The Role of Music Therapy and Ritual Drama in

Transformation During Imminent Death

NOAH POTVIN, MMT, MT-BC Drexel University

ABSTRACT: This case study w ill explore the ritual drama that
organically emerged in a music therapy session with an actively dying
patient and her loved ones. Death is a natural transition that awaits
every individual and impacts parallel transitions for patients receiving
hospice care and their caregivers. Hospice patients are challenged to
transition peacefully into their postlife construct, and caregivers are
similarly challenged to move toward a new understanding of the Self
in relation to their loved one's passing. Ritual dramas can provide a
cultural and spiritual structure for participants to experience these
transitions and embody their subsequent transformations in meaning­
ful ways. Ritual dramas are performed in the therapeutic space by
all in attendance, including the music therapist, and each performer
infuses the performance with their individual, cultural, spiritual, and
historical backgrounds. This ensures that each performance is unique
from all others, and malleable to the needs of the immediate set­
ting. Music therapy is uniquely equipped to assist in the facilitation
of ritual dramas, given music's inherent transitional and malleable
qualities and the recent repositioning of the music therapy process
as syntonic with meaning-based performance. How these elements
of music therapy were integrated into the performance of the ritual
drama w ill be explored. Additionally, the emergent themes from this
performance w ill be analyzed alongside the cultural, spiritual, and
historical contexts that informed them.
Introduction
The transitional period of imminent death, marked by
rapidly deteriorating global functioning and a significantly
impaired external expression, is a delicate phase that chal­
lenges the individual to die peacefully and caregivers to reach
a place of acceptance that supports this good death. What is
the role of music therapy during this phase, and what is the role
of the music therapist? What informs the therapeutic process,
and how is it to be understood both theoretically and clini­
cally? The limited available literature about music therapy and
imminent death has explored how music therapy can promote
relationship completion (Dileo & Parker, 2005) and healthy
release (Krout, 2003), but without theoretically grounding the
clinical processes. Without this grounding, clinical practice is
at risk of drifting like a boat without an anchor, and does not
provide other clinicians the tools necessary to integrate that
practice into their work.
Ritual drama provides a theoretical structure and depth of
experience capable of informing and explicating meaningful
music therapy practice during this treatment phase. The con­
tours of ritual drama w ill be explored here while building a
case for music therapy as a context-dependent practice. Ritual
Special thanks to Dr. Seran Schug and Dr. Joke Bradt for their guidance and
mentorship in the preparation of this manuscript.
© the American Music Therapy Association 2015. All rights reserved.
For permissions, please e-mail: journals.permissions@oup.com
doi:10.1093/mtp/miu040
Advance Access publication February 10, 2015
Music Therapy Perspectives, 33(1), 2015, 53-62
53
drama w ill then be explicated within a case study that dem­
onstrates its possibilities in the last chapter of life. My own
cultural, spiritual, and lived overlaps with this case w ill be
explored as well, to demonstrate how the therapist's own con­
texts inform the process.
Mitzi
Mitzi was a 47-year-old Caucasian woman who, at the
time I began working with her, had been battling her second
bout of breast cancer in a decade-long struggle with the dis­
ease. Remission had lasted for two years prior to the return of
the cancer, and its return was marked by an aggressiveness
that proved uncontainable by modern medicine. Mitzi had a
husband of 22 years, Jerry, and two children from the mar­
riage: Danielle (17) and Alex (15). All four lived together in
a middle-class suburban community in the greater area of a
major American metropolis. Jerry reported that they were part
of the Reform Jewish community, and the presence of their
faith in their daily lives was evident in the cultural artifacts in
the home, for example a hamsa on the wall and a mezuzah
on the door frame.
Mitzi's referral for music therapy indicated an urgency due
to her rapid decline over the past several weeks, including
decreased food and fluid intake, increased disorientation, and
an inability to independently ambulate. Upon completion of
the assessment, Mitzi's treatment goals were documented as
pain alleviation and improved quality of life, and her family's
goals as optimal emotional wellness and healthy prebereave­
ment, including increased acceptance and readiness to let go.
This case study w ill explore the process that emerged during
my second, and final, session with Mitzi. This session was held
one week after the assessment and took place when she was
actively dying and surrounded by family and friends at home.
Setting
Upon my arrival, Mitzi was lying in her hospital bed posi­
tioned adjacent and parallel to the foot of the bed in the master
bedroom. Mitzi was intermittently responsive every few min­
utes, presenting multiple classic signs of imminent death: shal­
low breaths, mouth in an open and fixed position, eyes glazed
and unfocused, and minimal movement that, when occurring,
was largely sporadic in nature. There are no predictable tra­
jectories for this phase,- and while a window of 24-72 hours
is usually given when caregivers inquire about how long until
death, individuals can persist in this state for a week or longer
in some circumstances.
Gathered around the head and sides of the bed, forming a
semicircle linked by Mitzi at the foot of the bed, were a collec­
tion of members of Mitzi's primary caregiver network, includ­
ing her husband Gerry), their two teenaged children (Danielle
and Alex), her parents (Ed and Margot), and her best friend
54
since childhood (Grace). These caregivers did not appear gath­
ered explicitly for the scheduled music therapy session, but
rather as the type of spontaneous gathering that occurs when
a loved one is actively declining. There was a pronounced
presence from those present in the home; all, including Mitzi,
were in the master bedroom, with nobody lingering in the
hallway or in another room. There was a collective effort to
not only be with Mitzi but be with one another, to function as
a unit with the apparent motivation to support each other in
the same way they looked to support Mitzi.
After checking in with each of those assembled, I positioned
myself next to Grace in a manner that allowed me visual and
empathic access to all. This physical positioning in relation
to Mitzi and her gathered loved ones connected me to my
emotional and spiritual positioning to them as well. My back­
ground as an American Jew and as the son of a breast cancer
survivor, all of which customarily silently inform my clinical
role and decision-making, rose to the surface and directly
colored my experiences in this session. The emergence of
these roles challenged me to use them to assist Mitzi and her
family in their growth in the same way these roles had assisted
in my own.
Epoche
I found myself, to a significant extent, sharing in this family's
spiritual/cultural expressions and expectations. This overlap
elicited strong countertransferential feelings related to (a) my
own role as caregiver in my personal life and (b) the influence
of my cultural psychology in my understanding and approach
to caregiving and death. These countertransferences in turn
positioned me to understand the work with Mitzi and her fam­
ily from a contextual stance such as ritual drama. I share the
following to indicate the extent of my overlap with this family,
to assist readers in positioning themselves as I was positioned
during this session, and to provide the background necessary
for my understanding of Mitzi's death and her loved ones per­
formed roles to be contextualized.
