from touchstone mental health
Kind Words Volume 8 Issue 1 Spring 2008
Mental Health Treatment: The Future By Kevin Turnquist, M.D.
Inside this issue Music for Recovery
Experiencing the Flute
With Voice of Flutes
Music as Therapy
Consumers’ Wish List
Donors Late 2007 and 2008
The Dance of Brainwaves
Staff’s Wish List
Rhythm of the Brain
I find it hard to argue that the current model of mental illness, which focuses on chemical imbalance in the brain, results in better lives for our consumers. Depression and the use of antidepressant medications are expanding dramatically in our society. The use of psychiatric medications in our children is skyrocketing. Far more people with mental illness live in homeless shelters and prisons than in facilities designed to provide them with treatment. When people get admitted to hospitals that can treat their disorders, they may be discharged far too soon. Or they can languish for months waiting for openings in our scarce residential treatment programs. Sometimes the entire situation seems hopeless. If any cause for optimism exists, it comes from basic research in the neurosciences. Our previous understandings of the relationships between brain functioning and the environment have seen a major overhaul during the past decade. Humans are far more complex and adaptable creatures than we previously realized.
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Consider a few examples: • Mothers who experience emotional trauma during critical periods of pregnancy are at significantly increased risk for having a child with schizophrenia. Schizophrenia is now seen as a disorder of nerve cell migration and hook-up, one that is laid down by the end of the second trimester of pregnancy. • Children who are exposed to sexual abuse during childhood are more likely to develop
structural changes in a key area of the brain called the hippocampus. Those changes can predispose the individual to the rapidly shifting moods, anxiety, impulsivity, and self-destructive behaviors that typify Borderline Personality Disorder. • Researchers have linked dietary deficiency of Omega 3 fatty acids to increased rates of depression, bipolar illness, dementia, violent behavior, and Attention Deficit Disorder. • A recent study found that for every hour of television that a child watches per day between the ages of one and three, he or she incurs a resulting ten per cent increase in the likelihood of having problems with attention at age seven. • Adult monkeys raised in private cages may develop pronounced changes in the dopamine systems of the brain when placed in group cages. Their social status has a lot to do with the type of changes that occur. Lower-ranking monkeys become Continued on page 4
Music for Recovery Board Members
By Jennifer Kapphahn, Independent Living Skills Coordinator, Residential Treatment
Liz Sjaastad, Chair Sara Barron-Leer Bill Cochrane Leslie Connelly Michaela Diercks Sharon Toll Johnson, LICSW Merrie Kaas, Ph.D. Katie Weiss, Esq. Sharon Wilson
Music as therapy began after World War I when musicians flooded the veterans’ hospitals of the nation to play for patients. Caregivers began to notice marked physical and emotional responses from the people receiving their care. Their awareness of the benefits of music was the beginning of formalized music therapy during recovery from illness.
• • • • • • • • •
At Touchstone, we believe that music can function in this same way, and it fits well with our holistic approach. Music as therapy allows our consumers to explore personal feelings, to make positive changes in mood and emotional state, to acquire a sense of control over life through successful experiences, to practice problem solving, and to resolve conflicts, which leads to stronger family and peer relationships.
Research in music therapy supports its effectiveness in a wide variety of healthcare and educational settings. The American Music Therapy Association (AMTA) promotes a vast amount of research exploring the benefits of music as therapy through publication of their Journal of Music Therapy, Music Therapy Perspectives, and other resources. A substantial body of literature exists to support the effectiveness of music therapy.
Administrative Team Martha Lantz, LICSW , MBA Executive Director Glen Albert, LICSW Director of Supportive Housing, Assisted Living Birgit Kelly, LICSW Program Director, Case Management Services Michelle Wincell, LICSW Treatment Director, Residential Treatment Lynette Anderson Finance and Human Resources Director Peggy Wright, MBA Communications and Development Director Sherry Thompson Billing and Accounts Payable Specialist
Therapists design musical interventions that: • Promote wellness.
