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So you're getting married or you have a friend, a cousin, a sister, somebody you know who's getting married.

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Hello, Bonjour and moi gwan, everyone.

Thank you for listening to another episode of the DNA airwaves.

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Please check them out before your next event online@thednaproject.ca Our guest today is Sarah Rose Black.

Now for those of you that have been around since the beginning, which is probably not many of you, she was on episode 17 and she was one of the founders and coordinators of the first music therapy program at the Princess Margaret Cancer center in Kensington Hospice in Toronto.

On that episode we kind of dived into the use of music and the therapeutic relationship that it has to promote health and well being.

So we wanted to have Sarah Rose come back on the show and chat with us a little bit more about the program and how far it's come since we spoke with her a year ago.

Any updates that she might want to share with us and our audience and see what's going on for the program in the future.

Another great chat about a really cool application of music and we hope you guys enjoy it.

This is the DNA airwaves.

Hey, we're rolling.

Well, that's good.

Oh, I know.

Hold on.

Can you say something again?

I'm saying things.

Words are coming out of my mouth.

Let the words of my mouth and the meditation of my heart.

All right.

Be acceptable in thy sight.

Yeah, your volume's good.

Okay.

Sarah, Hello.

Welcome back.

Thank you for inviting me back.

Thank you for coming.

It was.

It was great that we were able to catch up after, I think it's been over a year now.

Yes.

Sorry.

Real quick, gentlemen.

I always neglect you as well.

How are you guys doing today?

Feeling neglected.

Feeling neglected.

I hear you, buddy.

Yeah.

I don't want to just hijack the beginning, but we are excited to have Sarah Black with us.

Sarah Rose Black.

I'm sorry.

I get weirded out with the hyphenations because I never know if it's Sarah Rose or Sarah Rose Black or Sarah Black.

I'll answer to any of it.

There's no hyphen, is there?

There's no hyphen.

It's just one word.

Rose Black.

My parents got creative.

Sarah Rose.

One word and then Black.

My last name.

That makes it easier, right?

That does make it easier.

Damn.

Yeah.

So actually, the last time you were here, we had a lot of interest, and still to this day, people are talking about the music therapy episode that we did.

So we're back for round two and for those new listeners, because we have a lot of those.

Since there are a lot of you since the last time we chatted, can you just kind of give an overview of what music therapy is?

Maybe we'll start there.

It's always my favorite question to answer, so happy to dive in with that.

Music therapy is the intentional and clinical use of music in a setting to achieve goals that are related to health.

So the big difference between performative music and entertainment is that a music therapist walks in with an agenda to create some kind of support for a person, and that can be someone in a healthcare system.

So I work in a hospital, so I use music intentionally to do things like reduce anxiety and shift mood and improve pain management and create space for end of life work and trauma work.

So another music therapist might do something around rehabilitation or working with kids or working with the elderly.

But we're always going in with goals in mind, which we create with the people we work with.

But we also come with ideas on how to optimize wellness and health.

And what does that typically look like when you say optimizing health for.

For someone?

And I might be wrong, but you said near the end of life, how does wellness cause.

To me, that's kind of like an oxymoron.

But how would you prepare for wellness in that type of environment?

I guess this is such a good question.

It does feel like an oxymoron when you talk about wellness and quality of life when someone is dying.

But what I go in and observe is how well is this person's pain managed, how comfortable are they right now?

What's going on with their family in the room?

I create space for them to grieve, to be together, to share, to share silence, to share stories.

And how can I create optimal comfort for somebody at end of life?

So that can be, like I said, pain management, but that can also be surrounding them with memories that are dear to their hearts.

So if you're lying there listening to songs that are reflective of something important in your life, that can be wellness in a time of physical decline.

That makes sense.

And how long have you been doing this?

I started my training in 2012 and I started working nine, almost 10 years ago.

Is that right?

Nope.

I take it back.

I started training before then because I've been working at Princess Margaret almost 10 years.

I walked into Princess Margaret in 2012.

That's right.

Sorry, anyone, feel free to jump in?

No, no, we're just watching here.

Since the last time we spoke.

Can you may maybe just tell us some of the updates that you've been able to or some of the accomplishments or achievements that you've been able to achieve since we've spoken last.

Yeah, sure.

Thanks for that question and I'm grateful for the DNA project support.

It's always nice to be able to be asked about the work and share the work more broadly because it does happen in a bit of a vacuum when I'm in the hospital or at the bedside.

So since we last spoke, I became the editor of the Canadian Journal of Music Therapy.

So that's been really lovely to get to curate Canadian music therapy research and work with authors to publish it.

That's huge.

A lot of young authors too, which is great.

I've had three wonderful music therapy graduate students train with me over the course of four months, and the program continues to grow.

But one of the most exciting things, which I can't wait to share, is I have been able to start using a digital stethoscope.

And that's thanks to you, your amazing support.