I am an American Jew who best fits within the
Reconstructionist Jewish community. I practice the Sabbath
by filling my Saturday mornings with all the tasks I could
not accomplish during the week, but not without guilt. I use
words like mensch and chutzpah with an ironic tone but fully
purposeful intention, employing the language as an effec­
tive means to communicate but not without awareness of my
detachment from the Jewish communities those terms origi­
nated from. I practice and observe holidays with a religious
detachment but spiritual commitment. To be Reconstructionist
is to engage in this balancing act of identification between
traditions informed by religious teachings and spiritual con­
structs that do not readily connect with traditional concep­
tions of God.
I grew up in a religiously mixed household, wherein
my mother's Jewish traditions became the traditions of our
family. Raised with a Jewish education unaffiliated with a
synagogue, I was transplanted into an odd spiritual purga­
tory: educated on traditions that I never practiced trained in
prayers I never recited in services, morally shaped by biblical
lessons I never lived, and adopted into a culture I was bet­
ter acquainted with through media depictions than shared
experiences. My spiritual home was constructed with the
Music Therapy Perspectives (2015), Vol. 33
necessary framework and shape, but it lacked walls or insu­
lation. I could wander in and out wherever I liked, but w ith­
out rooms to indicate what tasks to complete and which tools
to use, I was adrift.
I came to find spiritual grounding in the rituals that my imme­
diate and extended family developed around each holiday (as
opposed to rituals developed in response to each holiday). In
this way, Jewish rituals became American in flavor and prac­
tice. This meaningful engagement with family was my access
point to religion, and my understanding and perspective of
religion was colored by this engagement. While this created
further distance between me and the "traditional" traditions, it
offered me ownership over my faith and my practice as these
adopted rituals came from practice that I was now involved
with. I stopped being a museum observer and became a prac­
titioner. As I grew older and my spiritual beliefs became more
eclectic and diverse, I held on to the Jewish traditions that pro­
vided me an emotional closeness with my roots and practices
to share with those around me. The blend between Judaism
and Americanism manifested here, and I developed ways to
further develop family-centered and Jewish-informed spiritual
practice.
In addition to these spiritual/cultural roles, I am the son of a
breast cancer survivor. My mother was diagnosed with Stage
I breast cancer at the outset of my senior year of high school.
There were multiple ways for me to respond to the situation:
I could have been highly involved in relieving household
responsibilities for my mom while she underwent radiation
treatment, or at least demonstrated an empathy that imparted
to her the concern and love she would naturally expect from
her oldest son. However, my response was to disconnect out
of a fear of directly engaging with this potential loss. Our fam­
ily communication skills at that time were lacking, and while
there was much love in our home, it lacked the focus or clarity
needed in order for any of us to offer each other the necessary
support. It was not until a year after remission that I recog­
nized the extent to which I had placed my needs as a caregiver
over the needs of my mother as a care recipient.
Given this, while sharing in a space comprised of loved
ones supporting one another, my countertransference was the
re-experiencing of a son's guilt who was unable to do the same
for his loved ones. This lived connection with the intimacy
of caregiving would help attune me to these themes as they
emerged in this session. Similarly, the shared spiritual/cultural
background with this family keyed me into the embodied roles
and implicit cultural practices at play within the session, and
provided me insight that these powerful forces are always
in play.
Ritual Drama in Therapy
Death at the most fundamental of levels, regardless of belief
structures and postlife constructs, is a transition from one state
of being to another. Be it the soul or the matter comprising the
body, our lived existence transitions to a postlife existence,
transforming those elements that comprise the tangible and
intangible facets of the Self. As relational beings existing in
interactive systems, this transformation does not occur in a
vacuum. Death impacts the impossibly convoluted web of
relations that encircle even the most isolated of individuals.
As such, caregivers are either willing, unwilling, or resistant
The Role of Music Therapy and Ritual Drama in Transformation During Imminent Death
participants in this end-of-life transition. W ithin the same
process, they are challenged to transition alongside the care
recipient. They know who they are in relation to the lived indi­
vidual, for example "M itzi is my wife and I am her husband,"
but are forced to acknowledge that this means of relating w ill
inalterably change w ithout their loved one's lived presence.
Ritual, defined as "part of a ceremony or ritual; done in
accordance with social custom or normal protocol" (Merriam-
Webster n.d.), is primed to play a powerful role in therapeutic
processes at the end of life by providing the necessary structure
to capture, organize, analyze, and express these transitional pro­
cesses and resulting transformations. This structure is balanced
by rituals' inherent "opened" and "closed" characteristics:
Open parts provide enough fluidity so that participants
can invest the experience with their own evolving and idi­
osyncratic meaning. Closed parts provide enough struc­
ture to give safety to strong emotional components, pass
on important new cultural information, and give form to
the actions. (Van der Hart as cited in Roberts, 2003, p. 6)
Essential to this structure is the ritual's co-construction by
therapist and client; this ensures that it is not viewed "solely
from the perspective of what the therapist says about the rit­
ual, but...understood from the participants' experience of it
as w ell" (p. 6). This situates the therapy process to utilize the
cultural, spiritual, and historical contexts of the session as a
context not only "for the work but also a context to be worked
w ith" (Stige, 2002, p. 113).
Central to any ritual is liminality. Liminality, derived from
the Latin word limen, or "threshold" (Ruud, 1998, p. 120), is
the point of transition in ritual. "Characterized by confusion,
ambiguity, and the dissolution of conventional meanings and
fixed points in life" (Ruud, 1998, p. 121), liminal states nurture
the transformations that must occur in order for the ritual to
successfully be completed. There are multiple layers of lim i­
nality in a ritual drama capturing an end-of-life process. Some
of these layers are unique to the situation, but some are shared
across all situations: the dying process, the death itself, car­
egiver identity in relation to the hospice patient, and caregiver
identity in relation to the now passed hospice patient.
