2008 Claudia Walker – The Efficacy of the Use of the Tritone in the Lydian Mode with Dying Patients in Music-Thanatology Vigilspdf

THE EFFICACY OF THE USE OF THE TRITONE IN THE
LYDIAN MODE WITH DYING PATIENTS
IN MUSIC-THANATOLOGY VIGILS
by
CLAUDIA HOUSER WALKER
RESEARCH PROJECT
Prepared to complete MTAI certification requirement
to demonstrate the competency standard 110.7141
“Demonstration of the ability to do clinical, scholarly, and reflective research,
and a willingness to be involved in research in order to further
the field of music-thanatology.”
January 2008
Copyright© 2008 Claudia Houser Walker All Rights Reserved

Table of Contents
Introduction……………………………………………………… iii
Foreword ………………………………………………………. vi
Part I: A Western Historical Look at the Tritone……………….. 1
Medieval Music …………………………………………. 3
Renaissance Music ……………………………………… 12
Baroque Music ………………………………………….. 14
Classical Music …………………………………………. 16
Romantic Music ………………………………………… 21
Twentieth Century Music and Contemporary Music ……. 21
Part II: Case Study on the Prescriptive Use of the Tritone
in the Lydian Mode with Dying Patients………………… 27
Research Design and Methodology …………………….. 27
Case Study Results ………………………………………. 30
Conclusion ……………………………………………….. 38
Looking to the Future ……………………………… 41
Appendix A ……………………………………………………… 43
Appendix B ………………………………………………………. 44
Bibliography ………………………………………………………45

Introduction
In the late 1950s and early 60s Leonard Bernstein’s musicalWest Side Storytook
Broadway and film audiences by storm. Based on Shakespeare’s tragic love story,
Romeo and Juliet,West Side Story was set in the modern day barrios of New York City.
The rivalry between the famous Capulet and Montague families became the struggle
between the Puerto Rican gang the “Sharks” and the White gang the “Jets.” One of the
most remarkable musical aspects of Bernstein’s score is that he “heard” the interval of the
tritone as, part of the music of the street, and as he said, it “pervades the whole piece”
(the whole score).
1
The love songMaria opens on this interval. Sometimes exquisitely
tender, sometimes frighteningly harsh, the sound of this interval grabbed me as a thirteen-
year- old. For a long period of that year, I would sit transfixed listening to the record and
would playMariaover and overagain on the piano. Striking me deep in the solar plexus,
the raw energy of this interval could, with Bernstein’s mastery, convey the fervent hope
of a young lover as well as the chilling reality of fear and hate.
What is the tritone? An interval of two tones that can be found naturally in major, minor,
blues and modal scales, it occurs most prominently in the Lydian mode. Larger by a half
step than the perfect fourth (e.g. C to F) it is an interval spanning three whole tones (as
from C to F sharp, or F to B). In the tonal system it is also known as a diminished fifth or
augmented fourth. This interval is the midpoint between a tone and its octave above. It is
so compelling that in centuries past it was namedDiabolus in Musica
2
and was avoided
in certain circumstances in Church literature from being sung or played.
Many years later, learning the East Indian syllables equivalent to the Westerndo, re, mi,
fa, sol, the Lydian mode and its tritone resurfaced in my life. This sparked a deep interest
in investigating the intrinsic qualities of the tritone. The intent of this paper is to point
toward possible prescriptive qualities of the tritone in the Lydian mode as a contribution
to the new field of Music-thanatology.
The work of Music-thanatology uses prescriptive music, offered with harp and voice, to
lovingly serve the physical, emotional, and spiritual needs of the dying and their loved
ones. Founded and developed over the last thirty years by Therese Schroeder-Sheker, it is
a field of work both ancient and inspired for this time of need as Western culture searches
to reclaim dignity, reverence, and meaning at the end of life. I am most grateful to Ms.
Schroeder-Sheker. I am indebted to graduates of the Chalice of Repose Project for the
opportunity to learn this work and to offer it to patients at the end of life care.
The case study method will be used to investigate this musical scale and interval. A case
study is an empirical inquiry which seeks to learn about a contemporary phenomenon
(e.g. the tritone used in an improvisation, or in a melody, set in the Lydian mode) within
a real life context (listeners) when the boundaries between phenomenon and context are
1
Burton, Humphrey. All rights reserved 1994
2
a misnomer, read on!

not clearly evident (e.g. how does the experience of listening to this mode differ from
person to person, what effect does it have on dying persons?).
The style of method will be a mixed form of narrative (personal story) written initalics
and phenomenological inquiry. Phenomenological inquiry examines what is called the
lived experience, and allows researchers to study phenomena,such as human experience,
as unified wholes.Key to this approach is the concept ofintentionality. “…this implies
that human consciousness is directedtoward something whether it is anobject(book,
music) or a concept (feeling,state of mind, or even transcendent consciousness). Our
reality of an experience is tied to the way we think about it.” The researcher also
attempts to suspend judgment about given outcomes, letting go of expected ideas of what
might happen. This is calledbracketing orepoche.In addition is the search for the
essential structureoressence of an experience. “This implies that there is a fundamental
structure within an experience that allows us to recognize it for what it is. This is not to
say that everyone experiences the phenomenon in exactly the same way, just that there
are necessary elements in an experience that let us know that experience and differentiate
it from other types of experience.”(p. 321 Chapter 26, Music Therapy Research)
Therefore, I’ll begin with a broad overview of this interval using findings from ancient,
medieval, and modern musical literature, with an emphasis on the evolution of modal
music. Using the harp, I will design a ten-minute listening experience which includes
playing the Lydian scale, improvising in this scale, playing a portion of the Gregorian
chantLaudem dicite,the Medieval piecesAd Mortem and Song of the Nuns of Chester,
and a chant I composed calledHoney on the Comb,all in the Lydian mode.I will ask for
feedback about how the music was experienced from a group of certified
music-thanatologists, the interdisciplinary hospice team at Providence Everett Medical
Center, and a group of people in my community. I will also prescriptively use repertoire
selected from this group of Lydian pieces when it is appropriate for a patient during a
harp vigil. In addition I will create a companion CD with examples of the tritone and the
ten minute meditation on the Lydian mode. From these findings I hope to offer ideas for
the prescriptive use of the tritone for the vigil setting when played as an improvisation or
in a melody set in the Lydian mode.
Working on this project has been like being on a treasure hunt. Many people have helped
me pursue this path and without their help I would not have been able to find the treasure.
I wish to convey my deep gratitude to my advisor/mentor Sister Vivian Ripp* and to Rev.
David Waggoner, PhD. for their invaluable help in designing and overseeing this
investigative study; to my spiritual advisor Rev. Dr. Beryl Ingram, for spiritual guidance,
creative inspiration, and practical help with editing; to Jeri Howe,* my rock, mentor, and
colleague at Providence Everett Medical Center; to the incomparable music-
thanatologists from the Pacific Northwest who have offered their wisdom, counsel,
instruction and friendship: Jane Franz*, Laura Lamm*, Anna Fiasca*, Gary Plouff,
Sharilyn Cohn, Barbara Cabot, Andrea Partenheimer, Michael Sasnow, Suzanne
Cerddeu, and Sile Harriss; to Music-Thanatology Association International for pioneering
work in this field and for the opportunity to pursue certification. To Bill Mc John and
Joseph Anderson, Seattle based early music and Gregorian chant specialists;

to Susan Alexjander, researcher and composer, and Randy Masters, musical scholar-
researcher-composer; to my friends at Enso House: Dr. Ann Cutcher, Myo o, Gaea, and
the volunteers; to those who support the foundation of my life: my Circle of Stones
writing group; Mona, Julie and Gail from our singing groupResonance; Bill Humphreys;
Eva Sher; Gaielle Fleming;Valerie Eyer and Erin Elizabeth Eyer;my dear supportive
husband Tom, and kids Amy and Ben; andfor the love which from my birth, over and
around me lies, my parents Dick and Ginny Houser. Special thanks to Mona Reardon and
Shelley Hartle for their editing expertise. And perhaps most importantly of all, my deep
gratitude to the people I serve as they are crossing the threshold. Thank you all from the
bottom of my heart.
*my Advisory team

Foreward
The pursuit of finding treasure is always about discovering what one needs to
learn in life. This has been a quest to understand my involvement with and
attraction to the tritone…to move toward a deeper understanding of the
possible prescriptive use of the Lydian scale and its distinguishing interval,
the tritone. It has been a study to understand the interconnection between
themes such as liminality, intention, consciousness, thresholds, surrender,
remembering, releasing, the anam cara, the healing of the cosmos, ushering
in the age of partnership, understanding the tritone as part of the family of
intervals, with no recipes, as sacred accompaniment, and with Grace.
—Claudia Walker

Part I
A Western Historical Look at the Tritone
What is the ‘big picture’? Does the tritone occur in the natural world ? What birds
sing this interval? Do whales sing it? What’ pre-civilization’ peoples sang the
tritone? Did they hear it in the wind? Did it come from the sounds of waves
crashing upon the shores of their villages?
This sound of the interval of three whole tones is part of the fabric of our human
vibrational soundscape. Though it took hundreds of years before music theorists
understood that the tritone occurs naturally in the overtone series of each pitch or
sound, we now understand that the tritone is there humming all around us. While it
would be fascinating to pursue study of the use of the tritone in music beyond the
boundaries of Western culture, I have chosen not to. Music-thanatology repertoire
comes out of Western ecclesiastic traditions (particularly plainchant) and Celtic
music (these melodies have often retained their modal characteristics). Therese
Shroeder-Sheker cautioned her students in the Chalice of Repose Project training,
that care must be taken in using sacred music from faith traditions not known to
us.
1
Being entrusted with a sacred musical tradition from an elder in that tradition
is very different from assuming use when it is outside our own cultural base. I do
believe that over time the musical repertoire of music-thanatology will expand to
include studies of the rich repositories of faith traditions and cultures outside the
scope of Western culture.
In looking at the roots of this Western musical heritage, ancient Greece stands as a
significant parent culture to Western music. What do we know about the tritone as
it relates to this ancient culture? Nothing. But historians do know that the music of
this time had patterned combinations of tones called modes, and that these modes or
scales were named after regional groups of peoples whose music was likely
characteristic of these modes. The name “Lydian” mode comes from the people of
Lydia in Asia Minor. Others were Ionian, Dorian, Phrygian, Mixolydian, Aeolian,
and Locrian. It is thought that these modes were constructed on two tetrachords-
tone sequences built between the intervals of a fourth. The key note lay in the
middle, with a fourth below and a fourth above, forming a seven tone scale.
2
Pythagoras (circa 580—500 BC), the great father of numbers, astronomy and
philosophy had an enormous influence on shaping the culture of Ancient Greece
and later, during the Middle Ages, the culture of Western Europe. His contributions
to the mathematical world are most famous, but in music his importance lies in his
discovery of a numerical basis of acoustics, the science of sound. He is said to have
heard the natural overtones of consonant and dissonant intervals in a blacksmith’s
shop as hammers were striking metal. Experimenting with lyre strings, he
1
Schroeder-Sheker, Therese. From a lecture given January 25, 1996,Prinicples of Music-Thanatology
2
Gardner, p. 133

discovered the ratios of 4:1 corresponding to a double octave, 3:1 to the octave plus
the perfect fifth, 2:1 to the octave, 4:3 to the perfect fourth, and 3:2 to the perfect
fifth.
3
Pythagorean doctrine proposed that the celestial bodies are also in direct numerical
proportion to themselves and to one another creating a “harmony of the spheres.”
He spoke of human harmony as well, between body and soul. “As above, so
below.” This basic principle of ancient wisdom has been scientifically proven:
4
More than 2,500 years ago, the philosopher Pythagoras told
his followers that a stone was frozen music, an intuition
fully validated by modern science; we now know that every
particle in the physical universe takes its characteristics
from the pitch and pattern and overtones of its particular
frequencies,its singing. And the same thing is true of all
radiation, all forces great and small, all information.
Before we make music, music makes us…The way music
works is also the way the world of objects and events
works….The deep structure of music is the same as the
deep structure of everything else.
5
Pythagoras also had views about the power of the modes on human behavior. He
and some of his disciples (including women) formed a religious/ philosophical
community known historically as the Pythagoreans. They lived a strict life
dedicated to Pythagoras’ teachings, particularly the supremacy of numbers. Music
was an integral part of their lives, shaping their hours with songs and modes sung
and played upon the lyre at the day’s rising and ending. Pythagorus’ biographer
Iamblichus, tells of a legend illustrating the power of these modes:
Walking out one night to contemplate the heavens, he
(Pythagoras) came upon a young Sicilian who had been
jilted by his woman and, incited by the music of a nearby
aulo-player, was preparing to set fire to her house. Instead
of accosting the crazed youth, Pythagoras approached the
musician and asked him to change his tune to a slow and
solemn spondaic one (having to do with a particular meter
and accent stress). The youth, his emotions already in
thrall to the music, responded instantly by calming down,
and soon went home.6
3
Barbera, Andre. p.1/3 Oxford University Press 2007
4
Berendt, p.67
5
Berendt, pp. 89-90, a quote from Leonard, George.The Silent Pulse, E..P. Dutton, New York, 1978
This description sounds like a forerunner of European monastic life.
6
Godwin, p.21

