An interview with Maciej Kierył

An interview with Maciej Kierył: A Polish anaesthesiologist, music therapist, and author of Mobile Music Recreation method (Polish: Mobilna Rekreacja Muzyczna, MRM).

1. When did you discover a positive, good impact of music on the patients?

It was a long time ago, in 1970, and it was connected with my job as an anaesthesiologist. While waiting for the main surgeon in the operating room, I helped myself, my colleagues and additionally the patient pass the time by playing popular music recorded on magnetic tape. We had a reel-to-reel tape recorder, but the modern one, it was small and on the tapes there were pop hits, slow ones on the one side and more expressive on the other. Of course, I played calm music. It was my concept yet from the time of dancing house parties. On this side, there were ballads by Ella Fitzgerald, Jim Reeves, Nat King Cole, Franck Sinatra, Engelbert Humperdrinck and instrumental pieces by the orchestras of J. Loss, G. Melachrino and A. Mantovani. The rhythmic and melodic monotony gave nice atmosphere, which was once described by the patient: ‘It’s a pity I have to have gallstones to listen to such nice melodies...’

At that time we desired to hear Western music so badly, and the concentration of topical hits, which I re-recorded from the borrowed albums, was something new at the hospital. In the operating room there was silence and serenity, there was time for displaying music. There was no hum made by the respirator, screens, coagulation, etc., no noisy equipment. It was the receptive action, recognised as a humanistic curiosity in the hospital. Back then I knew nothing about music therapy. It was called my private hobby and welcomed with tolerant kindness. In 1971-75 I managed to test these melodies in 5 operating rooms, with similar results: the patients appreciated the calming effect of music, and the personnel reduction of the stress level and nicer work atmosphere.

The beginning of my active undertakings was connected with anaesthesiology as well. After the intervention in the nursing home next door I observed a girl that was psychophysically less skilled and who choke on a pill. She was getting better, but I had to routinely check whether her breath was permanently stable. We moved her to the day room, where there was a piano. I was playing march, swinging. The home was run by nuns, who saw the dancing reaction of the girls and I saw that the tired ones breathed improperly. Soon, I was asked to hold after-dinner music classes at the day room.

2. How did you create the Mobile Music Recreation (MRM)?

While observing children, I noticed that the similar schema works:

At the beginning, a free dance to folk melodies played in the tempo of approx. 120MM. After several minutes, we corrected the breath with a slow passage CEGC, GEFDEC. Then, march-like music (e.g. country), 100-80MM with clapping hands. Proper breathing was repeated: inhaling through nose, exhaling through mouth and nose. The background for breathing and correcting body posture were calm folk melodies (e.g. The sun goes down, Kujawiaczek). After ca 10-15 minutes children willingly sat down, clapping to show their mood and imitating the sounds of the forest (cuckoo, woodpecker, hum) against the background of lazy improvisations. Calmed down, they sang the songs they knew, with a pantomime presentation (of how the harvester works, how the bird moves its wings etc.). At the end of this seating stage, there was music making on percussion instruments. We played emotions (joy, worry, anxiety), imitating the storm, wind, flowing stream or a waterfall). After 20-25 minutes, while Italian songs (e.g. ‘O sole mio’, ‘Sorento’) or pieces tested in the operating room were played very quietly and slowly, there was time for rest, laying, for 5-10 minutes. The twitter of the birds meant they should calmly stand up. Then, there was a march and the concert of requests, which showed creative skills. This stage was the favourite and it often prolonged the class to 60 minutes.

This Model of behaviours was repeated since 1976 until the end of my work at the Nursery Home in 1992. Supporting musically the early expression of the group, I called this stage Abreaction (Polish: Odreagowanie, O) and the march combined with clapping hands, which rhythmised and made motor coordination better: Rhythmisation (Polish: Zrytmizowanie, Z). The psycho-physical rest was provoked by moving to a sitting position. Imitating the sounds of Nature encouraged to sing and make music that expressed emotions. This stage is a simplified musical education: Sensitisation (Polish: Uwrażliwienie, U). After approximately 20-25 minutes of the activity, children willingly rested with quiet, serene and easy melody: Relax (Polish: Relaks, R). Calmed down, they stood up slowly to avoid dizziness and imbalance. It was a delicate Activation (Polish: Aktywizacja, A), and the concert of requests was a Dynamic Activation.

3. Where – besides work with disable children – did you use MRM techniques?

I discovered music therapy reading the interview with Prof. Natanson [fusion_builder_container hundred_percent="yes" overflow="visible"][fusion_builder_row][fusion_builder_column type="1_1" background_position="left top" background_color="" border_size="" border_color="" border_style="solid" spacing="yes" background_image="" background_repeat="no-repeat" padding="" margin_top="0px" margin_bottom="0px" class="" id="" animation_type="" animation_speed="0.3" animation_direction="left" hide_on_mobile="no" center_content="no" min_height="none"][the father of music therapy in Poland] in the Jazz monthly; he invited health professionals who used music in their work to collaborate and he evaluated positively my observations from the operating room. In 1978-80 I was already a student of music therapy at the University of Wrocław with Prof. Tadeusz Natanson and doc. Andrzej Janicki and in this way my active musical undertakings were established. Then, as a professional music therapist I worked at the addiction treatment centre and then at the Child Health Centre in Warsaw. At the AA Addiction Treatment Centre (1980-85) the second variant of MRM was created:

Launch, Rhythmisation, Abreaction, Sensitisation, Relax, Activation.

