A gently played harp can create an ethereal atmosphere in any setting, even one charged with the earthly task of caring for the seriously ill and dying. But the idea that this ancient biblical instrument could have a true healing effect was, until recently, a hard pill for the medical world to swallow.

That’s changing, however, as studies document how music — and especially the harp — can have powerful physiological effects. As facilities open their doors to therapeutic music, harpists are finding abundant opportunities to bring the gospel to the afflicted through live playing.

“For me, the therapeutic music is a ministry,” said Susan Page Howland, a member of Holy Trinity Church in Southbridge, Massachusetts, and a champion harpist in her teenage years. “When I’m sitting there with a person, I’m live as the face of Jesus to them.”

Howland, a retired nurse turned therapeutic musician, has experienced how the harp’s sounds can transform a dementia unit of a long-term care facility. One resident who almost never speaks was liberated. When Howland played in a dining room, the woman spoke and made sense for nearly an hour. Another time, a Holy Trinity parishioner was near death and struggling to breathe until Howland arrived and began to play one of her favorite hymns, “All Through the Night.” Before the song ended, she breathed her last, as people near death often do upon hearing a harp.

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That the harp could have such dramatic effects would come as no surprise to figures in the Bible. Saul, Israel’s first king, turned to the young shepherd David to help ease his inner torment.

“Whenever the evil spirit from God bothered Saul, David would play his harp,” reads 1 Samuel 16:23. “Saul would relax and feel better, and the evil spirit would go away.”

Now research is helping institutions grow comfortable with deploying the same instrument that worked for Saul more than 3,000 years ago. A study published in the May 2015 Journal of Pain and Symptom Management compared symptoms in two inpatient groups: one that heard no music during the first 24 hours of hospitalization and another that heard 30 to 40 minutes of live harp. Thirty to 50 percent of patients showed “significant improvement” in five symptoms — fatigue, anxiety, sadness, relaxation, and pain — after therapeutic harp treatment.

“The magnitude of effect of the results is striking and incontrovertible,” wrote the team of researchers at three medical centers. “The intervention had profound impact on virtually every aspect of patient [quality of life] examined.”

Harp is not the only instrument conferring benefits on institutionalized populations. An International Journal of Nursing survey of peer-reviewed studies found that music therapy using various instruments helps decrease pain and anxiety. It also regulates blood pressure, as well as cardiac and respiratory frequencies. Using music is so effective that it allows providers to use fewer drugs for sedation and pain management, the IJN survey found.

Institutions are responding by welcoming trained music therapists and therapeutic musicians (distinctions are based on differences in training). In 2015, more than 42,000 facilities offered music therapy, according to the latest American Music Therapy Association survey. For therapeutic musicians, opportunities come most often in hospitals, hospice, and long-term care facilities, according to survey data from the National Standards Board for Therapeutic Musicians.

In these settings and others, some take immediately to the harp. That can be because its open structure and long strings provide deeply resonant, soothing sounds, according to Joy Berger, an ordained Alliance of Baptists minister and a music therapist who educates families on hospice-related issues.

But others want no part of an instrument commonly associated with angels, heaven, and the Book of Revelation.

“I have heard families and patients say, I don’t want that,” said Berger, author of Music of the Soul: Composing Life Out of Loss. “They say, I woke up and I was afraid that I was dying and I was going to heaven! That’s just the meaning that’s been associated with it.”

Where the harp is welcome, ministry opportunities are beckoning the faithful. Harpists who have long played in worship services are now grabbing their travel cases and going to those who are, in many cases, suffering under the weight of unabating ailments.

“These are the individuals interested in using music to assist others,” said Nancy O’Brien, a harpist and sales representative at Lyon & Healy Harps and Salvi Harps in Chicago, via email.

O’Brien has seen interest in the harp grow steadily in her 13 years at Lyon & Healy. While parents sometimes buy larger pedal harps for their aspiring children, most who buy the more portable lever harps and attend lever harp festivals are adults, she said. Their goal is often to bring comfort to the institutionalized and homebound.

“They have experienced at this point in life events they would like to help others get through,” she said, “and they are very convinced that music plays an important role … harp being primary.”

That’s the case for Lisa Rhea, a harpist who plays often at All Saints Church in Smyrna, Tennessee, where her husband Robert serves as vicar. (The same congregation inspired the film All Saints.) Her lever harp with multi-colored strings is portable enough that she brought it to a Panera Bread Bakery in Hermitage, Tennessee for a TLC interview. When she plays, the soft notes blend easily with the relaxed atmosphere and smell of baking bread.

Each week, Rhea carries her harp to Alive Hospice in Nashville. There she confers with staffers on where she can do the most good that day, whether with a particular resident or in a common area. Then she sets up, reads the situation, and begins to seek a connection through her music.

“I’m not coming in to entertain,” Rhea said. “I’m coming into that room to create an environment with whatever I select as I watch that patient. What is going to comfort that patient? What is going on with the family in that room? What would bring peace to them?”

Rhea believes the harp’s vibrations have a soothing effect that goes beyond anything recorded music can achieve in a therapeutic setting. What she plays depends on her audience. Those who suffer from Alzheimer’s disease ideally hear music from earlier times of life, which helps them relax and remember. Non-acute cases hear contemporary or pop tunes. But those near death hear something different: unfamiliar, less rhythmic pieces, including high notes peppered with pauses.

“They’re arrhythmic because you’re going out of rhythm,” she said, referring to patients near death. “I might wait for you to take a breath and then just give you a tone to help support that breath.”

Rhea’s passion for this ministry is fueled by the results she sees. She knows from research that her music helps alleviate pain by filling neural pathways that would otherwise be carrying pain messages to the brain. The relief from pain and agitation sometimes lasts for hours or even days after the music has ended, she said.

“Once you can block the pain, the body can relax, the tension can ease,” Rhea said. “That allows them to sleep and allows them to rest. … We create a healing environment. It’s how the music makes you feel and where it takes you that is most important.”

Because harp-playing is so powerful among those at tender stages of life, the question of how to use it ethically is a matter of discussion and debate. Experts and trained musicians do not always agree on what constitutes proper goals and methods.

Among the questions is what a musician is there to do, especially when a person is near death.

“Think of it as a spiritual midwife,” Howland said. “You’re ushering the person out. You’re really helping them leave. You don’t want to play anything that’s going to ground them here, so you don’t want to play anything familiar, rhythmic, or energizing.”

But Berger challenges the idea that the familiar should be avoided or that the patient ought to be ushered out. Being present is enough, she said. Using music to influence a person’s dying — especially for someone who’s unable to express preferences — can become manipulative and unethical, in her view.

“Someone may need to be on a little bit longer — who am I to judge?” Berger said. “It gets back to who is deciding. Who knows whether that person is even aware at that point? Am I to give that person a bit of insecurity?”

For Rhea, a poignant moment comes when she returns to hospice and sees the list naming those who have died since her last visit. She recalls what she played for each of them and hopes it was helpful.

“I always kind of hope that in a way that I brought some peace and some comfort to that process of letting go,” Rhea said. “It’s an honor.”

G. Jeffrey MacDonald

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