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!

3 Ways to Reduce Rumination, Worry, and Attachment to Self Stories

Have you ever found yourself caught up in thoughts about the past? What life was like before your chronic illness/pain? Ruminating over and over about that old life… What about thoughts about the future? Worrying about what will happen to you and how your health will affect you, maybe even getting worse? Perhaps you are also really fused with the idea that you are just a sick person now and that is all your life will be. These are all common thought processes when you have a chronic illness or chronic pain. I’ve certainly dealt with these before. The problem with this dominance of the conceptualized past or future, or the conceptualized self, is that it often takes us away from living right now. It makes life worse. It increases suffering.

Rumination and worry are like the fog. Can you come back to the present?

I remember having the thought that I don’t want to suffer any longer. This was in the fall of 2016. My very recent ex blamed me for all the things that were wrong in the relationship because of WHO I was. What I quickly came to realize was that I was ruminating and worrying and fused with having an autoimmune disease. We didn’t break up because of who I was (trust me there were a lot of other issues that didn’t stem from me at all). However, the dominance of my thought processes wasn’t helping me at all. It was taking me away from the life I wanted to live and away from the person I wanted to be.

The Conceptualized Past & Future
I don’t think that being able to reflect on our pasts or contemplate our futures is inherently problematic. Our brains have evolved to be able to do this. Initially to keep us safe and alive. We just don’t run into as many instances of life-and-death situations anymore. When we excessively focus on the past, or ruminate, we tend to feel overwhelmed and depressed. When we excessively focus on the future, or worry, we tend to feel overwhelmed and anxious. Both anxiety and sadness can increase pain and set of flares for those of us with autoimmune disease, which in turn tends to lead to more sadness and/or anxiety. It’s a vicious cycle.

The Conceptualized Self
We all have stories we tell ourselves about ourselves. Like who we are, where we came from, and why we act the ways we do, essentially why we are the way we are right now. Often being sick or in pain is a large part of this story. The problem with these stories is that while they do contains some objective facts, they are also chalk full of our own subjective interpretations. When we are really fused with these stories about ourselves, we forget that life is constantly changing, most of it is not predictable, and we can also create change for ourselves. And yep, I know this is really hard to grasp when you have a chronic illness.

Why we need to contact the present moment
We we are stuck in the past or future, and when we dwell on our stories about ourselves, we are definitely not experiencing the here-and-now. The benefits of being present are plentiful, including the ability to gain more self-knowledge and self-awareness, enjoying our experiences more, feeling less pain (emotional and physical), and being more flexible in our interpretations of ourselves and of life. I meditate daily because it helps me become more present (and it took me so long to get into a daily routine). I also notice myself being able to come back to the present much faster throughout the day, even when I notice physical pain.

How do we counteract rumination, worry, and attachment to our self stories?

  • Mindfulness – it can be meditation, but really mindfulness means contacting the present moment, being here-and-now. So it can also be yoga, or mindful walking or eating. It can be fully engaging in an activity. It can be noticing your thoughts/feelings/sensations and then coming back to the present by noticing your feet on the floor. It can be many, many things, but it is always: being curious, open and nonjudgmental about your present moment experiencing. Check this out.
  • Noticing Self – the idea that there is a part of us that can step back and notice. Like the sky and the weather. The sky always has room for the weather. Even when the weather is thunderstorms and hurricanes, the sky is not bothered by it because eventually the weather changes. We can use this same part of ourselves, to just step back and watch our experiences without being swept away. It’s a safe place that just notices. This is particularly helpful for attachment to our conceptualized self.
    Check this out.
  • Creating Distance Between Ourselves and Our Thoughts – we can’t stop our minds from thinking, but we can notice when our thoughts are unhelpful and learn to let them pass like leaves on a stream. The more distance we can create, the more psychological flexibility we can have in order to return to the present. Check this out.

I know that was a lot of information! I’m a big believer in seeking help from a mental health professional in your area if you are really struggling with your mental health. Many people with chronic illness, chronic pain, TBI, etc. find it hard to cope on their own. One of the best things I ever did was go to therapy. I learned a lot of skills to help me cope and felt I had nonjudgmental support as I continued down this path we call life. And on that note, keep making the most of it!

