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How Music-Inspired Weeping Can Help Terminally Ill Patients

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Abstract

Music’s power to improve the ‘human condition’ has been acknowledged since ancient times. Something as counter-intuitive as weeping in response to music can ameliorate suffering for a time even for terminally ill patients. Several benefits—including catharsis, communication, and experiencing vitality—can be associated with grieving in response to “sad” music. In addressing the potential rewards of such an activity for terminally ill patients, this author combines concepts from philosopher Jerrold R. Levinson’s article, entitled “Music and Negative Emotion,” an illustration from a major motion picture, and supporting research from medical reports and aesthetic writings. Carefully offering this experience is recommended for patients who retain the capacity to express preference.

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Notes

  1. “Hospice care: Comforting the Terminally Ill,” MayoClinic.com, www.mayoclinic.com/health/cencer/HQ00860 (accessed 17 March 2011).

  2. “End of life: Caring for Your Dying Loved One,” MayoClinic.com, www.mayoclinic.com/health/cancer/CA00048 (accessed 17 March 2011).

  3. T. Morita, T. Ichiki, J. Tsunoda, S. Inoue, and S. Chihara, “A prospective study on the dying process in terminally ill cancer patients,” American Journal of Palliative Hospice Care 15, no. 4 (1998): 217–22. These hospice physicians found that “the mean (median) time from the onset of death rattle [and death]. . . was 57 (+ or—23, SD) hours.”

  4. K. Norton is a musicologist in the School of Music at Arizona State University who has specialized in hymnody and aesthetics and began working on medical humanities in 1996.

  5. L. Freeman et al., “Music thanatology: prescriptive harp music as palliative care for the dying patient,” American Journal of Hospice & Palliative Care 23 (2006): 100–4. Music therapy is “the systematic use of music by a trained professional to achieve individual therapeutic goals for a wide variety of clients.” B. Crowe, Music and Soulmaking: Toward a New Theory of Music Therapy. (Lanham, MD: Scarecrow Press, 2004), xxi.

  6. R.E. Hilliard, “The Effects of Music Therapy on the Quality and Length of Life of People Diagnosed with Terminal Cancer,” Journal of Music Therapy 40, no. 2 (2003): 113–137. Quality of life was measured by the Hospice Quality of Life Index-Revised.

  7. R.E. Hilliard, “Music Therapy in Hospice and Palliative Care: a Review of the Empirical Data,” Evidence-based Complimentary and Alternative Medicine 2, no. 2 (2005): 173–78. The six studies include: V. Longfield, “The effects of music therapy on pain and mood in hospice patients” (MS thesis, Saint Louis University School of Nursing, 1995); L.M. Gallagher and A.L. Steele, “Developing and using a computerized database for music therapy in palliative care,” Journal of Palliative Care 17 (2001): 147–54; R.E. Krout, “The effects of single-session music therapy interventions on the observed and self-reported levels of pain control, physical comfort, and relaxation of hospice patients,” American Journal of Hospice and Palliative Medicine 18 (2001): 383–90; N.M. Wlodarczyk, “The effect of music therapy on the spirituality of persons in an in-patient hospice unit as measured by self-report,” MM Thesis, Florida State University School of Music, 2004; R.E. Hilliard, “ The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer,” Journal of Music Therapy 40 (2003): 113–37; and R.E. Hilliard, “A post-hoc analysis of music therapy services for residents in nursing homes receiving hospice care,” Journal of Music Therapy 41, no. 1 (2004): 266–81.

  8. C. Conrad, H. Niess, K.-W. Jauch, C.J. Bruns, et al., “Overture for growth hormone: requiem for interleukin-6?” Critical Care Medicine 35, no. 12 (December 2007): 2709–13.

  9. J. Escher, U. Höhmann, L. Anthenien, E. Dayer, et al., “Music during gastroscopy,” Schweizerische medizinische Wochenschrift [Swiss Medical Weekly Review] 123, no. 26 (July 1993): 1354–8. Abstracted in English, PMID: 8393585.

  10. U. Nilsson, “The Anxiety- and Pain-Reducing Effects of Music Interventions: A Systematic Review,” AORN Journal 87, no. 4 (April 2008): 780–807.

  11. L.A. Mitchell, R.A.R. MacDonald, and E.E. Brodie, “A comparison of the effects of preferred music, arithmetic, and humour on cold pressor pain,” European Journal of Pain 10, no. 4 (2006), quoted in Nilsson, 805.

  12. J. Escher, “Die Bedeutung von Musik in der modernen Medizin” [Significance of music in modern medicine] Praxis 87, nos. 31–32 (5 August 1998): 987–96. German. Trans. S.M. Feisst, PhD.

  13. R. Spintge and R. Droh, “Musikmedizin, Physiologische Grundlagen und praktische Anwendungen” [Music medicine, physiological bases and practical applications] (Stuttgart: G Fischer, 1992), quoted in Escher 1994, 989.

  14. L. Chlan and M.F. Tracy, “Music therapy in critical care: indications and guidelines for intervention,” Critical Care Nurse 19, 3 (June 1999): 35–41.

  15. Scene 33, “The general thinking out there,” Philadelphia, (book by R. Nyswaner), videocassette, directed by J. Demme (1993; Culver City, CA: TriStar/Sony Pictures). Featuring T. Hanks (Andrew) and D. Washington (Joe).

