2015 Terese Cullen – Contemplative Dimension of Music-Thanatology.pdf – Music-Thanatology Association International

Running head: THE CONTEMPLATIVE DIMENSION OF MUSIC-THANATOLOGY 1

The Contemplative Dimension of Music-thanatology
Terese Marie Cullen
MTAI Research Competency 110.714.1

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Abstract
The music-thanatologist gains access into the depths of their own interiority
through the contemplative dimension, and it is here, on the path of ongoing inner
transformation, that one discovers the capacity for true presence at the bedside of
the dying. We examine how various growth models, as well as the contemplative
practices of mindfulness and breath awareness found within meditation, provide a
way for the clinician to move beyond the egoic consciousness toward higher levels
of awareness, ultimately leading toward an “I-Thou” patient-clinician encounter.
Empirical evidence shows that an attentional practice such as mindfulness
meditation enables one to disengage from previous habitual ways of
thinking (i.e. narrative awareness) and instead engage in present moment
awareness. Further research demonstrates that a person who is
experiencing perseverative cognition is able to disengage from the associated stress
and worry through such present moment awareness. By repeatedly and
intentionally shifting the focus of our attention, via our meditation
practice, we are literally changing the pattern of our brain activity, and by doing
so, we gain access to previously unavailable capacities. Intriguing
research also indicates that music may achieve the same effect as other relaxation
techniques and contemplative practices through the alternation of sound and
silence. The implications for the field of music-thanatology are significant in that
a patient whose body and mind are weakened from the dying process may obtain
the same level of relaxation, healing and peace through the vehicle of music that
one typically obtains through a relaxation technique or a contemplative practice.

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Music-thanatology would lose its sea legs if it did not have a contemplative
dimension; it would simply be pretty music at the bedside. As this paper will show,
research indicates that the clinical application of music-thanatology would lack the
deeper level of perception made possible when one embarks upon the path of
ongoing inner transformation.
The founder of the field of music-thanatology, Therese Schroeder-Sheker (2001),
teaches that in order to be an authentic presence at the bedside of the dying an
inner transformation is required. Schroeder-Sheker (2001) proposes that inner
transformation is made possible by continually returning to the metanoic process.
(p.71)
The word metanoia is defined as a transformative change of heart, a spiritual
conversion (Merriam-Webster, 2015). The literal meaning from the Greek is to
change one’s mind (Merriam-Webster, 2015).
It is through the practice of metanoia that we experience the continuous, daily
death of the ego; the death of our treasured illusions; the death of our unconscious
behaviors that we have become accustomed to; that allows us to be present at the
deepest, most authentic level for those we are serving.

“The agent of definitive transformation is nothing less than death. The function of
death is to provide the necessary entrance into our innermost selves.”
–Pierre Thielhard de Chardin

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Inner transformation always seems to involve a death of some sort. When speaking
about how the dying person transforms when nearing death, Kathleen Dowling
Singh (1998) says: “This powerful transformation involves the death of the ego
and the rebirth of the self as a vehicle of Spirit” (pp. 67-68).
The experience of those nearing death and our experience of the continuous death
of our egoic consciousness (the metanoic process), will ultimately lead and guide
us into what Cynthia Bourgeault (2008) describes as the “non-dual knowingness of
the heart which can see and live from the perspective of wholeness” (pg.41).
I have come to understand that the ego is not inherently evil but that it does prevent
one from seeing clearly. Richard Rohr (2009) describes the ego as leaving you
“blind to your own illusions and convinced that you see perfectly” (pg. 91).
It is precisely this blind spot that inhibits one’s inner transformation. For example,
during the course of my clinical internship I would sometimes have feelings of
inadequacy in regards to my harp skills and worry that the family members who
were present might be disappointed. My egoic consciousness prevented me from
truly serving the needs of the patient and/or family members in those moments. My
ego was too busy worrying about how I was being perceived.
The process of inner transformation is ongoing and requires practice. The practice
of metanoia not only moves one beyond the ego, but changes one’s perspective
through a gradual stripping away process, which can be viewed through three
broad phases invoking Andre Papineau’s (1997) writings on transitions, Breaking
Up, Down and Through and Vicktor Turner’s (2009) research on “Rites of
Passage.” (Schroeder-Sheker, 2010). Both of these growth models (Papineau,
1997, and Turner, 2009) may be employed regardless of one’s faith or religious
identity. They are as follows:

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1. Breaking Up/Rites of Separation: breaking up involves developmental
transitions and persona transitions; breaking away to find our own voice and
identity apart from others; death of the old self.

