Episode 09: Music and Trauma Informed Care (with Lindsy Burns, MMT, MT-BC, CCTS-I)

Podcast
Written By Marisa de Leon, MS, MT-BC

In this episode of Musical Mindspace, we dive into the powerful intersection of music and trauma-informed care. Music has long been recognized as a tool for healing, but how can we use it responsibly and effectively within a trauma-informed framework? Tune into our conversation with Linsdy Burns - a certified trauma specialist, music therapist, MARI practitioner and clinical counselor - as she shares insights on how music can support emotional regulation, build resilience, and promote healing in individuals who have experienced trauma. We explore the principles of trauma-informed care, discuss practical ways to incorporate music into therapeutic settings, and hear stories of how sound and rhythm can create safe spaces for healing.

Content warning: This episode discusses trauma, the various types of traumatic experiences, and its impact on mental health. Please be advised that some content may be activating for listeners.

About Lindsy Burns

Lindsy Burns (she/her/hers) is a masters level trained and board certified music therapist, certified clinical trauma specialist, MARI practitioner and clinical counselor that has trained and worked on Lenape Land, currently referred to as Philadelphia, for the past 10 years. Lindsy specializes in providing a trauma-informed and anti-oppressive approach to the experiential therapy experiences and interventions she offers both in her full time role at an inpatient psychiatric hospital and in the community with her solo practice Linden Tree Expressive Therapies.

Episode Resources

Transcript

This transcript was computer generated and might contain errors.

Marisa: Hello everyone and welcome back to Musical Mindspace. It’s been a minute - actually it’s been a year almost - since I’ve released an episode of this podcast so thank you so much if you are tuning in again after all this time. I appreciate you coming back to listen again with us. If you’re new to this podcast - welcome. Thank you for being here. 

This podcast has been a such a source of inspiration for me, especially looking back on the first eight episodes which I guess now we can consider those season one kind of in the grand timeline of things. And I’m just so grateful to have the opportunity to listen to others talk about their work in music therapy and how working in their niche areas of the field has impacted their lives and their work in many ways. It’s been amazing to look back at those episodes now and be able to plan and talk to new guests and I’m just really excited to start releasing some of these new episodes for you all. 

So to start things up again, I decided to invite one of my close friends - Lindsy to join us and speak about her work in music therapy and with individuals who have experienced trauma. Music and Trauma is something I’ve wanted to talk about on the podcast for a while and I’m glad we were able to find a time to have this conversation together. Lindsy was also someone I thought to have as a guest since I even thought about having a podcast. 

Lindsy Burns (she/hers) is a masters level trained and board certified music therapist. She’s also a certified clinical trauma specialist, MARI practitioner and clinical counselor that has trained and worked on Lenape Land, currently referred to as Philadelphia, for the past 10 years. Lindsy specializes in providing a trauma-informed and anti-oppressive approach to the experiential therapy experiences and interventions she offers both in her full time role at an inpatient psychiatric hospital and in the community with her solo practice Linden Tree Expressive Therapies.

Lindsy received her Bachelor’s degree in music therapy from Temple University before returning to complete a dual Master’s degree music therapy and clinical counseling.

I have personally taken so many classes with Lindsy at this point, many of which have become foundational to how I practice music therapy and how I think about music therapy spaces. I’ve always been so inspired when I hear about the work she is doing and by her passion to advocate for the individuals that she works with. 

I’m excited to learn more about her work in this episode and to give you a glimpse into the mind of someone I’m very grateful to be able to consider a dear friend. 

So, this is what’s on our mindspace today….this is episode 9…Music and Trauma Informed Care….

Marisa: Okay, everybody. Thanks for being here today. I am so so excited to share this episode with you. I mean, this is like a guest that I've wanted to have here forever since I started and happens to be one of my besties in music therapy. So, without further ado, welcome Lindsy Burns. Thank you for being here today.

Lindsy: Thank you for having me. I'm so excited to be here. I'm happy we were finally able to make it happen.

Marisa: Yeah, I'm excited because I feel like every time - well, for context for people that probably don't know us listening to this, we have taken a lot of classes together. We've done a lot of group supervision together. We did our Mari certifications together. I mean, we're in it. We’re in it.

*laughs*

Lindsy: *laughs*

Marisa: But every time I hear you talk about the work that you do and, like, trauma informed care and how passionate you are about the accessibility and the equality and inclusion and all the work that you do, I don't know. It's always such a big reminder for me. And so I'm just really excited for people to hear your story and hear more about the work that you're doing.

Lindsy: Thank you. Thank you for giving me the space to talk about it. I do really love talking about it and I'm grateful for a space where people want to listen. Because yeah, I feel at this point I'm always going to be learning more, which I think is so beautiful. And at this point, I feel comfortable saying like, “I have some things to say” like “I know some stuff” and I think it's important to share it. So, thank you for it.

Marisa: Yeah. No, For sure. You have so much to say and I'm just so excited to go on and on today about it. So, why don't you start by just telling everybody maybe a little bit about your background, your music therapy degrees, where you studied and the work that you're doing right now.

Lindsy: Sure, so, I identify as a white cis queer woman, a second generation American that's had access to higher education, situated fairly comfortably within a middle socioeconomic class. and I'm originally from New England, but have lived in the Philadelphia area for the past 10 years. And I initially came down this way because I wanted to pursue my first music therapy degree. I got my undergraduate at Temple University, finished in 2018, took a few years to work and then returned to Temple for my master's degree in music therapy and clinical counseling. And just finished that up in 2024.

Marisa: *cheers!

Linsy: So that's a completion.

Marisa: That's amazing. And can you tell a little bit about where you're working right now? The setting that you're in as a music therapist.

