Hibernation, according to Webster's dictionary is a state of inactivity and metabolic depression in animals, characterized by lower body temperature, slower breathing, and lower metabolic rate. When animals hibernate they actually conserve energy. During winter, when food supply is limited, animals use their energy reserves at a slow rate. It is the animal's slowed metabolic rate which leads to a reduction in body temperature.

Hibernation is the way that animals adapt to the climate and land around them. Animals must be able to live through extreme cold.... or die. Animals hibernate--or deep sleep--to escape that cold. They also do this because it is really hard to find food during the winter. (Thinkquest.org)

It is interesting to think about how cold weather affects humans. In cold climates, there is a slow stillness that often accompanies the winter. We move more slowly, we leave our homes less often and we initially see less sunlight and have less fresh air.

Some tend to cook more during this season; stews, soups, casseroles. Music can be softer, more lentando-easeful. While some enjoy the soft, slow stillness and see Winter as an opportunity to nestle, stay warm and relax more than they would during Fall, Spring or Summer; others become absorbed in the stillness and have a less than positive experience. People can tend to hibernate and resist the frigid feeling of having to go out in the wind and frigid temperatures. They may drop their activities and stay in bed for longer than usual periods.

The New Year comes shortly after the Winter Solstice-and can provide new life and prospective goal planning, and yet, there are many cold months to follow. It may be a most difficult time to carry motivation and incentives set forth on January 1. Resolution can quickly lead to disillusion if not fostered with structure and creativity.

It has been an especially cold Winter thus far-how do you rejuvenate? Let's share some tips to move ourselves through the frigid period...music or ????

I grew up listening and watching Michael Jackson. I have always been his fan. From "ABC" and Motown, through "Rock with You" -- into his dark side – "Thriller", "Bad", "Billie Jean" – like many, especially those near his age, I recognize his talent and electricity. Michael's genius was in creating new sounds and styles. There are not many artists whose signature songs span from Motown, soul, disco, rock...and where were we headed next? There is word that the London tour will be aired (as it was nearly complete), by stars (and friends of Jackson's) who will perform to carry it through, to honor his creation, and to memorialize the great Michael Jackson.

I was always hoping to see Michael on Broadway-his singing and dancing-so captivating. I found his videos poetic-each telling a descript story. There is no comparison I know, that exists in video today. I admired his pleas for us to look at humanity in a compassionate way – "Man in the Mirror", "Earth" and the well known "We are the World" A defining characteristic of Michael's personality was his extreme vulnerability. We can hear it in "She's out of My Life" and "Ben" – and certainly his anger in "Leave me Alone" – but we also saw this in interviews. The night he died, I was watching a recap of Barbara Walters interviewing him where he was nearly in tears when the tabloids called him "Wacko Jacko" – Walters, being her diplomatic self was inquiring (paraphrased): Wouldn't a star of your magnitude and one who has taken the unusual risks that you have, with your appearance and such....almost expect some public scrutiny? and Michael replied... "it is not nice to call me Jacko – my name is Michael, and it is hurtful to be called Wacko." He sounded hurt-seriously hurt to the core. This reminds me how sensitivity and vulnerability often have no shield-artists offer and often are defenseless.

As an artist, with fame, even to the point of being called an icon-one can always be fragile, and certainly open to the public judgment and scrutiny of others. No matter how profound the success, the knife of nastiness can often shake one's core. This is the backlash of putting oneself out there, as one does in sharing his/her art. We are vulnerable. This post is about the courage to create and how the human spirit, even through extreme public scrutiny or unfair judgment, or physical torture desires to create and share. Let's now shift to Farrah...and this shift probably seems as abrupt as it felt through the media visits many of us encountered this week – from Michael to Farrah, and then Michael, and Michael and Farrah, and probably people forgot about Ed (except for the myth of threes), and perhaps also we forgot, because in this fast tech world, Ed died a long time ago, yes? It was actually two days before Michael and Farrah.

In a certain way, the stars' passage prompt us to review where we are in our lives, because we all are familiar with them, and as such, we can have a communal, retrospective glance-and how we choose to view and what we choose to view, and what is said – is a reevaluation of meaning, life, art and history-a collective unconscious gathering of sorts. Farrah Fawcett. If you are like me, you may remember her poster, the Noxzema commercial and most notoriously her role on 'Charlie's Angels' – surprising to learn that this role was steady for just one season. This does perhaps speak to her level of impact. I would have guessed that there were many seasons of her part in that series, but I am not a TV watcher. She was also known for 'Extremeties' and 'The Burning Bed' which were serious roles and she was recognized for these.