What sounds incited that young man to want to set fire to his girlfriend’s house?
Could it have been an oscillating tritone? Or a soft ascending tritone calming and
turning his mind toward home?
More than a century later, Plato (427-347 BC) speaks about the modes and how
they have power to make or mar the public character. One example is that “pacific”
dancing (corresponding to Plato’s personal view of the Phrygian mode) represents
“the prosperous condition of the temperate soul in moderate pleasures.” He went
further to say that music must not be left to the musicians, “because poets are more
depraved than the Muses (Laws, II,669c): it must be determined and limited to the
Guardians of the city.” In theLaws, from which the last quotation comes, Plato
limits music still further, to be used in religious ceremonies only.
7
I wonder how serious Plato was about enforcing control over music suitable for the
masses? The institution of the Christian Church exerted such power in subtle and
not so subtle ways.
Medieval Music476 CE-1400
Ecclesiastical or Church Modes
Twelve centuries beyond the time of Pythagoras and Plato, the music of the
Christian church comes into the story of the tritone and the Lydian mode. “It
(plainchant) is our Western heritage-something which belongs to us. Everything
else has flowered from it.”
8
Plainchant is the body of sacred melodies sung in the western (and eastern
Orthodox) world of Christendom. This music had its roots in pre-Christian Jewish
liturgy.
9
As the early Christian community in Palestine began to disperse, moving
west and north, these sacred melodies(handed down orally) moved with them. The
Latin wordmode ormodus, means “to sing.” Using texts from the Psalms and other
biblical writings, the chants were sung devotionally within the fabric of monastic
life.
10
Chant was sung before and after meals and work, in worship and in
celebration of the rhythms of nature and the liturgical year. The chants also formed
7
Godwin, pp 33-34
8
Berry,Plainchant for Everyone, from the Foreward by Lionel Dakers
9
A liturgy is the prescribed set of elements that comprise a worship service. There is a discussion
about the Judaic roots of plainchant in Apel, pp. 34-36. These roots date from the time of the
dispersion of the Jews when the second Temple of Jerusalem was destroyed in 70 AD.
10
Monastery–religious community of men (monks) living under sacred vows. A priory is the name
for a community of women (nuns) who have taken religious vows. Another discussion of monastic
life can be found at: Department of Medieval Art and The Cloisters.”Monasticism in Medieval
Christianity,” inTimeline of Art History. New York: The Metropolitan Museum of Art, 2000–.
http://www.metmuseum.org/toah/hd/mona/hd_mona.htm (October 2001)

the musical part of the liturgy of the Mass, or celebration of the Lord’s Supper,
which remembers the last meal Jesus shared with his disciples (the Jewish Passover
meal). The Mass was the central worship service of the medieval community of
believers.
Over time the chant repertory became preserved in the monasteries of Europe as a
system of notation emerged. This is a rich, highly complex, and often speculative
history as different traditions evolved throughout Europe. David Hiley inWestern
Plainchant, a handbook states:
The growth of a music-theoretical literature from the ninth
century onward was stimulated by two factors. The first was
the interest in and the desire to emulate the writings of late
antiquity that had survived to the time of the Carolingian
renaissance.
11
The second was the need to abstract from the
practice of music in the liturgy some rules to regulate that
practice and make it more uniform from place to place. The
concept of ‘musica’ inherited by the Middle Ages from
classical antiquity was that of musical science rather than
practice. The Greeks themselvesdid not write about their
own practical music. So it is not to be expected that ‘musica,’
music theory, should have been of direct relevance to
Christian chant. The chant repertory had of course grown up
quite independently of any theoretical system, and it is
interesting to see how medieval writers wrestled with the
heritage of antiquity (mainly as transmitted by Boethius),
drew from it what was of practical use in the daily
performance of the liturgy, and used some of its simpler
doctrines as the foundation for speculative theory, all in a
completely new intellectual and musical environment.
12
This provides some basis for understanding the connection between the names of
the modes of Greek antiquity and church mode names. Boethius (c.480- 530),
whose writings about music inDe institutione musicaincluded chapters about
music’s ethical power, the harmony of the spheres, Pythagoras’ discovery of
musical proportions, and other matter, includes a comprehensive exposition of
proportional theory, scales and species.
13
He demonstrated the possibilities of
intervals of the different species of octave, perfect fifth, and perfect fourth within
the Greek Greater and Lesser System of division of the monochord.
14
Speculation is
that he was trying to reclaim this body of knowledge before it was lost to future
generations. His contribution laid a framework for what was to evolve.
11
Hiley, later explained on p.514, the Carolingian period was in the 8
th
century. The Frankish
kingdom under Charlemagne came into prominence during this time.
12
Hiley, pp. 442-443
13
Hiley, p. 444
14
Hiley, p. 445. The monochord was a single stringed acoustical instrument with a movable bridge
used for measuring intervals in mathematical ratios, the vibrations giving the notes in the musical
scale

David Hiley says that while ecclesiastical chant plays no part in the writings of
Boethius and his contemporaries, original writing about music theory is found in
the next generations of scholars three centuries later, beginning with Aurelius of
Reome (Musica disciplinac.850) Remigius of Auxerre (c.841- 900), and Hucbald
of Saint-Amand (c.840-930) and the anonymous treatisesMusica enchiriadis,
Scolica enchiriadis,and theCommemoratio brevis de tonis et psalmis modulandis.
These treatises created a body of new music theory, borrowing from the authorities
of the past. However, as Hiley says, these treatises were ”often startlingly
independent, all datable to the second half of the ninth century.”
15
Hucbald of Saint Amand’s writings are important to the understanding of chant and
emerging musical theory from many standpoints. He is one of the first theorists to
use examples of the chant repertory to explain such things as tone intervals of
differing size. He does not name them but gives examples. The intervals
demonstrated are semitone, tone, minor and major third, perfect fourth,tritone,
perfect fifth, minor and major sixth. He demonstrates how intervals are made up of
tones and semitones. The tritone is made up of three whole tones.
He also cites two examples of chant passages which run through a hexachord,
16
with
the semitone in the middle: in our modern notation this would be C-D-E-F-G A. He
says this corresponds to the six strings of the cithara ( a Greek instrument with strings
attached to a cross piece and stretched across a wooden base). He suggests using six
lines, like the cithara, as a template for writing chants.
17
Hucbald’s contribution is
unique during his time. He is demonstrating through chant examples the suggestion of
a two-octave scale built on tetrachords with a semitone in the middle A-B-C-D, D-E-F-
G. We can see in this a forerunner of the modern scale. Following this formula, if one
were to build a tetrachord on G with a semitone in the middle, this would create a B flat
(as in G-A-B flat-C). His example in the IntroitStatuit shows B naturals and B flats
practically side by side.
18
It is important to my tritone study because it sets the stage
for altering the sound of the tritone occurring naturally from F to B, down to a B flat.
The scale system eventually evolved from earlier Greek theory and early Byzantine
(Christian Orthodox) classification into eight modes. Hiley says:
There is plenty of evidence to suggest that the eight-mode
system was imposed in the West on a chant repertory not
originally so conceived. Western chant did not develop
within an eight-mode framework, with melodic material
assignable to eight families or types. The eight-fold division
15
Hiley, p. 448
16
Hexachord- a series of six tones with a semitone between the third and fourth tone, and whole
tones between the other tones, p. 372 Funk and WagnallsNew Desk Standard Dictionary, 1948
The first six notes of our modern major scale.
17
Hiley, p. 450, This would be an example of an early notation system.
18
See Appendix A

must therefore have relied primarily on the more abstract
criteria … range and prominent notes.
19
About 1000 AD, the anonymous author of theDialogues de Musicastates that the
final note of the chant determines the modality (Over time the termfinal has come
to mean the starting tone of the mode). The author also prescribes ranges for
melodies in the eight modes. Common terminology used by Hucbald, Aurelian,
and others at this time was:
Protus authentus/plagis (modern D-mode)
Deuterus authentus/plagis (modern E-mode)
Tritus authentus/plagis (modern F-mode)
(From F to B is a tritone in the authentus mode. The name of the
mode has no relation to the interval.)
Tetrardus authentus/plagis (modern G-mode)
20
It is in the Musica enchiriadis that the modes are referred to in the names of the
Greek peoples. The termhypo means “below,” meaning the scale begins below the
starting tone of the Dorian, Phrygian, Lydian and Mixolydian modes.
Mode 1 Authentic: Dorian.
The tones from D to D, on the piano beginning on D above middle C. The
tritone occurs between the 3rd and 6th tones of the mode.
Mode 2 Plagal: Hypodorian
The tones from A to A, on the pianobeginning on A below middle C. The
tritone occurs between the 2nd and 6th tones of the mode.
Mode 3 Authentic: Phrygian
The tones from E to E, on the piano beginning on E above middle C. The
tritone occurs between the 2nd and 5th tones of the mode.
Mode 4 Plagal: Hypophrygian
19
Hiley, p. 454
20
Hiley, p. 459. First found in the late eighth or ninth century, these terms came from the Byzantine
practice in the Orthodox church, though the termauthentus wasechos, which may have been hard
to translate.

The tones from B to B, on the piano beginning on B below middle C. The
tritone occurs between the 5
th
and 8
th
and 1
st
and 5
th
tones of the mode.
Mode 5 Authentic: Lydian
The tones from F-F on the piano beginning on F above middle C. The
tritone occurs between the 1st and 4th tones of the mode.
Mode 6 Plagal: Hypolydian
The tones from C-C, on the piano beginning on middle C. The tritone occurs
between the 4th and 7th tones of the mode.
Mode 7 Authentic: Mixolydian
The tones from G-G, on the piano beginning on G above middle C. The
tritone occurs between the 3
rd
and 7
th
tones of the mode.
Mode 8 Plagal: Hypomixolydian
The tones from D-D, on the piano beginning on D above middle C. The
tritone occurs between the 3rd and 6th tones of the mode.
The plagal modes are paired with the authentic modes (mode 1 and 2; 3 and 4; etc.).
This has to do with sharing an overlapping range of notes and the same final or
ending note. Mary Berry points out that the pitches named refer to the pattern of
tones in the mode rather than an actual pitch. She says, “One took whatever pitch
was suitable for the needs of the choir as one does today.”
21
It is also important to note that with regard to the chant melodies, these modes had
certain melodic characteristics in addition to range. Mary Berry puts it this way:
In practice, however, the modes are characterized more by
the way the melody is structured, the typical snatches of
melody, the beginnings of phrases, the phrase endings, and so
on, rather than a mere question of range.
22
Sometimes it is very difficult to assign early chant melodies to a specific mode
because they do not fall into a particular set of modal characteristics. But as theory
arose and time went on, composers began to write melodies in a particular mode
following the rules of the day.
21
Berry, p.21-22Plainchant for Everyone
22
Berry, p.19Plainchant for Everyone