Lindsy: Currently my primary role is, I work full-time at an inpatient psychiatric hospital in Philadelphia. We have mostly acute psychiatric units but we also have something called an extended acute unit program. And that is kind of a different level of care part of it you can kind of discern from the name. It's intended for people that need a more extended length of hospitalization. But because of the specific type of programming it is and how it's built through insurance and all that, it's kind of set aside differently than the acute units. And our hospital has two-thirds of those types of beds in the entire city of Philadelphia.

Marisa: Wow.

Lindsy: So we'll get patients transferred from other hospitals that need the extended ascended acute programming come to us. And an additional thing I think that's important to note about it is just kind of physically where it's situated. It is in the neighborhood of Philadelphia called Kensington, which is kind of known for being the largest open air drug market in the United States. and I like to mention that because sometimes when I tell people where I work, they'll say, "Oh, so you must do predominantly substance use work", and I actually don't. That is probably the least amount of work that I do.

The community is so much larger than just those set number of blocks and streets and I find that we are really servicing the whole of the Philadelphia community in that space and in that setting. And also I've been thinking a lot about lately in terms of who we service and where we are is that within Philadelphia there are a few different in patient psychiatric hospitals people can go to and then a few kind of in the outer suburban areas.

One of our inner city most in patient psychiatric spaces closed a few years ago and a lot of the current suburban places, a lot of them have harsher criteria for who they will admit and who they will not. And a huge barrier for admission for some people is like if they have a history of aggressive behavior or if they're presenting with more aggressive behavior at the time they need to be admitted. And we don't have kind of any of those restrictions for people. So what we tend to have happening is that the acuity level is very very high for people that are coming because they may have been attempting to be admitted somewhere else and they wouldn't take them. So then they all kind of get funneled over to us.

Marisa: Wow. Would you say that the patients that you service, are they there voluntarily or - for those listening - are they also there involuntarily?

Lindsy: They are predominantly there involuntarily. There are some that are there voluntarily. Lately, the hospital has been trying to push for more voluntary commitments and providing patients, with education about what that would mean and the ramifications of that. Because it does significantly change the atmosphere of the millu when you have more people that are there on the voluntary commitment as opposed to the involuntary one.

But I still would say that two thirds of them are there involuntarily and one third of them are there voluntarily immensely.

Marisa: Wow. I imagine that changes the dynamic of the work that you do and just you said the atmosphere of the hospital.

Lindsy: Immensely. If anything, it makes me want to lean into where they can make choices like the most. And even when it comes to a big part of what I do there is group therapy. And one of my favorite things to do is if someone doesn't want to go to group, just say, "Okay, that's perfectly fine." “You do not want to be physically here, the least you should be able to do is decide how you want to spend your time while you're in here”.

And it does make things feel very complicated and complex even just when they ask me, “What did you do when you left last night?” or “How did you spend your weekend?”

How I answer that question in a way that's authentic and honest, but also just considerate and mindful of again, you're talking to grown adults that are being robbed of their choice to make decisions for them for themselves.

And unfortunately, this is the current and has been the current arrangement that our society and culture has for when other people with significant amounts of power deem someone to be unsafe. and I don't know. It's something I've been thinking so much about and it does just feel really complex because yes on the one hand safety is important and like, are there other ways that we can do this?

I’ve been spending a lot of time researching kind of like liberation-based psychology and how the carceral the current, impatient mental health system is and how really there's this call for a total overhaul of the system that we have. And like, looking into what are those other ways to maintain a person's safety within their community, within the resources that they have or that their community has to prevent someone from again needing to be physically held in a space where they do not want to be.

Because again, how conducive can that be to any work that they can? So…

Marisa: Yeah, this is going to be such a good episode…

Lindsy: *laughs*

Marisa: And I know you touched on a couple things that I think we're going to talk about and just what trauma informed care means and I know we've had our own conversations and I've heard you and I'll ask you too about your final project/thesis that you did and how that kind of plays into your perspective.

But I know one thing that I really took away from hearing you in classes is about how sometimes even just the phrase trauma-informed care can be such like a buzzword for a lot of places or even just spaces in general in mental health.

But it's kind of recent that I feel relatively recent at least to the field - any mental health field- that we're really like now there's books about this and there's a lot more articles about this and there's more research coming out and more funding and there's a lot more advocacy and overall awareness for this theoretical framework.

Lindsy Mhm.

Marisa: But I think these conversations are so important and hearing from you and others and y'all stories are so important too and just what does this really look like for the people that are in it and what does it look like for the clients? What does it mean to them? How can we not just say it but live that and really educate ourselves as much as possible.

I mean, we're always going to have, things that we need to work on and things that we need to reflect on, but I think it's like that process of always learning and always researching and trying to be up to date with things and stuff. So, I'm just really interested to hear and I'm sure we'll get into the music therapy part too as well, but why don't we - can you tell us a little bit about that project that you did and that work that you did with the clients that you serve?

Lindsy: Yes. …so yeah, I've been very very interested in this for a very long time. And initially what kind of got me into this world was I started to just learn a lot about the nature of trauma.  And not only what it is and what it can be, but how it lives in our brains and bodies. And learning about what that meant for myself and also how it vastly applied to all of the people that I was working with.

At the time I was still in an inpatient psych space, but I was also in a children's hospital space where I was working with people with very complex physical injuries, infants and families that have gone through difficult births, teenagers having their first mental health crisis, just a lot of different people in a lot of different circumstances. And I was like, "Oh my god, it’s everywhere. This is actually everywhere”.

And, at the time, and with the training that I had, and also where I was working, I felt a call to kind of dive in more, but like I knew I was like I can't be doing trauma processing work with these people. I don't have what I need to do this. It's not the right time. It’s not the right place. But then the more time I spent in this space, I started to learn more about trauma informed care.

