I Can See Clearly Now

January 4, 2013

For any students of mine reading this…I am no longer irresponsible in the ways I will describe in this post.  However, my past errors in judgement have only made me better at calling BS on almost everything, so take my words to heart and take responsibility for your choices.

I had a student a few years ago who rarely turned in assignments on time, if at all.  When I would follow up, this person would tell me something to the effect of, “I’m really sorry – site reports just aren’t a priority for me right now,” or “It just didn’t get done.”  I appreciated my student’s honest statements so much that I didn’t deduct as many points when I gave a grade at the end of the semester.  Since then, I generally have much more respect for the responsibility students take, even if means that it’s really just honesty about being lazy or unmotivated or going out too many times and losing track of priorities.

Most of us aren’t like that.

We make excuses.  Specifically, we make excuses about why we didn’t [insert anything here].  We didn’t have time, our dog ate it, we spilled wine on our computer, we had a surprise hospitalization, our battery was dead, we were sick, our toenail was itchy, we had a headache…the list goes on.  Most of the time, these excuses come from not taking responsibility for our choices and subsequent actions.

Have you made those excuses, and in hindsight realized the error of your ways?

Well, I have.

When I was in school (every school, forever) I had my own ideas about the way things should go.  Here are a couple of examples:

When I was in early elementary school I didn’t understand the rules of kickball, so I would develop a “stomach ache” about once a month (kickball day) prior to gym class.  My mom would come and pick me up, and I would spend the rest of he afternoon on the couch pretending to be sick.  She eventually caught on and made me ask the teacher how to play.  I was fine with kickball after that.  What I should have done, was ask the gym teacher how to play kickball from the get-go. This wouldn’t have been so bad, since I was just six years old, but the patterns continued…

I also didn’t like doing homework.  My parents didn’t allow my brother and me to watch TV or play video games until our homework was done, so I would do my homework in a cursory manner in order to watch a little “Doug” or “Rugrats.”  Sometimes, I would say I did my homework but actually didn’t and I’d wake up the next morning with a “stomach ache” and stay home from school, for fear that I would get in trouble for not completing an assignment.  My parents eventually caught on and began checking my homework for errors and level of completion.  What I should have done was go to school anyway and take responsibility for the fact that I didn’t do my homework.  I’m sure the same irresponsibility happened in middle school, but nothing comes to mind, so…

When I was in high school, I did not enjoy gym class.  I did not have any interest in getting sweaty and having to shower or change in a room with my classmates.  So I wrote fake notes from my dad (who was a department head in that school system and worked in the building) getting me out of gym class.  The thing with doing stuff like that, is that someone always catches you.  Damn.  I was also a procrastinator and was easily distracted by everything that high school has to offer, particularly extracurricular activities like the plays and musicals, a social life, boys, so I left EVERYTHING until the last minute (except for stuff having to do with music or art, surprise surprise…). I can’t even think of what I should have done for these examples because they are so flagrantly unacceptable.

Which brings me to college.  There was something attractive about going to college in Boston – there was a lot to do, there was a bustling atmosphere, and culture and liberal ideas.  I love Boston, but in hindsight, I should not have gone to college there.  I am so distractible even without the bustling atmosphere and I ended up having many of the same issues as I did in grade school, except in college I was expected to be responsible for my choices and actions and accountable for myself, and I wasn’t ready.  (I also didn’t know anything about nutrition or exercise and gained 50 pounds, but that’s a story for another day).

Luckily, I became ready at some point during internship and began taking responsibility for myself.  And you know what?  It felt good.  I was calmer.  I was able to say, “I didn’t do this because I got distracted and didn’t use my time effectively.”  I was able to make the decision to get to sleep early so I would be well rested for an early morning the next day.  I was able to really plan ahead and make smarter choices so I would be successful in my internship, and when I didn’t, I was on edge and nervous, and it didn’t feel good.

Which brings me here, almost seven years later, to a place where most of the time, even if I don’t do something when I’m supposed to, I take responsibility for it, and try not to make excuses.

obstacles2Something that comes to mind when I think of excuses is the notion that there are these obstacles that we can’t get around, and I notice this in many areas of my own life.  When there is a reason that something that needs to happen can’t happen, chances are it’s an excuse.  It’s like that with homework, bills, getting to work on time, exercise, eating healthy, walking the dog, and there are many many others in that same vein.

