Music and Health in the Community Blog Post

 MAIN POINT: Socially and emotionally, people want to be understood and feel part of
something more than themselves. This is ten-fold for people with brain injury. Music
therapy can help people who have suffered a brain injury find their place in the world
again.

 People want to be understood.

o ABI is an invisible disability that people can’t see. Physically, people look the
same but they are not the same as they were before.
o This can be difficult for those around them to understand they are different post-
injury.
o Swaney Reading
 Severe brain injury causes enormous upheaval of one’s life, resulting in
experiences of loss in independence, physical appearance, status, future,
financial control, family role, ability to participate.
 The degree of derailment experienced by a TBI is the primary source of
emotional pain.
 Emotional pain is accompanied by feelings of grief, isolation, guilt
frustration, and self-blame.
 It is paramount that rehabilitation look at a person’s internal world, as
expression and processing of feelings following a traumatic event is
necessary to promote healthy well-being.
o Statchulski Reading

 “Even though I had changed due to my Traumatic Brain Injury, I struggled

for many years to try and live my life as the old me. I kept looking inward
expecting me to be the same person I was before the accident, but what I
constantly saw was a stranger. I didn’t like that stranger then and
sometimes I still don’t like him now!”

o Van Bost Reading

 Dual-Process Model of Coping
 Assimilative Coping: coping with adversity – identify factors that
hinder goal pursuit and attempt to reduce or eliminate said
obstacles.
o When obstacle is soluble, considered “adaptive” coping.
o When obstacles are uncontrollable, coping may feel futile
and increase frustration and distress.
 Accommodative Coping: patients accept that problem cannot be
resolved, disengage from pursuing unattainable goal, and engage in
new or rest goals according to personal values.
 Accepting attitudes toward problems that cannot be resolved is beneficial.
(Van Bost)
 Does not mean giving up – focus is on moving efforts toward other
aspects of life aligning with one’s personal values.
  Acceptance after brain injury often means patient is willing to cope
with their new reality.
 Acceptance is associated with less depression in patients following
stroke.
 However, brain injury can make it difficult for people to maintain social relationships.
o Hitchen Reading
 Difficulty with behaviour, insight, and executive functioning can leave
individuals with neuro-behavioural disorders at risk of exclusion from
rehabilitation programs for the safety of those around them.
 Depending on site of damage, behavioural problems can include:
 Verbal or physical aggression
 Sexual disinhibition
 Self-injurious behaviour
 Frontal Lobe Damage – Behavioural Symptoms
 Social disinhibition
 Impulsivity
 Egocentric personality
 Lack of insight
 Unrealistic attitudes
 Impaired executive functioning
 Profound passivity
 Medial Temporal Lobe and Limbic Structure Damage – Behavioural
Symptoms
 Explosive anger and aggression.
 23-year-old male, sever brain injury, admitted two years post-injury to
specialist neuro-behavioural unit.
 Had been excluded from local brain injury day centre and sent
parents, carers, and pets to the hospital.
 Presented with attention difficulties, inability to focus, inability to
understand verbal instruction, memory deficits, and impaired
executive skills.

o People need help managing social relationships.
 Those with brain injury struggle with social skills and emotions.
 In relationships, it can be difficult for people with brain injury to work
well with others.
 Music Therapy that can be used to help those with brain injury
o K Bliger – In the Community
 Situated in Guelph, Ontario
 Primarily long-term care with emphasis on complex and continuing care,
not so much as rehab.
 Group therapy most prominent to help with limiting social isolation.
 Focuses on fostering connection between people.
 Ex. Singing familiar songs and sharing favourite music as a way to
share connections between people.
  Group work focuses on song writing and lyric discussion to promote sense
of communication.
 The group writes songs about what its like to have a brain injury so
they can express their feelings with their friends and family.
 Talking about music helps people express their emotions and their
grief. Doing this in a group setting helps people validate their
experiences with one another.
 Patients in MT learn the value of connection and validation in session.
 Connection
o Gives people with ABI a chance to be with other people
like them and connect with those that understand them on a
deeper level.
o Many people with ABI feel like those close to them don’t
know what they’re going through. Finding connection with
people that understand you is very valuable to the healing
process.
o Many people have become estranged with their loved ones
because of difficult interactions they’ve had with the
friends and family as a result of brain injury.
 Validation
o Gives patients a sense that what they’re feeling is okay, and
they’re allowed to feel the way they do.
 Can happen through relating to songs heard in
group, or through hearing the experiences of other
people in the group.
o Being heard and seen for who they are.
 Patients can be their true self with other people who
understand why they act the way they do.
o Other Examples
 Swaney Reading – Clinical Improv
 Used as a means of self-expression and attending to emotional
experiences.
 Therapist uses gestures, sounds, and behaviours for people with
ABI to use as materials for constructing musical pieces.
 Through improv, the therapist supports awareness to the self and
others around them by “attuning”.
o Similar to the way a baby mirrors their mother’s
expression, a therapist can play something that the patients
improv and remake back, as a way of understanding and
processing their feelings.