I couldn't have done it without you.

So awesome.

Our pleasure.

I've been able to record patient heartbeats and use them within songs that I'VE written with patients, and that's been really special.

That's incredible.

Yeah, I love it.

Digital stethoscope.

Yeah.

What is.

How does that work?

So it goes into a USB recorder, and that kind of leads me to the next question, just about technique.

What kind of things do you do?

And what motivates different techniques.

This is such a great question, too.

So I'll take a step back.

If you can picture I walk around with the hospital in the hospital with a keyboard on wheels, on a cart, and I carry different instruments with me.

And those include auxiliary percussions, so small drums, an ocean drum that sounds like waves.

I use singing bowls to create resonance sounds.

I might have a ukulele.

I might have a guitar.

But mostly I use the keyboard and my voice.

So it's 95% live music in the room with the patient.

And in terms of specific techniques, it depends on what the patient needs.

So if someone's telling me, look, I'm exhausted.

I didn't sleep last night.

Can you help me?

Just rest.

So I might do something receptive where I'm playing based on their requests and their falling asleep, closing their eyes.

I might do a guided meditation with live music.

I might be asked to play the same song over and over again, because it's what they need in that moment, because it's comforting.

But alternatively, if someone is a little more wakeful and wanting to engage a bit more, they may actually play music with me or sing with me.

And it's nice to be able to hand them an instrument that is light and easy to use, for sure.

And I do a lot of songwriting, so that's where the stethoscope comes in.

So it doesn't matter if someone has never touched an instrument in their life.

I will see anyone at any stage.

The exciting thing is you don't need any musical experience to take part in music therapy.

Human beings are inherently musical, I like to say, by virtue of the fact that we have a heartbeat and we have rhythms coursing through our body all the time from birth to death.

So some colleagues in the States and around the world have been doing great work with recording patient heartbeats.

So I literally will go in and record it, and then I will use that recording, which Bluetooths to my phone.

It's just a direct Bluetooth, so it's super easy.

And I will embed their heartbeat over a song that we've written together, and that often becomes a gift to the family if someone's at end of life.

But even if someone just wants to Create something for self expression, for sure.

And how is, how long is the process that you have to create the song with the patient?

So for some patients, time is of the essence if they're declining and doing really, really kind of struggling with their health.

So it can happen in as short as a 20 to 30 minute session.

It can happen over a period of several weeks if that's what the patient prefers to really take their time and invest in creating the lyrics and creating song structure with me.

But I remember a patient years ago, she was very excited about writing a song and she said, come back tomorrow.

And I went back, but she had declined so much overnight, she could barely speak to me.

And I said, I'm back.

How can I be helpful?

And she said, I have three words.

Love, hope and peace.

Yeah.

And that was pretty much all she could give me.

And I said, do you want me to take those words and create something with them?

So I just used those three words with my voice on a loop with some piano music in the background, and that became her song that she gave to her grandchildren and kind of improvised on that.

Beautiful.

Really, really beautiful.

That's a really good gift to give someone.

Yeah.

Especially at that stage.

Yeah, I'm struggling.

Yeah.

It's an interesting conversation for today because Sarah Rose, I lost my grandmother on Monday this week, so I'm trying to keep it together here.

But thank you for sharing that.

I'm so sorry for your thought.

It was going to be a little easier, but we're talking about a lot of end of life stuff and I'm like, holy.

But given the work that you do, I imagine there would have been a lot of challenges bringing this type of treatment to hospitals.

Because just for people in that position, families especially, I know just to get the right type of care that individuals need is a challenge on its own.

So I'm wondering how you were able to overcome obstacles and probably have to convince people that what you do actually works.

Was there science that you had to go with that, or is it something that you have been able to prove just through practice?

Such an interesting question and thank you for sharing such a personal example of what you've been through and bringing that in.

People are often skeptical when I'm walking around the hospital with musical instruments or they make comments around, you know, where's the concert, where's the party?

And it's so the opposite of a party.

Sometimes, right.

When I'm with people, it's so serious.

But not always.

Sometimes it's very lighthearted and, you know, a Person asked me for Janis Joplin yesterday, and all she wanted to do was rock out to Janis Joplin.

It can be.

It can be light.

Yeah, for sure.

But, yes, there has to be an evidence base.

And luckily, there's a lot of wonderful research in our field.

I feel privileged to have been able to take part in research.

So there's that component that we get to do very intentional research around the role of music and examine what happens to people when they're listening to music, both from a very quantitative perspective, what's happening to their heart rate, what's happening to their brain, and a qualitative perspective.

What's their experience?

What are they feeling and processing?

So those two pieces are helpful, but I find what is the most convincing is when a nurse or a doctor is in the room with me and they see it, they're watching it, and suddenly they find themselves a bit tearful or they find themselves singing along.

So the stories I tell and then the experiences that I share with my colleagues speaks volumes more than the research.