Do I want to exercise every day?  Of course not.  It’s inconvenient, and there’s not as much time as I would like.  I’m also pretty lazy.  BUT!!  Do I have to exercise every day?  Yes, at least most days, or I will gain weight and become unhealthy.  If it’s cold, I run and become warm.  If it’s snowing, I shovel or snowshoe.  If there’s no time, I probably could have made more time, but either way, I make up for it the next day.

Do I want to go to work when I’m sick?  Of course not.  I feel crummy and can’t sing as well.  BUT!!  Do I have to work so that I can actually make money (self-employed people don’t get sick days) and maintain reliable relationships with my clients and contracts?  Yes.  Unless I’m really symptomatic or contagious, I go.  I lead types of sessions where I’m not forced to sing as much or at all, and I rest in between groups.

Sometimes obstacles are serious and inhibit certain other things from happening, but usually, they are petty and exaggerated.  When there is an obstacle in our way, do we see only the obstacle, or do we see a solution? Do we see a way around it?  If we don’t, then the obstacle is probably an empty excuse in disguise and should be treated as such.

So, all you excuse makers out there…pull yourselves up by whatever bootstraps you have, acknowledge the obstacle and come up with a way around it, or you will never survive in this world.


Learning to Fly: Part Deux

January 3, 2013

In September, I started a new chapter in my professional life.  With the help of a few wonderful colleagues and advocates, I was able to create an internship program based around the hospital system I work in, and let me tell you – it has been a whirlwind.

My two interns have just completed the third month of the six month program.  Yikes! How did the time go by so fast?

I’ll tell you how.


Before the internship was able to start, the universities and the hospital had to come to a contractual agreement.  This took a while. The issue was: the hospital I am working with has recently decided that it does not provide criminal record checks (CORIs) to interns.  The schools my interns are from also don’t provide criminal record checks.  Luckily, the memo didn’t get passed along to HR at the hospital, and the person in that department ran checks for us before I knew that CORIs were the main hold up. We eventually got everything straightened out, but the person in the legal department in charge of the contracts had not known that I had a relationship with the hospital prior to this, (or that project supervisor, S – a unit manager, was on my team) and had let the contract sit on their desk for over a month before it was sent to the administrators for signing.  The interns started a week later than expected, because in order for me to even set up hospital and behavioral health orientation for the interns, the contracts had to be signed.  In order for the interns to even start observing on the medical units and psych units, they had to go through said orientation and turn in their proof of immunizations, behavioral health and student rotation forms (this is something nursing students fill out so that the powers that be know where they’ll be, how often, and for how long), and get ID badges (which was a trial in and of itself).  It was painfully frustrating.

In the time that I was waiting with bated breath to hear about the contracts, I had to create a schedule for the interns, a list of assignments and readings, make a contract, sit down for IIPs (Individual Internship Plans), talk with liasons from both schools about the contracts and liability insurance, check with every single facility I work at to make sure it was okay to bring the interns with me (there are 12 facilities), send memos to the medical units explaining the brand new music therapy program to staff, and do some sessions to acquaint myself with the medical units and staff.  It was a lot of work, but I have to admit, getting my ducks in a row felt good, and with any luck, my experience this time around will make everything easier next time.

Then there was the actual internship.

Month 1 – First, we had two weeks of orientation.  This consisted of the interns coming with me to every place I go, observing and participating, engaging in discussion before, between, and after sessions, and doing various assignments. After they completed behavioral health and medical orientation, as well as the required immunizations and hospital forms, they were able to observe me facilitating bedside MT in the hospital.  After learning how to document, lead sessions in the hospital, and after a hefty amount of observing me in group sessions, they began to lead on their own.  This happened just in time for me to get violently ill and lose my voice (which I wrote about in THIS post).

Month 2 – The interns got their feet very wet leading sessions as a duo (without my direct supervision) in the hospital, and leading my groups while I quietly observed their progress.  There were a couple of misunderstandings and some personal issues that came up, but it was all productive, and all a great lesson in how to work and communicate effectively with others.  Both interns chose topics for research study – one created a survey to find out how staff is benefiting from the music therapy program (indirectly and directly), and the other is conducting research to find out what the most popular interventions are, depending on demographic information.