2. Breaking Down/Liminality: involves disillusionment due to setups and
letdowns; frame of reference lost; liminal (neither here nor there), however,
potential for an experience of rebirth.

3. Breaking Through/Rites of Reincorporation: transformation; growing level
of awareness; life changing experience; integration; rebirth of new self, new
way of being, forever changed by the experience.
Whether we are plumbing the depths of our own interiority or thrust into transition
through life’s circumstances, the path facilitates a reemergence with a higher level
of awareness; a tender, loving compassion for ourselves and others; presence of
being; as well as the capacity to see and experience the Divine essence within
ourselves, others and all things. When we are able to do this, we enter into what the
twentieth century philosopher Martin Buber (1970) describes as an authentic I-
Thou encounter with another and this is how we as clinicians can truly become an
authentic presence at the bedside of the dying.
Buber (1970) explains that: “When one says Thou, the I of the word pair I-Thou is
said too” (p. 54). He defines the I-Thou relation as an unmediated, direct encounter
with another as opposed to an I-It relation which is an experience of the other.
When we experience the other in an I-It relationship; the experience is mediated;
we see them as an object and the experience is based on either our knowledge of

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them or how they may be useful to us. (Buber, 1970) In contrast, an I-Thou
encounter is relational. (Buber, 1970)
Buber (1970) emphasizes that the I-Thou encounter happens in the present
moment. He says: “The actual and fulfilled present exists only insofar as
presentness, encounter, and relation exist. Only as the Thou becomes present does
presence come into being. Insofar as a human being makes do with the things that
he experiences and uses, he lives in the past, and his moment has no presence.
Presence is not what is evanescent and passes but what confronts us, waiting and
enduring. What is essential is lived in the present” (pp. 59-64).
When speaking about the I-Thou relationship, Trappist monk and mystic, Thomas
Merton (2003) says: “We are not capable of union with one another on the deepest
level until the inner self in each one of us is sufficiently awakened to confront the
inmost spirit of the other”(pg. 22).
So how can we have an I-Thou relationship with the patient who is no longer
verbal and nearing death? Aren’t we only able to supply one half of Merton’s
requirement? Buber (1970) explains that there are three spheres of relation possible
within the I-Thou encounter; the first is via vibration with nature; the second is
through language with man/woman; the third is through spirit. (pp. 56-57)
In this framework, the I-Thou encounter between the dying patient and clinician at
the bedside enters the third sphere of relation, beyond language. Buber explains:
“Here the relation…manifests itself, it lacks but creates language. We hear no
Thou and yet feel addressed…In every sphere, through everything that becomes
present to us, we gaze toward the edge of the eternal Thou; in each we perceive a
breath of it; in every Thou we address the eternal Thou” ( Buber,1970, p.57).

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Meditation as a vehicle toward awakening and inner transformation.
Meditation, in its various forms, is key to the awakening and transformation of
one’s inner self. Dowling Singh (1998) explains: “Within each tradition, the
adoption of the practice of meditation (or contemplative prayer) not only reveals
the state of being of an expanded level of consciousness but is the path to that
revelation” (p.116).
When we as clinicians develop the capacity to access an expanded level of
consciousness, our clinical applications are delivered with a greater level of
perception. For instance, there may be a time when we are playing or singing quite
softly and a patient’s loved one begins to cry. Having a greater sense of perception
may mean supporting the loved one’s grief by playing/singing more fully in that
moment, in order to provide a sense of support, a container for their grief.
Bourgeault (2004) describes how meditation creates a bridge between the egoic
and spiritual awareness within us by “offering a consistent and reliable way of
practicing the passage from the small self to the greater Self ” (p.82) through non-
attachment to whatever arises during the meditation period.
When there is non-attachment to whatever arises within the vigil setting, we are
more able to respond to the immediacy of the moment. We let go of needing the
moment to be any different than it is.
“Research into altered states of consciousness related to and occurring naturally in
intensive meditation consistently indicates profound cognitive-perceptual and
affective changes indicative of transformation in the person’s being” (Wilber, et
al., 1986, pp 161-218).

