Musicoterapia en COANIQUEM

Por Alejandra Salazar Melo
Musicoterapeuta Corporación de Ayuda al Niño Quemado COANIQUEM

La Musicoterapia es una disciplina que se ha desarrollado durante los últimos cuarenta años y que hoy ocupa un lugar importante en las distintas áreas de la educación y la salud en muchos países de Europa, Estados Unidos y en América Latina, en países como Argentina, Brasil, Colombia y Chile. En nuestro país, a partir de 1999 se crea como postítulo en la facultad de Artes de la Universidad de Chile y en el año 2005 se organiza la primera Asociación de Musicoterapia de Chile.

A través de la historia de la Musicoterapia como ciencia, han surgido diferentes definiciones según las diferentes corrientes, escuelas y músico terapeutas.

Se la define como “el uso de la música en la consecución de objetivos terapéuticos: la restauración, el mantenimiento y el acrecentamiento de la salud tanto física como mental. Es también la aplicación científica de la música, dirigida por el terapeuta en un contexto terapéutico para provocar cambios en el comportamiento. Dichos cambios facilitan a la persona el tratamiento que debe recibir a fin de que pueda comprenderse mejor a sí mismo y a su mundo para poder ajustarse mejor y mas adecuadamente a la sociedad” (1)

La musicoterapia como tal, surge de la investigación científica del uso de la música y sus efectos sobre el ser humano y su efectividad en todos los niveles: el psicológico, neurológico, físico, conductual, emocional, biológico y de educación especial.

Estas investigaciones arrojan métodos y técnicas a través de los cuales se aplica la musicoterapia y nos ayuda a darnos cuenta que cualquier actividad musical, no es necesariamente terapéutica.

Existe un tipo de clasificación de los distintos métodos musicoterapéuticos que los divide en:

– “Métodos Activos o Creativos, que requieren de la participación completa del paciente considerando sus capacidades y puede ser principalmente la ejecución de instrumentos. La improvisación instrumental consiste en “expresar libre y creativamente” a través de algún instrumento, emociones y sentimientos. A estas improvisaciones en ningún caso se las evalúa según parámetros musicales, ni estéticos.

– ”Métodos Receptivos o Pasivo” que utiliza como mecanismo básico la audición musical, música envasada principalmente o música que ejecute el Musicoterapeuta.

En la base de todas las teorías que tratan de buscar los fundamentos de la acción terapéutica de la música se halla un denominador común: “la emoción”.

Según algunos, la música tiene la capacidad para provocar emociones y sentimientos, los que influyen sobre la parte somática. Otros opinan que la influencia de la música afecta primero la parte somática y se transforma luego en emoción y sentimiento.

Los efectos terapéuticos de la música han sido observados a través de la historia, a veces con mucha exactitud. (2)

Del uso de la Musicoterapia con niños que han sufrido accidente de quemadura, tan sólo se conoce el trabajo de Christine Tuden en el Hospital Shriners de Quemaduras de Galveston, EE.UU., trabajo realizado principalmente en la unidad de agudos; y el de Gabriela Wagner, que es más reciente, del Centro de Rehabilitación Integral de la Fundación Benaim. Buenos Aires, Argentina.

Musicoterapia en La Corporación de Ayuda al Niño Quemado, COANIQUEM

La Corporación de Ayuda al Niño Quemado, COANIQUEM, es una institución privada sin fines de lucro, que ayuda al niño que ha sufrido un accidente de quemadura y a su familia, proporcionándole el tratamiento de rehabilitación integral que le permita sobreponerse a las limitaciones provocadas por el accidente.

El Centro de Rehabilitación Santiago de COANIQUEM es su principal establecimiento, funciona desde 1982, proporciona atención médica y quirúrgica en forma ambulatoria a niños de todo el país, y en los últimos años también del extranjero.

La Musicoterapia se incorpora formalmente en el equipo de Rehabilitación de COANIQUEM en marzo del 2005. Desde entonces, más de 80 niños han sido atendidos con esta técnica: lactantes, pre-escolares y escolares principalmente. Esta disciplina ha permitido adicionar un complemento a la rehabilitación física y emocional del niño quemado, dentro de un modelo de atención que es muy completo en su integralidad

El accidente de quemadura en el niño, es una agresión física y psicológica de gran intensidad, que provoca un cambio radical en la existencia saludable del niño y de toda su familia, trasladándolo a una situación de estrés mantenido, durante la cual sufrirá un intenso dolor.