Ritual dramas can be understood as the performance of
ritual's intersubjective practices to accomplish communally
based needs, tasks, or functions. Turner (1979) noted that "to
perform is to complete a more or less involved process rather
than to do a single deed or act" (p. 82), asserting that the
performative function of ritual is as essential as the customs
that comprise it. Rituals are grounded in cultural, religious,
communal, and/or personal histories, and the performance of
a ritual is steeped in both these historical meanings and the
specific context in which the ritual is being performed. The
context functions as a modifier to the historical demands of
the ritual, infusing the ritual with relevance for the present
proceedings. In end-of-life care settings, the clinical context
is frequently structured by the efforts of the hospice patients'
social network to say good-bye in a meaningful and person­
able manner (Clements-Cortes, 2010), lending itself well to
performed rituals that can facilitate such a process.
To be present with another through the lim inality of im m i­
nent death is, frequently, to be engaged in a ritual perfor­
mance that facilitates the experience to address end-of-life
themes such as release and acceptance (O'Gorman, 1998).
55
In sharp juxtaposition to the ocean of gray that is the dying
and prebereavement-into-bereavement process, the manner
in which family and friends respond to their loved one actively
dying is often starkly black-and-white. For some, the actively
dying process— marked by a cluster of symptoms that visibly
indicate a transition is underway— means their loved one has
already passed on. The dying individual is a dying body at
that point, as the soul has already detached from this plane
of existence and is merely waiting to be released from physi­
cal constraints. For others, the dying process is a time to slow
down and be present, often for reasons not consciously known
at that time. In lieu of conscious motivation, there manifests
an instinctual draw to be bedside and to assist in the transition
from life to postlife.
It is the search for ritual(s) that provides caregivers meaning­
ful roles to be embodied and performed. In a process rife with
uncertainty and the unknown (for, after all, no two deaths are
the same, and the only ones able to share what it is like to die
are already dead), these rituals provide the form that helps
caregivers determine their function. For families like Mitzi's,
used to a large measure of self-determination in their day-to-
day living, this offers the means to continue to actively pro­
vide care and feel engaged with both the process and their
loved one. This is one of the critical roles that music therapy
plays in end-of-life care, the construction and/or embodiment
of meaning-based rituals that empowers caregivers to be not
helpless observers but active participants. The process enables
caregivers to function as spiritual and emotional shepherds for
their loved one as he/she transitions.
Ritual Drama and Music Therapy
Music therapy is a practice well suited for engaging c li­
ents in ritual dramas. Ruud (1998) and Stige (2002) have out­
lined the most thorough arguments for as much to date. Ruud
focused on the liminal components of improvisation in situat­
ing music therapy as a parallel to ritual: "Musical improvisa­
tions may be thought of as part of a wide-ranging transitional
ritual— as an experience of liminality. Both rituals in general
and more specific rites of passage appear with many contexts
and on many levels both in the jazz world and in music ther­
apy" (p. 121). Stige, in contrast, painted a broader stroke. He
first defined music as a "situated event and activity" and as
"sound-in-time, organized as culturally informed expressions"
of human musicality (p. 82). W ithout this contexualization,
music becomes unattached to human ontogeny, or develop­
ment. Stige extended this definition of music to conceptualize
music therapy as "situated practice-, as health-related rituals
embedded in culture and enclosed social contexts" (p. 208).
Here, music therapy is not integrated into a ritual drama;
music therapy is ritual drama.
Complementing these explicit explorations is scholarship
that can be used to draw further meaningful connections
between music therapy and ritual drama. One potential theo­
retical ground for this integration can be found in Kenny's Field
of Play model of music therapy, which "envisions the aesthetic
field as a defined yet open space, allowing for ritual (stabil­
ity, routine) and creative process (change)" (Carroll, 2010,
Envisioning the Field of Play section, para. 4). This model is
constructed from music's ability to shift in and out of melo­
dies, harmonies, rhythms, and timbres to meet the evolving
56
needs of the situation. Lyrical themes, which were important
in the realization of this particular ritual drama, are similarly
malleable, as they move with the performance of the musical
elements that they have a symbiotic relationship with (Turry,
2009).
Burgeoning explorations of performance in music therapy
(Baker, 2013; Day, Baker, & Darlington, 2009), particularly
within the community music therapy paradigm (Aigen, 2004;
Soshensky, 2011), have uncovered the importance of own­
ership, expression, and creation in the therapeutic process,
features similarly important in ritual dramas. As individuals
explore new identities within the ritual drama's liminality, the
malleability of the music allows for an embodiment of these
identities by (a) evoking intrapsychic emotional content, (b)
attuning to their expressive needs, and (c) creating a container
safe for experiencing that content in a meaningful way.
Ritual Drama at the End-of-Life
Van Gennep's (1960) three stages of ritual drama—separa­
tion, liminality, and reintegration— w ill be used to structure the
drama that emerged in the music therapy process. In the first
stage, separation, "the ritual passenger must leave behind the
symbols and practices of his or her previous position" (Ruud,
1998, p. 120). Contextualized to this session with Mitzi, those
gathered were invited to embody a new state of being by
engaging directly with Mitzi's dying process, not as caregivers,
but as husband, son, father, mother, and friend. These primary
roles were essential because it was through them that their
relation to Mitzi's living presence was defined, and it would
be similarly through them that they could best transition with
Mitzi, and ultimately separate from her, as she died. Much
how an accordion only functions with movement toward
and away, meaningful prebereavement and grief requires an
attachment to and ultimate separation from the dying.
This facilitated movement into the second stage of lim i­
nality, "a period of transition in which the ritual passenger
is in a twilight zone between the old and the new worlds,
a period of ambiguity, perceived danger, and the absence
of roles" (Ruud, 1998, p. 120). For Mitzi's caregivers, this
was when they began their movement toward their pending
roles that would be defined by the absence of Mitzi's current
physical state. An important feature to this stage is the pres­
ence of a guide, or a shaman, to assist with the transition
and exploration of these new identities (Roberts, 2003). The
music provided a medium through which these transitions
could be explored, and the musicking, as w ill be further dis­
cussed, supported embodiment of their unfolding identities.
As such, my capacity as a music therapist fulfilled this role of
facilitator.
The third stage of reintegration is when "the ritual pas­
senger is reintroduced into society, but this time in his or her
new position" (Ruud, 1998, p. 120). This was the caregivers'
entrance back into the world with these new identities in
place. While Mitzi did not die in that session thus delaying
the birth of these new roles, the framework for these identi­
ties was in place for when the inevitable death occurred. It is
important to acknowledge the parallels of this caregiver pro­
cess with Mitzi's own process of detachment from this plane
of existence, her transition into her postlife construct, and her
Music Therapy Perspectives (2015), Vol. 33
integration with this new plane of existence with a new bodily
and spiritual form in place.