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With consistent and intentional practice we can eventually bring this higher level
of awareness into the vigil and into our daily lives.
One can practice moving through the various levels of awareness through daily
meditation. Michael Washburn (1995) describes the three stages of meditation
which are strikingly similar to the growth models mentioned earlier:
First, meditation applies a break to the ego’s ongoing activities, thus
bringing those activities into clear focus and exposing to view elements of
experience that those activities otherwise obscure. Second, meditation
progressively disengages layers of the embedded unconscious, thus throwing
those layers into relief and eventually unscreening or derepressing the
corresponding elements of the personal submerged unconscious. And, third,
meditation progressively loosens primal repression, thus drawing attention to
that deep psychosomatic structure and preparing the way of a return of the
submerged prepersonal unconscious (pp.159-160).
Meditation provides the gateway not only for the clinician’s inner transformation
but also for the patient-clinician encounter to be transformed into an I-Thou
encounter. As Buber (1970) pointed out, an I-Thou encounter is entered into
through the present moment. One can enter the present moment through
mindfulness and breath awareness, capacities that can be cultivated through the
practice of meditation.
Mindfulness
“In current clinical research, mindfulness is typically defined as nonjudgmental
attention to experience in the present moment. Mindfulness is typically cultivated
in formal meditation practices, such as sitting meditation, walking meditation, or
mindful movements” (Kabat-Zinn, 1990, as cited in Holzel et al., 2011).

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Being more mindful within the vigil setting intensifies the clinician’s ability to
compassionately serve the needs of the dying patient as well as their loved ones, at
the deepest level. With the intention to relieve physical pain and/or interior
suffering, and to foster an environment of peace and healing, we pay attention
without judgement to what is happening in the moment for that particular patient,
and their loved ones, at that particular time.
Research shows that “intentionally paying attention with a nonjudgmental attitude
leads to a significant change in perspective, a so-called decentering (Fresco et al.,
2007 as cited in Holzel et al., 2011 ) or re-perceiving” (Holzel et al.,).

Decentering is defined as “the process of seeing thoughts or feelings as objective
events in the mind rather than personally identifying with them” (Hayes-Skelton et
al., 2013).

Thus, entering the present moment through mindfulness allows the clinician to
objectively observe both internal and external stimuli such as emotions, sounds,
and family dynamics, as well as the subtly changing physiological conditions of
the patient: agitation, state of wakefulness, level of consciousness, etc.
Within the vigil setting the clinician must be able to shift between present moment
awareness which enables one to do many of the things mentioned above, and
narrative awareness which enables one “to understand the patient’s story and
conduct clinical reasoning” (Back et al., 2009).
Research indicates that we have “an automatic tendency to engage in narrative
processes in the absence of a strong requirement to respond to external stimuli”
(McKiernan et al., 2006 as cited in Farb et al., 2007).

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In other words, narrative awareness could be considered our ‘default mode’ of
awareness (Gusnard et al., 2001; Raichles et al., 2001 as cited in Farb et al., 2007).
Without the attentional training found in contemplative practices such as
mindfulness meditation “we are often unable to remove ourselves from the
narrative chatter of our busy minds and distinguish ongoing story narration…from
immediate experience of the present moment” (Siegel 2007). If we are unable to do
so, we are limiting the efficacy of our clinical applications at the bedside.

The results of a study by Farb et al., (2007) found that present moment awareness
activates different parts of the brain than does narrative awareness.
Functional magnetic resonance imaging (fMRI) was used to examine narrative
awareness and present moment awareness in both novice participants and those
with mindfulness mediation training (Farb et al., 2007).