Experiencing the Flute
Martha Lantz Peggy Wright
See the article on the opposite page for the story about Robin and her flute.
Monica Smith, Office Manager at Touchstone Assisted Living Apartments, speaks about Robin’s playing of the flute: I really enjoy listening to the flute music here. Since my work station is located centrally, I am privileged to hear the music whenever Robin plays. I am impressed with her skill and ability to play so many tunes by memory! I would like to thank the donor personally for this delightful gift. It has brought much joy to the building!
Assisted Living Apartments 7376 Bass Lake Road New Hope, MN 55428-3861 (763) 536–8134 email@example.com Case Management Services 2829 University Avenue SE, Suite 400 Minneapolis, MN 55414-3230 (612) 874–6409 firstname.lastname@example.org
Glen Albert, Director of Supportive Housing, whose office is at Assisted Living, also talks about his experience of Robin’s playing: Some afternoons, the pleasant playing of flute music from the apartment above my office briefly interrupts my busy work. The music allows me to pause, as I smile and quietly thank the donor of the flute and the skill of the resident for this gift. It truly amazes me how a simple donation, such as this flute, can impact so many people.
Intentional Communities 2025 Nicollet Avenue South, Suite 200B Minneapolis, MN 55404 (612) 767–3881 email@example.com Residential Treatment 2516 E. 24th Street Minneapolis, MN 55406-1209 (612) 722–1892 firstname.lastname@example.org
Touchstone Mental Health
Manage stress. Alleviate pain. Express feelings. Enhance memory. Improve communication. Promote physical rehabilitation. Captivate and maintain listeners’ attention. Stimulate many parts of the brain. Encourage movement.
With song and dance and voice of flutes By Peggy Wright, Communications and Development Director
According to an article in the September 27, 2004 issue of Newsweek, “experts now believe that 60 to 90 percent of all doctor visits involve stress-related complaints.”
The flute means everything to me. It is my love, my life. Music is a gift from God. Robin, Resident at Assisted Living Apartments During a major depression some years ago, Robin threw away her flute, an open hole Gemeinhardt. Because playing meant so much to her, she later bought a second Gemeinhardt, paying for it over time with her income from social security disability. Someone stole this second flute in 2000. She has prayed for a flute ever since. On March 25, 2005, she moved into Touchstone Assisted Living Apartments. Later that year, she told Tami Swiggum, the Activities Coordinator, about her desire to own a flute. Robin was ecstatic when an anonymous donor saw the flute on the wish list in Touchstone’s newsletter, and in late 2007, donated a closed hole Artley flute for her use. She indicates that playing the flute calms and sooths her. She’s now playing the flute more and is requesting medications PRN (as needed upon request) less often. Robin learned to play the flute in fifth grade. At a meeting to sign up new members for the band, her grade school’s band leader played The Alley Cat Song, by artist Bobby Rydell, on the flute. Since Robin and her sister both had cats, Robin’s Puffy and her sister’s Fluffy, the song struck a cord, and Robin fell in love with the flute. Robin played in the band all through grade school and high school, including in the band’s concerts. In the ninth grade, the band director recorded the band’s spring concert for members, and Robin played a solo in the concert.
Music as Therapy
the band leader told her mother that she needed a new flute. Her mother always enjoyed her practicing at home and supported her in her playing. Prior to Robin’s starting seventh grade, her mother took her to downtown Minneapolis to purchase a flute at Schmitt Music. They bought the flute that she later threw away. Because of her poor eyesight, Robin has always played more by ear, although she can read music. Her flute teacher, Dorothy Jacobs, continually gave her challenging pieces to practice. Robin indicates that she always got As in band. In the eighth or ninth grade, she participated in a contest for first chair of the band’s flute section. She won. Although she played the flute mostly for the band at school, she also sang in the choir at Calvary Lutheran Church from the tenth through twelfth grade. She continued to play the flute during college at Gustavus Adolphus. Since she received her Artley flute, Robin has practiced regularly, at least fifteen minutes a day, and has relearned The Star Spangled Banner; My Country, ‘Tis of Thee; and America the Beautiful as well as hymns and spirituals. Usually she practices between 4:00 and 4:15 p.m. and often plays at 6 p.m. She sometimes plays for staff and other residents. Robin also often listens to music on the radio: Christian music on KTIS at 98.5 and classical music, especially the symphony, on KSJN at 99.5. She now wonders if some day she will be able to play in a community orchestra.