And again, the distinction that there is between someone that's doing trauma work and someone that's approaching any kind of work they do with this trauma-informed mindset. And that's what really kind of led me into what I wanted to do my final project on.

I knew I wanted it to feel important to me and if I'm going to put so much time and energy into something, I would really like matter.

Marisa: That's fair.

Lindsy: I was really really struck to learn a little bit more about the kind of the grassroots of this concept and that it is a consumer driven phenomena. So people that have been through the mental health system developed this term and coined this approach to care and yet despite it being created by them there was so little research from them about what this actually means and how it can be implemented in practice by providers.

And at the time when I was doing my initial research about it, I only found one study that took place in Australia where they asked former patients or mental health consumers about what they think a trauma-informed mental health practice should be. And I felt very very called to ask the people I work with the same questions. And it was definitely more broad because I was really curious about what they would have to say about this in regard to their hospitalization as a whole. And I was also curious about what they saw meaningful in the music therapy space as well.

And perhaps part of that was a little selfishly motivated because on the one hand I was thinking I am approaching this from a trauma informed like mind frame and whenever I do do my work, I want to know where else this place needs to improve and hear from them about where they could see those improvements being made.

And initially when I set out to do the project, my vision had been ask them the questions, do the study, create training program based off of their responses, and then give the training program to the staff.

However, the powers that be at Temple University said, Lindsy, that's for a PhD, that's not for a Master’s.

*both laugh

So I said, all right, then we're just going to do the first part and we'll save the other.

Marisa: To be continued, hopefully…

Lindsy: But yeah, that's kind of how we got started.

Marisa: Yeah. You know, you said some really important things too about the lens of trauma informed care and how many people experience trauma in and outside of psychiatric settings specifically.

Lindsy: Mmhm.

Marisa: And I actually have a few statistics that I'm going to share. So this is from the National Council for Behavioral Health. And they documented that 70% of adults in the United States have experienced some type of trauma at least once in their lives.

And at the time that was done, that was totaling to about 223.4 million people. That's a lot. That’s a lot of people. 70% of the population is just…that's prevalent. That's significant. And in behavioral health specifically, they said that over 90% of clients experience trauma. And you touched on a couple of the ways because I think sometimes when we think about trauma, there's a tendency to think of one massive event or maybe associate it with veterans.

And while those are completely valid and really important examples of trauma, there's so many also areas that are maybe not as highlighted or as talked about. So, I'm going to read the list that they had. And it included medical trauma, war or violence, childhood abuse or neglect, emotional, and sexual abuse, accidents, natural disasters, grief and loss, the witnessing of acts of violence and then cultural, intergenerational, and historical trauma.

Lindsy Burns: Yes. Yes.

Marisa: That's a lot of ground to cover. A lot to consider.

Lindsy: Mmhm. Mmhmm. And as you were going through the list, I'm impressed that the list you found had that last bullet point on there. I feel like that's something that we're becoming a lot more conscious of the very complex trauma that can be caused by systems that are oppressing people of varying identities like both in the present moment and the historical consequences of said oppressions as well and how it’s gets passed down intergenerationally. Additionally, something that I'm also thinking about is Dr. Gabor Mate. He is a trauma and substance use doctor and he has some amazing, amazing stuff about how trauma is very often the root of many people's substance use disorders and he describes trauma as any type of painful past learning that is not healed.

So the list you kind of gave us are those capital T like Traumas and I don't say this lightly they're easier to identify. It's almost more understandable from an outsider hearing someone's story like, “oh yes, that is a bad thing that happened to you...”

Marisa: Yeah. Yeah.

Lindsy: But what I really like about what Dr. Mate says is that any type of painful learning we have, Whether it is like someone like yeah like calling us a name or just these little minute things that can kind of happen to us that teach us that there's threat or danger somewhere is also trauma. and as it remains unhealed and continue to kind of impact how we live in our present day life like that is also trauma. I really liked also the Philadelphia ACES Society.

For anyone that's unfamiliar ACES is an acronym that stands for adverse childhood experiences. And the initial kind of ACEs study that really kind of drove forward some of our awareness about why we need to talk about trauma and be mindful of it. It was essentially a huge survey that had 40,000 something responses asking adults if they had experienced 10 particular traumatic events in their childhood. and we got a lot of information from that study.

However, it was incredibly white coded the results that they were getting and also the traumas they were asking about. And the Philadelphia ACEs Society kind of re repurposed that study and asked questions about like, “Did you ever feel unsafe in your neighborhood?”, “Did you have a family member or a loved one or a parent that was incarcerated?”. “Were you in the foster care system or adopted?” “Did you have fear that or did a family member or parent get deported?”

Questions that were much more prevalent to different members and different communities in the Philadelphia area specifically, but also things that were not even considered in that initial study. 

Marisa: Wow.

Lindsy: So there are many things that can count as trauma. And another thing that I think is really important to note is that two people could experience the same thing but have such vastly different responses to it. And trauma isn't necessarily the event or the events. Trauma is the way it's encoded in our body and in our brain.

If our body is encoding a threat and then initiating a response then and holding on to that for years and years and years then yes, that is trauma. That thing that literally rewires our neural pathways and impacts our nervous system. That's the trauma. Without that encoding, it's an event.

Which again, it's harder to put all this information in a pamphlet and make it easy to digest.

Marisa: Yeah. Or even one podcast episode.

Lindsy Burns: Yes, e xactly.

Marisa: And it's like no matter how big or small those events are, and I really appreciate you describing it that way. I think that is just such an expanded way to understand and comprehend trauma. And it reminds me of just the evolution how we understand trauma now we have CPTSD. and for those that are not familiar with that, it's more of the prolonged exposure and it might be smaller events sometimes.