The patients were introverted, sleepy, repugnant. We started with a lazy movement and similar music. They were activating slowly, they preferred clapping their hands and patting thighs than singing. So, at the beginning there was Activation, so opposite to the behaviour of the children from the nursing home. Relaxing pieces tested in the operating room were working for the patients that were addicted in almost 100%. In 1985 I organised the Lab at the Child Health Centre and I conducted the classes of active music therapy with the patients from the neuro-orthopaedic rehabilitation ward, cardiology, ophthalmology, nephrology and asthma (over 1000 patients overall).

For 25 years, I have tested different combinations of stages: O.Z.U.R.A. and U.Z.O.U.R.A. Since 1995 I have started to see more frequently children at a low basic musical education level, which unfortunately manifested itself in reluctance towards music therapy. Among the participants of the classes, there were also children in a medium general condition, weak, on bed rest, but cardiovascularly and respiratorily stable. For them, the Early Musical Stimulation at the patient’s bed was created.

I started using harmonica and flute to reach the patient and assist them. I used short works. The classes themselves took up to 45 minutes, they were held no more than twice a week. Frequently, I searched for something interesting for the end, such as classical music pieces transcribed for mandolin, harpsichord, bassoon etc...

Since 1987 I was training special education teachers and therapists interested in using the MRM techniques in their work. At the beginning, at the Music Therapy Lab of the Child Health Centre in Warsaw – Międzylesie, then in Silesia and Zagłębie Węglowe (in approx. 25 centres), and then in pedagogical-therapeutic institutions in entire Poland (ca 30). Since 2015 I have been training at the Support Centre for Personality Development in Warsaw.

4. What pieces are used most frequently during the classes?

While relaxing: Siciliana J.S. Bach, Melody by C. Gluck, Lullaby by B. Flis, Moonlight by C. Debussy, 1st movement from Beethoven’s Moonlight Sonata, Swan by C. Saint-Saens and transcriptions of classical music for interesting, original instruments, such as the pan flute or the mandolin. During the launch: A. Vivaldi’s Four Seasons: Winter: Largo, J. Haydn’s Minuet. At the stage of rhythmisation: Scherzando by J. Haydn, Spring: Allegro by A. Vivaldi , Gavotte by F. J. Gossec, Minuet by L. Boccherini, Gavotte by J. B. Luly, The merry peasant by R. Schumann, but also country music: Jambalaya, Oh Susanna, Clementine, and traditional jazz and percussion improvisations (60-80MM). During abreaction: A. Vivaldi’s Four Seasons: Summer: Presto, M. Rimsky-Korsakov’s Flight of the Bumblebee, A. Khachaturian’s Sabre Dance, W. A. Mozart’s Turkish March, J. Haydn’s Presto Assai, D. Scarlatti’s Sonata in G major as well as percussion improvisations, Polish folk music, traditional jazz, swing, rumba rhythm, samba in fast tempos ( approx. 120MM).

5. What effect of your music therapy undertakings do you see?

I would divide them into three groups:

1. Immediate effects of MRM:

• Learning how to breathe properly: inhaling through nose, closed mouth; exhaling through mouth and nose: the most important pro-health impulse,
• Better mood,
• Better motor activity – small soft, march-like movement, broadening the territory,
• Broadening the knowledge of kinds of music – natural music making – clapping hands, patting, stomping, purring, humming, music played: easy serious, folk, traditional or classical jazz, ethnic, electronic music,
• Acquiring new musical skills – percussive features of the body,
• First musical successes – joy of creating,
• Better self-esteem,
• Discovering secondary music making – imitating breathing, types of movement,
• Playing through music – discovering small melodic instruments (harmonica, flute),
• Learning to concentrate.

1. Late effects of MRM:

• Consolidation of immediate effects,
• Discovering the emotions that are present in recorded as well as performed music (natural music making and using Carl Orff’s percussion instruments),
• Ability to react in movement using music,
• Making it easier to perform everyday activities using music (getting up, studying, physical work, sport, family meetings, social gatherings, driving a car, rest),
• Musical altruism (music from one’s homeland and abroad),
• Connection between music and visual arts (painting the music, illustration of the exhibition),
• Pro-health impulses (correction of breath, body posture, immediate reaction to tension, ability to rest),
• Practices preparing for speech therapy, voice modulation (self-presentation).

1. Recreational use of MRM techniques

• Musical organisation of free time (preparation in case of an illness),
• Discovering the musical hobby,
• Discovering the creative skills,
• Broad cultural awareness,
• Prevention of psycho-somatic diseases.

6. Do you have any advice for future music therapists?

Music therapy cannot be boring. The optimistic personality of the therapists will increase the efficiency of therapy and prevention. Music therapy supplements a proper treatment: surgeries, pharmacology, rehabilitation, psychotherapy and special education. We are an important supplement, we don’t try to be in the centre. The Music Prevention is dedicated to the healthy, and also serves to the ill people in the convalescence stage to adjust to the New Life. Music therapeutic practices can be used in prevention, but conducting the classes and interpretation is different. Both in therapy and prevention the participant is not evaluated. There is no disease the treatment of which couldn’t be enriched using music. In the case of the somatic disease, psyche is suffering as well. Music in the hospital must bend the knee to the illness, but in the Philharmonic the illness can disrupt listening to music. The technique of music therapy must ‘fit’ the personality of the therapist, so that it becomes their technique and would work better. The therapist must sing, make music and play recorded music efficiently in their office and at the bed of the ill person. The course of the therapy is dynamic. It should be observed and adapted to the changing behaviour to maximally strengthen the patient. The music therapist must believe in the efficiency of their actions. The diversity of the workplaces can prevent the professional burnout of the music therapist.

Interviewer: Kinga Majchrzak

WFMT Student Delegate for Europe

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