The Harp -- A Most Useful Tool for the Volunteer

[Greg Schneider]

The harp is an instrument that is welcomed anywhere because of its calming nature. It is rare that I play anywhere that I don't put someone to sleep within 10 minutes of starting to play. For the hospice volunteer, having a harp to bring with you when you go to see a patient allows you to bring your presence to the dying person first with healing sound, then with words, if they are deemed necessary. I began playing the harp 7 years ago after being inspired by a pair of harpists who came to the Zen Hospice Project to do a demo to some of the hospice volunteers. The two harpists had been trained by The Chalice of Repose Project in Missoula, Montana. The program was started by professionally trained harpist, Therese Schroeder-Sheker. She founded the palliative medical and pastoral modality of Music Thantatology. Watch a video clip of music thanatologists at work. Kelly Lockwood was one of those individuals who came that day. There were about 8 of us volunteers that were there to listen to Kelly and another Music Thantatologist. By the end of the session 6 of the volunteers were asleep on the floor. After witnessing the beauty of them singing and playing together, the seed was planted - I was hooked. I knew that I needed to learn to play the harp. I was fortunate enough to have Kelly train me. I had been playing piano for pleasure for about 15 years at that point and I found it reasonably easy to transition to the harp, which was similar in many ways. Two lines of music to read, one for each hand. Since I rested the harp on my right shoulder (Kelly plays with it on her left shoulder), I would be playing bass notes with my left hand and the melody with my right...just like the piano. For the volunteer, there are many choices for learning and applying the harp in your volunteer work. We have already mentioned music-thanatologists, who receive extensive training on how to combine voice with the harp to meet the needs of the patient in the moment. The music-thanatologists works with those who are actively dying (24-48 hours) or have received a terminal diagnosis, usually approximating six months. The basic objectives of music-thanatology and prescriptive music deliveries are:

• relief of acute and chronic physiological pain and/or spiritual or interior suffering;
• the creation of the supportive conditions which can facilitate reconciliation and meaning in the face of mortality and suffering;
• a blessed or peaceful or conscious death which is returned back into the fullness of life and the whole human life cycle;
• the transformation of the personal, familial, medical, cultural, and community experiences of death.

Prescriptive music can be understood as a compound sonic medicine, and is delivered live, at the bedside, on polyphonic instruments, by practitioners certified in music-thanatology. Using voice and harp, musician-clinicians often, but not always, work in teams of two, positioning themselves on either side of the dying patient. The person who is receiving the music may be experiencing either physiological pain or interior suffering or both, and may additionally be morphine-intolerant, or in general, greatly needing non-invasive and non-mechanical, profoundly human responses to increasing vulnerability. In all cases, the musician-clinician is working with vital signs, measurables, and is able to document in an evidence-based medicine the physiology of pain relief. Another aspect is Music Therapy. Music Thanatology is not synonymous with Music Therapy. Music Therapists are more broadly trained to apply their therapy methods in a broader number context of applications; whereas Music Thanatologists are very specifically trained for offering their services in the area of end-of-life care. Music Thantatology is very much directed toward the physiological processes encountered during the dying process. Yet another related area is that of Vibration Medicine. Diane Schneider, J.D., Ph.D. is a Vibration Medicine Specialist. Her work has broader application, similar to a Music Therapist. She describes how she uses the harp with a patient in her work: "The intent in the therapeutic harp sessions is to create a solid, uninterrupted 40 to 60 minute energy stream bridging to the patient, during which all of the above elements are carefully sequenced and layered according to what we are medically, psychologically, emotionally, and spiritually trying to achieve (i.e., lowering or raising blood pressure, inducing sleep, calming of anxiety, raising to consciousness, relieving migraine, and so on). I also integrate the diagnosis/prognosis, if the patient is pre- or post-op, what drugs they are receiving, any special needs, and gather some knowledge of the patient’s musical history or preferences. The harp vibration treatment is a therapeutic intervention, not a concert. In fact, about 80% of the session may be improvisational to create the necessary harmonies, melody lines, or segues to other keys, and would not be recognizable songs. Guests and staff leave the room, and we turn off TV’s or unplug anything which would produce voices, noise, or competing vibrations." "I apply this method quite differently with hospice patients, especially when death is imminent. As in ancient cultures, we want the community of friends and family to be present in whatever way they are able. Hopefully, I have been in relationship with the dying person for weeks or months before, and already know what “works for them,” what comforts and supports them musically. If the person is unconscious, or not known to me, I take guidance from others as to what would be healing and encouraging for the person at that time. Always, I find that a high degree of intuition is needed to know how, when, and how long to use harp vibration in these situations—and when to use silence. High vibrations coming from small harps and other instruments can be unintentionally agitating and annoying to someone who is ill, just as most of us prefer low, soothing notes for relaxing." "Once the patient is not clearly conscious, I move into non-cognitive music (i.e., without familiar words), possibly non-rhythmic, consisting of a lengthy series of resonant single notes and simple chords which are allowed to vibrate until they fade to silence. Often, a person breathes out on a final sigh during this sequence, and dies peacefully. I then continue to play for 30 or 40 minutes, to honour the person’s passing with a continued atmosphere of joy and peace, and to allow the beauty of music to serve as a witness and a welcome to their new life, just begun." I have no special training for playing the harp at the bedside. I was already a hospice volunteer and understood what it took to connect with a patient. I simply added the music and used my musical skills, such as music interpretation, to add another dimension to my presence. While the music is not delivered with the same technical methods/perspective as a music thanatologist, music therapist or vibration specialist, it has been my experience that music still soothes all within earshot...patient, family members, visitors and clinical staff wherever I play. The beautiful sound that eminates from the harp does a remarkable job of calming everyone. Many have told me that music was most meaningful. For example, as the grown children of a family watched as their mother was actively dying, one of the daughters said to me as I was leaving "the presence of the harp at this time of my mother's dying will make the memory of this moment especially memorable. Thank you so much." I have found that most of my patients have preferred that I start out my visit with harp music. It relaxes them and then they are more open to "talking" about what's really important to them. I find at times that they are open to getting into the deep discussions about their dying experience. I also have the privilege of being a vigiling volunteer in my community. To bring the harp to the bedside and then to be playing while the person dies, is a profound experience. If you are a volunteer and musically inclined, I highly recommend taking some lessons and broadening the dimension of your service to the dying and their families in a most beautiful way. Greg Schneider HCF Creator Hospice Volunteer

[Frances Shani Parker]

I love harp music and can easily see how it benefits patients and their families. This detailed explanation is very helpful.

Frances