Being a Michael Jackson fan, I mostly wanted to watch and recap his music when I learned of his death, and probably like many, I set out to view some of his videos on TV. Not having cable, I came upon an evening primetime special on Friday night that was offering a tribute to both Michael Jackson and Farrah Fawcett.

A bit bothered that I would have to watch Farrah first, I decided to stay and watch, so that I wouldn't miss Michael, and I became unexpectedly taken with what I was viewing. 'Farrah's Story' was a legacy film that she directed during her two year fight with cancer. I was learning about someone I never bothered to know beyond her blond feathered hairstyle, a style that probably every female who lived through the 70's has in their mind or at one time or another attempted to master when blow drying their hair. We are lovers of beauty. Farrah set quite a trend...and many did not know her beyond her beauty.

Farrah Fawcett created a film about her war....her pain, her desire to live, her struggles, her wishes, her life as she battled cancer. And it was quite powerful. It made me realize what a profound woman of courage she was. It was almost seemingly the exact opposite circumstance of death that Michael Jackson witnessed. He hid from the public eye during his extreme struggles and died with no apparent forecast of his ending.

Farrah's death and the years leading up to her finale were filled with grace. She powerfully and magically mustered up enough awe of her struggle, and her quest for life to create a piece of art; of beauty and of torture-so that others would know her better, know cancer better and perhaps would find comfort in holding those most cherished through the unknowns.

There is little to compare between Michael and Farrah – other than their stardom, and their day of death. But it is worth thinking about our lives and the art that we create, especially when we are most vulnerable--Art and creative risks can be a living act of courage, of pride, and perhaps in its most courageous tide, a means of legacy. We know as creative arts therapists, that the moment of making an art and the act of sharing an art can instill healing qualities. We research and tabulate the physical, mental, emotional and spiritual effects of our performance in our quest to advance health and wellness.

I think that orchestrating a film that depicts a wrestle with death and struggle by a star signatured for her beauty and vitality takes this art one step further. Our art in its moment of creation and its effect for future impact is needed. And our art also has the capacity to outlive us – and we can create a meaningful way of being, and one that we document and help others' hold once we die. Farrah's film seemed so completely honest and straight. Almost like a home movie. However, the fact that she made the film, and did not edit out pain, vomit and her shaved head, was more than the average home movie maker would risk. This is what makes her amazing. Our ability to live and understand our transition from life to death I believe is one of our ultimate tasks, and one that most cannot deal with. Most have fear. I am grateful to know Farrah Fawcett in this way and I am humbled by this film, which reinstills the power of creation, especially when ventured during such a time of profound vulnerability.

Writing is an essential way that humans report and communicate. Writing provides a context for our experience. I am always interested in the words people use to describe an experience. Even in the mundane day-to-day e-mailing and texting, it seems we are developing a new language of communication. Many of the words teens use in texting are not easily decipherable to the general population. History will unravel the benefits and compromises that modern technology affords human beings. In some ways, texting has abbreviated words. The idea seems to express a quick message in a limited window of time. In e-mail, there is an entire etiquette and culture of how and what to write-with cc and bcc, forward options, communication has become ever more tricky and sophisticated and certainly more thorough and immediate, but often less direct. How often do people pick up the phone for a uninterrupted dialogue and thorough conversation? What purpose does that serve in today's world? I am interested in how others think technology has changed communication in personal and professional endeavors-how are we communicating--more efficiently, less efficiently?

It seems that the modern day mode of communication for many is text messaging. I see an increasing number of people communicating through texting. I am aware that I am receiving an increasing number of text messages on my cell phone each day and I am wondering why this is seemingly becoming a preferred means of communication. I am hopeful that this is a fad, and that our voice-to-voice human connection of in-person contact will be restored once people realize that the texting limits us.

I write this reluctantly, because I am a writer and a hermeneutic researcher, and as such, I truly value the 'life' that written words can take on for both the writer and reader. Writing and reading calls us to be thoughtful, inquisitive, and creative. I believe that the process of translating an experience into a text has value and can further our understanding of experience, perception, expression, and history. A written text can be more accurate than the spoken word, particularly when it is saved, and texting provides such an opportunity.

Maybe it is my inner musician that longs for the individuality of a human voiced connection. The prosody or music of our speech presents perhaps the most uniquely human quality we present. The timbre, pitch, rhythm, and tone of our speech define an important part of who we are. I value the interchange of voiced communication, and furthermore, I notice the verbal idioms people tend to use in their conversation. We have a common language, but each person has a particular way of expressing - perhaps this comes across in texting, but I believe it is not as pronounced or immediate.

