The Benefits of Music Therapy, ft. Marisabelle Díaz-Falcón, MPH, MT-BC – Shrinking It Down
As Dr. Gene Beresin always says, music is a universal language. To kick off our new podcast season, and in honor of Gene’s new book, Music, today we’ll look into the ways music can help us heal. Special guest Marisabelle Díaz-Falcón, a board-certified music therapist at Massachusetts General Hospital, joins Gene and Khadijah to talk about the ways music therapy helps kids (and adults!) in the hospital. Backed by science, the benefits of music therapy are plentiful, and we’re here to give you tips on how to bring some of these benefits home!
Follow along with the conversation.
- “Better When I’m Dancin’” by Meghan Trainor (YouTube)
- Music (Arts for Health) (Emerald Bookstore)
- Marisabelle Díaz-Falcón, MT-BC (MGH)
- End of Summer Playlist 2022 (MGH Clay Center)
- Music Therapy (Mass General for Children)
- Community Music Center of Boston (CMCB.org)
- Center for Music Therapy (Berklee College of Music)
- Trauma: What Parents Should Know (MGH Clay Center)
- Gate Control Theory of Pain (YouTube)
- Just for fun: Gene’s Mug (Google)
Thu, Oct 20, 2022
Gene (Beresin, MD, MA), Khadijah (Booth Watkins, MD, MPH), Marisabelle Diaz-Falcon (MPH, MT-BC)
Marisabelle Diaz-Falcon 00:00
It’s called I feel better when I’m dancing by Meghan Trainor. And it goes like, “don’t think about it. Just move your body. Listen to the music sing Oh,” and it just it gets at least me in a great mood.
It sounds so fun.
Marisabelle Diaz-Falcon 00:18
Really enjoy it, yeah.
~ INTRO MUSIC ~
Welcome back to the new season of shrinking it down mental health made simple. I’m Gene Beresin.
And I’m Khadijah Booth Watkins.
So we’re two child and adolescent psychiatrists said the Clay Center for young healthy minds at Massachusetts General Hospital. Our sixth season. Can you believe that? Amazing. Khadijah, what do you think?
I mean, I can hardly believe it. But I’m so excited about this new season. We have so many great guests that are going to be joining us over the course of this year and so many incredibly interesting topics. So I’m super excited.
Yeah, it’s definitely going to be a great season, we’re going to start off with a topic that’s near and dear to my heart, the intersection of music, health in general, I would add well-being to that. And mental health. I have a new book coming out. I have. It’s my first book, actually. The 24th of October. It’s a series on arts, arts for health. And this one is music. And it’s on the influence of music and well being. So joining us for the conversation today is Marisabelle, Diaz-Falcon, music therapist here at MGH, who’s who sees every day, how music impacts those who are who are sick. And Marisabelle received her Bachelor of Music at Berklee College of Music, and has been at MGH ever since. So welcome, Marisabelle. We’re so glad to have you on the show today.
Marisabelle Diaz-Falcon 02:21
Thank you. I’m happy to be here.
So let’s get right into it. For our listeners who may not know. Could you give us an overview of of what is music therapy?
Marisabelle Diaz-Falcon 02:33
Yeah, so music therapy is an established healthcare profession that uses music and all its unique qualities to address different conditions and symptoms, such as psychological distress or physical symptoms is something that you study either at the undergraduate or graduate level. And once you finish all your coursework, you then are able to sit for a board exam to become a board certified music therapist.
So can you help us understand what the benefits are of music therapy? How does it just differ from someone just listening to their own personal playlists?