Luego se inicia un tratamiento invasivo y prolongado que contempla, en ocasiones, períodos de hospitalización con estadías variables, pero siempre vivencias con sentimientos de abandono, la pérdida de su independencia y habilidad para funcionar, el control de las situaciones que le corresponde vivir y su autoimagen. Paralelamente, la familia vive los primeros instantes con estupor, descontrol y desorganización.(3)

El objetivo de la Musicoterapia en COANIQUEM, es contribuir en la rehabilitación integral del niño, facilitando el proceso de recuperación emocional, físico y del desarrollo del paciente, junto al trabajo cooperativo de todo el equipo multidisciplinario, aportando desde la música, los sonidos y la ejecución de instrumentos musicales. La música trabaja a nivel de las emociones e involucra por completo a la persona, relacionándola con sonidos y música que hacen eco en su interior y que los conecta con sus sentimientos y emociones fácilmente. Además, el estado emocional del niño quemado, así como el de sus padres, sometidos al estrés del accidente, hace que el vínculo con la música sea más rico y fácil, expresando su mundo interior a través de los instrumentos musicales.

Las atenciones se han realizado de acuerdo a las necesidades del paciente. En sesiones con horas programadas semanalmente antes de sus controles o de sus curaciones para disminuir el temor al tratamiento, manejar su ansiedad y la angustia de los padres. A las sesiones de Musicoterapia, cuando es necesario, se incorpora un profesional. Por ejemplo, cuando el niño no quiere hacer sus ejercicios se integra al kinesiólogo o si se niega a usar alguna prenda compresiva, se invita al terapeuta ocupacional. También se efectúa antes de la cirugía por manejo de conducta y ansiedad, para reforzar el lenguaje y reforzar el vínculo madre-niño.

La música es incorporada en las sesiones de musicoterapia como una modalidad terapéutica de varias maneras: a través de diferentes actividades de interacción lúdica sonoro-musical, actividades de improvisación instrumental libre o con alguna consigna específica, relajación con música, cantar canciones infantiles principalmente, y actividades de creación: cuentos sonoros, una historia donde los niños van incorporando sonidos según sus intereses y canciones relacionadas con la propia vivencia del niño; en las que los pacientes pueden expresar sus pensamientos y sentimientos en un espacio propio. Este espacio favorece, primero que nada, la relajación, la expresión, alivia la ansiedad y el temor, tanto del niño, como de la madre, propicia un nuevo medio de comunicación madre-hijo y facilita la distracción del niño, a través del hacer y escuchar, generando sensaciones gratificantes. Por otro lado, la ejecución de instrumentos musicales refuerza la motricidad estimulando, entre otros, la flexión de dedos de ambas manos, la disociación de movimientos de manos, muñeca, codo y hombros, el desarrollo de motricidad fina de ambas manos y la fuerza en miembro determinado.

De esta manera la terapia de música ayuda al niño y a sus padres a sobrellevar las tensiones de sus tratamientos y rehabilitación a través de la participación en actividades de música, dirigidas a sus necesidades emocionales y físicas. Estas necesidades están basadas en observaciones clínicas y de valoración del trabajo de Musicoterapia realizado el año 2005.

Citas Bibliográficas

(1)- Folleto “A Caeer in Music therapy. Editado por La National Association For Music Therapy (NAMT),

(2)-Poch, Serafina Compendio de Musicoterapia. Volumen I. Ed. Herder. Barcelona. 1999.Pág. 58-78

(3)-Revista Terapia Psicológica. Año XVI. Volumen VI (2). No 26. 1996. Pág. 40 Musicoterapia

Music Therapy in Parkinson’s Disease, Mt. Sergio Hazard

Introduction

In my paper, I offer the results of a music therapy intervention conducted between September and December 2006 at the Physical Medicine and Rehabilitation Service of the National Institute of Geriatrics President “Eduardo Frei Montalva” in Santiago, Chile. The intervention was conducted during clinical neurological rehabilitation of idiopathic Parkinson’s disease in this treatment center.

Our goal for the intervention was to contribute to the rehabilitation of the patients’ health in the areas of functionality, emotionality and sociability.

We applied a music therapy methodology called the Rhythmic Auditory Stimulation and receptive and active methods.

Some results noted by the intervention team report improvement on gait functionality and a decrease in the risk of falling, improvement of the mood disorders of patients (depression); and an increase in the motivation and willingness to face new tasks.

This paper represents a contribution to the general knowledge of music therapy in the field of Public Health in our country, making it possible to incorporate our discipline in the process of rehabilitation of geriatric patients with neurodegenerative disorders, such as Parkinson’s disease.

General Background

Parkinson’s disease (PD) is a neurodegenerative disorder of the central nervous system, affecting the automatic component of movement (extrapyramidal syndrome). Its four cardinal symptoms are: gait and posture disorders, rigidity, bradykinesia (slowness of voluntary movements) and resting tremor (Burch and Sheerin 2005).

In Chile, there are approximately 23,000 people with PD (Chiófalo et al. 1992, Chaná and Galdames 1998) and there are very few institutions specializing in the treatment and rehabilitation of disease. Among them are:

  • Parkinson-Alzheimer Foundation (2006).
  • Agrupación de Amigos de Parkinson (Friends Association of Parkinson) (2003).
  • Liga Chilena Contra el Mal de Parkinson (Chilean League Against Parkinson’s disease) (1987).

All of them strive to create integration networks, medical support, psychological, as well as social and economic support to patients and their immediate families. They also attempt educate the general public regarding the disease.

