Why Music Might Increase Your Resilience to Chronic Pain

I’m a musician. Not professionally of course, but it is definitely part of my identity. I began playing the piano at age 5. I took lessons until I graduated from high school. I took practical and theory exams with Conservatory Canada (formerly the Western Board of Music) to the point that I have Grade 8 practical and Grade 4 theory. In junior high and high school I played the alto sax in band and jazz band. In high school I sang in the choir, played they keyboard for one of our vocal jazz groups, sang in another vocal jazz group, and always had a role in the school musicals. To this day, I still play my piano daily and sing along with songs as they come on the radio. I can play about 3 chords on the guitar, and I swear I’m going to take lessons one day! As a mental health professional I have also learned a lot about music and resilience.

Check out this podcast episode with singer-songwriter Sarah Luby who has T1D and UCTD.

Resilience can be defined as the ability to adjust to change or difficulties in life. Resilience utilizes our emotional strengths and our awareness of and ability to use our coping mechanisms to overcome adversity (Merriam-Webster, 2021). Resilience is also key to dealing effectively with chronic illness and chronic pain. Why? Because things are constantly changing and adapting. We have strong emotions and thoughts about our situations and these can often lead to depression and anxiety as well. We need to and want to be able to cope with what is happening. Yet many of us struggle with resilience for several different reasons, from childhood experiences to the pain itself and a lot in between. The good thing is we can learn to develop more resilience.

There is a ton of research on the benefits of music, such as increasing self-awareness, being more socially connected to others, and it helps to regulate mood (Schafer et al, 2013). It also enhances self-regulation, initiative and helps to strengthen relationships with others, not just connect us with them. Resilience skills in general do the same with our self-regulation, awareness, mood, initiative and relationships. There is a lot of overlap, so it makes sense that music would be helpful for this. In terms of how music builds resilience specifically, there is the idea of ‘musicking’ or our musical life in terms of an I-Thou relationship (this is an interesting existential idea that allows us to engage in perspective-taking, which in itself increases resilience as I’ve seen first-hand with my clients). The relationships of sounds, bodies, and psyches as presented in musical compositions/song builds this perspective-taking ability (Malloch & Trevarthen, 2018). Beyond this, musician can communicate musicality in order to enliven both themselves and listeners. (Malloch & Trevarthen, 2018). Therefore, listening to music, not just playing it, can build reslience.

In a clinical setting, music can be used in two different way. Music Therapists use specific music interventions to help individuals with their specific goals, mood regulation, resilience, etc. in an individual or group therapy setting. There is specific training to be able to do this. The other is “music for wellness” which is having musical experiences – listening, playing, etc. – for the purpose of wellbeing and general functioning. As I’m not a music therapist, I encourage my clients to engage in the latter, which is also how I engage with music.

I have since had my actual upright grand piano shipped to me. So much better to play on!

Music for chronic pain has also been studied. For example, in a palliative care setting, music was found to actually decrease chronic pain in patients, which I found super interesting. This really ties into the resiliency. Typically when we are more resilient our pain either actually decreases or just doesn’t bother us as much. Honestly, I’m fine with either scenario. The last few days my knee has been hurting a lot. I’m not sure if it’s related to my UCTD or my hyper-mobile knee joints (my physio thinks they’re related to each other). I do notice that when I play the piano, or even just listen to music while I’m on a walk, my pain is less noticeable. Perhaps because of distraction or perhaps because the music is building my ability to be resilient, not just in those moments but throughout life. Take a listen to this podcast episode with musician and music teacher Melissa, who has multiple chronic illnesses.

Pick a song to listen to, play, or sing along with today and see if that helps you to keep making the most of it!

10 Ways to Improve Your Mental Health When You Have a Chronic Illness

When I was first diagnosed with a chronic illness, my mental health started to suffer. I actually tried to hide that, even from myself, but my anxiety increased over the first 7 or 8 months until I started seeing a therapist (and thus my journey to becoming a therapist began). The thing is, I’m not alone as far as my story with my chronic illness taking a toll on my mental health. Many, many chronic illness warriors have been through the same thing. So, if you’re reading this and you’re struggling, know that it is normal and it is okay to struggle. Also note that change is slow. I can give you these 10 ways to improve you mental health (as I did a few weeks ago with physical health) but you aren’t going to feel better overnight, or after the first time you do these. It takes repeated practice and effort on your part (I still practice all of these!). If you’re ready for that commitment then let’s get into it!