Month 3 – Both of the interns solidified their final projects – One intern will be starting a music therapy program at two facilities with emotionally disturbed children and adolescents, and will be meeting with the coordinator to nail down details sometime in the next two weeks.  The other intern is starting a pilot program on the hospital’s pediatric unit.  We met with the unit manager to discuss logistics, my intern sent out emails and memos to the unit managers about the program so that staff is informed, and after a relatively easy process, it will begin this coming week!  We found out about a month ago, however, that in order to conduct research having anything to do with the hospital, the interns must propose the research to the Institutional Research Board which requires six additional steps/forms/written work!  Eek!  The Board doesn’t meet until mid-February, so there is time, but it was an unforeseen obstacle.  I guess this is all a learning experience!  At least I have my trusty project supervisor, S, to guide me through the maze.  Another fun and exciting thing that happened during the third month, is that my wonderful boyfriend (a professional photographer) did a photo shoot for me!  One photo of all of us in transit is pictured above (courtesy of Chris Conti Photography).

The interns have been home for the holidays for two/three weeks, and while it has been nice to have a little break between groups, there is still a lot to do, so I’m looking forward to getting back into the swing of things on Monday.  It’s amazing how productive I have let myself be, and how well this has all worked out.

Now, onto the National Roster application…


If you have any questions about the process, please don’t hesitate to ask!  “Like” Bostonmusiclady on facebook to get more updates.

Scars and Stitches

January 2, 2013

In October, I got sick.

Things were coming out of my face that had no business ever seeing the light of day.  I lost my voice at the end of one day of work and then had to take a last minute emergency trip to take care of a friend in a different time zone.  It was miserable.  I was hacking and coughing and wheezing and congested and couldn’t breathe, and then my voice never came back.

I waited it out, hoping it was just a lingering case of laryngitis, but after a month and a half, I still couldn’t sing normally and my speaking voice was strained and hoarse. My interns were still leading all of the sessions (which may have actually been a blessing in disguise, because they are doing an amazing job), and I had a looming unsettling feeling of pessimism about the tumor problem in my vocal chords.

About a month ago at one of the facilities where I work, one of the nurses walked by me while I was brooding (and eavesdropping), and I heard several people say, “Heeeey! You’re back?” “How aaaare you?”  It turns out that she got sick this past summer, got laryngitis, and never got better.  And then found out that she had a nodule on her vocal chords that needed to be removed.  And then found out she would need to be on vocal rest for three weeks.

The hypochondriac that I am, I freaked out and was 100% sure that I, too, had a nodule that was going to require surgery and vocal rest, and therefore ruin my career and my life.

Here are a few of the things I learned about nodules while Googling:

NodesThey are benign.  They are polyps, lesions or blisters caused by vocal abuse or misuse.  The nurse I spoke with said that the membrane tears, and the muscles, etc. behind the fold pop out like a hernia.  I can’t find that information anywhere, so I’m not sure if it’s true, but in any case…In order to restore normal voice function, they require surgical removal followed by voice therapy paired with vocal rest.  THEY ARE AVOIDABLE.  Here’s a link in case you want to worry yourself as well!

So…I was inspired by the nurse at work, and went to the doctor (an Otolaryngologist), and found out, after a nightmarish inspection-by-videocamera (microlaryngoscopy) that occurred in my poor gag-prone throat, I found out…that I don’t have a node.  I have been sporadically worried about nodes forever, so I was relieved, to say the least.  However…

What I did find out, is that instead, I have a giant scar on my vocal chords prohibiting me from singing and speaking correctly.  What’s worse, is that it is apparently not new, which means that the five years it took me to recover from the last time I had laryngitis was probably just my vocal chords adapting to their new topography.  That’s only a theory, but it makes sense if that’s the case.

Scar VCWhere did the scar come from, you ask?  Apparently, at some point one of my vocal folds tore (probably from coughing), it almost healed, and then tore again, and then healed into a scar, but the healing process wasn’t quite complete because I probably sang and talked and yelled through it and exacerbated everything.

Now, the fun begins.  I have to see a speech and voice therapist who specializes in voice disorders for singers (and who is a former music therapist!) for 4-6 sessions.  She will assess my current situation through a series of tests and give me exercises to do that will allow my vocal chords to heal (and get back to normalish).  I will also most likely have to adjust several aspects of my speaking and singing voice, and re-learn how to breathe and warm-up. Fun times.

