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"It is not stress that
kills us, it is our reaction to it."
Hans Selye, a pioneer in understanding the influence of
stress, knew what he was talking about. He spent 50 years
studying the causes and consequences of stress.
Being late to a meeting isn't harmful. It's your reaction
to it. Procrastination isn't necessarily bad, nor is it the
co-worker who talks too loudly on the telephone, or the
child who doesn't recognize the importance of a clean room,
or not having adequate time to do what you feel you must or
want to do. These are just everyday circumstances. It is
your reaction to these circumstances that is the problem.
How do you react to the situations that cause you stress?
Frustration, anger, attacks on your self-esteem? Your blood
pressure goes up, your tolerance goes down?
Instead of letting it bother you, how about learning to
respond differently? One of the secrets of dealing with the
everyday variety stresses is recognizing what you can't
change, what you can change, and what is worth the fight.
"Responding or choosing from a range of options in a
situation versus reacting in habitual ways is a skill that
can be learned. The practice of mindfulness meditation is an
effective way to develop that ability," says Bev Klug,
facilitator of the Mindfulness-Based Stress Reduction
Program, UI Family Care's Counseling and Health Promotion
Services.
There are several ways to let go of your frustrations.
Maybe it is through music, maybe it is learning how to have
fun again, maybe it is practicing and using relaxation
techniques. The secret is to find something that works for
you because life should be more than moving from one stress
to another.
If you have a health-related question, or to make an
appointment, call UI Health Access - 800- 777-8442 or
384-8442.
More information:
Listed above are several Web sites that offer additional
information on this topic. University of Iowa Health Care
does not sponsor or endorse these sites, or guarantee the
accuracy of the information contained on these sites. These
links are here for general information only, and should not
be used for personal diagnosis or treatment. If you have any
questions, please contact UI Health Access.
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"If you are patient in one moment of
anger, you will avoid a hundred days of sorrow."
- Tibetan proverb
Anger is a powerful emotion that can have a negative
impact on your life. Studies show that it doesn't matter if
you vent your anger or hold it in, anger results in death
rates two times greater than among people who choose
"reflective coping."
What is reflective coping? It means waiting until you
back away and cool off from what has angered you, THEN
rationally discussing what made you angry with the people
involved. You acknowledge the anger, but avoid the hostility
that can add guilt to the situation.
Next time you're ready to lose your cool, try the ACE
method:
A - Assess accurately. If you feel a
fight brewing with someone, make sure it is not just
tension or frustration you're sensing. Ask if something
in particular needs to be discussed. A great deal of
yelling escalates from emotions, accusations, and bad
timing rather than from real problems.
C - Choose constructively. Be careful with the
words you use. Don't use an accusatory tone of voice. Be
specific in the issues you are addressing.
E - Express effectively. Think for a moment
about why you are angry. Don't focus on who is "right" or
"wrong." Find a way to make constructive changes in the
situation that is upsetting you. Remember to talk to the
people who can help you. Complaining to co-workers does
nothing to help the situation, unless your co-workers are
causing the problem.
Source: The Power of 5, Harold Bloomfield, MD,
& Robert Cooper, PhD, Rodale Press, 1995.
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You can't go
wrong
"There is no such thing as the 'wrong' music to help you
relax," says Joey Walker, music therapist with UI Health
Care Rehabilitation Therapies.
"It's not like giving a specific pill for a specific
pain," says Deanna Hanson-Abromeit, UI Health Care music
therapist. "There is no 'one-music-fits-all.' It depends on
your preferences, experiences, and mood."
"If you've had a bad day at work, you might be inclined
to immediately put on some slow, quiet music, but you need
to transition your moods. Start out with something lively
and work your way to a level of music you find relaxing,"
says Walker.
"You have to create an environment in which you can
relax. Music is only a part of it," says Hanson-Abromeit.
"Relaxation is like everything else in life, you have to
practice it to be successful. The more you tune in to the
music, the more effective it is. Listening to certain music
time and again can bring a trained response. You may start
to relax with the first down beat."
If you have a health-related question, or to make an
appointment, call UI Health Access - 800- 777-8442 or
384-8442.
More information:
Listed above is a Web site that offers additional
information on this topic. University of Iowa Health Care
does not sponsor or endorse the site, or guarantee the
accuracy of the information contained on the site. The link
is here for general information only, and should not be used
for personal diagnosis or treatment. If you have any
questions, please contact UI Health Access.