Primitive systems in the human body help us respond to external stressors, such as the need to flee a burning building. Exposure to ongoing stressors causes that same protective mechanism to trigger a destructive biological response. Heart disease, cancer, infections, inflammatory processes, and diabetes can be the result. A growing body of research supports the use of sound to reduce stress, generate feelings of well-being, and even promote healing. An expanding field of health care known as music therapy uses music to heal: improving pain management, warding off depression, promoting movement, calming patients, and easing muscle tension. Rhythmic music has power. Many cultures use ritual drumming and rhythmic prayer and often induce trance through music in religious ceremonies. Music causes our bodies and brains to function differently. A mellow, softer beat slows our breathing and heart rate, lowers our blood pressure, and encourages the slow brainwaves of the hypnotic or meditative state. Louder music and faster beats produce the opposite effect and may prompt more alert and concentrated thinking. Research on brainwaves is still in its infancy, but we do know that alterations in brainwaves change other bodily functions. Music increases the levels of endorphins, our natural pain relievers, and decreases our levels of stress hormones, which may explain the ability of music to improve the functioning of our immune system.
She used her sister’s flute during the fifth and sixth grade, but at the end of the school year,
Listen to some music today. Page 3
To u chsto n e M e n tal H ealth
Mental Health Treatment, Continued
What’s New Need A Speaker? Two of our staff gave presentations at a conference that the Minnesota FamilyBased Services Association, Inc. offered February 20 through February 22, 2008. • Birgit Kelly, MSW , LICSW , who is our Director of Case Management Services, presented Supporting the Health of the Healer: Supervisory Skills to Identify, Address, and Prevent Secondary Traumatic Stress. Individuals such as our case managers, counselors, and other clinical staff, who work with survivors of trauma and other high-need individuals, sometimes suffer from secondary traumatic stress and/or compassion fatigue. Birgit identified causes, signs, and symptoms of these secondary effects and offered strategies that supervisors, managers, and practitioners can take to reduce or mitigate the impact of secondary stress. • Michelle Wincell, MA, LICSW and our Treatment Director at Residential Treatment, presented Using the Four Agreements in Supervision and Leadership. She discussed her application of these four basic rules across a wide variety of issues as a leader in the workplace over the past several years. Michelle provided group activities to explore ways in which using the agreements opens up new directions, insights, and questions. See our Summer 2007 newsletter for an explanation of the four agreements.
Integrative Services Consortium Stay tuned! We plan to reinstate the consortium and will hold a meeting later this year. If anyone is interested in helping plan it or has an idea for a topic, please contact Birgit Kelly at 612-767-2164 or email@example.com.
Touchstone Mental Health
greatly inclined to use cocaine when it’s made available, but the more dominant monkeys showed no such increase in self-administration of cocaine when put into the crowded conditions. • Depression is now linked to problems with the creation of brain cells in the hippocampus, something that we didn’t know took place until recently. Giving birth to those new neurons depends on a host of environmental factors, including adequate sleep, a healthy diet, physical exercise, and mental stimulation. Excessive exposure to stress hormones, sleep problems, boredom, and loneliness are toxic to the brain structures essential for a stable mood. So what can we conclude from these studies and others of their kind? We’re at an early stage of sorting it all out, but one conclusion appears inescapable: Brains develop and function differently according to the environments that they develop and function in. The implications for our mental health systems are enormous. Our current treatments for the major mental disorders focus on modifying the brain’s chemical environment in ways that we only dimly understand. While often very helpful, treatment with these medications alone almost never leads to recovery. And it’s becoming increasingly apparent that the newer generations of medications are no more effective than the drugs that we’ve had around for decades. Side effects differ, but one can wonder whether trading tics and shuffling gait for weight gain, sexual dysfunction, and diabetes is much of an upgrade. A mental health system based entirely on brief visits to adjust medications will never provide consumers with the sorts of things that their brains really need.