Within this three-stage process, three overarching themes
emerged: (1) Control/Resistance, (2) Contact/Release, and (3)
Permission. Concurrently, three emergent cultural, spiritual,
and historical contexts informed these themes: (1) Cancer
(in America) and Survival, (2) Judaism and Survival, and (3)
Judaism and Death. These contexts weaved in and out of these
themes, shaping them and infusing them with meaning. The
performance of these themes and the embodiment of these
contexts within the music process will be explored alongside
one another in order to capture and embrace the unique com­
plexities of this ritual drama. While presented sequentially and
in pairs for the purposes of this case study, therapy is a nonlin­
ear process with frequent transitions moving in multiple direc­
tions, forming more of a web than a smooth developmental
curve. The general contour of the experience will be shown,
but readers are advised to be mindful that these themes were
not exclusive to the stages they are aligned with here.
Act I: Separation
Context: Cancer (in America) and Survival
Cancer has been a pervasive issue for Americans over the
course of many decades. A poll in 2011 showed cancer to
be the most feared disease in America (41% of respondents)
(Harris Interactive, 2011). While a more recent poll showed
Alzheimer's to be the most feared, with cancer coming in sec­
ond (Home Instead Senior Care, 2012), cancer was similarly
relegated to second in the 1980s, when AIDS awareness rose
to prominence. Regardless of its exact ranking, it is clear that
cancer is well entrenched as one of our most feared diseases,
and demonstrates the extent to which it is engrained in the
American conscious.
As a result, cancer has been subject to an onslaught of narr-
ativizing dominated by metaphors. The benefits of metaphor
as a means for the individual to capture his or her experience,
"restorify" it(Leavy, 2010), and derive individualized meaning
and value from it is well documented in the literature (Bowker,
1996; Erwin, 2009; Raup-Kreiger, 2007). A sense of control
and grounding in one's recovery can be accomplished via
authentically constructed narratives (Knof Newman, 2001).
Narratives can, however, function as "two-edged swords"
that are "(a) fundamental to individual and collective expres­
sion, but (b) may be negative forces, creating confusion, ste­
reotype and stigma" (Czechmeister, 1994, p. 1227). Narratives
infused with externally developed and applied metaphors,
as opposed to those internally developed and nurtured, can
obscure the Self from an authentic illness experience. These
external metaphors can be appreciated and acknowledged by
individuals but not owned. In these instances, narratives cease
to be the expression of the individual story, instead trans­
forming into overarching predetermined narratives meant to
encompass a group experience.
Ironically, these predetermined narratives, having blocked
the individual from owning his or her unique experience,
can result in a sense of detachment from oneself and one's
surroundings. Instead of individuals using narratives to exert
control over their unique disease and wellness processes, the
The Role of Music Therapy and Ritual Drama in Transformation During Imminent Death
narrative(s) exert control over those who use them. In this light,
the group dictating the narrative is, in fact, exerting control
over the individual (Ehrenreich, 2001). These dangers were
evident as far back as 1978, when Sontag insisted that "the
most truthful way of regarding illness...is one most purified of,
most resistant to, metaphoric thinking" (p. 3).
The metaphors most pervasive in and around the cancer
community are martial. W ithin these martial metaphors, can­
cer becomes a battleground between the Self and the disease,
and it is a fight to see which entity survives (Harrington, 2012).
W illiam s Camus (as cited in Harrington, 2012) provided a full
illustration of how this narrative unfolds:
After the cancer's invasion of the body, the immune sys­
tem launches an offensive to beat the disease. The army
o f killer T cells and stealth viruses fight the tumour cells.
However, this is not enough to wipe out or eradicate the
invader completely, especially if it has spread throughout
the body becoming lethal. Thus, a bigger arsenal o f weap­
ons, consisting of magic bullets and blunt instruments, tar­
get the enemy. If the cancer is still resistant to the cancer­
fighting tools, other weapons are injected to attack the
disease or to boost the body's own defences. This attack
may eventually lead to defeating the disease although it
also involves serious side-effects as healthy cells are also
destroyed by the weapons. When an individual "fighting"
cancer dies, they have "lost their battle". When the indi­
vidual's cancer goes into remission, they have "won their
battle" and are dubbed a "cancer survivor", (p. 409)
These explicit terms are frequently used in our cultural dis­
course and are further perpetuated by their use in mainstream
media reports. Left unspoken w ithin these discourses, how­
ever, is the prominent subtext that every battle has a winner
and a loser. Nobody would take issue with the im plicit label
of cancer as a "loser" in the event of remission, but what does
it mean when the "loser" is the individual who dies because
of cancer? Does that make them weaker or less fit than the
"winners" who survived? Does that make them more deserv­
ing, from a spiritual vantage point, of "losing" than those who
have "won"?
Ehrenreich (2001) derisively labeled this potentially experi­
ence-narrowing narrative as "brightsiding." Brightsiding treats
breast cancer as if it were "a rite of passage— not an injustice
or a tragedy to rail against, but a normal marker in the life
cycle, like menopause or graying hair" (p. 47). It is an aggres­
sive movement to normalize a potentially life-threatening dis­
ease, a movement so extreme that to experience the complex
emotions that would accompany diagnosis and treatment is
marginalized and potentially labeled as "defeatist" or "selfish."
From this perspective, the mindless triumphalism of "sur-
vivorhood" denigrates the dead and the dying. Did we who
live "fight" harder than whose who've died? Can we claim
to be "braver," better, people than the dead? Why is there
no room in this cult for some gracious acceptance of death,
when the time comes, which it surely w ill, through cancer
or some other misfortune?...I w ill not go into that last good
night with a teddy bear tucked under my arm. (p. 53)
Life-threatening diseases always retain the potential to be
aggressive and unpredictable, and because no two disease
processes w ill be alike, therein lies the danger of a broad and
generalized narrative indiscriminately applied to all situa­
tions. At the danger of narrowing what one could experience
57
by emphasizing what they should experience, roles can be
pre-assigned to those experiencing the disease process differ­
ently. Similarly pre-assigned actions can be at odds with the
demands of the situations.