Absolutely.

What kind of research do you do?

So, a few different types.

I'm very much a qualitative girl.

I'm very interested in people's experiences.

And through my PhD work, I looked at the experience of music therapy while someone was having an assisted death, which has become legal in Canada over the past six years.

You can choose to have a medically assisted death.

I didn't know that.

Mm.

And what I found were a lot of my patients were asking me to be with them during their assisted death, and I thought, why?

Why do they want music?

Yeah.

So that became incentive for my questions.

So I had 10 incredible people willing to participate in research, plus their family members.

I recorded all of our sessions, and I pulled out the themes from those sessions.

What's.

What's going on in their experience and what's the same session to session and person to person.

Yeah.

So I wrote that up as a study, but on a different note.

I'm really interested in the experience of young adults with cancer using music to process their experience.

So I have a research project going where we run groups with young adults and they engage in music therapy, they improvise, they play drums with us, they write songs with us, and then we look at how they feel connected to the people in the group with them.

Do they feel more engaged?

Do they feel more supported?

Things like that?

Are there any brain scans or any.

That sort of thing?

Have you done that?

So, I haven't personally, but I have colleagues at, for example, different facilities who look at.

Yes.

Neuroimaging brain scans, measuring things.

Very specific.

A lot happens with the elderly, with older adults with dementia.

And you see the brain light up in all of these different places.

Right.

Not my area of expertise, but there's a lot of great stuff out there.

Okay.

During those.

When.

When somebody asks you or wants you to be there in their final moments, what is that experience like for you?

Is it taxing?

Is it something that sometimes you're like, I can't do this this week anymore.

I need a break.

How does that feel?

Or is it something that's just, you know, part of the job and.

And you've learned to get used to it?

Thanks for asking that.

It depends on the week.

And yes, it's challenging at times, sometimes more than others.

It depends on what's going on in my personal life too.

But there's a lot of things that we put into place as therapists so we can show up the next day and the next day.

And that includes things like personal therapy.

That includes supervision.

So I have colleagues and people senior to me who I can talk to, who I do talk to regularly.

I do a lot of peer to peer support.

So I can call my music therapy friends and say, oh, my God, this happened.

Can I just talk it through?

Because it was really hard and I have to learn how to take breaks and not just go room to room to room and pause in between and acknowledge if I'm having a hard day, but also acknowledge that when I'm in the room, that person's experience is not my experience, that's not a family member of mine.

And I have to kind of separate myself a little bit.

But I tell my students it's okay to cry in the room.

That's very empathic.

If a family sees you connecting and becoming emotional, that's normal, for sure.

Do you ever get compassion fatigue?

Absolutely.

Absolutely.

I don't really know anyone who doesn't within my group of colleagues.

How do you deal with that?

And I guess there's another part of my question is for some people, like myself, music is kind of my thing, therapy.

But if you're doing musical therapy all the time, do you have any personal musical therapy time for yourself, or do you just see it as like, that's work now, and you don't really do the music as like a hobby or a way to kind of escape the stress of work?

Do you know what I mean?

Yes, absolutely.

That's so intuitive that you ask that.

Because I've struggled with that, for sure.

You know, my husband's a musician, too, and people often say, do you guys play together all the time?

And, you know, because it's work for both of us.

We don't as much these days.

We have a ton in the past, but I have to separate music for work and music for fun.

And there are days when, no, I don't want to play music for myself, and there are days when I need to play music for myself or sing.

So, yes, compassion fatigue is so real.

I love doing things that are totally not related to my job, like running, biking, being outside, reading, writing, just separating, but also leaning right in.

And I've done songwriting for myself about my patients that I just keep very personal because I need to express for sure how much they've impacted me.

It's a balance.

How important is the exercise element?

Because I find anytime I personally am in a weird headspace or feeling emotional, that exercise or getting outside is vital.

Like, I don't know what it is.

I have no scientific data to back it up.

But I feel better every time I go on for a bike ride or go for run.

And I can think and, like, there's clarity and, I don't know, there's a bunch.

So is exercise vital, do you think, for your.

Not therapy, but for your release?

And would you probably share with others that that's probably number one or two in life as far as, like, anyone.

Because it's not just in your field.

Like, everybody gets stressed.

And I think for me, just running and exercise is just so important.

And I was wondering if you feel the same way, like, after a run or after you do that exercise, do you feel like, okay, I can get through this.

You said it so well.

Just you articulated it all.

Yes, yes.

And yes.

I encourage.

I mean, it's such a big deal in my life to find movement and exercise, but I encourage my trainees and my peers, you know, go out for a walk.

Have you stretched today?

Have you moved?

Because we carry experiences in our bodies.

So when I'm at the bedside and someone's head having a very visceral experience of pain, we're in it with them.

We don't experience it, but we watch it.

We witness and that we can hold that in our bodies.

Absolutely.

So to your point, I make it a very regular practice to move.

