Ep. 150 Transcript

Disclaimer: This is transcribed using AI. Expect (funny) errors.

Mindy Peterson: [00:00:00] I’m Mindy Peterson and this is Enhance Life with Music, a holistic look at the power of music in our everyday lives. My guest today is Dr. Nancy Jackson, professor of music and director of music therapy at the Purdue University Fort Wayne School of Music. Dr. Jackson is a board certified music therapist with more than 30 years of clinical experience in areas including music, psychotherapy and medical music therapy. She maintains a private practice in the Fort Wayne, Indiana, area. She’s a published author of numerous books and journal articles and is an in-demand conference presenter. Welcome to Enhance Life with Music, Nancy.

Nancy Jackson: [00:00:45] Thank you, Mindy. I’m so glad to be here.

Mindy Peterson: [00:00:47] Nancy, My heart really goes out to people who are dealing with ongoing chronic pain. If there’s one thing that we all have in common as humans, I think it’s the avoidance of pain. And we probably have no idea how much of what we do is instinctively motivated by pain avoidance. We’re talking today about how music is used for chronic pain relief and management. For purposes of our conversation today. How do you define chronic pain or when do you consider pain to be chronic?

Nancy Jackson: [00:01:21] Well, technically, the medical community would say that chronic pain is pain that lasts for three months or longer. For me, that’s not really a sufficient definition to reflect what the nature of chronic pain is. The way I think about it is that pain is chronic. When there really is no foreseeable ending, there’s no foreseeable resolution to that pain. So, for example, someone might have shoulder surgery and that actually creates lasting pain. That pain might be around for five or six months. And so technically that is chronic pain. But, you know, that’s going to get better when we talk about what we typically mean by chronic pain. We’re talking about something that’s really decidedly different. For example, someone who has back pain that’s coming from a permanent and an unresolvable injury. And maybe there’s no way to effect anything more than partial relief for very short periods of time. So in effect, that unforeseeable ending makes pain become a part of who you are.

Mindy Peterson: [00:02:41] Well, in that definition, the unforeseeable end brings into play for me anyways, a little bit more of the emotional aspect of things too, because when I hear that unforeseeable end, there’s this emotional response like that feels a little bit scary and a little bit hopeless, right? So I’m sure that factors into things as well. Well, tell us, how is music used to relieve and manage chronic pain?

Nancy Jackson: [00:03:10] Sure. So first of all, kind of continuing on from this unforeseeable ending, when you think about chronic pain, what it does is it causes a disruption in an individual’s time. So you don’t move rhythmically the same way because moving causes pain. You have emotional changes that impact relationships. You decrease the things you’re doing that are meaningful to you because they hurt or they take more energy than you have. So you slow down, you withdraw, your body doesn’t move the same. All of those are time kind of influences. And so when you have chronic pain, your life gets out of sync. And then if you think about music, music is all about rhythm and relationship. So the structures that are inherent in music provide the means for people to recalibrate the time of their system for syncing the internal and the external environments as it’s experienced in their body. So considering that there’s really three main general ways that music can help chronic pain and those are distraction, relaxation and resolution of internal conflict. So distraction, distraction interrupts your attention to pain. And while we like to think we can multitask, we know that our brains really can’t.

Nancy Jackson: [00:04:55] They’re just it’s just moving very quickly between attention on. One thing and then another. So when we are distracted, our mind is taken off of that pain for short periods of time. And those short periods of time are respite. They they give you a respite from that pain. Distraction is underrated. It can be very, very useful. It sounds like a kind of a silly plaything, but it really can be very useful. Now, relaxation has a lot to do with how the system is functioning, and particularly in terms of physical tension and feelings of anxiety, because anxiety and tension decrease our respiration, they cause us to hold our muscles tightly and perhaps creating more unevenness and out of sickness in our body than just the the pain in itself. So when music can help to assist a relaxation response, once what it’s doing is then increasing blood flow and oxygen flow, it’s helping to release tension in the musculature, which helps decrease that perception of pain because the body itself is not increasing the things that increase physical pain.

Mindy Peterson: [00:06:22] Yeah. Interesting.

Nancy Jackson: [00:06:23] Yeah. Can really be helpful when there’s that that physical tension and and anxiety and then resolution of internal conflict is really the the kind of most complex means through which music can can influence chronic pain. And so when you think about internal conflict, that conflict takes energy. It takes a lot of energy to hold inner conflict. And if your whole using your energy in that way to hold in that internal conflict, then that takes energy away from things like your ability to cope. And when you experience a chronic pain, you need coping mechanisms. So when you work with your internal self and help to bring about resolution of conflict, that sapping your your physical and emotional energy that allows you to free up that energy to be used to cope with the difficulties that being in pain bring and and you can just operate better in your daily life and that decreases the perception of how bad your pain is. Wow.