Enlightened mental health systems of the future will emphasize creating optimal environments for children’s development, from the womb right up to adulthood. For people who do have established mental illnesses, we must develop specialized living environments that provide a good fit for the quirks of their nervous systems. As we’ve repeatedly seen, giving our consumers complex combinations of high-dose medications—just so they’ll be calm enough to survive in an environment that would make any sane person anxious—is a dead end. Privacy, safety, community, healthy diets, laughter, and meaningful work are commodities that many of our consumers will never be able to acquire without our help. These needs are not solely the needs of people with serious and persistent mental illness. They are human needs. It may come as a surprise to some that Touchstone Mental Health is at the forefront of our country’s efforts to move the treatment of mental disorders to its next level. They have a proud tradition of bringing case management and therapeutic services right to where consumers live. They’re exploring the use of complementary medicine in the treatment of the major mental illnesses. Their residential programs are among the best that Minnesota has to offer. Two new intentional communities are already established and provide the very kind of dignified, respectful treatment that any of us would want for our loved ones. Exciting plans for the ground-up construction of a Model Therapeutic Community are in the works. At a time when our public mental health systems are in such disarray, Touchstone Mental Health provides a beacon of hope for a better future. They deserve our support and our thanks. Kevin Turnquist, a psychiatrist for more than 20 years, works for Minnesota State Operated Services.
Donors Late 2007 and 2008 Ceil Raleigh Endowment Fund Lynette Anderson in honor of Helen Raleigh Leslie and Michael Connelly Marianne Green in memory of Paul Croes; Chuck, David, and John Meistas; and Fred Cordell Liz and John Sjaastad Sharon Wilson
In Honor of Susan Armstrong in honor of Peggy and Milton Wright Julie Ryan and Barb Radtke in honor of Touchstone Case Management Services Devona and Harley Swiggum in honor of Tami Swiggum
Michael Tkach in honor of Michelle Wincell
In Memory of Birgit Kelly in memory of Tim (TW) Hanson Margaret Roser in memory of Carl Roser Mark and Mary Sanderson in memory of Scott Sanderson Dick and Rita Sanderson in memory of Scott Sanderson Ivy West in memory of Phillip Bebb and Gregory West
Cynthia Riggs Memorial Fund Jeannie Kenney Susan and Jean Le Picart David and Karen Miller Connie and Bill Riggs
Consumers’ Wish List
Businesses and Organizations
David Sagula Ellen Schmitz Kathleen Whiteford
Individuals Anonymous (3) Nancy Abramson Sandy Accola Birgit Birkeland Celeste Culberth Ernie Gunderson Sharon Toll Johnson Merrie Kaas Sandy Manning Meadow Muska Katherine Pollock Julie Roles Mary Kay and Charles Romportl MaryAnn Watters Katie Weiss Ivy West
Personal Care Items or Services
Fast Print Northwest Minneapolis Chapter of Thrivent Financial for Lutherans
• Dental floss, toothbrushes & tooth paste, dental work • Deodorant • Donations for medication copays • Facial tissue, toilet paper • Gift certificates for new shoes, clothing • Shampoo & conditioner, hair cuts • Multivitamins • YM or YWCA or health-club memberships
In Kind Donations Individuals Anonymous (1) Coni Bell Donna Redding Margaret and Carl Roser Heidi Van Amburg Michelle Wincell
Businesses and Organizations McQuay International St. Anthony Walmart
The Dance of Brain waves By Peggy Wright, Communications and Development Director The brain uses electromagnetic energy to function. Four characteristic categories of brain waves exist and are consistent across the boundaries of gender, age, culture, and national origin.