The way that I actually get into work every day is mostly running.

So I'm a run commuter or I'm a biker to work and back.

And that has made all of the difference to start my day that way and then end my day that way.

I could imagine getting that out before you get in the door must be so important.

That's awesome.

So I've been talking, too.

No, these are great questions.

So I thought I asked you a little bit about the resistance, possibly from the hospital.

What about families, though?

Do you ever get any resistance from families when patients may have heard of you or seen your work and request you, and then you have to deal with others who maybe don't believe.

Absolutely.

It's incredible how resistant people can be.

And often it can come from a place of unknowing or maybe a little bit of fear and a little bit of wanting to protect their loved ones.

So families are often like, no, it's too much.

It's too emotional.

She doesn't need that.

He doesn't need that.

We have our own music.

We're playing music on a recording.

I always encourage that, and I never push it.

But also, at such a tender time, sometimes it's tricky to even get into the room.

And I never want to force that.

Sometimes it's helpful if another staff member introduces me like a doctor or a nurse, and introduces the fact that I'm in there with a specific purpose.

Right.

Just to follow up on that, too, because in, I guess, introducing it to families or patients even.

Is the therapy based on more of just helping people feel better during that stage, or is there any aspect of, I guess, recovery or rehab involved through music?

Both, I would say.

I do very specific things that are physical, like heartbeat regulation or regulating someone's breathing through music or.

But if someone is on the road to recovery post chemotherapy, maybe they're what we would call deconditioned.

They haven't been moving as much.

Sometimes they want some motivation to kind of get out of bed and move their arms and move their bodies.

And I might use music to motivate that, because often our motor cortex in our brain is activated when we listen to music at a certain tempo.

And what's neat is people, as you can imagine, feel motivated to move.

If you think about yourself exercising or yourself even dancing, it's way easier with good music.

The same principle.

So, yes, rehabilitation can be a big part of what my role is.

And that's also why a lot of dance music and electronic music in general is almost always 120 beats per minute.

Because that's twice the resting heart rate.

Exactly.

And why I often tune in at 60 beats per minute when I'm trying to regulate someone's heartbeat.

So, to your point.

Exactly.

Yeah.

Science.

Beautiful science.

Yeah.

And now there's evidence that there are about 40, 000 neurons on the heart itself, which gives the idea that the heart does some thinking as well.

So that idea that, you know, you feel things in your heart, it's not completely just emotional.

There's an actual, possibly scientific reason for that as well.

So it's making more and more sense how using sound and pulses and visuals and any other other senses with rhythm, when you sync that up to what the heart rate is supposed to be, how your brain and your heart might start reacting to that, do you find?

Are there any things you're like, oh, that's a bad chord.

I shouldn't play that again?

Yes, but it often has to do with people's associations or their experiences.

There's no kind of one objective bad sound.

It all depends on what you associated with.

Because I might hear something and think that was the best thing I've ever heard, but you might hear it and say, oh, that was horrible.

So it's very subjective.

I mean, sometimes I just straight up make mistakes and that sucks if I'm trying to play a song that someone knows.

And sometimes people have preferences.

Often they do.

But I find music can be re triggering or re traumatizing if it's associated with a negative event.

And there are extreme examples of that.

Music is used as torture in some settings.

Certainly in war zones.

Absolutely.

So music can also be overstimulating.

If I'm too loud, that can be painful for somebody.

So there's no one objective wrong thing to do.

There are lots of wrong things I could do depending on the person.

And you just kind of figure it out on the go.

Because actually, were you the first program of this nature and was it Ontario or Canada or.

No.

I stand on the shoulders of many, many wonderful people.

But I was the first at Princess Margaret and Kensington Hospital.

Yeah, gotcha.

How widespread is it through Ontario now and Canada?

I guess it's huge.

I'm so excited to say lots of major hospitals in the GTA have beautiful music therapy programs, and those include big teaching hospitals like Sunnybrook.

St. Mike's SickKids has a huge program, and it has had a program for almost two decades, I think.

So I'm certainly not the first, but Princess Margaret didn't have anybody, so I was excited to build something there.

Absolutely.

Now, as someone say I was to get sick or I had a family member sick, how would someone as a patient or a family member of a patient get musical therapy?

Like, I wouldn't even know how to go about it.

In some of the hospitals in my area.

And probably they just look at me like, we got a speaker that you can use.

How do patients in the GTA ask or even like, who would be the best person to ask for that type of service or therapy or option?

If the hospital offers music therapy, chances are it will be advertised somewhere.

Or you ask your, you know, you ask your nurse.

But you're right, most patients don't know.

Even though I try and promote it as much as I can at the hospital, staff are my advocates and allies in that.

But for a place that doesn't have a program, a lot of music therapists work in private practice.

So you can actually hire one as you would a therapist through two different platforms.

And I'm happy to say a lot of music therapy is covered through insurance.