Marisabelle Diaz-Falcon 03:14
Yeah, that’s a great question. I think one of the main things to know is why music why use music as a therapeutic tool. And I think mainly, it’s because it engages so many areas in the brain, such as those that are associated with language cognition, executive functioning, sensory integration, and giving that we know this, we can use it within a therapeutic context. And music therapy is also something that addresses mind and body functions in a holistic way. So that’s one of the main reasons of of its benefit. And in terms of the differences of just giving someone a playlist to listen to, I think the main thing about music therapy is that as music therapists, we work to adapt music to the person’s needs, and to the person’s goals that we’ve established, either within their medical team or that once I am working with them, I establish as things that can help in promoting their wellness. And I always like to think about why music is also when we use it as music therapists. It’s very patient centered, and it’s the music that the patient prefers. Because if I just give everyone the same playlist, it might do some good for some people, but some harm because there’s music that sometimes people don’t like and that is not going to be of benefit to them. So I think about if one of you goes and sees a physical therapist for like a post knee surgery, and I see them for a post shoulder surgery, you’d expect that the physical therapist gives me different exercises to get better and heal from my soul journey that are going to be different from yours. So that’s one of the main things that I like to think about, we really tailor it to the patient and their needs.
So I can imagine the tailoring is obviously important. But I’m curious, because if you were going for physical therapy, it’s almost like a recipe, like they’re muscles. Music is so broad and vast, and there’s so many different genres of music, and it’s ever changing. How do you as a music therapists, kind of take all that in and then come up with a tailored, I don’t want to call it a playlist, I don’t know what else to call it, but a tailored compilation of music that you feel like it’s going to help a person with to reach their goals, or to reach that to reach their optimal, I guess, wellness? Or how does that work?
Marisabelle Diaz-Falcon 05:47
Yeah, I think it’s the same way as like, a doctor sees a patient and they do a medical history, and they check in with the patient of like, okay, you know, why are you here today? And what are some things that you’re presenting, that I can help you with? And so I do the same thing, I do an initial assessment with the patient, I like to learn about what their past experiences and music are, what is their relationship right now with music? And then also understanding, okay, what are some challenges that they might be experiencing within their hospitalization? And how are we coping at this moment with what’s going on? And once I have a conversation of that, either with the patient itself or with parents, when sometimes they’re a little bit younger, I can then decide what specific interventions I might use that can be of support.
So can you give us an idea of how often it’s used with kids, as opposed to adults?
Marisabelle Diaz-Falcon 06:44
Yeah, so music therapy is something that it doesn’t have, like an age restriction. I’ve worked with patients from, you know, infants that are just weeks old to older adults in the 90s. At this moment, I only work with pediatric patients. So it’s kind of the availability that the program has, at least between my colleague and I were, were on the inpatient units that we work in every week. And so patients are at least able to be seen quite consistently. But there’s other units that I might only see patients once a week or twice a week, because that’s the time that I have dedicated to that specific unit.
But let me ask you about your practice, do you actually play an instrument with the kids? Like a guitar? Or nd have them play along with you? And how do you decide to choose whether this is going to be kind of an active interaction versus listening with them to a playlist?
Marisabelle Diaz-Falcon 07:46
I would say that it really depends on where the patient is at. So if I have someone that is at a good, you know, maybe they’re admitted, because they have asthma, let’s say, but they’re in, they’re not as withdrawn as I might see another patient, and they’re, you know, looking to actually engage in more movement based activities, then I would definitely encourage them to play instruments, the more interactive, the more, you can see that the patient takes, you know, a lot away from the music experience when they’re kind of younger in that age. But I also just have patients that in that moment, what they need is receptive music listening. So live music at bedside with a guitar, which is the instrument that I mainly use in my voice. And that is doing enough for them on that day. It’s promoting a relaxing and calming environment, that sometimes there’s so many stressors in their environment, if you think about the ICU with so much sound that goes on that providing that time and space of live music can be just what they need in that moment. And rather than than passive music listening, I think the main difference is that you have a clinician there with you at the bedside providing direct patient care, but just using the different tools of music.
And do they get to choose the instrument they play with you?
