What 'Empire' Got Right (And Wrong) About Music Therapy

What 'Empire' Got Right (And Wrong) About Music Therapy

Perhaps one of the most stirring and sympathetic characters in Fox’s hit show “Empire" is Andre, who suffers from Bipolar disorder. In case you’ve been living under a rock for the past three months and haven’t watched the hottest TV show of 2015, here’s a quick recap of Andre’s situation: the oldest son of a music conglomerate CEO vies for power over the company he helped build, but between all the pressure (and betrayal, and violence, and lack of love and support), as well as his attempts to keep a lid on his emotions, Andre eventually flushes his meds down the toilet, precipitating a mental breakdown and entry into an in-patient therapy program. That’s where he meets Michelle White, a lovely and talented music therapist played by Jennifer Hudson.

Certain members of the Lyon family (cough-Cookie!-cough) express skepticism about music therapy, and there’s no doubt that Andre’s status as the “talentless” son who can’t sing doesn’t help things, either. But the show’s depiction of music therapy, along with the peace that Andre experiences at the piano bench with his therapist, isn’t just a way to shoehorn music into every aspect of the TV show. Instead, said Al Bumanis, a board-certified music therapist, the show is correct to represent music therapy as a powerful tool for people coping with mental illness.

“Music has a way of reaching people where other interventions, like regular talk therapy, occupational therapy, may not,” said Bumanis, a spokesman for the American Music Therapy Association (AMTA).

The Roots Of Modern Music Therapy

Music therapy, as the name suggests, uses music as a treatment tool to address non-musical goals. The idea that music can heal is an ancient one, but its status as a contemporary therapy truly began after World War I and World War II, according to the AMTA. Musicians would visit veterans hospitals to play for people suffering from both mental and physical war injuries. Medical workers immediately recognized a powerful patient response, which led hospitals to start hiring musicians to help care for patients. Eventually, training for music therapists began creeping into university curricula, where standards were established and board-certification programs instituted.

Nowadays, music therapy is an option for people going through a variety of illnesses. Like Hudson’s character Michelle in “Empire,” Bumanis has also had success drawing clients out of their shells or helping them reach their physical goals by using his voice, a piano or a guitar during therapy sessions. For physical therapy clients, Bumanis has in the past used a guitar to strum along as someone goes through their exercises. Live music is important: A music therapist can slowly increasing the tempo on an instrument to encourage, for example, a stroke survivor to try faster movements during rehab -- something that can’t be re-created by popping a CD in a boom box, he explained.

“Because I’m in the room, I’m much more aware and much more flexible and in the moment,” said Bumanis. For people with brain conditions, like dementia or Alzheimer’s disease, music can be a way to stimulate them and, in turn, provide much-needed sense of connection between patient and family. As for those with mental illness like Andre, singing or writing songs together can be a simple way to draw reluctant clients into any kind of therapy, at all.

"In that way, it worked to reduce Andre’s stress and anxiety, and to just engage him in the therapeutic process,” he said, although he does quibble at how Andre doesn't sing along with his therapist the way a client usually would. At heart, that’s the point of music therapy: to find a way for client and therapist to connect beyond speech.

Beyond The Small Screen

Real-life, high-profile examples of music therapy success include former congresswoman Gabby Giffords, who famously sustained a brain injury from a gunshot wound on Jan. 8, 2011. Last February, she posted a Facebook video of herself singing a few lines from the musical “Annie” with her music therapist. In an interview with People, she explained that "music therapy was so important in the early stages of my recovery because it can help retrain different parts of your brain to form language centers in areas where they weren't before you were injured.”

President Barack Obama has also praised the power of music therapy. In a speech last November, he relayed a story of a woman who helped her veteran husband wake up from his coma by playing his favorite songs. From Obama’s speech:

And then finally, Luis woke up. He couldn’t see. He couldn’t eat. He couldn’t talk. But he’d heard those songs. And in the months and years that followed, he kept fighting back with the help of hundreds of hours of music therapy. And today, Luis can see again, he can eat again, he can speak again. He’s even playing, as I understand, a little bit of golf. (Laughter.) And every night, he still goes to sleep with music playing.

Music has also been shown as an effective, drug-free way to relieve pain, which is crucial in special patient populations like children who don’t have the benefit of prescription strength pain killers especially designed and tested for them. A randomized, controlled trial conducted among post-operative pediatric patients showed that listening to their favorite music had significant reduction in pain as compared to the control group: those who simply put on noise-cancelling headphones. A group of scientists in Germany also found that listening to live harp music lowered stress hormones in premature infants living in a neonatal intensive-care unit.

It should be remembered that “Empire’s” depiction of music therapy is, in the end, fictional. In a blog for HuffPost published before Hudson's debut on "Empire," music therapy instructor Ronna Kaplan of the Center for Music Therapy at The Music Settlement, wrote about what a board-certified music therapist could truly provide for a client like Andre:

The question arises as to whether music therapist Michelle White (Hudson's character) is a "real" music therapist with appropriate education and credentials. Assuming she is, will she engage Andre in the therapeutic process? Will she elicit contributions from him as the treatment progresses? Will they make music together? Will she collaborate with Andre's psychiatrist and the other professionals on his interdisciplinary team? Will she apply conclusions drawn in music therapy research to her own practice in the hospital where she is treating Andre? These are just a small sampling of the myriad skills and competencies a Board Certified Music Therapist utilizes on a daily basis.

And of course, it was a complete breach of protocol for Michelle to ask Andre to pray with her later on in the episode; Bumanis explained that therapists would normally wait for the client to bring up prayer before figuring out how, and if, to incorporate it into sessions. Finally, there was no mention of continued music therapy in the episode following Michelle's introduction -- something that Bumanis hopes will change with season two.

"I think it was a positive that people saw that music therapy is a viable and real health care profession, but I think it would have been better to have continuity on the issue,” said Bumanis. “We’ve written to [ask] Lee Daniels to be technical advisors for the show."

Here’s hoping that Daniels takes him up on the offer, if only for more scenes of Michelle and Andre back at the piano together.

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