Galvanizing Action with Song
I influence my world, and my response to it, with the help of galvanizing actions evoked by music and rhythm. I was diagnosed with Parkinson’s disease in 1995. I experience varying degrees of symptoms; linked to my stress level, physical health, emotional well-being, self-esteem, passion in life, and, of course, the stage of the disease itself. I have discovered that I can enhance physical and cognitive function and quality of life if I Accent-tu-ate the Positive.
As I progressively lose the ability to do simple things, cut my meat, effectively brush my teeth, give my hair a good scrub in the shower, button my clothes, or open a soft drink, I discover alternate ways of experiencing my world. Most of my ‘lost’ functions seem to have been replaced with creative and innovative abilities and skills.
When I was first diagnosed, I remember lying in bed, focusing on the tremor in my right arm. By using relaxation techniques that I had practiced for over twenty years to help me control pain, I found that I was, indeed, able to stop the tremor, but only as long as I was totally focused on the task. If I tried to read, talk, and so forth, the tremor came back. I knew that I couldn’t spend the rest of my life lying inert, trying to conquer symptoms of the disease.
Music and song take me away from worry and regret, bringing me back to happier remembrances and feelings. My body remembers and responds to what my emotions perceive. I need to feel this on a sub-conscious level. If I am conscious of my movements, I am somehow trying to master myself.
There are many times that I need to be able to initiate movement, project my voice, and get unstuck, etc. That’s when I use music and rhythm to get me out of the “oh, oh” times; the times I feel helpless and alone; the times I feel brought down, when I think “This is how it is always going to be.” Music provides the galvanizing action I need.
Memories, Melodies, and Movement
As the end of a two-day facilitation training intensive approached in 1999, I was exhausted, with little dopamine in reserve. I found myself slipping into my other, silent world, disconnected from the other women. My Parkinson’s mask had slipped over my head, unbidden.
Past experiences with “disappearing” often lasted hours, and, in some cases, days. During these times, I have the sloughing walk and frozen facial expression of Frankenstein.
I am like a zombie, only minimally attending to bare survival necessities. My mind wanders and my thoughts float. I am not thinking in any substantive manner. I gaze, but do not see from a traditional, rational, or goal-oriented perspective. I am in a peaceful place, without pressure or expectation.
I was silent during the last hours of the intensive course, in the circle but no longer a part of the circle. My unwitting hostess had no clue that I had, effectively, moved into her home. I smiled, somewhere in my thoughts, but nowhere near my face.
Taj, who sat nearby, noticed my slack expression, empty of my trademark spirit and spark. She began a drumbeat, drawing others to join with her graceful rhythm. Without conscious intent, I found myself responding. I picked up my drum, galvanized by the rhythms swirling around and into me. Soon my entire body joined the beat. I began to dance. Later, when I sat down, I was back in my body; tired but connected; exhausted yet vibrant.
I drove home without incident or accident. Pensively gliding on my porch that evening, I wrote Tender Drums, the Awakening, which has become my standard introduction and invitation for others to join in the dance and spirit of life.
As I write, I find myself again revisiting “that” place compelled to slip into, and remain in, that place of surrender. I think of tales of bliss experienced by those who lie freezing in the northern tundra. I often visit my personal field of bliss where I feel a tug on the lure of imagined peace, and surcease from pain.
Tender Drums, the Awakening
I sit so wearily
I have no energy
I think I’ll always be
Lost in this apathy
But then the drums begin
They pull me back again
I sway. I start to grin
My fate is beckoning
So come and beat the drum
Welcome the grace to come
Embrace it. Hold it near
Its power is so clear
Come feel it in your soul
It heals. It makes you whole
So come and soar with me
Share in the energy
And then sit quietly
Feel the tranquility
Life is a rhapsody
A precious tapestry
Why Songs Work - Initiation vs. Response
Vintage songs are musical memories. They can create an immediate shift, an acoustic memory as well as galvanizing actions. Instead of being faced with consciously initiating movement, I respond to the memory of the music.