There is much confusion and debate around the B flat. Willi Apel inGregorian
Chant, p.152:
Considering the admirable variety of tonal realms afforded
by the eight-mode system on a strictly diatonic basis (a
variety much greater than the major-minor system was able
to elicit from the much fuller material afforded by the
chromatic scale), one cannot help pondering about the
reasons that led to the addition of the b-flat, the single “black
sheep,” as it were, among the “pure white” flock of
Gregorian pitches. Whatever answer may be given to this
question-the most obvious one being that it was added in
order to avoid the tritone above f– it is interesting to notice
the b-flat is not officially recognized in the earliest treatises
containing information about the tonal material of the chant.
Eventually that was changed by the avoidance of the tritone. In looking at the chant
repertoire I see occasional jumps up a fifth or a fourth. My musical colleague in
Seattle, an early music specialist named Bill McJohn, says most probably it was
avoided and eventually ruled out because it was so difficult to sing. It falls in the
crack between a perfect fourth and a perfect fifth. Fabien Maman, a music
researcher, says it is a powerful interval that wakes up the brain.
23
His colloquial
take on it: “In the middle-age it was forbidden precisely because the people were
becoming more smart(sic) than the priest.”
Apel poses that the B flat appears to be an innovation of the 9
th
century. He raises
the question without trying to give an answer, alluding to the probability of other
chromatic notes such as E flat and F sharp, though these were never adopted into
the theoretical system.
24
TheAnonymous II,one of the systems of letter
designations for pitches, uses the letter R for the B flat. TheDialogues de musica,
is the earliest treatise to distinguish between B and B-flat by the use of a “round B”
and a “square B.” These evolved to our present day flat ( ) and sharp (#) signs.
25
Apel offers some general conclusions about the use of the B flat vs. B natural as
they are found in the melodies in each of the eight modes on pp. 156-67 in
Gregorian Chant.
The tritone then was not sung directly in chant melodies (e.g. a jump up from F to
B, or B to F, or down from B to F) but could be found outlined in a melodic line.
See the examples in Appendix A.
Chant melodies were undoubtedly edited in later times. Apel contends that editions
of theLiber Usualis, Graduale, andAntiphonalecontain, “numerous b-flats which
23
Maman’s website (Tama- Do, The Academy of Sound, Color and Movement)ishttp://tama-do.com/
24
Apel, p.153
25
Apel, p.152

cannot be justified.”
26
The term for the body of knowledge about the rules of
chromatically altered pitches supplied by performers, was calledmusica ficta (from
the Latin, “false” or “feigned’” music).
27
These were notes that fell outside the
modal system and were used to avoid harsh melodic intervals such as the tritone.
28
Mention should be made here of the singing of the psalmody and the formulas for
singing them because, the tritone or influence of the B comes into play. Each of the
eight modes had a psalm tone,
29
which was a formula for reciting/toning the psalm.
Psalms were often paired with other melodies such as antiphons, and there needed
to be a way of smoothly transitioning between the two (e. g., antiphon, reciting of
the psalm, repeat of the antiphon). The general formula for thereciting tone or the
tenorof each mode was:
Final Tenor (reciting tone)
Mode 1 A (the ‘rule’: a 5
th
above the final)
+ D
Mode 2 F (the ‘rule’: a 3rd above the final)
Mode 3 C (not B as the formula would suggest)
+ E
Mode 4 A (not G, explanation historically unclear)
Mode 5 C
+ F
Mode 6 A
Mode 7 D
+ G
Mode 8 C (not B)
26
Apel, p.153
27
13th-16
th
centuries.
28
Oxford University Press c. 2007
29
Berry, see pp. 26-32Plainchant for Everyone

This system appears as early as the 11th century and remains unchanged
thereafter.
30
As music emerged from being a strictly oral tradition to written notational systems
as mentioned above, the preservation of music was slanted toward the sacred due to
the power and influence of the Church. The politics of the Church intervened by
banning music that Holy Church deemed inappropriate. Manuscripts of sacred
music were preserved in monastic libraries and church -supported universities.
However, secular music was alive and well. The folk music of the people
continued to be sung, played, and passed down orally from generation to
generation. It is rare to find secular music in the Lydian mode, but Gary Plouff’s
collection of medieval music offers a fascinating piece from theLlibre Vermell, a
14
th
century codex from the monastery at Montserrat, Spain.
31
The piece is called
Ad Mortem(translatedAt, orNear Death) and is written in the Lydian mode. It is a
pilgrimage song, religious in nature but not from the Church. It was most likely set
to a folk melody of the time. The music is in Appendix A, p.8. Here is a
translation of the text:
To death in haste proceeding,
From sin our course be leading.
In writing, I attempted proof,
For worldly life contempt.
That fleeting ages be
From bruising vanity exempt,
From dread till now but dreamt.
I feel a kinship with these words–how anticipating death is so like a dream.
Polyphonic Music
Multiple part music emerged in a form known asorganum, an early attempt at
harmonic or polyphonic music, in which two parts progressed in parallel fifths and
fourths. TheMusica echiriadis cites examples of organum (end of the 9
th
century).
A general rule involving the tritone was the avoidance of the parallel fifth from B to
F (a diminished fifth), and conversely, a parallel fourth from F to B (an augmented
fourth), which are both tritones.
This style of voicing (with a melody moving on top while the same melody is
moving below in parallel motion), began to evolve as composers experimented with
30
Apel, pp 210-11
31
Plouff, p 27 See Appendix A

other intervals, the use of parallel motion, oblique motion (where the lower voice
stays still as the melody moves above it), and contrary motion.
32
Guido of Arezzo
(c.991-2; d. after 1033), known for centuries for his treatiseMicrologus (completed
around 1030), wrote about polyphonic music and plainchant.
33
He worked at the
Benedictine monastery in Pomposa, Italy. He is most famous for his system of
precise pitch notation using the syllables ut (now known as “do”’), re, mi, fa, so and
la.
34
His unique sight-reading method dramatically changed the time it took to
learn music and is still used widely today.
What aboutDiabolus in musica? I finally found a reference to it in the Grove
Music online article aboutmusica ficta. It is a musica fictarule dating to the 16
th
century when solmization was well established. The correct termismi contra fa
est diabolus in musica(“mi” against “fa” is the devil in music) which refers to a
tritone being created when the hexachord from G to E interfaces with the
hexachord from C to A. When played as perfect intervals of fifths and fourths as
arrival points, B would be the “mi” in the G hexachord and F would be the” fa” in
the C hexachord. Another rule concerning avoidance of the tritone: una nota
super “la” semper is canendum “fa” (a note above “la” is always to be sung
“fa”).This means that the top of a phrase bounded by a sixth or a fourth, or even a
tone which descends within itself (D, F, or A up to B and down again), should be
rounded off so that the boundary interval is a minor sixth, a perfect fourth, or a
semitone.
35
I’m thinking how fascinating it is, the way something new and original comes into
being, how its creator often feels like a channel in which this new something comes
through and manifests itself. Then over time the new creation may become codified
and might lose its meaning or its creator’s original intent. I think about the tritone
being banned from the family of intervals,when all along it was shaping musical
theory.
Music composition continued to evolve and grow in sophistication as counterpoint
came into practice. Contrapuntal lines moved independently from the melodic line,
offering new rhythmic vitality and shifting harmonies. The modal system began to
break down as the new system of tonality was born. Cadences of intervals which set
up tension/dissonance and moved to resolution/consonance had many rules during
different times and according to different regional areas.
36
As the modal system
32
Wikipedia, citing “Organum,” fromThe New Grove Dictionary of Music and Musiciansed. Sadie,
Stanley. vol. 20, London, Macmillan Publishers Ltd., 1980.
33
Hiley, p 466
34
A wonderful discussion of the famous ‘Guido’s Hand’ can be found on pp 32-33 inCantors a
collection of Gregorian chantsselected and edited by Mary Berry. Solfa or solmization is a
widely used practice of sight reading using syllables for each tone. Most widely used is a movable
‘do’ that can be applied to any key.
35
implied is the understanding of the medieval semitone definition ofmi to fa
36
Grove Music Online offers extensive discussions about the Medieval periods of theArs Antiqua
(c.1150-1300),and the famous School of Notre Dame (which set the compositional standard well
into the Renaissance);Ars Nova (1300-1400);and the treatiseArs Nova by composer/theorist

began to fall away in favor of experimenting with these “fractured”
37
modes, the
augmented fourth and diminished fifth (both tritones) became common tonalities of
dissonance. These tritones resolved to consonance, (e.g., the sounds of open fifths,
octaves and eventually triads built on the root, major or minor third and fifth tones).
It is this quality of tension that the tritone evokes (thought of as unstable) that
pushes the ear toward resolution.
Renaissance Music (1400-1600)
The Renaissance age (meaning re-birth), a highly creative time in all areas of the
arts and sciences, marked a huge shift in consciousness, when access to the arts
became more available to the populus (e.g., the invention of the printing press,
Luther’s Reformation, the works of Shakespeare, Galileo, Da Vinci etc. An
example of this cultural shift is a book published in England (1597) calledPlaine
and Easie Introduction to Practicall Musicke by Morley. It’s not uncommon
during this time to hear tritones occurring between moving lines, resolving for
example from a C against an F-sharp and A, to a G. See measures 67-70 in
Appendix A, from the middle section of theKyriefrom the Ut Re Mi Fa Sol La
Mass by Palestrina.
38
You can also see hisMagnificat, a rare example of his use of
the Lydian mode. These two examples of Palestrina’s music demonstrate how
music is bridging from modality to tonality.
In the bookStudies in the History of Italian Music Theoryby Claude Palisca (taken
from a treatise by Artusi in 1586
39
), examples are given of the rules of resolving the
diminished fifth. Palisca says:
He (Artusi) particularly sought to liberalize the
employment of the diminished fifth and augmented fourth,
which he found to be the source of many beautiful effects,
applicable ‘with much elegance’ both on the down-beat and
up-beat. Zarlino had already noted that the diminished fifth
could resolve the suspended fourth, as in Artusi’s example
(Ex. 1.2). The diminished fifth itself may also be the
dissonant interval of a suspension when it is resolved by the
major third (Ex. 1.3), and the augmented fourth may
similarly be resolved by the minor sixth (Ex. 1.4). A
Phillipe De Vitry. The ‘motet’ a polyphonic form usually set to a chant melody, and the song
forms of the chanson, rondeau and ballade sung by the trouveres, were prominent.
37
A term used by Therese Schroeder-Sheker, in a lecture given Jan. 25, 1996,Principles of Music-
Thanatology.Therese does not define the term, but I imagine it to be when tones were split into
half-tones creating 12 semi- tones in the scale. And all of this was happening slowly over
hundreds of years.
38
Giovanni Pierluigi da Palestrina (1526-1594), prolific composer of masses, motets, and madrigals
from the town of Palestrina, was said to have created the iconic standard of his time. Oxford
University Press c. 2007
39
Palisca, pp. 3-5. Examples from p.5

diminished fifth may thus appear on a down-beat as well as
on an up-beat (Ex. 1.3). For its occurrence on the up-beat,
Artusi gives several interesting examples, noting that the
interval may be ‘natural’ that is, caused by notes within the
mode (Ex. 1.5), or ‘artificial,’ caused by accidental notes
(Exx. 1.6, 1.3, 1.4).
One remarkable composer at the end of this age is Carlo Gesualdo.
40
The intense
moods of passion, agony, lovesickness, and grief are central to his music and
conveyed through his florid use of chromaticism.
I remember singing Gesualdo’sMorro lassoin Collegium Musicum as a student at
University of the Pacific. As a college coed I didn’t tune in on a conscious level to
the sound of the tritone. I just remember it was devilishly hard to sing the highly
chromatic phrases. It gave me tingles down my spine.
40
Remarkable in many ways! He notoriously murdered his wife and her lover. Because he was
nobility, he was exempt from prosecution, but not from scandal. You can read more in Grove
Music online Oxford University Press c. 2007.

