Music in Recovery

May 20, 2013
Music is perhaps one of the most underutilized tools in mental health recovery. Host Shannon Eliot chats with Michael Kessler, a veteran music therapist, and Paulette Franklin, a lifelong vocalist, about the roles of rhythm and melody in healing. Learn how music can be used in both therapeutic and non-therapeutic settings to ease symptoms of mental illness and promote emotional health. Hear remarkable accounts of the positive psychological and physiological effects that music can have on anyone's life. At the end of the show, enjoy a special musical collaboration by Michael and Paulette.

Mental Health Matters - Music in Recovery

Transcript: 

Hi, welcome to Mental Health Matters. I’m Shannon Eliot. 

Today I’ll be discussing the role of music in mental health recovery with a music therapist and vocalist.

Michael Kessler serves as the Program Specialist at Alameda County Behavioral Health Care Services. He has practiced music therapy for more than 20 years. Michael has developed therapeutic programs in adult acute psychiatric, geriatric, and long-term rehabilitation settings. In his sessions, Michael uses a variety of tools including guitar, piano, drum circles, and composition. He has a Bachelors degree in Music and a Masters in Rehabilitation Counseling.

Paulette Franklin was born and raised in the East Bay and has been singing in church since the age of 5. For many years, she also operated her own child development center. While going to therapy, she discovered that singing was the best wellness tool to lift her spirits and help her get through one day at a time. Her training with Best Now and internship at Alameda County Behavioral Health Care Services are contributing to a healthier lifestyle.

Welcome, Michael, and welcome, Paulette. Thank you for joining me today.

Paulette, I know you’ve experienced a lot of loss. Can you tell me what led to your mental health challenges?

>>Sure. My brother was murdered in Alaska. Someone tried to rob him and shot him in the head. And so he passed away. And then next my mother, she had cancer of the liver, and I took care of her months. And then of course she passed away. And then 18 months after that my father passed away. And after that I think my mind just couldn’t take any more. And that’s when all my challenges began. And I started to go get help for the challenges I was experiencing.

>>What kind of challenges were you experiencing?

>>Mostly depression. I didn’t want to talk. I didn’t want to go outside. I didn’t want anybody to ask me about anything. I just wanted to be by myself.

>>So how did you discover music as a wellness tool and use it for recovery?

>>Well I have been singing since I was a child.  My grandfather used to take me to churches and make me get up and sing. He said, ”Just stand there and sing. It’ll be ok.” [Laughs] And I was a little nervous, but I would do it. And then just from that point on I’ve been singing. I was in a group, we made an album, and different things music has been in my life. So it wasn’t until I had stopped going because after my mother passed that I went back. And I could hear my mom telling me to sing. She said, “Just sing, Paulette.” She would love to hear me sing. And so I started singing again and I realized that’s what contributed to my wellness.

>>So Michael, you have a background in music therapy. Can you tell me a little bit about what music therapy is and how it works?

>>Music therapy – the definition I like to use is art and science, using music to achieve a non-musical goal in conjunction with a credentialed professional therapist who has gone through training to do it. A great example of that is the ABC song, just singing a song not to learn the song, but to learn the alphabet, so that’s one thing. And I use music as you mentioned in sing-alongs, drum circles just trying to get people focusing and working together.

>>Paulette, what kind of treatment options did you try when you were going through your depression and how did those compare to music for you?

>>I’ve tried therapy, small groups with women who had similar things that were going on with me, medication, and it wasn’t until – like I said earlier – I went back to church and started singing that I realized that event though I had to do all those things and I was doing them, it was ok but I really wasn’t feeling a lot better. And then when I would sing, it just made me feel a lot different. And I knew that’s what I needed to do.

>>Do you think the singing magnified the effects of those other things or do you think the singing on its own is really what has gotten you to a better place today?

>>I think a combination of both, I mean of all things that have helped me. But I think that singing was at the top of the list.

>>Michael, from a provider perspective, how effective do you think music therapy is compared to these other treatment options?

>>Music therapy is fun. It’s non-threatening. It’s not invasive. It’s kind of a sneaky form of treatment. You don’t really know. You’re having fun, having a good time. And it’s much easier, I believe, to express yourself or tell what the sound of the drum just made than what is going on inside. It’s much easier to sing someone else’s words sometimes and just understand them and go hey, that connects to me in such a way as well that I can just talk about this other person’s lyrics. And it hits home without actually having to tell you what’s going on in me and come up with it on my own. It’s that way.