Back to top
Music can be useful in many
ways
By Joey Walker
University of Iowa Health Care Music Therapist
Music therapy has become more established and popular
since the 1940s.
A music therapist can help cancer patients express their
feelings in a positive way through a variety of musical
experiences.
People can react with emotion to music, which may help
patients get in touch with their feelings or even make them
stronger. Music can be a social activity, and groups of
people can get together and share common thoughts and
feelings. Lessons on keyboards, guitars, or other
instruments can improve self-esteem and encourage
constructive use of leisure time. Studies show it is easier
to move or do repeated tasks while listening to
music--imagine an aerobics instructor or exercise class
without music. Music is also a powerful distracter from pain
and painful procedures.
You can use music to distract yourself from pain. First
of all, the music being used must be chosen by you. Next,
try and think, hum, or sing words to the music if it has
some. If not, concentrate on tapping your toe or finger to
the beat of the music--even watch yourself doing this so you
are focusing on the actual movement of your finger or toe.
Or you might try thinking of pleasant memories you have
which are associated with the music. Concentrating on one of
these three things will help distract you from the pain.
Pain sometimes seems greater if you are scared or are
feeling stressed. Try using music to help you relax; but
remember, it might take some practice and energy on your
part. If you are feeling anxious or stressed, try matching
the music to your mood. It might mean first listening to
some music that is faster or has a distinct beat. Then
slowly change the music so it is more flowing or mellow as
you calm down and slow your breathing.
Try using music as a social activity. Join a community
chorus or band, a drumming group, or church choir or take
lessons on the instrument that you always wanted to play.
It's never too late to learn to play an instrument. You can
form new and supportive relationships by doing these
activities or by simply attending different concerts and
recitals.
You can also use music to make your exercise routine more
interesting and fun. You can pick music that will help give
you that "pumped up" feeling--or the feeling of pacing
yourself along your walking route. Many recordings are
available which are steady and have a certain amount of
beats per minute.
Music can be used to help calm us down, to have more
energy and get more things done, or to distract us from
pain. It allows us to react with emotion--it's okay to cry,
feel chills up the spine, or get a lump in the throat. In
this way, we might figure out feelings that are locked
inside of us.
So although you might not be a music therapist, you can
use music in your daily life to make yourself feel better or
more energetic and to have the best quality of life possible
for you.
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Strategies for relaxing with
music
Remember that most music is not intended for relaxation.
Most music is too fast.
Choose music that is slow enough to decrease your heart
rate. If possible, try to match your resting heart rate
(this is often around 60-70 beats per minute). This will
lead to deeper relaxation.
Choose music that has no lyrics. Music with lyrics can be
distracting because people tend to focus on the lyrics
instead of the relaxation itself.
And most importantly, choose the music that makes you
feel comfortable. Everyone has different tastes in music.
You will have difficulty relaxing to music you do not like
to listen to!
Music Suggestions:
New Age
- Janalea Hoffman: Mind-Body Rhythm and Music
Acupuncture. These CDs were created by a board-certified
music therapist who designed the music for deep
relaxation.
- Stephen Halpern: In the Key of Healing. The slow,
orchestral music was created to promote healing and
relaxation.
- Enya, Yanni, David Lanz, and other New Age composers
have created many pieces that are appropriate for
relaxation.
Classical
Many classical composers from many eras wrote beautiful,
relaxing music. The following are a few suggestions of
specific pieces to relax to:
- Bach--Air, Sinfonia in G, Oboe Concerto in D
Minor
- Barber--Adagio for Strings
- Beethoven--Largo from Piano Concerto Number 3 in C
Minor
- Brahms--Intermezzo in E Flat
- Chopin--Larghetto from Piano Concerto Number 2 in F
Minor, Raindrop Prelude
- Giodani--Caro Mio Ben
- Grieg--The Last Spring
- Handel--Large (from Xerxes)
- Mascagni--Cavalleria rusticana (Intermezzo)
- Massenet--Meditation (from Thais)
- Mozart--Clarinet Concerto in A (Movement 2)
- Pachelbel--Cannon in D
- Pavane--Op. 50
- Schumann--Traumerei, Romance in F Sharp
- Tchaikovsky--Andante from Violin Concerto #2 in
D
Relaxation Exercise Suggestions:
- Focus on your breathing. As you inhale, think of all
your worries and tensions; and as you exhale, release
them.