But just having that occur over a long period of time. and I appreciate you also bringing up immigrational stuff. for those of you that maybe follow our practice, we are right along the Texas Mexico border and that is a huge, huge piece of the work that we do and just the community experience in general. I think a lot of people in our community, I mean, we're up to 96% quote unquote, Hispanic in the Rio Grande Valley. And so, a lot of us are first, second generation Americans or our parents were, immigrants.

And it changes how we do assessments as therapists and it changes what interventions we bring into the therapeutic space and just I don't know lately I've been in this space of the sociohistorical context of everything whether it's like the music or whether it's just like any type of work that we're doing or intervention that we're providing what's the context of all of this in a community based but also individually, but then culturally what does this mean? And so it's just like something that I feel like never ends. like the learning never ends. T here's always more to learn and always more to explore.

Lindsy Burns: Yeah, absolutely. And when they started talking about trauma work, right, very direct trauma work the US involvements in Vietnam, in the 70s, in the 80s, in the 90s even, the way to do it was you have to tell your story. You have to be able to tell your story again and again and again because that's also the information that they had and they were working with again they were expanding their understanding of this concept. I just read a book actually recently. Tt was a fiction book about a woman’s, a nurse's experience being in Vietnam.

And I remember when they got to the chapter of a psychiatrist was there's this new thing we're learning about. It's called PTSD and we're trying to understand more of it. I'm like my god it hasn't been that long since just that as a diagnosis was on our radar.

I mean, again, it's always been there. They often called other things like hysteria, especially when it impacted mostly white women. and then other things for people in communities of color.

Marisa: Yeah.

Lindsy: What I'm trying to say is, what I'm trying to get to is, back then, in the 70s, 80s, 90s, you had to tell your story again While again, what we see now is how re-traumatizing that must have been for people and, at least in the spaces that I am in, trauma processing work is much more about regulation and integration and you don't necessarily have to tell your trauma story in order to be considered healed. But if you're able to regulate when you are experiencing post trauma symptoms, like that is trauma work.

Being able to either bring yourself down out of a hyper-aroused state or bring yourself up out of a hypo-aroused state so that you can maintain your moral integrity and the things you say, how you respond that is considered now, successful trauma work. We don't even have to touch the story if someone doesn't want to or they don't feel that that's useful to them.

And I'm curious, and again, in 30 40 years, what are we going to be saying then? I imagine will be different than what I'm saying now. And part of that I think, for some of us, can be really exciting, but then for others of us, or again the way we kind of have the system set up right now, well that's a lot of freaking work. and where does it end?

How do we make it more efficient? Especially given that the current inpatient setting It's all about efficiency. It’s all about stabilization as fast as possible and then relinquishing someone back into the community which on the one hand isn't a horrible thing. Of course we don't want someone to be institutionalized for so long but our community resources are still so lacking.

And not to say that our trauma processing work should even occur on the impatient level in this model. I don’t personally believe that it should. It shouldn’t happen at this level; however, 90% of people in the United States that are accessing mental health care treatment are doing so at the inpatient level.

Marisa: Mmm.

Lindsy: 90% of consumers are at the impatient level. 

Marisa: Wow.

Lindy: So then you have 10% on the outpatient level where again, and this could be like your private practices, your IOPS, intensive outpatient settings, your community clinics, things like that, solo therapists just doing their own thing outside. 90% of people are at the inpatient level. And this is how we're serving them when the vast majority of them are living with toxic post-traumatic stress.

Marisa: Wow. It's so much to think about …

Lindsy: Yeah. Yeah.

Marisa: how do we do better? How do we not just talk about it or write about it, but how do we reach the people who need it? It's so systemic.

Lindsy: Yeah. Yeah.

Marisa: Wow. Mmm. I'm wondering too so now kind of maybe shifting from the work itself or the kind of more broader mental health context because I think that's such an important foundation for even beginning to talk about, what does music look like in the context of all of these things.

Lindsy: Yeah. Yeah.

Marisa: You know what I mean? It's a lot to unpack.

But we're going to try in this one little episode or who knows, we might have to do some more. Who knows?

Lindsy: I'm here.

Marisa: Yeah. But I'm curious So, now that we've kind of talked about all of this and kind of zoomed out in some sense to the system and the overall work and the profession of mental health in general and all that. Can you tell us a little bit about what this looks like now in the context of you as a music therapist doing music interventions with these patients?

Lindsy: Yes. Yes. Absolutely. So I would say that for me, what informed care means to me is that as the music therapist, I'm holding awareness that the people in the room with me have very likely experienced trauma that they are re-experiencing in different ways like in their current circumstances and that the way they respond and the way they are presenting themselves to me and, in music therapy, in their music, and in their interactions with other people has a high likelihood to be connected to the painful past learning that they have encoded in their brain and in their body.

So, a huge part of how I even approach my practice is by trying to increase positive expectancy with people and always holding them in unconditional positive regard. I find, and to me also, informed care is again I don't need to know all the details.  I don't need to know the horrible things that have happened to you in order for me to work in this way. It's more so about knowing how it may impact the interaction or the conversation we're having right now. 

And it's about co-creating a space that's built upon safety and trust in accordance with that person or with the group of people that I'm with. And when I say positive expectancy at the very basic level, that is living up to what you say.

Because if I'm setting an expectation that's not accurate or authentic and they see that then how is my word something to be trusted? How am I to be like a trusted person? So, simple things like starting and ending group on time. That's an example of setting positive expectancy. When group is getting started, doing what I can to explain along the way in advance like what is going to happen so again, that they know.

I mean I’m still able to work in some wiggle room because obviously as you know our work is so fluid and flexible and things do change on a dime sometimes so obviously there's no foolproof way of doing this but there are ways that we can kind of give a little bit of a heads up for certain things and kind of create that positive expectancy. And the positive expectancy is when they start to feel and see that when we say something, we are going to deliver on it.

