Introduction
Music therapy is an evidence-based clinical use of musical interventions to achieve individual goals within a therapeutic relationship by a certified practitioner. Music therapy may sound not like a very much practiced medical procedure but that is not true. In fact, music therapy dates back as early as ancient civilizations like Egyptian, Indus valley and old Chinese civilization. Music combined with various dance forms was used at that time to treat various illnesses. Even today music therapy is used to address physical, cognitive, emotional and social needs of an individual. After assessing the problems of a patient, a certified music therapist provides treatment which may involve creating, improvising, singing or listening to music. Music therapy is also used for people who are unable to express themselves well, and music helps them express their emotions in a better manner. This essay will discuss different aspects music therapy including the development of music therapy, types of music therapy, Mozart effect, music-based interventions results of music therapy, comparison between therapeutic music and modern day music, positive and negative effects of music therapy, the changes brought into music by music therapy and music as medicine.
Development of Music Therapy in the 18th Century
Using music for the purpose of healing has been an ancient practice the evidence of which is found in biblical scriptures, historical documents of ancient civilizations belonging to Rome, Greece, Egypt, India and China. Music combined with songs and dances were considered therapeutic for curing wounds. In fact, the oldest known medical documentation, the Kahum Papyrus, mentions about the use of chants and incantation for curing the indisposed (Halpern). It was in the 18th century, however, that physicians and scientists began researching upon the effects of music on human minds and body. Charles Burney was the first historian in the 18th century to have recorded the use of music as experimentation to cure the King of Spain, Philip V of "the dejection of spirits" he suffered from (Rorke 2001). The new stage of developments as regards the music therapy in treating ailments was first captured in detail by one of the reputed physicians of late 18th century London, Dr. Richard Brocklesby in his book titled 'Reflections on Ancient and Modern Music with the Application to the Cure of Disease'.
In his book, Brocklesby discusses the effect of music on human mind that "has a faculty, or disposition to be pleased, or displeased with certain airs, or systems of sounds" because mind has the propensity to like uniformity amidst variety (Rorke 2001). Not only Brocklesby, there was a slew of researchers and scientists who became interested in investigating about the music therapy in treating illness. It was during the late 18th and the early 19th century that the effect of music on different functions of human body such as cardiac output, blood pressure, circulation, respiratory rate, pulse rate and fatigue came to light (Halpern). Besides investigating about the physiological responses to music, researchers also tried to find the effect of music on human psychology. Brocklesby in his book discusses that music has the power to allay the violent passions and emotions of human mind like anger, fear, grief, joy and enthusiasm. He believes that sometimes diseases take root in human body due to mental disturbances like melancholia, delirium, frenzy and mania, and concludes that music is therapeutic to cure all these mental conditions, which would resultantly help the medicines to work more effectively (Rorke 2001). He also believes that music helps soothe the minds of a pregnant woman and her unborn baby.
Music therapy as a profession began to develop in USA during the two world wars, WWI and WWII. The role of music in comforting and healing patients reached a new height during this time. In Veterans Administration Hospitals, music therapy was used to comfort patients with traumatic injuries. It was found that music had an amazing effect in relieving wounded soldiers of their feelings of pain. Music made a wonderful healing effect on the psychological, physiological, cognitive and emotional conditions of the veterans (Rorke 2001). Music helped the recovery process of the soldiers. Seeing the therapeutic effect of music, music therapy was established as a profession, and towards the end of WWII, musicians were designated at hospitals to administer music therapy to the patients. Since that time, universities and colleges developed various programs to give training to the musicians to use music as therapy. The National Association for Music Therapy (NAMT) was founded in 1950. It was a professional organization of music therapists who provided therapy to the mentally retarded, veterans, psychiatric and hearing/visually impaired people (AMTA #1 2014). In 1983, the Certification Board for Music Therapists was created to add credibility to the music therapy profession. In 1998, NAMT merged with another music therapy organization called the American Association for Music Therapy (AAMT) and came to be known as American Music Therapy Association (AMTA). The mission of AMTA is to spread awareness about the benefits of music therapy among public and help people have an easy access to quality services of music therapy. It is the single largest music therapy organization in the world. It represents music therapists not only in USA, but also in more than 30 countries around the world Association (AMTA #1 2014).
