Therapies of Joy
Sweet music. Uncontrolled laughter. Visual arts. The unconditional love of a large furry dog. What do they have in common? All have been shown to be effective tools to treat serious diseases of the body, mind and heart.
What, you doubt?
So did author Sean Hurley when he began to research this story. And now? Read on.
I am someone who early on believed in everything, then nothing, and then, finally, something. The world was magic, then not, and over the creeping flight of a dozen years, laid out the starry blanket of its cosmic mystery. From Santa Claus to Sartre and then finally to the stars.
I have been blessed or burdened - surrounded by anyway - people who believe in fancy and exotic and unprovable things. The closest people to me, the people I love the most, believe in ghosts and aliens and crystals and Big Foot and power centers and healing across distances. I do not.
I used to scoff at such flimflammery. I may even have bemoaned. I certainly lectured. While my old-timey skepticism remains, I am mostly silent now.
Like the squinting doubter from the sci-fi extravaganza forced to fire his laser at the giant bugs he still doesn't quite believe in, I accept that I don't know and that anything is possible and nothing is perfectly true.
But a smoldering flag still rises when I hear talk of UFOs or psychic powers or alternative healing. When my terminally ill mother-in-law was at Dartmouth-Hitchcock, I learned that the hospital offered palliative services such as Reiki, the ultra-soft Japanese energy therapy. Does insurance pay for that? I wondered (it doesn't). Do the doctors know about this? I worried (they do).
As with the seeming con of the touch-free car wash, I found it hard to believe that the closest thing to nothing could have any positive effect. How could the art of not touching - or barely touching - do anything for anybody?
Certified Harp Practitioner Margaret Stephens comforts a patient by playing soothing music.
On a subsequent visit to the hospital, I learned that Margaret Stephens, the in-house harp therapist, was available to visit the sick and dying. I heard her playing down the hall behind a mostly closed door. The old skeptic in me squinted. The music was so soft and pretty, like the sound of twirling clouds or an eerie preview of heaven. But the closer I got, the more I warmed to it. Someone in the room was possibly dying. Someone else - Margaret, I assumed - was playing the harp.
In my old Sartre days, I would have seen only the irony. I would not have sympathized with what I'd perceive as cozy intention and sentimentality. This is self-serving, I would have thought. It is saccharine. They can't hear you. And how about this - what if they don't like harp music?
But in these latter starry days, I did what a lot of people do when they hear live harp music coming from a room where someone is gravely ill. I cried.
I did a little bit of what we might call "looking-into-it" and discovered that music and medicine have shared hands for a long time. The Greek God Apollo was the God of Medicine and the God of Music. Throughout history, in fact, medicine men and priests were almost always also musicians, rubbing their patients with herbs and dousing them with remedies while plying them with sound.
The Greek philosopher Pythagoras played the stringed Kithara and believed in "musical medicine." He played music for the sick and dying and for his students during different parts of the day, to make them calm or revive them. And he believed music had the power to heal.
It's one thing to say that music is a comfort, but that it heals?
Alice Kinsler, manager of Therapeutic Arts and Activities at Concord Hospital, tells me it is so. She oversees a staff of freelancers and volunteers - from therapeutic musicians to certified pet therapists.
"Studies show that these alternative therapies help boost the immune system and reduce a patient's reliance on medication," Alice tells me. "It actually lowers health care costs. We like to say that 20 minutes of music can replace a Valium. If we can use less medication or spend less nursing time at the bedside because a patient isn't as needy because they are calm and happy because of something like a musician playing for them or a visit from one of our pet therapists, that's going to save an institution money and make the work more efficient."
The notion of a shaggy dog panting at a patient's bedside brings me to the edge of argument. The only dog-assisted medical relief I can imagine is a St. Bernard with a barrel of brandy sloshing around its tree trunk neck.
Alice Kinsler offers patients art they can display in their rooms.
"Our program is called PUP - Pets Uplift People," Alice says, "We have six trained and carefully screened dogs and their caretakers. Of course, we are very careful and have a protocol but the dogs are brought right into the rooms and our patients get to pet them and talk to them. There's a lot of talk. A lot of reminiscing."
