Over the most recent Memorial Day weekend, the millions who tuned in to the Memorial Day Concert heard a special performance of “God Bless America” by opera sensation Renee Fleming, Captain Luis Avila, and music therapist Rebecca Vaudeuil. I found their performance captivating, particularly the passion and heart that shone through Captain Avila’s performance despite his obvious physical challenges.
Captain Avila sustained severe physical and neural injuries following an IED explosion when deployed to Afghanistan in 2011. These injuries (and the subsequent strokes and heart attacks he experienced) left him in a coma for 40 days, after which followed years of rehabilitation. In addition to physical therapy, occupational therapy, and speech therapy, Captain Avila also improved through music therapy.
Prior to the “God Bless America” performance, Renee Fleming talked about the role music therapy can play in the rehabilitation of military personnel who sustain traumatic brain injuries (TBIs) or develop post-traumatic stress disorder (PTSD). Here are some of the points she made, and what they mean.
Music has a tremendous influence on human brain and behavior functioning. This influence cuts across a wide range of emotional, social, physical, communication, and cognitive abilities.
Similarly, individuals with a TBI may experience equally as vast a range of symptoms, including, but not limited to: difficulties in concentrating or learning new information (cognitive skills); anger, depression, or anxiety (emotions); slurred speech (communication skill); balance disorder and difficulty walking (physical abilities); and dependency on or aggression towards others (social skills).
Given this overlap, it follows that engaging in music may provide a way to relearn or improve some of the abilities damaged as a result of the TBI. A trained music therapist is able to design and facilitate music-based interventions to target specific therapeutic goals for those with TBIs, interventions meant to strengthen or practice whatever skills that individual needs to improve. Why does this work? As Renee Fleming indicated, this works because engaging in music engages the entire human brain, allowing for new connections (pathways) to be made to compensate for neural damage, and helping strengthen existing connections to accommodate neural damage.
There is a strong connection between physiological arousal and emotions. The experience of an emotion is accompanied by a change in arousal. This change can be an increase or a decree in markers such as heart rate, respiration, skin conductance, and more.
Here’s a second connection we know—the connection between music and emotions. It is well established (and commonly experienced) that music influences our emotions and, by extension, our arousal states. Based on a number of considerations (e.g., personal preference, temperament, current mood state, previous musical training, etc.), some music can increase our arousal, some decrease, and some elicit no change.
It’s common for individuals with PTSD to experience severe anxiety, a symptom accompanied by increased physiologic arousal. A music experience appropriately designed and facilitated by a trained music therapy clinician can decrease these symptoms and, thus, help alleviate experiences of anxiety.
Rhythm organizes our motor system, allowing our muscles to work together more smoothly and efficiently when walking or completing physical exercises (e.g., bicep curls, standing marches, etc.). A music therapist can capitalize on this naturally ability by providing a steady rhythmic pulse, set to the pace the client needs to do that walk or complete that exercise. This steady beat serves to synchronize the motor system of the client, which helps improve the coordination, fluidity, and pace of the movement itself. With practice, this can translate to increased muscular strength and endurance as well.
Singing and speaking utilize shared and parallel pathways in the brain, meaning that some of the neural processing involved during singing and speaking is similar and some is distinct. Clinically, this is an advantage. Why? If speech production areas in the brain are damaged (particularly Broca’s area in the left hemisphere), a trained music therapist can designed specific singing-based interventions to elicit both spontaneous and intentional speech production, as this draws on the undamaged areas in the brain.
So, yes, a soldier like Captain Avila who cannot speak may be able to sing, and through singing regain his speech.
Follow me on Twitter @KimberlySMoore for regular updates on the latest research and articles related to music, music therapy, and music and the brain. I invite you also to check out my website, www.MusicTherapyMaven.com, for additional information, resources, and strategies.
American Music Therapy Association. (2014). Music therapy and military populations: A status report and recommendations on music therapy treatment, programs, research, and practice policy. Washington, DC: Author.