My Personal Evolution, aka As It Turns Out, She Was Not "All That"

Lists are a way to keep track of the things you should--or should not--be doing or have done. When you're done with the list, presumably you're finished with all the things appearing on the list. But are you really? The lists are usually in 5s or 10s, convenient, familiar numbers to use. Take a look at some samples:

5 Foods That You Should Never Eat (I still eat 3 out of 5)
5 Stages of Grief for Chiefs Fans (They were doing so great for a while)
5 Stages of the Sleep Process (If you think of the 5 stages, you won't go to sleep)
5 Stocks With Big Insider Buying (Wall Street sucks)
5 Books to Help You Reach Your Goals for 2014 (Reach your goals? Really?)   
5 Signs You May Have Pre-diabetes (Or maybe the actual diabetes)
5 Best Films Oscars Nominations (They usually come in 5s)
The Top 10 Lists of David Letterman (Er, that is, David Letterman's writers)
Best 10 Movies of Matthew McConaughey (It's the dimples...anything he's in, I like)
5 Years After, 10 Things to Remember (I could think of a lot of things if this article was called, "10 Years After, 5 Things to Remember")

Lists are completely and purposely definitive. But are there only 5 or 10? How about if there's so much more? Take Elizabeth Kubler-Ross, for example. She was the author of the 1969 legendary bestseller, On Death and Dying, and a psychiatrist, who died in 2004. I wonder if she took her own advice about death and followed all the stages of grief: denial, anger, bargaining, depression, and acceptance. In one article, she said that she was ready for death after suffering multiple strokes. But was she really? Known as the Kubler-Ross model, did she skip the first 4 stages and go directly to acceptance? I have my doubts.

Yale University conducted a study of bereaved individuals between 2000 and 2003, based on the Kubler-Ross model, and concluded from their findings that half were consistent with the five-stage theory and others were conflicting with the model. P.K. Maciejewski said in 2007, in the Journal of the American Medical Association (JAMA), several letters were also written and published in JAMA, criticizing this finding and belittling "the stage" concept because, for one thing, the Kubler-Ross model didn't evaluate the support--friends and family--aspect.

More recently, Megan Devine, the author of "Everything is Not Okay," and a contributor to the Huffington Post, wrote "The 5 Stages of Grief and Other Lies That Don't Help Anyone" in December 2013. In the article, Devine says of Kubler-Ross model, "The griever is expected to move through a series of clearly delineated stages, eventually arriving at 'acceptance,' at which time their 'grief work' is complete...and if you don't progress correctly, you are failing at grief. You must move through these stages completely, or you will never heal.This is a lie."

Devine goes on to say, "[Even] Elisabeth Kubler-Ross wrote that she regretted writing the stages the way that she did [in retrospect], that people mistook them as being both linear and universal. Based on what she observed while working with patients given terminal diagnoses, [Dr.] Ross identified five common experiences, not five required experiences."

Ruth Konigsberg, the author of "The Truth About Grief: The Myth of its Five Stages," confirms Devine in saying, "The Kubler-Ross theory has never been validated by one single study. But it certainly seems time to move beyond our current habit of using untested theories to create unnecessarily lengthy and agonizing models for loss, ones that I believe have created more fear of and anxiety about the experience.” 

Konigsberg also says how the Kubler-Ross five stages mistakenly "show a hopeless road, making people think that they must grieve for the rest of their lives." Konigsberg stated that “loss is forever, but acute grief is not, a distinction that frequently gets blurred.”

You're reading about death, but actually this advice from Devine and Konigsberg, in my opinion, applies to anyone or anything you're mourning, i.e. death of a marriage, of a job, of a pet, of an illness. I don't know what's going on in the head of another, so I'll only talk from my perspective. There is no cookie cutter pattern for me, and most likely others, as it relates to stroke. Each stroke survivor grieving the loss of impaired body function, just as snowflakes (presumably), is different.

We are constantly evolving, from one day to the next. Grief has its own timeline, custom to fit you. The stages don't go in order either. I still, five years later, have not accepted my condition for any significant length of time. The shortest stage for me was bargaining because I already had the stroke. Bargaining in duration was not an option. The longest stage for me was anger.

I have a theory. The better your life is right before the stroke, the more you will resist positivity after the stroke. Distractions, like going to the movies or going out to dinner help, but they are only temporary. When I get into bed after the chilly, bleak day is done, I don't like how my affected foot is just lying there outside the cover, or I have to pee two hours later and just can't "run" to the  bathroom. Stuff like that.

And I have more stages than the five in the Kubler-Ross model:

I got "guilt," a 6th stage, when after I had a stroke at 4am. My manager was left in a lurch without me. Not so much anymore, but traces of it surface now and again.

I got "ambivalence," a 7th stage, because I didn't know where I was, emotionally speaking. Sometimes, for about a year when I first had my stroke, anger would be followed by depression going back to anger in rapid succession, and sometimes, both anger and depression would come simultaneously. Or I'd lay there in limbo, trying to decide on my emotion.


And finally, I got "frustration," an 8th stage, even now, when the people looking at me and on the phone don't understand me. Sometimes, the ones in person put their heads at an angle and squinch up their faces in anticipation of not understanding me. The people on the phone probably do the same as well. I'm intelligible, but when I get tired, I have to be careful that I'm not slurring my words. Like I said, I'm evolving.