Marisabelle Diaz-Falcon 09:09
Yeah, I, I often like to encourage that, but there’s, there’s times that there’s certain considerations that I have to take. So let’s say I have a patient that recently had a surgery that they can’t lift up a certain amount of weight, that I’m not gonna go ahead and and give them a guitar because it’s heavier than the weight that they’re supposed to carry. But maybe I can give them some other options that can work great. But I oftentimes Yeah, I really like to encourage them to get their hands on something it it really makes the experience even better.
Or what about singing and dance? Because those two are often used? Yeah.
Marisabelle Diaz-Falcon 09:48
Yeah, singing is another great instrument that we have, and and movement as well. When you think about the way that you listen to a song and you just like You can’t help but like bob your head to the beat of the song, it’s because our auditory cortex and our motor cortex are working together. And so the repetitive tempo and beat of the song, your body just wants to coordinate a movement to it. So that just kind of comes along the way I have people who are, you know, they’re not feeling great, but I still see them tapping their toes or, or bobbing their head a little bit. So they’re getting some, some movement. And even when I think about like, patients with a disability, that might not have as much mobility, there, there can still be moments where even just them raising their hand a little bit is a sign of like, Hey, I’m, I’m here, and I’m responding to what’s happening in this moment with music.
So so it sounds like you are obviously working in a hospital based setting, and you’re seeing kids of different ages with different ailments. How would a family go about accessing music therapy? If they weren’t in a hospital? I mean, is it covered by insurance typically, like what is the the process?
Marisabelle Diaz-Falcon 11:05
Yeah, so what I know is that there are some outpatient facilities that might be covered by insurance or may not. I do know that a lot of programs are philanthropically funded. So there are some centers in the Boston area that provide music therapy, and also private practices that people have within the Massachusetts area that I’d be happy to send a more detailed list. But some that I can think about, like off the top of my head is the Community Music Center that’s in Boston. And then Berkeley just launched a Center for Music Therapy, that their whole kind of goal is to provide community based music therapy to address health disparities. So there’s definitely some programs out there.
That’s awesome. And how would that differ? Or would it differ from a hospital based music therapy? intervention versus an outpatient music therapy session?
Marisabelle Diaz-Falcon 12:04
Yeah, I think that the, the main difference sometimes can be just like, the acuity of someone when they’re admitted inpatient of how they’re feeling and doing that. The interventions and music therapy can look a little bit different, maybe in a community setting when we’re everyone’s you know, feeling well, and it’s maybe more tied to health promotion, you might see very much like more active based experiences. Whereas in the hospital setting, you can see a little bit of everything. I have patients that are still intubated or post extubation and still kind of going through, you know, still being a little bit somnolent.
Yeah, okay, so there’s another interesting aspect to music therapy. And that is whether you involve the parents, and both in the hospital. Although they might be a bit shy, or at home, and if it’s at home, do you recommend a music therapist come to the home? What do you recommend? Do you actually prescribe certain exercises, songs, drum circles, whatever that the family and, and kid can actually do together.
Marisabelle Diaz-Falcon 13:23
When I think about experiences that I’ve had with kids and their parents in the hospital setting, both outpatient and inpatient. Specifically, more more inpatient, there’s times where I really encourage, you know, family bonding experiences through music, especially with like infants, including the parents who maybe have already started playing some music for the kids or, or specific songs that they played while the kid was in the mom’s womb, can really help in supporting that connection. But there’s other times where I know mom could use some time for self care, and they know that it’s okay for them to step out and take a walk, take a coffee, because that’s what they need in that moment. And that’s important, we want the parents to take care of themselves. So I think in the home based setting, if there’s someone who was seeking music therapy, there are times where it can be for the family as a whole. You know, it’s not just the patient that is going through an illness, the whole family is impacted by a child’s illness. So I oftentimes really like to encourage the family to be part of it. But there’s other times where maybe it is just a time and space for the patient to build a connection and a therapeutic relationship with their provider. And that in and of itself is is really important to for them to be able to do things on their own as well. So we often
hear about music therapy being used as part of cancer. Treatment especially with children, can other children who are struggling with other ailments benefit from music therapy and thinking about maybe kids who are struggling with anxiety or depression or maybe have OCD?
