In her article “Hard and Heavy Music: Can It Make a Difference in the Young Cancer Patients’ Life?” Fereshteh Ahmadi shares from her personal experience and research on using an unusual genre of music to treat cancer patients. Through being open to using the often stigmatized genre of hard and heavy music, she shows how this genre can ironically help patients cope with the pain and suffering of cancer. She includes heavy metal, hard rock, hard rap, punk rock and aggressive pop music as examples of hard and heavy music. Two case studies are used, and although she makes no attempt to generalize what was discovered, Ahmadi challenges negative assumptions about the therapeutic appropriateness of this genre.
Before reading this article, I'm not sure that I would have considered using heavy music in this way. My inclination would be to use relaxing, soft music to treat a patient’s pain, anxiety, and stress. Ahmadi effectively shows the necessity for therapists to recognize each patient’s needs on an individual basis, especially in terms of coping with cancer. Both clients interviewed expressed how aggressive music allowed for a kind of self-expression and coping that didn’t exist elsewhere. They needed to express their sense of anger, hopelessness, and dark worldview that healthy people didn’t have.
Although I have not the experience of providing music therapy for young people with cancer, Ahmadi’s words resonate. In my brief experience doing student clinical work at an oncology unit, I often observed older patients attempting to hold back the anger, fear, and hostility they felt. I remember one patient saying how he felt “just fine” at the beginning of the session. He stated that he wouldn’t object to music therapy, but that he really didn’t need help with decreasing pain and anxiety or increasing relaxation. After presenting him with some options on what we could do, he requested Louis Armstrong’s song “What a Wonderful World”. About half way through the song, he stopped humming and tapping his foot. He sat and listened for the duration of the song. After the song -- silence. I waited for a response. Then after approximately 30 seconds, he looked up at me and said in a very loud voice, “Well it’s NOT a very ‘wonderful world’, is it?!” He then began to cry and asked me to leave. I respected his request, but said that I would check in on him in a few minutes. After a couple of minutes had passed, he walked out of the room with the aid of his wife, and pulled me aside. When he apologized for his behavior, I assured him that no apology was needed, and that he had responded to the music with honesty and integrity.
In this session, a patient felt anger rather than thankfulness for a “wonderful world.” A common thread connects his experience and Ahmadi’s younger clients who wanted heavy metal music: they need to be given the freedom to express how horrible they feel. Although hard and heavy music may or may not help with this, the typical “uplifting/encouraging” spiritual or secular music therapists often choose doesn’t always speak to a person during an emotional crisis. The two interviewees in Ahmadi's article, as well as the client I referred to, experienced a calmness and acceptance of their situation once allowed to get mad and feel some level of hostility. Once given the space in their minds to not have to be gentle and calm, they found themselves gentle, calm and relaxed.
I remember an odd recommendation a friend gave to me during a difficult time in my life. My friend recommended the movie “No Country for Old Men”. Far from having a light, inspirational message, this movie's themes were heavy and dark. The violence was almost unbearable in certain scenes. Yet my friend knew that this movie would help me cope with my situation. Best of all, the movie had no easy answers or reasons for the suffering and death the characters faced. No answers were given at all. Besides the occasional humor, the only “positive” elements of the movie were subtle, hardly detected by most reviews I've read and friends I've talked to. But the experience of sitting through that movie, then reading the book, then discussing it with friends is exactly what I needed to help me be honest about the uncertainty, sadness, anger, and helplessness I felt. Many viewers seemed to miss the small glimpse of hope offered at the end of the movie. If any hope was felt, it was subjective and seemed to find viewers who weren't necessarily asking for it.
I found similar themes between this movie and aggressive music. When watching a movie like this or listening to aggressive music, one may experience the uncomfortable feelings of anger, weakness, and uncertainty. Hard and heavy music often expresses despair and hopelessness, yet in the cases Ahmadi provides doesn't result in actual despair. Rather it helped them to not feel alienated, find relief from stress, and process the feelings most difficult to communicate.
Hard and heavy music would not be an effective treatment for everyone, as Ahmadi is careful to point out. But allowing for it as one of many diverse mediums for therapy is important. Her words about diversity and openness are true: “Finding this diversity requires being open to the possibility of different ways of coping with a difficult crisis, even if certain ways may seem harmful and undesirable at first glance.”