- Close your eyes, allowing your face to relax. Let
your jaw lower so your mouth is comfortably open. Focus
on your breathing, trying to temporarily take a break
from any anxiety or troublesome thoughts.
- Think of a place that makes you feel comfortable and
safe. This special place can be in nature, such as the
beach or mountains, or even in a favorite chair in your
favorite room. This place can be real or in your
imagination. Use all of your senses to explore the area:
look, listen, smell, taste, and touch everything you
can.
- Imagine a soothing ball of light or energy massaging
any tensions or discomforts away from your body so you
feel relaxed and refreshed.
- Think of particular positive statements you want to
tell yourself, and repeat the statements while listening
to relaxing music.
When Listening to Music:
Note: If you are using a tape which includes verbal
guidance, follow the instructions. Otherwise, try to do the
following when listening to music for relaxation.
- Stay awake for the duration of the tape.
- Lie on your back, sit in a chair, lay on the
floor--whatever is most comfortable.
- Find a warm and protected place--you may want to
cover yourself with a blanket as your body temperature
will decrease with relaxation.
- Choose a time when you will not be interrupted by
anyone. It may be necessary to unplug your phone so there
are no distractions.
- If you feel comfortable, close your eyes while
relaxing. This will help increase possible visual
distractions.
- Dress in loose and comfortable clothing that does not
constrict your waist or breathing.
- Your breathing should be an easy gentle experience as
air moves in and out of your body. Try to be aware of
your stomach expanding or rising on the in-breath,
deflating or falling on the out-breath.
- Do not try too hard to relax. This will only create
tension. Just let go of judgmental thoughts. There is no
right way to feel while you are relaxing.
- It is helpful to see this time as totally set aside
for you to be by yourself. This is a time that you
deserve to give yourself. You can receive nourishing,
positive energy and attention and open sources of
strength and healing within yourself.
With music, you can experience the benefits of true
relaxation and inner peace!
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Music therapy and medicine
From the American Music Therapy Association Inc.
- "I certainly think that every institution should
have its music therapy and its music therapists."
- - Oliver Sacks, M.D.
Neurologist
What is music therapy?
Music therapy is an established health service similar to
occupational therapy and physical therapy. It consists of
using music therapeutically to address physical,
psychological, cognitive, and/or social functioning for
patients of all ages. Because music therapy is a powerful
and non-invasive medium, unique outcomes are possible. In
addition to its applications with hospital patients, music
therapy is used successfully with persons of all ages and
disabilities.
What is AMTA?
The American Music Therapy Association (AMTA) was founded
in 1998 as a result of the unification of the American
Association for Music Therapy (founded in 1971) and the
National Association for Music Therapy (founded in 1950).
Its mission is to advance public awareness of the benefits
of music therapy and increase access to quality music
therapy services. AMTA establishes criteria for the
education and clinical training of music therapists. Members
of AMTA adhere to a Code of Ethics and Standards of Practice
in their delivery of music therapy services. Through the
Journal of Music Therapy, Music Therapy Perspectives, and
other publications offered by AMTA, research findings and
clinical studies relevant to the practice of music therapy
are shared with interested professionals.
How does music therapy make a difference for medical
patients?
Music therapy has been shown to be an efficacious and
valid treatment option for medical patients with a variety
of diagnoses. Music therapy can be used to address patient
needs related to respiration, chronic pain, physical
rehabilitation, diabetes, headaches, cardiac conditions,
surgery, and obstetrics, among others. Research results and
clinical experiences attest to the viability of music
therapy even in those patients resistant to other treatment
approaches. Music is a form of sensory stimulation which
provokes responses due to the familiarity, predictability,
and feelings of security associated with it.
What do music therapists do?
Music therapists use music activities, both instrumental
and vocal, designed to facilitate changes that are
non-musical in nature. Music therapy programs are based on
individual assessment, treatment planning, and ongoing
program evaluation. Frequently functioning as members of an
interdisciplinary team, music therapists implement programs
with groups or individuals addressing a vast continuum of
outcomes, including reduction of pain and anxiety, stress
management, communication, and emotional expression.
What can one expect from a music therapist?
Music therapy utilized in a medical setting complies with
the expectations and requirements inherent in the medical
model of treatment. Professionally trained music therapists
design and utilize individualized music experiences to
assess, treat, and evaluate patients. Music therapy patient
objectives are specific and relevant to medical diagnosis,
course of treatment, and discharge timeline. Benefits are
described in medical, and not musical, terms.