Types of Music used in Music Therapy
There is no particular type of music specified for music therapy. Depending on the patient, his condition and his needs, the music therapist decides upon the kind of music to be used for his treatment, and usually all kinds of music, starting from classical to pop, are used for therapeutic effect. However, usually, the music played for therapeutic purpose is quiet and peaceful. Loud music is not suitable for therapeutic purpose. That is why classical music is considered to be well-suited for music therapy whereas hard rock, heavy metal and modern pop songs are considered to bring discomfort in patients.
Mozart Effect
The term 'Mozart Effect' first came into light in 1991 when Dr. Alfred A. Tomatis claimed in his book titled “Pourquoi Mozart” that Mozart's music has the therapeutic property in healing and curing people of depression (Sorensen 2008). However, the real popularity of Mozart effect gained momentum when psychologist Frances Rauscher conducted a study on college students and claimed that the group of students, exposed to Mozart's music for 10 minutes, scored higher than the unexposed group. His claim that listening to Mozart's music improved the cognitive prowess and spatial-temporal reasoning of students gained such popularity that the parents in USA went into a frenzy of buying Mozart CDs with the hope to boost the IQ level of their children (Sorensen 2008). The concept of Mozart effect was further reinforced when Zell Miller, the governor of Georgia, announced in 1998 that a state budget of $105,000 had been earmarked for the purpose of providing every child born in the state with a CD of classical music (Sorensen 2008).
Music-Based Interventions and Their Results
There are mainly four kinds of music-based interventions including improvising, re-creating, composing, and listening to music. Improvising involves the client creating, singing and playing his own music extemporaneously with or without the directions of the therapist (TUMT 2014). Improvisation is most suited for clients with the needs to develop creativity, spontaneity, communication, interpersonal skills and freedom of expression. Emotionally disturbed patients with psychiatric disorder or children with delayed brain development respond well to improvisation as they learn to communicate their feelings to others through this technique.
Recreating involves the client playing or singing pre-composed music or songs. The recreating session is suitable for patients with speech impairments and mentally retarded people. Usually for these patients, music of slow tempo, medium pitch range and appropriate phrase lengths are used. Music involving fast tempo, long pitch range and difficult phrases are not suitable for this purpose (TUMT 2014). In the third intervention of composing, the patient learns to compose music or write the lyrics of a song. Patients suffering from life-threatening diseases like cancer are often provided with this treatment to express their fears and feelings about life and death on paper. Listening involves the client responding to live or recorded music. Depending upon the patient and his condition, he can be made listening to a variety of music from classical, jazz, folklore, pop, country and new age. Listening to music soothes minds of the patient, helping him relax, manage pain and de-stress. Listening also helps regulate different body functions including heart rate, breathing and so on.
That the above mentioned music-based interventions bring positive results in terms of improving the health of the patients have been proven by many studies. A group of Finnish researchers conducted a study on 54 patients who had suffered a stroke either on the right or left hemisphere middle cerebral artery and came up with the finding that listening to music for few hours a day improved the recovery process of the patients. The music therapy was administered to the patients for the duration of two months immediately after their admission in the hospital. The patients were followed up for 6 months after the stroke. Within three months after the stroke, it was found that the verbal memory improved by 60% in music listeners. Their ability to control and perform different mental operations also improved by 17% (Preidt 2008). There is also evidence of music therapy working effectively on patients suffering from depression. The National Institute of Mental Health (NIMH) reports that about 18.8 million American adults are affected by depression in a year (Erkkilä et al 2008). Several researches have shown that music therapy has resulted in better responsiveness to depression medications. Music therapy not only soothes and calms the minds of the depressed patients; it also improves the heart rate, respiratory rate and blood pressure.