When the participants were engaged in the narrative awareness exercise, the
medial prefrontal cortex (mPFC), responsible for learning “associations between
context, locations, events and corresponding adaptive responses, particularly
emotional responses” (Euston D.R., et al., 2012) was engaged.

When the participants were asked to focus on present moment awareness, the
novices had a slight reduction in the engagement of the mPFC while the
participants trained in mindfulness had more extensive reduction in the mPFC, as
well as increased engagement in the right lateralized network (Farb et al., 2007)
responsible for “visuospatial attentional abilities” (Gotts et al.,2013).

Functional connectivity analyses further demonstrated a strong coupling
between the right insula and the medial prefrontal cortex (mPFC) in novices

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that was uncoupled in the mindfulness group. These results suggest a
fundamental neural dissociation between two distinct forms of self-
awareness that are habitually integrated but can be dissociated through
attentional training: the self across time and in the present moment (Farb, et
al., 2007).

Daniel J. Siegel, (2007) director of Mindsight institute, UCLA, explains: “The
ability to differentiate previously coupled and automatic elements of the mind
enables these components of information flow to be linked in new combinations.
The overall process of linkage of now differentiated elements is the formal
definition of the term, integration.”

This means that through an attentional practice such as mindfulness meditation one
is able to disengage from previous habitual ways of thinking, (i.e. like ones that
cause suffering), and instead engage in alternative ways of thinking that may
enhance one’s over-all wellbeing (Siegel, 2007).

Siegel (2007) explains: “This shift in the focus of attention the way we use the
mind to channel the flow of energy and information through the various circuits of
the brain changes the pattern of activity in the brain. With repetition, such
mindful practice can create intentional states of brain activation that may
ultimately become traits of the individual.”

For example, by choosing to engage in a mindful, regular, intentional practice of
loving-kindness meditation or compassion mediation, one is “oriented toward
enhancing unconditional, positive emotional states of kindness and compassion”
(Hofmann et al., 2011), within themselves and toward others.

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We have examined how mindfulness can mediate one’s entrance into the present
moment, literally changing who we are and what we perceive. Now let’s take a
look at how breath awareness provides yet another portal into an expanded
awareness of the world around us.

Breath Awareness

Breath awareness can bring us into the present moment immediately, whether it be
our own breath or that of the patient.

When I asked Kathleen Lahiff, (2015) certified Music-thanatologist and Swami at
the Temple of Kria Yoga in Chicago, to describe the role that meditation plays in
the contemplative dimension of our work at the bedside she particularly
highlighted the importance of breath awareness.
Meditation trains one to turn their awareness inward, to study consciousness.
One learns to observe the activities of the body and mind and gradually,
through whatever method they are using, experience various levels of
stillness. Many meditation practices work with awareness of one’s breath. A
practitioner becomes intimate with the movement and stillness of the breath.
Cultivating awareness of our own breath is useful in learning to be present
with the patient’s breath. When we are present and focused on the patient’s
breath during a vigil, the vigil becomes a meditation (Lahiff, 2015).
Many years ago I experienced firsthand how the act of being present to my
mother’s breath, in the final days of her life, became a meditation. As I began to

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synchronize my breath with hers, we were, as Hildegard of Bingen says,
“breathing in and breathing out the one breath of the Universe” (Nepo, 2012).
Poet Mark Nepo (2012) posits that Hildegard “speaks to an immersion of attention
that all the traditions aspire to; each claiming in its own way that peace resides in
this completeness which arises when our individual sense of being merges with the
ongoing stream of being that is the heartbeat of the Universe” (p.19).
We as music-thanatologist’s are continually called to merge our own sense of
being, and our prescriptive deliveries, with the ongoing stream of being that is the
heartbeat of both the patient and the Universe. “With single-pointed attention,
mindfulness of the breath, it is possible to have direct connection with the Ground
of Being. Breath, the act of breathing, is one of the points of intersection between
the world of form and the world of the formless” (Dowling Singh, 1998, pg.148).