Baroque Music(1600-1760)
The synopsis of this section on Baroque music is taken largely from David
Schulenberg’s bookMusic of the Baroque, synthesized in an excellent article in
Wikipedia. The original meaning of Baroque is “pearl of irregular shape,” a term
first applied in 1919 by musicologist/art historian Curt Sachs.
41
While the East
Coast of the Americas was being settled, the music of Claudio Monteverdi (a
transitional composer at the beginning of this period), Heinrich Schutz, Johann
Pachelbel, Francois Couperin, Antonio Vivaldi, J. S. Bach, George Frederick
Handel, was filling the soundscape of Europe.
A few characteristics which distinguish Baroque music from the music of the
Renaissance:
·In Baroque music there is more of a distinct tonal center. In
Renaissance music this is more tenuous.
·Baroque music has longer lines and stronger rhythms.
·The fugue emerges out of theriecercars, fantasies, and canzonasof
the Renaissance and is extensively developed, especially by J.S.
Bach.
·Baroque music often depicts a single particular emotion with greater
intensity.
·Baroque music employs more ornamentation and a virtuoso level of
performance.
·A cappella style (unaccompanied) receded somewhat as more
instrumentation was written for vocal accompaniment.
·The basso continuo comes into prominence. This is a kind of
continuous accompaniment notated with a new music notation
system called the figured bass. The “figured bass” is written for a
sustaining bass instrument and a keyboard instrument.
·Opera, a form of musical drama, had begun during the Renaissance
but Claudio Monteverdi’s creation of the “recitative” style of singing
brought a new element to this early form.
David Schulenberg says:
Musically the adoption of the figured bass represents a
larger change in musical thinking—namely, that harmony
that is ‘taking all the parts together’ was as important as the
linear part of polyphony. Increasingly polyphony and
harmony would be seen as two sides of the same idea, with
harmonic progression entering the notion of composing, as
well as the use of the tritone as a dissonance. Harmonic
thinking had existed among particular composers in the
41
Curt Sachs was a German-born American musicologist, adjunct professor at Columbia University
from 1953-59, Oxford University Press 2007

previous era, notably Gesualdo; however, the Renaissance
is felt to give way to the Baroque at the point where it
becomes the common vocabulary. Some historians of
music point to the introduction of the seventh chord
without preparation
42
as being the key break with the past.
This created the idea that chords, rather than notes, created
the sense of closure, which is one of the fundamental ideas
of what would be called tonality.
William Drabkin in an article on the Tritone from Grove Music online states:
Since the 16
th
century the instability of the tritone has led to
developments in two directions. On the one hand, its
presence in the dominant 7
th
chord in four-part counterpoint
has made the authentic perfect cadence an even stronger
affirmation of the tonality, providing an approach by
semitone not only to the tonic degree but also to the third.
See Ex. 1(a):
43
42
I believe this refers to voices (or keyboard instruments) sounding the chord simultaneously, as
opposed to a contrapuntal or broken style of the chord.
43
p 2/4 Oxford University Press c. 2007

He goes on to say:
However, because it divides the octave into two equal parts, the tritone has
also assumed the role of the tonally most ambiguous interval, as opposed to
the 5
th
, which divides the octave into unequal parts and is ( apart from the
octave itself) the interval most fundamental to tonality: in particular, the
tritone has come to be recognized as a basic substructure within the
diminished 7
th
chord, and the whole-tone scale. “
See examples (b) and (c) above.
Here is an example by Bach in the choraleEs ist genugwhere he uses the tritone
embedded in the major scale to “create an ambiguity in the relationship between
tonic and dominant.”
44
This excerpt can be heard on the companion CD.
The tritone interval brings color and expression, and tension to the musical phrase.
It is by now clearly a prominent and integral part of the palate of dissonances that
are used to move the musical phrase to resolution.
Classical Music(1730-1820)
Joseph Haydn and Wolfgang Amadeus Mozart stand out as the defining composers
of this age. Some of the characteristics distinguishing Classical music from Baroque
are a de-emphasis on the role of counterpoint (though forms such as canon and
fugue are still prominent) which is replaced by a homophonic texture. Also,
ornamentation is lessened but improvisation is used particularly in the ‘cadenza’. A
cadenza is an improvisation by the solo performer at the climax of the cadence just
before the resolution of the section or finale of the piece. And lastly, modulation
(changing of keys) becomes a structural and dramatic element, so that a work is
heard as a kind of dramatic journey through a sequence of musical keys (outward
44
p. ¼, Drabkin, Oxford University Press c. 2007

and back from the tonic). It is a grand age for the forms of opera, the sonata, and
symphony.
45
During the Classical and Romantic eras, both prolific periods of musical
expansion, the modes of plainchant gave way to these scales which are formulas
for any key in the chromatic scale. These are the major, harmonic minor, melodic
minor and chromatic scales. Chords built upon each tone of the scale are given
these names and Piston’s descriptions in his music theory textbookHarmony:
46
“I Tonic (the keynote), II Supertonic(the next step above the tonic), III
Mediant (halfway from tonic to dominant), IV Subdominant (as far below
the tonic as the dominant is above it), Dominant (actually a dominant
element in the key), VI Submediant (halfway down from tonic to
subdominant), VII Leading-tone (with melodic tendency toward the tonic).”
The scale examples are referenced from pp. 3-4. He also has a discussion of the
tritone referring to it as the Diabolus in musica. This is referenced from p. 27:
45
p. 2/11Baroque Music,Wikipediacited from David Schulenberg’sMusic of the Baroque,Oxford
University Press, 2001
46
Piston, Walter.Harmony,Third edition, W.W. Norton and Co., New York, copyright renewed
1969

Referenced from page 162 of Walter Piston’sHarmony.

Here are examples of the tritone in an excerpt from the Allegro section of Mozart’s
String Quartet in E and Beethoven’s Trio in C minor in which the tritone splits the
octave in half:
47
47
p. 3/4 Oxford University Press c. 2007. These excerpts can be heard on the companion CD.

Romantic Music(1815-1910)
Romantic music is characterized by long expressive melodic lines, which explore
emotional states in more depth and length. Music of this period demonstrates
expansion of the symphonic form and experimentation with instrumental “special
effects.”
48
The music of Franz Schubert and Ludwig von Beethoven bridges the
Classical and Romantic eras. Schubert, it is said, spoke of the F sharp as a “green-
note.”
49
Examples of the use of the tritone are found in Beethoven’s opening bars of
thePiano Sonata No. 8 in C minor (thePathetique). Franz Liszt uses a descending
tritone (starting from the octave) in hisSonata After a Lecture of Dante (Eine
Symphonie zu Dantes Divina Commedia)as a representative of the descent into
Hell. Tritones are also found in his late piano works.
The Grove’s Music online article on the tritone mentions its use in 19
th
century
opera where it is used to herald something ominous or evil, citing the dungeon
scene fromFidelio(Beethoven) which has the timpani playing A-E flat. Richard
Wagner uses the tritone extensively in his operasParsifalandTristan und Isolde. In
fact, his use of the chord F-B-D#-G# (or F-A-flat-B-D sharp), a half diminished
seventh chord also known as the “Tristan” chord, became widely used during this
time. It played an important role in the last developments of chromatic harmony in
the late 19
th
century and early 20
th
century.
50
Late in the Romantic period, the French impressionistic music of Gabriel Faure and
Claude Debussy enters the soundscape in contrast to the expansive, strongly
emotional music of composers like Johannes Brahms and Richard Wagner.
Debussy uses chromaticism and experimentation in different modes, including the
whole tone scale which provides a rich palate of color and light. This music is lush
in sonority, yet often less complex and more cerebral and cool emotionally.
Debussy uses the sound of the tritone in his opening motif ofAfternoon of a Faun.
You can hear this excerpt on the companion CD.
20
th
Century Music(1900- 1999) and Contemporary Music
(2000- present)
Where to begin? The music of the last century is highly complex and much too
broad to capture completely here. Music of the people (folk and popular music) was
slowly evolving as well, and is rooted in the simple harmonic structure of tonic,
48
such as Beethoven’s use of the timpani playing the tritone in the dungeon scene of Fidelio
(mentioned in a paragraph below)
49
Berendt, pp 69-70, More about this in the second part of this paper.
50
Hill, C. p. 7-10 “That Wagner-Tristan Chord”, Music Review, xlv (1984) Oxford University
Press c. 2007

subdominant, dominant: I -V-I; I -IV-V-I (and variations of such).
51
Musical ideas
come from all sectors of the globe. The music of Jazz with roots in Africa, uses the
tritone prominently in its ‘blues’ scale (as in C-B flat-G-G flat-F-E flat-C).
52
On the extreme end of 20
th
century composition, experimentation beyond tonality to
atonality is characterized by the music of Arnold Schoenberg and others. This
music uses the chromatic 12 tone scale. Putting the tritone at the center of the scale,
this framework neutralizes the sound of the tritone because the normal rules of
tension/resolution no longer apply.
I’m thinking in Big Picture terms: how the invention of the radio, and the
technological audio-visual advances since then have put the world in touch with
any kind of music recordable. Musical cross-pollination has ignited across the
world. Advances in brain research now scientifically confirm what humanity has
always known deep at our core: that music profoundly affects us physiologically (a
basic tenet of music-thanatology) on physical, mental, and spiritual planes. Music
is a gift that can move us negatively or positively, terrify us, or comfort us. Music
can communicate when words fail and is sounding all around us. The worldis
sound, reminding us that we are never alone.
53
As everything is part of and
connected to everything else in this miraculous web of Life, the sound of the tritone
is also a part of this picture, adding its unique voice to the whole.
And we have come to realize just since our parent’s generation, that the fragility of
life on Mother Earth is confronting us. We have the power to end life as we know it.
I think it is this knowledge within us that turns conscious individuals toward
honoring and serving the whole. At a deep level we are all in need of continual
healing.
We are in the midst of another historical wave of keen interest in the healing effects
of music and how music influences behavior. From this lens I’d like to cite
examples of the use of the tritone and Lydian mode in Contemporary music that
have moved me:
Chloe Goodchild, British vocalist and student/teacher of Nada Yoga (yoga of
sound) works with people interested in finding their authentic voice.
54
Her work is
calledThe Naked Voice. She teaches the use of the contemporary modes (see
Appendix A) sung in scales and chant form to express the states of wonder,
pain/grief, gratitude, joy, and devotion. She uses the East Indian system of
syllables that align with Western solmization. They are:
51
I found an amazing Welsh lullaby in the Phrygian mode with a prominent descending tritone in
the second measure of the melody. The tritone falls on the translated words “pretty one.” It can be
found in Appendix A.
52
Gardner, p. 131
53
referring toThe World is Sound: Nada Brahma,the title of the book by Joachim-Ernst Berendt
54
www.thenakedvoice.com

Do/SARe/REMi/GAFa/MASol/PALa/DAHTi/NEEDo/SA
In a Chloe Goodchild workshop some years ago:
We are talking about the fourth tone and how in the Lydian mode it is raised. The
syllable for the fourth tone isMA. She is talking about this syllable as the
“pregnant MA” or mother. We are standing and singing the syllable pitches giving
each one a body position with the hands. OnMAthe arms extend out in front of the
body, with palms open and facing upward in a sign of devotion or service. Each
time I do this I immediately feel the vulnerability of this position and feel it in my
heart as gratitude. I experience the Light and expansion of this sound, especially
when the group sings it in the Lydian mode (with its raised fourth, the tritone).
Kay Gardner, a flutist and composer devoted to the healing qualities of music,
wrote a piece calledViriditas.
55
Kay wanted to create a piece for healing based on
the Pythagorean theory of proportion sometimes called the “divine proportion.”
The piece was divided into three movements according to this ratio of proportion
a:b::b:(a+b).
56
The second movement is of particular interest to me and can be
heard on the CD. Here is what she says about this piece:
In the second movement I would use the Lydian mode.
With its tritone, it seemed to reach upward and, for me, had
the special ability of lifting spirits…. Several modes,
scales and ragas were used in the melodies of Viriditas and
were chosen specifically for the imagery they could project
(the pentatonic and blues scales evoking Earth and her
depths in the first movement; the Lydian mode with its
otherworldly tritone evoking soul flight in the second
movement; the Mixolydian mode, being both major and
minor , bringing centeredness in the final movement). The
instruments were scored throughout the piece to help coax
out emotions and to bring resonance to specific areas of the
listeners’ physical bodies. The compositional form was
based upon the divine proportion. Last, but never least,
was the intent of the work: Healing.
I go to bed and cannot sleep. This paper beckons, thoughts are racing from the far
corners of the subject matter, yet my wrists are sore from typing. Suddenly I hear
the alto flute singing the tritone in Gardner’sViriditas: c d e g f #…..g..f#edc…the
second movement is with me, singing its “greening power.”
55
a term coined by Hildegard of Bingen, (1098-1179) German abbess, visionary, scientist, writer,
artist and composer.Viriditas means “greening power.” Hildegard saw this greening power in all
of nature, in Christ, Mary his mother, and the Holy Spirit, who refreshes and enlivens humanity.
56
Gardner, p.217. A chambered nautilus follows this principle, each chamber becoming bigger in
proportion to the last. The DNA molecule follows this principle as well. It follows that music
composed with these proportions would be healing to our bodies, also composed on these
proportions. More discussion can be found on pp. 229-31.