The reason I decided to write about this, is to stress to all of you (my colleagues, students, and friends who sing) to take care of your voice and your vocal chords.  Warm up before leading sessions.  Drink water until your pee is clear. Avoid coffee, sugar, citrus juices and smoking right before sessions.  For the love of Pete, don’t sing through a cold or cough.  Take the day off, rest your voice, and forsake the money you would have made (if you’re self-employed).  It is not worth it to have your instrument stripped of its function just for a day’s pay.  You’ll end up spending far more than that in medical bills and therapy.

Unfortunately, voice disorders having to do with scars or nodules affect adult women between the ages of 20-50 most often.  Look at that!  Music therapists are mostly women who use their voices every day to speak and sing.  Double whammy for MTs.  And even more reason to take my words seriously.

For now, I am dealing with the issue, and will start voice therapy in two weeks, but I can’t tell you how frustrating it is not knowing how long it will be before I can really sing again, or at least sing comfortably.  I can tell you, though, that I’ll be far more careful from now on knowing what I do.  Take my word for it, take care of yourself, and don’t take your voice for granted.

I am Woman (Hear Me Roar)

November 8, 2012

Tuesday was a big day – regardless of which way we voted – and I’m glad it’s over.

As I stood in line that morning for two hours (freezing my tuchas off outside for one hour, and inside a gymnasium for the other hour) I did some reflecting on what it means to be considered.

In 1920, something big happened.  Women in America, after hundreds of years of being second class citizens, and thanks to the 19th Amendment, were finally given the constitutional right to vote.

In examining this I found out several things: Some women didn’t want the right to vote; men thought that if women were given the right to vote, arguments with their husbands would ensue and break up the family; women were delicate flowers who couldn’t handle such “hurly burly” things; women were too emotional and made irrational decisions which did not belong in politics; men belonged in the public sphere, while women belonged in the domestic sphere; women couldn’t physically handle the consequences of their political actions; there would be more women voters than men, which men feared would cause the government to focus on female views or an anti-male agenda; some men thought that women were already represented and influenced by the men in their family, which would mean that some men would theoretically have more votes than others.  I could go on, but it’s really not worth it.  Women got the right to vote, and even though some women’s rights laws are in danger of being undone if certain people (who shall remain nameless) were to take control of the government, this one is here to stay.

You might wonder what this has to do with music therapy, or my work in general, and believe it or not, I have an answer.  Some women I work with were alive before the 19th amendment was passed in 1920, before wearing pants was acceptable for us, before women were able to enter the same education and careers as men, before divorce from abusive husbands was possible, before birth control was available, before they were allowed run a marathon, before Roe v. Wade. I talk with them, sing with them, drum with them, write songs with them, and because of all that I learn from them.  I’m amazed at how strong they have been in the face of of war, genocide, grief, loss, abuse and exclusion.  In talking with some of these remarkable ladies, I am humbled by some of their desires and subsequent efforts to be more than a wife, mother and housekeeper.  Don’t get me wrong, there are a lot of people who choose to stay at home with their children, who couldn’t imagine life any other way, and that is awesome – and their choice.  But, that choice is really what the women’s suffrage movement, and the current women’s rights movement were/is all about.

Kathrine Switzer, in 1967. She was the first woman to run the Boston Marathon, but not without conflict.  The race commissioner is the man behind her, trying to get her to leave.

Ladies I work with have allowed me to grow as a person this year.  While this was not my first election (it was my fourth!), it WAS the first election where I didn’t take my ability to vote for granted.  I have never felt more privileged than I did on Tuesday, standing in line without anyone telling me I couldn’t, and proud that I was using my ability to vote to try to stand up for others, like those suffragettes did in the early 1900s.

All around the world, women have struggled.  Women ARE struggling.  A few months ago, I heard a story about a female singer in Pakistan, Ghazala Javed, who was hated by religious extremists and assassinated because she was too outward with her talent and voice. Just last month, a 14 year-old girl, Malala Yousufzai, also from Pakistan, was shot in the head by members of the Taliban for going to school, and for being a loud voice regarding the education of girls.  She did not die, and the Taliban who shot her have said that they will not stop until she is silenced for good.  These are just two stories of many that show me/us that we are so lucky, here in this amazing country.  Because we were allowed to vote in the election on Tuesday, some of our rights will be preserved for another four years.


Here, we are capable of and entitled to make our own decisions about how our lives are going to go, we elect female political leaders, and we empower each other. No one should be able to make our decisions for us, except for us.  Welcome to 2012.

We are strong, we are invincible…

We are women!

Sweet Emotion

October 2, 2012

I am a crier.  I cry all the time.

