Vol. #13, No.11
Welcome to the February edition of Tips and Topics. Thanks for joining us this month.
David Mee-Lee M.D.
A few years ago, I was part of a small group at a weekend retreat. As part of the team building, we were guided by a professional singer-songwriter to craft a song which expressed our mission as a group. Not only did we write the song together, we even helped as backup singers to the final product. Last I checked it hasn’t hit the top 40 playlist yet.
When I met Kathy Moser recently at a conference and heard what she was doing with Music for Recovery, it reminded me of my previous meaningful experience on the retreat. So I asked her to guest write this month’s edition of Tips and Topics. I guess most of you have not had much experience with how “music is a powerful way to help people choose a useful and joyful life,” as Kathy’s brochure rightfully declares.
Who is Kathy Moser? She’s an award-winning songwriter, a master teaching artist and a person in long term recovery. Her vision is to create a Recovery Artists Institute where people can share ideas and experience and learn how to use all the arts in treating Substance Use Disorders (SUD).
Here is what Kathy is sharing with us about the power of music:
Make music a part of treatment and recovery.
Music has been part of many people’s addiction story. Now you can help make it part of their recovery. Creating music is a potent tool for recovery as it can:
* Reduce stress
* Help rewire the brain
* Build cohesion in a treatment facility population
* Provide sober fun
* Mirror the recovery process
For the past 7 years Music for Recovery (MFR) has been conducting song writing workshops and concerts in treatment centers around the country, including The Meadows, Gosnold On Cape Cod, Caron Texas, Father Martin’s Ashley and more. Clients participate in a two-hour workshop in which they work with the teaching artist to write, rehearse and record an original song on a recovery topic. Over 140 songs have been written and they have been played over 6,500 times by clients after treatment.
Additionally, Music for Recovery has created an interactive recovery themed concert “A Musical Guide to the Landscape of Recovery” which has been performed for thousands of clients. This interactive performance is a musical travel guide to the emotions of early recovery and tools for dealing with them successfully.
Some of the Science Behind the Power of Music
1. In 2015 The Recovery Research Institute (RRI) at Harvard University and Massachusetts General Hospital, led by Dr. John Kelly, worked with Music For Recovery to design a questionnaire to evaluate the effectiveness of this work. Reviewing qualitative evaluations from a series of workshops and concerts, RRI designed a questionnaire to capture quantitative data.
The results of the questionnaire showed that:
“Music for Recovery participation is shown to enhance these therapeutic factors in patients undergoing residential treatment for substance use disorders … by mobilizing common therapeutic mechanisms that ultimately enhance the likelihood of long-term recovery.”
RRI used the Grounded Theory Approach to identify common themes centered in Irvin Yalom’s group therapeutic factors. Music for Recovery (MFR) was found to help in the following areas:
* Catharsis (MFR enabled patients to express emotion better)
* Cohesion (MFR led patients to feel a greater sense of community, trust, bonding, and belonging)
* Existential factors (MFR helped patients boost confidence and empower them to make changes)
* Installation of hope (MFR helped patients believe that positive change and recovery was possible)
* Interpersonal learning (MFR helped patients learn more from one another)
* Universality (MFR helped patients feel closer to their peers and more a part of the community).
2. Over 400 Scientific studies
In March 2013, McGill psychologist and leading mind-and-music researcher Daniel Levitin co-authored the first large-scale literature review of the impact of music on health outcomes. The review of findings of more than 400 scientific studies, showed clinical evidence that playing and listening to music can boost our immune systems and reduce stress. Additionally, listening to music was found to be more effective than prescription drugs in reducing a patient’s pre-surgery anxiety.
Learn from the experience of others who are using music as part of treatment.
It is not surprising that such an essential element of human culture can play a useful role in helping clients transition into recovery. In fact, more and more treatment centers are using writing, recording and performing music as a central part of treatment. Here are a few at the forefront:
Recovery Unplugged – has a Creative Director, weekly concerts and a recording studio.
Gosnold on Cape Cod – brings in teaching artists to do regular songwriting workshops and concerts with clients.
Spring Hill Recovery Center – brings in teaching artists to do regular songwriting workshops and concerts with clients.
Right Turn – has performance venue and using songwriting and performance with clients.
Preferred Family Health – ARTC (Achieving Recovery Through Creativity) – has a music studio and instruments, creates music videos and client performances.
Daytop NJ – instrumental music, music video and recording studio program. Music program is fully integrated with clinical work and clients can request music as part of their treatment plans. Clients can collaborate with each other on music projects.
Little Creek Lodge – recording studio on premises. Clients collaborate in writing and recording during their treatment.
Cumberland Heights – has teaching artist on staff, rehearsal room and instruments are available to clients. They can use the music program to do their Step work and clinical work.
Several of these facilities have hired music professionals as integral parts of their treatment team.
