phone (wooden) with a mallet. We sang and played “Hello” to each member of this quintet and noticed Collette able to look to the person to whom we were saying “hello”, and she smiled as we continued around the group.We then continued with “Getting to Know You” (“The King and I”), directed toward each member of the group, beginning with Collette, who rec- ognized this song. She smiled and mumbled something unrecognizable to the rest of us, but she was trying to communicate, making eye- contact when directing her ‘mumble’ to some- one specific. As we continued singing and emitting much musical sounds and energies, Collette first played the tambourine for a short time, then took the maracas and began shaking them in pulse with the song. Basically, Collette used only her right hand throughout her playing activities. She then held one maraca over the standing drum (a conga) and began to beat a specific pattern along with the song: / / / // / / / // (quarter-quarter-quarter-2-eighths, repeat). Collette was very focused on playing this pat- tern, and continued playing even as we brought the song to a
close.Soon we continued with just rhythm and Collette maintained her own pat- terns, being totally engaged in the music-mak-
ing.As she ended, she picked up the maracas and shook them into a finale! The session continued, and by now some 45-minutes had elapsed. Added to the session was a sequencing task (“Pass The Shaker”), which was difficult for Collette. We also undertook to march, but in a sit- ting position… and this, too, was difficult for Collette who seemed resistant to lift- ing each leg in a march tempo. (Things to work on in future sessions). We concluded with singing “Michael Row Your Boat”, which she thoroughly enjoyed, smiled, and attempted to repeat the word “Hallelujah” quite clearly, smiling throughout. The last few minutes of the sessions provided quiet relaxation music (I played Keyboard) to al- low a calm-down conclusion.We were done with the first meeting and Collette was now reluctant to leave! The results of this first session indicated that my clinical goals seemed well-targeted. Collette ‘came into herself’ during this session, and displayed what was left from the ravages of this illness – quite a bit was left! When I asked her to use more of her left hand to play, she clearly stated, “It hurts, I hurt it!” She did allow me to prompt her as we worked on the use of the left arm.
OCTOBER 2013
In all other respects, she could control her movements at least in playing the rhythms; she could track the melodies and even attempt lyric inclusions; she could enjoy a portion of “normalcy”, smile, awareness of the rest of us. By the fourth encounter (virtually the 4th
hour of meeting), Collette
was entirely engaged in this activity. My notes are as follows: Session four: Collette was highly
responsive today! She entered the room which was already filled with the “Hello Collette” song(being played by me) as we all sang the greeting to her! Walking into the music environment made a big difference in Collette’s desire to participate. She smiled, looked at each of the four of us, and did not rush to the couch. Instead, Collette stood and “danced” to the music, moving from side to side, alternating legs, smiling broadly, picking up and shaking the maraca (again right hand only) in perfect rhythm! This focused activity continued for at least 10 plus more minutes, and finally we concluded the ‘hello’, and helped Collette settle onto the couch: same arrangement as in previous sessions, same instruments before her. In this session, I attempted to do more playing of the recorder (we each had one), but Collette had great difficulty understand- ing how to put it in her mouth and blow. However, she sang the pitches we were pro- ducing, instead, and smiled in awareness that she was imitating the pitches we were playing on the recorder! Obviously Collette was engaged! Her all-time favorite activity was play- ing the 5-tone xylophone. Her focus on this (which we have on video) lasted more than 20-minutes. She used her right arm pre- dominantly, but said, clearly… “I should use the left hand…!” Surely we were obtaining some small break-throughs. Collette seemed much more lucid and understandable in this session, and was extremely appropriately en- gaged throughout. We sang a tune suggested by Christine, with adapted lyrics, “I don’t want to work, I just wanna beat the drum all day.” It was amazing to observe Collette’s energy output here, as she beat the drum! She was totally engaged. Laura played the xylophone with her, then took some videos of the activity (through the iPhone) It was an excellent session, and obvious-
ly this woman was displaying some changes back to parts of her that could function “nor-
63
mally.” She even spoke in a less mumbling
manner.Not only was Collette enjoying the music-making, but the group interaction as well. External energy that music provides is an important stimulus to keep the brain and body appropriately engaged; and rhythm was and is the admission ticket to her (and anyone’s) brain. The more we used rhythm, the more creative and responsive Collette be- came, developing and sustaining clear rhyth- mic patterns, and making continuous eye- contact with her own playing on the drum. We had twelve hourly sessions in all,
over three months, and although there were times when Collette was less motivated to participate, the musical energy often pre- vailed and induced her to do ‘something’, however minimal. Collette was never given specific directions, except once in awhile a request to blow recorder, or use the left hand. Otherwise, the music took control of the activities in which Collette engaged. Our final session was in the form of a holiday par- ty. We played, sang holiday songs. It was dif- ficult to say good-bye (she is bi-coastal and was leaving for the West Coast), but all told, it must be said that the music treatments were able to bring out the working portions of Collette’s brain. What’s more, one must conclude that
creating a gathering of “normal” members of a group may provide better opportunity for progress in brain-injured patients. A person with dementia needs role models to recreate “normal” imitative behaviors. Collette cop- ied our movements, manners, and language. This is not unlike the “inclusion” trend for diagnosed children attending school, in which parents prefer to have the child in a class with typically functioning children rather than a closed classroom only for chil- dren with various diagnoses. Perhaps an advocacy group for adult in- clusion should be considered. In any event, there is no mystery about the fact that music plays an important role in bringing out the working parts of the human system, as Col- lette and other clients clearly demonstrate. The energies, vibrations, pitches, timbres, and music-playing processes involved have no competitors in resonating with, and driv- ing a system toward response. Science is simply verifying what musi-
cians have known for centuries – that indeed music soothes the ravaged brain. *(Names have been changed to preserve confidentiality and anonymity).
TEMPO
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