Eery, spooky, ominous, the “Sound of the Beast”…These are contemporary
descriptions of the tritone as well. The sound of the siren on the police cars in
France, or Jimi Hendrix’s oscillating tritone in his intro toPurple Haze.Heavy
metal band Black Sabbath (led by Ozzie Osbourn) uses the tritone in their signature
pieceBlack Sabbath..The band’s guitarist Tony Iommi says, “When I started
writing Sabbath stuff, it (the tritone) was just something that sounded right, I didn’t
think I was going to make it Devil music.”
57
We hear the sound of the tritone all around us. Whether we realize it or not, it
impacts us. Remember the toilet paper commercialMarina?The commercial was a
sound/word play onMaria fromWest Side Story.
The tritone sounds in the opening bars of the 60s cartoonThe Jetsons (C-Meet E-the
F# Jet- G sons)and today’sThe Simpsons (C-The F#- Simp G-sons).Both families
are a bit out of this world.
I remember sobbing the first time I heard soprano saxophonist Paul Winter’s
setting of a song of a humpback whale. He called itLullaby of the Mother
Humpback.The music begins with the whale singing a descending minor sixth: A-
flat-C, followed by a descending perfect fourth: G-D, with a quick trill G-A-flat-G
down to D (the A-flat down to the D a tritone). The mother sings and then Paul’s
sax echoes her. Then the ensemble (Paul Winter Consort) quietly enters, wrapping
the sounds of the cello, guitar and bass around the mother’s song while Paul sings
a sweet descant above the lullaby…this tender rendering ends leaving the listener
alone again with the mother’s song, singing to her baby, and perhaps the young,
vulnerable one in each of us.
In 2003 I was involved in arranging and adapting a group of songs for an original
musical calledGaielle Remembering.This was the questing story of a young girl
learning to rely on her own courage and to ask for help along the way. The finale
needed a climax and I heard the Lydian scale. Gaielle had reached her goal. The
raised fourth of the Lydian scale launched her into a new personhood.
58
Christina Tourin, harpist and founder of the International Harp Therapy Program
says this about the Lydian mode in her bookIlluminations,p.7 :
This mode can be playful and whimsical. I liken it to a
kitten prancing on piano keys…I interpret the energies of
various trees in sound. I pictured the dancing yellow leaves
of the aspen fluttering in the wind and felt that this tree
simply had to be realized in the Lydian mode…when I
encounter a happy-go-lucky patient, I improvise in Lydian
57
Rohrer, Finlo. p. 2/6The Devil’s Music,BBC News Magazine
58
Gaielle Remembering,,a musical by Gail Fleming, with music by Gail Fleming and Claudia
Walker. The song appears in Appendix A

to provide a light, whimsical background while we
converse.
I receive an e-mail from Music-Thanatologist Andrea Partenheimer telling me that
she recalls a piece composed for infirmary music, in the Lydian mode, by her
music-thanatology classmate Kelly Lockwood. It is entitledDeep Peace, the words
of the Celtic blessing. The melody traces the tritone in an ascending pattern.
Beckoning the listener withdeep peace of the shining star… deep peace of the
flowing air… running wave… quiet earth…the tritone is heard on the first syllable
of the adjectiveshining,flowing, running,andquiet.
59
After beginning this study, I realize I often playRainbyCeltic harpist Kim
Robertson. It’s expertly written in the Lydian mode. It calms me and…is playful.
Ma-ri-a…As above, so below.
Leonard Bernstein’sWest Side Storyevoked many emotions with his brilliant use of
this interval. Just a few decades after Bernstein composed this music, German
musicologist Wilfried Kruger and French nuclear physicist Jean E. Charon made
some fascinating discoveries at the atomic level. These two men, working in
different countries, discovered almost simultaneously (and therefore complimented
and verified each other’s findings) that harmonic proportions exist in the
microworld. Joachim Ernst-Berendt reports inThe World is Sound: Nada Brahma-
(excerpted from pp. 68-69)
The concurrence between microcosm and harmonics
becomes even more astonishing when one notes that the
model of the nucleus of the oxygen atom with its protons
has twelve steps, the exact number of intervals found in the
scale formed by the atomic model.
(p. 68 paragraph 5)
The electron shell of the carbon atom, saturated according
to the rules of nuclear physics and in the steps of the basic
theorem, produces the tone scale C-D-E-F-G-A
which is the hexachord of Gregorian chant.
(p. 69 paragraph 1)
A key position …is held by the mysterious tritone, the
diabolus in musica:the augmented fourth or diminished
59
Kelly has graciously given permission for me to include her piece in Appendix A

fifth, which is neither consonant nor clearly dissonant, and
which in the microcosm produces exactly the same “touch
of freedom” as in music-for instance, in bebop. There, it is
often felt as a “jumping” fifth: and in the division of the
cell nucleus, too, it has a “jumping” function. The energy
necessary for the jump comes from incoming photons
which, as we shall see below, are the “carrier of
communication.” The “blessing of the photons” as Kruger
put it, comes down “pentecostally in large swarms mainly
on the tonal region of the tritone,” on F, F sharp, and G;
and it does so particularly intensely briefly before mitosis
(the cell division) when two identical nuclei with identical
genetic information are formed. In this process that Kruger
has analyzed carefully, the “flatted fifth” (as jazz musicians
call it), still
60
is what it was for the alchemists: thequinta
essential, the quintessence. Being open to all sides, it is
“seesaw” and “swing,” creating freedom and paths into
new life.
(p. 69 paragraph 4)
It is no wonder that Bernstein intuitively heard the tritone. His masterful use of it
conveys the emotions of an entire continuum: from fear, hate, death, and remorse,
to hope, love, and even the possibility of redemption.
61
These qualities of the life
experience are all present in the use of the tritone in the musical score ofWest Side
Story.
As part of the family of intervals, how might we use it within the Lydian mode,
prescriptively, at the bedside?
60
my emphasis
61
perhaps for the tritone itself. The final sounds we hear in the movie score ofWest Side Storyare
the melodic fragment ofMa-ri-a.

Part II
Case Study on the Prescriptive Use of the Tritone
in the Lydian Mode with Dying Patients
Research Design and Methodology
The method of looking at the tritone interval played in the Lydian mode and played
prescriptively in the vigil setting, was conducted with a modified case study design
through the lenses of phenomenological and narrative perspectives. In the vigil
setting I was looking at the “big picture,” by observing the patient’s physical
demeanor and respiration rates as I played music in the Lydian mode. This is a
phenomenological lens. I was also reflecting narratively on what happened during
the vigil.
62
This was a modified case study. The music was tested on groups other than patients.
Dying patients cannot tell us how they are experiencing the music. During a music-
thanatology vigil, music is offered without asking anything from the patient except
that they receive the music as a gift.
63
With the research design help of Sr.Vivian Ripp and Dr. David Waggoner, I chose
three listening groups to hear and respond to a pre-planned, ten-minute meditation
of Lydian music. They were a group of certified music-thanatologists, the hospital
interdisciplinary hospice team at Providence Everett Medical Center, and a group of
62
These entries are included in indenteditalics.This is not to be confused with the music-
thanatology clinical narrative which is a prescribed reporting of the vigil experience. Some of the
descriptions are taken from clinical narrative accounts of the patient vigils which I’ve written as
part of the requirements for music-thanatology certification
63 The vigil experience is the core work of music-thanatology:
Music-Thanatology is a field whose practitioners provide musical comfort, using harp and voice at
the bedside of patients nearing the end of life. The word “thanatology” comes from the Greek
word for death, thanatos. The service at the bedside is called a music vigil and is delivered by one
or two highly trained music-thanatologists. Its purpose is to lovingly serve the needs of the dying
and their loved ones with prescriptive music. From the Music-Thanatology Association
International website:
http://www.musicthanatologyassociation.com/NewFiles/What%20is%20music%20Thanatology.ht
ml
Music-thanatology training is an infused curriculum comprised of six areas of competencies.
These are Personal, Musical, Medical, Clinical, Thanatological, and Professional. A music-
thanatologist is a musician-clinician who has integrated these competencies as s/he prescriptively
uses the raw elements of music (such as silence, key, mode, melody, harmony, tempo, dynamics,
meter, non -meter, intervals etc.) to accompany the patient as they are transitioning from nearing
the end of life to completion of life. Each vigil experience is completely unique to the needs of the
patient and is offered with this intent in mind:
“I lovingly care for the physical and spiritual needs of this dying one with prescriptive music.” (a
quote I adapted from the Chalice of Repose Project pinning ceremony in Missoula Montana
c. 1994-2002)

people from my community on South Whidbey Island, Washington. The time
frame for these sessions was thirty minutes.
The first group was comprised of six certified music-thanatologists who had
gathered for a monthly Clinicals meeting and agreed to take part in this listening
meditation. We met in the living room of the private home of two of the music-
thanatologists. The second group were six members of the interdisciplinary hospice
team. We met in a lounge area on the eighth floor of Providence Everett Medical
Center before the weekly team meeting. The third group were nine people I know
through musical, social or spiritual group connections in my community. We met
in the living room of my home. The varying groups offered a broad spectrum of
responses to the music.
The selection for membership of the three listening groups was as follows: I
received permission from the music-thanatology group to offer the listening session
at a regularly scheduled meeting time. Six music-thanatologists were able to attend
the meeting. Likewise, at a hospice interdisciplinary team meeting, a time was set
prior to the regular meeting time, for people to come and participate. Six
interdisciplinary team members participated. For the community group, I called
people I knew and gave a brief explanation about my interest and study in the use of
a particular musical scale and interval. Nine (out of ten people asked) were able to
attend.
The thirty-minute listening group design was comprised of: (1) a script I read to the
participants, (2) a set of questions to be answered before listening, (3) the ten minute
Lydian music meditation, and (4) a set of questions to be answered after listening.
64
People were invited to become comfortable in their chairs. Two of the music-
thanatologists chose to sit on the floor. Chairs were set in a circle for the hospice team
members; the other two groups had seating in a modified circle. The community
group had two people sitting at a small table near the chairs. During the short sharing
time after the second set of questions was answered, these two brought their chairs
over to join the circle. I allowed 30 minutes for each session and explained this to
participants before our meeting and in the opening remarks to each group. During the
first ten minutes I read the script to the group, and participants answered the “before
listening” questions. The next ten minutes I played the Lydian music meditation. The
last ten minutes listeners answered the “after listening” questions and shared anything
they wished to say aloud in the group.
Before the music began, I gave participants the first questionnaire, asking them to
write a brief description of how they felt physically, emotionally, mentally, and
spiritually.
65
This was so that I could get a baseline of how they began the session.
They were then invited to put paper and pencil down as I read a simple suggestion of
how to prepare physically and mentally for the musical meditation. After the
64
Please refer to Appendix B for this script and sets of questions asked of the listeners. There is also
a recording of the Lydian meditation music on the companion CD in Appendix B.
65
See Appendix B

meditation was played, they were invited to fill out the second questionnaire which
asked: (1) Do you feel differently now than before the music? (2) Were you aware
of feeling the music in any specific areas of your body? (3) Did the music “take” you
anywhere? (4) Did any feeling(s) arise? (5) What qualities did your experience
have? (6) Did you experience imagery of color, shape or form in an abstract way?
and (7) Was there anything unique about the music you heard?
I attempted to play the Lydian meditation the same way for each of the listening
groups. I always played it in C Lydian with the key signature of F sharp. I began
with the Lydian scale, playing this several times in different registers, followed by the
opening of the unmetered chantLaudem dicite. I followed this with two metered
medieval pilgrimage pieces:The Nuns of Chester andAd Mortem. I ended with an
original unmetered chant I had written years earlier calledHoney on the Comb.
66
This
music does have an improvisatory nature. While I played the pieces in the same order
each time, and strove to make the meditation ten minutes in length, each rendering
was unique.
In a preliminary meeting to discuss my project, Tim Serban, Manager of Mission
Integration and Spiritual Care,
67
told me that we would only need informed consent
from families/patients if this study is published. I chose not to publish this study.
This also avoided intrusion on families and patients. The patients’ names were
changed to honor confidentiality. The six patient vigils were played between June
21, 2007 and October 4, 2007. Patient selection was first determined by a baseline
of stable vital signs from the patient. I could not predict if a patient would be a
good candidate for this study before the vigil experience. I began the vigil with
selections from the shared thematic material of the music-thanatology repertoire.
The decision to play selections from the Lydian repertoire was made during the
vigil experience, using the following criteria: (1) The person’s respirations were
steady, ( 2) The patient’s countenance was calm, and ( 3) The mood of the room
mirrored the patient. (This meant that if staff or family/friends were present, they
remained in a quiet supportive space to the patient and the vigil.)
My colleague and mentor Jeri Howe CM-Th., took the observer role. She counted
respirations at the beginning of the Lydian music and again at its end. She noted the
duration of the music and at what point in the vigil the Lydian music began. She also
noted any physical changes in the patient or changes in the flow of the vigil. If
family/visitors were present, this was noted. She also recorded any noticeable change
in their demeanor during this music. When we decided the patient and situation were
appropriate for the Lydian music (Jeri and I conferred ahead of time, usually non-
verbally), I continued playing alone while Jeri made observations. The Lydian music
was rendered for each patient according to their need and situation. The sound of the
raised fourth (the ascending tritone) or diminished fifth (the descending tritone) was
prominent to the offering because of its special “beckoning” quality. When I finished,
we both ended the vigil with a selection or selections we had played previously. The
66
This can be heard on Band 5 of the companion CD
67
My manager at Providence Everett Medical Center