There is also the Physical Medicine and Rehabilitation Service and Day Hospital of the National Institute of Geriatrics President “Eduardo Frei Montalva” (1968).

Theoretical Framework Reference

My theoretical guidelines are based on three thematic areas of action: music therapy in the field of geriatrics, neurologic rehabilitation, and the sciences of sound.

1. Music therapy in geriatric treatment

In this field, the main source of research has been the work and impetus of the Australian music therapist Ruth Bright, who with more than 40 years of clinical experience, is considered a pioneer and authority in the field of music therapy in geriatrics and neurological disorders.

2. Music therapy in neurological rehabiltation [1]

This area highlights the work of the Center for Biomedical Research in Music (CBRM) at Colorado State University in the United States, where initiatives have been guided by its directors Michael H. Thaut, PhD, Gerald C. McIntosh, MD, and others.

The Center consists of three areas: The Academy of Neurologic Music Therapy Training, Neuroscience Research Laboratories, and Neurologic Music Therapy Clinics, which consist of groups of physical therapists and neurologic music therapists focused on services for members of the local community with mobility/motor deficits, resulting from stroke or other neurologic diseases such as Parkinson’s.

3. Vibroacustic Therapy

This theoretical influence highlights the important work of Norwegian teacher, music therapist, and researcher, Olav Skille, who designed the process and technical equipment used in what he called Vibroacoustic Therapy (VAT). His work began in the 1980s.

In general terms, VAT is the use of sinusoidal, low frequency (30 – 120 Hz), sound pressure waves, blended with music, for therapeutic use. This intervention offers a way of using the physical properties of music and sound waves in order to improve the quality of life of persons who are suffering from different ailments.

Context

The music therapy interventions took place at the Physical Medicine and Rehabilitation Service of the National Institute of Geriatrics President “Eduardo Frei Montalva” of the East Metropolitan Health Service, Santiago, Chile.

The National Institute of Geriatrics (NIG) is a unique center in both specialty and national coverage. NIG takes a multidisciplinary approach. This is interesting because there is a rich mix of processes, people, actions, and structures that contribute to the learning experience. Attention is directed to the age group older than 60 years with geriatric syndromes (gait and balance disorders; swallowing problems; mood and memory disorders; problems with sleep; frequent falls; immobility issues; sensory disorders, and other disorders.). The Institute operates in two modalities:

  • Inpatients for diagnosis, treatment and rehabilitation, corresponding to 32 residents (women’s room, 18 beds and men’s room, 14 beds) whose average stay is 24 days (middle-term stay modality).
  • Outpatients who come to the Attached Center of Specialities for medical consultations in geriatrics, physical medicine and rehabilitation, geriatric psychiatry, among other things. Outpatients can also be served in the Day Hospital, initiated by a physician of the Institute, for functional rehabilitation, managing the risk of complications from geriatric syndromes and supporting the continuing capacities.

NIG’s principal strategic goal is to improve the quality of service by creating a model of comprehensive care specialty for the Elderly.

Health care is delivered by a multi-professional and interdisciplinary team consisting of geriatrician, physician specializing in physical medicine and rehabilitation physiatrist (a physician who specializes in physical medicine and rehabilitation), neurologist, traumatologist; kinesiologist (an individual skilled in or applying kinesiology), occupational therapist, phonoaudiologist, psychogeriatic specialis, nurse, nutritionist and social worker. This comprehensive team conducts geriatric assessments and designate a clinical diagnosis of functional capacity as well as physical, mental, and social capacities of the patient, and indicate a treatment regime, assistance, and rehabilitation of a preventive nature, progressive, continuous and integral.

Photo 1: Context a

Context 1

Photo 2: Context b

Context 2

Intervention Goals

General Goal

To contribute to the rehabilitation of the patients’ health with idiopathic Parkinson’s disease in the areas of functionality, emotionality and sociability.

Specifics Goals

  • Functionality- related specific goal:
    • To improve gait and balance disorders.
  • Emotionality- related specific goal:
    • To motivate and improve mood disorders such as depression.
  • Sociability- related specifics goals:
    • To improve and enhance the patient-caregiver relationship.
    • To facilitate intra-and interpersonal relationships.

Methodology

The medical model guided our interventions, to a degree. So we can call our work clinical or medical music therapy. However, in relation to the goals raised there was a mixture, to some degree, with the orientations of existential humanism and learning theories.

The methods that formed the underpinnings of our interventions at different stages of the work were:

  • Rhythmic Auditory Stimulation (RAS) [2], which uses the rhythmic quality of music and the physiological mechanisms inherent in rhythm perception and production, and rhythmic synchronization. RAS has been shown to have beneficial effects on gait spatiotemporal parameters (speed, cadence, stride length and breadth of gait).
  • Receptive methods where the basis is listening to music, which can be presented in different modalities, as a stimulus to creativity and a tool of diagnosis, and also as a stimulus to imaging the process and outcomes of treatment, as well as a modulator of moods.
  • Active methods deal with a basic activity where the focus is musical improvisation, consisting of facilitating spontaneous expression, a form of free and creative expressions for the patient.

