Our Song: Music Therapy with Couples When One Partner is Medically Hospitalized

Practicing music therapy in a medical setting, I have had frequent opportunities for sessions with patients and their family members together. In these sessions, I have found that music becomes a facilitator of family interactions and a resource through which connections can be strengthened and maintained. When working with adult patients in a general hospital, 1 have observed that the familial visitor or caretaker is often a spouse or intimate partner and that this unique and sacred dyad has particular needs that are relevant and notable for the music therapist.Couples may function in crisis mode while one of the two is hospitalized. Issues about the relationship that may be problematic can escalate; however, neither partner may want to raise the issue verbally due to the compromised health of the other (Langer, Abrams, & Syrjala, 2003; McDaniel & Cole-Kelly, 2003). When one member of a marital couple/intimate partnership is hospitalized and the relationship becomes stressed, the integrity of that relationship may also become threatened over the course of time as with chronic illness (McDaniel & Cole-Kelly, 2003). The problems identified in this literature indicate that intervention may be necessary to protect intimate relationships from the negative implications of the hospital experience.The music therapy experience is known to include empathy and experiences of intimacy and has been used to promote empathy in families (Hibben, 1992). Music therapy has been found to facilitate effective communication (Miller, 1 994) and reduce anxiety (McDonnell, 1984) in family sessions. I have found that examining relationship struggles as defined in the non-music therapy literature and applying music therapy interventions can help to make clearer the issues of this population and the role that music therapy can play in finding solutions.Review of LiteratureMedical Hospitalization and its Effect on the Intimate Partnership UnitIn studying the psychological effects of illness and hospitalization, I have found it difficult to research the patient's needs and potential issues without also reading about the effect of the illness on the family. The psychological stressors that are relevant to hospitalized medical patients are vast and well documented and include fear, guilt and shame, depression and anxiety, emotional numbness, impaired self-image, and other difficulties (Halford, Scott, & Smythe, 2000; McDaniel 1992; Kleinman, 1988; Falck, 1987; Lichtman & Taylor, 1986; Burish & Bradey, 1983; Strain, 1977). (Some of these stressors, particularly fear and anxiety, are apparent in the case studies described later in this paper.) But the patient's sickness has profound consequences for the rest of the family as well. According to Kleinman (1988), "illness influences relationships as strongly as it influences individuals" (p. 185).In their study of a systemic philosophy of medical treatment, Connell and Connell (1 995) stated that illness is not an experience limited to the sphere of the patient. Everyone involved with the patient, including family members, experiences the uncertainty and lack of control inherent in a hospitalization experience. A family's identity and resources are challenged during this time. In turn, family members who respond to the illness with depression, anxiety, or argumentative stances may complicate the patient's adjustment and communication with the healthcare team.McDaniel, Hepworth, and Doherty (1 992) gave conscious attention to the interpersonal life of the family. The authors noted that a family seems to halt its development when one member is sick and resist change as they focus on that member. This shift, where the needs of the hospitalized individual are made top priority and other family members' needs are pushed aside, can create frustration, resentment, and poor communication within the family unit. Families may become exhausted from caring for their relative and isolated in that process. …