Resistance to inner transformation via perserevative cognition
If the contemplative practices of mindfulness, breath awareness, and silence all
found within meditation are such powerful vehicles toward inner transformation,
why do we as a society, even we as contemplative clinicians, at times seem to
resist it so much? Perhaps it is the anticipatory stress of not wanting to die, even if
only for the period of our meditation practice.
Ken Wilber (1993) captures just how similar the mediation practice and dying
process are when he says: “Ultimately, a person in meditation…must face having
no recourse, no way out, no way forward or backward, he is reduced to the
simplicity of the moment…His boundaries collapse and, as St. Augustine put it,

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‘he arrives at That Which Is’” (Wilber, 1993, as cited in Dowling Singh 1998,
p.117).
Whether one earnestly desires or greatly fears the inner transformation made
possible through the practice of mediation, feelings of anticipatory stress at the
thought of engaging in the process are not uncommon. The process involves
moving our egoic consciousness and resting in silence, both of which can feel an
awful lot like a death to the ego.
Research suggests that anticipatory stress, worry and rumination are the
manifestations of perseverative cognition and that “perseverative cognition might
act directly on somatic disease via enhanced activation via cardiovascular,
immune, endocrine, and neurovisceral system” (Brosschot et al,. 2006, p.113).
For instance, a dying patient who is processing the news of their impending death
may experience a great deal of interior suffering related to perseverative cognition,
as they find themselves repeatedly anticipating and worrying, perhaps about their
physical demise, regret over unfinished business, what awaits them after death, etc.
The research (Brosschot et al., 2006) suggests that as a result of a patient engaging
in perseverative cognition the clinician may note their enhanced cardiovascular
activity during a vigil, possibly manifesting in shortness of breath or a quickening
pulse.
Family members, who are often the patient’s caregivers, may experience
manifestations of perseverative cognition while dealing with their loved one’s
terminal diagnosis and may suffer from various somatic diseases that may affect
their cardiovascular, immune, endocrine, and neurovisceral systems” (Brosschot et
al., 2006, p.113).

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Interestingly, the path to overcoming one’s perseverative cognitive activities is
through the practice of mindfulness meditation. “There is evidence that
mindfulness helps develop effective emotion regulation in the brain” (Corcoran et
al., 2010; Farb et al., 2010; Siegel, 2007b as cited in Davis et al., 2011).

“In terms of proposed mechanisms of change, Corcoran et al., (2010, as cited in
Davis et al, 2011) theorize that mindfulness meditation promotes metacognitive
awareness, decreases rumination via disengagement from perseverative cognitive
activities, and enhances attentional capacities through gains in working memory;
these cognitive gains, in turn contribute to effective emotion regulation strategies”
(pp.199-200).

Intriguing research by Bernardi et al., (2006) indicates that music may achieve the
same effect as other relaxation techniques and contemplative practices such as
mindfulness meditation through the alternation of sound and silence. We will
explore the research findings in the following section. It is often said that “all roads
lead to Rome.” I would propose that when speaking of one’s inner transformation
or awakening all roads lead to silence.

Silence
The music the clinician delivers at the bedside comes, “most deeply, from the
practice of silence…stilling the inner tumult, …listening deeply to a voice much
more important than the relentless and limited voice of our personality…Listening
into the beyond” (Schroeder-Sheker 2003, as cited in Horrigan, 2003, p.74).