length of the Lydian music during the vigils ranged from five to ten minutes
depending on my sense of how the patient was responding.
Dr. David Waggoner was of invaluable assistance in helping me design the data
collection sheets for the listening groups and the patient group. As a result, I could
begin to discern what can be learned from their experiences. With the listening
groups I used a spreadsheet to transcribe the responses verbatim. The next step was
to look for and collate repeating descriptors, ideas, emotions, and images to
determine common experiences as well as unique experiences. These were
organized in a descending pattern beginning with largest number of same responses
to single responses.
68
This gave me clues as to how patients might receive the
music in the vigil setting. Jeri’s observations were transcribed verbatim on a
spreadsheet so they could be compared among each of the six patients.
Case Study Results
Before the Musical Meditation
The responses from the three listening groups varied greatly and at the same time
had common threads. I have classified descriptors into “like” groups when
possible.
The 22 listeners reported:
Physically, responses fell into two broad groups:
Low energy group: Tired (12), in pain (3), distracted, fidgety, restless, jaw
tightness, full stomach (2) anxious, wired, exhausted, hungry (1)
Energized group: Relaxed (8), open (2), focus-oriented, physically alert, present,
ready,
settled, (1)
Emotionally, responses fell into two broad groups:
Stressed group:Stressed (9), anxious (6), sad (5), irritable/crabby (3), worried (3),
spent/little to give (2), heaviness (1)
Expectant group:Expectant/anticipating (9), happy (4), calm (3), peaceful (2),
content, curious, grateful, open, not stressed, positive, neutral (1)
Mentally, listeners were evenly divided between scattered and focused:
Focused group:Alert (7), ready (4), focused (2), moving toward (1), emptied,
settled (1)
68
See the data collection sheets in Appendix B

Scattered group:Scattered (10) mind on many things, blank, brainless, distracted,
mind on hospice program (1)
Spiritually, more people felt some sense of being peaceful or held than in a
restless or searching mode:
Peaceful group:Peaceful/at peace (7), loved (5), connected, open (2), held, fed by
Spring’s promise, calm, integrated, feeling safe (1)
Searching group:Questioning (4), needing time to meditate, on the surface,
praying for direction, restless, searching, unsure, not on that plane right now (1)
I remember the two professional groups, the music-thanatologists and
hospice team members as a whole being more tired or stressed. The
community members had come on a Friday morning to my house. Most of
them are self-employed and have flexibility in their schedules. Two are a
clergy couple and their responses reflected the weight of work yet to do.
Also feeling the weight of too much to do was a woman who, with her
husband, is involved in building their new retirement home. As a group,
though, the community members were more refreshed, alert, and ready to
begin the meditation.
Each time before I played the Lydian meditation I asked for guidance, to
be relaxed and present to this group and to allow the music to flow
through me.
After the Musical Meditation
I asked the participants to answer seven questions. Here is a summary of their
responses.
1. In a general sense, do you feel differently now than before you heard this
music?
Yes: N= 21; No: N= 1
The comments were positive. The descriptions indicated the music had
enhanced a change in how they felt, with the exception of one person who felt
no differently.
Narrative responses:
Relaxed/relaxation (7), calmer/calming (5), awakened, balanced (body-mind-
spirit), better than agitated self, centered, grounded, lighter, peaceful, reduction in
cares, stimulated (1)
After reading the responses to the first question, I learned I needed to ask
“If so, describe how you feel.” I actually had 22 different descriptors but
seven people just answered “yes.”

2. Were you aware of this music being felt in any area of your body? If so,
please offer where in the body and describe what the sensations felt like.
Yes: N= 19; No: N= 3
Responses demonstrated a variety of places where the music was felt in the
body and a variety of physical sensations.
Narrative responses:
Area of body where felt: Head region (5), heart (4), belly (3), nervous system,
shoulders (2)
Sensation felt: Body temperature warmer (1), warmer in hands/fingers/chest/legs/
head region, heightened skin sensitivity, heaviness in legs/arms/face/base of torso,
circulatory system/heart rate into steady beat, rising quality up and out of body (1)
3. Did the music “take” you somewhere? If so, please describe what happened.
Yes: N= 19; No: N= 3
There were many one-of-a-kind responses. Please refer to these in the “After
Meditation Word Count” data sheet in Appendix B. Generally there was an
experience of movement to another place or to something else.
Narrative responses:
Ascending qualities:Ascending quality, lifting out, drawn out of self, being
borne up, floating quality, flying with eagles (1)
Images of water: Water (2), bubbling brook (1)
Places taken: Meadow, bright beautiful meadow, dark tropical forest, clearing in
a forest, place of deep calm, place of peace & tranquility (1)
Other responses: Directionless, moved out of the body, calm (when music was
unmetered), chaos (when music was metered), transitioning from this life (1)
II found it interesting that two felt calmer with the metered pieces and one
calmer with the non-metered.
4. Did any feelings arise? Please describe.
Yes: N= 20; No: N= 2
There were a variety of feelings named that are grouped in three categories
of nonstressing, stressing, and neutral.
Narrative responses:
Nonstressing: Tenderness when voice came in, gratitude, happiness, holding
“unfinished stuff” in a hopeful way, pleasure, sweetness, voice satisfying,
poignancy, poignant, feelings relaxed into pure joy, overall feeling of joy (1)
Stressing: Metered music making me crazy, irritation until let go of expectations,
unresolved music brought agitation and anger, disconcerted during unmetered

section, wanting to cry, sadness aware of before the music, sadness related to
longing, melancholy, longing (1)
Neutral:Coolness, neutral pleasure, expectant, curious, amusement, acceptance
(1)
5. What qualities did your experience have?
Yes: N= 19; No: N= 3
Again, there is movement noted as expanding outward, moving deeply
inward, and connected-calming-grounded responses.
Narrative responses:
Expanding outward: Uplifting (4) uplifted, uplifting in a very real way,
releasing (letting go from out of body), sometimes taken out of self, opening
(unmetered section), open (1)
Moving inward: Inward (2), inward feeling (1), inwardness (1)
Calming-connected-grounded responses: Calming (2), healing (2), unmetered
section calming, intimate, connectedness to this world, intimate sense of
connectedness with the universe, intimate sacred space that felt safe, grounded,
grounded-not airy fairy (1)
I’m thinking of one of the listeners, a chaplain from the hospice team for
whom the unresolved quality of the unmetered pieces was very unsettling. In
fact, this feeling built in her to the point of anger and wanting to leave.
When I began to play the major chord built on the second tone of the scale,
which gives a feeling of resolution because of the F sharp (the tone that is
the tritone played with C, the root) she relaxed and began to feel calmer.
She had seen the color black which shifted to a ‘peaceful blue’ when the
music moved into a feeling of resolution toward the end of the meditation.
In contrast, a listener from the music-thanatologist group described her
experience as a “meandering journey” which was “strange at first,
intriguing, and often expansive/liberating- (I was) being drawn out of myself
to meet the music. By the end I didn’t want the music to stop, was definitely
drawn in.” She finished saying the experience had been “a good
prescription for me today” and that it made her want to “further explore
this mode.”
6. Did you experience any imagery of color, shape, or form in an abstract
way?
Yes: N= 12; No: N= 10
This question had a great variety and uniqueness of response. The
categories fell into color, shape, form, and other responses.

Narrative responses:
Color responses: peaceful blue, cobalt blue, sunlight,black (unresolved
sections of music) (1).
Shape responses: Clouds (2),beam of sunlight,eternity symbol at position of
the third eye, fairies, filigree/dust motes dancing, spiral coming out of the head,
a shape of lifting/being drawn out of the head (1)
Other responses: Yes, but can’t describe.
7. Was there anything unique about the music that you heard and experienced?
Yes: N=21; No: N= 1
This question yielded the most variety in response. The responses are
grouped into categories of experiencing the voice, resolution, and other
responses. See Appendix B for specifics.
Narrative responses:
Voice responses: Voice added healing quality, transformational quality, was
grounding, voice re-engaged me, found satisfying the space created between
harp and voice, ethereal quality when voice came in/felt mothered, scale jumpy-
voice smoothes it out (1)
Resolution responses:Experienced deep sense of flow, ending pleasing, music
resolved to different comfortable place, did not feel unresolved as some modal
music, music went from one quality to another without noticeable change, like
Life, music to die in the presence of (1)
Other responses: The tritone, strangely familiar and unfamiliar, counterpoint
between this music and voices in next room, snippets ofSome Enchanted
Evening,not hummable, pleasant, (1)
These responses were fascinating to me. Participants took such care with
their descriptions. Just one person reported it was the tritone that was
unique. Other comments that piqued my interest were that one experienced
“a deep sense of flow in the music.” Another said the music “went from
bubbling to soaring and floating to without any noticeable obvious change
from one to the other.” This encouraged me to think about using this music
for the vigil setting, as care is taken not to break the flow or energy during
the offering of the music. Another said that the music seemed to “resolve to
a different and comfortable place” which gave him an “openness to
alternate or fresh ways of framing things.” One said it was good that the
music didn’t have “recognizable melodies” or anything that could be
“hummed” by her. Another said the music was “strangely familiar and
unfamiliar.” The most evocative comment was that this was “music to die in
the presence of.”

The Patient Group
Over the course of nearly four months I played for six patients. These were patients
I determined to be stable and appropriate for playing this Lydian music
prescriptively during the bedside vigil. Two were imminency
69
patients, three were
processing
70
patients, and one was transitioning from processing to imminency.
They were all patients at Providence Everett Medical Center. Three of the patients
were alone in the room while we played, and three had family members present
during the visit.
The responses from the listening groups strongly determined that this music had for
many a quality of “beckoning” or “seeking” or taking the listener “up and out of
their body,” or more “deeply inward.” In the historical study it was evident that the
tritone can be very “activating.”
71
Therefore, I felt it important to establish a
baseline of stability in the patient before offering this music. Using music well
established to be supportive to a patient prescriptively, Jeri Howe
72
and I began the
vigils with music from the shared thematic material of the music-thanatology
repertoire.
73
I also sensed it important to end the vigil by reprising a piece played
before the Lydian music (most often the piece played just prior to this music). Thus
in the imaginal sense, it might bring the patient back to a more grounded place.
The actual observations made by Jeri Howe at the vigils can be found in Appendix
B. The comments in this section are a combination of descriptions of visits that
illustrate conclusions I’ve drawn, Jeri’s observations, and my own personal
reflections (indented in italics). Again, the patients’ portion of this study reflects
that they themselves were not asked about the Lydian experience.
“Kay”
74
was one patient for whom the vigil ended with the Lydian music. She was
a retired missionary who was in hospital for a recent diagnosis of recurring breast
69
Meaning that the person has stopped eating and drinking and that the body is actively shutting
down. They are usually unconscious and not able to rouse from this state.
70
The person is moving closer to the state explained above. They are deeply into a terminal process
but may still be eating and/or drinking, perhaps processing verbally (or non) with loved ones and
those caring for them. They can still be roused from sleep.
71
E.g. The evidence of its role in mitosis, and, when played as a repeated interval or oscillating
pattern the sound can be nerve racking, even terrifying. Additionally, this mode with its
augmented fourth added to the major scale is the brightest mode (apart from a whole tone scale).
Though the tritone is part of our contemporary soundscape, it is usually buried harmonically or
used melodically in energizing upbeat music. The sound of this scale is not so usual to our ears,
and though I did not play the scale for patients per se, scale-like passages were often rendered as I
improvised in this mode. In the vigil setting the music-thanatologist takes great care to follow the
patient’s lead, respecting the patient’s vulnerability physically, mentally, emotionally and
spiritually. My rationale was such that if the patient were calm and steady in demeanor and
respirations, introducing the sound of the tritone within the context of the Lydian scale might offer
a soundscape less binding or associated with what is familiar. It could possibly be freeing and
supportive to their process of letting go.
72
Jeri was acting as both a supervising music-thantologist, overseeing the certification requirement
for 50 supervised vigils, and also as the observer during the Lydian music portion of the vigils.
73
The shared thematic material does not include music in the natural Lydian mode
74
All patient names have been changed to protect patient confidentiality

