How “Twinkle, Twinkle Little Star” is helping Gabrielle Giffords

The other day I came across a very interesting article about how the nursery rhyme “Twinkle, Twinkle Little Star” has played an important role in the recovery of Congresswoman Gabrielle Giffords from her traumatic brain injury. The article, in the UK’s Telegraph, talks about how music therapy is helping the Congresswoman:

When Miss Giffords mouthed the words of Twinkle Twinkle Little Star as her music therapist Maegan Morrow sang the ditty and strummed a guitar, it brought tears to those gathered at her bedside.

She has now progressed to sing-alongs of jazz and rock classics such as I Can’t Give You Anything But Love and American Pie in her sixth-floor room at The Institute for Rehabilitation and Research (TIRR) in Memorial Hermann hospital.

After reading the article, I turned to music therapist Shanna Clark to discuss What is Music Therapy, and how is it being used. Here is her guest blog:

While it seems cliché and even somewhat garish to look for the proverbial “silver lining” in a tragic story like that of Congresswoman Gabrielle Giffords, I must say that, as a music therapist, I feel a certain sense of pride in learning that music has played such a vital role in her recovery. A piece of this satisfaction is, of course, in knowing that this work in which I believe so whole-heartedly is making a difference for Ms. Giffords and her family. Yet another piece is on behalf of the field of music therapy as a whole. Music therapy, though legitimized as a health care profession by its professional association and credentialing board for over 60 years, remains something of an enigma. As a music therapist and an active member of the American Music Therapy Association, I have assumed responsibility in supporting the mission of advancing public awareness of the benefits of music therapy (AMTA, 2010), and I do so every time I field the question, “What exactly IS music therapy?”

The American Music Therapy Association’s official definition of music therapy is:

“…the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program” (AMTA, 2010).

Beyond a dictionary definition, though, what people really want to know is, “What does music therapy LOOK LIKE?” This elicits a much lengthier and more complex answer. AMTA tells us “music therapy interventions can be designed to promote wellness, manage stress, alleviate pain, express feelings, enhance memory, improve communication, promote physical rehabilitation” (AMTA, 2010). What people still want to know is what I DO. Do I play live music? Do I sing? Do my clients listen to recordings of music? Do they play instruments and sing? Do we write songs together? Do we perform? Make recordings?

The answer to the question of, “What is music therapy?” is almost never simple, because the methodology depends completely upon the music therapist and the clients engaged in the treatment process. I happen to work with adolescent girls in a residential treatment setting. Most of them come to treatment with some kind of trauma history-ranging from abuse and neglect to witnessing acts of violence, prostitution to loss of attachment figures, and so forth—which yields psychiatric and behavioral issues. The majority of the girls I work with are relatively cognitively high functioning, though some have intellectual limitations. And what does music therapy look like in my setting? Each client has her own clinical goals established by her treatment team, but many of them focus on acquiring skills for emotion regulation, communication, and self-expression, improving distress tolerance and interpersonal relationships, and building self-esteem and self-efficacy. Music therapy techniques are built into both individual and group therapy sessions and range from listening and lyric analysis to song writing and performance. Through discussions and ongoing music-based projects, the girls learn how to reflect on their own thoughts and feelings, work with others toward a common goal, increase insight around their own responses to challenging situations, and gain a sense of mastery and accomplishment.

My work is just one possible answer to the question of what music therapy is. I have colleagues who work with elders suffering from Alzheimer’s and dementia, using music to maintain their declining memories and cognitive functioning while providing opportunities for social interaction. Music therapy has proven successful with children on the autism spectrum, promoting language acquisition and developing basic social skills. Other music therapists work in hospitals, correctional facilities, schools, substance abuse clinics, physical rehabilitation facilities, and outpatient therapy practices.

Giffords’ story is of particular interest to music therapists for a variety of reasons, but perhaps specifically because it tests the results of a number of studies examining the relationship between music and the brain. Research has shown that because music stimulates multiple areas in the brain, people who suffer traumatic brain injury and lose their ability to speak are often still able to sing and recall melody. Over time, researchers and music therapists have developed techniques using retained language and melody to retrain damaged language centers in the brain, allowing patients to regain the ability to speak. Additionally, victims of traumatic brain injury sustaining loss of motor abilities have had success when their physical rehabilitation regimens have included music therapy. Techniques such as rhythmic auditory stimulation, which relies on the brain’s connections between rhythm and motor coordination, use tempo to stimulate and regulate movement. Research conducted at Temple University revealed “rhythmic auditory stimulation therapy improved walking speed by an average of 14 meters per minute and helped patients take longer steps…[and] also improved arm movements, as measured by how far the elbow could be extended” (Bradt, et. al, 2010). Furthermore, multiple studies have suggested that music reduces depression symptoms, which aids in the rehabilitative process following a traumatic event.

So the next time you hear your favorite song on the radio or find yourself reminiscing about a familiar childhood nursery rhyme or lullaby, you might think of it as something more than a simple amusement. I would speculate that Gabrielle Giffords and her family now have a far more profound relationship with Twinkle, Twinkle, Little Star than they previously thought possible.

Shanna M. Clark, LMHC, MT-BC

Licensed Mental Health Counselor

Board Certified Music Therapist