>>And that’s a beautiful thing because even though you go to talk therapy to feel better, there’s probably a lot of anxiety just going into talk therapy because you know you’re not only going to have to explore things that are painful but then articulate them in a way for another person to understand. And this seems so much more welcoming and non-threatening.

>>Correct. And you’re going in thinking, “Ok, this guy is going to analyze me….”

>>Yeah. What’s his background? What are his credentials?

>>”He’s going to dig into my head.” And no, let’s just sit back and have a good time and hopefully something wonderful will come out of it.

>>So walk me through a sample music therapy session. What do you do? What are the goals? What are the ideal outcomes? 

>>Ok. Usually we start off with a talk session. Sit down and do an assessment with the client, just finding out what they’re there for, what issues they want to talk about or deal with. So come up with a really good assessment and also talking about the history. And what music does connect with you, what music doesn’t, if you are musically inclined, if you’re not. And then after that come up with a goal. Help the client identify what they want to try to achieve. Sometimes people come in and they have no clue.

>>What might a sample goal be?

>>A sample goal might be anything from being able to get up out of bed. Just getting up and starting the day. Or being able to talk to somebody, being able to engage, start a conversation, just get the conversation going. Or sometimes there’s music therapists – I haven’t done it – but work with people with physical disabilities as well. So helping someone to start walking again and so forth. So that’s what we come up with, these goals or overall goal. Then I will go into my little bag of tricks and find a nice session plan or develop a session plan which would have the overall goal and objectives, how we’re going to try to get there, what hurdles we might see in the process of getting there, and hopefully there will be some hurdles that I don’t expect because I kind of like working when things don’t quite work right. And then do the session. And it could be – like with you, you’re talking about just singing – we just find out some songs you like. Sit back and just sing.

>>Sing.

>>And maybe even – you talking about singing at church…

>>That’s right.

>>Encourage you do to more of that. Go our and sing at church. Sing with your family.

>>Not only in the therapy session but out in the world in your everyday life as well.

>>And that’s hopefully what the music therapy will do. It will transfer to everyday life. Because you will start off with just trying to express yourself or identify a feeling that you might not even know is there. And then maybe that will transfer to going to a grocery store and just trying to converse with the person at the counter. 

>>Are you taking new patients? [Laughs]

>>So you said you liked the hurdles. You smiled a little bit when you mentioned that. What are some potential hurdles that someone might face?

>>The hurdles that someone might face is dependent upon where they’re coming from. I was mainly speaking of hurdles within what I think will or what I’m hoping an assessment will look like and if it doesn’t. I’ve gone into group sessions with a whole plan started up and the group just looks at me and goes, “Uh uh. That’s not going to work today.” My music therapy professor when I went to school, Ron Borczon – brilliant guy, helped me out, my mentor – he told us to prepare for an error-free environment meaning…

>>Is there such a thing?

>>There isn’t. But just try to figure out what might happen and what might go wrong before you go in just so you’re ready. Because you don’t know. So yeah, the hurdle is the group not digging it, not wanting to do what I had in mind. And then we change and turn it around and say ok well, we’re not going to write a song today. We’re going to just listen to music really loud and dance or find out what’s going on with them.

>>So Paulette, you’ve pretty much been singing your whole life, definitely since you were five. There are other people out there who have not been singing as long or who might not be as musically inclined but are sort of drawn to music as a recovery tool but might be scared trying it. What would you say to them?

>>See Michael. [Laughs] You have to try. Find a group, find a vocal teacher, find someone that knows something about music and at least go and try. Figure out if that fits for you. You know, like he said, some people, it’s not for them. And if you have it inside, I think more people, if they would try, would see that it’s there. Because music is a thing that really touches your heart and gives you a lot of feelings that I can’t express to you. But it really does something for you. So I encourage people that I know who may say, “Oh, I can’t sing.” I tell them, “Oh, yes you can.” You don’t need to be in tune, nothing. Just sing. 

>>Have you engaged in musical activities other than singing?

>>Yes. I’ve been in a band. I used to play the bells. I used to play the violin. I still do on occasion but not very often because my nails are too long. [Laughs] I love the violin. My mother played it and my son played. 

>>Michael, in your experience, does music ever lead to negative flashbacks and if so, how do you deal with those?

>>Negative flashbacks, no, not per se. As I mentioned before, I do a thorough assessment. So hopefully I will find or figure that out. But yeah, ideally some thoughts that maybe the client did not know they had come up. Because then you’re touching upon things that have maybe been repressed. Again, I like kind of playing on my toes. So if there is something that comes up out of left field and I had no idea and the client had no idea where it was coming from, we can really just grab hold of it and focus on what’s fueling that. So yeah, negative no, but maybe thoughts they didn’t have or emotions that weren’t there come to the surface.