Theme: Control and Resistance
These metaphors of "w inning" and "losing" were very much
present in the psychosocial dynamics around M itzi, though
the advanced nature of Mitzi's disease had transformed the
narrative into one of guilt, dominated by statements begin­
ning with "I should have" and "I could have." This was most
evident in prior discussions with Jerry, who would frequently
return to the regret that he had not pushed for one more round
of aggressive treatment. This represented a clinging to Mitzi's
living physical and spiritual presence out of a selfish need to
rectify what has been conceived as an erroneous decision.
Mitzi's death, at this point in the ritual, would represent a fa il­
ure on the part of Jerry to have cured, and saved, her. It took
the actions of Mitzi's father, Ed, to initiate movement toward
an initial separation from M itzi.
As he did during the assessment the week prior, Ed
requested "You Are M y Sunshine" at various points through­
out the session. The lyrical content of this song— at once
sweet and melancholy, grounded and w istful— resonated
w ith the childlike melodies, and I found my voice naturally
assuming a higher tim bre to embody this role as "child." This
was necessary in lieu of his child's voice not being available
to sing.
You are my sunshine, my only sunshine
You make me happy when skies are gray
You'll never know, dear, how much I love you
Please don't take my sunshine away
"You Are M y Sunshine" was symbolic of two dialectics: (1)
Control/Release and (2) Resistance/Acceptance. The first
dialectic was the family's active pushback against accepting
the pending reality that their loved one had approximately
24-72 hours left in this life and the challenge to be fu lly
present and supportive for her through that transition. The
childish features of the song had set the stage for this con­
frontation w ith reality through an intersubjective regression
wherein M itzi's father was interacting w ith M itzi not as a
helpless bystander observing an ill individual but as a pro­
tective parent watching over his daughter in sickness and
in health. As DeNora (2012) noted, "It is more fruitful to
conceptualise of wellness and illness as mercurial, not only
fluctuating along a continuum of 'good' and 'bad' times, but
also bundled together, coexisting at any moment as a mix of
wellness/illness" (p. 93). Engaging w ith the individual as the
totality of their person rather than by a singular physical or
emotional state situates the caregiver away from "fixin g" and
toward "witnessing."
One of the most important tasks of caregivers at the end of
life is to bear witness, the art of being present and patiently
"being" w ithout "doing":
Witnessing is bound to the fact that "the face of the other"
awakens a responsibility and a wish to care for him. Being
a witness entails being able to see the other and admit
what his face means, by facing him in his vulnerabil­
ity. The other calls you to responsibility for his welfare.
(Arman, 2007, p. 85)
58
The other night, dear, as I lay sleeping
I dreamed I held you in my arms
When I awoke, dear, I was mistaken
And I hung my head and I cried
In order to be in a position to receive "the face of the other,"
Mitzi's loved ones needed to move outside their need to change
the situation and move inside Mitzi's need to be supported dur­
ing this period of transition. Turner (1984) understood such a
transition to be a "betwixt-and-between condition...a liminal
phase of seclusion" (p. 21) that presents with significant chal­
lenges but offers opportunities "for the emergence of a soci­
ety's deepest values in the form of sacred dramas and objects"
(p. 22). Here, within the known and predictable melodic and
harmonic structure of "You Are My Sunshine," the family was
able to lyrically express those "deepest values," namely the
desire for Mitzi to survive and persist as Jews always have. My
shared spiritual roots with them, while intellectually known
before, became a lived experience in these moments; I moved
with their struggle to let go and separate.
I'll always love you and make you happy
If you will only say the same
But if you leave me to love another,
You'll regret it all one day
The second dialectic grew out of the emergent survival
instinct (this created a bridge to Act II, as w ill be seen below).
Having confronted their "deepest values" of survival, the gath­
ered caregivers were challenged to release themselves from
the need to control the situation: cure Mitzi's illness and fully
ease her discomfort, and by extension release Mitzi from hold­
ing on to a life that was slipping away. Present in my mind
at that point was a discussion I had with Jerry two days prior
to this session, during which Jerry processed feelings of guilt
about decisions made related to her treatment. He acknowl­
edged second-guessing their jointly made decisions about
when to be aggressive and when to pull back, and discussed
feeling as if he should have asserted himself more in encour­
aging the aggressive treatment. Here, Jerry had assumed the
role of "general" or "field commander," and was experiencing
acute guilt at not having "done more" in pushing for contin­
ued treatment and accepting defeat. This guilt was a product
of an intersection between this earlier narrative of fighting
and the emergent narrative—the one he was sensing but not
actively acknowledging—of letting go.
With a previously unrevealed yet still unspoken narrative of
survival having been drawn out with "You Are My Sunshine,"
I moved into several songs, including "Danny's Song" (Kenny
Loggins) and "You've Got a Friend" (James Taylor), that har­
bored themes of being present and supportive by "being"
without "doing." This "being" was of the greatest comfort for
Mitzi at this stage in her disease process, and could be pro­
vided by an empathetic interpersonal presence that would
hold her as she was, not as they wished her to be.
When you're down and troubled and you need
a helping hand
and nothing, whoa, nothing is going right.
Close your eyes and think of me and soon I will be there
to brighten up even your darkest nights.
Here, in connecting with the non-idealized Mitzi with an
internal narrative developed around acceptance and love in
Music Therapy Perspectives (2015), Vol. 33
contrast to the previously present external narrative around
fighting and surviving, her family began their separation from
her earthly, tangible presence and began their movement into
the liminality of transformation.
Act II: Liminality
Context: Judaism and Survival
It is easy to imagine, even in a general sense without much
context, the difficulty of sitting vigil with a loved one while he
or she is actively transitioning at the end of life. To fully under­
stand the depth of such an experience, however, requires a
contextualization of the emotional, spiritual, and relational
factors informing those experiences and, ultimately, infusing
them with meaning. As Jews, the loved ones gathered around
Mitzi had embodied implicit and explicit Jewish expectations
and practices at the end of life, and the performance of these
embodied death and dying customs organically manifested in
the aesthetic experiences of the music therapy process (the
same can be said for American culture, which will be explored
further below).
Death and dying is a difficult subject for contemporary Jews,
due to the strong survival instincts that have manifested over
time in the Jewish community. The way one dies is reflective
of how they have lived, and chronic illness or severe disability
"reveals much about how a culture conceives life in time"
(Mattingly, 2000, p. 1). The "life in time" for contemporary
Jews has been an adopted tradition of centuries of persecu­
tion made contemporary by the Holocaust and the culture of
"Never Forget" that manifested in its wake. As a result,
death is an adversary to be defeated at all costs. In this
view, to be Jewish is to fight valiantly to the end, regard­
less of circumstances. Death, when it finally comes, is
viewed as a kind of defeat, a capitulation to an enemy.