And I never try to make promises that I'm never going to say something if I don't think I can deliver on it. Even if I may have a session scheduled with somebody, if I have to call out sick that day, I'm going to do everything I can like to alert my colleagues, alert my boss, “Hey, I'm supposed to meet with this person. Can you please go to them and tell them I apologize, I'm not going to”. Those are ways to create positive expectancy.

As for the unconditional positive regard, this is something I think we talk about more in the therapy space, especially in the music therapy space coming from a more strength based foundation. Sometimes in the inpatient psych setting, I find that that can be so challenging for other providers. And very hard to maintain in given just the high level of acuity that there is and what that looks like.

And for anyone that is less familiar, unconditional positive regard is simply continuing to accept and genuinely care about the people you're working with regardless of what they say or do. And I was just giving a talk to a class of mental health technicians about some of these same topics. And when we got to this, someone was, “You mean, like before they come into the hospital? We accept what they did before that? Or we accept what they're doing and saying when they're in the hospital?" And I said, "I mean it's both, but I'm really specifically talking about right now when they're in the hospital, when they're in continuing to accept them and care about them."

And specifically, in music therapy, doing what I have to do if I know this person is about to wail on this instrument and it is going to be from a sensory perspective so challenging for me, being open to that and perhaps in future not taking that instrument away to protect my own self. That is a minute. It may seem minute, but that is an example of not maintaining a unconditional positive regard towards someone.

Even regardless of how someone is presenting in my music therapy group, of course, I'm always going to be looking how I can maintain physical and emotional safety in that room. And if someone's having a tough day, they're having a tough day in that group.

If I need to make a judgment call about how to maintain safety in that room and not cause a ripple effect of events, I need to be okay with that and do whatever I have to do on my end to feel comfortable if it is safe in the future to give them another chance in that room. Just because someone has a rough day in music therapy should not mean that they're not allowed to come back. That's not the point.

If they're not allowed to engage in treatment, what are we there for?

Marisa: Yeah.

Lindsy: And I also thinking a little bit more about interventions and bringing the trauma informed care into the interventions I do. A lot of what I do and what I offer to people is a lot of self-regulation techniques that are music-based and that are body based. And again, I also try to let people know that when we're in group, you might notice yourself starting to feel a type of way or you might start to notice your body doing something that feels uncomfortable or you're not used to. Know that that's normal. That's okay. You're not doing anything wrong.  Here are some ways to help you feel a little bit more comfortable in that moment should it happen.

I rely on a lot of breath work, a lot of voice work for that.  A lot of incorporating the bilateral tapping with recorded music and even just like general bilateral or both sided stimulation when it comes to instrument play and music like that. And I also will always say, especially if we're doing maybe something that's a bit more like relaxation based or more receptive, I always let people know this may not feel good to you and you can always stop. Just because we are starting this doesn't mean you have to finish it.

You see with a lot of the relaxation scripts inviting people to close their eyes and lay down. No, you don't have to do that in order to have a conducted experience. I really leave a lot of those types of prompts whenever we're doing stuff like that in their hands. And it's even comes down in my language of like, “Do what you can do to make yourself 5% more comfortable. Whatever that is, whatever that is. If you want your eyes open, that's fine. If you prefer them be closed, that's perfectly fine. If you need to change positions at any point, feel free to do that. And if you need to leave the room. It's okay. You can come back if you want to, and you can come back if you. want to or you don't have to.” 

Marisa: Yeah, that acceptance for whatever experience that they need and I appreciate that and I've been taking this chicano training and one thing that they talk about is that they focus on the fact that it's competency based and really believing this person on some level knows what they need and knows what's best for their body which can be scary sometimes for I think a lot of practitioners or maybe early professionals cause it's like no I'm supposed to be the expert I'm supposed to know what but in this lens we're really shifting that power dynamic and just saying, on some level if it's safe to close your eyes or not and you know if it's safe to sit or lie down like cause everybody's nervous system regulates differently and everybody's had different responses and even what we would think of as relaxation music might be completely activating to someone else. You can bring a song that could be I guess considered quote unquote positive or uplifting for a group of people…

Lindsy: Yes.

Marisa: which they've all have their own backgrounds, they all have their own situations like that's difficult to find something for everybody I would imagine in a group like that.

But somebody might have experienced something in relation to that song. And so, I guess what I'm trying to say is there's so much to consider, but I think giving them those choices that you mentioned or just giving them that power back and it's almost an act of resistance in a system or when we're talking about people these systems were historically not made for or not built for or not researched with, and so excluded and so giving them that opportunity to say what is best for you in this moment which could change but in this moment that I'm here with you in this room, what do you need right now and how can I give you that..

Lindsy: Yeah, exactly. Exactly. And I think not only how can I give you that, but what do I need to do or not do so you can give yourself that?

Marisa: Yes. Yes.

Lindsy: Or that so your community can give themselves that.

Marisa: Mhm. Yeah.

Lindsy: I say to them all the time, regulation is a radical act. And there's a really really incredible therapist I've been following lately on Instagram. Her name is Pat the Radical Therapist and she has shared a lot of really interesting information about how this concept of regulation historically has been an oppressive especially towards communities of color like no diminish your feelings.

Marisa: I saw that post.

Lindsy Burns: Yeah. Diminish your feelings. diminish this. Diminish that. And how this regulation is a way of again quieting and subduing communities of color's experiences. And I really appreciate her saying that because it really made me reflect a lot on what does regulation mean to me? And how do I understand it? And I think to be very transparent when I initially started this work I understood regulation to be very subduing and for it to be like we're coming into calm like this is what this means.

I think to me what it means now though is not necessarily we're coming into calm but I am connected to my body. I am connected to my emotions and I am able to access my logical and emotional brain whatever that is. it's not coming into this docile space and when I say regulation now that's very much what I mean and that I feel like is the very radical act for people and for communities to be able to access for themselves.

