1.1. Music Therapy in Oncology
1.2. Music and Mindfulness for Women with Breast Cancer
1.3. Purpose and Background to the Study
2. Participants and Location
3. The Development of the MBMT Program
4. An Overview of the MBMT Program
5. Opening Exercise with Focus on Sound
In this exercise we will begin the practice of mindfulness. First, bring yourself into the present moment by sitting up straight, but comfortably. If possible, close your eyes lightly and take time to breathe deeply. Then ask yourself silently, “What is my experience right now…in bodily sensations or tensions (scan your body from your feet to your head)…in thoughts…in feelings?” Take time to acknowledge and register your experience, even if it is unwanted.Now, gently redirect your attention to the sound of this bell and when you no longer hear it ring out—raise your hand … (sound of tone chime). Now, listen again, and listen to whether the sound is shorter or longer than what you just heard (play sound of tone chime). Was it shorter or longer? Now, again, listen to this … (play soft) …. And then listen to this … (play loud) … Which was louder?
Continue to direct your attention to the music tones as they sound one after another. When your mind wanders and gets caught up in thoughts or feelings or other sensations, simply notice where your mind is, and gently bring your attention back to the music as best you can. Be aware that you do not have to follow your upcoming thoughts or feelings and try not to judge yourself for having them or analyze them in any way. It’s okay for the thoughts or feelings to be there. The music you hear can function as an anchor to bring you into the present and help you tune into a state of awareness of the present. Simply observe any thoughts or feelings, let them drift on by, and bring your attention back to the tones. (Music therapist improvises a short melodic or tonal sequence.)
5.1. Week One—Music Listening and Non-Judging
This is a music listening exercise in which you will hear a few selections of different styles of music and you are asked to identify, as best you can, what you hear in the music. You are also asked to write down your responses and then you will have time to share. Here is a listening chart that will guide you through the exercise.After hearing each music selection, and following the columns on the chart, write down your “first impression” of the music selection (e.g., like/dislike, good/bad, etc.), then the music elements that stand out to you (e.g., voice, guitar, drum, fast rhythms, quiet volume), the emotion of the music (e.g., sad, happy, excited, etc.), and then lastly, anything you notice in yourself (memory, image, body sensations, or any judgments you have of yourself, others, the activity).
What was your experience with this exercise? Was this listening exercise a pleasant event or experience for you? Most music experiences, when chosen by a person, are positive experiences. (However, listening to a loud pounding bass rhythm coming from another driver might not be!) What were you aware of as you listened? Did your mind wander? If so, where did it go? Were you able to bring it back to the music? What, if any, judgments arose you took part in the music listening? Were you able to notice them and let them just be there, as opposed to reacting to them?
Homework of Non-Judging in Daily Living
This week, take note of events that are experienced as pleasant and those events that are unpleasant. Observe your thoughts, feelings, sensations and/or emotions that you become aware of during or after these events. Be attentive to the response produced and practice quickly letting go of your own biases and fears . Non-judgment attitudes in mindfulness practice are an awareness quality nurtured by assuming a detached observance within your own experience. In this attitude, we are bystanders throughout our own experiences. Use the pleasant/unpleasant chart to guide your recording of at least one event daily.
It was 4 a.m. and I couldn’t sleep … My mind teemed with little worries and then I conjured up a big one: A grizzly bear was tearing me apart and eating me, starting with my arm. I thought: Here’s an unpleasant one for the log. I felt tense and hot (chemo has restored my hot flashes). I was, in part, a detached observer … I decided to try and remember the music that had been part of the homework CD: Rodrigo tickling the Spanish guitar, [the opera singer] belting out the gorgeous area. It seemed to work: next thing I knew it was a respectable 7:30. I arose, took a hot shower, and felt like a new woman. Still feel that way hours later.
5.2. Week Two—Novel and Familiar Instruments/Songs and Beginner’s Mind
You will explore a few instruments that you may not have heard or seen before. Take time with each instrument and listen to its sound (what you are hearing)—be aware of what you feel (in your hands, on your lap, its vibrations). Now as you explore these instruments take time to notice your thoughts, feelings, and body sensations. Were you surprised or in awe of the sounds or feel of the instruments?One attitudinal foundation of mindfulness practice is called beginner’s mind. It is an attitude of mind of practicing seeing (or hearing) the richness of the present-moment experience. Practicing the mindfulness attitude of beginner’s mind develops perceiving the world with a quality of newness and awe. This attitude is developed by seeing or experiencing events, things, and/or people with a child-like sense of wonder.
