Thoughts on Being a Compassionate Presence

This week, I had a new nurse shadowing me. Every time a new IDT [interdisciplinary team] member signs on with Iowa Hospice, part of their orientation is to shadow me [and the other disciplines as well]. This is show them the roles of their other team members. As we were driving to see a client, she asked me, "What are your goals if someone cannot respond to you at all? What if you've never heard them talk or seen them respond? Do you still see them?" I responded by saying, "Well, then, if I see them, it is to provide compassionate presence." Then I had the task of trying to define what that looks like and the rationale for that little phrase "compassionate presence."

I like the way this Edge Magazine article defines "compassionate presence":

"Being completely present with one who is suffering means being able to be present with the suffering itself. This, you may recall, is the very definition of compassion. True compassionate presence is not about denying someone his experience with the dark realities he is experiencing; instead, it provides illumination that allows him to explore all the aspects of his situation with clarity."

That sounds very holistic and spiritual, right? This is something I strive to be in my professional and personal life, but what does that look like in a medical setting? What does that look like? How does one become or provide a compassionate presence? I am by no means an expert on the subject, but I would like to take some time and discuss how it plays into the care I provide for my clients.

It's a hard thing to see happening, first off. If someone walks into a session where the goals are to provide compassionate presence, it may just look like I'm playing guitar for someone who is sleeping. The music may sound pretty, but it's hard to see what is being accomplished. I hold the belief, however, that part of showing someone they matter and giving them the dignity that is due all people is spending quality time with them. Essentially saying, in not so many words, "You matter! If you did not matter, I would not be here spending time with you." It is being empathetic, aware of how they may be feeling, even if they cannot tell you, and being a part of their journey for a short time. This may be accomplished simply by breathing with someone or talking with someone about the things that matter, or used to matter, to them. Being completely present with someone, not worried about what else you have to do or where you should be, is a gift that everyone can bring.

In the medical field, even hospice [although not to the same degree], a lot of emphasis is placed on results. Is this medication working? Do we need to adjust their visits? What is the problem and how do we fix it? All this is most definitely valuable, but does not give people much time to just sit and be with someone, not thinking about the laundry list of other tasks to be completed in the day. Simply focusing, instead, on the patient. This makes them more than a patient with a diagnosis and poor prognosis, but transforms them into a person, capable, or once capable, of so many things. This levels the playing field, bringing people to their most basic role - being people who help people.

My challenge for you, then, is to take some time this next week, and really try to be a compassionate presence for someone. Whether that is your spouse, friend, co-worker, parent, or child, give it a try. It may be hard, but, like everything, it takes practice and the dividends are great.

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As you do this, which I hope you do, take some time to read up on another great music therapy blog called Mindful Music Therapist.

Grief Group Self-Review

Yesterday, I led a grief group in place of the bereavement coordinator. I haven't led a group for quite some time, and had never led solo. I wanted to just talk a bit about what I did and what I would have done differently.

I started off with "The Rose", which I did some research on. Apparently, the song was voted #83 of American Film Institute's "100 Years of the Greatest Songs" in 2004. This song was written by Andrea McBloom, but was made famous by Bette Midler. Other covers done by Conway Twitty, Leann Rimes, and Westlife.

I sang the song and we talked about different lyrics of the song that stood out to them and compared them to their grief journey. It turned out that this song was used for the funeral of the mother of one of the participants, so it already carried quite a punch. We talked about the lyrics and it sort of went on a few rabbit trails after that. I tried to concentrate on coping strategies, especially when they talked about being angry or depressed. At the end, I tried to lead a relaxation exercise, but it didn't really work out very well.

I think some of this next section may be due to walking into a new group. I had never met any of these people before and some of them had other issues that they were dealing with. I try not to blame others, but one lady in particular tended to dominate the conversation, which was actually a bit of help at first. In the end, however, I wish I had attempted to take a little more control so I could include others, one in particular who didn't actually say anything. Another thing I would have liked to see happen is some realizations toward the end. I understand that everybody works at a different pace, but I felt as though the participants were more depressed when they left.

Despite this, I do feel that there was a lot of great sharing. My intentions were good and I felt I did stay mentally present throughout the entire session. I felt that I was able to take a tangents and connect them to some lessons that I've learned working with patients. I especially tried to show that they were very connected through their grief and I encouraged them to lean on each other when they are feeling depressed or needed to talk.

I guess that's all I have. Sorry for the ramblings, but this blog is great for me to process how things went. That's important for anybody to do.

Septemer 11th - Music for national healing

Today is the tenth anniversary of the terrible attacks on the World Trade Center and, in some ways, the wounds still feel fresh. I specifically remember sitting in science class my freshman year of high school. It was early in the day and the teacher was watching television, told us to sit down and watch, and we did. We just watched the smoke billowing out of this building I had never heard of before. As we watched for the next two days, we learned a lot about life. We learned about hatred, we learned about resilience, and learned what real heroes looked like. We saw a plane fly into the second tower and could do nothing but watch as a few thousand people died, right on television. We saw police officers and firefighters fight the debris, trying to find jsut one more person they could help out of the rubble.

I know I'm not alone in my experience. The media still talks about it and a new sense of American pride began to manifest itself in songs about national pride. People took all stances to the mayhem. Toby Keith, very angry, states his case in "Courtesy of the Red, White, and Blue."

I personally don't agree with Mr. Keith. The anger, I think, was felt by millions of people, but the jump to immediate violence, I don't believe is the correct answer. I feel this anger is misdirected sadness and there are more appropriate ways to deal with this grief.

Others stood with stoicism and sang the Star Spangled Banner and Amazing Grace. It seems that everybody took these songs much more serious after 9/11. 

The song that most touched me, though, at this time was a song that seemed to symbolize the struggle of rebuilding and realizing that nothing would ever be the same again. This song reminds of the people who helped others during this time. To me, it talks about feeling invincible only to be knocked down and hurt. But it also gets back up. It's called "Superman" by Five for Fighting.

What were songs that you remember from that time? What meaning to they carry for you now?