Marisabelle Diaz-Falcon 15:11
Yeah, definitely, any child can benefit from music therapy and every child is, is growing and developing, right. So in a way when, when they might be going through a difficult time, we want to see in what ways we can still help them promoting their development. And music therapy can be a benefit during those moments. And I think that adverse childhood experiences is something that is coming up a lot. And so that’s something that impacts a person’s health. And we know that music therapy can help with someone that’s experiencing crisis, or trauma, or anxiety, OCD depression. So we want to make sure that we offer a supportive healthcare service like music therapy that can complement those treatments that they might be seeking that are more traditional based.
And pain management is a huge issue. And we’re often trying to figure out and think of creative ways, you know, either in addition to or instead of medication to help people manage pain, what’s the role of music therapy in terms of pain management? How does it help?
Marisabelle Diaz-Falcon 16:17
Yeah, music oftentimes can serve as a positive distraction for patients when they’re experiencing pain. And there’s a theory called the gate control theory of pain, that basically, the spinal cord sends a signal up to the brain that helps process the perceived pain. And what we know is that in a way, music can kind of change that incoming input. So and this is because of the way that music can have an impact on both physiological and emotional aspects to pain. So given that we know this, we can use music to offer a distraction.
So we have a question from a listener about music. It happens to be our managing director, Michelle Marshall, who’s the mom of three kids, but let’s listen in and see what she has to ask.
Michelle’s Voice 17:16
So sometimes when I feel my kids are stressed out going to or from some activity, or sports, I put on 99.5, WCRB classical radio, because I believe it calms them down. Is that true?
Okay, so what would you what would you say?
Marisabelle Diaz-Falcon 17:40
I would say that, maybe, you know, there is some classical music that is slower in tempo. And oftentimes, when, when we’re kind of a little bit in a more higher energy place, music that is a little bit lower in tempo can help provide a more relaxed state. But it’s also important to take into consideration maybe they already have had some exposure to classical music, that they have a positive connection to it, that that can also tie into them, having this positive response, but definitely listening to music that’s a little bit slower and softer, and tempo, can help regulate our mood and our energy.
And there’s other genres of music that are similar to classical that, that are, you know, largely instrumental and quiet and soothing.
I just want to I want to follow up to your to your point, and you mentioned about you mentioned whether or not they might have experience or exposure to classical music. How does this work when this is maybe not a genre of music that maybe your kid is familiar with? Or maybe even enjoys? Does it have to necessarily be slow, calm and soothing music to give to create kind of a soothing environment or great calm?
Marisabelle Diaz-Falcon 19:12
I would say for the most part, yes. But I’ve had patients who they find relaxing, a beat rock music, and that’s just their preference and how their body responds to it. It’s not what I usually see. But once in many patients, I hear that type of response. So that’s where it all just goes back to what’s the patient’s preference, what’s the kid’s preference? And, and how does the music make them feel taking the time to really process that? That we oftentimes we might just think about it in our head, but it’s not until you maybe talk to someone you you even as a parent asking the kids like, Well, what do you notice like, you know, when you go hopped in the car and you were a little bit, you know, restless. And now, you know, we’ve we’ve listened to a couple songs and I notice you’re, you know, your shoulders are more relaxed, you’re able to take a, you know, breathe a little bit in a more relaxed way, noticing the changes that you see, that can help them also, them acknowledge it themselves.
So are there activities that we could do at home with our kids that we can kind of take away from clinics and programs that specialize in music therapy, but apply them in our homes with our kids?