(Eilberg, 2012, pp. 375-376)
Much of Jewish history is defined by the withstanding of
aggressive and violent acts. These experiences have been
immortalized in holidays such as Passover, Channukah, and
Purim, so that one eye may gain perspective on the lessons
of the past while the other eye looks warily into the future
with gained wisdom. So abundant are these celebrations of
escape from genocidal threats that a common contemporary
joke among secular Jews is that all Jewish holidays share the
theme of "They tried to kill us. We survived. Let's eat!"
A society exposed to such recurrent conflicts cannot help
but be shaped by them, and for the Jewish people, that shap­
ing manifested in an aptitude for survival and a related pre­
occupation with the various dimensions of that survival. The
Jewish preoccupation with survival is such that there is debate
about the very nature of this persistent survival in the face
of centuries of persecution (Mizrahi, 2012). Of greatest rel­
evance to this discussion is Goldstein's (2010) position that
survival, instead of being a gift bestowed upon a chosen peo­
ple (Kelemen, 1990), was a way of life developed through the
fostering of unique skill sets and cultural values that empow­
ered Jews to persist in the face of ongoing threats.
The Jewish community learned that survival was not predi­
cated on challenging their aggressors' with reciprocated vio­
lence and physical threats. Rather, they learned to "emotion­
alize" these threats by fostering a dogged tenacity, dry and
The Role of Music Therapy and Ritual Drama in Transformation During Imminent Death
self-deprecating sense of humor, and heightened focus on the
meaning of suffering (Boteach, 1999). As a result, the Jewish
people exchanged the development of physical traits that
would pose a direct challenge to an enemy's physical domi­
nance for the development of professional skills that have
allowed unique niches to be carved out in a diverse array of
communities.
This cultural psychology manifested in delicately inter­
woven living symbols, "a reality distilled" (Wouk, 1959,
p. 26), which provided form and function to embody those
values and practices developed for survival. These symbols
have functioned as guideposts, directing the diverse Jewish
community in collective movement toward the shared goal.
Perhaps no Jewish ritual captures this symbolic expression
of survival more powerfully and succinctly than the Passover
Seder, the annual commemoration of the Jews' improbable
freedom from slavery in Egypt. From the timing of the cer­
emony at the blossoming of spring to the intricate semiotics
of the Haggadah and Seder plate, Passover expresses through
metaphor and analogy the rebirth and renewal common to all
Jewish holidays.
This rebirth is an important component to the survival stories
that inspire Jewish celebrations. If survival was simply about
scratching and clawing to merely exist, then the community
would die out from chronic stress and existential fatigue. For
survival to be meaningful, it needs to be about thriving as well,
and this is what Jewish holidays look to celebrate. The perse­
cution is commemorated, but it is the thriving, the renewal
of a way of life, that provides fulfillment and meaning. This is
reflected in the traditional Jewish teachings on death that wel­
comed death as a natural occurrence (Eilberg, 2012).
At the end of life, these survival instincts become particu­
larly pronounced. In this drama, the first manifestation of
these instincts occurred as the family explored how to simul­
taneously make contact with Mitzi and say good-bye as she
transitioned. Both of these phases—contact and tra nsition-
are essential to survival. They facilitate movement through the
experience, and help avoid an existential stagnancy as a result
of remaining stuck in a state of perpetual grief, or denial that
grief is occurring.
Theme: Contact/Transition
Maintaining an active presence with Mitzi through her
decline was a manifestation of the ritualistic practices of kevod
ha-met, the honoring of the dead, and Judaism's view that "the
human body is one of the miracles of Creation," a "rever­
ence" to be continued into death (Diamant, 1998, p. 52). Of
note, following death, traditionally one or more shomrim, or
guardians, stay with the body at all points to and from the
house or hospital, to the morgue or funeral home, and finally
graveside, but given contemporary practices of managing the
dead (including refrigeration), there are modifications made
as needed (Diamant, 1998). Much like Charon, the ferryman
in Greek mythology who transports souls to the afterlife, the
shomrim's importance is tied not only to the maintenance of
this connection but also to the facilitation of release once the
function of this contact is fulfilled.
Becoming a shomrim is not a quick transformation that
occurs due to mere circumstances. It is an embodied role
first assumed during the prebereavement process, when the
59
individual is engaged in relationship completion with the
dying. The functions of the shomrim are an extension of the
physical, emotional, and spiritual care afforded to the dying
individual. Maintaining these acts of love and compassion can
be challenging for the longtime caregiver, for whom they have
turned into mechanical tasks, tasks because they are done only
with goal, not process, in mind, and mechanical because they
are completed by rote with minimal humanistic compassion.
Thus, assisting Mitzi's caregivers to connect in their pri­
mary roles as husband, son, father, mother, and friend (the
roles through which such love and compassion manifested)
was integral in helping them connect with Mitzi as a sacred
being whose time was ending, as opposed to a source of sad­
ness and suffering that made engagement with too unbear­
able. By receptively and recreatively engaging—that is,
through active listening and live musicking of precomposed
songs (Bruscia, 1998)—with "Danny's Song" and "You've Got
a Friend," Mitzi's loved ones embraced the fullness of their
roles through the blending of laughter and tears while shar­
ing stories. When silence would manifest, I would encourage
them to sustain both their engagement with Mitzi and their
embodiment as shomrims through encouragements under­
scoring Mitzi's receptivity to expressions of love, letting go, or
physical support.
Of great importance during this phase was the sensorial
anthropologies that influenced the manner of sensory engage­
ment each caregiver would assume with Mitzi (Howes, 1991).
Of note was Jerry's initial reluctance to be physically present
with his wife. It required several prompts of encouragement
for him to tentatively approach her bedside, a sharp shift
from my observations of him the prior week, when he was
exceedingly affectionate with Mitzi and was gentle even when
needing to be firm in his physical redirections. Jerry had fre­
quently remarked on the beauty of Mitzi prior to her cancer,
and being with her affected body, so weary and worn from
its travails with the physical and emotional toll of the disease
and its attempted cure, in this last chapter may have felt odd
or out of place. My countertransference was activated in these
moments. My investment in assisting Jerry to connect with
Mitzi became personal, as I attempted to compensate for my
emerging guilt at not having been similarly present and mind­
ful for my mother. As I came into contact with the emotional
distance I experienced at that time, this countertransference
attuned me to Jerry's similar emotional distance.