  16. U. Giordano and L. Illica, “La mamma morta.” Act III, Andrea Chénier, 1896. Recording M. Callas, soprano; A. Votto, conductor; live performance, La Scala, Milan, 8 January 1955. Reissued EMI Classics, 2002.

  17. R. Glaubitz, Aria-database.com, “La momma morta,” C. Bardera, translation. http://www.aria-database.com/translations/chenier07_mamma.txt (16 March 2011).

  18. J. Levinson, “Music and negative emotion,” in J. Robinson, ed. Music and Meaning (Ithaca: Cornell University Press, 1997), 226, n23. The present author has re-numbered Levinson’s rewards for her purpose.

  19. Levinson, 230.

  20. Aristotle, A Treatise on Government, Politics, trans. by W Ellis (London: J M Dent & Sons, 1912, repr. The Project Gutenberg EBook of Politics by Aristotle, prod. by E. Eldred http://www.gutenberg.org/etext/6762), (accessed 17 March 2011).

  21. R.R. Cornelius, “Toward a New Understanding of Weeping and Catharsis?” in A.J.J.M. Vingerhoets, F. van Bussel, and J. Boelhouwer, eds. The (non) expression of emotions in health and disease (Conference Publication) (Tilburg: Tilburg Univ. Press, 1997): 303–22.

  22. Ibid., Tables 26.1 and 26.2, respectively, 305–6.

  23. Ibid., 313.

  24. Ibid., 315.

  25. Ibid., emphasis mine.

  26. L.M. Bylsma, A.J.J.M. Vingerhoets, and J. Rottenberg, “When is Crying Cathartic: An International Study,” Journal of Social and Clinical Psychology 27, no 10 (December 2008): 1165–87.

  27. Cornelius, 307.

  28. B. Bub, “The patient’s lament: hidden key to effective communication: how to recognise and transform,” Medical Humanities Online 30 (2004): 63–69. www.mh.bmjjournals.com (accessed 17 March 2011). Emphasis mine.

  29. Ibid., 64, emphasis in original.

  30. Ibid., 65.

  31. Levinson, 231.

  32. N. Goodman, Languages of Art (Indianapolis: Bobbs-Merrill, 1968), 250.

  33. L. Kramer, Musical Meaning: Toward a Critical History (Berkeley: University of California Press, 2002), 3, 4.

  34. A. Spathis and S. Booth, “End of life care in chronic obstructive pulmonary disease: In search of a good death,” International Journal of Chronic Obstructive Pulmonary Disease 3, no. 1 (2008): 11–29, and D. Fitzsimons et al., “The challenge of patients' unmet palliative care needs in the final stages of chronic illness,” Palliative Medicine 21, no. 4 (June 2007): 313–22.

  35. L. Sand, M. Olsson, and P. Strang, “Coping strategies in the presence of one's own impending death from cancer,” Journal of Pain and Symptom Management 37, no. 1 (January 2009): 13–22.

  36. S. L. Mansoa et al., “[Communication as the cornerstone of the care of patients with advanced cancer. Starting points for improving our communication skills],” Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria [Primary Care: Spanish Society of Family and Community Medicine] 1, no. 38 (November 2006): Suppl 2:7–13. Abstracted in English. PMID: 17286931.

  37. Levinson, 235.

  38. D.R. Frampton, “Restoring creativity to the dying patient,” British Medical Journal Papers and Reports 293 (20–27 December 1986): 1593–95.

  39. J. Panksepp and G. Bernatzky, “Emotional sounds and the brain: The neuro-affective foundations of musical appreciation,” Behavioural Processes 60 (2002): 133–155.

  40. Kramer, 15.

  41. I. Stravinsky, “Some Ideas about my Octuor,” repr. in E.W. White, Stravinsky: The composer and his works, 2d ed. (London: Faber, 1979), 574–7.

  42. V. Frankl, Man’s search for meaning (Boston: Beacon Press, 1946; repr. New York: Washington Square, 1985), 95; Spinoza, Ethica Ordine Geometrico Demonstrata, 1677.

  43. Quoted in Frampton, 1595.

  44. Frampton, 1593.

  45. J. Levinson, message to author, 10 June 2005.

  46. Quoted in Frampton, 1595.

  47. D. Turk and C.S. Feldman, “Noninvasive approaches to pain management in the terminally ill: The Contribution of Psychological Variables,” in Turk and Feldman, eds., Noninvasive approaches to pain management in the terminally ill (Binghamton, NY: Haworth Press, 1992).

  48. Ibid., 1.

  49. Ibid., 18.

  50. Organizations such as the American Music Therapy Association (www.musictherapy.org, accessed 17 March 2011) or the British Society for Music Therapy (www.bsmt.org, accessed 17 March 2011) may be consulted for advice.

  51. Kramer, 5.

  52. M. Nandan, “Cross-cultural perspectives in thanatology: Through a prism of religious faiths,” Gerontology & Geriatrics Education 26 (2005): 43–56. See also M.T. Halstead and S.T. Roscoe, “Restoring the spirit at the end of life: music as an intervention for oncology nurses,” Clinical Journal of Oncology Nursing 6 (2002):1092–1095.

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  1. School of Music, Arizona State University, Box 870405, Tempe, AZ, 85287–0405, USA

    Kay Norton

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Norton, K. How Music-Inspired Weeping Can Help Terminally Ill Patients. J Med Humanit 32, 231–243 (2011). https://doi.org/10.1007/s10912-011-9140-x

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