cancer. She was there to assess a course of care. The day Jeri and I played for her
she was awake and sitting up in bed, receiving the music as if we were playing a
concert for her. Just before playing the Lydian music, I asked her if she wanted to
hear more music. She responded with an enthusiastic “yes.” She remained alert and
upright during this music. In my clinical narrative report I wrote:
I play the chant (unmetered Lydian) with momentary
pauses to the phrasing, broadening the range to expand
possibilities for loosening and outward expansion
imagining this may be an unfamiliar scale pattern to ‘Kay’.
The chant is improvised with an original chant in which the
words “always returning home” and “thy will be done” are
sung intermittently…they are sung quietly,
introspectively…I wonder at the time if Kay registers the
words, satisfied that they are simply being offered as
possibilities for contemplation whenever needed in the days
to come.
In her observations, Jeri remarks about how Kay seems to be keeping herself
awake, intent on watching me play. She notes: “It seemed the Lydian mode brought
a deepening of the sense of calm.”
75
During another vigil a sense of deep calm was present. In the vigil with “Bob,” the
flow of the vigil was kept from dissipating or stopping when Bob’s wife and her
cousin entered the room. I remember my strong intention of holding the field as
this music was being offered with the hope of deepening his ability to rest and let
go. I had just begun the Lydian music when they arrived. The women came in and
stood still for about six or seven minutes. I was deeply into the flow of the music
and did not stop playing. I believe they found themselves in this sound field and
the “arriving” energy around them softened or was released as they joined us
energetically for those minutes, becoming still and silent. I remember feeling
grateful to them and awed by the power of the sound field and the held intention.
All six patients’ respiration rates remained the same from the beginning to the end
of the Lydian music portion of the vigil.
This was astonishing. I have questions about this. Does this lead toward
confirmation that the Lydian music is on some level energizing because
respirations did not go down? Yet they did not rise. Were patients
entraining to the music?
76
75
See Jeri’s observations for patient # 2 in Appendix B
76
entrainment- gaining control of a heart rhythm (esp. a tachycardic rhythm) with an external
stimulus such as a cardiac pacemaker -fromTabers Cyclopedic Dictionary, p.714 (or live music
delivered prescriptively and with intention)

During the vigil with “Sara,” her involvement with the music and with us was most
fascinating and poignant. She seemed to be in a ‘holding pattern’ in her coma. She
seemed unwilling or unable to release from this earthly plane. The hospice care
team imagined she may be waiting for personal contact with her son (who
unbeknownst to her is serving time in prison). Jeri and I played many times for her
during the 11 days she was in this liminal state. Sara seemed to have a tendency to
physically engage with anyone who came into the room. She leaned toward them
slightly and immediately breathed more deeply, even sometimes beginning to moan
or move her mouth. On this day Sara seemed to be deeper in her coma (unable to
open her eyes or move her mouth) but outwardly focused towards us and the music.
She began to intone on her outbreath. We followed her, sometimes echoing softly
her sounds with our voices. For twenty minutes Sara “sang” with us. Remarkably,
she was intoning on the same pitch center-on or very near an “A” the whole time.
Consequently I transposed the Lydian music into D Lydian and modified that music
as if I were in dialogue with Sara. A single line ofIn Paradisum,played on the
harp in D mixolydian, became the benediction.
In contrast, the listening group experiences, with their set order of musical offerings
designed for the Lydian meditation, were a much different experience than the vigil
setting where there is no set order of repertoire. However, I was very grateful for
the listening group experiences because of the richness of the responses, and the
surprises I received. I also confirmed some of my hunches about the nature of the
tritone played in the Lydian mode, when used prescriptively in the vigil experience.
One of the surprises was how many people commented that the voice enriched the
experience. Listening group comments (e.g., that the voice offered a healing or
transformational quality, had a grounding quality, mothering quality, and that the
voice added spaciousness between it and the lower harp tones) gave me the sense of
the importance of the voice’s added dimension. However, I had to be aware that
the voice might be too stimulating and/or complex for the patient. I often used the
voice sparingly or softly (as if covertly, diffusely) for warmth and human
connection. Sometimes I simply hummed without the harp.
I am remembering the difference between playing for the listening groups
versus the patient group. It’s like comparing apples and oranges. The focus
is completely different between set repertoire and prescribed music, and
between a group of people who are well and a person who is nearing death
or actively dying. With the set repertoire I am thinking as a performer. I
am focused on the flow of this set of pieces, and creating a meditational
listening experience. With the person dying I am a clinician/musician
following the patient’s lead in sacred accompaniment to their process. I am
creating a flow, but it’s a different flow. I am flowing with the patient.
As I thought about Leonard Bernstein’s treatment of the tritone in West Side
Story, I wanted to use this interval as he had– to inspire hope, possibility,
the longing of union– and to ask the questions that drive our fears and

imaginations. Since my early 20s my overarching goal in life has been to
“evolve,” to keep growing beyond what I have known. My study of the
possible prescriptive uses of the tritone played in the Lydian mode seems to
support this inner life directive. Whether this interval jolts us through
“unsettling” fear, or gently beckons us “inward,” or “upward and
outward,” it is energizing. It seems to move us from one state to another.
When we are in a liminal experience, we are betwixt and between. We are neither
here nor there–yet. The tritone, which is found betwixt and between, right at the
midpoint of the octave, might be thought of as a micro-pattern of this liminal state.
Therefore it meets us where we are. The patients we serve are in various stages of
liminality. When a person can no longer speak or move, when the power of
volition has ceased, and one is moving from known to unknown, our work as
music-thanatologists is to mirror that place of open possibility in the patient, and
point toward resolution, peace, tranquility, transcendence. Steven Levine suggests,
“(There is) fear that this degree of consciousness, this spaciousness in which to die,
is beyond our capacity, (and yet) that is not what I have seen. Death often brings
out the best in us.”
77
Conclusion
The pursuit of finding treasure is always about discovering
what one needs to learn in life. This has been a quest to
understand my involvement with and attraction to the
tritone…to move toward a deeper understanding of the
possible prescriptive use of the Lydian scale and its
distinguishing interval, the tritone. It has been a study to
understand the interconnection between themes such as
liminality, intention, consciousness, thresholds, surrender,
remembering, releasing, the anam cara, the healing of the
cosmos, ushering in the age of partnership, understanding
the tritone as part of the family of intervals, with no
recipes, as sacred accompaniment, and with Grace.
I began my project in theForewordwith this statement. I have discovered that the
treasure itself can be imagined on many levels and that it is as infinite as Life itself.
I have discovered that my work as a certified music therapist (which began over
thirty years ago) was moving me inexorably toward the field of music-thanatology
all along. As we are taught in our music-thanatology training, this work is both an
ancient practice
78
and a newly emerging field in palliative care. I wanted to make a
77
Singh, p. 217, as referenced from Levine, Steven.Who Dies? p. 260
78
Central to the foundation of music-thanatology study is the work of Frederick Paxton. He has
researched the late 11
th
century monastic death ritual customaries of Bernard and Ulrich of Cluny,
France. SeeA Medieval Latin Death Ritual,by Frederick Paxton, translator and commentator, St

contribution to this field. Music-thanatology is on the cutting edge of health care.
This model is helping to usher in a new age of partnership in the world. We are
modeling the vision of beingalongside each other rather thanover anotherorunder
another’sauthority.
The listening groups intimated that the sound of the tritone within the Lydian mode
does have qualities that, for some, beckon to realms of tranquility or peace, or offer
a sense of connectedness with the universe. For some, the Lydian music brought
physical changes such as warmth to their extremities, enhancing the nervous
system, and relaxing muscles. For a few the music was disconcerting, unsettling,
and one person shared in discussion that the tritone felt “a little scary.” The
unmetered music and unresolved music was difficult for a few, and for one, the
unmetered music was essential. And, for another person it is “music to die in the
presence of.”
Regarding observed respiration rates and physical countenance, the patient group
appeared stable during this music. The flow of the vigil was not broken and in one
case seemed to “deepen and widen.”
79
One patient had leg tremors during the
Lydian music that were present throughout the vigil. He became agitated during the
last song after the Lydian music. Jeri’s observation was:
Could this have been a reaction to the unusual quality of the Lydian mode?
It seemed to be a cyclic pattern of restlessness according to the nurse. We
can’t assume it was caused by the music but how can we know when a
patient is unable to communicate?
80
We can’t know. Mystery permeates the work, and yet we have clues as we observe
and listen in loving silence. Ultimately we have to let go and trust that our offering
has been of benefit. I discovered (from the listening groups and the patients) that
the tritone played within the context of the Lydian mode has a place in music for
meditation and within the infirmary repertoire. My advice is to ground the Lydian
music with music from the shared music-thanatology thematic material because the
sound of the tritone can be energizing, stimulating, or may leave one feeling
ungrounded. But there is always the exception. With someone taking their last
breaths, this mode might be appropriate for that ultimate release.
As with any offering of music in the vigil setting, music-thanatologists must take
their cues from the patient. The art of the work is to meet patients where they are,
Dunstan’s Press, Missoula, Montana, 1993. Therese Shroeder-Sheker, visionary and founder of
music- thanatology, has brilliantly reclaimed this sacred tradition of accompanying the dying at
the bedside with harp and voice. Now placed in the diverse cultural context of the 21
st
century, the
sacred intention of the work is to restore beauty, dignity and grace to this life passage as the
music-thanatologist lovingly serves the physical and spiritual needs of the dying, using music
prescriptively through the medium of harp and voice.
79
See Jeri’s observations for patient #6 in Appendix B
80
See Jeri’s observations for patient #1 in Appendix B

offering unconditional regard and the skills of the musician-clinician. More and
more I have come to learn the importance of this intent as I play for patients.
81
As time passed I became more skilled in delivering the Lydian music prescriptively.
I learned to trust the moment and allow myself to experiment. For example,
sometimes I played a fragment of a piece, varying it, repeating it, etc., rather than
offering the piece in its entirety (particularly when the piece was repeated). One
idea I had in order to ground the music within the Lydian portion was singing the
fundamental tone C, as I played a passage with the tritone in it. I would hum it or
intone on a vowel. Twice I sang the word “Alleluia” slowly as I played the Lydian
passages in the upper harp register.
I was inspired by the inner directive of grounding the Lydian music in the vigil
setting, and composed a twenty-minute piece calledModes of Light.
It begins in the Dorian mode. The Dorian mode is perfect for a beginning and
ending. This mode is a mirror of itself, meaning that the intervals from note to note
are the same going up the scale as they are coming down the scale. It offers a
perfect balance of light and dark as the first, third and fifth notes form a minor triad
and the fourth sixth, and eighth notes form a major triad.
After beginning in the Dorian mode,Modes of Lightmoves on using the cycle of
fifths to the Aeolian, Phyrgian, and Locrian (which are progressively darker
modes), and then back to the Phyrgian, Aeolian, and Dorian. The piece continues,
now using the cycle of fourths and the progressively lighter modes of Mixolydian,
Ionian, and Lydian. It then moves back through these modes from Ionian, to
Mixolydian, ending in the Dorian.
I explored repeating melodic themes and musical ideas to convey these “modes of
light.” The Lydian section happens two-thirds of the way through the piece, at a
81
Peter Robert’s study in Australia eloquently illustrates this through the viewpoint of his patient
Stuart Heywood, a patient under the pseudonym of ‘Robert’ in the study. Stuart was so moved by
the experience of Peter’s music that he wanted to tell the world about it in a video interview- his
last wish before his death. Three components stood out in Stuart’s case. One is that Peter was
able to play for Stuart many times. The second was that over time Stuart was able with the music
to ‘go to a place of ‘peace and beauty where there was no fear and no pain’. Peter showed Stuart’s
video at the 2006 Music-Thanatology Association International Conference in which Stuart so
movingly tells of the third component, which is ‘it’s the love that Peter brings to the music’ that
makes all the difference. Peter went on to say that his work as a music-thanatologist comes to
completion when people are able to go to this place of beauty, and peace, on their own– without
the music. The music has been a bridge for them from a place of fear to a place of no fear. See
Relief of Suffering at End of Life: report from an Australian project to implement and evaluate a
live harp music-thanatology program.December 2005, p. 56