Through a planned and systematic use of music and
music activities, the music therapist provides opportunities
for:
- Anxiety and stress reduction
- Nonpharmacological management of pain and
discomfort
- Positive changes in mood and emotional states
- Active and positive patient participation in
treatment
- Decreased length of stay
In addition, music therapy may allow for:
- Emotional intimacy with families and caregivers
- Relaxation for the entire family
- Meaningful time spent together in a positive,
creative way
Who is qualified as a music therapist?
Graduates of colleges or universities from more than 70
approved music therapy degree programs are eligible to take
a national certification examination in music therapy. Those
who pass the exam become Board Certified (MT-BC) by
demonstrating entry level skills in the profession. In
addition to the MT-BC credential, other recognized
professional designations are Registered Music Therapist
(RMT), Certified Music Therapist (CMT), and Advanced
Certified Music Therapist (ACMT), as listed with the
National Music Therapy Registry. Professionals who have
proper training and credentials are the only ones qualified
to provide music therapy services.
Where do music therapists work?
Music therapists offer services in medical hospitals,
skilled and intermediate care facilities, rehabilitation
hospitals, adult day care centers, senior centers, hospices,
psychiatric treatment centers, drug and alcohol programs,
schools, and other facilities. In the medical setting, music
therapists work with a variety of patient needs and may work
in many different hospital units, including ICU, NICU, pre-
and post-op, surgery, chronic pain management, cardiac care,
obstetrics, emergency, pediatrics, physical rehabilitation,
and outpatient programs. Some therapists are self-employed
and work on the basis of independent contracts, while others
are salaried hospital employees.
How does music therapy help patients and health care
staff?
Walter Quan Jr., M.D., oncologist-hematologist of St.
Luke's Medical Center in Cleveland, Ohio, attests that:
"Music therapy has a wide range of applications. We see some
patients whose blood pressure does come down and seems to
stay down through regular use of music therapy. Another
important aspect is the use in the labor and delivery room.
We know that patients, who go through Lamaze training for
instance, can also use music therapy to help them relax and
to have pain relief in terms of labor pains."
Music therapy is quantifiable and qualitative.
Quan continues: "…[I]n general, as a physician,
you only use those things that you can measure or that have
a number related to [them]…but there are a
number of disciplines, and music therapy is one of them,
where there is a qualitative effect which can give a lot of
benefit for patients."
Music therapists complete assessments for each patient
and collect extensive data in order to write a complex
patient history and develop a client-centered treatment
plan. The music therapist is then able to evaluate the
patient during the course of treatment. All of this
contributes to the quantifiability of music therapy
treatment.
Music therapy is reimbursable. The government has
recognized music therapy as a reimbursable service. A
program memorandum was released in June, 1995, by the Health
Care Financing Administration (HCFA) that cited music
therapy as a reimbursable service under Medicare's Partial
Hospitalization Benefit; other coverage is on a case-by-case
basis. Similarly, insurance companies are recognizing the
advantages of covering music therapy as a benefit as they
respond to increasing market demand for greater patient
choice of health care services. Healthcare plans are
reimbursing for music therapy services on a case-by-case
basis as well based on medical necessity.
Music therapy interventions are favored for the ability
to meet quality of life needs. As quality of life issues and
patient choice are pushed to the forefront of the national
healthcare agenda, music therapy is being increasingly
recognized for its unique contribution to patient quality of
life.
Music therapy can help to relieve pain and reduce
stress and anxiety for the patient, resulting in
physiological changes, including:
- Improved respiration
- Reduced heart rate
- Lower blood pressure
- Relaxed muscle tension
- Improved cardiac output
Music therapy has been shown to have a significant effect
on a patient's perceived effectiveness of treatment, self
reports of pain reduction, relaxation, respiration rate,
behaviorally observed and self-reported anxiety levels, and
patient choice of anesthesia and amount of analgesic
medication.
Why use music therapy?
"I think the therapist plays an integral role when
talking about a team of physicians, a team of nurses,
therapists, physical or occupational therapists, and so
on… that team needs include a music therapist," said
William Frohlich, president, Beth Abraham Health Services,
New York.
He believes music therapy should be part of the total
treatment. The observations where a patient may be singing
where they could not speak before or they may be walking or
dancing where they could not move before--that is important
for the music therapist to bring to the occupational
therapist or physical therapist to become part of the total
treatment modality."