Music helps reach and communicate with young people.
With young people being an increasing part of the treatment population, it is important to be able to reach them through the music they enjoy. Interestingly, hip-hop’s history is rooted in positive social change. Although the art form at times celebrates the drug lifestyle, its power is easily turned towards recovery.
A recent article in the NY Times highlighted the increasing use of hip-hop music in therapy around the country, a trend that has been growing since the early 2000s.
Playing music helps the brain.
New studies using fMRI and PET scanners show that playing music is the brain’s equivalent to a full body workout. Although more research is to be done, it appears the artistic and aesthetic aspects of learning to playing a musical instrument are different from any other activity studied, including other arts. Several randomized studies have shown that playing an instrument increases cognitive function.
When you play music:
* Different areas of the brain light up simultaneously.
* It engages practically every area of the brain at once.
* It increases the volume and activity in the brain’s corpus callosum, the bridge between the
right and left hemispheres, allowing messages to get across the brain faster and through
more diverse routes.
* It enhances memory functions.
* It increases cognitive function.
* It may enhance executive function, a category of interlinked tasks which includes planning,
strategizing and attention to detail, and requires simultaneous analysis of both cognitive
and emotional aspects.
The example of Gabrielle Giffords
It’s already clear that song and rhythm can rewire our brains to overcome brain damage. U.S. congresswoman Gabrielle Giffords was shot in the left side of her skull and awoke from a coma unable to speak, but she’s able to sing. Music therapists used melodic intonation therapy to rewire Ms. Giffords’ language skills, using melody to shift her brain’s language center from the left hemisphere to the right one.
Since many clients with Substance Use Disorders (SUD) have trauma histories, as well as the effects of SUD, playing and creating music can play a role in helping their brain heal and rewire itself.
Kathy goes on to now provide some tips on how to make music a part of treatment and recovery.
Allow people to bring instruments to treatment. Consider purchasing some guitars and keyboards for clients to use.
* Keyboards and electric guitars can be used with headphones, allowing clients to play without disturbing others.
* “Teach Yourself to Play” books can help clients get started.
* Clients who know how to play are often able to teach other clients.
* Poll your staff to find employees who already have musical training and experience.
* Playing music together can improve the therapeutic alliance.
* Adding music programming can help reduce employee burnout.
Invite clients to consider writing a song or rap about the issues they are working on.
* Record the song for the client using a phone or tablet.
* For clients who like hip-hop there are free instrumentals available on YouTube. Ask the
clients to help choose beats they like. You can convert these to music files easily and for
free and download them using http://www.youtube-mp3.org/
Creativity is essentially a mystery. That’s part of the magic of it. When clients get ready to record and perform this is a great opportunity to work with anxiety, and explore how the body can be used to calm the mind. We reframe this anxiety as courage, when someone is out of their comfort zone they are being brave.
The creative process is messy and non-linear, just like recovery. The facilitator needs to be comfortable with this and confident in bringing the group through the awkward phases.
Provide MP3 players loaded with recovery positive songs.
* Recovery Unplugged in Florida makes this part of the intake process.
Bring in a teaching artist to partner with clinicians to work with the clients as a group to create a song on a recovery topic.
Having clients create and record their own music and lyrics gives them hands-on experience in developing skills directly applicable to their recovery. Used in this way, it is not music therapy, but rather a fun and engaging way to practice specific skills. We give a simplified version of this handout to clients at the beginning of each session and then we check back in at the end to identify which gifts we used.
Gifts of the Creative Process for People in Recovery
The Gift of Process:
Gives us hands-on, low-risk experience of participating in an unfolding process.
* Because recovery is an opaque and long-term process, clients can experience a
miniaturized version of process through songwriting.
The Gift of Sober Fun:
It’s great to learn that we can relax, be silly and have a good time without drugs and alcohol.
* We regularly see in the post-workshop evaluations how clients are genuinely surprised to
find they can have sober fun. I believe having real fun in treatment not only gives clients
hope for the future, but also makes it easier to do deep work.
The Gift of Repetition:
We can go from not being able to do something to being able to do it, simply by repeating the action a large number of times.
* Because music is fun and important, clients are more willing to give themselves the gift of
repetition. In music ten is a small number of repetitions.
The Gift of Imperfection:
Perfectionism is not a success tool! Allowing gradual progress from ‘not-that-great’ to ‘slightly better’ to ‘good’ is the path to success.
* We live in a culture where we rarely see the awkward growing phases. When clients feel
awkward they tend to stop and want to discard their work. Creativity gives a low risk
opportunity to help midwife them through the awkward periods. We use a series of photos
of baby eagles, teenage eagles and a soaring eagle; we encourage the clients to not kill the
The Gift of Slowness:
Giving ourselves the gift of going one day at a time, one step at a time is one of the most powerful tools for successful recovery.
