As a music therapist I can do something no drugs can do

I first encountered music therapy at a day centre for older adults in Hackney, east London. I was shadowing a music therapist for the afternoon and helping her run a group for older adults with severe dementia.

Each person’s dementia was different. One woman spoke and sang every spiritual song known to her; she was on her journey to meet her maker, she kept saying. Another woman was quiet and polite; it was difficult to know if she knew what was happening around her. There was one man in the group. He was nodding off but every now and again would startle himself, say something and then close his eyes. There was another woman in the group whose eyes sparkled when we looked at each other. She tried to speak – she opened and closed her mouth but no words came out.

As the therapist initiated the beginning of the session, taking her lead from the lady singing spiritual songs, I watched something miraculous happen. All four of the adults began to come alive – vacant gazes transformed into laser-sharp eye contact and they began to say hello to each other.

The music was lively and invigorating, yet at times it was reflective, poignant and sincere. It brought them to life and enabled them to connect with themselves and others.

As the session went on, the music picked up pace. People were getting up on their feet, dancing and singing. The woman with sparkling eyes couldn’t stand unaided. She reached out her hand to me and before I knew it, we were dancing together with everyone else. As I leaned into her and thought I heard her sing a little. As the singing and dancing continued, her voice grew stronger and her gentle “la la la” started to become beginnings of other words. She was beaming the biggest smile at me as the song came to an end. After the music had stopped, she held my hand and said a few words to me. I felt she was trying to thank me.

Later, the music therapist told me that was the first time anyone had heard her say anything in years. It was also the moment that I knew I wanted to train as a music therapist. Playing a role in this profound experience changed my understanding and relationship with music. Six years later, I am still working as a music therapist with people of all ages who have a diverse range of needs. From adults with severe and enduring mental health conditions, to young children with profound and multiple learning disabilities.

I can’t cure the children I work with of their autism, or reverse their congenital condition or learning disability. Not even drugs can do that. But I can do something drugs can’t do, which is help them communicate and, in turn, support their quality of life, relationships with their families and their experience and understanding of the world around them.

When a parent tells me that they have given up hope after receiving a diagnosis for their child and feel their world has caved in, I know that music therapy can have a role to play.

I finished working with a boy at the end of last summer. He had been referred to music therapy for emotional issues. The first time we met, when I tried to play music with him, he simply said no and wouldn’t let me play a note. His grandmother looked anxious and alarmed, worried that the music therapy wouldn’t work. No means no surely?

After six weeks, when it came to our last session together, he sang for 30 minutes about what his music meant to him: “It’s my music time, it’s all about the music, the music, it’s all about the music.” Offering time each week for this little boy to play and explore enabled him to express himself. He had found his voice. At the end of the session, his tearful grandmother wrapped her arms around him and said, “I love you”.

Music really does have the power to transform lives.

If you would like to contribute to our Blood, sweat and tears series about memorable moments in a healthcare career, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

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As a music therapist I can do something no drugs can do

The gap between funds and delivery is a chasm in the NHS: something has to give | Chris Hopson

It is now time for our national health chiefs and political leaders to acknowledge publicly that the NHS can no longer deliver what is being asked of it for the funding available.

Despite the best efforts of hard-working staff, hospital accident and emergency performance is now the worst it has ever been. In the first three months of this year only four of the 138 large A&E departments saw the required 95% of patients within four hours. One in 10 patients had to wait more than four hours, the highest level at this time of year since 2003-04.

Waiting lists for operations, with 3.9 million patients, are now at their highest point since December 2007. The three million mark used to be considered a line not to cross, but experts have suggested that the waiting list target is irrecoverable. There are similar problems of dropping performance against cancer and ambulance standards, with mental health and community services under similar pressure.

At the same time, we ended the last financial year with trusts reporting the largest deficit in NHS history – £2.45bn but, in reality, above £3.5bn once you strip out one-off transfers and accounting adjustments.

These challenges are being matched by unprecedented staff shortages, including nurses, key specialists, GPs and emergency doctors. These have led to closures of A&E departments and other services, unsustainable pressure on GPs and, in 2015-16, an unaffordable extra £3.6bn agency staff bill.

Demand for NHS services also continues to rise much faster than predicted: between April and June, A&E attendances and emergency hospital admissions were up by more than 6% compared with last year – three times the predicted increase. If funding fails to keep up with this demand, the challenge for the NHS grows year on year.

These problems are now affecting the whole NHS. In the first three months, 94% of A&E departments missed the four-hour A&E standard. At the end of 2015-16, nearly two-thirds of trusts, and more than eight in 10 acute hospitals, were in deficit.