"The mind/body relationship is particularly important in
terms of looking at the immune system to treat cancer," said
Walter Quan Jr., M.D., hematologist-oncologist, St. Luke's
Medical Center in Cleveland, Ohio. "We believe that patients
under less stress who are in a brighter mood, appear to do
better in terms of their anti-cancer therapy. I think music
therapy and imaging and immune therapy of cancer all tie
together
"I think it can be helpful used in conjunction with
biologic therapy for cancer. A recent study on cancer
patients showed that approximately 75 percent of cancer
patients that had their usual pain medicines but also had
the additional music therapy experienced less pain than
previously. Music therapy helps patients relax and could
possibly be beneficial in raising the innate immune system
which could have therapeutic implications for cancer."
Susan Shurin, M.D., Chief of Pediatric-Hematology,
Oncology, at the Ireland Cancer Center in Cleveland, Ohio,
said music therapy enables people to sometimes put words
together in ways that are hard for them to do otherwise. "It
often seems to be easier if [the patient] has the
rhythm and cadence that comes along with music. Particularly
with people with certain kinds of neurological deficits, I
think that [music therapy] can be very helpful. The
music seems to get through to the patient, and in many ways,
it enables [the patient] to get through to us which
[may be] very hard to do with any other modality."
Joseph Arezzo, Ph.D., Vice Chair, Department of
Neuroscience, Albert Einstein College of Medicine, New York,
talks about music therapy's role in restorative neurology:
"The degree to which function can be recovered is
phenomenal, and we are just tapping into the extent that we
can get recovery following stroke or injury or disease. We
hope that music might play a particularly important role in
helping [the regeneration of] those cells, in
helping the individual learn to interpret the pattern, and
essentially to help that person learn again."
Selected Bibliography in Music Therapy and
Medicine
Bartlett, D., Kaufman, D., & Smeltekop, R. (1993).
The effects of music listening and perceived sensory
experiences on the immune system. Journal of Music Therapy,
30, 194-209.
Boldt, S. (1996). The effects of music therapy on
motivation, psychological well-being, physical comfort, and
exercise endurance of bone marrow transplant patients.
Journal of Music Therapy, 33(3), 164-188.
Cassidy, J. W., & Standley, J. M. (1995). The effect
of music listening on physiological responses of premature
infants in the NICU. Journal of Music Therapy, 32(4),
208-227.
Clair, A. A. (1996). Therapeutic Uses of Music With Older
Adults. Baltimore, MD: Health Professions Press.
Edwards, J. (1998). Music therapy for children with
severe burn injury. Music Therapy Perspectives, 16, 21-26.
Hurt, C.P., Rice, R.R., McIntosh, G., & Thaut, M. H.
(1998). Rhythmic auditory stimulation in gait training for
patients with traumatic brain injury. Journal of Music
Therapy, 35(4), 228-241.
Lane, D. L. (1991). The effect of a single music therapy
session on hospitalized children as measured by salivary
Immunoglobulin A., speech pause time, and a patient opinion
Lickert scale. Pediatric Research, 29(4, part 2), 11A.
Loewy, J. (1997). Music therapy pediatric pain
management: Assessing and attending to the sounds of hurt,
fear and anxiety. In J. Loewy (Ed.), Music Therapy and
Pediatric Pain, (pp. 45-56).
Lorch, C., Lorch, V., Diefendorf, A., & Earl, P.
(1994). Effect of stimulative and sedative music on systolic
blood pressure, heart rate, and respiratory rate in
premature infants. Journal of Music Therapy, 31(2), 105-118.
MacNay, S. K. (1995). The influence of preferred music on
the perceived exertion, mood, and time estimation scores of
patients participating in a cardiac rehabilitation exercise
program. Music Therapy Perspectives, 13, 91-96.
Malone, A.B. (1996). The effects of live music on the
distress of pediatric patients receiving intravenous starts,
venipunctures, injections, and heel sticks. Journal of Music
Therapy, 33, 19-33.
Rider, M., Floyd, J. W., & Kirkpatrick, J. (1985).
The effect of music, imagery, and relaxation on adrenal
corticosteroids and the re-entrainment of circadian rhythms.
Journal of Music Therapy, 22, 46-58.
Robb, S. L., Nichols, R. J., Rutan, R. L., Bishop, B. L.,
& Parker, J. C. (1995). The effects of music assisted
relaxation on preoperative anxiety. Journal of Music
Therapy, 32(1), 2-21.
