“It’s in God’s Hands” by Tim Siegel: A Review

by Lilah Pittman, MA, MT-BC with introduction by Madison Michel, MT-BC

Madison here, with a brief introduction to Lilah’s book review on “It’s in God’s Hands,” written by Tim Siegel.  I met Tim and Luke Siegel in November of 2018 when we did our music therapy assessment for Luke, who has a traumatic and anoxic brain injury, and have been doing music therapy sessions ever since. It is very apparent in Luke’s sessions that music is highly motivating and can be effectively utilized for therapeutic outcomes.

Though there have been groundbreaking discoveries in the fields of neuroscience and music emerging with neuroimaging technologies over the past 30 years, it is important to note, there is still a lot we do not know and cannot claim to know.  Cautions out of the way, I’d like to share with you some of the evidence-based insights on music and the brain that I have acquired as a clinician pursuing a neuro-based advanced degree:

 

Music and Neuroplasticity

The natural structure of music, rhythmic, melodic, harmonic, or otherwise, has the potential to maximize the efficiency of neuroplasticity when applied appropriately. Efficiency in neuroplasticity is key because it encompasses not only creating new neural connections but also pruning old neural connections as well. 

For example, by pairing a task like tongue movement for Luke with an auditory cue at the end of a phrase of music where there is high musical tension, Luke’s brain has been primed to expect musical resolution. This resolution will come with completion of the motor task, tongue movement.

Since rhythmic, melodic, and harmonic pull work together to efficiently cue the initiation of the motor task, the brain is building more connections than if we were to verbally cue the movement alone. We aim to strengthen Luke’s ability to move his tongue on cue with music and then fade out the musical cueing over time so that Luke can then independently move his tongue on cue with higher frequency.  

Music and Cortical Remapping

The idea behind cortical remapping is the incredible ability to learn a skill in a new area of the brain that was not fully responsible for that skill before. Music therapy clinicians, especially when working with clients who have TBI, often “focus on restoring lost behaviors or finding alternative behaviors. Thus, cortical remapping is a critical component in explaining how the brain is able to restore and/or use alternative pathway,” (Stegemollar, 2014). 

For example, singing is a skill that encompasses speech but accesses more of the brain than speech areas alone. So, in theory, one could work on regaining or re-learning speech skills in a different area of the brain with singing as a middle man. (Collaboration between speech therapy and music therapy disciplines can be extremely valuable!)

 

Music and Dopamine

Dopamine is a neurotransmitter associated with reward-seeking behavior and motivation. “Neuroimaging studies have revealed that listening to music stimulates dopaminergic regions,” which “suggests that music listening may stimulate the same neural network as that involved in reinforcement learning and reward,” (Stegemollar, 2014).  Basically, we know that listening to preferred music releases dopamine which helps us learn. Music therapists have the unique skill set to then use client-preferred music to structure therapeutic interventions in the most rewarding way possible for a client. 

For example, when working on learning to self-initiate leg extension, a music therapist could add preferred music with a built-in structure to cue the extension of one’s leg. The preferred music would, in theory, increase dopamine levels in the brain while performing the functional motor task the client is learning to self-initiate.

Your questions propel me to be a better learner and communicator,  so don’t hesitate to ask. E-mail me at madison@heartandharmony.com. Without further ado, please enjoy Lilah’s beautifully written review!

 

Lilah’s Review of “It’s In God’s Hands”

 

Phenomenal. That’s one of few words that can accurately begin to describe “It’s in God’s Hands” by Tim Siegel. Siegel’s son, Luke, is a client of Heart and Harmony Music Therapy and I had heard Luke’s story during the weeks that I was able to see him for music therapy sessions. However, this book provides so much more insight into Luke’s life, his family’s life, and the impact he has made on so many individuals than could ever be communicated in conversation. Siegel’s writing is both raw and eloquent; heart-wrenching and beautiful. He doesn’t sugar-coat the severity of Luke’s accident or the hardships his family has faced afterwards; he bares it all. But through all of this is a message of unwavering hope and faith. And that is what makes this such an important and powerful book.