Were you aware of anything new in your experience of singing or hearing these songs? What occurred in your thinking, feeling, body sensations? Did you have any judgments of the music or yourself?Often, we let our beliefs about what we “know” prevent us from seeing things as they really are. To see the richness of the present moment, we need to cultivate this beginner’s mind attitude or a mind that is willing to see everything as if for the first time.
Homework of Beginner’s Mind in Daily Living
Where can you practice beginner’s mind today? Is there a time when beginner’s mind might be useful? Is there something you might view differently or anew? Is there something you might hear differently or anew? Someone you might see differently for the first time? Next time you see your friend, try to see something new in him or her. As you practice this attitude, it is helpful to consciously let go of past experiences and expectations. Witness the fullness of your new awareness. Use the beginner’s mind logs to record this week’s experiences to familiar music listening and to daily events/people. I look forward to hearing your experiences, whatever you experience, when you return next week.
Piano very joyful and upbeat, beautiful melody. I feel very calm and happy listening.
Plastic surgeon—I was afraid he wouldn’t listen, but he did, and embraced my plan for surgery. He’s no diva after all.Sat outside in my yard quietly enjoying the plants and flowers without focusing on the “jobs” to be done—just enjoyed the air, trees, fragrance and peaceful environment. It was so relaxing.
5.3. Week Three—Rhythm/Instrument Playing and Suspending Judgment
Let’s play some rhythms. This is a paddle drum (demonstrate sound using a mallet). I will play a rhythm on my drum and once I finish, you play it on your drum.
Let’s play and sing a song together. Here is a song sheet that shows changes in harmony indicated by changes in color placed over the text. You will play this pulse or beat with these two mallets on these tones (marked with matching color to the text) for each harmony change. (Demonstrate beat and practice harmonic changes with an accompanying support, such as keyboard or guitar). Now, let’s play and sing this together. (If a family member or friend is in the session, she can play the drum on the chorus).
Here are two tones that you play together, called a bordun. Play at this tempo. (Demonstrate). Keep playing that pattern while I play a melody over top. (Music therapist improvises a melody above the bordun).
Notice where the numbers are labeled on the keyboard. Play from number 1 to number … (6). Follow the song sheet reading the numbers above the words and once you are comfortable feel free to play and sing along.
What was your experience with this activity? What, if any, judgments arose when you took part in the music making? Were you able to notice these judgments, observe them and let them go? Can you be aware of feelings, thoughts, judgment and not react to them? Just observe.
Homework for Suspending Judgment in Daily Living
Practice with the music CD throughout the week. Try to practice imitating the rhythm items (try 4 to 5 rhythms per day), as heard on the CD, repeating the exercise as often as you’d like. Once you are comfortable with playing the rhythms, feel free to create your own rhythms!Next, using your egg shaker, practice to keep beat to the recorded music on the CD as often as you’d like.The next time you find your mind saying things like “I can’t do this”, “This won’t work”, “This is boring”, “I don’t like this”, remind yourself that the mindfulness practice involves suspending judgment and simply observing whatever comes up for you, including your judging thoughts, without pursuing them or acting on them. If you doubt this description of your mind, just observe how much you are preoccupied with liking and disliking during a ten-minute period as you go about your day. Record anything you might have done differently or tried that was new. What was your experience and what came up in your thoughts, feelings, or body sensations? Were you able to suspend judgment? (These instructions provided from MBSR)
Listened to a conversation where people gossiped about someone and I was starting to have negative judging thoughts about the person. I noticed [this] and stopped myself by thinking about something else.Several issues come up for my [family member] and because of his narcissistic history I immediately didn’t believe him [or] the situation. I did stop that thought, listened to the story. For first time I did not get angry or frustrated, just tried to observe as an uninvolved party. I was more calm and detached, which was wonderful.
