Songwriting as a means of meaning and remembering

On April 20^th, at the HPCO Conference in Toronto, I had the privilege of facilitating a workshop that used music therapy techniques to address the grief that hospice and palliative care workers experience from the death of patients. It was an emotional, vulnerable and cathartic hour. Attending were hospice nurses, managers and directors, palliative physicians, complimentary therapists, and volunteers, among others, all who were willing to share their experiences of occupational grief.

The workshop was focused on participants’ reflecting on one particular patient or resident they had lost – someone they haven’t forgotten, that has made a lasting, lingering impact on their lives. Everyone was invited to anonymously write reflective statements about this one person on slips of paper – what they cannot forget about them, what they have learned, what they are grateful for, what they wish the could tell this person. There were tears in the room as participants wrote down their personal reflections, tissues passed around from table to table.

We gathered these responses into my Tibetan singing bowl, an instrument I have played at the bedside of many dying patients. To pay homage to these incredible legacies left to us by patients who had passed on, I rang the singing bowl for a moment of quiet reflection.

We then began to explore these experiences through the non-verbal, spiritual language of music. Participants volunteered to draw slips of paper from the pile, pulling out words written anonymously about the impact of patients’ deaths on health care workers. “I cannot forget your smile when I gave you permission to go,” “I love you,” and “you have taught me how to leave in peace,” were just some of the statements pulled from the pile. We discussed our impressions of those statements, and then in small groups, improvised music together about the statements on various instruments. In most cases, participants had no experience playing these instruments, but were able to find a voice on an ocean drum, a tone bar, or a shaker. I played piano to contain and ground the musical exploration. Through exploring these feelings in music, new things were learned, discovered, and heard about the impact of patients and their deaths.

The workshop concluded with a brief songwriting experience, where we took some of these words and synthesized them into a song. Songwriting can be a wonderful way of drawing meaning from fragmented thoughts, organizing experiences into thematic, aesthetic creations, and this final songwriting exercise seemed to ground the group’s experience.

It’s not always easy to discuss the impact of patient losses with our colleagues. In the early months of my career in palliative care, I struggled to find a new framework for processing the loss of patients. I think I am finding it, and music is helping. It was a privilege to facilitate this workshop, and to bear witness to the unspoken grief of other hospice and palliative care providers. It was a powerful hour of vulnerability and tears, expression and reflection, remembrance and creation.

Sarah Pearson is a music therapist working in palliative care and oncology in Kitchener, ON, and is the program development coordinator at the Room 217 Foundation. Workshops using music and music therapy techniques such as this one can be provided through the Room 217 Foundation.