“It’s in God’s Hands” intersperses Facebook updates, pictures, and handwritten notes with Siegel’s writing to provide more insight on his exact thoughts and feelings through the seasons following Luke’s traumatic brain injury. The book begins with Siegel detailing the events surrounding the golf cart accident that caused the injury. The focus is on how he and his family reacted to the news of the accident and the subsequent long nights spent in the hospital with Luke. Siegel goes into great detail about the emotions he experienced during those first few weeks with Luke. He mentions how he doesn’t have memory of certain events that took place during the first few days after the accident. He explains how he couldn’t understand anyone, (including passersby in the hallway outside of Luke’s hospital room,) being happy while Luke was fighting for his life. He talks about getting very little sleep and habitually watching Luke’s brain pressure monitor. He doesn’t shy away from sharing the intense details of the grief that he experienced during those first few nightmarish weeks and months following the accident.

Following Luke’s stay at the hospital, he was transferred to a rehab hospital in Fort Worth. Siegel describes the highs and lows of Luke’s time at this hospital. But what I found to be the most moving part of his description of this time was the sacrifice his family made. He mentions that his wife stayed with Luke, (about a 4-and-a-half-hour drive away from the rest of their family in Lubbock, Texas,) for weeks on end while Siegel would make the trip to Fort Worth twice a week. Eventually, this took a toll on both Siegel and his wife’s mental health as Siegel began taking antidepressants and his wife began having panic attacks. In addition to the toll taken on their mental health, the sacrifice their two young daughters made by not being able to see their mom very often and their father being emotionally unavailable at the time is not lost on Siegel. The family made a lot of sacrifices in order to get Luke the best care possible. The love they have for Luke can so clearly be seen in this book, and especially during the description of this chapter of their lives.

After Luke’s condition began to stabilize, Siegel started a foundation- Team Luke Hope for Minds (stylized as Team Luk3 due to the importance of the number three in their family.) It’s through the vehicle of the foundation that Luke has impacted so many lives. The foundation helps children who have received brain injuries and their families by providing them with funding for therapies, informational resources, and support. In addition to all the lives Luke has impacted through the foundation, Siegel also mentions that he has been told by many, many individuals that Luke’s fight inspires them to strive to be the best they can be.

Siegel mentions throughout the book some of the hardships their family has gone through in the years following Luke’s accident. He explains how the relationship he has with his wife is very different from before the accident. While he continually reaffirms how amazing of a woman she is, he states it feels more like they are roommates now. He talks openly about how he takes antidepressants and goes to therapy. He states that Lubbock holds triggers for him now and how it is hard to experience happiness while he is there. The open honesty he displays when discussing all of these hardships is incredible. His willingness to share these details is so helpful for understanding the point of view of someone who has experienced such a traumatic event in their life.

Through his descriptions of Luke’s fight in the hospital, his drive to work hard in therapy, and the sacrifices Siegel’s family has made in the aftermath of the accident, there is a strong sense of tenacity. If there is one thing that people going through a similar situation can take from this book, it’s to never give up. The amount of inspiration one can gain from this book is astounding, but this book is also important for health professionals due to it’s in-depth look at the toll a child’s brain injury can take on a family.

I believe health professionals- specifically therapists- can truly benefit from reading this book. It serves as a great reminder that our client’s have a whole life they live outside of the time we see them, it sheds light on all the sacrifices a family may be required to make, and it helps bring an awareness and sensitivity to empathizing and understanding the emotions a parent might be feeling but not verbally expressing in the moments you see them.

With so many clients, I feel like it can be easy as a therapist to get caught up in the client’s goals and objectives. One would address whatever goals and objectives the client is currently working on, but they might not meet the client’s needs on an existential level. (To clarify, one is still doing their job and isn’t doing anything wrong by interacting with clients in this way.) This book is a good reminder that all clients- including children- have a backstory that can go deeper than could ever be gleaned from conversation with parents or caregivers. While they are the therapist’s client, they are also their own person with their own life. 

