The Power of Songwriting with Cancer Patients in Palliative Care

Categories: Care.

Songwriting is a very common therapeutic intervention for music therapists, and there are many approaches. Some are more structured than others. For example, many therapists use a “fill-in-the-blank” model, where new words are added to an already-familiar song. Less structured techniques can include improvising musically with clients on a theme to come up with an emergent melody, then drawing out thematically-relevant lyrics.

There is no right or wrong way to write a song – though I think the human heart can distinguish between art that has the rigidity of overthought, and art that was birthed from some place deep in the soul. While structure, practice and form are vital qualities of art-creation, in my life the most powerful songs that I’ve written are the ones that have “just come.” So I try, as often as possible, to allow for that process to emerge in clinical practice.

Music therapy sessions in my oncology practice often begin with a casual discussion about feelings or experiences, which usually deepen in disclosure and emotional content as trust develops. As emotions deepen, I will often present the idea that we write a song. If patients are interested, I will invite them to journal some free-form thoughts based on themes from our conversations.  I join them in the process, reflecting in my own writing on the feelings being presented.  We then share our writings and thoughts. Getting a sense of what the strongest messages are in the words, we will begin to structure lyrics – a chorus and verses – out of the words in our writings and conversations. Syntax and vocabulary will be tweaked for the sake of lyrical flow, rhyming and meter, but typically, these lyrics emerge out of fluid conversation and reflection.

The results can be astonishing. Words emerge around hope and knowing one’s own inner strength – words to say they will conquer this, that life will go on, that they will feel joyful again. Words emerge about loved ones – words to comfort those who will be soon losing someone, words of how love is the accumulation of the memories built together.

It is then time to spin these words to music. As much as possible, I try to include patients in the actual music-creation process. There are techniques for that – pre-composed chord patterns can be presented, patients can pick which ones they like, and we can trouble-shoot the crafting of melody. Often though, time is of the essence.

So often I draw on the Powers-That-Be, along with my years of musical training and experience pouring my own heart into songwriting, and take a shot in the dark. I’ll take the existing lyrics, and improvise a song-structure right on the spot, while the patient listens. Sometimes the results can be rough and a little un-focused, and I can feel exposed. But often, the emotional urgency of the lyrics, and the creative space the patient and I are holding together, just propel the music right out. My fingers will find their way to the right keys on the piano, my voice will find the right melodic cry to match the words. I don’t take credit for anything that happens in those moments – I simply become a channel.  

Patients have been deeply moved hearing their own words sung back to them. One patient summed it up, saying: “the music said something I couldn’t say myself.” The creative high from the experience can be mood-enhancing and spiritually uplifting. Often, patients will share those songs with loved ones, as a way of speaking emotions that the words alone couldn’t say. Those songs can become signposts to moments in the patients’ lives, and provide comfort and resilience to them and their caregivers through life’s challenges. Weaving our emotional experiences into art can help us carry on.

There is a sacredness in that shared creative process. I too come away from those sessions with a high, and a strong sense of fulfillment and connection. While those songs become signposts for patients and their families, they also become signposts for me. They stay with me, popping into my head when I least expect it. They grace me with the memory of the patients, their beauty and strength, and the powerful creative process we shared. What a beautiful way to share humanity with another person, in some of life’s most vulnerable moments.

Written by Sarah Pearson, MMT. Sarah is the Program Development Coordinator of the Room 217 Foundation, a registered Canadian charity dedicated to caring for the whole person with music.