A well-developed ability to connect with others can create unexpected successes. Zubin tells the following story.
Heather MacTavish was with a group of women at a particular meet. Olga, a woman with advanced Parkinson’s disease, was frozen. Heather had seen that when Olga had to travel in the car, two care facility attendants would lift her by the arms and literally shove her inside the car. They would push her head down so that she could sit in the car. It was a very clinical and inhuman way of assisting anyone.
After the end of the meet, Olga had to be taken back to the car. There were many that were ready to pick her up and put her in the car, but Heather walked up to her and said to her “Do you trust me?” Olga said “Yes.”
Heather started singing: Dance with me. I want my arms around you. She was reaching out to Olga emotionally by singing a beautiful song as she embraced her. 8-1
Motor Music 8-1After taking a series of halting and exhausting steps in this manner, Dr. Sacks paused to rest and reflect: “This is walking?” I said to myself, and then, with a qualm of terror: “Is this what I will have to put up with for the rest of my life? Will I never again know a walking which is natural, spontaneous, and free? Will I be forced, from now on, to think out each move? Must everything be so complex – can’t it be simple?
And suddenly, into the silence, the silent twittering of motionless frozen images – came music, glorious music, Mendelssohn, fortissimo. Joy, life, intoxicating movement! And, as suddenly, without thinking, without intending whatever, I found myself walking, easily joyfully, with the music. And, as suddenly, in the moment that this inner music started, the Mendelssohn which had been summoned and hallucinated by my soul, and in the very moment that my ‘motor’ music, my kinetic melody, my walking, came back – in this self same moment “the leg came back.”
It was as if I suddenly remembered how to walk – indeed, not “as if.” I remembered how to walk. All of a sudden I remembered walking’s natural, unconscious rhythm and melody; it came to me suddenly, like remembering a once-familiar but long-forgotten tune,and it came hand-in-hand with the moment – not a process, not a transition, but a transilience, - from the awkward, artificial mechanical walking, of which every step had to be consciously counted, projected, and undertaken – to an unconscious, natural-graceful, musical movement. (Oliver Sacks) Job’s Body, Deane Juhan, p287-288
This was very different from holding Olga's arms and lifting her—a method without love. But Heather embraced Olga, singing to her. 8-2
Spatial Perception and Physical Action 8-2 Physical actions also activate bilateral use of the parietal lobe where spatial perception is handled. This information is forwarded to the frontal association cortex where it is used to plan locomotion and arm-hand movements, thereby resulting in active motor responses such as walking, clapping, waving, turning and/or playing an instrument, for example maracas, omnichord, or guitar. Biomedical Foundations of Music as Therapy, Dale Taylor, p42
She then began a gently rhythmic movement, turning it into a slow waltz. This was an invitation for Olga to join her in the dance, and Olga did!
Olga’s body had to synchronize with Heather’s dance steps because rhythm is so powerful, that it surges through your entire body—awakening and energizing. In the slow and graceful dance, Olga found herself next to the car and, after a few more rhythmic movements, she was in the car. The transfer was experienced as a dance of connection rather than a process to be endured. No lifting, no helplessness, no fear—simply trust, support, dance, and joy.
All of us are connected, and when we experience the connection, we are provided an opportunity to see beyond ourselves, sharing the immense energy and resources of those with whom we connect. That is how Heather danced with Olga, inviting her into community.
Rhythm, dance, music, and love help us find these connections again.
When I am low on dopamine, I often drag my right leg. It is as if I am pulling a lead weight along with me. I have found that my movements can be jump-started if I do not focus on the movement itself, but use the emotions evoked by rousing songs to galvanize me to action. The more difficult the initiation of movement is, the more I sing. I basically spend my life as if I am in the shower.