And also, Marisa, yes what you said there is a lot to consider in finding balance in these power dynamics shifting power back, using our knowledge in the space that we are taking up while also honoring theirs.

There is so much to consider and I really do believe that informed providers and practitioners and healers are considering those things. They're having those conversations with themselves and with the people that they're working with.

And I think that's another one of the things that makes this challenging to pin down and be able to explain this is what it is. This is how we do it because it is incredibly immense. And what it is and how to do it is likely going to be different depending on who you're working with, what day you're working with them, who they are, where they're at in their healing and self-discovering journey. and all and all of that, which again makes it all the more complex…

Marisa: Yeah. Yeah.

Lindsy: To figure out how to do it. And I think when we can lean more into the this will be co-created with the person in community that I am with, the more successful we're going to be in our pursuits of this. But again, it requires a very different kind of work on the therapist, healer, provider than we've been trained to do, which is taking a step back and not letting it be about us and not letting it be about the training we have, the work we are here to do. It's a really really deep perspective shift.

Marisa : Yeah. I appreciate you saying that because I feel like for me as a music therapist working along the border with a community that is predominantly Mexican American or Latine, it's really a lot to think about, historically what we've been through and generationally like what the community has endured. And I always say we didn't cross the border crossed us. And there's a lot that comes with that generationally and…

Lindsy Burns: Mhm.

Marisa: obviously my parents had a way different experience of microaggressions and things like that representation and stuff than what is my experience now all these years later. But even for me thinking about okay, how does our community, how does my culture even view trauma because even that in itself is so different like how we conceptualize trauma and I wrote a little bit about it with an article that I just submitted and in our culture in Spanish we call it susto which means fright it's literally translates to a big fright and indigenous communities because a lot of the indigenous medicine and healing arts that we have in Mexico and here in the borderlands is looking at susto in every part of our ecology and typically the people that treat that are what are called curanderas which some people refer to them as the original humanistic counselor.

And a lot of their work with that is too and they believe that, but I believe too that when you experience something and they would say it's very holistic. So if you have the social part of you, the physical, the emotional like the spiritual, I mean community, that kind of ecology, generation, immigration. all those kind of bullet points. If one part of you is out of balance is experiencing some type of trauma or any just unresolved feelings or emotions that affects our entire body. And it's so interesting to kind of see it that way. And a lot of the work that they do is about that co-creation that you mentioned.

It's about how do we work together to find out what is going to be best for you and what do you need right now and what is resonating with you versus what do you need to let of or what do you need to hold on for a little bit longer to really sit in it and process it because, like you said, I think moving straight to regulation or just healing kind of skips over what is still - Dr. Zanders said something, he has a quote too in one of his articles about foster care that we posted a long time ago and and he talks about that is the positive psychology of things and sometimes how as wonderful as that can be in terms of strength and stuff and healing it it also kind of sometimes can negate these very real emotions and very valid and skip through because as humans I think it's good and bad and so I guess what I'm trying to say is not to take away from those situations, and not to skip not to work so quickly to try to just skip over them and sitting in it if it needs to be there to let your body feel it and experience it if that's appropriate and if that makes sense for that person.

Lindsy: Exactly, and it’s a conscious choice on their part because sometimes the sitting in it happens unconsciously and then we're doing all these other things kind of as you were saying maybe moving on too quickly. but really we're not moving anything.

Marisa: Yeah. Yeah.

Lindsy: Yeah.

Marisa: There's a quote from there’s a book that recently came out in the last couple years called Trauma Informed Music Therapy: Theory and Practice and I want to read a little quote because I think it kind of ties in a lot of what we're talking about. but it says:

"Music therapy is a therapeutic treatment modality that can unlock frozen thought patterns, ease detrimental physical responses, and give form to chaotic emotions. Children, adolescents, adults, and older adults respond to trauma in different ways. The fluidity of music gives music therapists a way to give comfort, bring a sense of safety, and allow people to find their voice. A voice that is uniquely theirs, yet forever changed by trauma.”

Lindsy: I find trauma to be such a physiological, neurological and emotional experience. And it be encoded in our bodies in all those different ways. And music is very much the same. It’s a neurological process. It’s a physiological process. It's an emotional process that lives in ourselves in all those different ways. And I remember when I was initially starting to learn about all of this, it really was like a light bulb going off moment. I was just like, " This makes so much sense. This makes so much sense where and where music therapy fits into all of this because of its connections to these frights, these memories, this post-traumatic stress that people continue to experience and in such a more accessible and approachable way than for some in years.

And I know you and I talked so much about how I feel about the experiential means of our discipline and how powerful it is. And I really do feel that for so many the fear of going to talk therapy is, “I don't want to talk about that. I don't want to talk about that.”

And the thing that we have on our side is the music. And we can do so much in the music without needing to talk about it, whatever it is. And again, for I cannot reiterate this enough, in order to do successful trauma processing work, you don't have to talk about it. And we don't even have to get into expressing it or processing it in trauma informed care. but it really is just amazing how the music can connect with us on all these different levels and really be there for us in these moments of dysregulation that are having a profound impact on our present day life.

And I also think too it's really important to note that just as it can be so powerful to help us, as with anything, it does have the potential to hurt us as you were kind of speaking to before, and why it's all the more important to really have those considerations and not only how could this help, but how could this hurt somebody? And are we asking ourselves those hard questions?

And it is really hard and uncomfortable, I think, for us to think about that and talk about that because I don't think any of us come into this profession because we anticipate hurting people or because we don’t care about other people. But I really do believe part of having a trauma informed philosophy is sitting with the possibility that we could re-traumatize them. and that we could trigger somebody.