Being more of a brandy than dog person, I can still concede the comfort of warm fur. Petting and so on. I can see a windy bit of "uplift." But how far up can such lift go?
There's still a difference between things that are nice and things that heal.
"Did I tell you about the horticulture cart?" Alice continues, "It can be wheeled into a patient's room and set up right in front of them. There's soil and seeds and basically for gardeners it's a way to reconnect to their own garden. Touching the dirt, smelling it. It reminds them of who they are and it makes them very happy just to mess around with the earth."
DUP, I think, skeptically grumpy. Dirt Uplifts People.
Alice has me talk with Emily Mills, one of the certified music practitioners at the hospital. Emily points out a helpful distinction - these therapies don't cure things like cancer, but only aid in recovery, "in the healing process."
Before we spoke, Emily was in session, playing piano at the bedside of a woman in distress. "This woman has been in the hospital for a week and is very sad and having trouble breathing," Emily says. "She was initially reluctant to have me play the keyboard and not clear on how it would help - but she leaned back and closed her eyes anyway. I played improvisational music to help calm her breathing. I asked her if she wanted me to continue and she said, 'Yes, this is really helping me.'"
Alice returns to tell me a story from a few years back. "There was a woman very close to death, unable to breathe on her own. She was unconscious and just very sick. Every day, I would sit beside her and read her poetry. I wasn't sure what happened to her but a few years later, I was walking through the hospital and I saw this woman. She was beautifully dressed, with her hair nicely done and make-up. She was carrying an oxygen tank. 'Alice!' she shouted with a huge smile. 'Alice! Do you remember me? I always wanted to tell you that the poetry saved my life!"
Emily Mills, a certified music practitioner.
Could it really have been the poetry? Or was this just a bit of grateful hyperbole?
If poetry can literally save someone's life, how exactly is it working?
Instead of searching for answers in the Google factotum, I try to imagine the cold, dark place of grave illness. I wrap myself in an unresponsive body, void of good things and comprised mostly of stresses. There is pain of every sort, cold bars and rough rocks. There is woozy exhaustion and self-grief. An almost scientific awareness of how far away true wellness is - a knowledge of how sick one is. A recognition that a kind of coup has taken place - one's body is dangling in the mechanical grip of the hospital. The colorless computers and the flesh-puncturing tools and the elsewhere doctors are the only things keeping you alive.
Into that space comes a voice like Alice's reading poems. It is sound in the shape of fine words, it is company. It is a warm and wandering storytelling. It is finally, and firstly perhaps, an invitation to travel away from where one is.
Stories and poems and music don't need to ask you to come away with them. You just go.
In departing from where you were, you remember who you are. Where music and poetry do it for some, perhaps dirt and dogs do it for others.
To return to one's self is to become simple again. Transcendence doesn't involve distance. It's the letting go of the material burden of whatever it is that ails you. When you have cancer, you can become cancer. When something - anything - from dirt to a dirty dog to a song to a poem, reminds you of who you are, you are no longer the dark name of a difficult condition. You are yourself.
The conveyance of this I will guess - the re-uptake delivery system for the self, I believe - is joy.
So for this moment, in a watery, half-glassed and non-scientific way, perhaps we could say that music and poetry and dirt and dogs have the power to remind us of who we are.
A recent viral video, "Alive Inside," about the power of music shows this dramatically. Ninety-year-old Henry Dryer slumps in a wheel chair. He suffers from dementia and is unresponsive, locked in a kind of catatonia. But when a pair of headphones is set into his ears and the music starts, he literally wakes up from his condition. He becomes animated, even articulate. "I feel a band of love, dreams ..." he says, "It gives me the feeling of love, romance!"
The video shows Henry Dryer remembering Henry Dryer. Music was his reminder. To see him revive is to see a happy compression where music and joy and self are simultaneous and nearly the same.
When we think of joy, we tend to shine it up with sun and clover. Glistening grass and triumphant arms. It is the golden apricot dessert of happiness, the über-goodest feeling.