In texting, the trend seems to be, to simplify, and cut back what is communicated. Is why this is favored by a growing number of people, or whether, perhaps, the texting is used simply for quick, easy arrangements and therefore some would argue, does not interrupt the 'live experience' one might be in, in the moment. I would argue that texting pushes people to multi-task, and therefore takes away from the live-moment for both texter and receiver...unless I am in a meeting and needing to tell someone I will be late for the next meeting. (I am certain there are a variety of such circumstances, and for these, texting is invaluable)

I believe that technology and multiple options of communication move us ahead, and I have witnessed texting save lives and increase opportunities. This blog is not addressing such circumstances. This blog is questioning the concern that perhaps this trend is pulling some away from direct human-to-human voiced communication and that something is lost when texting is overused. I would like to hear from you - particularly if you are a fan of frequent texting.

There's a hand drawn montage in our guest room...at 5 years old, my son (now 17!)used colored pencils to draw pictures of "Winter" "Spring" "Summer" and "Fall." I framed them. What is most striking about each picture, completed in colored pencils, is the gesture-like movement of each character he creates to depict the season. Of the two characters, the "Fall" and "Spring" are most striking.

"Spring" has color, and a figure looking as if he is 'springing' up off the page. It is joyful. "Fall" has an illustration of a little gnome-like creature actually falling, almost, sliding down the page. No wonder Van Gogh studied children's art for so many years. There is such purity and depth in a child's interpretation. I have my kids' artwork framed all over my walls. Masterpieces to me.

Most people love Spring...its warmth and beauty...flowers sprouting, sweet smells. Not me. I never trust the beauty of Spring. It is too quick and immediate. The crocuses jump out of the ground, faster than I can open my eyes. It is too easy, too innocent and too short.

But Fall? Fall is for the melancholy. I love the Fall. If Spring is for lovers, than Fall is for dreamers. Fall is full...most of us feel a sudden transition from Summer to Fall; from the warmth to cooler weather. The freedom followed by structure...many schools and trainings begin in Fall...and then, the leaves change...so many colors and variations. Fall is about ending...and reflecting, which is quite connected to beginning. Death is about re-birth... to die well, is to reflect and celebrate the life one has led. The leaves do this so beautifully. Living in the Northeast, I relish the leaves and their change of color...one by one each leaf floats, willowing in the wind with a dance that seemingly purposefully relishes in the life it lived through its seasons on the branch of a tree.

I found a song today. There are so many good songs about Fall...such as September Song, Try to Remember and others. The song I heard today, it seems everyone already knows! How could that be? It is called: 'Who Knows Where the Tim Goes?' I first heard it on an Eva Cassidy album and was struck by its tenderness. Most know it covered by Judy Collins. The British folk starter Sandy Denny is the composer and lyricist and she sings it with heart: http://www.youtube.com/watch?v=vbpURBJA4uA&feature=related Sadly, Denny fell down a flight of stairs at age 31-and died. Cause of death-not completely certain. This does impact the way I hear this song-she had so little time on earth.

Since one of the most frequented blogs of mine was about favorite songs...I wondered about what songs or pieces of music hold others during this time of year. I would love to hear from you.

I have been thinking for some time about the impact of music therapy in the traumatic experience of people who are hospitalized. Whether a diagnosis is chronic, and treatment is on-going, such as chemotherapy (Cancer) or blood transfusion (HIV), or a diagnosis is more sudden, or acute such as a gun shot wound, animal attack or heart failure; the mind and body, and in particular one's belief about treatment, including the episode and the doctor's, nurse's, therapist's, words about treatment have an apparent influence on treatment outcomes.

Today I am writing about placebo and nocebo, both understood to create 'effects' in the medical experience. Placebo is the measurable, observable, or "felt improvement" in health behavior that is thought to occur outside of one's admistered routine medical treatment. Placebo is Latin for "I shall please"-and in the pharmacological realm, implies that an inert substance such as starch or saline has the capability to produce an effect similar to a pharmacologically induced active substance/pill.

