been demonstrated that music intervention can be effectively used with grieving clients, who willingly embrace this approach to grief work. We have attempted to illustrate the effectiveness of music intervention in a working model along a continuum of loss and grief. Further research using experimental or quasi-experimental designs is required to corroborate the current exploratory approach.
To promote healing, counselors must engage various strategies: (a) "test the waters" by using music creatively in practice; (b) incorporate prose, narrative, or poetry writing as an integral part of grief work; (c) ask clients to write about the positive and negative aspects of their grief; (d) ask clients to personalize lyrics for their favorite songs (e.g., "Amazing Grace," popular folk or contemporary music); (e) meet clients where they are in the grieving process and build toward a mutually agreeable direction; and (f) join colleagues with similar interests and use songs that have been tested in the field.
The use of music at the practitioner level is process-oriented, emotionally sensitive, socially directed, and awareness-focused (Gladding 1992b). It can be used as an adjunct to grief counseling or as an integral part of the therapeutic process. Since grief counselors are trained to recognize and understand the unique personalities of clients and their environments, they are ideally positioned to incorporate music into practice.
- Gallant, Wilfred & Michael Holosko; Music intervention in grief work with clients experiencing loss and bereavement; Summer 2001; Vol. 16; Issue 4.
Reflection Exercise #9
The preceding section contained information about music intervention in grief work with clients experiencing loss and bereavement. Write three case study examples
regarding how you might use the content of this section in your practice.
Peer-Reviewed Journal Article References:
Bensimon, M. (2021). Integration of trauma in music therapy: A qualitative study. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication.
Fallon, V. T., Rubenstein, S., Warfield, R., Ennerfelt, H., Hearn, B., & Leaver, E. (2020). Stress reduction from a musical intervention. Psychomusicology: Music, Mind, and Brain, 30(1), 20–27.
Howard Sharp, K. M., Russell, C., Keim, M., Barrera, M., Gilmer, M. J., Foster Akard, T., Compas, B. E., Fairclough, D. L., Davies, B., Hogan, N., Young-Saleme, T., Vannatta, K., & Gerhardt, C. A. (2018). Grief and growth in bereaved siblings: Interactions between different sources of social support. School Psychology Quarterly, 33(3), 363–371.
Landis-Shack, N., Heinz, gA. J., & Bonn-Miller, M. O. (2017). Music therapy for posttraumatic stress in adults: A theoretical review. Psychomusicology: Music, Mind, and Brain, 27(4), 334–342.
Online Continuing Education QUESTION 16
In order to promote healing, what six strategies can counselors utilize with music therapy? Record the letter of the correct answer the