Mindy Peterson: [00:07:45] That’s fascinating. I, I didn’t see that one coming. That last one, the resolution of internal conflict.

Nancy Jackson: [00:07:52] Right. But, you.

Mindy Peterson: [00:07:53] Know, it’s interesting. I’ve heard before that pain relievers like Tylenol and ibuprofen can actually relieve emotional pain. And so part of me just kind of thinks about this in that context in terms of we think of pain as physical pain, but the emotional piece of it certainly can play a part of that, too.

Nancy Jackson: [00:08:20] Well, pain is a perception. And so while you sometimes can point to where pain is in your body, you don’t just feel it in that spot because. That’s right. It’s there. The emotional connections, there’s your ability to cope. There’s how you relate to others when you’re experiencing that. So pain is more than just that place you can point to. And and that makes it complex. And it’s complex because my pain is not the same as your pain. And we have no way to even describe or measure the differences because we can only know our own pain.

Mindy Peterson: [00:09:03] Hmm. Sure. Yeah. I suppose it is a subjective type of a thing.

Nancy Jackson: [00:09:07] Absolutely.

Mindy Peterson: [00:09:08] Huh. Well, tell us a little bit more about what this process looks like. If somebody is in a position where they may be able to use music for pain management or pain relief, do they meet with a music therapist? Is this usually happening in a clinic, in a hospital setting? Tell us a little bit more about what that process looks like.

Nancy Jackson: [00:09:28] Sure. Well, when you’re addressing chronic pain and music therapy, you might be anywhere that you would interact with the music therapist. So maybe you’re in a hospital, maybe you’re at home, maybe you go to your therapist’s office. There isn’t a place because particularly with chronic pain, we’re talking about pain that follows people every day through their life. So they might access those services in many different ways. How? The music therapist is going to work with the client in relation to their pain is going to have a different look with each person because it will be based on the nature of their pain, how they’re perceiving it, what they want to get out of that music therapy. Because we know with chronic pain we’re not going to make the pain go away. We know that it’s chronic. If if it could be made to go away, it wouldn’t be chronic anymore. So. So the music therapist will will have an assessment, typically a discussion type of assessment with their chronic pain patient, and they’ll be assessing what the intended outcome is. And the music therapist is going to get a feel for what role music plays in this person’s life, what their preferences are, the kinds of sounds and feelings, textures, styles and genres, things that are going to relate to the client, because this has to have some personal meaning in some way. Even with distraction, you know, you’re not going to distract somebody with music that doesn’t get their attention, that isn’t pleasant, that doesn’t feel good, or remind them of happy things, or the distraction requires that connection to the style of the music, and certainly so does relaxation.

Nancy Jackson: [00:11:36] You need to be able to connect to the music and to work physically to achieve that relaxation response in the body. And so the music needs to be pleasant and the client needs to be able to connect with that. So understanding the client’s music preferences is an important part of this process as well. And then working together, the therapist and the client will decide what kind of approach is going to make the most sense in order to help change the client’s perception of their pain, whether it is a distraction, if it’s relaxation. And in both of those cases, what you’re looking at is developing some some tools for the client with them, tools that they can then take and use. So, for example, when you start identifying music that the client can affect a good physical relaxation with, you’re going to help them to put those materials together so that they can use that on their own. So you’re going to do some some skills training and you’re going to help them to compile the music that they can use for that purpose and take with them and use at home on a regular basis. So it becomes a coping mechanism in and of itself.

Mindy Peterson: [00:13:05] Yeah, that’s really definitely a huge benefit that this method of pain management has is you really are teaching a life skill. It’s a healthy coping skill, a healthy coping mechanism that can be transferred to other situations in life.

Nancy Jackson: [00:13:21] Absolutely. Absolutely.

Mindy Peterson: [00:13:23] And of course there’s the advantage that it’s non pharmacological, it’s non addictive as many opioids and pain meds are noninvasive. Any other advantages that you want to mention of music as pain relief?