The interventions were based on the work of a music therapeutic team formed by a supervisor, a co-therapist and myself, in the role of music therapist in charge.

The sessions were performed in the wards of the Physical Medicine and Rehabilitation Service, specifically, the gym of kinesiology and a clinical ward where men were inpatients.

Photo 3: Gym of kinesiology

Gym of kinesiology

Photo 4: Clinical ward

Clinical ward

The interventions progressed in 3 to 16 sessions lasting 30 minutes each, twice weekly.

The numbers of patients during the interventions were 4 (2 inpatients and 2 outpatients): Patient 1 (67-years-old), 5 sessions; patient 2 (92-years-old), 3 sessions; patient 3 (72-years-old), 11 sessions in NIG and 1 session at home; patient 4 (73-years-old), 15 sessions in NIG and 1 session at home.

The music therapeutic setting included wind instruments, percussion instruments, electronic instrument (keyboard), digital devices (chronometer, metronome), radio, videocamera, photo camera, audio recorder, a musical library based in the personal cultural background of patients, songbooks, design of special musical material, parallel bars, walker and a notebook.

Music Therapeutic Process

The treatment was oriented as a whole considering the clinical data of the patients and their diagnosis. The goals of intervention were constantly modulated by the main goal in geriatric rehabilitation that is “to maintain and/or improve functionality” of patients.

Thus, the intervention was organized considering a system formed by three integrated and related units of action. These units were present within all of the therapeutic processes giving a holistic view of patients, as well as the concept that there always is a place for rehabilitation. Hence, the specifics goals in terms of improving gait and balance disorders; motivating and improving mood disorders; improving and enhancing the patient-caregiver relationship, and facilitating the intra-and interpersonal relationships, were all regulated by these units. Units were designated as corporality and movement; emotionality; music, sound and vibration.

1. Corporality and Movement

The work unit of functional integration related to re-educate the gait and balance progressive in parallel bars and transferring from one point to another in training. It was worked using RAS, based on the use of clicking of the metronome, with or without background music, with or without support from rhythmic cues by the percussion instruments played by the music therapist in unison with the click of the metronome or the rhythmic pulse of meaningful music to the patient. In addition, it utilized the re-education of body schema based on passive mobilization exercises segmentally (head, neck and scapular waist) and Eutony [3] (cognitive sensoperception).

Re-education of gait and balance progressive in parallel bars based in RAS from Voices: A World Forum for Music on Vimeo.

2. Emotionality

The work unit of psychosocial integration related to management mood disorders (depression), cognitive impairment, sleep disorders, anxiety, post-fall stress and cognitive-behavioral management. All of these activities were based on the ISO principle (related to the patient’s sound identity) (Benenzon 1998), elaboration and integration of life history (free and guided imagery), guided listening (passive and active), phonation exercises and vocal output, musical improvisations referential and non-referential, and integrating patient-caregiver.

Phonation Exercises and Vocal Output from Voices: A World Forum for Music on Vimeo.

Elaboration and integration of life history (free and guided imagery) from Voices: A World Forum for Music on Vimeo.

3. Music, Sound and Vibration

The work unit of integrating sound technology related to the use of music, sound and vibration in therapy. It had a transversal development in the therapeutic process and it was the linkage between functional and psychosocial work. All activities were focused to get physical and organic relaxation and a good sensorimotor integration of patients and they were base on the principle of vibroacustic (use of pure and complex tones, sound bath) (Skille 1991).

The unit was made by a library according to the sound-musical history of patients (ISO) and by the design and production of specific musical product through an audio-professional editing software (CD Work).

Sound bath from Voices: A World Forum for Music on Vimeo.

Concluding Remarks

At the end of the music therapy interventions, we observed the following results related to goals raised:

1. Functionality- related Goal (assessed on patients 3 and 4 by 12 and 16 sessions, respectively)

Observers noted improvements on gait functionality, specifically in terms of speed, cadence, stride length and breadth of, turns, changes of direction and transferences from one point to another.

Moreover, an improvement in the balance and decrease the risk of falling was noted. Before the therapy, patients were falling 2 to 3 times per week. During the therapy, patients were not fall. Patient reports were indicated by the caregivers (patients’ wifes).

Results were assessed by the use of the gait and balance valoration scale, Tinetti. Reaching scores within normal range:

Tinetti Sessions Admission score Discharge score
Patient 3 12 13/28 24/28
Patient 4 16 15/28 26/28
Note: Cutoff point ≤ 20 suggests risk of falling

This is relevant because, as previously noted, the main goal in geriatric rehabilitation is to maintain and/or improve the functionality in the patient. In addition, the gait preservation is a very important prerequisite for preserving the quality of life of Elderly.

2. Emotionality-related Goal

Observers indicated a slight improvement in the mood disorders of patients (depression) and strengthening their self-esteem.