If your therapist is also a psychotherapist, which I am.

A lot of my colleagues are.

So you can actually hire someone to work with you.

And a lot of folks do that for family members or for themselves.

So I'll share.

The Music Therapy association of Ontario.

If you give them a Google, you can find a therapist very easily.

And the Canadian association of Music Therapy, same thing.

That's awesome.

That makes me wonder.

You said you're a.

You're a licensed therapist.

So sort of like with acupuncture and I don't want to make this controversial in other fields.

Crack, crack, crack.

Maybe that'll tell you.

Do you find that there are just charlatans who, you know, buy a sound like a couple of sound baths and like I'm a therapist now and they don't really help people or how do the how's.

How are the qualifications coming into play here?

Yeah, it's a good question.

I'm glad you brought this up.

And we're fighting so hard in our profession to talk about what it means to be credentialed.

So the two credentials you want to look for.

If you're looking for a music therapist, MTA in Canada, music therapist accredited or mtbc Music therapist board Certified.

A hospital won't really hire someone unless they are legit.

So you know that if you're in a healthcare space, chances are you're working with a licensed therapist.

Or if it's covered by insurance, it must be as well.

Right.

I would assume insurance company's not gonna.

Exactly.

So the way that music therapists are covered through insurance is through their registered psychotherapist designation.

So rp.

And that's legit.

That's through the College of Registered Psychotherapists of Ontario, which requires many, many hoops and training to get through.

So yes, there are posers all over the place, people who charge a lot of money for not a lot of training.

And that's tricky for our profession.

But mta, mtbc, rp, those are those credentials you're looking for.

So follow up.

What's the accreditation like?

Do they blindfold you and give you a piano or what do they do?

I should do that with my students.

So you have to have a degree, either an undergraduate, most people, many people rather, have graduate degrees in music therapy from a specific training space.

So Wilfrid Laurier University, Concordia U.

Of T. Kapilan.

A lot of schools in Canada offer designated training.

Tons in the States and around the world.

So first off you have your degree, then you go through your certification, which includes a thousand hour internship.

So I'm proud to be a music therapy supervisor.

I take students through 500 hours.

They're with me for four months if they want to train in cancer care and palliative care.

But people can intern a lot of different places.

So they're with a trained supervisor.

They get their thousand hours.

They have to write an exam.

There's multiple steps, but that's generally what it looks like.

So it takes several years.

Okay.

So also, do you still wear some of the other hats because you were, I guess, musician then teacher, now therapist.

Do you still have opportunities to teach and actually scratch that question.

You can answer that after.

But how did you get there?

Like, how did you go from musician to teacher to therapist?

Ooh, I love that question.

So like many young kids, I was signed up to piano lessons from a young age.

I was a Suzuki piano kid and very proud to be.

And you didn't quit like most, which is the big thing.

I didn't somehow.

I don't know if that was.

Cause I genuinely loved it.

There was part of that or I just knew I had to keep going to a certain point.

But my parents made it really fun, my teachers made it really engaging.

I was excited to perform and so I was also excited to teach.

So I loved having young students.

So I started to dabble in piano teaching, got some certification around that and just kept going.

And it became a real passion of mine to teach.

But as I got further and further into teaching, I realized I was actually more interested in and captivated by my students mental health than I was in their ability to play the piano.

Because they would often come to piano lessons and bring with them a lot of emotion.

Yeah, Especially teens, but even young kids, adults, I mean, people would sometimes sit there and Just cry for so many reasons.

And I've done that in music lessons.

Right, right.

And I thought, why is it in this space that we're doing this?

I started to volunteer at the center for Addiction and Mental Health in the City.

I would play the piano for an hour a week on an inpatient floor, not knowing what the heck I was doing.

I just played stuff I knew, thinking, oh, I'll just do something pleasant.

But, oh, my God, the patients were reacting, coming up to me, singing, crying, telling me their stories, engaging.

And I thought, something is going on here.

I need to know how to harness this.

I need to learn, I need to train.

So that's why I went into music therapy.

Wow, great.

And how long from that moment to St. Margaret's gosh, that.

Several years.

That would have been 2009.

Ish.

And then I started at training in 2011, then started at Princess Margaret, interning the following year as I was working through my training.

I think that's the timeline.

If you weren't doing this, would you still be teaching music, you think?

I think it's very likely.

I love teaching.

I love that I can still teach music therapy now.

I don't teach private piano anymore.

Maybe I'd be performing a little more, but I feel like I get the chance to perform every day at work.

It's just a totally different style and context with different intention.

Yeah, I'd probably be writing and teaching and playing differently.

Do you play a lot at home?

Off and on, yeah.

With friends and, you know, with my family, yes.

Not probably as much as I used to, but I still.

That's still a big part of my life, for sure.

Okay.

Do you recommend music therapy outside of the hospital?

And how would that look for an average person just going about their day?