Gait Keepers for Galvanizing Action
The following songs help when I am dealing with challenges of movement. 8-3
The Instantaneous Effect of Music 8-3
The effect of music, in contrast to the effects of L-DOPA or other drugs is virtually instantaneous: the patient suddenly switches from one neural mode to another and may do so within a fraction of a second. It is not imaginable that the chemical status of the basal ganglia could be normalized in so short a time; one must suspect, rather, that the basal ganglia are being bypassed, and that alternative neural pathways are being brought into use. Clinical Applications of Music in Neurologic Rehabilitation, Concetta Tomaino, p3
♪ Ain’t She Sweet (see her walking down the street. Now I ask you very confidentially, Ain’t she sweet?)
♪ I Was Left, Right Out of your Heart
♪ When The Red, Red Robin Comes Bob, Bob Bobbin Along
♪ I’m Walking (yes indeed, and I’m talking, about you and me)
♪ These Boots are Made for Walking (and that’s just what they’ll do)
♪ I’d Walk a Million Miles for One of your Smiles
Although I am still able to use large motor movements, actions involving my hands and fingers are becoming more and more challenging. 8-4
Musical Animation 8-4
The power of music to animate and organize brain activity is particularly spectacular in patients who lack the normal ongoing motor and motor-regulatory activity the rest of us have. Music is not a luxury but a necessity to such patients and can...provide what their brain can no longer supply. Clinical Applications of Music in Neurologic Rehabilitation, Concetta Tomaino, p3
Suggested dressing songs are:
♪ You Belong to Me (Button up your overcoat when the wind is free)
♪ Tie a Yellow Ribbon 'Round the Ole Oak Tree
♪ Yakety Yak (Don’t talk back. You just put on your coat and hat.)
♪ Zippedy Do Dah (for zipping up pants)
Momentum for Meals
I used to love to putter around in the kitchen. Now, it is often too much of an effort to cope with combined issues of back pain from standing, stiffness from Parkinson’s, and weakness from arthritis, while struggling to open cans, cut parsley, or slice cheese. Vocal action instigators include: 8-5
Using Rhythm to Facilitate Gait and Movement 8-5
Thaut et al. (1994) also conducted studies using rhythmic auditory cues to facilitate gait performance in Parkinson’s and stroke patients. Results showed that subjects without auditory cues were not able to perform sequential movements at regular time intervals. However, the use of auditory cuing led to significant decreases in variability of movement duration. Biomedical Foundations of Music as Therapy, Dale Taylor, p89
♪ Hey good lookin’, what’s ya got cookin’? (How’s about cooking something up with me?)
♪ Sugar time (Sugar in the morning, sugar in the evening sugar at suppertime)
♪ Just a Spoonful of Sugar (helps the medicine go down)
Beating the Blues
A high percentage of individuals who have been diagnosed with Parkinson’s disease must also cope with depression. Depression sneaks up unannounced. I have learned to observe my moods and emotions and try to take action to ward off the ennui that sets in. 8-6
Sing, and Laugh, and Sing Some More 8-6
For his first year at the home, he had a repertoire of maybe forty songs: ‘Clementine,’ ‘Oh Susannah,’ ‘Red River Valley,’ other American standards, and quite a few Jewish folk songs. I’d start singing, and just two or three notes into the song he would recognize the song and join me. He’s lost many of the words now, but he still sings with such feeling! Singing always puts him in a good mood. We sing, and laugh, and sing some more. There is Still a Person in There, Castleman et al., p28
Singing songs such as those shown below helps enormously.
♪ Help! I Need Somebody
♪ Mama Said There’d Be Days Like This
♪ Que Sera, Sera (whatever will be, will be)
♪ You Can Get It If You Really Want
♪ Pick Yourself Up (dust yourself off, and start all over again)
Confusion is a factor of my existence when my dopamine level is low. My movements become slow and my thoughts are sluggish. Having spent most of my life in action, the following song is a reminder that it is ok to be slow.