>>So you really see that as a growth opportunity.

>>Exactly.

>>Paulette, what do you do when you hear a song that triggers your sadness?

>>Well I’m a little different than Michael. I don’t want to deal with it. Hearing something that brings back things that I don’t want to deal with, I shut it out. And that’s where I’m at right now. But the other day after speaking to some friends, a song came on. And it was a song of course I didn’t want to hear but because I’m around other people I can’t say, “Turn off the radio. I don’t want to hear that.” So I tried to deal with it. And it wasn’t bad, but I still -- right now I’m not at a place where I want to hear those things.

>>That’s interesting you mention that. At parties or in social settings if you hear something that upsets you, how would you recommend to someone else dealing with that in the moment?

>>There’s no way in life that you’re going to be able to go anywhere that something’s not going to trigger you. And so you really have to deep down inside figure out how can I deal with this. And have that plan in your mind so that if you go to a place that triggers you, you can walk out of the room or sit down and take a deep breath, whatever you need to do. But you have to have a plan so you’ll be able to deal with those things.

>>Michael, how cost effective would you say music is as a recovery tool or music therapy is as a therapeutic practice?

>>It’s getting more. Around the mid-90s, a few celebrities and neuropsychologists went to the feds and said this needs to be reimbursable and Medicare. So for some music therapy interventions, it is. Those people are like Dr. Oliver Sachs, who wrote “Awakenings” and is a strong advocate for music therapy. So that’s one thing. Unfortunately right now also in behavioral health and mental health, salaries aren’t that high, especially for a creative arts therapist. So it’s an inexpensive form of therapy that way. We’re working on trying to educate the providers and the powers that be. I said Medicare, but MediCal -- some states have state-funded things. California is working on it. But not yet, not that I’m aware of. So it’s cost-effective. But there’s also not that many providers that actually offer it. They say they do creative arts therapy, but they might not have a credentialed creative arts therapist on staff. So yeah, music and arts can be therapeutic and we all do it. Even walking down the street, you’re hearing the beats. Music is everywhere.

>>Everywhere.

>>So we’re doing it. Having it billable as music therapy you need a credentialed music therapist.

>>How important is it to be a credentialed music therapist as opposed to just a musician leading a drum circle or leading a singing choir?

>>I think it’s quite important. And unfortunately music therapy is not a licensed profession in this state. So there’s no governing body overseeing it. As a creative arts therapist, I need to do it myself. So if I see something I will go, “Hey, wait a minute, I know what you’re doing is great, but….” And the rationale behind that is the training. We’re not just playing music to entertain. As I was saying, it’s about those things that I don’t expect. Fortunately I had the training and now the experience to backpedal and figure out how to not cause damage. 

>>That’s a lot of responsibility.

>>That’s the ultimate goal. You might not reach your ideal goal or your rehab goal, but I don’t want to hurt you in the process. And maybe someone who doesn’t have the training and the experience might send you somewhere you shouldn’t be going. 

>>How does music therapy work with deaf and/or mute clients?

>>It’s interesting. Humans don’t hear music with just their ears. You feel the music. You feel the beats. You feel the drum. If I had one here, if I had my hand on it and bang, you’d hear the vibration. I personally haven’t worked with the hearing impaired or deaf community per se. But what I’ve read and the research I’ve read about says that taking speakers, instead of having them standing up, you put them face down on the floor. And you raise the bass up a little bit and crank it up a little bit. And you’re going to feel that through the room. You probably hear cars driving by with the thumper in the trunk. You’re going to feel that going. And then the movement. We haven’t really touched upon music and movement. It’s hard not to bop your head when you’re listening to music. You’re going to move. You’re going to feel the beat. So that’s what I’ve read and learned about when working with people with hearing impairments.

>>Paulette, how does singing now in your life compare to singing before you had your mental health challenges?

>>It’s a big difference for me. When I was singing when I was younger or as a teenager, I was just singing. And now everything has a meaning. And I feel what I’m singing and I listen to the words and apply it to me so that I can become a better person and recover from my illness. 

>>Michael, in your experience, what are some success stories you’ve witnessed?