Yeah.

I'm a firm believer in therapy for everybody.

I think anyone could benefit because, you know, life throws us all kinds of curve balls, and being human is really complicated and beautiful but hard.

So I'm a big advocate for therapy, period.

In terms of your kind of average, everyday person engaging in music therapy.

It's amazing what happens non verbally when suddenly you take away words and you use music.

So I have recommended it to people I know.

People have come to me and said, how do I find a therapist for my family, for me, for my kids?

A lot of people want it for a specific reason, but I think as the profession grows, we're gonna see more and more people integrate the arts into their wellness plans, personally and professionally.

Got you.

What kind of qualities would you tell Someone to look for in a musical therapist.

Ooh, it's such a good question.

Because finding the right fit for a therapist, it's so individual.

Yeah.

And I think some of the best qualities you can look for in any therapist, but absolutely, a music therapist is openness, adaptability, the ability to listen to what your needs are and not come pre scripted with a plan unless that's what you want.

But I like the idea of someone who's really open to what you need.

Someone who's a highly trained musician.

That's important.

And I keep thinking just somebody who listens and really listens well, that's a good one.

It's very necessary to listen.

A lot of people don't listen well.

What else would you say?

People should just know about the work that you do.

Overall.

It almost makes me emotional to think about because I'm so passionate about advocating for the work.

So thank you for that question.

Being musical is being human, and being human is being musical.

It's not just for people who specifically enjoy music or are trained.

It's such an integral part of who we are as human beings.

So it just makes sense to have a music therapist integrated into many healthcare teams across all ages and stages of life, from the time we're born to the time we die.

And it's just an inherent part of being alive.

You know, integrating rhythm, embodying cadence, harmony, dissonance.

It's part of being human.

So we're growing as a profession.

I want people to know.

And my hope and my dream is that music therapy becomes a standard of healthcare.

And it's not a surprise to have a music therapist at a hospital anymore.

That's my dream.

But I think that piece around being human and being musical, that we all carry that, that's what I really want people to take away.

What is the state of music therapy like around the world that, you know of?

My sense is it's far more integrated in the United States.

There are more training programs, there are more therapists working in different settings.

I think it's the organization, the American Music Therapy association is bigger than the Canadian association, but we're growing too.

So it's just.

It's bigger, it's more robust, it's more widespread.

The same would go for Europe.

In Europe, the regulations are different.

And I think again, there's a lot of really robust research happening in Europe.

Same goes for Australia.

It's massive in different parts of the world.

And I think in Canada it's growing fast, but we have some catching up to do too I hope I'm not controversial in saying that, but we have a long way to go, and I'm excited about that.

Any idea about what the rest of the world is like?

Is it more integrated into cultures outside of the Western world, or is it something that you think could help countries like that a bit more as well?

It is actually quite a Western notion to take music and make it clinical.

And if you think about cultures that use music for healing very organically and inherently, it might feel foreign to say, oh, we're gonna have a music therapist come in and guide you.

Cause I've heard people say, well, I use music already.

Why do I need someone to teach me or show me or guide me in how to do.

That's a good question.

Yeah, yeah.

But, you know, I think there is a role for someone who's trained as a therapist to look at.

To look at cultures that already use music and just maybe amplify that or empower that or learn from that.

Actually, some of my favorite lessons have been from people who don't speak English as a first language.

And they teach me so much about how music moves them because they teach me folk songs and they sing with me.

But our World Congress of Music Therapy was held in South Africa a few years ago.

There's a lot of amazing music therapy and research coming out of Asia.

So it is an excellent question.

I think music therapy is a strange concept in some cultures, but for the most part, I think we're all aiming for the same goal.

Which is music for wellness, health.

Well, being.

Absolutely.

These programs that you're mentioning, too, these are all based on live music, right?

Typically, yes.

I mean, I will use recorded music if someone wants that, but yes, because.

We did speak with somebody from the Music and Memory Organization a while back, and I know they're all recorded music, but I think theirs is also based on dementia and memory issues.

Do you see any.

Is there a correlation between the two or any sort of balance or any thoughts on the difference between the live recorded music?

There's a lot of crossover, I think, with the great work that the folks at Music and Memory do in music and dementia care.

What I always say is the recording, though extremely powerful, does not react to whatever the patient's experience is or the person's experience is.

Whereas a live musician can adapt, shift, change tempo, change lyrics, change all kinds of things to really match the person's experience.

But, you know, sometimes people just want to hear Elvis, and I'm not.

I can't emulate that or want to hear the Sound of something that's so intimately familiar.

So I'll pull out my phone, I'll pull out an iPad, and not ever resist that, but embody that as much as possible.

I just love being able to react in the moment with live music.

Yeah, I know.

That's powerful.

I also was wondering, too, just on the flip side of things, because how do you feel about where, I guess, school systems kind of are, at least in Ontario?