Results were assessed by use of the geriatric depression scale, Yesavage (15-GDS):

Yesavage Sessions Admission score Discharge score
Patient 3 12 4 4
Patient 4 16 5 4
Note: Cutoff point ≥ 5 suggests depression

3.- Sociability-related Goal

The therapeutic process allowed to patients to satisfy the need to feel integrated into the world, to keep their individuality, and to build a bridge of communication between selves and surroundings, shifting the barriers imposed by the chronic and progressive nature of the disease. Moreover, staff reported an increase in the motivation and willingness to face new tasks and proposed learning. An important achievement was strengthening of the patient-caregiver relationship. This was assessed by a phonoaudiologist and an occupational therapist from the local Service.

Photo 5: Thanks to…

Thanks to...

Acknowledgments

  • To Dr. Lorena Cerda, head of ING’s Physical Medicine and Rehabilitation Service.
  • To Dr. Marcela Arias, head of ING’s Day Hospital.
  • To therapeutic entire team for their valuable assistance and contribution to this experience.

Notes

[1]For more information about the Music therapy in the neurologic rehabiltation, visit the Center for Biomedical Research in Music (CBRM) website athttp://www.colostate.edu/depts/CBRM

[2]For more information about the Rhythmic Auditory Stimulation (RAS), visit the Center for Biomedical Research in Music (CBRM) website athttp://www.colostate.edu/depts/CBRM – Neuroscience Research Laboratories.

[3]Eutony is a psycho-body discipline based on the experience and development of one’s own body created by Gerda Alexander (1908-1994).

References

Benenzon, R. (1998). La Nueva Musicoterapia. Buenos Aires: Editorial Lumen.

Bright, R. (1991). La Musicoterapia en el Tratamiento Geriátrico: Una nueva visión. Buenos Aires: Editorial Bonum.

Burch, D., Sheerin, F. (2005). Parkinson’s Disease. Lancet, 365 (9459): 622 – 627.

Chaná, P., Galdames, D. (1998). Accesibilidad a la farmacoterapia específica de la enfermedad de Parkinson. Revista Médica de Chile, 126 (11): 1355 – 1361.

Chapuis, S., Ouchchane, L., Metz, O., Gerbaud, L., Durif, F. (2005). Impact of the Motor Complications of Parkinson’s Disease on the Quality of Life. Movement Disorders, 20(2), 224 – 230.

Chiofalo, N., Kirschbaum, A., Schoenberg, B., Olivares, O., Valenzuela, B., Soto, E., Alvarez, G. (1992). Estudio epidemiológico de las enfermedades neurológicas en Santiago Metropolitano. Revista Chilena de Neuropsiquiatría, 30(4), 355 – 341.

Fernández-Del Olmo, M., Arias, P., Cudeiro-Mazaira, F.J. (2004). Facilitación de la actividad motora por estímulos sensoriales en la enfermedad de Parkinson. Revista de Neurología, 39(9), 841 – 847.

McIntosh, G. C., Thaut, M. H., Rice, R. R. (1996). Rhythmic Auditory Stimulation as Entrainment and Therapy Technique in Gait of Stroke and Parkinson’s Disease Patients. MusicMedicine Vol. 2, 145-152.

Skille, O. (1991). Manual of Vibroacoustics. Levanger: ISVA Publications.

Thaut, M.H., McIntosh, G.C. (2006). Rhythmic auditory training in sensorimotor rehabilitation of people with Parkinson’s Disease. Neurorehabilitation & Neural Repair, 20, 81.

Thaut, M.H., McIntosh, G.C., McIntosh, K.W., Hoemberg, V. (2001). Auditory Rhythmicity Enhances Movement and Speech Motor Control in Patients with Parkinson’s Disease. Functional Neurology, 16, 163-172.

Thaut, M.H. (1997). Rhythmic Auditory Stimulation in Rehabilitation of Movement Disorders: A Review of Current Research. In D.J. Schneck & J.K. Schneck (Eds.).Music in Human Adaptation (pp. 223-230). Blacksburg, VA: Virginia Polytechnic Institute and State University.

“The Meaning of Music in a German Sect in Chile: Colonia Dignidad”, por Susanne Bauer

After reading Lia Rejane’s column about Easter Island, about secrets and musical traditions of this wonderful culture, I felt inspired to show another face of music and culture in Chile. It is perhaps the most violent contrast to Lia’s excursion, but it is worth being mentioned as it shows, how our feelings toward music are conditioned by life circumstances and how music can be misused to cause damage and destruct personality on one side, and used to survey and resist, on the other.