Marisabelle Diaz-Falcon 20:34
Yeah, I would say that, that thinking about ways that music can support how we feel. So if we’re looking for music to support, us feeling more relaxed, listening to music, to support, connecting with other people, to modify how our mood is to increase our energy to get moving a little bit more. Once we have kind of that, that goal, we can then decide, okay, I’m going to listen to if I’m thinking about music to, to connect with other people, I’m going to I’m going to see if I can listen to music with with my sibling or with my mom or my dad, and see if there’s certain memories that come up from listening to the music, see if if listening to the music makes me want to move and dance a certain way, or seeing if, if listening to the song makes me want to sing singing is a great way that we can kind of access music and that it can promote us like to express ourselves to improve our mood and to evoke just overall positive responses, and instrument playing. Although that might not be accessible for everyone. I think it’s a great way for cognitive stimulation and for emotional expression that many people benefit from. The other thing I can think of as well is it just went away from me. What was it thinking, playing instruments listening to music, and I haven’t like on the tip of my tongue. Oh, another thing that people can benefit from is writing their own music. If you’re someone who likes to write poetry or likes to journal, you can use that as a way to then turn it into a song, even if it’s no instrumental background, but seeing what would it look like if you if you sing what you write.
This is like so incredibly helpful, because I think about the ways in which I use music and we use music in our home. And I never thought about it in the way that you just kind of so nicely like outlined it. So we have a morning playlist that kind of gets us ready. And in the mindset to kind of face the world a little bit of lifting, a lot of it is more so not so about the music because the music is different, but more so about the words, we definitely have a cleaning playlist that we use, like when we’re when we’re in chore mode. Definitely, you know, in the evening, when we’re trying to relax, we have these different playlists or music selections that we have to achieve different goals. And I guess I never thought about it, it just happened automatically. But I never thought about that I’m trying to achieve if we’re trying to get moving. If we’re trying to increase our energy, we’re trying to increase our mood like this. There’s different music for different things. We don’t we’re not very musical in terms of instruments here, but we definitely like to sing and dance.
Marisabelle Diaz-Falcon 23:28
Yeah. And creating playlists is such an awesome thing that you’re already doing. I often encourage that for for certain times of the day, I work with kids that getting out of the bed is really hard. And getting out of the bed in a place that’s not their home can sometimes be even harder. So doing a playlist that is started with the ISO principles. So it meets you where you are, you’re maybe feeling just a little bit sluggish to feeling more like okay, the end of this playlist is going to be me getting ready to get out of bed. So what music you might start that meets you feeling a little bit sluggish to more energized and like gradually shift to that and desired mood. That’s something I really think that can benefit many people or just even, you know, talking with people in your family and thinking about times that you’ve spent together with them and say, Hey, is there a song that reminds you of a time that we spent together that you really like and you’d be surprised to hear what family members might say that you can then create a playlist that just has a bunch of great music that you can access when when you need to uplift your mood and you need music that reminds you of of your support system and of of how it feels to feel good.
I can give you a great example. Not about music at home but for 20 years. I used music as a good morning. It’s kind of like Good Morning Vietnam. for that film, I use a good morning residents. And I sent out a song every morning. Usually they were according to themes. So, you know, at the beginning of the year back to school themes, there were plenty of themes, you know, for Thanksgiving and for holidays, and —
I’ve begged you for two years to dust them off.
And I’ve got them all recorded. And what was so cool about it is I would do it the night before. And they had to be under three minutes, because back then, voicemails were not allowed to be longer, or they couldn’t be longer. So I had to time them. But every morning, the residents and and a whole bunch of faculty, and you know, it kind of sets the tone for the day. Yeah, it kind of, and then there were requests for other other tunes. So it was it was an interesting way of using music for folks and trainee who was super stressed, and are looking forward to some kind of hard during the day, because it’s not easy being a resident. So it was it was helpful.
That’s all right. So we created here at place in our SMR and the summer playlist, what what would you put on that list? If you had to pick a song for the playlist?