I know there's been a lot of changes and probably reduced efforts to allow students into music programs.

How do you feel about that?

And what advice do you have for parents or people who are interested in music might not have the access.

It breaks my heart that music and the arts get cut so quickly and often are the first to get cut.

It really upsets me.

But I encourage people to not necessarily only rely on formalized music education for their families, for their kids.

We all carry a musical history with us, and I think sharing music that's important to you with your family can be so powerful.

Maybe that's listening to music around the dinner table and intentionally doing so and choosing music to engage with, whether it's listening, singing, attending live music, now that it's starting to come back.

I am a huge advocate for music in schools, and I think the more the better.

But I think we have to also recognize the fact that we can all share music with each other in a way that's very powerful and educational, even if it's not formalized music education.

Absolutely.

My dad would turn off the TVs after dinner on Saturday, and we would be forced to.

Like, we would play still because we're kids, but we were forced to listen to music.

And it wasn't always just.

Just what he liked.

Sometimes it was country.

Like, we became very familiar with guys like Conway Twitty, Kenny Rogers, and just, like, pop stars like hall and Oates, and just, like, random stuff that I would never have gravitated toward, even listened to.

But because every Saturday, he, like, intentionally made sure TVs were off.

So you're getting music, we're absorbing it.

And that, to me, even though it was.

He might have had it in an intentional purpose, to us, it just seemed like normal.

And I was able to absorb so much different music from that.

And even just being around other people when they play music, just, oh, what is this?

And the connection that you can have with people and you share, it's so powerful that I would.

I love just listening to other.

Like, when someone comes in my car, I want to hear what you're listening to.

I hear my shit all the time.

I want to hear what you like, because I can then get something from you.

And I kind of feel like I'm learning and experiencing and enjoying a little bit of that person's personality.

Does that make sense?

That's such a beautiful example that you shared.

I love that.

Yes.

That's gorgeous.

Oh, did you.

I was going to ask you, what impact do you think that had on you growing up?

That's a great question.

It allowed me to get out of my own box because I would like rap at the time.

So if it wasn't rap, I'm.

I'm not playing it, but if I hear it, oh, what is that?

But I would never have given that a chance or something that someone else was playing.

Like my dad, for example, country music just didn't resonate with me.

But every now and then, there's that one song.

It's like, wow, I think I like a country song.

And then, like, now when I hear it, it's like, oh, yeah, country's okay, you know, And.

And then I might listen to another country song or at least not have my guard up so much anymore with certain music because my dad never had me in a box or I was able to or forced to listen to other people's interests.

And that was really important to me growing up because my whole family, from my brothers to my dad to my aunts, they all listened to such different music that I got such an incredible blend of music that I listen to that now my iPhone is just.

You wouldn't even believe some of the music that I have on there.

But if it wasn't for my childhood, it wouldn't have opened up all of those doors for me.

That's such an extraordinary example and a perfect example of your own musical autobiography, which is so rich and diverse thanks to the influences of your family, of your dad.

But this concept that we each carry a musical history and yours is shaped by the people around you, as all of ours are just so neat.

It was cool when you said that earlier, that we all have a musical history, and I was like, wow, you know, you're absolutely right.

And we always joke about music being in our DNA.

It's part of our brand, right?

So it's.

It's just tuning in or kind of reinforcing some of that that we've already believed, like us here in this groom and you as well, that there's music is a part of us if we like it or not.

It's.

It's unavoidable.

Beautiful.

Doriki used to rap.

Have you ever had to rap?

This is a. I mean, this conversation's made me feel a little bit better.

Have you ever had a rap for a patient?

Because you get requests of all sorts.

I'm sure that's true.

Yes.

Yes.

And I don't pretend that I have any skill set in that regard, although, boy, do I love rap.

And I love a lot of.

That's awesome.

Oh, a lot of hip hop and R and B, like, just from my own musical history.

I just adore it.

I suck at it, but I love it.

But I love what, like, patients have asked to rap.

And I'll provide a backing track, which is wonderful.

And what I try and do is just always flip it back to the patient, like, tell me what you want to hear.

Do you want to do it?

Or, like, is it the lyrics?

Is it the cadence?

I had a young guy the other day do some spoken word with me over.

Over some music.

Over a heartbeat, actually.

So yes is the short answer.

And I just use.

My patients are my best teachers, and I just kind of lean into what they want or what they're looking for.

That's incredible.

I think you brought the stethoscope with you.

I sure did.

I almost forgot.

But I do want to see it, so please, can I.

Can I.

This will be our first time seeing it.

Yeah, absolutely.

This is such a gift.

So.

So let's do a little unboxing here.

We'll have to put some pictures up.

Yeah.

I'll tell you a funny story, too, but first I'll show you, so.

Thanks, Littman.

They make a lot of stethoscopes in general, but if you press in this button on the side, which I'm doing right now, it Bluetooths directly to my phone, so I have an apple and I can hear.