When you are fully awake and alert, your brain produces these brain waves. In this state, you think and perform activities in a conscious manner. Your focus is outward. You might associate it with left-brain thinking.
When your brain is producing alpha waves, you feel comfortable and mildly relaxed but are aware of your environment. You might associate this state with right-brain thinking. The transitional state between beta and alpha brain waves is the doorway to your subconscious. Alpha waves appear during meditation. These brain waves calm your nervous system, and
when you practice meditation regularly, cause changes in the body. For example, your blood pressure and heart rate lower, and your body produces fewer stress hormones.
Theta waves represent a state of awareness associated with total relaxation. This state promotes creativity, improves problem solving, and permits learning to occur faster. Although close to a state of sleep, your brain is actually highly alert and receptive. The transitional state between alpha and theta brain waves is the doorway to your superconscious mind, which manifests itself in most people as bursts of insight.
During deep, dreamless sleep, your brain produces these slowest of the brainwaves. During this state, your brain and body regenerate and rejuvenate. Page 5
• Art supplies, including colored pencils or markers; other drawing supplies • A large dry-erase board • Musical instruments—digital piano, guitars • Gift cards or certificates to coffee shops, McDonald’s, Target, Cub • Household products—dish soap, laundry soap, antistatic sheets for the dryer, paper towels • Household items—Flatware, rugs, table lamps, lamp shades, laundry baskets, TVs, DVD players, microwaves, firm pillows • Long-distance phone cards • Recreational products—Magazine subscriptions, movie tickets, VCR tapes/DVDs, 10-speed bicycles, film, radio/CD player, Walkman, scrabble game, dominoes • Punch cards for the FUMC therapeutic pool • Supplies for quilting and needlework: rotary tools, fabric pencils, transparent rulers, scissors, quilting tape, quilting pins, cutting mat, fabric, needles, embroidery floss, cross-stitch fabric, thread, latch hook for rug hooking, knitting yarn, crochet needles, craft kits • Transportation: bus passes • Free or low cost veterinarian services
To u chsto n e M e n tal H ealth
Staff’s Wish List • • • • • • • • • •
Copier paper, white CDs (blank PC ) Garbage bags (40 gal. & 12 gal.) Laundry soap, dryer sheets Laser printer (new) Monitors (flat-panel) Mouse (cordless, 1 or more) Pens (black) Services from a print shop Snow removal for residential sites
Touchstone Mental Health inspires hope, healing and well-being.
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Rhythm of the Brain By Peggy Wright, Communications and Development Director In 1656, Dutch scientist Christian Huygens made an interesting discovery while working on the design of the pendulum clock. When he placed two unsynchronized clocks side by side on a wall, they slowly synchronized to each other, and the effect was so precise that mechanical calibration could do no better. This synchronization of two or more rhythmic cycles, called entrainment, is a principle of physics. Entrainment is universal, appearing in chemistry, neurology, biology, pharmacology, medicine, and astronomy. Our brains are no different. Brainwave entrainment refers to the brain’s electrical response to rhythmic sensory stimulation, such as pulses of sound or light. When a stimulus reaches the brain through the ears, eyes, or other senses, it emits an electrical
charge in response. The brain will reproduce a rhythmic stimulus, such as a musical beat, in its electrical impulses. Quiet, calming music will produce a soothing rhythm in the brain. Fast, energetic music will produce an invigorating rhythm in the brain. Our staff intentionally uses music to create a healing environment that supports recovery. For example, Kara Vangen, our Healing Touch practitioner, and Ingrid Bloom, our Licensed Acupuncturist, both use music to set a peaceful tone in their therapeutic sessions, helping the consumer’s mind to relax. When the brain relaxes, an individual’s mental resistance decreases, and the person is more apt to respond positively to treatment.