It’s no surprise that cutting social care year after year has created major problems. Given the lack of capacity in community and mental health services, the number of patients waiting for a hospital discharge is now the highest it’s ever been. As a result, hospitals are being asked to routinely run at capacity levels that risk patient safety and would be unthinkable in France, Italy or Germany.

Taken together this means the NHS is increasingly failing to do the job it wants to do, and the public needs it to do, through no fault of its own.

This concrete evidence is supported by the testimony of frontline NHS leaders. Thanks to the dedication of staff, NHS performance rarely goes off the edge of a cliff. As the 1990s showed, instead we get a long, slow decline that is only fully visible in retrospect. It’s therefore difficult to isolate a single point in that downward trajectory to sound a warning bell.

But NHS trust bosses are now ringing that bell – we face a stark choice of investing the resources required to keep up with demand or watching the NHS slowly deteriorate. Trusts will, of course, do all they can to deliver efficiency savings and productivity improvements. But they are now saying it is impossible to provide the right quality of service and meet performance targets on the funding available.

Something has to give. This is particularly so since NHS funding increases are about to drop from 3.8% this year to 1.4% next year and 0.3% in 2018-19. As total NHS demand and cost rises inexorably, by at least 4% a year, this will mean even larger gaps after seven years of the deepest and longest financial squeeze in NHS history.

There are unprecedented shortages of emergency doctors and other staff. Photograph: Alicia Canter for the Observer

So what does give? A range of options are now open to political and NHS leaders. Additional funding is the most obvious, with the new government’s first autumn statement on 23 November providing an immediate opportunity.

If, however, there are is to be no extra funding, the NHS must make some quick, clear choices on what gives, however unpalatable these choices may be. The logical areas to examine would be more draconian rationing of access to care; formally relaxing performance targets; shutting services; extending and increasing charges; cutting the number of priorities the NHS is trying to deliver; or more explicitly controlling the size of the NHS workforce. These are all approaches adopted by other public services such as prisons, local government and the police when faced with similar funding challenges over the past decade – though they would clearly provoke public unease and ministerial anxiety if applied to the NHS.

In reality, individual areas are already having to make decisions like these on a piecemeal basis. For example, in the last three months, clinical commissioning groups like St Helens and Vale of York have developed proposals to suspend all non-urgent care for four months or suspend non-urgent treatment for obese patients and smokers for a year. A number of trusts have had to close services on safety grounds and others have announced plans to reduce the size of their workforce. Unsurprisingly these decisions triggered local opposition and adverse national media coverage.

NHS trust leaders rightly argue that this piecemeal approach is unsustainable. It is not tenable to ask local leaders to deliver the impossible, make unpopular local decisions as quietly as possible and then carry the can when the decisions become public. As the junior doctors’ dispute shows, it is also untenable to ask NHS staff to close the gap by simply working harder and harder.

In the absence of extra funding, we need an open, honest, realistic, national debate on what gives, translating into immediate clear choices, with national leaders explaining why such choices are necessary. Any such debate must extend beyond the NHS and involve the public. The earlier that debate starts and the more open and honest it is, the better.

The gap between funds and delivery is a chasm in the NHS: something has to give | Chris Hopson

Thane Prince: "There"s something quiet and proper about jam-making"

Soon after the accomplishment of Prince’s programme and its forebear, The Great British Bake-Off, coupled with the rise of grow-your-own-ers and the beatification of all things WI, a single may feel that Britons minded to make their own chutneys, condiments and cordials would have got the hang of it by now.

Yet, jam-producing is one particular of the most rewarding locations in food publishing, echoing the latest boom – revenue of preserving paraphernalia such as jars, thermometers and jam funnels rose by two,000 per cent final 12 months. Even Prince, whose Ideal Preserves is out at the finish of the month (her 12th recipe assortment and her third about jam-producing), as soon as asked: “Who goes to bed with a cookbook about ketchup?”

Her coolly modern kitchen has four ovens, a dining table that simply seats twelve, shelves of Emma Bridgwater crockery and drawers that heave open to reveal a lifetime’s collection of utensils, including a prize possession: a stepped jam funnel picked up throughout a weekend in Prague with her husband of 41 years, Bob.

“People usually remark about the dimension of my kitchen,” says Prince, “but it is exactly where I work. If I was a whore, I’d have a massive bed.”

In Best Preserves, Thane explains in jolly, useful prose the subtle differences in between jams, jellies, butters, marmalades and chutneys. Preserving is not just for harvest festival time, she says, it’s a yr-round work. “It begins in the spring with marmalade – these oranges come in in February – and runs all the way through to December, when I make my cranberry vodka. There is always anything to be done. It’s about taking anything that is very good and producing some thing even more stunning with it. So forget your leftover strawberries, which are often rotten. And overlook gluts of courgette if you do not consume them although they are fresh, you’re not going to when they’re in a jar on the shelf, are you?”