♪ You Can’t Hurry Love (no, you’ve just got to wait)
♪ Slow Down, you move too fast. (you’ve got to make the morning last)
♪ Happy Days are Here Again
Keeping Count with Timing Tunes
When I get ‘stuck’, unable to initiate movement, I have found that songs with counting words help to punctuate the rhythm I need for movement. 8-7
Einstein’s Joy 8-6
If I were not a physicist, I would probably be a musician. I often think in music. I live my daydreams in music. I see my life in terms of music....I get most joy in life out of music. Albert Einstein
♪ One for the Money (two for the show, three to get ready, now go cat. Go)
♪ One, Two, Three O’clock, Four O’clock Rock!
♪ (One, two, three, uh!) Look at Mr. Lee (three, four, five, uh! Look at him jive!)
Some songs are guaranteed to place a smile in my heart and boost my energy level.
♪ Barney Google (with the goo, goo, googley eyes)
♪ I’m Looking Over a Four Leaf Clover (that I overlooked before)
♪ Who Put the Bomp in the Bomp-sh-bomp-sh-bomp? (Who put the ram in the ram-a-lam-a ding-dong?)
Creating Personal Beats
Participant’s names are powerful tools to incorporate into any group session. Using one beat per syllable of a name serves as an anchor. It is also a powerful experience to be an individual acknowledged by the rest of the group with the rhythmic use of one’s name. Even one-beat names can be effective by repeating the name with different note lengths or emphasis.
Certain songs such as Old MacDonald Had a Farm provide space to elicit a response from participants allowing them to contribute their own words to the song. For example, “and on his farm he had a (cow, buffalo, kangaroo, etc).”
Another favourite, Hallelujah, I’m a Bum (I went to the next house to ask for some…coffee, bread, gum, milk, and so forth) engages participants, leading to humour and playfulness within the group. 8-8
Priming the Higher Levels of the Brain 8-8
One of the major emerging principles in the neurology of 1990’s is the notion that the feedback between layers or levels of the brain is bidirectional; If you activate a lower level, the higher level gets primed, and if you activate a higher level, you will be priming a lower level. So smiling can improve your mood. A User’s Guide to the Brain, John J. Ratey, p164
Thanks to Dr. Koeck-Hatzemann’s teachings, I begin most circles with a welcome song, focusing on eye contact, acknowledgement, and a singing of participants’ names. 8-9
The Role of “Self” in Organizing Mental Life 8-9
Egocentric biases in memory reflect the important role that “the self” plays in organizing and regulating mental life. Many psychologists conceive of the self as a richly interconnected knowledge structure – the sum total of stored information about personal attributes and experiences. Numerous experiments have shown that when we encode new information by relating it to the self, subsequent memory for that information improves compared to other types of encoding. If I ask you to think about whether such attributes as “honest” or “intelligent” describe you or not, you are more likely to remember those words than if I ask you to make the same judgments about somebody else, such as a friend or celebrity.
Self-encoding also produces higher levels of subsequent memory than asking you to elaborate on the words by focusing on their meaning or other properties that are not directly related to the self. The Seven Sins of Memory, Daniel Schacter, p150-151
The greeting song that works best for me when facilitating individuals in skilled nursing facilities or with those with developmental challenges is sung to the tune of Skip to My Lou, My Darling.
As I approach each person on my scooty chair, I hold out my beater in pantomime of a microphone, inviting participants to sing out their name. I love to watch the almost universal leaning into the “mike” that occurs.
Hello Jenny, glad you’re here. Hello Laura, glad you’re here.
Hello Eddie glad you’re here. Let’s all do some drumming.
The greeting song has been changed after a recent experience with a group of well elders at a local retirement community. Although individuals may be well enough to live independently, they are not exempt from the physical wear and tear that time exacts on the human body.
For almost ten years I sang: “Hello Jenny, how are you? Hello Laura, how are you?” In response, I received universal smiles, nods of acknowledgment, and responses such as “Good.”
One day I received the response: “Not so good.” I had not heeded my own cautions warning against asking individuals how they are feeling (see On Site Insights) and received an unexpectedly candid answer. Realizing the need to follow my own advice, I changed the greeting song, making it a declarative statement rather than a question.
