Friday, September 30, 2011

Music and Grief

Music and Grief


Title: Music and Grief

Speaker: Dr. Kay Redfield Jamison
Series: Music and the Brain
Date: November 18, 2010


Dr. Kay Redfield Jamison is a clinical psychologist, author and the co-director of the Moods Disorders Clinic in the Department of Psychiatry at the Johns Hopkins University School of Medicine where she is a professor. Music and Grief appeared as part of a series of podcasts presented at and then published by the Library of Commerce, a project for Redfield Jamison was advisor. Her professional interests and publications center around mood disorders, suicide and creative temperament and here, she presents excerpts from her most recent publication, "Nothing Was the Same: A Memoir” which reflects on grief and loss in the context of her personal grieving process after the death of her husband, Dr. Richard Wyatt. Dr. Redfield Jamison is joined by Ara Guzelimian, Provost and Dean of the Juilliard School presenting perspectives of grief and depression through the life and music of composer Felix Mendelssohn and J. Raymond DePaulo, Jr., MD, Director, Department of Psychiatry and Behavioral Sciences, also from the Johns Hopkins University School of Medicine who brings his perspective as a clinician and researcher. Finally, the Afiara String Quartet from Julliard, play the first movement of Mendelssohn’s Quartet in F minor.

First, Dr. Redfield Jamison discusses the differences between chronic depression and grief. Having experienced and written about depression in the context of bipolar disorder and extraordinary grief over the loss of a partner, she describes reads an excerpt from her book, a portion of which I have transcribed below:

It has been said that grief is a kind of madness. I disagree. There is a sanity to grief and its just proportion of emotion to cause that madness does not have. Grief, given to all is a generative and human thing. It provides a path, albeit a broken one, by which those who grieve can find their way. Still it is grief’s fugitive nature that one does not know at the start that such a path exists. I knew madness well, but I understood little of grief and I was not always certain which was grief and which was madness. Grief as it transpires, has its own territory…”

Dr. Redfield Jamison goes on to define the differences between her depression experience as a sufferer of bipolar disorder and her grief as a widow. She identifies, for example, that though her grief was overwhelming she could look to the future and understand better days were to come, something depression doesn’t allow. She also makes note that though she had derived great pleasure from classical music prior to her husbands death, these works were now too painful to bare, seemingly bringing to the surface a depth of feeling beyond what she could manage. This experience was so acute she regrettably gave away her entire classical music collection during that time.

Ara Guzelimian then explores depression and grief by looking at the life of Felix Mendelssohn, specifically after the sudden death of his older sister Fanny. From his paintings and writings to the Quartet in F minor, which was his only large scale musical work written after Fanny’s death before passing away himself, Guzelimian explores Mendelssohn’s expression of grief. Though he was at the height of his career, Mendelssohn quit his creative activity cold and he sequestered himself from family and most friends, staying in the Swiss Alps looking for comfort in the landscape. Though Mendelssohn made an effort to return to work, he ultimately suffered several strokes, the same malady that took Fanny’s life, and passed away less than six months after her. The Quartet in F minor is a striking departure from Mendelssohn’s earlier works and uses a vocabulary of instability; rhythmically, harmonically, melodically and beyond. It is also notable that within the movements of this work there is no relief from the dark turmoil it seems to express.

To close the presentation, Dr. DePaulo brings his clinical expertise to the discussion of grief. Bereavement, though individual, is predictable and progressive which makes it easy to distinguish from depression. Grief presents with emotional numbness and is followed by deep sadness and disinterest in activities, though in most cases this comes and goes. These periods of sadness become increasingly intermittent with periods of welling emotion connected to memories of the loved one, but can go one for years or even decades. Depression or melancholia presents with a change in mood (vacant, hopeless, anxious), vitality both physically and mentally, there is a change in self attitude and these symptoms are pervasive and persistent. Depression can be triggered by the loss of a loved one and is strongly evidenced to be hereditary. Clinicians must differentiate between these two conditions (though this is sometimes difficult) and be prudent not to medical-ize a common human experience.


This past year my grandmother past away quite suddenly so I am familiar with the above mentioned patterns of grief. Though my grandma and I were close, the symptoms I experienced were mild compared to others in my family losing a wife or a mother. My family also has a history of depression and I have instinctively been aware that grief can lead to depression especially in those with a predisposition to melancholia. I appreciated learning the clinical distinctions between these two conditions and also exploring Mendelssohn’s seeming progression from grief into depression through his work and writings.

During the question and answer period after this presentation it became evident that science has not yet discovered enough about brain function to conclusively explain our responses to music as a comfort or otherwise during periods of emotional turmoil such as grief. It is clear, however, that music commonly elicits a heightened response, be it emotional pain or pacification during the common human experience of bereavement.

A study of interest that I encountered in my research of the brain and grief, looked into the brain response in those identified as suffering from “complicated grief,” or grief that doesn’t have the normal dissipation over time. The study, conducted in 2008 at UCLA by researcher Mary-Frances O'Connor, centered on women that had lost mothers to breast cancer. Subjects were shown pictures of their deceased family members while hooked up to an fMRI machine. Normal grief is identifiable on an fMRI scan as areas of the brain that control emotional pain are activated when the bereaved subject is shown a picture of those they lost. The subjects with “complicated grief” (a term Dr. Redfield Jamison takes exception to because she argues all grief is complicated) display this same activity, but also show activity in the nucleus accumbens, a region of the brain associated with pleasure, rewards and addiction. The women in that group were unconsciously prolonging their grief, the study concluded, because memories of the person they missed gave them pleasure—as well as pain.

In listening to music, it is my experience that one can experience a variety of emotional responses ranging from something similar to pain or sadness to pleasure. I can’t help but wonder if the parts of the brain that are stimulated when listening to music include the centers of emotional pain and the nucleus accumbens. Could this explain in part why music commonly elicits heightened emotional responses during times of grief? In my research on this topic I have not yet found conclusive data to prove my theory, as both grief and music are complicated stimuli eliciting complicated brain activity. I plan to continue looking for connections between music and grief and their effects on the brain and appreciated the dynamic way this topic was explored in Dr. Redfield Jamison’s lecture.

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