>>Oh wow, that takes me back.  The first one was when I was doing my music therapy training. We were placed at different facilities. The first place I went was UCLA in the children’s unit. And there was this one boy there, about 10 or 12 years old. And whenever I came in – I went there once a week for an hour – whenever I walked in to start the session with the kids, he would misbehave and the staff would remove him. He was actually there because he assaulted his baby brother pretty badly, but the child was ok. So one day I show up with my guitar. And I walk in and he sees it and runs right towards it. And he goes, “I want to play it.” And I said, “Great. Have a seat at the session and right when we’re done, you can play the guitar.” Because I was using the guitar, he couldn’t play it right then. So we’re all on the floor with kids and I’m playing and right when I finish the activity, I took the guitar without warning and just dropped it in his lap. And this tough hard adolescent – really, 10 year-old – looks at me and has that 10-year-old look in his eye again and went, “How? Show me how.” And he was a little kid again and that’s what he needed to be. So it was wonderful. I stayed longer than I needed to because of schooling but I stayed and played.

And then more recently, when I was working in inpatient, a locked acute unit over in San Francisco, there was one woman who showed up, an older woman from Austria, very very quiet. Mute, actually. She refused to talk or didn’t talk. We didn’t know if she refused to at first. I tried to get her to come to groups and she never wanted to. But one day she started sitting in the room where I was doing my music groups. And she stood there for awhile. I would say a month, maybe. And then I was thinking, going through my musical knowledge trying to figure out some song that might connect with her. And the only thing I could think of relating to Austria -- because what do I know – was Sound of Music. And I said “Edelweiss.” That’s the flower. So I’d sing it and she started singing and talking to a point where the docs on that unit were kind of annoyed that she was talking and advocated for yourself, which is what you’re supposed to be doing when you’re a patient. You’re supposed to tell them what you need. And so it really connected and was tons of fun.

>>So how do you gauge which music works for which people? Do some genres have adverse effects while others have positive?

>>Again it would be with that initial assessment, finding out what would work and what doesn’t. And it’s not always a genre of music. It could just be beating on a drum or making up your own. You said you were in a bell choir? You play bells? Just ringing bells or just listening. Listen to other people within the group. That’s the one thing I really like to focus on with music. For me, music is community. Music is not me, it’s everybody. So I try to encourage that in my sessions. Like with bands. When we started, we had a little band going and a choir going. And just people being able to get out of their heads and get into something and interacting with somebody else and singing with someone else. And hopefully again that will transfer to outside things. Again I spend most of my time working as a music therapist in inpatient locked units. So these people, they didn’t want to be there. And I was able to help them find something fun and try to connect with other people and then maybe be able to go out and have society accept the way they are.

>>Paulette, would you say music has also helped you connect with others in addition to just overcoming your own internal struggles?

>>Yes, I feel it has. Who would have ever thought that through music that you could reach so many people? And people enjoy music. And when they hear you singing – depending on where you’re at – most people will join in and say, “Oh yeah, let’s sing this” or “Let’s do that.” It’s helped myself recover along with other people, even if maybe they don’t have the condition that I have. But I think just music in general can help everyone.

>>Michael, what have you learned from your clients?

>>That I need to know more. I started as a music therapist. I got my degree in music therapy and then working in the field, I thought I need to know more. So I went back and got my graduate degree in rehab counseling focusing on psychiatric rehabilitation, which is the Boston model. It’s really simple. Everyone thinks it’s all intense and stuff, but it’s really simple. You just ask somebody what they want to do and then help them do it. It’s not that complicated. Even if it’s way out, find out why they’re going there. And also it’s not about the diagnosis. It’s not. It’s a real thin line to hop you over into that. I used to tell the clients that the only difference between me and them was that I had a key to the front door, unfortunately. But music has been therapeutic for me. It’s kept me from having someone else diagnose me. I’m not going to do it. So yeah, it’s not the diagnosis. That’s not who they are. It’s a diagnosis, which again for most people is not a cure, so how are we going to function with it and have fun doing it?

>>Well thank you both. We have a special treat and you’re going to close with a song for us. But before we get there, I’m going to close with some resources. 

To find a music therapist near you, visit the American Music Therapy Association at www.musictherapy.org.

“Musical Minds” is a one-hour NOVA documentary on music therapy produced in 2009 by Ryan Murdock. You can learn more about the piece at www.pbs.org.

To learn more about how rap therapy is being used for youth and other segments of the population, view a previous episode of Mental Health Matters at www.youtube.com/user/peerstv.

So now we’re going to listen to “His Eye is on the Sparrow” performed by Paulette and Michael.

>>The title of our song is “His Eye is on the Sparrow.” And it’s very important to me because it tells me that God is always watching over me and knowing Him makes me happy.

I sing because I’m happy
And I sing because I’m free
For His eye is on the sparrow
And I know He watches me 

And I sing because I’m happy
And I sing because I’m free
For His eye is on the sparrow
And I know He watches me