A half-dozen people sit semi-circle at the Sorrento Valley office of MusicWorx, counting out their breath, blowing through harmonicas at their weekly session of the agency’s blues harmonica group.
Lindsay Zehren, a board-certified music therapist, counts out their cadence, soothing and nearly hypnotic, as she leads the group through a series of exercises that, although simple, have an outsized impact in combating one of the more debilitating ravages of Parkinson’s disease. Really, the session isn’t about the quality of their playing—or even being in key.
“As long as you’re breathing together, you can’t play a wrong note,” she tells the group.
That rhythmic effort of breathing through the reeds—in and out, in and out—made Zehren wonder last year whether the harmonica might have a special therapeutic value. When she looked into it more, she couldn’t find any research on how the harmonica impacts people afflicted with Parkinson’s.
The American Music Therapy Association shared her curiosity and funded a 12-week research project that ended in November. Zehren is working with the University of Colorado to sort through the data and publish the findings, but so far, the results have been stark: the 15 patients’ ability to inhale and sustain sound increased 47.5 percent, while their ability to exhale and sustain sound increased 35 percent.
“As progressive a disease as Parkinson’s is, it’s a big deal any time any numbers stay the same,” Zehren said. “Typically with this disease you would see some decline. We didn’t.”
The exact mechanism isn’t fully understood, but people with Parkinson’s are particularly prone to struggling to swallow and clear their throat. That can lead to aspiration pneumonia, which is the leading cause of death for Parkinson’s patients.
MusicWorx hopes that the findings are compelling enough to spur a larger institution to replicate the study on a bigger scale. Those prospects aren’t yet clear: whereas hundreds of millions of dollars are spent on research into the causes and possible cure for Parkinson’s, comparatively little is spent to research therapies.
“There are a lot of people suffering daily that we could be doing things for to help increase their quality of life now,” Zehren said.
Testifying to that are six members of the study who immediately signed up for the blues harmonica group. Two years ago, the Parkinson’s Association of San Diego approached MusicWorx about starting therapy groups to help the 16,000 San Diegans afflicted with the degenerative disease. The program, dubbed AudAbility, started as a singing group to help patients with speech and swallowing. It quickly branched out into four instrument-based groups, among them the blues harmonica that morning. Sitting alongside was Wayne Label, board president of the San Diego Parkinson’s Association. Sitting next to him: Barbara Reuer, MusicWorx’s founder and CEO.
As Zehren guided the group through the color-coded routines—exercises she had tailor-made to fit the unique needs of each member—Reuer couldn’t help but be impressed by yet another reminder of how sophisticated music therapy has become in the 30 years since she forged her path into the field.
Back when she was wrapping up her doctoral work in Iowa, coming to San Diego to start her own private practice was a bold leap at the time, given that private practices were all but unheard of.
“Music therapy has been around since 1950 as a profession, but in the late '80s and early '90s, there might’ve been three or four people in the country who had their own practices,” Reuer said. “I had no idea what I was doing, and there was no model.”
It took six years—and an abundance of ramen noodles, she said—to get her practice off the ground. At the time, the practice relied on contracts with senior care facilities. Her big break came after a nurse from Scripps La Jolla saw a presentation by music therapy pioneer Deforia Lane and was determined to start a similar program at Scripps. Reuer started small: a few hours a week bedside with Scripps’ cancer patients. That success quickly begat more success, and her practice grew.
Having ventured into an uncharted arena, she had no idea the path would lead to the foremost music therapy practice in the region.
“My intention was always to become a sole proprietor doing my own thing,” she said. “One thing always led to another.”
In 2004, she created Resounding Joy, which sends therapists and trained volunteers out into the community to work with home-bound patients. Five years later, she incorporated her private practice into MusicWorx as it stands today, and expanded its offerings to hospitals, schools and nursing homes on a wide range of ailments. The agency now boasts nine board-certified music therapists and a pioneering internship program that has spawned many of San Diego’s music therapists.
The internship program is a special source of pride for Reuer. MusicWorx takes in eight interns each year for six months at a time, one of fewer than 200 approved sites in the country where music therapists can hone their craft while waiting to sit for their board certification. Over its 20 years, the internship program has enabled Reuer to pass on her knowledge to some 160 music therapists, a legacy that can be seen both near and far.
“When I moved here, there were three to five music therapists in town, and they were all working for a community college,” she said. “Now we have close to 90 music therapists, and about 60 percent of them are former interns of mine.”
That reach extends far beyond San Diego. Past interns have hailed from as far afield as Brazil, Colombia, Israel, Japan, South Korea and Turkey. Just as she rattled off the list, an intern from seven years ago peeked into her office, in town for a few days to observe techniques to take back with her to Iran.
Using music to improve people’s lives is universal and timeless, Reuer says, but it’s also a field in the midst of massive leaps forward. The most exciting frontier over the past decade has come as neurologists and neuroscientists make startling breakthroughs in understanding how music affects the brain and a wide range of biological functions.
“Used to be when I first started, we all thought music is right-brained. People didn’t know that music can actually reprogram the brain,” she said. “We see it every day, those moments of not only enjoyment but those amazing moments when a Stage 4 dementia patient learns a rhythm and remembers it the following week. How is that possible?”
Reuer’s days of leading therapy sessions finally gave way a few years ago to the daily duties of managing her still-growing agency. But she makes sure to find time to sit in on therapy sessions to rekindle the joy of engaging with clients and to see where the next generation of music therapists are taking the profession.
For MusicWorx, she wants that future to deepen in its collaboration with medical endeavors, especially for Parkinson’s and patients recovering from a stroke. And as she looks at the corporate landscape, she sees opportunities to grow as companies try to find ways to unify their workforce as the sexual harassment reckoning transitions to reconciliation and healing.
“Music and mindfulness are really powerful, and we can offer a lot to corporations dealing with staff stress and how to better manage that,” she said. “Music changes how you connect with people. You can’t stop sound. It connects you. It’s about working together and then letting go. There’s something really powerful when we make music together.”
For more information, visit musicworxinc.com