But joy is not so armed and forceful. Not so exuberant or victorious or even winning. It is almost invisible - or as visible as the tiny sparkle in a hidden eye. As fragile and rarely sprung as a Lady's Slipper.
It's not that joy is actually so hard to come by, but that we are often in no good condition to receive it. All clichés about stopping to smell the flowers are simply reminders of our need for joy. Stop and feel the joy, is what the sayings mean. Stop and remember who you are.
It is not hard to smell flowers, but we are often so time-bothered and life-heavy that the fragrance of a lilac does nothing.
Who can have any joy while multi-tasking? While supple with stresses in the rush of here to there? I have smelled flowers in such states of panicked microscosm and let me tell you, it is simply irritating. Just a dumb flower. What a dumb saying.
But real joy is a candlelight. A drop can duskily illuminate an entire room. And by room, I mean the self.
In sickness and even in death there can be this joy. Juliane Weeks is a music therapist from Temple, NH, who is regularly called upon to play sound and music for people on the threshold.
"Everyone leaves in their own way..." Juliane says. "So I sit first quietly and tune into the person. Their breathing. And then I follow the breath. I breathe with them and we breathe together. And then I begin to hum. And then I will start to sing perhaps, if the breath is agitated, I will try to slow it down. Then breathing. Then silence. You have to be very present in the moment. It is not something I bring with me or a sheet of paper. Very few tones might come. It is not about playing a complex piece of music. But helping the releasing, the letting go, and comforting the person in the transition. It is breathtaking."
In her depiction of sacred death, I perceive a kind of healing that even my inner skeptic can allow. Perhaps my definition has been too demanding, too surgically aggressive. I want a dollop of excision with my healing. I want flesh improved before my very eyes. I want disease canceled and branded with a capital X.
But in Juliane's story, I sense a kind of healing that continues right up into the moment of passing away. It is not a healing that makes you better - that cures. But a healing that lets you stand to one side of your circumstance. That lets you live, even as you die.
Like Henry Dryer, close to death, we may always have access to the bands of love and dreams, the feelings of love and romance.
We may not always be able to get better, but perhaps we can always heal.
Maureen Ross, founder of New England Pet Partners.
Art and music therapies are used in healthcare settings all over the world, offering patients the mysterious (but proven) healing power of creative expression. Many such practices are available right here in New Hampshire.
Alice Kinsler runs Concord Hospital's extensive art therapy program with choices like crafts and art activities, Art a la Carte — through which patients can choose art to display in their rooms — and live music at the bedside. email@example.com.
In addition to playing at patients' bedsides at Concord Hospital, Emily Mills also performs her piano music at Peterborough's Pheasant Wood Nursing Home and Keene's Castle Center Adult Day Care Center. She can be reached at firstname.lastname@example.org.
Certified Harp Practitioner Margaret Stephens uses the soothing music of her instrument to guide patients at Dartmouth-Hitchcock's Norris Cotton Cancer Center in Lebanon to healing, wholeness and health.
Marv Klassen-Landis, a teacher of literary arts, gives patients at Dartmouth-Hitchcock's Norris Cotton Cancer Center in Lebanon the chance to parlay their emotions into poetry or prose, or to listen to his reading of their work.
Russian artist Marina Nazarova Forbes holds workshops in painting Fabergé-inspired wooden eggs and nesting dolls and in illustrated storytelling to people living with illnesses like cancer, HIV and Alzheimer's disease.
Littleton Regional Hospital hosts area musicians each week to act as volunteer therapists. These artists play everything from accordion music to jazz, show tunes and classical for the hospital's patients.
Dogs may be a man's best friend, but they're also an extremely useful tool in treatment. Encounters with dogs, cats, horses and some more exotic pets can improve a patient's social, emotional and physical health during recovery. Below is a short list of in-state pet therapy practitioners.
Doris Irwin, a chairperson of the ElderPet Board, brings her cocker spaniels Sebastian and Tango to Wentworth-Douglass Hospital regularly.
