Music Therapy to Support and Care for the Consciousness of Palliative Patients

One must allow things their own stillness and undisturbed development, which comes deeply from within and cannot be pushed or accelerated by anything. (Rainer Maria Rilke)

Music therapy can bring relief and relaxation in palliative situations (1). In addition, people often describe “coming to rest” as an important experience, which is also associated with relief from pain and anxiety. When listening to the live music of a therapist, whether played on an instrument and/or sung, the patient immerses himself with his soul into the musical experience. The patient’s neurosensory pole, usually excessively alert, loses its dominance (letting go of the “carousel” of thoughts) and the person’s breathing becomes freer and deeper. Many patients listen with closed eyes or fall asleep to the music and wake up refreshed. Words like “that was beautiful” express a new inner mood. From the inner peace experienced, the impulse to join in may arise, e.g., to sing together with the therapist or to play an instrument.

If verbal communication is limited or not possible, music therapy comes into play. Musical experience stimulates contact with one’s own inner world and promotes the ability to relate to others. When memory loss is caused by dementia, then musical impressions and the singing of familiar songs can stimulate emotional expression and activity of one’s own. Experience has shown that people can usually still remember melodies and the words to songs, unlike spoken language.

Therapeutic support and recommendations

• Organically caused reduced consciousness (e.g., brain tumors, brain metastases, intracerebral hemorrhages) are associated with inner insecurity. Music therapy can positively influence vigilance disorders, calming the person down and reducing anxiety. The listening process focuses the person’s attention, their life forces can be strengthened via the sounds. Such therapeutic interventions convey new orientation and confidence. “The music brings me back to life” (quote from a patient). Instruments that have a lower pitch are recommended, such as alto lyres, Tao lyres, kanteles, tenor or bass gemshorns, gongs (hand forged), metallophones and singing.
  
  
• A person’s hearing changes in the palliative phase of an illness. The space around the patient expands. Their consciousness seems less punctual and more present in the surrounding space. The streaming sounds of a Tao lyre can stimulate warming processes when the instrument is played first in the surrounding area and then on the patient’s body itself, for example on the feet or hands.
  
  
• Since memories strengthen our sense of identity, it is valuable for palliative patients to remember and, if necessary, transform their own experiences, including musical events and experiences.  If the person has no previous musical experience, but is open to this, then music therapy offers a space for discovering the “musician” hidden in every one of us. As the soul begins to vibrate, the healing potentials slumbering within it are awakened: the sigh of relief after listening to the therapeutic sounds of a lyre, the clear expression, show the sense of peace that has come over the person. Understanding for and acceptance of one’s fate can arise from this. Spiritual experience can thus be stimulated and nourished by music (2).
  
  
• The need to continue to take in something new until the very end is a developmental motif: one patient in the final phase felt “refreshed in spirit” when the therapist played something therapeutic for her on the lyre which she had never heard before.

Musical aspects

The different moods of the musical intervals appeal to different inner spheres and states of consciousness. This fact opens up possibilities for finding therapeutic answers in connection with the great life gestures of incarnation and excarnation. The “breathing” interval of the fifth mediates between the inner and the outer, while experiencing a third brings about an inner space in the soul. A seventh leads far into the periphery. A dissonant sound creates a tension through which the person can listen and then find a hold. This requires the sound quality of a lyre or singing.

Research

Using modern imaging techniques, neuronal reactions to musical impressions can be made visible, e.g., in the limbic system, in the autonomic nervous system, etc. Neuroplastic processes are also stimulated. In research, investigations into the neuronal level of action are becoming increasingly important and, in addition to indicating music therapy’s effectiveness on the level of soul and spirit, also show responses on a physical level (3).