I recently cried while watching “The Blind Side,” “Crazy, Stupid Love,” a random “Friends” episode and almost cried when listening to a random movie theme.

Truth be told, I have been meaning to write a post about emotion for quite a while, but the interns started a couple of weeks ago, and things have been a little crazy.

Here we go…

To be in this profession, empathy is key.  We all know that.  We need to be able to make the right decisions about how to handle a situation based on our ability to read someone, and putting ourselves in someone else’s shoes is how we do that. Duh.

There are situations when our own emotions come out at unexpected times, and I think we have to be okay with that, at least for the most part.  One of my interns said to me recently something to the effect of…the more we cry at movies and weddings and Hallmark commercials and anytime anyone else is crying, it reflects how empathetic we are as people.

I agree.  But sometimes we miss the boat.

Last week in the psych unit, we had a group singing session.  I have piles of lyric sheet copies which are laid out on a large table for patients to choose from (I know there’s a better way to do this) and a few tissue boxes.  I encourage patients to choose a song that speaks to them or that they enjoy, and to take the entire pile of copies to hold on to.  Each person shares their choice, and I ask them why they chose that particular song.  Sometimes there’s a deep and meaningful story attached and sometimes they “just like it,” but regardless, we sing the song (sometimes using small percussion instruments, if the person wants us to) and when we are finished, I thank the person for choosing that song and we move on to the next patient’s choice.

Last week during our group singing session, a patient began to cry during “Bridge Over Troubled Water,” which was a song chosen by another patient in the group.  I thought to myself (during the song) that I should process with her when we had finished, but I stopped myself.  I didn’t know this person, and since another patient had chosen the song, I didn’t want to make the other patient feel that her choice wasn’t honored.  We finished the song and I moved onto the next patient’s choice.

Following the session, when we were all processing, the intern I mentioned above posed an extremely good question, wondering why the tearful patient was crying during that song.

I forget sometimes…I forget that crying is an individual’s situational outpouring of emotion or pain or joy, and that in a psychiatric unit, it might be something worth asking that person about.  So many people cry when music is present (especially in those forums) that I forget how new it is to my interns, and how much better I should be about making sure I process those feelings with patients.  Not only that, but spending the time at least asking the person if they want to talk about how they’re feeling, which I have done in the past, but didn’t that day.  I forget that not everyone is attention seeking, like a patient who was in the unit several weeks ago.  I forget that crying can be significant, even if it’s an every day occurrence in my life because of sitcoms and pictures of cute animals and human interest stories that turned into movies.

After I responded to my intern’s question, I went out to the milieu and, sitting down next to the crying patient, asked her if she was okay.  She responded with “Yeah, I’m fine – that song always makes me cry – I have it on CD…but I’m okay.”  I thanked her for coming to the session and told her I hoped that she would come to the drumming group on Monday if she was still there (she did).

I thought about my lack of good judgement in that moment all weekend and realized that I got lost in the structure of my session and forgot the important parts.  Having tissues on the table is not enough.  Surely, some people just want to be alone with their tears and are crying for no reason in particular, but what if someone was crying about something very specific?  What if someone was crying for the first time in years?  What if someone was crying for attention? Or out of frustration? Or anger? Or despair?  The significance of any of those may not ever matter.  We don’t have to pry if we think the person may need that solitary safe space to cry in, but we should at least ask.

Everything seems new-ish again with my interns asking simple but poignant questions, and I feel so happy that I’m able to share my knowledge with them, even if I make mistakes sometimes.

I’m so happy, I could cry 🙂

(But I won’t because I met my quota today during an old episode of “How I Met Your Mother”)

The Voice Within

September 18, 2012

Last summer, I decided I was going to take a huge risk and audition for NBC’s “The Voice.”  Let me give you a hint about what happened:

I got super super nervous and completely butchered “Bridge Over Troubled Water.”

My first problem was choosing that song to begin with, and if I am ever compelled to put myself through that kind of torture auditioning again, I will choose something fun and impressive, not slow and moving.  But I digress…

I have been watching that show since the very first episode.  I love it.  It is the only performance-competition show I have ever watched, and the banter between the coaches makes me laugh at the end of long days. I have been catching up on my DVRed episodes this week, and just watched tonight’s episode, during which I had a moment of “YES!” and felt I needed to share.