As we speak, Prince desires to demonstrate me how to make a fundamental berry jam and a much more innovative gooseberry curd with elderflower (“perfect on scones, or folded into cream with meringue”). “With sugar, acid and pectin, you can set anything. The fruit is coincidental in jam. But a curd is, fundamentally, a set custard, a silky-soft luxury.”

She folds a thick white pinny close to her waist. “The apron is emotional rather than needed. I utilized to be a nurse, and I by no means truly feel happier than when I’m sporting one.”

And with that, we get to the heart of why we Britons adore jam-generating: it is about the nesting instinct. “There’s something about preserving that is quiet and appropriate. The place does a child really feel safest? It’s at granny’s residence, holding her hand and opening a door to a larder that’s full of lots. You are with somebody who’s going to safeguard you, with her existence if she demands to, and in front of you is cake, and ham and jam. And that’s how I come to feel about preserving.”

Prince suggestions a kilo bag of sugar on leading of a pan of macerating berries, in equal proportion of sugar to fruit, then hands me a wooden spoon. Given the growing concern about the amount of the granulated white stuff in our diet programs – final month, a government study revealed that we eat on average twice as significantly sugar a day as we ought to, and to stop soaring weight problems amounts we ought to reduce our advisable everyday consumption from six to five teaspoons – isn’t she anxious about what peddling preserves is performing to the nation’s waistlines?

“It’s all about portion manage,” she says. “There is no normal food that is bad for you. Extremely handful of food items are, apart from diet program and minimal-body fat meals, which replace excess fat material with sugar. And the far more we place visitors-light labelling on factors, the more we disable folks. You can operate a smartphone and can perform Globe of Warcraft to level 29, but you cannot understand that a banana is not going to have as many calories as a sweet fizzy drink? We say to folks you are as thick as —-.” She could be daintier than a doily, but can swear like a trucker.

Her personal svelteness is maintained with “a minor Photoshop on my book jackets” and, far more readily, by following an intermittent fasting diet. Earlier this yr, that other grandmother of foodie Television, Mary Berry, admitted that she had problems preserving her figure. “I eat enormously,” says Thane, “but I stick to the 5:2. I’ve been undertaking it for a 12 months, and it performs for me since I have this odd daily life. Final week, I ate twice at Fischer’s, had lunch at the River Cafe, I went to The Delaunay and The Palomar – all in a single week. With the five:2, you are not permanently ‘on a diet’, there are just a couple of days a week when you don’t consume. That’s significantly, much simpler to live with.”

Prince’s conviviality is a surprise, following her sometimes prickly visual appeal on The Massive Allotment Challenge, the new series she began filming in Oxfordshire last week. “I consider they showed my difficult bits. That is tv. You can only say what comes into your head. The contestants were all pretty, they all experimented with extremely difficult and had been all terrified of me. But a person has to be the Simon Cowell of the display. It was always going to be me.”

But then several of the contestants did get her dander up. “A lot them thickened their curds with cornflour. I’m sorry, that is just anathaema.”

If her gently whispered disapproval and best diction give her a slightly schoolmaamish demeanour, it’s created for delivering those neat lines of vague disappointment that made her turns on The Huge Allotment Challenge such a draw. Soon after a Norfolk upbringing in the 1950s, she worked for ten years as a ward sister at the former Middlesex Hospital in central London. “My maiden title was Miss Hurry and I was a bit bossy, so you can envision the jokes.”

She switched careers following marrying Bob, who was in undertaking finance, and starting a family. “In these days, you did not carry on hospital nursing when you had youngsters. It was tiring. I didn’t actually want to depart, but in those days, we used to operate 12-day shifts. And so I started out cooking for a deli, and then began creating about foods, and then it was just at the time off in the 1980s when tv cooking was beginning to get. I did cable Tv for a even though, then Ready, Steady, Cook – they were desperate as there have been fewer women chefs in people days – and it was fascinating. My daughter was at Exeter university at the time, and I would could walk through the campus and individuals would all turn and smile and say ‘Hi’.

“Fame was very addictive. The excellent side of it is lovely, the poor side is when you’re no longer renowned, which often happens. It’s element of the deal.”

This also brought a honest sum of hob-nobbing. “I was at a single of Jeffrey Archer’s shepherd’s pie and Krug events once, and was absolutely amazed. He had shelves and shelves and shelves of books… but they were all his books. I thought he’s possibly going to give them away as we left the celebration, but he did not.”

For the ideal portion of a decade, she was the Telegraph’s meals author ahead of moving to the Norfolk coast to open a cookery school in Aldeburgh. “It ran actually efficiently for ten many years. Then it just was time to shut it. We were too total, if that tends to make sense – booked up for a yr. It meant I couldn’t be spontaneous at all. I had to be there all the time.”