I've tried it on myself a few times just to make sure I could do it.

You can pick up the heartbeat and it records it graphically, so visually.

And you also have the actual audio recording, which then just functions as a track.

So it's easy peasy and really awesome.

So I'll tell you my funny story.

I was with a patient, and I was working on recording their heartbeat.

I had my keyboard out, and I was in full PPE because this guy was in an isolation room.

And at one point, I just had to put my stethoscope around my neck kind of like a doctor would.

And an actual doctor walked in and said, oh, I'm sorry.

I thought the music therapist was in here and I was like, I am, I am.

And she's looking at me and she's looking at the stethoscope.

I said, I'll explain later, just let me finish up here.

That's funny.

I wonder if you put it on someone's stomach if you'll get all the.

Those gurgle sounds.

Yeah, sure will.

I've tried that too.

Yes, that could be fun.

Make dubstep out of it.

Totally, totally.

Just on your process with the stethoscope.

So, two questions, actually.

I want to know a little bit about your recording process after you take the heartbeat.

Like just what you use software wise or instrument wise to put a song together.

Yeah.

But also another thing that just occurred to me because heart rates probably aren't steady or constant at whatever 60 bpm.

I'm sure they fluctuate a bit.

Are you taking like, are you going to manipulate the heart beat or the bpm, or do you just use whatever it is and kind of flow freely to, you know, the fluctuation in the heartbeat?

So both are absolutely possible.

And what I have started to play around with, I'm certainly still learning.

I will say that is taking one clip that's really steady and looping that so then that becomes the track.

So it's very steady and then matching any kind of musical recording to that.

So that's been sort of my strategy, as advised by other colleagues who have done this work in the States.

They're like, just take a clip that's really steady and loop that.

And so what's really cool is I can use, I have a little handheld zoom recorder.

I can do it right in the room.

If I'm amplifying the heartbeat through my phone, I can record right in the room and just use that track.

And that's been how I've been doing it most recently.

But GarageBand, you just input the track right in there and it's super easy to play around with it, loop it, amplify it, and then I'll use my handy handheld recorder if I need to.

So again, I'm just.

I'm playing around with different things.

What I find is the most powerful moment, interestingly enough, is when the patient hears their heartbeat amplified.

They're like, oh, that's me.

That's my life force.

Yeah, yeah, yeah.

I wonder if Matt has any ideas as far as just the recording process or.

Yeah, I can think of Thousands.

You're using GarageBand, you said, right.

Well, logic also works really well and it's a little better.

So sometimes I'll use that.

But.

Well, there's a lot of tools that creators like to use, especially in electronic music, but I've used them as well in rock stuff where you can take.

Where you can take a recording, like a wavetable synthesizer, for example, where the kernel of sound that you then work out of, usually it's an oscillator.

So just imagine a synthesizer plays a note, and then you modify that note and do stuff to it.

So what if that note was actually a sample that you recorded?

So there's wave table synthesis, there's granular synthesis, and there's all kinds of stuff that you can do where you are synthesizing sound, but it starts with an actual recording of your choosing.

Very cool.

So that could be fun.

Very cool.

I am so open to any and all advice or ideas.

My husband's really the audio guy in the house, so sometimes I'm like, hey, can I just.

Can you just.

Can you just help me?

He knows what he's doing way more than I do, so thank you for that.

Like, I'm really open to hearing because this is a new world for me, but an exciting one.

Yeah.

Well, if we could help in any way, just please let us know.

Absolutely.

And we'll do whatever we can.

Thank you.

We definitely have to let you run.

We know we've had you for a little while here, but can you let us know what kind of future plans you have for the program and also just let people know where to find you and what ways they can support what you're doing?

Thanks for that.

It's been such a delight to hang out with the three of you and chat about the work.

So, future plans.

There's more and more exciting research projects that I'm getting to tap into.

I'm really looking forward to expanding the ones I'm currently doing, especially with young adults and learning about their experiences, continuing to grow the program and having more students publishing, more writing, more using technology, more in an intentional way.

I have a lot of learning to do.

Personally, I'm excited to just open up a skill set on guitar, which is a little bit newer for me.

I don't use it as much as my students do.

And some other instruments that I've acquired that I'm excited to learn more about.

And as things start to come back in person, giving more talks as I love to do, giving more presentations on music therapy, not just in the hospital, but outside.

And I love doing that.

And as far as giving me a shout, I will acknowledge Pulse Music Media, which is the umbrella under which my husband Andrew and I share music therapy stories and share live performances and we are on all different platforms but you can find us on Instagram and YouTube and TikTok telling all kinds of stories and performing together.

Amazing.

Thank you so much.

We really appreciate all of the work that you do and the fact that you are willing to come back and talk to us some more.

So thank you so much.

Thank you for the support.

It means the world to me.

Of course we'll see you next year same time.

Sounds great.

Sam.

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