How’s your mental health right now?
  1. Support and Connection – this is pretty much the opposite of isolation, which is common with chronic illness, and mental health issues such as depression and anxiety. Support and connection can come in the form of joining formal support groups (which are likely still mostly online due to the pandemic, but may be in person depending on where you live), or informally by talking with your family and friends, or connecting with others in the Spoonie community via social media. As we’ve seen from the pandemic, isolation is not good for our mental health so do what you can to stay connected. Check out this podcast episode.

2. Mindfulness – I know this comes up a lot but there are many, many studies showing that this has powerful effects on both physical and mental health. It can be formal meditations, but it doesn’t have to be. Mindfulness can be fully engaging in an activity, such as mindful eating or mindful walking. If you’re present you’re unlikely to be ruminating about the past (depression) or worrying about the future (anxiety). Take a listen to this podcast.

Being mindful take practice.

3. Assemble your healthcare team – that includes someone to help you with your mental health. If you can’t afford to see someone in private practice, check out community settings. I’m currently doing my internship in a community setting, where our services are free. There is a bit of a longer wait time, and is usually brief/short-term service, but it is definitely a good option for many people. Check out this podcast on depression and this one on anxiety.

4. Use holistic approaches – what I’m talking about here are approaches that utilize the body-mind connection. If you’re lucky you can find several practitioners that do so. For me, my physiotherapist has a BA in psychology so she always takes a body-mind approach (podcast with her here), and I also saw a naturopath before I moved, which is all about the body-mind connection. They can give you more ideas for how to take care of your mental health and understand it interacts with your illness. This podcast is with my naturopath.

Make sure your healthcare team is able to help you with all aspects of your health.

5. Get moving – movement, of any type, is helpful not just for your physical health but for your mental health to. There have been studies to show that exercise decreases depression. Even if you’re not super mobile, going for a walk, doing some yin yoga, or taking up Tai Chi (podcast here) are good options to increase those endorphins and other neurotransmitters in your brain.

6. Connect with your values – who and what is important to you? If you can figure that out, then try to brainstorm some ways you can continue to live by your values, even with chronic illness. I’ll give you an example from my life. It is important to me to have adventures. Obviously travel is harder with a chronic illness, but it’s not impossible. So my friend and I (pre-pandemic) went on an “adventure vacation” to Costa Rica and for every “adventure day” we did a “rest day.” Honestly, it worked out super well, and we both felt more mentally and physically healthy that trip then we had in a long time. Check out this podcast.

Connecting with my values and doing what matters to me.

7. Do what matters – this ties into this above, connecting with your values. Once you have done the brainstorming, it’s important to do the things that matter to you. So for me, it was travel. It might also be spending more time with family and friends, or being creative. Doing the things (what therapists call behavioural activation) actually decreases depression (lots of evidence here). Check out this podcast for more.

8. Find an outlet – this might tie in to doing what matters for you. My main outlet is writing (probably no surprises here), but I have other ones too, such as playing the piano and colouring. I know a lot of people use art or photography or music or dance. It doesn’t necessarily have to be a creative outlet, but creativity can be useful, because a lot like exercise, it gets those helpful brain chemicals to increase.

Being in nature also matters to me and is an outlet as well.

9. Distance yourself from thoughts, feelings, sensations, etc. that are “hooking” you – what I mean by hooking, is the ones that pull you away from your values, the ones you can’t stop thinking about and make your anxiety/depression/etc worse. If you think of it like fishing, when you cast, and then hook a fish, you immediately start to reel it in, and the fish struggles, flopping around. This is what some thoughts, etc. can to do us – make us struggle and flop around, doing things that are unhelpful. By putting some distance between ourselves and them can help decrease their power (this includes physical sensations of chronic pain).

10. Acceptance – whoa I know this is a big one because no one really wants to accept that they have a chronic illness. And yet this might be the most powerful part of the list for Spoonies. Not just accepting that you have a chronic illness, but allowing your to sit in the physical sensations of pain (without getting “hooked” by them), and allowing yourself to sit in feelings of sadness and anxiousness, etc. These are all adaptive for us. They are part of our evolutionary history. They are here for a reason, and we can learn to allow them to be without it stopping us from doing what matters.

Acceptance can feel peaceful.

I’m sure I’ve given you a lot to think about, so that’s all from me for this week. Keep on making the most of it!

And don’t forget, the self-care challenge starts for premium members on April 24. If you haven’t signed up yet, it’s just $5 CDN for 4 weeks of posts and check-in around self-care!