Music in Early Childhood

Since research started about musical dialogue in infant-mother relationship, we know that music is a potent element in early childhood which influences affective and cognitive development, as well as social relation (Jaffe et al. 2001; Malloch, 1999/2000; Papousek, 1981; Trevarthen, 2002). It contributes to the two big needs of human being: individualism and togetherness (Kerr & Bowen, 1988). A sound is able to connect you with yourself or with others, you may listen to your own voice or to the voice of others, to a piece of music on your own or sharing an auditive experience with others. The way, how adults speak to a child and relate musically to it, influences the organization of brain functions, emotion and language. Personality development is also connected to musical influence in the widest sense of the word: since earliest experiences of our mothers’ voice (soft, hard, slow, rapid, paused, quick, fluid, etc), through the “family music”, (meaning the way how we relate vocally: who is the director of the orchestra, the solo player, the bass, the violin etc.) and the predominant music of our culture. Children take the music of their parents, which give them a solid ground for personal and family identity, but they may let this music or include new sounds when they are in need of differentiation (Ruud, 1998).

What happens when the experience of sound and music is manipulated, with a deprived choice determined by one person?

Colonia Dignidad – Colony of Honour

Colonia Dignidad (CD), today “Villa Baviera”, was a German community of 300 people, women, men and children, which arrived in the South of Chile in 1961. What was “sold” as a Benefit Organisation, became a religious sect, a close system and a place of crime. German journals and newspapers informed about sexual abuse, physical and psychological violence and even torture against the members of the group, accusing his leader, Paul Schäfer as main responsible and some of his men as collaborators (Gemballa, 1989; Heller, 1993, 2006; Vedder, 2005). In spite of these early publications nothing was done against Paul Schäfer, the opposite happened, while members of Colonia Dignidad lost their identities and were more and more repressed with all kind of methods, he became more and more power.

My First Impression

Since I was interested in Chile I knew about Colonia Dignidad and had read all these stories about Paul Schäfer and his sect. Therefore, once in Chile, we decided to go to the restaurant that belonged and still belongs to Colonia Dignidad, a 100 km away from their territory, which, by the way, is about 14.000 ha. My feelings were mixed between curiosity and fear. The restaurant was much known in the region for the quality of the food and the nice surroundings of the place. Chileans like to go there on weekend with the whole family to enjoy a good lunch or dinner and relax in a very beautiful landscape. Once a day, some of the Germans transform into actors and present a show, telling jokes and making the audience laugh. I admit, I could not laugh, as I felt that something was wrong with it, too bizarre and strange. These Germans where definitively very different: from the phenomenological point of view, their way of dressing, brushing and speaking. Like Germans from the 30th, cut off a book and put in the South of Chile. There was no congruence feeling and I did not understand why Chilean appreciated all this so much. May be, they liked it, because Germans are supposed to be different, but not bad. Germans arrived in the 19th century as colonists, building up houses, introducing German culture and education in some parts of the south of Chile. They were very recognized people, as they were strong, busy and honest. Everybody knew that they spoke more German than Spanish and that they did not like to mix so much with the Chilean people. Young German people were supposed to marry a German partner. Even the fact that a lot of them followed radical political ideas in the thirties, that is declare themselves as Nazi or forbid Spanish language to their children and in German schools as a sign of adherence to racist ideas, would not change the opinion of most Chilean people. So, nobody seemed to have doubts about the good intention of Colonia Dignidad. How could they? Colonia Dignidad built up a Hospital attending thousands of poor people and a school only for Chilean children. Everybody was grateful, with exception of those Chilean mothers or families, most of them analphabets, who brought their children to the hospital and who never saw them again, as they “agreed” to give their children in adoption to German families. Chilean babies grew up in the German colony without never learning Spanish language or getting to know their biological mothers and fathers (Vedder, 2005). – I never went back to that place but would not forget it either.

Fifteen Years Later …

I never returned to that place, even after settling down in Chile. But, as life is full of surprises, 15 years later, in 2005, as a German psychologist, I was invited to join the psychotherapeutic team to help and assist victims of CD! Why then? The leader of the group, Paul Schäfer, was persecuted by Chilean justice and escaped in 1997. The German government finally decided to visit the place, which was not allowed before, and to get to know the “Colonos”. They wanted to inform about the real situation and offered assistance and help to everybody who wanted. One of the tasks was the renovation of German passports and other documents. Not everybody wanted their help as they felt like betraying the leader. The loyalty was still so strong, even if they did not know where Paul Schäfer was and what would happen with them when Colonia Dignidad disappeared. In their eyes, people from outside where bad people which they must not trust, because they did not believe in God. Only some of them contacted us immediately and told us their horrendous stories. They were our first patients and the first to go back to Germany one year later.

Why and How: A German Sect in the South of Chile?

Colonia Dignidad was a sect with all the rules during 40 years. Beside mental and emotional repression, brain washing and oppression, children and young men suffered sexual abuse by the leader. Most of the boys were victims during more than 20 years of Paul Schäfer’s paedophilic homosexual abnormal conduct (Salinas, 2006).

