How art and music therapy help people recover from tragedy and trauma
• KATE LEGGE • THE AUSTRALIAN • OCTOBER 12, 2013

WORDS get stuck when Rhonda Pels tries to speak. Even the name she's worn for 62 years sometimes jams, leaving her to draw the letters with one hand in sweeping gestures through the air. A stroke six years ago crippled her capacity to express simple thoughts. Yes or no questions are fielded with nods and shrugs or a shake of her strawberry blonde hair. Pels has command of around 20 words but threading them together in a fluent sentence defeats her. Then a hearttugging melody familiar to every lovesick girl who grew up listening to Elvis Presley starts to play: "Wise men say only fools rush in, but I can't help falling in love with you..." The lyrics are projected on to the wall of the red-brick suburban church where the Stroke-A-Chord choir is rehearsing. "Like a river flows surely to the sea, Darling so it goes, some things are meant to be, Take my hand, take my whole life too..." Pels's lips are alive as she sings clearly each phrase in tune and in time until the other voices fade away and only her sweet soft solo fills the high-ceilinged space. "For I can't help falling in love with you."

The young woman sitting beside her is tearfully overcome by a miracle she didn't think possible. "There's never a dry eye in the house at our concerts," whispers Wendy Lyons, a stroke survivor who got this Melbourne choir on its feet after discovering that song can somehow endure even when the power of speech does not. This preserved ability to sing is thought to be the result of language and musical ability being processed by different parts of the brain.
Therapists have known about the phenomenon for decades but nobody had taken the next imaginative leap. The possibilities struck Lyons when a man at her stroke support group revealed how he'd been playing guitar one day to his speech-locked wife when all of a sudden she began to sing. "I've got to do something about this," Lyons, 73, decided, her energy and passion giving rise to an ensemble now being copied around Australia and overseas. "We couldn't get a single conductor interested in the beginning," she recalls of the brainstorming and tin-rattling that led her eventually to Melbourne music therapist Dr Jeanette Tamplin, 38, who knew from her own discoveries that this idea was gold.

Art and music therapy are demonstrating their worth inside hospitals, rehabilitation wards and communities coping with natural disasters. Once medicine has stabilised life-threatening injuries and the white-knuckled sense of emergency has passed there is increasing anecdotal evidence that creativity can help people move beyond whatever tragedy has dealt them. When fate, in the form of a firestorm or a stroke or a road accident, turns worlds upside down, the joy of participating in a choir or a band or picking up a paintbrush or a sculptor's chisel lifts survivors out of their nightmare. It distracts them, cheers them, empowers them with a sense of accomplishment, and if the project is collaborative these benefits are multiplied by the shared spark.

In 2006 Lynne Panayiotis and her husband George were on their first overseas trip, in Egypt, when their tour bus rolled and hit a pole. George was one of six Australians who died; Lynne was speared into the sand and lay trapped under the chassis for two hours. She surrendered to doctors who put her body back together as best they could. They amputated her left leg, secured her spinal fracture and medicated her pain. She was left a paraplegic and her spirit was in pieces, compounded by the grief of losing a partner she'd known since childhood and lived beside for 20 years. One day she curled into the foetal position, unable to get out of bed. Staff at Melbourne's Royal Talbot Rehabilitation Centre suggested she might like to try music therapy. Leaving behind the noisy ward, she wheeled herself into a quiet room where Jeanette Tamplin welcomes wounded souls. Tamplin gave her a list of songs she might like to listen to and then picked up her guitar and started to sing. The music unlocked a river of grief - and Panayiotis wept. "I didn't start healing until that happened," she says.

Over several weeks with Tamplin's encouragement she wrote a song dedicated to her late husband. Woven into the chorus is the phrase "for you darling anything". This was his signature response to her requests. "For me it was a way of expressing the feelings I had for George since I hadn't been well enough to do anything for his funeral," Panayiotis says, recounting how she arrived by ambulance to attend the memorial service in Melbourne against doctor's orders. Their marriage had been tested by infertility's rollercoaster cycles of hope and despair. "I always thought that was my cross to bear. It turns out it was just a practice run," she says blackly. His loss was the hardest adjustment she faced but the health system dealt only with her physical injuries - until Tamplin helped untangle her emotions through writing the song. "I'd come up with the words and Jeanette would pluck away. It was amazing for me. I'd seen a psychiatrist and had counselling but I think the music was better for me," she says.