Standley, J. (1986). Music research in medical/dental
treatment: Meta-analysis and clinical application. Journal
of Music Therapy, 23(2), 56-122.
Standley, J. (1991b). The role of music in
pacification/stimulation of premature infants with low birth
weights. Music Therapy Perspectives, 9, 19-25.
Standley, J. (1992a). Clinical applications of music and
chemotherapy: The effects on nausea and emesis. Music
Therapy Perspectives, 10(1), 27-35.
Standley, J. M. & Prickett, C.A. (Eds.) (1994).
Research in music therapy: A tradition of excellence. Silver
Spring, MD: National Association for Music Therapy.
Taylor, D. B. (1997). Biomedical Foundations of Music as
Therapy. St. Louis, MO: MMB Music, Inc.
Thaut, M., Schleiffers, S., & Davis, W. (1991).
Analysis of EMG activity in biceps and triceps muscle in an
upper extremity gross motor task under the influence of
auditory rhythm. Journal of Music Therapy, 28, 64-88.
Thaut, M. H. (1985). The use of auditory rhythm and
rhythmic speech to aid temporal muscular control in children
with gross motor dysfunction. Journal of Music Therapy,
22(3), 108-128.
Wheeler, B. (Ed.) (1995). Music Therapy Research:
Quantitative and Qualitative Perspectives. Phoenixville, PA:
Barcelona Publishers.
For More Information on Music Therapy, Contact:
- University of Iowa Hospitals and Clinics
- Joey Walker, MA, MT-BC
- 200 Hawkins Drive, 0733 JPP
- Iowa City, IA 52242-1009
- Phone: 319-356-4718
- FAX: 319-353-7199
- E-Mail: walkerj@healthcare.uiowa.edu
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Reviving memories with a dose of
music
Hershey, Pa.
Strumming her guitar, Janice Stouffer opens the music
therapy session with an exercise in name recall, singing a
slightly altered version of a well known Doors tune: "Hello,
how are you, won't you tell me your name?"
Music therapy has long been looked upon as a "soft
science," a nice idea but hardly a true specialty in
medicine or counseling. Janice Stouffer is one of a growing
number of researchers working to change that view by
subjecting music therapy to scientific scrutiny.
Stouffer's laboratory is a small classroom on the
outskirts of Hershey, Pa. Her tools are a guitar, hand-held
drums, a triangle, and maracas. And her experimental
subjects are five brain-injured adults sitting in a
semicircle before her.
Stouffer, a registered music therapist affiliated with
Penn State's Milton S. Hershey Medical Center, is involved
in a clinical trial comparing music therapy to standard
"talk therapy" for adults recovering from serious head
injuries. The study, which is funded by the National
Institutes of Health's Office of Alternative Medicine,
focuses on people who have suffered brain injuries from an
auto accident, stroke, or viral infection. Their injuries
have left them intellectually normal but hobbled in memory
and speech and prone to angry outbursts and antisocial
behavior.
Strumming her guitar, Stouffer opens this afternoon's
music therapy session with an exercise in name recall for
the group, singing a slightly altered version of a well
known Doors tune: "Hello, how are you, won't you tell me
your name…?" During the hour they will spend with
Stouffer today and twice a week throughout the summer, they
will sing and sometimes shout, tap their feet awkwardly, and
occasionally look off into space, apparently forgetting for
a few moments what they are doing or why they are there.
Although some of her clients are in wheelchairs as a
result of their injuries, physical disability is not the
major barrier to their becoming self-sufficient, Stouffer
said. They need to understand their emotions and control
their behavior, she said, "and music taps into emotions and
behavior in a very deep way."
So instead of just talking about their feelings and their
difficulties, Stouffer gets the individuals in her group to
sing about the accidents that caused their troubles, use
simple musical instruments to express their joys and
frustrations, and move together to the music of Billy Joel
and Gloria Estefan to learn how to cooperate as a group. A
series of psychological tests before and after the 10-week
series will help evaluate the group's improvement.
"We can talk to them as much as we want, but music may
link the dialogue more to feelings," said Michael
Rohrbacher, director of music therapy at Elizabethtown
College in Pennsylvania, who is videotaping every session to
analyze group members' facial expressions, movements, and
other behaviors and so document what happens during a music
therapy session.