Paul Schäfer was a self-proclaimed spiritual leader in the fifties. In a little German town called Heide, he started his malign work with adults, children and young men and women. He was very successful in recruiting people and thanks to his charismatic appearance and his religious discourses, many of the still wounded souls of exiled German families, fall into his chains. When German justice accused him because of paedophilic practice, he escaped with a group of people to Belgium; from there he organized the immigration to a far away country, called Chile. He promised a better life, announcing an important social mission that was to help poor children and adults, promoting religious ideas, education and health to them. His group was with him. Most of them left Heide and arrived 1961 in Chile. Others had to stay in Germany, especially fathers and husbands. They had to help organizing financial tasks. The real reason was the plan to separate families as soon as possible, with the intention to put into practice his sexual necessities. Most of the elder people where so convinced that they gave all their money to Schäfer or even sold their houses to help with the project. He promised them to pay back the money once they would have an income in Chile. This moment never arrived – CD became very rich, but nobody never ever received a salary until 2005, the same year, when Paul Schäfer was captured in Argentina, where he stayed hidden during more than seven years, in a luxurious farmhouse located in a big territory, accompanied by five “Colonos”.

The story of Colonia Dignidad lasted about 40 years, years of oppression, brainwashing, sexual abuse of children, punishments, psychical and physical torture, separation of families, brothers, sisters, boys and girls. Colonia Dignidad functioned with pear groups for age and sex, each group with its own name. Each group had to obey to an adult, who had to watch out for control and order, with the instruction to punish whenever it was necessary. Like in all sects, the individual wishes were eliminated. Work, praise and punishment were used to constitute a hermetic system. In case one of them tried to escape, he/she was punished so hard that he/she would not try it again. There is some exception, like Wolfgang Kneese who tried three times until he succeeded. He founded an organization called “Flügelschlag” in Germany to help victims of Colonia Dignidad until today.

The separation between men and women was significant, on one side, it meant isolation, a limited and distorted sexual evolution and abnormal conducts in children. On the other hand, it affected the population of CD: between 1982 and 2000 no children were born. Sexual relation and marriage where forbidden. Those who opposed to this rule were severely punished, isolated or drugged. Some time the victim was shut away in the Hospital during months. People who suffered this kind of oppression still do not remember certain periods of their life.

Well, what about music? How can person play music in these same conditions?

Power of Music – Power through Music

Music played a very important role during all these years of oppression. People related to us that it had different functions. On one side, music helped them to think on positive aspects, it was a part of their education and stimulated their intellectual development. They learned about composers, different pieces and interpreters. Almost all of them grew up playing an instrument, receiving group classes in violin, trumpet, horn, fagot, and other classical instruments. So far so good; but when we asked more about this topic, we could realize that even with music the leader achieved his malign purposes. Let me give some examples: children were asked which instrument they would like to play. When they said “violin”, he or she would learn any other instrument but the violin. When they discussed, they were punished immediately or later on at the group meeting. Their will was broken as soon as possible. Children and young musicians were not supposed to play better than adults, so children with special aptitudes received fewer classes or had classes with others, who were on a lower level, obligated to “wait for them”. It was forbidden to show any emotion while playing, as well as to show pride or ambition. This was very hardly punished. There was one girl, D., with special musical aptitudes. They told us that during 10 years they used to have an invited orchestra director from Germany. This man came regularly during summertime and studied very difficult pieces with the orchestra. He gave D. a special role, e.g. a solo part of a concert. Paul Schäfer did not like that at all, as she was younger than others, and forbid her to do this again. When the same director proposed to take D. to Germany so that she could realize violin studies at the conservatory, Paul Schäfer decided to take her off the orchestra and led her without playing the violin.

Alone While Together

Music was also used to separate people: every day, after lunch and after dinner, they had to practice on their instruments, individually. This made it almost impossible to have a space of time to relate to each other directly, without control and without being observed. Music was used to silence them. In spite of promoting togetherness, it produced more and more isolation. In the orchestra and in the choir they stand together and played or sang together, but they did not watch each other, they had to face straight on to the director. This is a cruel way of being together without being together, without connection, without empathy between them. They were educated to hate and to betray each other. How could they play music together without confidence to each other? They were educated do denounce the other, they were not allowed to listen to the other or keep any secret, otherwise they were punished; the one was punished who listened to the other. How could they play together? They were not expected to enjoy their music. Paul Schäfer loved Paganini and Caruso. He did not support “Liebesleid and Liebesfreud” from Kreisler. He hated titles and music who spoke about love. What are the men, they had to sing and participate in the choir. Paul Schäfer was the director. He chose the repertoire, no love songs were permitted. From one day to the other he changed rhythms and melodies. The one who did not follow his new arrangements was punished and blamed in front of everybody else. The worst punish was to be excluded and to sit down on a bank beside him, sometime during weeks without participating. They felt guilty and blamed. Which healthy and strong personality can develop from such kind of experience?