Find Their Song
Show Me the Way to Go Home
Mr. Anderson, a resident at a skilled nursing facility, had been dealing with the issues of Alzheimer’s disease for years. At first he sat slumped in his wheelchair, looking down, seemingly unaware of his surroundings. Then I found his song. When I began to sing Show Me the Way to Go Home his eyes lit up and he became an active and engaged participant.
His beater became his punctuator. Memory had been accessed by that song. 8-10
Songs Stimulate Recognition Memory 8-10
To stimulate recognition memory, the more emotionally charged the song is, the more likely a person will respond. Even when they have deteriorated and can no longer make appropriate connections to the music, there is a “sense of knowing”, a “sense of familiarity” that can provide a feeling of comfort and security to one who has lost all connections to the outside world. Clinical Applications of Music in Neurologic Rehabilitation, Concetta Tomaino, p26
Over time, his clothing seemed less rumpled, as if he were taking more notice of himself. The drums serve as connectors to parts of him that had become elusive.
Sing It and Play It
Although participants may have physical or cognitive challenges, they can often play a steady pulse. Since culturally specific rhythms or complex drum patterns are often too challenging and may not capture and keep attention as do familiar songs, I have adopted a sing it and play it approach. 8-11
Re-experiencing That Which Cannot Be Remembered
Challenge and Cognition 8-11
…Select musical tasks for therapeutic applications that will facilitate a balance between successful participation and challenge to reach higher levels of cognitive functioning. Biomedical Foundations of Music as Therapy, Dale Taylor, p48
Nursery rhymes and songs are fertile grounds for creating connections and successes in all populations. Capitalizing on childhood memories, verbal rhythms can act as springboards, connecting participants through a shared rhythmic memory. Nursery songs entice community by virtue of their commonality.
The words may be different in English compared to French or Finnish, but the rhythm inevitably remains the same. Although the songs may not be among those that are traditional within each culture, most are recognized.
Frère Jacques comes to mind. It is a punctuating piece, with a downbeat completing each word (well, almost all). It contains a beautiful piece of simple and certain rhythm. As I sing, I find myself nodding my head to each syllable—in time and emphasis to what I am hearing in my memory.
In my mind’s eye, and my remembered experience, I feel light and airy. 8-12
Musical Tempo-ral Organization 8-12
There is a widely accepted view that rhythmic music stimulates movement of skeletal muscles, and that rhythm in music serves as a structure that is used by the brain fortemporal organization of bodily movements. Clinical Applications of Music in Neurologic Rehabilitation, Concetta Tomaino, p30
It is as if I am actually flinging up my hands with each beat. Part of this is the memory of me skipping around a tree with a small group of happy children. I am reasonably secure in assuming that this memory is a false memory, yet one that I possess each time I hear this song.
Consider the outcome before judging the method. Drum~singing to nursery rhymes is neither a demeaning approach nor is it condescending in attitude or in atmosphere. 8-13
From Little Lambs to Beatles 8-13
When my mother-in-law was dying, painfully and reluctantly, I sang to her, in sequence, the songs she had heard and loved during her lifetime from the year 1902 to 1976, beginning with lullabies and nursery rhymes, ending with the Beatles, and including many hymns along the way. She was able to die with the story line of her life, heard in these songs, carrying her through the transition.The Search for the Beloved, Jean Houston, p99
I am not advocating that the entire rhyme be recited and drummed. However, the beginning lines serve as an anchor for shared rhythms. For example:
One Two Bu-ckle My Shoe
X X X X X X
(X = mallet on drum)
The advantage of this method is that innumerable patterns are possible and, at the same time, one can incorporate melody thereby activating responses that are more neural. 8-14
Can’t Manage Canned Music 8-14
… live music was found to be superior to tape recorded music in generating significant improvements in physical comfort and tension relief among hospitalized cancer patients. Biomedical Foundations of Music as Therapy, Dale Taylor, p61
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