Nancy Jackson: [00:13:39] Now, it’s interesting that you mention invasive because people will say, Oh, music is so safe and it’s noninvasive, except that that’s that’s not really true. If you think about what sound is sound, absolutely does enter your body. Physics tells us that we have we are affected by sound waves. So it is not as noninvasive as we would like to believe it is. And it can be harmful if it’s not used properly, which is where the music therapist comes in. We can help our clients to understand how to use music that speaks to them and moves them in an appropriate way and help to mitigate any potential difficulties that might come with that. Because remember, music is is attached to our memories, our earliest memories. It’s attached to important events in our lives. It has to do with our identities. And and because of that, it also can bring up trauma. It can bring up difficult emotions. Right. So it’s this it’s not an innocuous kind of way of. Working when you when you start engaging with music, music is powerful. So if you think of water, you can’t live without water. But water can be really damaging. It can be deadly. So anything that’s powerful can also damage. So music is not different. We just don’t tend to think of it in that way.

Mindy Peterson: [00:15:21] Mm hmm. Well, and I’m glad you brought that up. I will link in the show notes to an episode that we did on the dark side of music and how music is powerful. And if used improperly, it can cause.

Nancy Jackson: [00:15:34] Harm, right? Yeah. So that’s. That’s the role of the music therapist. We do understand how to build materials and skills and make recommendations that help people to really ramp up the effectiveness and to avoid potential problems with that might come with using music indiscriminately. Mm hmm. When we talk about resolution of internal conflict, then we’re talking about using music in a very different kind of way. That really is a depth therapy kind of approach to dealing with pain.

Mindy Peterson: [00:16:15] Yeah. Is that where you bring in the Bonny method of guided imagery and music? I know that’s something that you’ve written and spoken quite a bit about.

Nancy Jackson: [00:16:24] Absolutely. That’s exactly where that comes in. Tell us a little.

Mindy Peterson: [00:16:28] Bit what that is.

Nancy Jackson: [00:16:29] Sure thing. Yeah. The Bonny method of guided imagery of music is a very music centered approach to working with one’s inner life. And so it has to do with expanding one’s awareness and consciousness in the moment and allowing music to become the bridge to one’s internal life. So it’s like a connection to the unconscious bias mind and what can happen within those structures that are created by music is that those issues that are near the surface that are ready to be worked on, that the unconscious mind is is willing to let go of. It kind of sends that material across the Bridge of Music and uses music as as a great big music movie screen in a way. And so an individual can interact with their own inner life and understand themselves in deeper and new, broader ways than they did before. And so the music then is the bridge. It’s the screen, it’s the stimulator of the imagination. And when you’re working in those kinds of internal spaces, you’re working where your creativity lives. And creativity is problem solving. No matter how you look at creativity in some way when you’re creating, whether it’s imagery, whether it’s art, whether it’s music, whatever it is you’re creating, you’re solving problems, and you’re doing that by putting new old pieces of information together in new ways.

Nancy Jackson: [00:18:19] So as people work with their inner life in music, that’s what they’re doing. They’re taking the themes that are coming from inside themselves and they’re putting those pieces of information together in new ways that help them to solve their internal problems, that help them to see things from a new perspective or to have a new insight about themselves. And that’s where that resolution of internal conflict then frees up the energy that it’s been sapping from the individual. Sometimes clients will actually say they feel lighter afterwards, they feel lighter, they feel like they have more energy. And it also helps them then to make similar kinds of resolutions or changes in their external life, in their everyday life. And all of these things help someone with chronic pain to be able to cope better because again, it’s chronic. We aren’t making the pain go away. What needs to happen is that the perception of how bad it is and how much it impacts daily life that needs to lessen.

Mindy Peterson: [00:19:35] Well, when you’re talking about that bonding method, I was just going back to that term, non invasive or invasive and thinking when people get involved in that, I mean, would you say that’s a form of music, psychotherapy or vocal psychotherapy, depending on how it’s used?

Nancy Jackson: [00:19:51] Absolutely. It is a psychotherapeutic technique.

Mindy Peterson: [00:19:54] Okay. So I can imagine a patient or a client getting involved. In a session like that and thinking this is invasive because we’re talking about some really deep things here and.

Nancy Jackson: [00:20:06] They’re feeling it too. And music allows them to actively feel that. So they’re engaged with those internal feelings and thoughts.

Mindy Peterson: [00:20:16] Sure. So you’re right. I mean, it is invasive in a much different way than we would think of, say, a pill or an injection or a surgery being physically invasive. It’s it’s invasive and maybe other ways, but with probably much more long term positive results in a holistic way where it’s affecting all of them, not just the physiological but the emotional relational. I’m sure relationships can be affected positively by psychotherapy, work and sessions and just pain relief as that emotional and physical self is so intertwined.