Music as a Hang Out

The choir and the orchestra where utilized for social events, every time the CD community wanted to demonstrate a happy German family life, they had to perform. The public consists on specially invited neighbours, sometimes on men of politics or military people. The intention was to give a good impression or receive some advantage or special permission. They played German and Chilean music, singing Chilean songs inclusive the National Hymn. Every time the auditory applauded immediately after the performance, Paul Schäfer enraged. Why? Because the musicians were instructed to sing and play in such a deep way, that at the end of the music, nobody should move. The applause meant that they did not succeed this effect, he shouted to them furiously as soon as the public disappeared.

When Paul Schäfer escaped from Colonia Dignidad, on 1997, and years later, when the habitants realized that he would not come back, most of them led their instruments, feeling unable to go on playing in the orchestra. When asked, they did not even know the answer. I suggest that only then, they felt that the instrument represented oppression and obligation, a conditioned life and robotic conduct – not to play brought them a new sensation of liberty.

Improvisation?

I tried to have a few music therapy group sessions with some of them. Of course, the idea of “Free Improvisation” did not work at all. They just could not play any tone without feeling insure and helpless. In an Improvisation there is no structure, no base where to lead on. There was no sense-of-Self prepared to articulate a single tone on his/her own. One of them asked me to play some “real song” and to accompany him while singing arias. Then they begged me to play on the piano a strong rhythm, so they could follow me. They liked that very much! They recognized their need of dependency and even laughed about it – but would not like to try improvising again. I then started a new way to relate me with them through music: preparing presentations about famous musicians, Chilean or German compositors and interprets and telling about their lives. So we had the authoritarian and ambitious father of Beethoven, Anne Sophie Mutters way of dressing and presenting herself in a concert and her warm and empathic attitude towards others, Robert Schumann’s and Clara Wieck’s life as a couple, Claudio Arrau’s arriving in Berlin as a child to study piano and so on – we started talking about these little arguments and sometimes, the discussion ended up in a very carefully expressed critical look at their own lives. They appreciate very much my performance; they were so much used to listen to the leader and admitted how difficult it was to give an opinion, to pronounce the word: I think.

With all, most of them felt that the music was a very important part of their lives, some of them were sad because the orchestra stopped, others felt a great relieve. The letter expressed that music always helped them to support difficult moments, acting as a life jacket, as an anchor, as a detractor and a connection to the world. Although they were never allowed to speak to the public, at least they could see other people and compare themselves with them. More than one of them must have felt the difference and questioned the dogma about good and bad human beings.

Finale

While habitants from Easter Island where singing their beautiful melodies, in the same land at the same time, thousands of km away, the habitants of “CD Island” where singing their songs, following the perverted ideas and interpretations of a perverted soul. Even worth: on one of these past days, a Chilean woman was detained and tortured in CD. During the procedure, she had to listen to Tchaikovsky’s “Capriccio Italiano” again and again (Gemballa, 1998). She survived and told her story, but will she ever forget this melody and what they did to her, while music was going on?

We cannot blame music for hatred. Music doesn’t create hatred, it can only support a hatred that is already there (Moreno, 1999, p. 13).

Reference

Gemballa, G (1998). Colonia Dignidad: ein Reporter auf den Spuren eines deutschen Skandals. Frankfurt: Campus Verlag.

Heller, P. (1993). Von der Psychosekte zum Folterlager. Stuttgart: Schmetterling Verlag.

Heller, P. (2006). Lederhosen, Dutt und Giftgas. Stuttgart: Schmetterling Verlag.

Jaffe, J., Beebe, B., Feldstein, S., Crown, C.L., & Jasnow, M.D. (2001). Rhythms of dialogue in infancy. Monographs of the Society for Research in Child Development 66(2 Serial N°265).

Kerr, M. E. & Bowen, M. (1988). Family Evaluation. New York: W. W. Norton & Co.

Malloch S. (1999/2000). Mothers and infants and communicative musicality. Musicae Scientiae, Special Issue: Rhythm, Musical Narrative and Origins of Human Communication, 29-58.

Moreno, J. (1999). Orpheus in Hell: Music and Therapy in the Holocaust. The Arts in Psychotherapy 26(1), 3-14.

Papousek, M. (1981). Die Bedeutung musikalischer Elemente in der frühen Kommunikation zwischen Eltern und Kind.Sozialpädiatrie in Praxis und Klinik 3(10), 468-473.

Ruud, E. (1998). Music Therapy: Improvisation, Communication & Culture. Gilsum, NH: Barcelona Publishers.

Salinas, C. & Stange, H. (2006). Los Amigos del “Dr” Schäfer. Santiago, Chile: Debate.

Trevarthen, C (2002). Origins of Musical Identity: Evidence from Infancy for Musical Social Awareness. In: R. Mac Donald, D. Hargreaves, & D. Miell (Eds.), Musical Identities (pp. 21-37). Oxford: Oxford University Press.

Vedder, E. (2005). Weg vom Leben. Berlin: Ullstein.

How to cite this page

Bauer, Susanne (2009). The Meaning of Music in a German Sect in Chile: Colonia Dignidad. Voices: A World Forum for Music Therapy. Retrieved July 03, 2012, from http://testvoices.uib.no/?q=colbauer200409