5.4. Week Four—Music-Assisted Relaxation and Acceptance/Letting Go
If your mind wanders and gets caught up in thoughts or feelings or other sensations, simply notice where your mind is, and gently bring your attention back to the speaker’s voice as best you can. It’s okay for the thoughts of feelings to be there. Just notice any feelings or body sensations, let them drift on by, and bring your attention back to the voice.
Start by listening to the piano tones … Simply listen to the music and notice the sensations of your body as you listen to the music …Try to focus all of your attention on the speaker’s voice … (music continues) … As you listen, close your eyes and imagine that you are laying down on a lawn of soft grass, looking up at a blue sky … Let your mind become as clear and empty as a perfect blue sky. If you need a break from being tired or from worrying, or if any thoughts drift into your mind, imagine yourself breathing them out so that each thought forms a cloud that you send blowing across the clear, blue sky … Allow your thoughts to drift away from you, like clouds across the sky, until your mind becomes empty again, only filled by the image of a clear, blue sky … Continue with this visualization until you no longer hear the music.
We will continue to take some time to relax the body … Find a relaxed position, so you can be as comfortable as possible. Free your mind and your body of any stress and tension. Let go of draining thoughts and daily responsibilities, and just focus on this moment and my voice. Feel free to lightly close your eyes and be aware of your breathing, take deep, slow breaths … inhaling … and exhaling slowly (pause) … As you exhale, release all of the tension in your body and feel yourself start to relax.Be aware of your body ... relax your head, release the tension from your shoulders, move any way you like to help you release tension. Feel your hands resting on your chair or lap … Let your legs sink into the chair, and feel your feet in a relaxed, flexed position. Be aware of the feeling and relaxation throughout your body … And the complete release of tension and stress …Now, imagine a time in your life when you were in a joyous, relaxed state. For many people, it is a beautiful spot visited on vacation … but the beauty of this is, you may choose whatever your ideal place is … now visualize yourself in that place, wherever it is. It may be walking along a beach, amongst some beautiful trees, or a mountain hike, or it may be in a comfortable chair in your backyard … where it is, be there now while you the music plays … [Allow the music to sound for a few minutes here].Now with all of your senses, breathe in the fresh air, feel the warm sun and the gentle breezes on your face. Internalize how this makes you feel. Does it make you smile? These are precious moments we have in our memory, and we can revisit them any time we wish.Now bring this feeling, this smiling feeling—to the core of your being. Start with feeling the smile on your face, then move it in. Slowly move this smile into your body. Let it penetrate from inside your heart to the rest of your body. Feel this smile in every cell of your being.Know now that you may return to this feeling anytime you wish. [Allow the music to sound for a few minutes here and then fade music here.]Now slowly begin to become aware of the presence of those around you, the sounds of the room, the feeling of air on your skin. Feel your feet planted firmly on the ground and as you breathe deeply again, slowly open your eyes and become aware of your surroundings. [Stop music]
Homework for Acceptance/Letting Go in Daily Living
This week the music was extremely relaxing and beautiful. From the beginning of the CD my mood, thoughts and feelings changed. I was apprehensive, nervous, etc … Now I feel acceptance, relaxed, ready for the approaching surgery Totally with a positive attitude!The air around the room was cool but once the music stopped the room felt really warm and hot. I imagined being so small that I could fit inside a flower. There were pleasant images.
6. Conclusions and Recommendations
It was for me, the culmination of the experience and what the study gave to me or reinforced for me, was my love of music…
Getting rid of all the extraneous crap so that you can live in the moment. Depending on the age of the group I may or may not use the word “crap”! … And stopping to smell the flowers and even if it’s in the middle of a garbage dump, you are smelling the flowers. You definitely focus on the positive. In fact, [a project being asked of me lately] has been nothing but aggravation. And I finally [decided to say] “You know, this music therapy that I am concluding today has made me realize that I don’t want to do this project. I want to have positive experiences right now, which may sound selfish, and is more selfish than I like to be, but it’s necessary right now.
Supplementary MaterialsSupplementary File 1
Conflicts of Interest
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|Session||Music Experience||Mindfulness Attitude|
|1||Opening Exercise |
Music Listening and Writing
|2||Opening Exercise |
Novel Instruments, Familiar Songs
|3||Opening Exercise |
Rhythm, instrument playing
|4||Opening Exercise |
|Acceptance and Letting Go|
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