In response to this insight, I moved on from the supportive
verbal prompts that Jerry was well defended from and used
the music to facilitate a meaningful interpersonal connectiv­
ity. The music evoked strong emotional responses: expressions
of love, stories of remembrance, and physical affection that
expressed more than any words could. With this emotional
energy now freed from the psyche, the music's task was to
create a supportive aesthetic container that would allow those
gathered to directly engage with this emotional content in
efforts to construct meaningful experiences. To accomplish
this, I adjusted my vocal qualities "to reach, to stretch around
and encompass, to contain and ground the energy of residents
and to create a feeling of safety" (Cadesky, 2005, p. 208).
Jerry did not resist this container, and moved with the music
that began within him and found a resting space within her.
Holding her hand and softly singing to her as I gently supported
60
both with guitar and voice that was shaped around this emer­
gent dyad, he neither left her side nor disrupted physical con­
tact for the duration of the session. Kenny (1989) understood
the aesthetic as "a field of beauty which is the human person"
(p. 75), and here the aesthetic process was the entry point for
Jerry to acknowledge her full beauty. Jerry had assumed his
role as shomer and, at this point of deepest connection with
his beloved partner, was also at his most ready to let both her,
as an earthly presence, and himself, as a husband, go. The
transformation into shomrim was the liminal stage of moving
from "husband" to "widower."
Reintegration
Context: American Jewry and Death
There are clear overlaps between the Jewish fight for sur­
vival and the individual with cancer's fight for survival. Both
frame the discourse in black-and-white terms that establish
all-or-nothing outcomes. By heightening the stakes in such a
manner, they are increased by stakeholders in order to influ­
ence potential stakeholders. In other words, for an older
Jewish generation that fears the loss of traditions and cultures
that were of importance for them growing up, framing mar­
riage as a means of protecting the "purity" of Jewish genetics
is meant to evoke the survival instinct in the younger gen­
eration. And for cancer foundations that seek the membership
that improves their community standing and annual revenue,
evoking a martial metaphor that "recruits soldiers" in the "war
against cancer" instills a feeling of duty and responsibility in
both cancer survivors and those who have yet to be diagnosed
but fear it nonetheless.
As Jewish identity becomes more inextricable with an
American identity, these values may not only intermingle but
also fuse, strengthening the traits of each (Boteach, 2012). It is
this social chemistry experiment that has created a communal
construct of perpetual struggle, one Boteach characterized as
the Jewish "obsession" with the Holocaust: "An outsider who
studies modern Jewry and its education institutions would be
forgiven if he concluded that before the Holocaust nothing
of significance ever took place in Jewish history" (p. 134).
Coupled with the Christian tradition of ennobling suffering
as a source of wisdom and growth that has percolated into
Jewish thought through assimilation, Boteach lashed out, not
against integration or remembrance, but at the glorification of
suffering:
In Judaism...suffering is not central to redemption. Any
appraisal of suffering leads to the undeniable conclusion
that suffering leads to a tortured spirit and a pessimistic
outlook on life...There is no good thing which comes
through suffering that could not have come about through
some more positive means, (p. 135)
In contrast to this contemporary cultural psychology, tradi­
tional Jewish teachings advocate for an embracing of death's
role in the life cycle. Diamant (1998) recalled a parable in the
Talmud that honored a rabbi's maidservant who distracted the
rabbi's disciples long enough to allow his "soul to depart in
peace" (p. 38).
Such teachings have been obscured by a contemporary
urgency to survive, driven by the frequent recall of past
transgressions against the Jewish people, calls to protecting
the genetic pool and (by extension) traditional spiritual and
Music Therapy Perspectives (2015), Vol. 33
cultural practices, and pressures to emphasize the uniqueness
of Judaism to Americanism (Magid, 2012). Thus, the challenge
for Jews is to accept that death is inevitable and beyond mortal
control. At the end of life, when an end to struggling against
physical decline becomes clear, those individuals and their
caregivers are assertively confronted with resolving and/or
moving through this emotional and spiritual suffering to avoid
becoming stuck.
This was one of the realities I was most acutely confronted
with at the outset of this session. Mitzi required the permis­
sion from her loved ones to transition into her afterlife and the
assurance that they would persist. End-of-life trajectories can
vary wildly, even during the phase of imminent death when
the body is actively preparing for death. It is not uncommon
for those lingering to wait to pass until a moment of privacy in
their room or until a loved one has found acceptance or peace
with the inevitable outcome. An expression of this permission
and a conveyance of this assurance would need to come from
her partner in life who had fought so hard for her survival.
From Jerry's end, he was experiencing not only guilt for not
having "fixed" his wife's cancer, but grief for the lost promise
of a life imagined for himself and his family in the years to
come. The future now facing them left Jerry at a loss for his
role: "I've done my job as their father. They know right from
wrong and my son knows how to respect women. They need
their mother now."
Denail or avoidance may manifest in the absence of accept­
ance, but no intrapsychic defense w ill stop the inevitability of
role transformation initiated by death. Literature on meaning­
making at the end of life indicates a wide variety of needs that
includes developing a sense of normalcy (Munn et ah, 2008),
reconciling desired end goals with realistic outcomes (Norton,
1999), dying a "good death" (Vig & Pearlman, 2004), foster­
ing spiritual well-being (MagiII, 2009; O'Callaghan, Hudson,
McDermott, & Zalcberg, 2011), and engaging in relationship
completion (Clements-Cortes, 2011). These represent struc­
tured tasks that cast light on pathways that lead out of suffer­
ing toward fulfillment.
Theme: Permission
A number of studies have explored the processes of letting
go and saying good-bye at the end of life (Broom & Kirby,
2012; Clements-Cortes, 2011; Heyland et ah, 2006; MagiII,
2009), and its importance cannot be overstated. For the dying
individual, it is one of the last meaningful acts they will com­
plete in this lifetime. For caregivers, giving permission to that
individual to let go and transition into their postlife is the
final, and perhaps most important, gift that can be given to
the one they love. In grief, Judaism developed ritualistic acts
of letting go that empowered healthy bereavement. Such ritu­
als do not exist in the Jewish culture for the dying process,
a phase quite distinct from the death itself. The setting was
challenged therein to explore means of letting go that would
enable a moving through the experience, as these iconical
signs advocated for.