In Aldeburgh, she started to miss the city. “In a small town, it’s really simple to p— individuals off,” she says, enigmatically. For the past 10 years, she and Bob (“a sweetheart, head and shoulders above other men”) have lived in four-storey splendour following door to the equally amazing property where pop star Lily Allen and her younger brother, Game of Thrones star Alfie Allen, had been brought up. When I inquire how they were as neighbours, the grimace says it all.

Prince was fairly the tearabout herself as a kid. “I fell in a fire when I was small. I do not don’t forget it, but I have two massive burns on my forehead, which is why I’m always patting my fringe. All the pictures of me as a little one seem like I’ve received horns.”

Her very own daughters Jade and Amber (“we had been hoping to have a Garnet, for the total set of targeted traffic lights”) have lengthy flown the nest. One now lives in walking distance, although the other moved to Seattle a year ago with Prince’s grandchildren.

When she’s not writing books, judging others’ preserves or holding court at residence (“I like informal parties, but I really do not like occasions”), she volunteers each Tuesday at the Clinical Study Unit at University University Hospital. “I do the teas and coffee, and have a natter with the individuals. Nursing is the hardest issue I ever gave up. It is a extremely precious point that nurses do.”

Which, like ripe summer berries and heirloom tomatoes fresh from the vine, has to be worth preserving.

* Best Preserves: one hundred Scrumptious Methods to Protect Fruit and Greens, by Thane Prince (Hodder and Stoughton, £25), is obtainable from Telegraph Books at £22.50 + £1.95 P&ampP. To buy, call 0844 871 1514 or check out books.telegraph.co.united kingdom

Thane Prince’s gooseberry and elderflower curd

Substances

500g gooseberries

Five eggs

125g salted butter

100ml elderflower cordial

200g white caster sugar

Place the washed gooseberries in a pan above a low heat, with just the water that clings to them, cover and cook till the fruit softens and boils. Rub the mixture by means of a sieve into a round-bottomed pan. Lightly whisk the eggs until smooth, and include to the pan, along with the butter reduce into 1cm cubes, the elderflower cordial and sugar. Put the pan on a quite reduced heat and srit continuously with a wooden spoon, as however scrambling eggs. Cook right up until the sugar has fully dissolved and the butter melted. The mixture ought to not come to feel gritty when stirred, and there must be no signs of sugar on the back of your spoon. Flip the heat up a notch to reduced, stirring continuously, cook the curd till it is thick adequate to coat the back of the wooden spoon. Do not stop stirring or depart the pan do not let the mixture bubble. When the curd has thickened – remembering it will thicken far more as it cools – take the pan from the heat. Pot the curd into sterilised jars, using a jam funnel and a ladle. Cover with the lids and leave to awesome. When the jars are cold, label them and check out the lids are firmly screwed on. Keep in the fridge unopened, it keeps for up to 4 weeks.

Thane Prince: "There"s something quiet and proper about jam-making"

I cannot be satisfied, I never want something poor to happen

“Some of the beliefs about the adverse consequences of happiness look to be exaggerations, typically spurred by superstition or timeless suggestions on how to enjoy a pleasant or prosperous lifestyle.

“Nevertheless, taking into consideration the inevitable individual distinctions in regards to even dominant cultural trends, no culture can be expected to unanimously hold any of these beliefs.”

The researchers at the Victoria University of Wellington, New Zealand, explained currently being pleased with your lot is far more most likely to be the ultimate aim of westerners, than individuals from other cultures.

The examination published in Springer’s Journal of Happiness Studies is the initial to overview the notion of aversion to emotional satisfaction, and seems at why a variety of communities react in a different way to emotions of effectively becoming.

Dr Joshanloo and Dr Weijers explained it is “a cultural phenomena” that for some individuals happiness is not a supreme value.

The researchers believe being raised in a culture that does not value happiness could motivate a particular person to back away from it. And while avoiding it exists in both Western and non Western cultures, it is far more valued in the West.

In America, it is nearly taken for granted happiness is a single of the most essential values guiding people’s lives. Western cultures are much more driven by an urge to maximize happiness and lessen sadness.

Failing to seem content is typically a result in for concern. Its worth is echoed through Western constructive psychology and investigation on subjective properly becoming.

But in non Western cultures it is much less valued. The ideals of harmony and conformity are usually at odds with the pursuit of personal happiness and the endorsement of individualistic values.

For instance, research have proven East Asians are a lot more inclined than Westerners to feel it is inappropriate to express happiness in a lot of social conditions. Similarly, Japanese are less inclined to savour constructive feelings than Americans.

I cannot be satisfied, I never want something poor to happen