The placebo effect has been studied and is most often written about as a psychological phenomena. University of Connecticut, psychologists Irving Kirsch and Guy Sapirstein wrote about Prozac's effects as the result of a placebo when they analyzed 19 clinical trials of antidepressants and concluded that the expectation of improvement, rather than adjustments in brain chemistry, accounted for 75 percent of the drugs' effectiveness (Kirsch,1998). "The critical factor," according to Kirsch, "is our beliefs about what's going to happen to us. You don't have to rely on drugs to see profound transformation." Sapirstein analyzed 39 studies, from the 70's-nineties and found that depressed patients were treated pharmacologically, psychotherapeutically, or with a combination of both drugs and verbal psychotherapy. He found that 50 percent of the drug effect was due to the placebo response.

Nocebo is Latin for "I will harm." This term coined by Walter Kennedy, in 1961, is the antecedent of the term "placebo." If placebo is the drug that induces a desirable consequence as a direct result of that subject's beliefs and expectations, the term "nocebo" instills an unpredictable unintentional injurious response with unpleasant results that are pharmacologically-generated and have predictably injurious outcomes resulting from its administration. W.R.Houston was among the first of doctors to pose that harmful "placebo" procedures, as distinct from the other, harmless sort of "placebo" procedures a doctor might apply has "usefulness... in direct proportion to the faith that the doctor had and the faith that he was able to inspire in his patients".

It is interesting to think of treatment affects as being will-ful and faith-related. One of my favorite doctors, Herbert Benson said: "Surgeons are wary of people who are convinced that they will die," There are examples of studies done on people undergoing surgery who wanted to die to re-contact a loved one. Close to 100 percent of people under those circumstances die."Martina Amanzio et al. (2001) demonstrated that "at least part of the physiological basis for the placebo effect is opioid in nature" (Bausell 2007: 160). Chemical substances such as endorphins, catecholamines, cortisol, and adrenaline can be activated with positive belief and thought processing.

Daniel Levitan's "This is Your Brain on Music" and Oliver Sack's "Musicophelia" address in a variety of ways that the power of music can instill and effect a person's thoughts and wishes which may in turn directly alter biochemical factors of the brain. Music is a sensory experience which can alter neurochemical system affects and this includes the hormonal and immune systems.

Music therapy builds resiliency by generating a person's incentive and belief which may empower their physical well-being and enhance the recovery process from illness to wellness. I wonder why people are so surprised when they are told that the "effective drug" they are using is a placebo. Hearing that their problem may be "in their mind" implies that there is in reality nothing wrong with them. There is a great deal of research which has reported objective improvements in health-related outcomes which are the result of placebos.

I am awaiting the day when we use our psychological impetus more consciously to create a desired effect. Music making builds the means for incentive. In consciously visualizing, singing, or playing about our desired outcomes, we create the field for change to occur. In music we can address the physical, emotional and cognitive in a single experience. I am hopeful that the experience of making music can enhance the brain's ability to alter the body. This is occurring in ways we have only just begun to understand.

Healing Circles, Services, Memorials...today as my colleague and I begin planning a 9-11 memorial event, I am feeling the angst and compassion that comes up in the process. I am thinking about the most difficult part of life; perhaps in some ways more difficult than approaching death itself-the anniversary of death. In the seventh year of remembrance since September 11, 2001, we cannot hear the date of "9-11" mentioned in passing without vivid triggers. Hospitalists are not certainly not excluded from the impact which ripples from the grief that accompany thoughts and experiences of the event. Many therapists I speak to wonder how to approach this day. To formally remember is to open a wound, yet to forget is to deny that which is lurking in all of us. To soothe those who live with the horrendous loss and to honor those whose lives ended too soon; making a sacred space for healing is an important and necessary part of our grieving. Creating a community for remembrance where we gather with many of the same people returning to mourn takes strength, courage and commitment. I am awed by the members of our 'Caring for the Caregiver' group who return each year-wives who lost husbands, woman who lost sons, therapists who lost friends, colleagues...we mourn together. In thinking about the day, I am grateful for music. Music has the ability to preserve and transcend. Our group has preserved its membership through sacredness and continuity. The music speaks to our spiritual needs, allowing us to transcend; and reach out and beyond the mundane daily routine of what we know...into a sacred unity where community members can hold one another in a safe way. How do you approach this day? What is helpful?

"A young doctor sat down with a terminal lung cancer patient and her husband to discuss the woman's gloomy prognosis. The patient began to cry. Then the doctor did, too. The scene was undoubtedly moving. But should physicians display this much emotion at the bedside?" This was the start of a thought-provoking essay in the New York Times by Barron H. Lerner, MD, a Columbia University Medical School and School of Public health faculty member, internist and renowned author. Lerner, in this article, addresses opinions about the issue of whether health care providers should stay stoic or show emotion in their communications, particularly regarding bad news to patients. Bloggers can access his essay: Excerpt from New York Times Article: At Bedside, Stay Stoic or Display Emotions? http://www.nytimes.com/2008/04/22/health/views/22essa.html

This article focused mainly on physicians' responses and relayed that at a recent meeting of the Society of General Internal Medicine at Harvard Medical School, colleagues reported that 69 percent of medical students and 74 percent of interns said they had cried at least once during their yearly trainings. (How wonderful to know that our doctors of tomorrow are human beings!)