* Part of what makes the recovery process hard is that it is very slow. People with SUD tend
to want instant results. When clients are learning to deliver lines, especially in rap music,
we can help them perceive slowness as a gift, not a punishment.
The Gift of Walking in the Unknown:
There usually comes a time when it feels like it’s not working. The important thing is to keep taking actions in the direction you want to go, even if you can’t see how it’s going to work out.
* People with SUD are often strong starters and when they encounter a period where they
are not achieving immediate results they tend to stall. Having a set time period to finish a
song helps to keep moving through that period.
The Gift of the Group:
The more different types of people you have, the more solutions are available. Tolerating differences leads to success.
* We use a photo of the crew of Star Trek. We tell clients: when you are on a mission the last thing you want is people who are just like you. We have seen over and over that
songwriting helps build cohesion in the group.
The Gift of Service:
Keeping in mind that the project we create can be of service to others helps us do a better job.
* Whatever creative project you choose, consider adding a service element, as this calls
people to a higher level.
The Gift of Mistakes:
What look like mistakes can often lead us to unexpected places when we remain open and relaxed and keep going. America, X-rays and chocolate chip cookies were all discovered by mistake.
* People tend to tense up and freeze when they think they’ve made a mistake. In creativity
mistakes can be amazing. There’s a great book called “Mistakes that Worked.” I show the
clients a copy of it and tell the story of how chocolate chip cookies were invented. We invite
clients to pause when they’ve made a mistake; we ask whether that might be a chocolate
The Gift of Completion:
Addiction and perfectionism robbed many of us of completion. Creativity lets us practice finishing what we started.
* Providing access to the finished product helps people remain connected to their treatment
experience when they go home plus having an additional way to share the experience with
family and friends. We post the songs on SoundCloud.
“Whenever I see your smiling face, I have to smile myself because I love you…..” As I write this, it’s Valentine’s Day so an appropriate line to open up with…..right? But there’s an even greater reason this song, written and performed by one of my favorite singer-songwriters, James Taylor, opens up SOUL this month. It always gets my foot tapping, puts a smile on my face and reminds me how music can set the mood. It brings back memories and has such a powerful influence.
James Taylor has been a favorite of mine for 40 years and this song appears on the album JT (1977). He has experienced the ravages of addiction and the fruits of recovery. Last year James Taylor was presented at the White House with the Presidential Medal of Freedom, the nation’s highest civilian honor.
If you want to see him sing “Your Smiling Face”along with the lyrics, here’s the link. This is not how he looked in 1977, but neither do I. I am such a fan, that I even named my son, Taylor, after him and it wasn’t Taylor Swift. She wasn’t even born yet.
I marvel at the creativity and artistry of people who can sing and entertain us. My most recent joy, amongst a rash of really young children who never cease to amaze me, is Angelina Jordan from Norway. Start watching her YouTube videos and you’ll be hooked. Watch her sing “Fly Me To The Moon” when she was 8 years old! You’ll be astounded.
Alert** The following is a proud father sharing:
Music has always been a central part of our family. All three of our children played the violin, cello and flute respectively, and for all three, music is still an important element of who they are and what they do. They still keep their day-jobs though. The music industry is brutal.
Taylor has written and performed many songs. However if you’d like to hear him cover another songwriter’s song and then enjoy one he wrote while traveling in Cambodia, here’s the link. Don’t be confused by the cute little boy photo he posted:
Mackenzie or her performing stage name, Kenz, has recorded songs I am still coming to understand! They are not exactly the style of James Taylor nor Taylor Mee-Lee, but many enjoy the techno sound. Take a listen if you dare:
For a more traditional sound you can see her sing the National Anthem at AT&T Park, for a San Francisco Giants and Chicago Cubs baseball game:
Music, music, music.
Here are links to articles and programs Kathy shared to help you learn more about using music in treatment and recovery.
1. Recovery Research Institute Study on Music for Recovery
Special thanks to Dr. John Kelly, Harvard professor and Director of the Recovery Research Institute, and his graduate students for their dedication and efforts.
2. Music and the art of recovery
3. Achieving Recovery Through Creativity http://pfh.org/artc-intro/
4. Recovery Unplugged Florida http://www.recoveryunplugged.com/
5. Music for Recovery https://www.sonicbids.com/band/musicforrecovery/
6. Right Turn http://www.right-turn.org
7. Little Creek Lodge http://www.littlecreekrecovery.org/music-expression/
8. Beats, Rhymes and Life: Organization Pioneering Hip-hop therapy https://www.youtube.com/watch?v=pNavHWM3fBY
9. Article about Academic review of 400 studies on music and the brain http://www.universityaffairs.ca/features/feature-article/music-on-their-minds/
Until next time
I hope you enjoyed and were educated by this guest edition this month. See you in late March.