And the impatient psych setting is notorious for re-traumatizing people for so many, so many different reasons. And again, unfortunately it's the system that we have right now. It's the setup that we have right now. And it would be very encouraging to me if the system could just simply acknowledge, there is a potential that people are harmed by this. Until you can acknowledge that, then things aren't gong to get better, things aren't going to be able to change in a way that's sustainable and actually helpful for the people you're trying to serve.

So I think that that's so so important for any type of provider, any type of of therapist, healer, we need to understand that we have that possibility of hurting people.

Marisa: The awareness

Lindsy: Yes, yes. And something an intervention thing that I was thinking about before but is also coming back to my mind now is a huge thing that the patients I work with are always advocating for is for us to do song sharing. They want to hear their music. They want their songs and not me playing their songs. They want to hear their songs.

And with this song sharing, a way that the people I work with and I have kind of established over the years for how we can approach it in the most trauma informed way is something we've coined as the heads up - which many of the patients that I interviewed for my thesis mentioned the heads up as an example of something that they felt like was trauma informed in their music therapy experience.

Essentially, what the heads up is this - we acknowledged together at the beginning of the group that no music is really off limits. And one of the reasons for that is that there's a lot of conversation, especially the inpatient space where the predominant community of people are black and brown, how censorship of music is extremely harmful. And just kind of re-energizes white supremacy and takes away autonomy and just so many things.

It's hard for me to even articulate it because it feels like such an old conversation. Like, oh my god, it's 2025. Are we still seriously talking about whether or not people should be allowed to music with curse words in it?

Marisa: Yeah. Yeah. Adults too, nonetheless.

Lindsy: Even grown adults. Exactly. That's another thing I will say is that I'm really speaking to my particular setting and what we have found works best for us. In other settings, this may not be it.

Marisa: Mhm.

Lindsy: So yeah, we start off with that all music is welcome and present in this space. And there also very well may be words, topics, sounds that cause people in this room to feel upset, to feel uncomfortable, to feel a whole number of things. So, in order to keep the space as expressive and free as possible and as safe as possible, is there anyone in this room needs a heads up about before they hear it in a song?

And if people name some things, if they say, I need a warning for mention of death. I need a warning if there are gunshot sounds in the music. I need a warning if they use this derogatory name for women. Before each and every song, I will ask the person playing it, “Do you know if there's any presence of this, this or this? If not, okay, let it play. If yes, thank you for letting us know. I want to reiterate to the group that we believe there's presence of this material in the music”. And then we will play it.

And what I feel like it does and also what people in my thesis also articulated to me that it does is it once again just puts the agency back in people's own hands for what they want to do with that information. For some of them having the information is enough, having that heads up. For some, it means they're able to do something for themselves to help them cope with that kind of disruption or that discomfort- whether that’s using a fidget, whether that's changing their position in their seat, whether that's going from a sitting down position to a standing up position, whether that's taking a walk out of the room for a few minutes and then coming back. Either way, they have the opportunity to take care of themselves. And I make it known to them, if they need more support than that and more direct support from me, I'm able and comfortable to give that to them.

And I think that's another thing too that's really important for providers to know is that you don't want to open anything up that you don't feel capable of handling anything. If you are not feeling up to comfortable with people having perhaps these very adverse reactions like to music that might be played, you may need to adjust or adapt what you're doing. But I am very much willingly signing up and very much consenting to if something happens, I'm here to help and support kind of as is necessary.

And thus far it's been something that, has worked for us.

Marisa: That's amazing.

Lindsy: And it's something, sometimes staff members are walking by the room and they hear what we're listening to and they're like, “Is this seriously going on right now?” But they haven't heard this conversation, that we've had.

Marisa: A little out of context. Yeah.

Lindsy: And I have had to communicate with people after the fact like, listen everyone was actually okay. And I can literally tell you why because again this is an active conversation that we are all having before any music kind of gets played. And I really do feel like it sets us up to have as safe of an experience as possible. And again, it doesn't mean that dysregulation isn't going to happen. It's very likely that it will. However, again, we've made these considerations. We have these safeguards up and we're signing up to handle it.

Marisa: That's such an important way to take care of yourself, but also to learn how to take care of other people who might be experiencing different or similar things to you in terms of the symptomatic responses to different situations.

Lindsy: Yeah.

Marisa: That consideration. there you go. I think all music therapists listening might steal that from you. The heads up.

Lindsy: A heads up, a warning. And sometimes people will say "I have a heads up about my song. It's got this, this, this, and and this in it." I was like, "Hang on, that's not quite what we mean." but it's amazing I think too just and again especially the clientele that I work with, so much of their music has been demonized and has been deemed as bad, inappropriate, like it's not put this when it's online right but when they say can you play the clean version of the song, you're implying that original form of the song is dirty and…

Marisa: Yeah.

Lindsy: And it really is incredible I think and this does a lot I think going back to the unconditional positive regard piece. How people have responded to just their music and, again what they are deeming as what they need or an important part of themselves that they want to share with the group or something that is significant from a prior time in their life that it is as it is just allowed and not only allowed but it's welcome in the space. And even when somebody says, “Miss Linds, you can play the clean version?” I was like, I'm happy to do that if that is the version that you want.

Marisa: the choice again.

Lindsy: Exactly if that is the version you want, we will play because then again, if someone does want the censored version of their song to be played, for me to be like, no, we're playing the original wipes out everything we've been trying to do. But just again reiterating that people know that it really truly is their choice and whatever choice they make is not going to change the way I think or feel about them.

Marisa: That's empowering.

Lindsy: Mhmm.

Marisa: And that's what mental health work should be, right? To empower our clients to have a safe way to express themselves and process their emotions and…

Lindsy: Yeah. Yes. Yeah.