As therapists, we are trained to work with our countertransference and to be clear on how we might use countertransference in an informed way within our sessions with patients and families. Recognizably the role of a doctor is considerably different than that of a therapist; however, the role of holding a space for a patient, especially during a time when traumatic information is being shared, seems vital. Granted, it is quite difficult to be the barer of horrible news, and yet, I wonder if, in crying, the doctor induces a feeling of trauma in the patient that in reality would take more time for the patient to digest, in order to arrive at such a point of emoting. Second, in watching the doctor cry, the patient may feel an unconscious (unreasonable, but existing nevertheless) sense of shame or guilt that s/he is failing the doctor in his mission to heal. Third, the patient, particularly if not well-adjusted, may be faced with having to worry about the doctor's emotional well-being. And so, I think it is inappropriate and on some level unprofessional and even selfish for a doctor to cry in front of a patient, especially in the face of having to relay traumatic material. Fine to stay with the patient; please, offer long listening, a shoulder, extra silence...but not with tears. In my opinion, the patient has enough to worry about, and needs a holding place - one who understands and who is present. I would love to hear your thoughts on this and most particularly if you are a doctor, nurse, social worker, OT, PT, clergy and of course, creative arts therapists... Patients too - what do you think? Cry or no cry?

What is your favorite song? Has it been your favorite song for a long time or does your favorite song change through time? Music therapists have written about songs from their client/patients' perspective and many have eloquently described how their use of a patient's favorite song has enhanced their ability to address significant moments or personal themes, thus enhancing the therapeutic relationship. Let's think about songs we use for ourselves for a moment. Indeed, songs can capture the essence of a moment or the flavor of an experience. Songs in some ways represent a piece of our culture and may directly or indirectly reflect issues or themes of relevance to our society. There are many musical and lyrical components to consider when thinking about a favorite song from a purely artistic/aesthetic perspective. Let's delve into the past or perhaps consider the present moment for a minute. Tell me: What is your favorite song and what image or snapshot in time do you tie to this song?

A close friend and colleague gave me a nudge e-mail last week: "How about a blog on American Idol's effect on people's perception of their own singing voice?" I had coincidently recently read in a NY newspaper days before that the show, in fact, has lost thousands of viewers this season. And I remember thinking that this was not surprising.

I am not a television viewer, but I do have friends and often hear of students who watch this show weekly. Certainly through the years, there have been more than a handful of singers who have made their mark on American Idol and graduated to fame and fortunate with dignity. Kelly Clarkson, Clay Aiken, Bo Bice, and Jennifer Hudson are reputable singers who took their start on the pop-show.

In the Performing Arts and in Fine Arts, as in Sports and virtually every field involving creating or utilizing aspects of showing ourselves, we, as human beings are prone to create opportunities or venues for competition. It further defines the art of who we are and what we aspire to be. Competition can extend the skill and dexterity, and the definition of expression within our talent. Competition also stimulates growth and development.

In every generation, we hear and see new styles and means of expressions which often forge the birth of a new idiom or way of playing. We hear this in Louis Armstrong, and the birth of Jazz. We hear this in the development of blues and rock and roll. I guess what comes to my mind when I think of competition and how we, as a society define, refine and expand our means of artistic development is striving for beauty, humor, integration and original expression.

I have seen American Idol one time and I felt that the show lacks integrity. Although many of the contestants do present talent, the way that the judges insult and fail to provide insight in their ratings takes away from the kind of venue that I would want to see our world watching. Clearly the show is about carving an 'idol' and the artistic quality of the music is not seemingly taken seriously. Furthermore, the singers' feelings are rarely spared. The feedback is often demeaning - this is no doubt purposeful, to entertain the viewing audience.

I remember watching competitive shows as a young child; figure skating, Miss America and The Gong Show, which was purposefully humored. Even later shows such as Star Search, were entertaining without being insulting, demeaning and crude.

To answer my colleague's question: I think American Idol has a discouraging effect on America's talent. I find their selection of talent to be constrained and rather contrived. I would like to know your thoughts. Maybe there is more to the show than meets the eye?