Expressive Writing for Health & Mental Health

I love writing (hello, this is a blog after all) and I’ve always found it to be helpful for me in my own life (and health) journeys (that and music). I came across some research on the mental and PHYSICAL health benefits of expressive writing, so I did a bit more digging and damn, we should all be doing more of it! And hopefully, this post will inspire you to do some. Hearing that there are mental health benefits is probably less shocking than that there are physical health benefits to expressive writing, so we’ll start there, but before we get into that, let’s quickly establish what expressive writing is. Expressive writing is simply writing about our deepest thoughts and feelings about an event or situation, without holding back. When people do this, it is often through journaling, and is often free-writing, without too much thinking about it. It can be done on the computer or by hand, really whatever you prefer. The leading pioneer in this research is Pennebaker (too many articles to site them all), but I’ll site some of the other research on the subject (which also references him) at the end of the post.

Buying a journal (or using an online one) can get you in expressive writing mode.

Okay, so the mental health benefits:

  • reduces stress
  • reduces symptoms of depression
  • reduces post-traumatic symptoms
  • improves mood
  • improves focus and concentration – including in people with ADHD
  • improves working memroy
  • improves emotion regulation (which is our ability to control the quality, frequency, intensity and duration of our emotional responses to situations)
  • and it increases our self-awareness
Improve your mood!

If these aren’t good enough reasons to do some expressive writing, then maybe the physical health benefits will convince you:

  • decreases the number of doctor’s visits you’ll have
  • reduces the number of days spent in the hospital
  • reduces the overall number of hospitalizations – i.e., people with cystic fibrosis
  • reduces blood pressure
  • reduces chronic pain – i.e., cancer and chronic pain conditions
  • reduces the severity of inflammatory conditions – i.e., rheumatoid arthritis, lupus (SLE)
  • improves immune functioning – i.e., cancer, HIV
  • improves lung functioning – asthma
  • improves liver functioning
  • improves and speeds up post-operative recovery
  • improves overall physical well-being

And then, if that’s still not enough for you, there are some other general benefits:

  • reduced number of “sick” days from work plus faster return to work if you were layed off
  • increased GPA in university students
  • improved sporting performance in athletes
Even improve sporting performance! Me and some friends after a curling tournament in 2019.

Okay, so how does this all work? I mean, I understand how it can improve some of the mental health problems we may experience, because we’re writing about our thoughts and feelings. But how does it improve our physical health? Well, actually the two are related. Remember that stress has a HUGE impact on our physical health, and the mind and body are connecting, meaning that anxiety and depression can also feed into (and trauma can cause) physical health problems. The processes of expressive writing are as follows:

  • it allows for cognitive processing and restructuring of painful events and situations – cognitive restructuring changes how we perceive emotional stressors (both internal and external)
  • it allows for repeated exposure – which is controlled re-experiencing of events and situations so that they have less influence over our minds and behaviours

Improving our bodies, improves our minds and vice versa. Here’s the podcast episode on it.

How do we engage in expressive writing? According to the experts we need to write about our deepest thoughts and feelings, without holding back, about situations or events or really anything relevant to us at this moment that are painful. This could be anything from having cancer, to spending time in the hospital to going through a traumatic event. When we sit down to write, it should be for 15-20 minutes at time, without stopping, and be done on 4 consecutive days. Just doing that is enough to lead to all the benefits I listed earlier. It’s possible that more consistent writing could have more improvements, but I honestly didn’t find much on that. So, I’m curious, who’s going to try out some of this expressive writing to see if it helps?

Me! Me! I like health & well-being!

I want to remind everyone that in addition to this blog, if you’re looking for more information to improve your health, I have a podcast: Chronically Living and how to make the most of it, which is available on Apple, Spotify and everywhere else you get podcasts, including this web link. I also have a YouTube channel for those of you looking to incorporate more mindfulness as it has a number of benefits for your physical and mental health as well: Kelsey L Harris Meditations.
Until next week, keep making the most of it!

References:

Baikie, K.A., & Wilhelm, . (2018). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment, 11(5), 338-346. https://doi.org/10.1192/apt.11.5.338
Lepore, S-J., Greenberg, M.A., Bruno, A., Smyth, J.M. (2002). Expressive writing and health: Self-regulation of emotion-related experience, physiology and behaviour. In S.J. Lepore & J.M. Smyth (Eds), The writing cure: How expressive writing promotes health and emotional well-being (p. 99-117). American Psychological Association. https://doi.org/10.1037/10451-005
Stanton, A.L., Danoff-burg, S., & Huggins, M.E. (2002). The first year after breast cancer diagnosis: Hope and coping strategies as predictors of adjustment. Psycho-Oncology, 11(2), 93-102. https://doi.org/10.1002/pon.574