There is a teenager on the show named Jocelyn whose story is this: She was born prematurely, which caused a latent neurological disorder preventing her from keeping up with her peers developmentally.  Her parents took her to a specialist because at the age of four, she hadn’t spoken at an age appropriate level, so he…GUESS WHAT HE DID?  He prescribed music!  Granted, he didn’t prescribe a music therapist, BUT WHO CARES!?!?  I love that her story was just on national television, and that her neurologist knew his or her stuff. The girl has a fantastic voice (she is 17) and seems completely well adjusted and developed.  Go Music!


There is a woman I work with at one of the nursing facilities I contract with, D, who I wrote about in this post.  She is in her seventies and a few years ago, had a major stroke which left her with speech impairments  and the inability to use the right side of her body.  She comes to my music groups every other week and sings like a bird.  She is able to process information, has a great sense of humor, and when she speaks (however incoherently), you can just tell that she knows exactly what she wants to say, and I think she believes she’s saying it so I can understand.  This is obviously all very subjective and just my perspective, but I would be surprised if it isn’t true.  When she sings, though (this is an outcome I know most of us are very familiar with) she sings the words “as clear as a bell” (as the activities director says), and a few times, in a very Gabrielle Gifford kind-of-way, she has spoken words clearly in the context of music, to the delight of us all.

One day, I asked her to make a choice between two songs: I Left My Heart in San Francisco (one of her faves) and Side by Side.  She had never successfully chosen a song before, since her verbal skills are so compromised, but I always try.  That day she said something to the effect of, “I would like to sing… I Left…San Francisco.”  Clear as a bell.  It made my day.  Before then, and since, she has also sung AND spoken “Hello” as we’re greeting each other in the group (and with very little prompting). The activities director’s face takes on a emotional quality every time this happens – I know that there are few times that D’s real speaking voice has been heard, but it’s there, and I feel so lucky to be a part of those moments.

Music is so powerful, and those moments of amazement are what keep me doing this work day after day.  I hope that no matter how emotionally draining being a music therapist can be, we all take some time once or twice a week to be amazed at what we are able to bring out of people and accomplish using an art that we love.

Learning to Fly

September 16, 2012

I apologize in advance that there are a few capitalized phrases.  Rest, assured that I am not yelling at you.

Hi there!  You MUST be wondering where I have been.  For a moment, I was trying to reach a crazy goal: Write 100 blog posts by Labor Day.  I never actually thought it was possible, and now I’m happy to announce that I have…REALISTIC EXPECTATIONS.  I did not meet my goal.  Oh well.

What I have been doing is A LOT OF LEARNING.

A few months ago, I was approached by a colleague about taking on an intern. I am never one to turn down opportunities, and I have enjoyed supervising students for several years, so I said “sure!?” not knowing exactly where, when, or how this was all going to happen.  A couple of weeks later, the same colleague called me and asked if I could take another intern?  Sure! Why not.  I asked my problem-solver unit manager at the geri-psych unit how she would feel about interns, and after the enthusiastic response, I had a better idea of what I was in for.  This woman is a huge advocate of MT and is the reason I have most of the jobs I have.  She has also been trying, for some time, to find a way to provide music therapy, hospital-wide.  This was it.

So here I was a few months ago, ignorantly blissful and assuming this was not going to be hard.  I was wrong.  This is hard.

Here is what I’ve learned:

1. Bureaucracies are very difficult to work with.

2. These things take a lot of time (but if you have a person on your side who gets things done, it is a little speedier).

3.  In order to do an internship in a hospital, one needs to get immunizations, have contracts signed, do orientation, do criminal record checks, have liability insurance, have contracts signed, do orientation, have contracts signed…Have I mentioned that contracts are somewhat important?

4. The internship director (me) has to do a lot of preparation to make everything happen.

5. Funding doesn’t grow on trees, but if you can get paid to supervise somehow, it’s better.  if not, you adjust what you had planned.

6. Relinquishing some control is very important, though not easy.

7. Sometimes plans change – go with it.  And don’t cry.

8. In my case, applying to have a National Roster internship (and getting approved) will make things a lot easier next time.

9.  Asking for help is okay.

10. Being organized is key.

I will be applying for National Roster status shortly, and I was happy to notice that I meet the criteria! In the meantime, my interns start tomorrow, and I am thrilled to be starting this program!!

Wish us luck!

About a month ago, I found out that a place I used to work at, one that I left at the end of January which caused my schedule to change significantly (for good), and which I have talked about many times in this blog, is closing.

