Times Observer photo by Stacey Gross Ellen Paquette plays the harp she uses to soothe Hospice patients and their families.

After seeing a post from Ellen Paquette on social media, a picture of her harp and a caption that she was beginning her sixth year playing bedside harp, I was curious.

I asked Ellen for an interview. She wasn’t sure she wanted to talk.

“It’s important that people understand I didn’t seek this out,” said Ellen, who volunteers to play for patients enrolled with Hospice of Warren County. “It’s a service. The ego must be separated from it. There’s absolutely no place for it.

“Separating ego,” said Ellen, is one of the first things a Certified Clinical Musician (CCM) must learn, and the most important thing to maintain. “Separating ego from the playing of music is revelatory.”

What she does, Ellen said, “is a tool of healing. It’s a service. It is not a performance.”

In the six years since Ellen started playing bedside harp she has worked through about half of the coursework required to become a CCM. What she needs to do now, she said, is complete internship hours in settings other than hospice. But hospice, she said, is what initially compelled her to pursue the certification in the first place, and she’s just not quite ready to play in other settings that have begun employing music therapy. Some of those settings include NICUs and surgery centers. The variety of internship hours, she said, is required to finish the certification, and she will do them at some point, but right now she still feels called to do just what she’s doing – being on call as a provider of music for Hospice of Warren County patients.

When a patient is enrolled into Hospice of Warren County, said Ellen, an intake worker sits down with the patient and family members to try to understand all of the things that may be of use at any point during that person’s end-of-life journey.

“It’s such an intense time,” said Ellen, and patients and their families are often feeling pulled in many directions, overwhelmed by it all. So they may have been told about all of the volunteers that provide services but may not recall them when they would be useful. If a hospice patient identifies music as something they enjoy, that person may very well have Ellen’s name attached to their intake, and Ellen may be called when her services could benefit the patient, as well as the family.

“It’s an honor to volunteer with Hospice of Warren County,” said Ellen. “It’s a huge honor to be allowed into someone’s space at that point in their life. Birth and death are the two most intense moments in a person’s life,” said Ellen. “It really is a sacred space.”

But how can music be therapeutic? How can playing a harp have any verifiable effect on physical space or body functions?

It turns out that there is plenty of peer reviewed science to attest to decreased pain ratings and less requests for analgesics when therapeutic music is offered in a palliative care setting. Without getting too technical or too esoteric – both of which can be elements of the course of study for those working toward becoming CCMs – the basic idea is that the body can be affected by certain musical vibrations.

Neural entrainment is a strategy of bringing the frequency of electrical activity in the brain of a subject in line with a desired neural frequency by introducing a periodic stimulus. Beta and Alpha waves are rapid brain frequencies associated with wakefulness, alertness, and a faster heart rate. Theta and Delta waves, by comparison, are associated with deep relaxation, rest, and comfort. The goal of the CCM, then, is to enter a patients room and meet them where they’re at physiologically, adapting and improvising the melody he or she plays to bring the patients brainwaves, and thereby heart rate and anxiety levels, down. The stimulus could be anything, but clinical musicians tend to like the low, resonant notes of the harp.

Ellen said that CCMs measure their success by their ability to put people to sleep. “I tell people,” said Ellen, “the greatest compliment you can give me is to fall asleep.” Ellen said that in therapeutic settings like hospice, her goal as a musician is to use the harp as a tool to assist patients in disengaging.

So, said Ellen, “unfamiliar is always better.”

Familiar tunes and melodies engage the brain, which is hardwired to complete patterns and solve puzzles. In palliative care, though, the goal is to ease pain and anxiety, and in that way to improve a patients quality of life. By playing unfamiliar tunes improvised to match and gently coax a patients heart and brain into deeper rest and less engagement with their surroundings, Ellen said, the music becomes a tool to provide patients and families the ability to “just be.”

The ability to sit quietly in a room without ruminating or focusing on circumstances, but instead to allow oneself to disengage from the situation, can be healing, both for those at the end stages of their lives and those holding vigils around them, she said.

Paquette said that she’s played for people from their 20’s to their 60’s and above, and she’s provided bedside comfort music to over 100 patients since she started six years ago.

“We’re there to serve the mind, the body, and the spirit,” said Ellen, who said she understands the spirit as “simply the essence of that person. We’re not there biased by any religious beliefs or anything. We’re just there to serve the patient and provide comfort, a higher quality of life.”

While Ellen said she’s never been present during the actual death of a patient, she did say that she’s been called to play for patients who have died within 10 minutes of her finishing. And while she’s been present to see many children hold vigils for dying parents, Ellen said she’s been present only once with a parent holding a vigil for a dying child who was in her 20’s.

Asked whether she was ready for the prospect of being present during a person’s death, Ellen said she doesn’t really think that much about it. Ellen said she’s never felt nervous or anxious while playing in a Hospice setting, and that she really doesn’t need to do a lot of self care afterward because her intention isn’t to perform, but to serve.

“It really is all about your intention,” said Ellen. “If you’re there just to serve, I think you don’t get drained the way maybe a therapist would.”

Ellen did say, though, she sometimes craves sugar or coffee after a session.

“Not really drained,” she said, “but just like I need to eat sugar or drink caffeine.”

Ellen said that while empathic people often take on the emotional states of the people and settings around them, and even while that can be something she does without realizing it in other settings, it’s not something she’s seen a need to worry about as a CCM.

Ellen said that part of the training for CCMs is learning how to be tuned in to patients.

“I listen to what they say,” said Ellen, “or if they’re unconscious, I look at the expressions on their face, their breathing, all those things that let me know,” she said, how she needs to play to provide comfort or relief moment-to-moment.

Ellen said that she uses a nine pound portable harp with a smaller soundbox, but that is able to produce the rich, low notes best suited to musical therapy in a hospice setting.

“It’s just something I feel compelled to do,” said Ellen, demonstrating some of those rich, low notes as she talked. “I feel really connected to the Hospice setting. Volunteering with Hospice of Warren County is an honor.”