Comparison between Classical and New Age Music
Acoustic music which sounds soothing to the ears is ideal for therapeutic purpose. Acoustic music is the form of music in which no electrical amplification is used for the purpose of producing sound. Restful, meditative, rhythmic songs with low or medium pitch are preferred for therapeutic purpose. Classical music including classical pop, rock or hip hop songs are usually acoustic in nature compared to the New Age songs. New Age songs are those which, during the recording stage, are engineered to produce high frequency loud sound (Macrae 2012). Therefore, New Age songs like the pop music of Miley Cyrus, Lady Gaga, Beyoncé and Drake are not ideal for therapeutic purpose because of their artificially amplified loud sound. A group of Spanish Researchers conducted a study to draw comparison between classic music and New Age music, and they came up with the finding that modern recordings of pop, rock and hip hop songs are far louder than those of the 1950s or 1960s (Macrae 2012). Modern day music is engineered and cranked up during the recording to be well-suited for discos, and therefore, extra beat and tempo are added to bring motion to the music whereas classical songs were more soothing and easy on the ear.
Negative Effect of Modern Day Loud Music
Since modern day music is spiked with extra beat, high intensity, tempo and frequency to be more addictive and catchy for listeners, it is usually louder and noisier than classical music. Therefore, listening to New Age pop or rock songs could bring in an array of negative effects on human health. Listening to loud heavy metal music can irreparably damage the inner ear or choclea, which could result in hearing loss. A group of researchers from the National Institute for Physiological Sciences in Japan and the University of Muenster in Germany conducted a joint study to find out how loud music affects human health, and they came up with the finding that listening to loud music for a lengthy period of time can impair the ear and nerves of the brain resulting in a decline of the ability to distinguish sounds (Fitaihi 2013). In fact, a prolonged period of listening to heavy metal loud music through earphones can result in memory loss too. A study conducted by German researchers showed that people fond of loud music experience memory loss by 15% to 60% (Fitaihi 2013). Many a time young people get drawn to loud music in order to remain oblivious to their problems and pressures in life, and as a result of listening to loud music through earphones, they develop a myriad of problems like insomnia, psychological imbalances, reduced immunity and a debilitating nervous breakdown.
Psychological Responses to Different Types of Music
Music on the basis of the elements used can be broadly categorized into two types- harmonious and disharmonious music. Melodious music with soft pitch, slow tempo, medium range of rhythm and timbre fall into harmonious type whereas high frequency music with loud pitch, fast tempo, disharmonic rhythm and timbre are disharmonious. Classical music with all its properties is considered to be harmonious whereas modern day artificially spiked loud music is considered to be disharmonious. Harmonic music like classical music has been found out to be extremely soothing to the ear. A number of studies have showed that listening to classical music like a Mozart sonata or soft pop has led to the reduction in tension, anxiety, fatigue, melancholy and depression (McCraty, Barrios-Choplin, Atkinson and Tomasino 1998). Harmonic rhythm and tempo used in classical music is sympathetic to the body. With the tempo of most of the classical music being within the range of 70 and 80 decibels, it corresponds well to the normal human heart rate of 60-120 decibels per minute. However, disharmonious rhythm and tempo used in modern day pop or rock music is outside the normal human heart rate of 60-120 decibels per minute, and therefore, this type of music triggers a number of negative effects like lethargy, hyperactivity, increased blood pressure and pulse rate, anxiety, insomnia, aggression and inattentiveness (Severance 1999). Besides, disharmonic music is artificially engineered to be addictive in nature, and therefore, people addicted to listening loud music get into depression if they are held off their preferred style of music for too long. Depression is the sign of withdrawal symptoms that the people, addicted to loud music, suffer from because the disharmonic music with its fast tempo and rapid rhythm creates a heightened state of arousal, a state comparable with the state of addiction to drugs.
Did Music Therapy Bring Change in Music?
