From Moan to Tone to Drone: Music Therapy and Pain Management

The voice.

This story took place many, many years ago. I’m not mentioning the location, setting, names, therapist, Protected Health Information, etc. I don’t even remember those details. And after you take it all in, you won’t care anyway. =)

The individual experienced severe abdominal pain. (Let’s call the individual “Susan.”) The music therapist received a referral to alleviate pain and promote relaxation.

Intense Pain, Intense Sounds

When the music therapist entered the room, she noticed that Susan was moaning loudly with quick breaths, over and over. As Susan winced and clenched her stomach with her hands, the music therapist slowly came closer.

As soon as the therapist met Susan eye-to-eye, she softly introduced herself as the music therapist and quickly mentioned that she was going to try something with Susan.

Susan didn’t seem to care much as her moans escalated and her pain seemed to worsen.

Vocal Mirroring

The music therapist came comfortably closer and breathed with Susan – with slight moans in between fast inhales. Both tempo and slight movements were in sync between the two.

The music therapist became louder to match the volume of Susan’s moans. Once the volume of moans matched, Susan glanced at the therapist, then looked away again in pain.

As the therapist mirrored the volume, tempo, movements, and pitch changes of Susan, the therapist made the breaths slightly longer.

Susan replicated the therapist’s slight change in tempo, and slightly slowed her breathing as well.

As the breath slowed, so did the moans. A few moments later, the moans became steady tones. Literally, the pitch of the moans turned from wavering, cracking ups and downs to a monotone sound.

Susan Takes Over

Then Susan took control of the sound. What had first been a reactionary pain response slowly turned into Susan’s one source of power.

Susan took the lead, making the tones louder, slower, steadier, and longer. The therapist simply followed Susan, mimicking her every move and sound.

Minutes seemed like ages passing by. The strength of Susan’s voice was in charge of the experience. As her vocal tones became even slower and lower still, the therapist continued to follow.

Susan’s body movements changed from tight squirming and restlessness. Now she was purposefully using the core of the body as an air cavity. The stomach and shoulders rose up and out, then completely deflated with each breath.

The breath and sound went on and on.

Exhaustion Kicks In

The repetition was tiresome for Susan, and the Oooo’s and Ohhh’s soon morphed into Ahhhh’s and Haaaa’s. The therapist continued the vocal mirroring.

The intensity inside the room seeped away as Susan continued to slow her breath and elongate the vowels.

Relaxation and Sleep

It wasn’t much longer that the open vowels became hummmmmms, Susan gave a yawn and closed her eyes as soft tears rolled down her cheeks. Susan’s breathing was still deep, but the sound disappeared. Only long sighs came from Susan’s voice.

When it looked like Susan was asleep, the music therapist left the room to go document.

The end.

Thank you voice.

6 Responses to From Moan to Tone to Drone: Music Therapy and Pain Management

  1. Janea August 7, 2012 at 12:05 am #

    Wow! Awesome outcome. I wish I could relax a little myself and imagine myself doing that as a therapist. To be honest, toning seems so foreign and weird to our American culture, if I were the therapist I think I would be looking out the the hospital door out of the corner of my eye wondering and worrying what doctor or nurse was observing me. Even if I understood the purpose and efficacy of toning, I know that most people don’t and I would be concerned about the jugements they are making about me or the field of Music Therapy. How do you get past this? Can anyone relate?

    In this case the woman responded beautifully so the end justified the means, and I am sure most observers would agree. But what if she hadn’t responded to this intervention as hoped, (and I am sure that happens at times) , people who have never heard of toning would be thinking “what on earth is going on in there?” Has anyone had this problem or overcome these worries?

    • Kat Fulton August 7, 2012 at 9:19 am #

      Hey Janea, Great point. Here’s my take: In some instances, you could say the same thing about playing a song on the guitar. “How can she make herself *that* vulnerable to share a song, out loud, in front of people?” In fact, I KNOW people personally who become uncomfortable when they hear someone sing/play guitar.

      It’s kind of like the judgment brain takes over . . . And I know from experience what that’s like because I grew up with that mind set.

      Anyway, in this instance, the door was closed, but the room walls were like a fish-bowl with windows surrounding. No one could hear what was going. They could only see. I truly believe in this situation, the staff was willing to try just about *anything* to help Susan. That’s why no one questioned. It was a pretty dire circumstance.

      About the outcomes not always being this great… true, BUT the music therapist knows to STOP and adapt before ever getting to the point of “come on, why isn’t this working…”

      I think it’s delicate balance between trying something unusual and new, but being super present and sensitive to the patient’s response as you go along.

      Does that make sense? Thanks for your thoughts here! So important to talk about this…

      I did my thesis on toning, and found that most people are not responsive to a single-session. So I would recommend trying single-sessions only for extreme cases like this one. Also single-sessions would work for people who are familiar and/or open to trying it.

      But with a few weeks of workshops in practicing toning, I believe the outcomes can be quite powerful.

    • Anonymous September 23, 2013 at 5:01 pm #

      I had an incredibly painful experience. More pain than I could take. I was loosing consciousness because of it. I ended up putting on my headphones and I found a song that was loud and it had a good beat. It gave me relief. Soft music made me freak out. The rocking iPod saved me from utter doom. It really did. It gave me the only relief.

  2. Selina November 27, 2012 at 6:04 pm #

    Hi Kat,

    Thanks for sharing this fascinating story! And thank you for your website! I have a few questions for you, if you wouldn’t mind answering.

    1) What was the title of your thesis? I’d be very interested to read it.

    2) I’m a music therapy student. I would love to try and demonstrate this in class, because we don’t learn a lot about toning in our particular program. Here you say:

    “The music therapist came comfortably closer and breathed with Susan – with slight moans in between fast inhales. Both tempo and slight movements were in sync between the two.”

    When you say slight moans, were those moans Susan produced and you mirrored back, or did you insert the slight moans? Also, when you say slight movements, do you mean that when Susan winced and clenched, you imitated those movements back?

    And then after meeting her, when you began making the breaths longer, did you also lengthen your moans too, for her to follow? Or did you keep mirroring her moaning, as the breaths became longer?

    Thank you so much again for sharing this with the world!

    • Kat Fulton November 27, 2012 at 7:20 pm #

      Hi Selina! Here are my answers:

      1. The title was The Effects Of Music Therapy On Physiological Measures, Perceived Pain, And Perceived Fatigue Of Women In Early Labor. You can download it here:

      2. Susan produced the moans and I mirrored them back. She was in a lot of pain. And yes, Susan was wincing and clenched, so I mirrored those, too. You need to present it in a way of support, not copy-cat. More like “I’m here with you.” It’s tricky, and I don’t think this would work for every patient out there.

      And finally, yes – I tried to make my breaths and moans longer slightly, but hers became longer as time went by because she was so exhausted.

      The main thing is to be as totally present with the patient as possible. You can equate the technique to what cardiologists call “over-drive pacing.” It’s using a machine to stabilize a heart-rate. But it’s the same principle — the machine “latches on” to the irregular rhythm, then the irregular rhythm eventually catches on to the machine’s regular rhythm. Check it out here:

      Good luck! =)

      • Selina November 27, 2012 at 8:14 pm #

        great, thanks!

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