You don't have to buy my book to know that nobody, except the evil doers of horrendous deeds, like Hitler and Osama bin Laden, deserves a stroke. Nobody.

Tra-la-la-la-la: Music Therapy Solves So Many Problems

When I was 12, my parents bought me a transistor radio for my birthday--no headphone output and only AM. That was good enough because I didn't know any better. I listened to broadcasts of WIBG and rock 'n roll aficianado Hy Lit before school, and the same channel again in the late afternoon after I got home until bedtime. I used to joke that the transistor radio was surgically attached to my ear. My parents, who were Tommy Dorsey fans from the 40s, couldn't understand the words the maniacs (their words, not mine) were singing. But I understood all of it. 

I was married at 21, but still took my transistor radio with me everywhere, like in the summer to the apartment's pool where I blasted it to the Mamas and Papas and Credence Clearwater Revival and Hall and Oates. My husband was not a music fan and called the singers maniacs, too. The next year, the transistor radio went in the crawl space along with my beloved dolls because I was all grown up. And I upgraded to the boom box.

I always loved music and that's why I loved playing the piano, by ear where I could play anything that was written. Those days are gone now because of my stroke, and with it a paralyzed arm, but I still tap my foot to the music.  In therapy, for instance, when I’ll have have my eyes closed and the therapist always comes over to me in fear that something's wrong. I'll open my eyes for a brief moment and say, "I'm not having another stroke. I'm just in the zone." You'd think the therapist would get it by now. Then I close my eyes again and groove with the music. It doesn't matter what genre--soft rock, hard rock, country. I love the musicmakers. So I wasn't surprised that music therapy has evolved to accommodate conditions like stroke, schizophrenia, heart conditions, and many more.

Medical News, an online mag, reported that music, in a positive way, affects the brain in social interactions and emotions, like less anxiety and reduced depression, giving people "quality of life, involvement with the environment, expression of feelings, awareness and responsiveness, positive associations, and socialization." Medical News also reported current research that suggests when traditional therapy is used with music therapy, it boosts the chances of success significantly in allowing the patient--inpatient or outpatient--positive emotions and motivation. One study concluded that there was "a decrease in blood pressure, heart rate, and levels of anxiety in heart patients." Source: http://www.news-medical.net/health/Music-Therapy-for-Stroke.aspx

Here's why: music has been shown to affect portions of the brain pertaining to control of muscles, mood, speech, cognition, and motivation. Research by Atasu Nayak, MD, has shown that music therapy is linked to a decrease in depression. Nayak and his group also found the more dysfunctional an individual's social behavior was at the beginning of treatment, the more likely the outcome that music therapy would be beneficial. Barbara L. Wheeler, PhD, et al found that group music therapy sessions boosted the ability of  stroke patients responded to social interaction, and individual sessions assisted with motivation for treatment. (Aretha Franklin's, toe-tappin' "Respect," please).

Rita Safranek, a writer in 2011 for Discovery Guides, said that stroke victims who participated in music therapy recovered functionally better than those who had not. She goes on to say that notions of music therapy exist in written texts dating back to ancient Greek civilization. 

In the last century, after World Wars I and II, musicians routinely visited veterans VA hospitals in the US to make music for those suffering emotional and physical hardships. In the late 1940s, Safranek said, the patients’ responses to music led the medical staff to ask that facilities hire musicmakers. As a result, the request grew into a college curriculum for music therapists.

Thus, the inevitable American Music Therapy Association (AMTA) came to be. The association’s membership is around 4,000 AMTA-certified professionals in the US. The first music therapy degree program was begun at Michigan State University in 1944. 

Around 70 colleges and universities in the United States now offer a bachelor’s degree programs in music therapy. Persons who complete an undergraduate degree in music therapy and subsequent clinical internships
are then eligible to take the Certification Board for Music Therapists’ national examination. Several colleges and universities offer advanced degrees as well.

Like all therapists, music therapists have to have goals like the patient writing music, playing a drum, and exercising to upbeat music. Since 1944, Medicare has been examining those goals and has identified music therapy as a reimbursable expense under benefits for hospitalization programs. The ever-growing requests for music therapy, and the ever-increasing research that supports music therapy, have created helpful third-party reimbursement for music therapy services.

"There is a pretty strong research foundation for music therapy," says Al Bumanis, Director of Communications for the AMTA. He says that music therapy can assist stroke patients to get their functioning back by rhythmic exercises, like walking in time with the music and singing to restore speech.

In the same vein, Oliver Sacks, a neurologist and author, wrote Musicophilia, a book music's ability to migrate us out of depression and about dancing to its beat. A review offers the following: Musicophilia offers mind-blowing stories of people of the powers of music "from a man who is struck by lightning and suddenly inspired to become a pianist at the age of forty-two, to an entire group of children with Williams syndrome, who are hypermusical from birth; from people with amusia, to whom a symphony sounds like the clattering of pots and pans, to a man whose memory spans only seven seconds — for everything but music." 
 

For 7 weeks after my stroke in 2009, I stayed at the state-of-the-art Bacharach Institute for Rehabilitation, a world renowned New Jersey rehab facility (alluded to negatively as 'Rehab X' in my book, "The Tales of a Stroke Patient"). I asked the doctor all the time whether I'd play piano again. She knew I had the music gene, but even so, I was never afforded music therapy at Bacharach. There wasn't even background music playing. I couldn't tap my feet.

No music therapy? It's not an option. It's a necessity.