The girl who took my place there, L,  called me the day she found out, and the following week I paid a visit to the residents there to whom I promised I’d come back, and simultaneously participated in their music therapy session.

Before I went back though, I had several thoughts.  I thought about L – how she had just taken that position at the end of January and how now she’s losing her job.  Subsequently, I had a selfish thought about how lucky I was that I left when I did, and now don’t have to deal with some of the issues she is currently dealing with.  Of course I thought about the staff and how they may have a hard time finding another job, but most of all, I thought about the residents.  Where are they going to go?  How are they feeling about all of this?  Are they going to be able to keep in touch with the friends they’ve made there?

So…during the group I visited, the new MT asked if anyone wanted to talk about the news they had received.  The residents started out by saying cooly, “What are you gonna do?” “There’s nothing to say,” and “It is what it is,” among other very vague and apathetic-sounding answers, but as the hour wore on, more information came out.  Some became tearful and talked about how “I thought I’d live out my days here,” “we are losing our home,” and “we have nowhere else to go,” and talked about how their families (or lack thereof) can’t care for them at home, so they’ll have to go somewhere else, and how scary it is not knowing where or when that will be.

How terrible it must be, having literally no control in the matter. When a natural disaster occurs – a fire, an earthquake, a flood – I wonder the same thing.  There’s something about the lack of control in all of this that must take a lot out of a person.

The group ended up being a good forum for people to discuss their feelings and I can only hope that they didn’t stop there.  I hope they found solace outside of the group in talking to others about it and commiserating on their uncertain futures.  I hope they were able to keep in touch.  I just hope that it doesn’t kill them in their such fragile conditions.  Or maybe (for those who are emotionally ready to die) I hope the change does something to make whatever end someone might be experiencing more quick and less physically painful.  I’m sure it won’t take away the tasking emotional pain – in fact, it may make it worse, though I hope not.  I have probably too much hope, because I can’t bear to think about one hundred miserable elderly people who have to move AGAIN in the last years of their lives into a new place with strangers and an unfamiliar set of norms.

When I talked to the MT who took my position the other day, she told me there were 34 residents left in the 120+ bed facility.  I can’t even imagine what it must be like to go there right now.  It must feel like a ghost town.

I wonder…when someone’s home is gone, what do they do?

I discuss the idea of  “home” a lot in my sessions and what it means to individuals.  It can mean a country, it can mean a city or state, it can mean a specific house one once lived in, it can be where someone currently lives, and it can be a feeling you get when love and comfort is surrounding you.  The residents at this facility that is closing will have a new home, but I wonder how long it will take for it to feel like home.  It doesn’t happen overnight, and these elders don’t have a lot of time.

I’m going back to visit this coming week, one last time.  I wonder if the reality of it all will be palpable.  I’m sure I’ll get a lot of answers that I didn’t have the last time, and I’m sure there will be more questions.  Here are two more:

In a society that depends on elder housing and relies on space in skilled nursing facilities, how can we avoid this kind of thing from happening all over?

Building codes change and inspection criteria gets more nitpicky, but people still need a home.  Without a home, who are we?

I heard a story recently.  Here it is, more or less:

My friend (let’s call her Bianca) has been seeing a therapist for a while now, maybe a year or so, and as far as I know has been having a rewarding experience.  The therapist is a little out there, from what my friend says, and sometimes will go into side stories about herself and her somewhat dysfunctional family.  Questionable boundaries, it seems…

A couple of weeks ago I was having dinner with Bianca and another friend and Bianca mentioned that she is having some issues with her therapist.  She told us that Dr. X, without asking, had given her e-mail address to another patient who is also a musician. Right after a session, Dr. X  informed Bianca of this and told her that she was going to receive an e-mail from this other patient, giving Bianca very little time to figure out an appropriate response before having to leave.

It bothered my friend substantially.  She eventually did receive an e-mail from the other patient, who was harmless, and over the next couple of weeks, she worked up the courage to confront her therapist.

This past week, she did.  She told her how it made her feel, and how she felt her privacy was violated.  Dr. X apologized, but then explained that many other her patients network with one another, and if Bianca had a problem with that she should have said something earlier.  Bianca was in disbelief.  She reminded her therapist that she was not asked about the e-mail situation – she was told, presumably after Dr. X had already given the other patient her e-mail address (which includes her full first and last name – hello HIPAA!?!?).

