By Brittany Edelmann
One evening in the beginning of May 2021, birds chirped along with the sounds of a piano and voices outside of a hospice facility in Texas. A small group of about seven people finally met in person after four months of meeting weekly on Zoom during the COVID-19 pandemic. They gathered in a circle, wearing masks, and sang songs such as “Here Comes the Sun” and “Keep Me in Your Heart.” The songs became part of their repertoire because they reminded members of a person they lost, in hopes of ultimately helping with the grieving process. These individuals were part of what is known as a grief choir.
Allison Burns joined this virtual grief choir after losing her father to congestive heart failure about six months prior. Burns said singing by herself while on Zoom was “kind of strange,” but coming together in that moment, in person, to sing the songs they worked on each week, provoked tears and was “really cathartic,” “therapeutic” and “unworldly.”
Burns’ father is just one of the estimated 650,000 people who die from heart disease each year, according to the Centers for Disease Control and Prevention. COVID-19 deaths have surpassed 1 million in the United States. While there are different ways death takes people from the world, death is one thing all have in common. Yet, everyone copes differently.
The National Cancer Institute reports there are many different types of grief, different factors that can affect grief and different treatments. For example, some people who lose a loved one may experience complicated grief, or grief that lasts longer than normal and causes extreme distress, while others may not be affected as much. The NCI states some studies have even shown personality can play a role and be the reason someone has “long-lasting depression after a loss.”
“Grief is not a linear process,” music therapist Anne Wilkerson said. Music therapists are trained professionals who incorporate therapeutic techniques with music in different ways. Wilkerson said she loved how her identity as a musician perfectly lined up with her interest in therapeutic processes and psychology, which led her to pursue this career. Wilkerson worked in North Carolina with Lauren DiMaio, another music therapist.
After being promoted to head of the bereavement department at the hospice facility she worked at, DiMaio wondered, “How do people musically grieve?”, particularly because the voice gives so many indicators of how someone is feeling. She said she can hear it when people are crying and how they communicate with others.
Wilkerson was also interested in using the voice within a group setting with bereaved individuals because of how closely the voice is “connected to our emotions and our identities.”
“The voice is as unique as a set of fingerprints. No two people have the same voice,” Wilkerson said.
So, 10 years ago, the grief choir was born. DiMaio and Wilkerson brought people together once a week for three years. They hoped people would discover their voices and their identities in the grief process, while also feeling the support of other people going through something similar.
How does a grief choir work? Participants in the choir are given the option to choose a song that reminds them of the person they lost. The group also uses songwriting to come up with their own verses. They practice the songs weekly, and then they join to perform them. And it isn’t required that members have a background in music. For those who are unsure or don’t know how to read music, DiMaio and Wilkerson mentor them so that anyone can join. Verbal check-ins at the beginning of the sessions are also a part of it.
DiMaio also found “grievers often don’t take care of themselves,” which led her to teach them how to take care of themselves through their voices and doing vocal warmups. She said this helps remind them “they’re important.” The National Institute on Aging reports people who are grieving can have trouble sleeping, little interest in food, problems with concentration and a hard time making decisions.
Wilkerson described one participant (whose name is being kept confidential due to privacy) who lost her husband and was in the very early stages of grief. The first stage is confronting the loss, and this participant was stuck there. She didn’t read music, so joining the grief choir “was a courageous leap for her,” Wilkerson said. Her voice remained “very soft, very breathy,” and “sometimes she couldn’t sing without getting tearful.” Over time, her voice got stronger, and she became more confident. Finally, she sang a song by herself with the rest of the group’s support. Wilkerson mentioned how amazing it was to see how this woman’s “musicality expressed itself as she went back and forth between stages of grief,” ultimately finding a “new identity” through her voice.
Unlike other members who joined the virtual version of the grief choir in 2021 because they lost somebody more recently, Leslie Childs hadn’t. Her most recent loss was her sister-in-law, who died three years prior. The retired 69-year-old heard about the choir at the hospice facility she volunteered at and still decided to join.
Later in the process, Childs realized singing some of the songs made her think of her dad, who died when she was about 14 years old. She said she was in school and distracted by friends at the time.
“I think it was very hard for me, but the grieving process probably goes on your whole life.” Childs said.
After joining and participating, she became aware of underlying emotions she never really expressed or even recognized after her father passed. The choir “pulled” this grief and the emotions from within, allowing her to become “cognizant” of them, Childs said.
“It came full circle after all,” Childs said. Childs’ father was a musician and always wanted her to follow in his footsteps. While she took singing lessons as a young child, nothing really came of it. Childs suddenly wanted to sing more and ended up taking lessons with one of the graduate music therapy students. This evoked even more emotion, and she found herself tearing up while singing the song she chose, “If it’s Tuesday, This Must Be Belgium.”
It’s no surprise that DiMaio believed in the healing power of music. She became a music therapist herself and worked with end-of-life patients. A few years after starting the grief choir, she wanted to look further into the role of music in grief. This 2017 study revealed 94% of 141 adult respondents “intentionally used music during their grief journey.” So, for DeMaio, the grief choir just made sense.
There are traditional verbal therapy groups, which DiMaio said are the “standard care in most bereavement departments” and are usually run by social workers or licensed professional counselors. They “use verbal techniques to help educate people about grief and help them find insights” and “coping strategies through words,” DiMaio said. When it comes to loss, DiMaio wanted to see how the use of music and specifically the grief choir compared with traditional verbal therapy.
The results she documented showed the grief choir to be as effective as the verbal grief group. She also wanted to see the long-term effects of the choir after about six years later, so she conducted in-depth interviews with participants.
One person she interviewed — a woman who originally moved to the mountains of North Carolina without any friends — talked about her isolation and grief soon after the move when her husband died. She joined the grief choir without any prior music background and would travel by bus each week to attend the sessions. Through the grief choir, she was “really able to find herself,” and when she moved to Costa Rica, one of the first things she did was join a choir, DiMaio said.
“So that’s like an example of, because of this, she found a new part of herself,” DiMaio said, which she mentions is a common theme through all grief theories. “You’re having to find your new normal. So, her new normal included being musical.”
“We are all musical,” Wilkerson said. “I mean, our heartbeats. Our cells vibrate. The rhythm of our breathing. I mean we are all musical creatures. We’re wired for music.”
Brittany Edelmann is a registered nurse and health and science reporter. Follow her on twitter @brittedelmann