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2 8 S X S W o r l d | F E B R U A R Y 2 0 1 5 | S X S W. C O M ot so long ago, music therapy meant listening to soothing, relaxing music—say, a daily dose of new age or light clas- sical. However, today's music therapists acknowledge that there is another side: Music gives you a buzz that might actually be the best medicine. "At a very basic level, music has the ability to relax people," says Suzanne Hanser, founder and chair of the Music Therapy Department at Boston's Berklee College of Music. "It enables us to breathe deeply and our blood pressure goes down. Blood flows to our vital organs, and we relax. But if you absolutely love music, you know how excited you get when you hear the most beautiful piece of music, or a powerful song. It can bring on great passion and exhilaration." Last year's award-win- ning documentary, Alive Inside, tapped into this passionate response to music. The film featured Dan Cohen, MSW, whose nonprofit organization, Music & Memory, provides iPods loaded with per- sonalized playlists to the elderly. Alive Inside showed heart-rending scenes of seemingly catatonic Alzheimer's and dementia patients in nursing homes responding to songs they enjoyed during their lives. The film compounds the theory explored by many neuroscientists and music therapists: it's not just Holly wood stories that have a soundtrack: we all do. From birdsong, on a rudimen- tary level, to Beethoven to Beck: therapeutic music has direct links to individual lives and engages the brain, stimulating an emotional response. Thus, the fan who connects to Swedish Viking metal band Månegarm will not necessarily respond to Greek new age guru, Yanni. (Well, not on a therapeutic level, at least.) Cohen found a bonus too: the music that stimulated memory also calmed patients and negated behavioral problems. The effect is similar to that on autism. "What happens with dementia is people become agitated," says Cohen. "The usual response is: give them a drug to calm them down. One in five of the 1.6 million people in nursing homes are on these antipsychotic drugs, and almost all of them inappropriately. Even the federal government now says it's not appropriate treatment for dementia patients. Most of the time, we can give them the music and take them off the drugs." Using music as a substitute for pain killing drugs dates back decades to midwives aiding women in natural, drug-free childbirth. Hanser, who specializes in pain management, has worked with Boston Medical Center in developing personal music playlists to help patients with both anxiety and general pain relief. This work has also resulted in a reduction in the use of often-addictive conventional drugs. The basic scientific model is the "Gate Theory of Pain," which says stress hormones alerting the brain to pain are met with a flood of counteracting neurochemicals "flooding the brain," as Hanser puts it, which are stimulated when listening to music we love. "I have this theory about the balancing power of music ... It helps us restore homeostasis." Hanser explains about the body's innate balancing act. "It's not just deeply relaxing; it can send us into awe and peak experiences. It's very engaging. That's exactly what we want if we're in pain. If we're in pain and really anxious, we can't just relax. If we're angry, we can't just relax. But we can engage our minds with something really positive." Music is not a cure for dementia or much of any- thing else, but restoring balance can allow the body to heal itself and the pal- liative becomes curative. "Very simply, music mem- ories are in parts of the brain that aren't destroyed yet," says Cohen. "We're taking advantage of what still functions. The patient engages and becomes more social and functions more. In that way they are being restored." Cohen says he is not always looking for smiles in a patient's reaction: "Songs can bring up all the emotions; some bring us to tears pretty quickly. Is that bad? If someone is crying to music, maybe it's good; it's a release for them. Let them feel. If the song is disturbing, if they have an obvi- ously bad reaction, then, yes, take the song off." What both have found is that music we engage with lessens suf- fering without the often-damaging side effects of conventional drug therapy. Just as with physical pain, engaging music aids psycholog- ical pain, too. But there are limits. "It's interesting, here at Berklee everyone is plugged in all day long," says Hanser. "Maybe they are numbing themselves from the noise—and I mean that in a very general sense—of the outside world. But I have a quotation from a very disturbed young man who said, 'I can plug into the music and out of my pain.' Sometimes we need an escape, but if we escape for too long, then we run into problems, because we're not dealing with the root of whatever is causing that pain." Hanser thinks music therapy needs the right prescription with correct dosages to be effective in the long-term: "Music therapists promote a very individualized package that takes into account not only what music to listen to, but when and for how long, so it doesn't inure you to underlying problems. If we need an immediate escape, that's OK, too. We just don't want to ignore any problem that's going on." For Many, Music is the Right Prescription for Pain and Anxiety by Linda Laban N S o ci a l wo rke r s h a ve u s e d m u s ic to h el p s t ir m e m o ries in p a t ie n t s w it h A l zh ei m e r's a n d d e m e n t i a P H O T O C O U R T E S Y O F B O N D 3 6 0