Marisabelle Diaz-Falcon 26:32
I don’t know the songs on a playlist yet, but it’s called I feel better when I’m dancing by Meghan Trainor. And it goes like, “Don’t think about it. Just move your body. Listen to the music sing. Oh.” And it just it gets at least me in a great mood. So it sounds enjoy. Yeah.
We can tailor it to illness. But what about music for general wellbeing? For general, you know, for general well being I mean, how can we incorporate music into our lives into our day, that can actually help us? function better?
Marisabelle Diaz-Falcon 27:24
Yeah, I think that even the example that you shared of how you start your day with music, tying music to certain moments of your day, I think can definitely be of benefit. I’m someone who I have specific set of songs that I like to as I’m getting into work, to help me stay centered and get ready for the day that I like to listen to. And that’s why I kind of always go back to listening to music, because it’s the most accessible thing that many people are able to have. That’s one thing that I like to encourage an even music based activities of, if you see your community has a concert that’s coming up that you can attend, going to community based experiences can help you also engage in healthy practices. And I think music can be seen as like a social determinant of health, because of the community aspect that they can have. And any way that we can help in and in addressing any disparities that people might experience and other determinants of health, that music can kind of reach is important.
So we hope that this is been an interesting and helpful conversation. So music really is a universal language. And there’s been a lot to show to improve wellbeing for individuals, as we’ve talked about for families, for communities. And so thank you for joining us for this new season. Not to wrap it up on a positive note morrisonville What is something you looking forward to in the next week or so?
Marisabelle Diaz-Falcon 29:05
I am looking forward to seeing my sister this weekend to thinking about the conversation that we just had. Now she’s someone who when I started music, I was four and it was because of her she was around seven or eight at the time she had started taking flute lessons and I was monkey see monkey do I wanted to do it my sister did so I’m excited to see her and and just to thinking about what we talked about reminded me of her.
And Khadijah, how about you?
I think I’m looking forward to enjoying some of this pleasant weather that is still lingering around for the rest of the week here in Boston, hoping to get some outdoor activities. I just think given some inspiration, I’m going to also send out a request to my families who’s supposed to come down for Thanksgiving to ask them what is a song that they think of when they think about hanging out with family So I’m gonna create a playlist for Thanksgiving. Because again, I think our house is always full of music, especially when families around. So that is what I’m looking forward to. I’m looking forward to hearing the responses and enjoying the weather. What about you, Gene?
Well, I second that about about the outdoors. I’m looking forward to two things. I mean, one is I just got word today about my book, and a promotional plan and sending it around and seeing what people think about it and hope it is it’s going to be helpful. The other thing is, I actually end the day, every day this week, early. For me, that’s like 6pm. But that means that I get a chance to practice the piano. And I’m looking forward to kind of and I have a lesson with my teacher, Ben Cook, who plays for the Pops who’s like, just amazing. I don’t know how I don’t know how he does it. But I’m kind of excited about what I’m going to be working on, you know, for the next, you know, three or four days to get ready for my lesson on Saturday. So, thanks, everybody. Don’t forget that episodes will be every third Thursday of the month. And we’re hope we hope that our conversation helps you have yours. I’m Gene Beresin.
And I’m Khadijah Booth Watkins. Thank you for joining us.
~ OUTRO MUSIC ~
What is it that mug that you just put to your lips?
That’s quite an impressive mug. I mean —
This is a mug that’s a replica of the mug that they used and Paul Revere probably drank out of mug….
Paul Revere drank out of that mug??
Well, this is a reproduction but this was used in the Jones tavern where the Minutemen met right before they did that fateful trip to Concord meanwhile, and the shot her down around the world so I got I got about 20 of these. Well, maybe 15.
Well, I need I need a pair of my own. So next time I come wait,
I’ll give you I’ll give you a couple if you can’t,
I need two — you can’t have just one. I need a pair.
Episode produced by Bianca Dempsey
Edited by Sara Rattigan
Music by Gene Beresin
Transcribed by https://otter.ai
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