Goffstown's UpReach Therapeutic Riding Center allows people with conditions like cerebral palsy, brain injuries, multiple sclerosis and autism to learn to ride on horseback.
Maureen Ross founded Pelham's New England Pet Partners to train, evaluate and support the Registered Pet Assisted Therapy and Reading Education dog teams regionally.
The Science of Joy
Music and laughing and playing with dogs are generally things that make us feel better, happier, more alive. But it's not just a temporary mood lift or diversion from stress - scientific evidence shows that our brain and body chemistry actually change when we engage in these activities, and the effects are only positive.
Music is clinically proven to influence the body's biological responses, such as heart rate, breathing and blood pressure. Sedative music can lower blood pressure, reduce anxiety and even pain levels by increasing the production of endorphins in the body. A recent study from the Montreal Neurological Institute at McGill University found that listening to moving music causes the brain to release dopamine, the feel-good chemical associated with reward and pleasure. Many hospitals and cancer centers report decreases in recovery time and less use of anesthetics and pain medication for patients who are repeatedly exposed to music. This could also be because the brain, prompted by music, actually releases antibodies that speed healing and reduce the risk of infection.
Various studies have measured the beneficial effects of interaction with animals, including a reduction in stress hormones. When you play fetch with your dog, your brain increases production of serotonin, the neurotransmitter associated with positive mood. An early report by researchers at the University of Pennsylvania indicated that stroking a cat or dog can lower a person's blood pressure, which may be why clinicians have noted faster recovery from heart attacks in patients who use therapy dogs. Petting an animal also releases oxytocin into the bloodstream. Oxytocin is referred to as the "love hormone" as its levels are particularly high in women just after childbirth. High levels of oxytocin create feelings of calm, contentment and nurturing. Just 10 minutes spent petting a dog reduces anxiety and can even lower cholesterol.
The healing powers of laughter were first scientifically noted by Norman Cousins in 1979. Diagnosed with ankylosing spondylitis (a form of spinal arthritis where bones can become stiffened and joined) and given a poor outlook, Cousins was determined to recover and credits his success to Marx Brothers movies and copious laughter. In his memoir, he wrote about his "joyous discovery" that ten minutes of genuine belly laughter had an anesthetic effect and would grant him at least two hours of pain-free sleep. When we laugh, our brain is flooded with endorphins and dopamine, firing up the same reward center that is stimulated by things like money and even cocaine. This buzz explains the euphoria we feel after a good joke, say researchers at Stanford University. Other studies have shown laughter's ability to boost the immune system, decrease stress hormones, increase blood and respiratory flow and even exercise the heart, similar to a workout session. Even better news: fake laughter can be just as effective as real laughter. Your brain can't tell the difference, and your body reaps all the benefits.
For more information visit newenglandpetpartners.org
Is Laughter the Best Medicine?
A year and a half after her stroke Marcia Wyman of Concord now finds herself bursting into laughter whenever she sees her own reflection. "I laugh every time I see myself in a mirror. Even a store window! Everywhere!" she says, and laughs.
This isn't wacky fallout from the stroke - in fact, she credits laughter with her recovery.
After physical therapy and medication brought no relief (her left side was pretty much non-functional after the stroke), Marcia saw a documentary on "Laughter Yoga."
"I'll try anything once," she says. During her first class she felt her body tingling and coming back to life. She immediately signed on to become a Laughter Yoga leader and now runs weekly sessions in Concord.
Developed by Dr. Madan Kataria, Laughter Yoga is not like a visit to the local comedy club.
"Fake it till you make it," Marcia says. "We don't rely on jokes, comedy or humor. It's been scientifically proven that the body has the same physiologic response to fake laughter as real laughter."
While humor therapy isn't formally practiced at the hospital bedside yet, there are staff workshops on the power of laughter at Concord Hospital and a free Laughter Club at Dartmouth-Hitchcock.
As to why Marcia laughs at her own reflection? That's the homework part of Laughter Yoga. "The idea is that if you do something for 40 days, it becomes a habit. So I've trained myself to laugh every time I look in the mirror!"