Marisa: build community and get the help that they need from people that they feel comfortable and safe with. That's the goal I think broadly speaking in a lot of the work that we do as music therapists but just as health care professionals in general. Yeah.

Well, I guess then, my next question would be because you talk...Oh, Hi Buttons!! Sorry.

Lindsy: Sorry. Yeah.

Marisa: Lindsy's cat just walked by and I love him. Hi, Buttons.

My next question because you spoke a little bit about if you don't feel like you have that training or you're not comfortable taking someone there to that place and versus maybe I hear the word container a lot keeping things in the container and that always made sense to me whenever I heard it.

But I'm curious now that you are comfortable, having those conversations and holding the space for clients in that way, what are maybe some of the trainings or resources that has kind of led you to feel comfortable and kind of led you to that space?

Lindsy: Yeah, definitely. I think a huge one was my certified clinical trauma specialist training. I did that online during the peak of COVID through the Arizona Trauma Institute.

Marisa: Okay.

Lindsy: I believe there is one kind of subsect of the training that's for individuals and then another one that's for families. I did the one for individuals. and that in it of itself was such an eyeopener for me. And it had so much in there all about again just like the bio neuro components of trauma. It educated me so much about this active ingredients approach as it works for person to person or community to community.

And I think did a really good job opening my eyes into how much of the work needs to come or from the person or from the community that we're working with and being able to trust them. In addition to giving me a lot of resources and information about different regulation techniques and especially very like body-based techniques they introduced me a lot of somatic practices and just not only that training in particular but I feel like the Arizona Trauma Institute they really lean into the somatic and regulation piece of it. So, I've done a lot of webinars with them kind of over the years for continuing education credits and stuff. and they're always sharing different resources and different things like that. So, I highly recommend checking them out. I even think they have YouTube videos and stuff of some of their things.

Marisa: Oh nice.

Lindsy: I've done a few different CMTEs about poly vagal theory. And for people that aren't super familiar, basically it's the concept that we're kind of moving within three zones all the time. Whether that's a shutdown zone or your free state, a fired up zone, which is your fight and flight state, or your, kind of safe, connected, regulated state. And you're kind of just moving within this, they call it the polyvagal ladder. And you're just constantly moving up and throughout it. And that was again another kind of interesting lens to take it from what I really want to do. I want to kind of bridge this gap I feel between all of this so far and more like somatic experiencing because I think that is very interconnected to all of this and I would love to just have more things like that in my back pocket.

And honestly my biggest teachers by far have been the people that I work with. Absolutely. The gift they have given me in their time, in their honesty. And in giving me the opportunity to build trust with them has by far taught me the most.

Marisa: Wow. Yeah.

Lindsy: And they have very graciously over the years shared with me that they do feel and see the difference between people that come from this approach and people that don't. To be really transparent there have been so many times in the setting where I work where I have wondered it's been a really bad day not because of anything like patient related just but from the way things are being run and the management of it all and feeling very different from this space where I feel like this is such like a beautiful aligned alive conversation and there where I feel like I'm just screaming into the void sometimes and nobody understands like a word I'm saying.

I found myself on those days thinking like, “ Does this even matter? Do these little things I'm doing does it actually make a difference? Like, I'm doing all of this. I'm trying to learn about all this. I'm bending and flexing myself this way and that way. does it even matter?” Especially when I feel like I'm just swimming upstream in this system. I'm like, “I’m fighting so hard. I'm working so hard. Is this worth it?” And they have shown me and they have told me that it does. They see us so much and they see the really crappy things and they see when people aren't doing what they should be doing. And they see when people are. And that always is, again, I would love to say I don't need this validation, but I'm human and like it does it's incredibly powerful to get that confirmation from them that okay, we are on to something here. This is the and frankly this fight is necessary and it is worth pursuing. And yeah it has been their confirmation at times that has gotten me through that day without quitting.

Marisa: Yeah, those are the things to hold on to. I feel like especially in mental health, but in just any setting right now, I think there's just so much happening in all little pockets of this country and even in the world. And holding on to those experiences and holding on to that feedback and using it to recharge ourselves in spaces that there is so much burnout from professionals and it's so easy to just question everything and to just not know for sure. And it's just beautiful to hear you say that. I think it just speaks so much volumes about the work that you're doing and then the person and the therapist that you are and I appreciate you sharing all of this. Really, I am so excited for people to hear you and to listen to this episode.

Lindsy: Thank you.

Marisa: Yeah. One thing that we do with every episode though, I will say is that we put up all of these resources on our website, so on own website, if you go to rgvmusictherapy.com/podcast, I shouldn't say usually, there will be a blog post that has more about Lindsy's work, some links to some of the things that we talked about today, either maybe some of the training, I'm thinking, the music therapy book about trauma and the article that we pulled from. I'll go ahead and put links for all of that for anybody interested in reading more about those and I'll also put info about Lindsy's practice which she is working on and getting started which I think is incredible. And so we'll put a link to that as well and the social media for her practice you can go and follow. And what we also do - second thing is we put up questions.

So, if you're listening on Spotify, I'm not sure if it works anywhere else, but for sure if you're listening on Spotify, there will be a few questions there. So, if you have questions for Lindsy, there's a space where you can put that in there and we'll try our best to respond in some capacity.

But yeah, let us know. and I appreciate your time and being here, Lindsy, and I appreciate your time, the listener, whoever you are, wherever you are in being here and kind of listening to our stories and perspectives.

And with that, we'll go ahead and let you get back to the rest of your day. But again, we appreciate you so much for being here and sharing. And hopefully we'll hear from you all soon. And we'll hear from Lindsy soon again as well. Thank you all so much.

Lindsy: Thank you everybody!

Marisa: Thank you all, bye!

Lindsy: Bye!

Marisa de Leon, MS, MT-BC
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