Music therapy; Dr. Sachs; Awakenings; thinking/doing dichotomy; personal music therapy

Over the past few weeks, I’ve written several times about the thinking-doing dichotomy as it relates to my experience with Parkinson’s Disease. Once again, I am returning to this familiar idea with some new insights. As is the case with most of these posts, the topics are chosen because they seem to be relevant to me in my life at the time, but also because I deem them to be important to the greater community of readers. The thinking-doing dualism is important to everyone who wants to achieve, whether they have Parkinson’s or not. We all think. We all do. We all seem to need better balance in our lives so that we can invest the necessary energy thinking and planning to achieve the desired action results. I’ve been thinking quite a bit about this topic. It’s time to take an action step.

In his book “Musicophilia,” Dr. Oliver Sachs, one of my favorite neurologist/authors, shed some interesting light on his work with Parkinson’s patients, or parkinsonians, as he referred to them. In this book, he includes his clinical notes and insights regarding the therapeutic use of music with patients who suffered from brain disorders. One chapter details specific patients at the Beth Abraham Hospital in the Bronx, where he started working in 1966. During his time there, he treated patients who suffered from severe freezing of motion and function. There was a connection to the so-called sleeping sickness of the 1920s and 1930s, which plagued most of these patients. Their freezing states lasted decades and were described as parkinsonian in nature. By and large, they were unable to initiate most motions, but seemed to be able to respond appropriately. For instance, Dr. Sachs could throw them a ball, and they would automatically reach their hand up to catch it and throw it back. However, if he gave them a ball and asked them to throw it, they could not. Dr. Sachs describes various other therapies, which were musical in nature. Patients who were unable to walk steadily were drawn into a fluid gait by music and dancing. One patient was severely “compressed, clenched, and blocked, or else jerking, ticcing, and jabbering—like a sort of human time bomb. The next minute, if we played music for her, all of these explosive-obstructive phenomena would disappear, replaced by a blissful ease and flow of movement…” (Musicophilia, page 274-275).

Another patient used the word “graceless” to describe her movements due to the condition. She felt that it had caused her to lose her inner “naturalness and musicality of movement; in short, she said, she had been ‘unmusicked’ by her parkinsonism.” But listening, or even imagining steady beats and flowing music, was often enough to unstick her movements and allow her to move with relative freedom. However, this flow was often short-lived and the parkinsonism would return along with her jerky movements.

The efficacy of musical therapies is well-documented, with many people with Parkinson’s (PWP) employing music therapy with significant positive outcomes. As a musician myself, although not trained or certified in music therapy, I wonder if I can design a helpful music therapy program to address my own parkinsonism. With this as a guiding light, I decided to spend some time playing the piano today. I played some pieces by Mozart, Chopin, and Elton John. Although my finger dexterity was diminished, I was able to produce musical sounds. The emotive quality of the music was apparent, although the interpretations seemed to bend towards my limited technique rather than being driven by established performance practice. In other words, my compromised technical capability determined what I could or couldn’t do musically. If I can accept this flipped approach to interpretation, then I can enjoy making and sharing music. Even though some of the interpretations contained odd changes in tempo and dynamics, the music conveyed a high level of emotional intensity that comes from a place of pain and loss. While my fingers and hands did not hurt while I played, my heart did, but the pain was quickly replaced with the joy of making music again.

I plan to write more about the potential of music therapy in my own journey with Parkinson’s Disease. As I continue to employ therapeutic music activities into my own life, I will remember Dr. Sachs’ words comparing music to the drug L-dopa: “Music did everything that L-dopa, still in the future, was subsequently to do, and more—but only for the brief span while it lasted, and perhaps for a few minutes afterwards. Metaphorically, it was like auditory dopamine—a “prosthesis” for the damaged basal ganglia.” (Musicophilia: pg. 283).

775 words
Day 40: September 8, 2023
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