Imagine that you are a veteran living in a residential care facility. It has been many years since your service, but memories still pop into your mind; some welcome and some unwelcome. Your feelings about your service are complex, blending pride with grief, honor with remorse. Most of the time, you feel in control over feelings evoked by your military memories. Except when you hear “The Marines’ Hymn.” For you, this is a sacred song that immediately transports you right back to the emotions you felt during ceremonies for your fallen comrades.
Now imagine that on several occasions each year (near Memorial Day, Veteran’s Day, and the Fourth of July), dozens of well-meaning volunteers lead boisterous sing-alongs and expect your cheerful participation.
The problem is, you don’t feel boisterous or cheerful when you hear that music. And when tears well up in your eyes, people turn away. They don’t know what to do or how to respond.
This isn’t a challenge unique to nursing homes. Other healthcare facilities, mental health programs, community groups, and religious organizations all need to be aware of the unintentional emotional impact that patriotic or military music can have on veterans.
Does this mean that we should stop using patriotic music in group settings?
Music and the military go hand in hand. Historically, music has been integral to the military experience, from bugle calls that summon one awake in the morning, to cues for when to charge or retreat in battle, to "lights out." While the modern military may use different formats, music remains an integral component of one's military experience. It is used for celebration, bringing people together, showing pride of country, and honoring the fallen. There are many occasions where playing music is wanted and appropriate.
Many veterans love hearing patriotic music, and shying away from military music is not the message we want to send. What we are suggesting is that if you are going to bring patriotic music to groups where members have a military background, you need to have the skills and resources to help group members cope with strong emotional reactions. When these groups also might include people who have dementia or other significant conditions, it is even more important to bring awareness, sensitivity, and clinical skills.
Music Therapy and the Military
The profession of music therapy had its beginnings in military treatment facilities and VA hospitals. The U.S. Army and Navy were among the first organizations to identify the power of music and its therapeutic potential. Yet very early on, the need for specific training and protocols was identified by musicians and healthcare professionals working with veteran populations. Because of the powerful memories, emotions, and associations that music elicited in this setting, volunteer musicians soon recognized they were not always equipped to effectively work with military populations.
In 1945, the U.S. War Department issued a bulletin explaining how music was being used for recreation, education, and rehabilitation in Army hospitals. This lead to the first large research studies about the impact of music as a therapy. It was in the aftermath of WWII that our first professional organization - the National Association for Music Therapy - was founded, in order to lead the way in developing standards for the training and practice of music therapy. (You can read more about this history of music therapy and the military here.)
Music therapists now work across all phases of military service, from pre-deployment to active duty, to veteran status. We address clinical issues ranging from physical rehabilitation to PTSD and substance use disorders. Current practice is grounded in evidence-based approaches that are part of the individualized service plan for each participant. Much of the work being done with Veterans today focuses on working through traumatic experiences and promoting healing, growth, and reintegration.
Using Music with Care
Music is a powerful tool. It directly impacts our emotions, cognitive functioning, and physiology. It can evoke memories and associations, even when those memories are deeply buried or unwelcome. Like all treatments, it has the potential to both help, and when used incorrectly, to harm. Music therapists are specially trained to address the wide array of responses that people have to music, and to help them integrate these responses into beneficial outcomes.
We do a disservice to our military veterans when we do not consider the full implications of the patriotic programs we bring to our facilities and gatherings. Yes, bring music, but do so responsibly. This means knowing the history and background of participants, allowing a graceful way for people to decline to participate and be out of hearing range during the event, and consulting with, or even hiring a board-certified music therapist who can address the individualized needs of people who may be grieving or struggling.
*Special thanks to cowriter Michelle Muth of M3 Music Therapy, with whom the first version of this article was published.