Today, Stouffer is having the group work on feelings of
anger. She plays heavy, almost threatening, minor chords on
the guitar and asks group members to talk about what makes
them angry.
"If I don't follow a conversation with all my attention,
then it's gone," replies one frustrated woman, who suffered
head injuries from an automobile accident a few months ago.
"I used to be one of those 'do four things at a time' kind
of people. Now I just want to know how long we're going to
be like this. It irks me that I can't do things any more."
Another group member, a man who fractured his skull in a
car crash, said "I get so mad at myself when I get lost in a
building or someplace. I shouldn't get lost. Now I've lost
my self-confidence because I think something is one way and
really it's another way."
After telling their stories, each person leads a
percussion session in which all in the group, using drums
and wooden blocks and sticks, express feelings of anger,
building up to a release and then calming again. In this
group of people whose injuries make them prone to sudden
emotional outbursts, the exercise is designed both to help
them recognize their feelings and to teach the value of a
measured release of those feelings.
Paul Eslinger, a Penn State clinical psychologist who is
overseeing the Hershey study, said he has high hopes that
music therapy will prove a useful addition to standard
counseling for brain-injured patients.
"The traditional psychotherapeutic approach to developing
insight is generally of limited value in brain-injured
patients," Eslinger said. And perhaps music, with its
ability to evoke emotions, can help. After all, he said,
"any real change in behavior must come from a change in
feeling."
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You can take control
 Stress
starts when you are confronted with more than you can
handle, be it physical, emotional, or a combination.
You can't avoid stress, it's part of life. But you can
take steps to reduce the impact of stress. Here are a few
suggestions:
Don't drink caffeine. Stress and caffeine build on
one another. Have you ever noticed you drink more coffee or
eat more chocolate - both sources of caffeine - when you are
stressed? Caffeine causes "coffee nerves" and can lead to
insomnia, headaches and stomach pains, among other
complaints.
Get the rest and relaxation you need. Don't skimp
on sleep in order to get everything done and with the idea
that this will eliminate some of the stress in your life.
Your body needs the "down time." When you're tired you tend
to be less civil and more irritable, neither of which will
help you deal with the stresses in your life. Learn to relax
and play sometimes.
Exercise. Just like sleep, you need it for a
healthy, happy life. It helps control weight (which can ease
that stress), lowers your risk of heart disease, stroke and
other illnesses. Exercise makes you feel better and you'll
look better - now how about that for reducing stress.
Alcohol. If you use it to relax, you might want to
re-examine your decision. Light to moderate drinking is not
as dangerous as chronic or habitual drinking, but there are
still some dangers. Stress increases your nutritional needs
while alcohol reduces the amount of nutrients you get from
the foods you eat.
Stress eating. We've all done it. A bowl of ice
cream. An extra helping. We call it comfort food. But it
doesn't always work. Stress can change your eating habits.
Avoid sweet, fatty snacks during breaks or late at night.
Too much sugar and fat do more harm than good. The more your
body has to handle, the more it relies on what you feed it.
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Everyone needs a little help every now
and then
And University of Iowa Health Care has just the thing to
help you better deal with the everyday stresses in your life
- the UI Family Care Center's Counseling and Health
Promotion Services offers an eight-week seminar, Responding
to Life's Challenges: Mindfulness-Based Stress Reduction.
The program helps you learn to use your internal
resources to change your response to stress, chronic pain,
or illness. Mindfullness meditation teaches you to have
moment-to-moment awareness of what is happening, rather than
reverting to "automatic pilot" in our reactions to certain
situations. You learn to respond, rather than react.
The next class begins in January. Please call 384-7900
for information and a reservation.
If you have a health-related question, call UI Health
Access - 800- 777-8442 or 384-8442.
You can be a winner
CHAMPS - Cardiovascular Health Assessment, Management and
Prevention Services - offers practical and productive ways
to reduce and relieve stress trhough its Stress Management
Class each Monday at 10 a.m. There is a $10 fee per session
for those not enrolled in the CHAMPS program.
Call 356-4652 for details and visit www.uihealthcare.com/depts/champs/.
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Did you know . . .
Millions of Americans suffer from unhealthy levels of
stress at work. A study several years ago estimated the
number to be 11 million. Given events since then, this
number has certainly more than tripled. Approximately 75
percent of the general population experience at least "some
stress" every two weeks. (National Health Interview Survey
and U.S. Department of Health and Human Resources)
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