This went on and on during their session, and as far as I know, Dr. X just. did. not. get. it.  Things really weren’t resolved – at least for Bianca.  Dr. X did not give her an opportunity to express her concern about their relationship, and instead tried to move on from the conversation with her non-apology, not taking appropriate responsibility for her lack of judgment and nonexistent patient confidentiality policy.

This woman has been practicing for over 20 years and used that as an excuse in justifying her behavior.

I am so disturbed by this story.  I asked my friend if I could write a post about it, because I think it’s important for us to remember what the rules are, and that there are professionals among us who probably needed to take a refresher course somewhere along the line.  We are not to share our clients names. How hard is that to remember?  And that’s obviously just one piece of the puzzle.  It may have even been inappropriate for Dr. X to ask Bianca if she could pass her e-mail address along to another patient of hers – therapy is not an opportunity for networking – but she didn’t even do that!

What are the requirements to remain a practicing counselor?  Does a therapist have to take professional development courses or periodic ethics exams?  Should they?  It seems like we, as music therapists, have to do an awful lot in order to remain certified.  Because of the courses I’ve taken and feedback I’ve received, I have been constantly reminded of what my standards of practice should be, and while sometimes there are questions, I ask them before anything goes awry.

I told my friend that if her therapist, in response to confrontation about the matter, had said, “Oh my god.  I am SO sorry.  I don’t know what I was thinking – It will never happen again,” then things might be different.  We all make mistakes.  We are all human.  BUT, she didn’t.  She had the prideful arrogance to turn the problem back on my friend, as if it was Bianca’s responsibility to keep her therapist in check.

My conclusion, is that we need to actually read the HIPAA guidelines we sign.  We need to read and live by the standards of practice and the code of ethics. Not very interesting, I must admit, but I know I really wouldn’t want to be responsible for one of my patients feeling violated and unsafe.

Doesn’t that defeat the purpose of therapy?

There is a super catchy pop song that has been running circles in my brain for the past two months.  I’ll give you one guess…

You guessed it.

So I watched all of the different iterations, learned the words to the first verse and the chorus, figured it out (functionally) on the guitar, and it’s still stuck in my head.  Every time someone says, “that’s crazy!” or something of the like, I start singing or humming the song.  I always thought that if you overplayed something, or learned the words, the song would become unstuck from your head (clearly not the case here) which got me thinking…

What happens in our brains to produce a tune in our heads?  What keeps the tune there?

I have a client who sings the same phrase over and over again, sometimes regardless of other music being played, and always regardless of anything else going on.  A staff member at this facility told me that this client, B. has not stopped singing this phrase for three months.  Holy Moses.  Why is this happening?  It’s not an identifiable song, and she has advanced dementia.  For some reason, this phrase just keeps going on and on like a broken record.  Hi-| Ho-Oh-Hi | Ho-Oh-Hi | Ho… in 3/4 starting with the first “Ho” as the down beat.  The melody is simple and not rhythmically consistent. We have all come to the conclusion that she is not singing “Hi-Ho” from Snow White, but it may have started as that song once upon a time.

I had another client, years ago, who would always hum “Rudolph the Red-Nosed Reindeer” despite it usually not being Christmastime.  That was her go-to song for some reason, and I always wondered why that was the one that popped into her mind when so much else was gone.

Anyway, I was wondering why songs get stuck in our heads, and a whole lot of very obvious information cropped up when I Googled.

I would try to recreate the information I read, but I think it’s easier for us all if I just link to an article that seems valid.

One of the worst parts of this phenomenon, is that sometimes a song gets stuck in our heads that we don’t even like!  Occasionally, for me, this becomes a sign that I secretly do like the song, and eventually I have to make my peace with that (the song “Stronger” by Britney Spears – early 2000’s – comes to mind).  Another frustrating part is when you want to hum the melody to a song – take, for example, Gotye’s “Somebody that I Used To Know” – but the melody is unpredictable at times and hard to remember.  Then, you’re singing this song that you don’t really know, but can’t get out of your head.  AHHHHHHH!!!

Anyway, all of this got me thinking about something further.  I wonder if we get more annoyed that a song is in our heads if we are simultaneously worried about annoying others with our constant melodies.  I sing all day, so having an “earworm” is a regular part of my day (many of you are probably dealing with this as well), and I’m not usually annoyed that its there unless someone else is around.  Ahh, projection.

My conclusion is that we can’t fight the earworm, and if you can’t beat ’em…