Nancy Jackson: [00:20:56] Absolutely. When you think about the emotional, the physical, we like to think about those as though they’re silos. You know, it’s like this part and this part and this part, except that those parts are all one thing. It’s us, right? And there really isn’t any separation between those things. So anything that affects us in one domain of our life affects us in all domains. So when you feel better emotionally, you’re going to feel better physically. When you feel better physically, you’re going to feel better emotionally, you’re going to think clearer, you’re going to act better. People will respond back to you better because all of that is connected. We aren’t we aren’t just a lot of little parts. All of those domains of our health work together. Yeah, well, when.

Mindy Peterson: [00:21:49] Should people consider music for pain relief? When is it a really good option?

Nancy Jackson: [00:21:56] Well, I think it’s always a good option because people don’t necessarily need a music therapist to distract themselves using music. That’s a pretty simple technique to get kind of lost in something you really enjoy and give yourself some respite from that pain. So those are things that people can do for themselves really easily, particularly if they have worked with the music therapist and they have a heightened awareness of how they can help themselves to do that. Certainly with relaxation, medical personnel are increasingly recognizing just how important things like relaxation are for any number of physical and emotional mental types of difficulties. So I think that that’s really encouraged, particularly with people with chronic pain, because we know that that pharmaceutical treatment is not really very effective for pain. Inflammatories will work short term sometimes, and then the opioids, they don’t do anything to help the pain, they just block it. And then, of course, you know, the pain, just the awareness of it just comes back. So I think that medical personnel are very open to encouraging people to seek out these other things that really can have a significant impact. And relaxation is an easy one to go after. It doesn’t take a lot of energy. It doesn’t take long term work with a therapist where, as you know, working, for example, with a bonny method or with depth, psychotherapy, kinds of things that are really focusing on resolution of inner conflict, those aren’t things that you do in a week or so. That’s that’s really a therapy process that occurs over time. So people who want to seek that out are people that need to be willing to put that kind of time in vestment into their process.

Mindy Peterson: [00:24:04] Mm hmm. And I’ll just point out, music can be used to enhance the effect of pain medication. It can be used along with pain medication or in some cases, in place of it, or when patients aren’t able to use medication for some reason.

Nancy Jackson: [00:24:20] That’s right. And music is never a bad influence on a drug. Right. You don’t want drug interactions? Well, there is no such thing as a bad music drug interaction.

Mindy Peterson: [00:24:34] Well, I will definitely include lots of links in the show notes where people can get a look at your articles and your research, your books that you’ve co authored. What other resources do you recommend for listeners who want to learn more or find a qualified music therapist to help with pain management?

Nancy Jackson: [00:24:55] Sure. Well, you can always go to. The American Music Therapy Association main page or to the certification board for music therapists. Both of those websites will allow you to search for music therapists in your area. Each state also has a state organization that you can find online. So Minnesota has a state music therapy association. The state associations can put people in touch with music. They’re in touch with music therapists who are in their area. And then if you’re interested in something like a longer, deeper process, such as working with guided imagery and music, you can go to the website of the Association for Music and Imagery, and there you can find ways to contact a properly trained gym therapist in your area.

Mindy Peterson: [00:25:52] And gym is guided imagery and music.

Nancy Jackson: [00:25:55] Yes, that’s and sometimes it’s called the Bonnie Method, and sometimes it’s just called gym. But that is that kind of in-depth music based psychotherapy approach.

Mindy Peterson: [00:26:07] Wonderful. Well, Nancy, I ask all my guests to close out our conversation with a musical ending a coda by sharing a song or story about a moment that music enhanced your life. Tell us about that song that you wanted to share with us.

Nancy Jackson: [00:26:22] Yes, this song I’ve been listening to a lot lately. It’s called Walking By Flashlight, and it’s by Maria Schneider, a rather well known jazz artist. And I’ve been listening to this a lot because I know that in my daily life I have really been feeling the the weight of chaos that’s in the world all around us right now. And sometimes that feels very heavy and very dark and that feels very hopeless. And what strikes me about this particular piece is that, you know, there’s this idea when you walk with a flashlight, you don’t really see a whole lot of what’s around you. Right? You only kind of see the steps you’re taking where you shine that light. But when I listen to this song and think about that. It shifts my perception on that. And the way it does that is that it kind of changes that heavy, dreadful, chaotic feeling into something that feels more like, wow, this is kind of this is a wonder. We don’t know what’s out there in the dark. And it doesn’t necessarily mean that something bad is out there just because you can’t see it. So as this piece kind of grows and develops it, it has such a hopeful kind of feeling, even though it does kind of give you that feeling, feeling as though I don’t exactly know where I’m stepping next, but it might be wonderful.

Transcribed by Sonix.ai