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The prophet Elisha did not hear the voice of God in the strong wind, the
earthquake or the fire, but instead in the silence (New Jerusalem Bible 1 Kings
19:11-13). As clinicians, our ability to revere that “still small voice” at the bedside
depends upon the depth of our own interiority.
By engaging in the contemplative practices of metanoia, meditation, mindfulness
and breath awareness mentioned previously, as well as other contemplative
practices such as yoga, tai chi, and more, one is fostering silence on many levels.
Silence nurtures the clinician’s ongoing inner transformation in that it allows, as
Dowling Singh (1998) says, “the slowing and eventually the cessation of the
internal dialogue that maintains the structure of the mental ego. … It increases the
possibility that we will recognize that the boundaries we have drawn between self
and others, self and the environment, are illusory. … By facilitating our entry into
the immediacy of existential awareness, silence nurtures presence and the
immediate prehension of experience” (pp.143-144).
In other words, we could say that the purpose of the clinician’s ongoing inner
transformation through the various contemplative practices is ultimately to enter
silence; because it is silence that nurtures the listening Presence that facilitates the
clinician’s ability to respond authentically and from the very depths of one’s being,
to the needs of the patient who is dying.
Silence within the music is a paradox that we are called to embrace at the bedside.
The contemplative mind or non-dual mind is at home with paradox. Richard Rohr
(2015) defines contemplation as “a long, loving look at what really is” (p.88), and
that this look is capable of holding paradox because it is without judgement.
Research indicates the potential health benefits that a pause or silence in the music
can have on inducing relaxation and reducing sympathetic activity.

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Even short exposure to music can induce measurable and reproducible
cardiovascular and respiratory effects, leading to a condition of arousal or
focused attention that is proportional to the speed of the music and that may
be induced or amplified by respiratory entrainment by the music’s rhythm
and speed. A pause in the music induces a condition of relaxation greater
than that preceding the exposure to music and leads to the speculation that
music may give pleasure (and perhaps a health benefit) as a result of this
controlled alternation between arousal and relaxation (Bernardi et al., 2006).
Tony Pederson CM-Th, (2015) writes about the importance of creating
space/silence within and around the music being delivered at the bedside. He
found that after 20 years at the bedside of dying “one of the most unexpected
lessons came from the music itself.” He has noted that the level of peace,
tranquility and relaxation within the vigil setting is “directly related to the space,”
within and around the music. He speaks of the space that exists between notes,
between phrases, at the ends of phrases, and between the themes; different in
duration yet all important.
During the longer pauses or periods of silence, for example between themes, he
notes more visible changes. The pause/silence, he says, “is a time to process what
has just happened; the music is still going on in our heads, and yet in the silence
we are released from the structure of the music. There is a freedom that people find
in this pausing. This is when I see breaths deepen and shoulders relax and tension
drain out of foreheads. On good days, I have the awareness that half of what I do is
not play” (Midwest Palliative and Hospice CareCenter Blog).
The research shows that even during the shorter pauses within the music
reproducible cardiovascular and respiratory effects can be measured. The very

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nature of the music vigil is an alternation between arousal and relaxation through
the alternation between music and silence. These findings further prove the
importance of making room for silence, so the patient may experience ever deeper
levels of relaxation and peace within the music and within the vigil.
The research also indicates that music may achieve the same effect as other
relaxation techniques and contemplative practices, “by alternating faster and
slower rhythms or pauses, or simply after its cessation” (Bernardi et al,. 2006).
This is due to the fact that many of these practices require one’s attention or
awareness to the moment, breath, body, pose, etc., eventually followed by a release
of that focus, which often times causes a deeper levels of relaxation.
The implications of this research for our work are significant especially when
viewed from a contemplative perspective. This means that the patient whose body
and mind are weakened from the dying process may obtain the same level of
relaxation, healing and peace through the vehicle of music, via our prescriptive
deliveries, that one typically obtains through a relaxation technique or a
contemplative practice.
When the patient experiences a deeper level of relaxation they are better able to
access their own interior processes. They are able to rest in silence that is pregnant
with possibility and mystery. Silence, or stillness becomes the pathway home to
one’s inner being…to Being itself.
Quantifiable differences in respiration and heart rate may not always be apparent
during or even at the end of a vigil, after the alternation between one’s musical
deliveries and silence. Sometimes the patient’s shift in respiration and heart rate
takes place in silence over a longer span of time.