Tamplin would type the words out for Panayiotis to polish as she lay in bed. On a laptop in her kitchen Panayiotis plays me the song. "You'd do anything, for anyone, especially for me and your Mum, your compassion, your caring made my heart sing, If I was down you'd lift me up just by saying 'For you darling anything'". She wheels her chair over to the counter to fetch me a tissue. For days afterwards the song lingers in my head. Therapists have been employed sparingly by hospitals and palliative care centres in Australia for more than 30 years. Most commonly used to soothe dementia sufferers, people who are dying and patients regaining consciousness, or to distract children from painful procedures or anxiety in the hours before surgery, the power of music to heal is increasingly being quantified by academic researchers such as Tamplin. And the idea that music can influence health outcomes is gaining traction in scientific circles.

A post-doctoral fellow at Melbourne University, Tamplin believes empirical studies will help anchor music therapy's place in medical practice. She won a vice-chancellor's award for a PhD that demonstrated how singing builds muscle strength and respiratory function in people with quadriplegia, who are vulnerable to pneumonia because of their inability to cough. The biggest plus in her 12-week study of therapeutic singing, however, was the dramatic lift in mood, motivation, and quality of life for people imprisoned in this way. "A lot of them are paralysed below the neck or shoulders so singing is one of the few things they could do on their own," Tamplin says. "They can't even brush their own teeth. So the ability to sing independently had a really big effect. They said it motivated them to get out of bed and made them want to do things. I kind of knew it would make them feel better but the big secondary roll-on effect was fascinating." Watching Tamplin draw out patients who are staring up the steep mountainside of rehabilitation almost beggars belief. She takes me to visit Mark, a 40-year-old who arrived at the Royal Talbot in June after suffering a severe stroke. "Talk before you touch," warns a sign above his bed.

His anxiety at close contact meant the speech pathologist assigned to him couldn't perform the soft tissue massage that he needed to relieve the tension in his throat - so Tamplin brought her guitar to help him relax and possibly stir him to sing. She hadn't yet interviewed his wife about the music he liked so she chose the Bob Dylan song Knockin' on Heaven's Door, hoping its repetitive phrasing might elicit a response. "I would sing the song and leave long pauses for him to fill in the gap. There was no progress at first, he was so tense and hunched up, and then one day he sang the word 'door'," she says, smiling at the memory of this breakthrough moment as she ushers me inside his room, warming it with her presence. Mark now speaks haltingly but he is disoriented by his surroundings and the event that landed him here. "Do you know where you are?" Tamplin asks him. Silence leads to her suggesting: "Are you in a jail or a hospital or a hotel?" His brow knits as he thinks before answering tentatively: "It's not a jail. Possibly a hospital," he suggests. "We're going to try and help you remember that," she encourages him. When she prompts him to tell her the names of his two young children, he names his wife and his son but struggles with his little girl. Tamplin cues him with one syllable at a time.

Odd how a stroke blocks the retrieval of some supposedly unforgettable details, yet allows other random memories. "What shall we sing?" Tamplin wonders. Perched on the edge of his bed she rests the guitar on her lap and flicks through a folder of music. He sits surrounded by photos of his family and favourite things they have brought to remind him of home. His face appears glum and unresponsive. She begins strumming the opening chords to the Pink Floyd song Comfortably Numb. As her beautiful voice leads he joins in effortlessly, reciting the lyrics word for word. They could have been penned for him. "Hello. Is there anybody in there? Just nod if you can hear me. Is there anyone home? Come on, come on now. I hear you're feeling down. Well I can ease your pain. Get you on your feet again." Young and exuberant, with two kids of her own, Tamplin was a classical pianist who didn't know music therapy existed until she studied at Melbourne University's Conservatorium of Music and discovered a vocation that married her two loves, music and helping others. She exudes the energy of Julie Andrews in The Sound of Music with her acoustic instruments at the ready and a song for every occasion.

The power of that film was music's role in escape from repression. Tamplin offers people stricken with terrible injury the same hope of reprieve. "For some people, the first session when I play a song brings them to tears because it takes them back to a time before their injury, so we have to work through those emotions gently before we use music to work on functional goals," she says. More extraordinary than the emotions released in patients is the mysterious way songs draw forth language otherwise blocked. "Often I hear patients sing before they can speak. I'll be singing songs they like and leaving gaps and they might listen silently for weeks and then when they come out with their first word or sound it's almost like being a parent and hearing your child's first word. It's an amazing experience." Early research into the neuroscience of music processing held to the theory that language is processed on the left side of the brain and melody is localised on the right side. New thinking about the brain's plasticity suggests music processing is more diffuse and deep and therefore protected from head injury - but science is yet to fully explain therapists' stories of patients emerging from the mists to grasp a familiar refrain.   >> MORE