The Creative Use of Singing in Therapy

By: Rebecca Rubin, LMHC, LCAT

“I sing because I’m happy, I sing because I’m free…”-His Eye is On the Sparrow (Hymn)

As a Creative Arts Therapist, trained jazz vocalist, and music lover, I have a personal and professional connection with the power of music and the voice as part of the therapeutic process.

Many of us as children know the joy and playfulness of using our voices. Whether it be singing songs at school, church, or temple, jamming in the car, making silly noises with our friends or siblings, screaming bloody murder when we can’t have what we want, whispering quietly into another’s ear when we feel shy or have something private to share; or pretending to be a car or train zooming down its path…Our voices lead the way to community, imagination, connection, and attachment. 

Unfortunately, as we get older, the opportunity to use our voices begins to diminish, and before one knows it, they stop singing because they believe their voice is “no good.”  

“You’re no good, you’re no good, you’re no good, baby you’re no good”- As sung by Dee Dee Warwick 

This idea of being good enough is something I think many can relate to in one way or another. Most of us have experienced this feeling, whether related to our singing voices or other areas of our lives. In such moments, we can literally and figuratively shrink and become silent.  

“In this white wave, I am sinking, in this silence…” As sung by Sarah McLachlan 

In the book, “The Theory and Practice of Vocal Psychotherapy: Songs of Self,” leading music and vocal psychotherapist Diane Austin says, “Singing can provide clients with an opportunity to express the inexpressible, to give voice to the whole range of their feelings. Singing meaningful songs often produces a catharsis and emotional release due to the effect of the music, the lyrics, and the memories and associations connected with the song.” (2009, p. 20)

“It’s a cold and it’s a broken Hallelujah…” – As sung by Jeff Buckley and Leonard Cohen

We experience this type of catharsis not only when we are singing but also when we deeply listen to music.  There are times when we feel music and songs touch and transform something inside of us.  From these experiences, we may be moved to joy as much as we may be moved to tears.  From time to time, we need both to feel our full range of affect, to be complete and whole human beings.  In this age of numbing, music brings back feeling into the body, and the voice can affirm existential meaning. 

“I see myself in joy and love; I know myself, I am enough.” –Beautiful Chorus 

Furthermore, therapy can be a safe space to experiment and explore the depth and limits of the voice in a safe container, much like a baby experiences with their caregiver. Diane Austin says, “We enter the world and, with our first sound, announce our arrival. Our first cry proclaims our birth and life force flowing through us…After birth, the bonding between mother and child occurs through touch, eye contact, and sound. Babies naturally tune in to the music of their mother’s voices and, optimally the mother is attuned to her child’s sounds and learns to distinguish the nuances of the different sounds and the needs they convey…The infant feels safe and begins to trust the mother…” (2009, p.22)  

This is a beautiful illustration of a way in which the therapy space can parallel the caregiver-child relationship, through which clients can experience (sometimes for the first time) a secure attachment with themselves and a vocal co-regulation with another (the therapist), much like the co-regulation between parent and child. 

“I love you a bushel and a peck…”-From the Musical Guys & Dolls and as sung to me by my father as a child. 

Vocal creativity and improvisation in therapy can allow us to explore new territory. Many of us have never been offered a space to explore our limits and depths freely or to discover the different facets of ourselves through the sounds our voices and bodies can make from within. Even undesirable sounds that are abrasive, gritty, dissonant, out-of-tune, or cracked yearn for a space of expression, just as fragile parts of self-desire to be heard, seen, and accepted.

“All of me, why not take all of me…”-As sung by Billie Holiday 

In addition, research has shown that singing is good for our health. It relieves stress and boosts the immune system; it improves mood by stimulating the release of endorphins; it increases concentrations of immunoglobin (proteins in the body that function as antibodies) and hydrocortisone (anti-stress hormone); and it promotes lower heart rate and decreased blood pressure. Furthermore, in another study conducted by McGill University, listening to or singing one’s favorite piece of music stimulated the brain’s release of dopamine and other euphoria-inducing opioids. (Austin, 2009, p. 21)

What might using the voice in psychotherapy look like? A session might include listening to and singing songs together that have present or past significance. The therapist may also share music or songs that may be relevant to lyrical or musical themes that the client has shared, or that might be explored with new sounds or in new ways. A technique called ‘vocal toning’ may also be used.  

Toning is a vocal exercise similar to meditative breathing exercises, integrating the voice. For example, with each breath’s exhale, one sustains a vocal tone and sound with the full length of the breath, experimenting with different notes, tones, and volumes. (Clements-Cortes, 2013; Snow et al., 2018). 

You may also do voice exercises and scales to improve the strength and agility of the voice and breathing exercises to further support the sustainment of sound. Clients may explore unison and harmonic singing, vocal improvisation, lyric writing, and spoken word. Playlists can also be created and sung, representing different memories, emotional experiences, and parts of self. In addition, it may include verbal processing, reflecting on the experience of singing together and how they might connect to your life story, or spur feelings about current and past relationships. 

Engaging the voice in the therapy process is vulnerable and courageous, but being a ‘good singer’ is not required. It may take some time to build trust with your therapist as you open up to the process and discover your voice's natural and innate sound. Once you do, the possibilities of using the voice for growth and healing are as expansive as the voice itself. 

“It’s a new dawn, it’s a new day, it’s a new life, for me…and I’m feeling good.”-Nina Simone  

References:

1. Austin, D. (2009). The theory and practice of vocal psychotherapy: Songs of the self. Jessica Kingsley Publishers. 

2. Clements-Cortes, A. (2013). Vocal psychotherapy: Connecting to the Self via Voice. The Canadian Music Educator, 55(1), 39-41.

3. Snow, S., Frances Bernardi, N., Sabet-Kassouf, Moran, D. & Lehmann, A. (2018). Exploring the experiences and effects of vocal toning. Journal of Music Therapy, 55(2), 221-250.