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The following narrative demonstrates how one patient gradually made his transitus
into ultimate silence over the course of a few hour period, consisting of three
consecutive vigils. The narrative also demonstrates how our ongoing inner
transformation, in this case my own, made it possible to listen and revere that “still
small voice” which called me back to the bedside repeatedly. I experienced
firsthand how “silence nurtures presence and the immediate prehension of
experience” (Dowling Singh, p.143-144), both of which made it possible for me
enter into a genuine “I-Thou” relationship with the patient.
A few months back, I played a vigil for Mr. D., who was actively dying. I could
hear his congested, stentorian inhalations from the hallway as I approached his
room. Upon entering, I found that he was alone. His eyes were open yet unfocused.
Fine, snow white hair framed his regal face. When I approached his bedside to
greet him, he was unresponsive. His pulse was irregular at 60 bpm and his
respirations were 18 bpm. With his mouth open, his brow un-furrowed and no
other signs of agitation, he appeared to be resting peacefully.
I alternated between music and silence throughout the vigil paying close attention
to his breath, but noticed no discernable difference in his vital signs, by the end of
the vigil.
On this particular day, I had decided to remain at the hospital a while longer in
order to do my charting as well as attend to Mr. D. I returned to Mr. D’s room,
without my harp, about a half hour after the end of the vigil. His respirations were
now at 16 bpm and his forehead, which earlier had been feverishly warm, had
cooled considerably and was clammy. I stroked his hair and softly sang to him,
pacing the melody to his breaths. I eventually exited and headed toward the
nursing station.

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It was ten minutes later that I returned for a third time. He was barely breathing
now and his pulse was no longer palpable. I called the nurse and then proceeded to
sing to him one more time, as I gently caressed his hair. During the silence that
immediately followed, Mr. D. breathed his final breath while I held his hand in
mine.
Over the course of the three musical deliveries Mr. D demonstrated deeper levels
of relaxation and unbinding, within the periods of silence. Notable differences in
his heart rate and respiration were not evident immediately following the first two
deliveries, but happened while he was alone in silence. Silence appeared to be his
bridge homeward.

Concluding thoughts
How can we truly be an authentic, compassionate presence at the bedside of the
dying if we are not willing to die while we are still living? Can we recognize that
our path toward inner transformation is the same path of inner transformation that
the dying patient is on, and that the goal is ultimately the same?

As Dowling Singh (1998) puts it: “The reality of mortality, whether it be the death
of the physical body or the dismantling of the identity structure of the mental ego,
evokes transformation in priorities, needs, dreams, and cherished illusions. The
unlearning, the stilling, the emptying of both dying and meditation allow us to
remerge with the Ground of Being from which we have emerged” (p.124).

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“We shall not cease from exploration,
And the end of all our exploring,
Will be to arrive where we started,
And know the place for the first time.” – T.S. Eliot

And thus, through the continual exploration of our own interiority, we truly
become an authentic, compassionate presence at the bedside of the dying as we
travel with them, accompany them, bear with them, attentive to the dynamism of
their being as well as our own, for that moment in time during the vigil, on this
journey of transformation.

THE CONTEMPLATIVE DIMENSION OF MUSIC-THANATOLOGY 22

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THE CONTEMPLATIVE DIMENSION OF MUSIC-THANATOLOGY 30

ACKNOWLEDG EMENTS
I would like to express my sincere gratitude to my research paper advisors, and
clinical internship mentors Tony Pederson CM-Th, and Margaret Pasquesi CM-Th.
Without their generous support, guidance, insight and encouragement this paper
would not have been completed.
I am also indebted to Mary Werner for generously volunteering to be my
educational advisor; Judy Fay for generously volunteering to assist Mary in
verifying my educational documentation.
A special thanks to Kathleen Lahiff CM-Th, for agreeing to be interviewed for this
research paper, as well as all the moral support she has offered to me during the
process.
I would also like to thank the MTAI certification team, Elizabeth Markell, Beatrice
Rose and Raya Partenheimer, for kindly volunteering their time to consider me for
certification.
And finally, I would like to express my sincere gratitude for all that I learned from
the founder of the field of music-thanatology, Therese Schroeder-Sheker.

2015 Terese Cullen – Contemplative Dimension of Music-Thanatology.pdf

2015 Terese Cullen – Contemplative Dimension of Music-Thanatology.pdf

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About the Author: Romeo Montague