This book also brings to light the fact that many families of children who have acquired a brain injury have to make many sacrifices. This is also good to keep in mind as a therapist. While we may not necessarily be able to empathize with everything the family has gone through, having a better understanding of these sacrifices leads one to have a heightened awareness and sensitivity to any needs the family of the individual may have. Of course, these needs will differ from family to family, but this book provides a wonderful example of the depth and gravity of some of the situations these families may face.

As I’ve previously stated, Siegel does an amazing job articulating many of the different emotions he was feeling and how they physically and mentally affected him. The full scope of these emotions may not be readily apparent to much of the world outside of a family member’s circle of family and friends. This includes people such as the child’s therapists and medical team. The writing in this book provides a better understanding of what a family member might be experiencing. This insight allows therapists to be more considerate and empathetic to emotions that are deeper than what appears on the surface. 

I feel that I am a better person because of reading this book. It not only affected me on a professional level, but on a personal level as well. Luke’s fight is inspiring, but so is the drive and determination of his family to give Luke the best care and treatment they can. In one of the last chapters of the book, Siegel presents a handwritten note with such a short but powerful message from author and motivational speaker Sonia Ricotti: “Surrender to what is, let go what was. Have faith in what will be” (Siegel, 2019, p. 203). This quote sums up the struggle a lot of parents have after their child receives a brain injury. But then it also conveys a much-needed message of hope. I feel that these two short sentences sum up Siegel’s book and its message perfectly.

Perhaps my favorite passage of the book (see appendix) also comes out of one of the last chapters. Siegel is very honest with himself and the reader about how the road to recovery is difficult and there are sure to be setbacks. But within this frankness he weaves a candid message of undeniable hope, strength, and faith. It’s a truly inspiring message that I’m sure many need to hear. One thing is for sure, Luke has and will continue to make an impact on the world.

Lilah Pittman, MA, MT-BC

Music Therapist – Board Certified

lilah@heartandharmony.com

Selected Passage from “It’s In God’s Hands”

 

“Over the last three and a half years, I have been through a lot. And I have seen a lot…. God knows it isn’t easy. At times, moving forwards feels impossible. Day after day, week after week, hoping for improvement. But one of the many things I have learned is that without hope and faith, there is absolutely no way I could survive. Hope has become one of the most important words in my vocabulary. Without hope, without faith, we have nothing.

…I am here to tell all of you that as wonderful as our doctors have been, and as bad as Luke’s last MRI was, I choose to believe that Luke will improve. I have no doubt in my mind. Remember, an MRI can’t measure your will to fight or how hard you work. I am 100 percent convinced that consistent therapy has helped Luke more than anything….

We have no idea what his potential is, but I will never stop trying to find out how far he can go. He has progressed far more than our doctors had predicted…. It does Luke no good when I live in the past, and does me no good when I worry about the future. This is our life now, Luke’s life now, and I will do my very best to make the most of it.

Don’t ever give up hope and faith. I’ve had many emotional nights when I wondered if we would ever see improvement. But I believe with all my heart that with love, therapy, hope, and faith, Luke will continue to make strides. Yes, small strides, very small, but it’s still progress.

The road is bumpy at best. For a short time, everything will be going smoothly, then all of a sudden, you’re dealing with infection, constipation, or any number of things than can happen. Just stay the course, despite the setbacks. We certainly have had our share. Don’t ever stop praying. Believe in miracles. And you’ll begin to see better days” (Siegel, 2019, pp. 203-206).

References

Stegemöller, E. L. (2014). Exploring a Neuroplasticity Model of Music Therapy . Journal of Music Therapy, 51(3), 211–227.

Edwards, J., & Gilbertson, S. (2016). Music Therapy and Traumatic Brain Injury. In The Oxford Handbook of Music Therapy. https://doi.org/10.1093/oxfordhb/9780199639755.013.34

Park, S., Williams, R., & Lee, D. (2016). Effect of Preferred Music on Agitation After Traumatic Brain Injury. Western Journal of Nursing Research, 38(4), 394–410. https://doi.org/10.1177/0193945915593180

Siegel, T. (2019). It’s in God’s hands. Austin, TX: Fedd Books.