In most humanistic/existentalist therapeutic processes,
patience is a virtue as the therapist nondirectively supports the
client(s) to move toward solutions and ideas that offer them
the greatest value in context to the present issue. However,
in end-of-life work, the therapist is confronted with tempo­
ral limitations that force a more directive approach to ensure
The Role of Music Therapy and Ritual Drama in Transformation During Imminent Death
a healthier process. The aforementioned example of Jerry
establishing physical contact with Mitzi is one such instance.
Here, I recognized the need for all these loved ones to come
together in collectively letting go of Mitzi, and allowing her to
feel that release.
With the survivalist mentality rooted out and exposed to
allow room for a more accepting stance of Mitzi's decline, and
with the establishment of meaningful aural and physical con­
tact within the music experiences, the assembled caregivers
were in a position to say good-bye to Mitzi's body while retain­
ing a sense of her presence and spirit. This meant adopting
roles that were designed to accept rather than stave off death,
and to further the dying process in the interest of working with
the flow of nature and assisting Mitzi in her journey. These per­
formed roles carry with them an embodied significance that
communicates to both the individual and those around him or
her their acceptance and readiness for this transition to occur
(Biesele & Davis-Floyd, 1996).
The role collectively established by this group of caregiv­
ers was one of a bard, eloquently recalling significant points
along Mitzi's timeline that comprised quilt squares to be
stitched together into a comprehensive narrative about her
life. A requested song with a title that contained Mitzi's real
name was the entry point into this narrativizing. It allowed
those gathered to connect with the Mitzi whose life and exis­
tential meaning were defined by the totality of her experiences
rather than just her illness.
As they engaged with the fullness of her life, her father
recalled her birth and her time as a child; her best friend tear­
fully recalled how they met and how their bond strengthened
as they paralleled each other's life accomplishments into
adulthood and middle age; Jerry told Mitzi (in response to an
earlier discussion we had together) that he was okay and he
would look after the family when she was gone; their children
listened and observed silently, absorbing the younger mani­
festations of their mother they had never known and perhaps
contemplating the unrealized future potentialities of their
mother that would never be known. Stewart (2004) noted that
"different places on a personal-professional journey offer par­
ticular ways of 'seeing' and finding meaning in experience.
Each stopping point is a new context of time and place within
which the world...can be shaped and transformed" (p. 281).
These stopping points that each loved one resided in within
this experience were a witnessing of the fullness of Mitzi's life,
an important aspect of letting go and giving permission at the
end of life (Kruse, 2004).
What emerged most powerfully at this point were feelings
of gratitude. "Gratitude is a way to celebrate who we are to
one another as well as to recognize the way our lives have
been fashioned and inspired by others" (Clements-Cortes,
2011, p. 35). After a brief verbal reflection of this observa­
tion and a discussion about a song(s) that could fully capture
these feelings, "You Are the Sunshine of My Life" was selected.
Unlike in previous music experiences, when some soft sing­
ing or humming was audible from at least one person, Mitzi's
loved ones were actively silent, intensely connecting with
her through the song. I reflected this intensity in the song by
repurposing the song's original peppiness and joy into a more
solemn and reflective aesthetic through adjustments in voice
quality and guitar accompaniment. I chose to retain the cel­
ebratory characteristics, however, as I recognized this as an
61
important moment of their acknowledging who Mitzi was and
who she was to become in death.
This music experience found resolution in "Isn't She
Lovely," Stevie Wonder's celebration of the birth of his daugh­
ter. Within this song, Mitzi and her loved ones remained sus­
tained in a shared intersubjective space that balanced celebra­
tion and sadness for a life lived well and full. Engaging in this
song allowed for a similar celebration of birth to occur: Mitzi's
birthing into her postlife presence and/or existence, and her
caregivers birthing into the external world with their new
roles. Here, reintegration took root.
Discussion
Ritual drama has the potential to contribute a means of
understanding, capturing, and expressing a deep, intersub­
jective process of wellness and healing. This is a potentially
important framework, given the difficulty of accurately con­
veying a rich and full music therapy process. Ritual drama can
also help expand on the understanding of music therapy as
a context-dependent practice infused with cultural, spiritual,
and lived influences. Future consideration should be given to
applications of ritual drama in music therapy with different
populations across clinical settings, and across different cul­
tural and spiritual contexts.
Ritual drama may hold additional benefits in other end-of-
life care situations. Music therapy during imminent death is
particularly time sensitive, requiring a compressed process to
ensure a good death. A good death is one in which the indi­
vidual readily releases from life as a resolved and actualized
being. When a client's decline is not so acute and sharp, there
is more opportunity to allow a drama to unfold over two or
more sessions. Future applications of ritual drama in end-of-
life settings should explore how ritual dramas may unfold dif­
ferently over time, and clinical situations that would dictate a
more decompressed process.
Finally, music is a culturally informed medium that shapes
to the cultural, spiritual, and lived traditions that conceive and
perform it. The meaning ascribed to music becomes more fluid
and localized from this perspective, and less static and univer­
sal, as is often assumed. Ritual drama assists in highlighting
the contextual dimensions of music and meaning-making, but
the contextual dimensions are not exclusive to ritual drama.
Music therapy practice stands to benefit from an increased
sensitivity to this fundamental component of music.
Conclusion
Mitzi died two days after this session, as comfortable as pos­
sible, with no signs of terminal agitation and surrounded with
the embrace of a family that had learned to hold her without
restricting her. I have reached out to the family several times
since and have been received with warm words but little wel­
come, indicating that our ritual drama had come to a close
and that, upon their reintegration into the larger community
and their new reality, they did not require further music ther­
apy services.
My own daily ritual of letting go is one of musical reflection
in the welcomed privacy of my car. Following Mitzi's death,
I sang "Each Coming Night" by Iron and Wine in commemo­
ration of that which made Mitzi unique and special, and in
honor of the familial, spiritual, and cultural contexts that she
infused with meaning and vice versa. "Each Coming Night"
62
is a song I often use both personally and professionally, but
found a special closure in creating, holding, and releasing the
unique manifestation of that song in that moment for that per­
son and situation. When I return to it with subsequent clients,
I am able to receive them and their drama anew, and I make
sure it is theirs as much as it was, and still is, Mitzi's.
W ill you say to me when I'm gone
"Your face has faded but lingers on
'Cause light strikes a deal with each coming n ig h t"
Each coming night
Each coming night
Each coming night
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