The Schubert dressing – an innovative experience from France

In this new series, The Arts in Palliative Care, we look at how the arts in palliative care settings can be a powerful and effective way of addressing the practical, psychological, social and spiritual issues that face people at the end of their lives.

Today, Claire Oppert, Cellist and Art Therapist, Unité douleur chronique et soins palliatifs, CHU Sainte Perine, Paris, France, explains how music can help to relieve patients’ anxiety and pain during painful procedures.

Having trained in three different disciplines, I entered the field of palliative care in 2011 wearing three hats: as a cellist (Moscow Conservatoire), a philosopher (a Masters at the Sorbonne, Paris) and an art therapist (Faculté de médecine de Tours – University of Tours medical school). After much experience with autistic patients and those with dementia, the focus of my research is now on end-of-life patients.

Claire with a patient at the CHU Ste Perine, Paris. Photo courtesy of RTS (Radio Télévision Suisse).

The name, ‘Schubert dressing’, was inspired by an impromptu music session with an 84-year-old patient. The lady was in intense pain during her treatment but found enormous relief as she listened to me playing the slow movement of Schubert’s 2nd trio on my cello. This creative experiment led to an open, prospective, non-randomised comparative study conducted over four years which included 107 painful care procedures, such as complex dressings, bed baths and hair washing, intra-venous and intra-catheter insertions, difficulties in moving patients, or therapeutic baths.

Using a validated pain scale, nurses assessed communication and pain during care sessions on alternate days: one with a cello accompaniment and one without. Pain relief was evaluated at 10 to 50 per cent following a ‘Schubert dressing’ session, demonstrating its effectiveness as a non-medical analgesic.

In spite of methodological difficulties, we find that the emotional impact of the music is beneficial to both the patient and the carer who provides the treatment. Bringing the patient and carer into contact with Art through music relieves the patient’s anxiety and improves the carer’s psychological wellbeing too.

To develop my understanding of patients’ experiences during music therapy sessions, I did a retrospective, exploratory and qualitative study based on methodical analysis of the words uttered by 250 patients.

This analysis reveals through a growing acceptance of ‘beauty’, true symptom relief with genuine sensory satisfaction expressed. Despite the complexity of the patient’s experiences, an ‘existential renewal’, of what is referred to as the patient’s ‘deep core’, appears in many of the words spoken. During this shared musical pause, patients also describe a unifying movement in time and a possible revival in their family relations. This embodied experience, mediated by music and the human encounter, appears also as a yearning for transcendence.

Links and Resources

• Contact Claire by email.
• Video clips:
  RTS – Un violoncelle pour soulager la douleur.
  France 5 – Le Magazine de la santé : La musique pour apaiser la douleur.
• Article about what patients say during music therapy sessions.
• Read the abstracts of three posters presented by Claire at the 15^th EAPC World Congress 2017 in the EAPC 2017 Book of Abstracts
• What patients say during music therapy sessions: an exploratory study.
• An art-therapy experience: stimulation of residual capacities in patients with dementia.
• THE SCHUBERT DRESSING: Musical counter-stimulation and its impact on painful care procedures in palliative care.

Read more posts in the Arts and Palliative Care series on the EAPC Blog.