Music therapy has brought significant changes in the way music is perceived. Before the concept of music therapy gained popularity, music was looked upon as a form of entertainment only, but now music is used as an element of therapeutic purpose. That Mozart sonata besides giving enjoyments to the auricular nerves can improve the function of the brain was unthought-of even a few decades back. Since the benefits of music therapy have come to the fore, a lot of changes have taken place not only in the way music therapy is administered, but also in the form of music used for the therapeutic purpose. Depending on the type of music-based intervention used, different techniques and music therapies are tailored for the client to suit his needs. Most of the time, prerecorded or pre-composed music is used for the purpose, but in some interventions like the composing and improvising, patients and therapists both work together to create and improvise music. Especially in the intervention involving the patient to compose music, extra focus is given on the composition of lyrics, and the patient also needs to attach tunes to his lyrics (AMTA #2 2012). In improvisation, a lot of musical instruments like piano, drums, xylophones and cymbals are used to help the patients improvise and create music. Often patients are encouraged to match the traditional beats of classical music or traditional folk songs to be able to keep their physical movements in control. Sometimes patients get so much immersed in creating music that they develop a passion for it. There are many patients who have their songs recorded on CDs, and they perform live in fundraising shows.
Live music is ideal for music therapy. In live music, acoustic music using only harps and voice is performed to soothe the patients. In most of the occasions, pre-composed music or popular classical music is performed in live music, but at times music is formed for therapeutic purpose in the style of classical music. Since classical music due to its slow tempo, slow rhythm and timbre is soothing on the ear, music therapists, depending on the patient’s needs, composes and maneuvers music in a way that responds best to the psychological and emotional needs of the patient.
Music and Medicine
There is no doubt that music therapy helps the recovery process of the patients, and numerous research results substantiate how music therapy helps the prescribed medicines work on a patient by improving his vitality, heart and pulse rate and different body functions. A slew of studies have brought forth the point how music therapy has improved the muscle movements and neurological functions in the brain (Shulman 2008). In fact, there is evidence that music therapy has benefitted patients in their healing process after they have suffered a stroke. Trevor Gibbons is one such example of how music therapy functions like a medicine to the sickly torn down by a debilitating health condition. At the age of 51, Trevor Gibbons had his speech impaired after he suffered a massive stroke and a spinal injury from a fall. Not only his speech was damaged, he was even unable to move for days. He went into a severe depression as a result. However, with the help of music therapy for several years, he has not only been able to restore his speech, but also has over 400 songs to his credit. His songs are compiled into three CDs, and he has performed at Lincoln Center for fundraising shows (Shulman 2008). There are several patients like Gibbons who have benefitted from the medicinal effect of music therapy and have overcome their various health problems like dementia, autism, depression and Alzheimer’s disease.
Conclusion
Music therapy is an evidence-based clinical use of musical interventions by a certified practitioner to treat patients suffering from illnesses. Though music has been used for therapeutic purpose in ancient civilizations, music therapy as a profession began to develop only after the two world wars when for the first time while administering treatment to the wounded soldiers, the benefits of music therapy came into the limelight. Though all kinds of music are used for therapeutic purpose, depending on the conditions of a patient and his needs, usually soft, meditative, acoustic and restful music is ideal for the purpose. Modern day pop or rock songs with heavy beats, increased rhythm and tempo are unsuitable for the therapeutic treatment as the loud noise can trigger an array of health problems. Music based interventions are categorized into four types - improvising, re-creating, composing, and listening to music and depending on the conditions of a patient, an intervention is recommended. Over the years, a lot of changes have taken place not only in the way music therapy is administered, but also in the form of music used for the therapeutic purpose, and therefore, music is composed by the therapists for the therapeutic purpose in the style of classical music. There are a lot of evidences of music having been an effective medicine in the treatment of different ailments like autism, stroke, dementia and depression. Music therapy, is truly, an effective alternative way to help patients fight their ailments.
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