natural climax point.
82
Modes of Light can be heard on the companion CD in
Appendix B.
I was disappointed not to have the time to explore some of the ideas that I learned
about in the research, such as “the greening power” of the note F sharp which Franz
Schubert spoke of, as referenced in the Kay Gardner bookSounding the Inner
Landscape.
83
There is fascinating material out there about this note
84
deserving of
exploration. This information informed my decision to play the Lydian music in C
Lydian whose key signature is F sharp.
Looking to the future
I hope that this study inspires rich exploration of the modes and repertoire within
the thematic material currently used in the music-thanatology vigil, as well as new
sources. I have barely scratched the surface of understanding the uses of the tritone
in the Lydian mode played prescriptively in the vigil setting, yet I know much more
about it now, and I have some experience sharing it with others.
I’m thinking about the world of the dying and how frequently dignity and
respect are lacking in end of life care. Music-thanatologists see the end of
life as a natural part of the privilege of human form. We work to restore
beauty, grace and dignity to this profound time of passage. My children are
being influenced by this work I do. They are learning to understand and
trust the idea of theanam cara,
85
the soul friend, the one who sits alongside
another, asks nothing of that person, and knows how to “sing” the universal
song of life. I see my children searching for such a person in their lives. I
see them learning to become such a person to others. May the angel of the
work of music-thantology give us the courage to be such a soul friend to the
people we serve, so that our children will find it natural to enter into the
sacred time of our death, and the sacred time of their death.
I am so grateful for what has come through this learning. I’m grateful to
have been mentored by Sr. Vivian Ripp, Dr. David Waggoner, the music-
82
Similar to what is known as the “golden section” or “divine proportion” in mathematics which is a
natural principle in nature. It can be found at the molecular level in our DNA. Da Vinci and
others used it in architectural design. See pp. 214-222 in Gardner’s bookSounding the Inner
Landscape
83
p.117, Gardner.
84
I have an article about the note F sharp which has been researched by Susan Alexjander, MA,
calledF#s-What’s This All About?available throughwww.oursounduniverse.com/f-sharp-great-
pyramid.html
Here’s another amazing thing: “the tritone (relative to C) forms the key tension in the nitrogen
atom during photosynthesis when sunlight is transformed into chlorophyll, into “living green”
p.70, Joachim-Ernst Berendt,The World is Sound: Nada Brahma
85
A term used in the end of life care training developed by Richard and Mary Groves. SeeThe
Anam cara Projectatwww.sacredartofliving.com/

thanatologists of the first training school in the Pacific Northwest,
86
and the
members of MTAI. And I’m grateful to play the harp alongside Jeri Howe
who is a handmaiden of holy Silence- the Ground of Being.
The Song is singing
unto Thyself, Honey on the comb,
Always returning
Home.
Thy will be done, Thy will be done,
Thy will be done.
87
86
As well as the group of 11 students I am privileged to be part of
87
The text ofHoney on the Comb found in Appendix A

Bibliography
Abbey of St. Peter of Solesmes.Liber Cantualis,Desclee, Paris-Tournai, 1978
Appel, Willi.Gregorian Chant, Indiana University Press, Bloomington-Indianapolis,
1958, paperback edition 1990
Berendt, Joachim-Ernst.The World is Sound: Nada Brahma,Destiny Books, Rochester,
VT, 1991
Berry, Mary ed.Cantors: a collection of Gregorian chants,Cambridge University
Press, Cambridge 1979, 3
rd
printing 1987
Berry, Mary.Plainchant for Everyone,third edition, Royal School of Church Music,
Addington Palace, Croyden, England. 1996
Gardner, Kay.Sounding the Inner Landscape: Music as Medicine,Element Books,
Rockport, MA, 1990
Godwin, Joscelyn.Harmonies of Heaven and Earth: Mysticism in Music from Antiquity
to the Avant-Garde,Inner Traditions International, Rochester,Vermont. 1987,
1995
Hiley, David.Western Plainhant a handbook,Oxford University Press, Oxford, 1993
Isacoff, Stuart.Temperament: The Idea That Solved Music’s Greatest Riddle, Alfred A.
Knopf, New York, 2001 pp
Levine, Stephen.A Year to Live,Bell Tower, New York, 1997
Levine, Stephen.Meetings at the Edge, Anchor Books, New York, 1984
Oxford Online,Grove’s Dictionary of Music, 2007 (Internet subscription)
Palisca, Claude V.Studies in the History of Italian Music and Music Theory,Clarendon
Press, Oxford, 1994
Partenheimer, Andrea. Research paper:Embracing the Voices of Chaos and
Possibility: Developing a Musical Response to the Liminality of the Dying
Piston, Walter.Harmonythird edition, W.W. Norton & Co., New York, 1957
Singh, Kathleen Dowling.The Grace in Dying, Harper Collins, San Francisco,CA.
1998
Tourin, Christina.Illuminations Healing Music for Harp or Piano, Emerald Harp
Productions, Mt.Laguna, CA., 2003
Yin, Robert K.Case Study Research: Design and Methods,second edition, Sage
Publications, Thousand Oaks, CA. 1994
Background Bibliography
Anderson, Megory.Sacred Dying: Creating Rituals for Embracing the End of Life
Prima Publishing, Roseville, CA. 2001

Bamford, Christopher.Sacred Smell,The School of Spiritual Psycho logy, The Sophia
Series, USA. 2000, 2001
Bernstein, Leonard.The Joy of Music, Simon and Schuster, New York, 1959
Bukofzer, Manfred.Music in the Baroque Era-From Monteverdi to Bach,W.W Norton
and Co. Inc, New York 1947
Grout, Donald Jay and Claude V. Palisco.A History of Western Music fifth edition,
W.W. Norton, New York, 1996
Levine, Stephen.Guided Meditations, Explorations and Healings, Anchor Books, New
York, 1991
North, Carolyn.The Experience of a Lifetime: Living Fully, Dying Consciously,Amber
Lotus, San Francisco, 1998
Nuland, Sherwin B.How We Die: Reflections on Life’s Final Chapters,Alfred A.
Knopf, Inc. New York, 1993
Palmer, Parker J.A Hidden Wholeness,John Wiley and Sons, San Francisco, CA.94103
Sardello, Robert.Silence,Goldenstone Press, Benson, North Carolina, 2006
Sardello, Robert.Touching Silence,The School of Spiritual Psychology, The Sophia
Series, USA. 2000, 2001
Soesman, Albert.Our Twelve Senses: How Healthy Senses Refresh the Soul, Hawthorn
Press, Stroud, 1990
Articles
Alexjander, Susan.F#s-What’s This All About?www.OurSoundUniverse.com
Shroeder-Sheker, Therese.Music for the Dying: a Personal Account of the New field of
Music-Thanatology-History, Theories, and Clinical Narratives,ADVANCES,
the Journal of Mind-Body Health Vol.9 No.3, Winter 1993
Shroeder-Sheker, Therese. Lecture:Principles of Music-Thanatology, given at the
Chalice of Repose Project, Missoula , MT. January 25,1996, synopsis by Jeri
Howe
Sunn, Casper.In Memoriam: Kay Gardner MemorialIAWM (International Association
of Women’s Music) Journal, 2003
Musical Sources
Alexjander, Susan.Sequencia,Science and the Arts: Logos Series, Berkeley, CA.
discography
Commins, Dorothy Berliner.Lullabies of the World,Random House Inc., New York,
1967
Gardner, Kay.Garden of Ecstasy,Ladyslipper, Durham, N.C. 1989 discography
Masters, Randy.inner vision,Masters Publishing House, Aptos, CA. 2004 discography

Plouff, Gary.In a Medieval Garden: Music of the Middle Ages Arranged for Harp
Memory Tree Music, 2004
Soderlund, Gustave Fredric and Samuel H. Scott.Examples of Gregorian Chant and
Other Sacred Music of the 16
th
Century,Appleton-Century-Crofts Ed. Div.
Meredith Corporation, New York, 1971

Appendices

Appendix A
1. IntroitStatuit ei, as described by Hucbold Hiley,Western Plainchant, a
handbookExample of b-naturals and b-flats, both used in the chant. p. 450
2.Ecce veniet Dominus,chant example from the Lucca Antiphonal using b-
naturals and b-flats
3. Examples of chants in the Lydian mode Soderlund and Scott,Examples of
Gregorian Chant,p.5
4.Laudem dicite, another example with b-natural and b-flat. I have the opening of
this chant in the meditation played for the three listening groups. Jeri Howe and
I accompanied this chant for a concert sung by Peregrine Vocal Ensemble in
Seattle (February 2, 2007)
5.Mors vite propitia,from the Florence manuscript compiled in the 13
th
C in Paris.
This is written in the mixolydian mode. The tritone is set up in the descending
run from B down to F (repeating numerous times)
6.Alma redemptoris mater, also from the Florence manuscript- 2 part vocal,
mixolydian
7.Dic Christi veritas, from the Florence manuscript- 3 part vocal, mixolydian
8.Ad Mortem, Plouff,In a Medieval Garden p.30
9.Song of the Nuns of Chester,Plouff,In a Medieval Garden p.38
10.Magnificat,(Palestrina) Soderlund and Scott,Examples of Gregorian Chant,p.
146
11.Excerpt fromUt Re Mi Fa Sol La Mass(Palestrina) Soderlund and Scott,
Examples of Gregorian Chant,p. 252
12.Lullaby, My Pretty One,ed. Commins,Lullabies of the World, p.86
13.Deep Peace,chant by Kelly Lockwood (used with permission)
14.I’ll Meet You There,chant by Chloe Goodchild
15.Finale, fromGaielle Remembering,Fleming/Walker (used with permission)
16.Table of Modern Modes, Wikipedia article

Appendix B
1.Script for Musical Listening Meditation on the Tritone/Lydian Mode
2.Template for “Before Listening” questions for listening groups
3.Data sheets composite from the three groups: “Before Listening”
4.“Before Listening” word description/count
5.Template for “After Listening” questions for listening groups
6.Data sheets composite from the three groups : “After Listening”
7.“After Listening” word description/count
8.Template for Patient Vigil Feedback
9.Vigil Patients Data Collection composite
10. CD companion

Script for Musical Listening Meditation
On the Tritone/Lydian Mode
(Check the time)
Thank you for being willing to join me in this next half hour.
In a few moments I’m going to play some music in a particular
mode/scale. This will last about 10 minutes. As you are listening I
would ask that you be aware of how the sounds of this music affect your
body, your mind, and your spirit. Be aware of any sensations you feel in
the body and where they are felt, any imagery, or thoughts about
yourself, your relationships, the natural world, our global village, the
Divine, whatever might come to mind. Afterwards I’ll ask you to share
what you experienced on paper with some questions.
We’ll then have a few minutes to share in the group.
So that I have a baseline for your experience please answer this question.
(Pass out Page 1 and a pen to each person. When this is done say, ‘We’ll
take two minutes’ to answer. )
Alright, please put the pen and paper aside and allow yourself to receive
this music, and what it might be offering to you. Please take a moment to
get comfortable and tune in now to your body, mind and spirit. Position
yourself so that you are comfortable, alert, and aware. Take a cleansing
breath or two. Let your awareness be open and receptive.
After I finish playing we will pause in silence for a minute.
(Claudia plays for 10 minutes)
After silence, I pass out the 2
nd
page and say ‘Let’s take ten minutes to
answer this’ Check back with folks and give two more minutes if needed.
When folks are finished, check time and say, ‘we have____min.
left, is there anything anyone wants to share with the group about your
experience of the music?’ Thank everyone again and end on time.

Feedback for Claudia’s Musical Project
Now that you’ve heard the introduction about what we are doing,
please offer a brief description of how you are at the present moment:
Physically:(relaxed, fidgety, tired, rested, aware of any pain, heart racing, …)
Emotionally:(happy, sad, stressed, calm, irritable, peaceful, anxious, expectant…)
Mentally:(alert, blank, mind on something else, thoughts racing, ready…)
Spiritually:(integrated, searching for meaning, deep peace, questioning Ultimate, loved
by the Other)

Patient Vigil Feedback Form
Claudia’s study on the
Lydian mode/Tritone
Patient’s first name & last initial___________________________
Age__________
Location____________
Date______________
CW’s vigil #______
Patient’s vigil #_____
At what point in the vigil was the Lydian mode introduced (early,
middle, late) and what was happening with the patient and the family at
that time?
What was the duration of the Lydian experience for the patient?
RPM at begin. of Lydian music____________________
RPM at end of Lydian music______________________
Were there physical changes in the patient during the Lydian
experience? (facial color, movement in face or body, vocalizations, perspiration, etc.)
Was there a change in the flow of the vigil during this music?
(describe)
Were family/visitors present? N__ Y__ Who?
Were there changes noted in them during this music?