The nursing home resident—I’ll call her Marian—was not especially popular on her unit. The reason was that she spent most days vocalizing at full volume. Often she sang fragments of old spirituals. Other times it sounded like an agitated distress call, including cries for help as if she was under attack. It was hard to tell the difference between the two.

Marian, who was born just as the Great Depression was getting underway, presented with advanced Alzheimer’s-type dementia. She grew up in the Deep South, and her life was defined by the kind of trauma that pervaded the Jim Crow era. According to her daughter, Marian was beaten and whipped regularly by her father. She ran away to Florida, where she married a man whom she eventually fled. “She’s a runner,” her daughter said. Marian brought her five children to New York City, where she cleaned houses, earned her GED, and became a nurse. She bought a piano when her daughter was young and always liked to sing.

Marian’s mind had gone back to live in that earlier time. Approximately 20 minutes into my assessment, after a long stretch of singing, there was an abrupt shift in her affect. Suddenly, with a terrified look on her face, she looked me directly in the eye and shouted fearfully, “Mama, please help me! Please!”

After two months of therapy we fell into a regular groove. As I quietly played blues chords, Marian would relive what appeared to be incidents from her younger days. In our early sessions she would speak these narrations in prose. Then she started to sing them melodically, as if they were recitatives in the opera of her life. She told stories in improvised song, and the melodies she invented fit perfectly with the accompaniment that I played at the piano.
Marian often sang variations on “Wade in the Water,” a song associated with the Underground Railroad.

Wade in the water.
Wade in the water, children.
Wade in the water.
God’s gonna trouble the water.

One reason the creative arts are a powerful therapeutic resource is that they function on multiple levels. This particular song operated on at least three. The literal meaning of the words tell the Bible story of Israel’s enslavement by Egypt; the water in question is the Jordan river. In Harriet Tubman’s time, the lyrics acquired a second dimension that reflected the reality of Americans attempting to escape from slavery to the northern United States and Canada. More than a century after Tubman’s death, the song continued to resonate in Marian’s singing with the particulars of her personal story of running away from people who posed a threat to her very being.
It was no longer possible for Marian to have a conversation in the usual sense of the word. Our music making took the place of the talking cure, and this song was the best and, perhaps, the only avenue open to her for processing the hard truth of her life.