“Even if one member of every Indian Family had studied Music the country would never have been Partitioned”……Bade Gulam Ali Khan
Music has been used since time immemorial to comfort and console the crying babies. Lullabies listened to during one’s childhood bring back the fond memories of one’s innocent childhood and carefree existence in the secure lap of one’s mother.
Use of music in hospitals and nursing homes is of recent origin. The two world wars, which brought in untold destruction and doom to mankind also brought in what we call ‘music therapy’. The suffering war-veterans, who were torn both mentally and physically by these two wars had to be consoled and comforted in the same way a mother would care for her baby.
Music here had readily stepped in to play a mother’s role.
Positive responses to the motherly support extended by music to the suffering soldiers led to chalking out a formal music training programme in the care of the mentally traumatized and physically wounded war veterans.
It is this training programme which has come to exist today as music therapy.
The origin of music therapy, however, can be traced back to a period much earlier than the World Wars. Even in medieval Europe and India such application of music has been in existence. In Europe, a tradition of monastic chant for the sick was existing as the Benedictine Order, which embraced communal living and supported their sick or dying fellow-members through formal musical rituals. While the ancient Indian Vedic chants and the system of nada yoga were all known for their ‘elevating’ effect, shamanism, which had also existed in several continents, had also employed sounds for altering the state of consciousness.
Hospitals as we know are a relatively recent development in health care. They harbour the sick and the wounded and care for their recovery.
As caring and comforting are the prime needs for a suffering patient — at times even more preferable than the quality or efficacy of a medicine – modern hospitals are fast introducing the much-needed care and comforts within their four walls, in addition to accommodating the annoying, monstrous and horrible-looking surgical and diagnostic giants called equipment. The care and comfort givers for the patients in human form are not really their mothers or sisters, but actually a set of trained nurses or physicians who themselves, like fellow-humans, are prone to stress and tension, thereby needing their quota of care and comforts!
Realizing this, some volunteers at Veterans hospitals began to play music and sing for patients in a few selected hospitals which had accommodated the wounded soldiers. Positive responses to this musical support had eventually led many hospitals to go for musicians directly, in course of time, formal music training programs for health care applications came to exist. In 1944, Michigan State University offered the first college degree in music therapy.
Music as a Medical Subject
Recognizing its importance as a therapeutic tool or as a complementary system of medicine, many behavioral and psychological scientists started observing the overall impact of music on the sick and the forlorn, It was found that music, by its inherent nature, starts a dialogue through interactive phrases and passages and encourages a sort of ‘internal communication’ within its listeners, who are not able to express their anguish and sufferings to others. Every genre of music incorporates in its body a stream of question or ‘tension’ to be followed by yet another stream of answer or ‘relief’. Listening to music, in other words, is a sort of mental gymnastics in which one undergoes an exercise of tension and relaxation. Like muscles becoming supple and flexible with a constant dose of physical exercises, the mind, over a period of time, also becomes supple and flexible – an essential prerequisite for triggering healing.
It also – through reminding its rhythms and resonance in the back of the mind – helps to develop positive and healthy interaction with others one comes across.
It was therefore felt that all places where stress is automatically built up need to be neutralized with appropriate musical inputs. Hospitals, which concentrates the sick and the suffering who, at times, writhe in pain and fear, and trouble-shooters who were equally prone to stress, were identified as the most stress-causing area which needed immediate action.
All the leading hospitals across the world have now started employing music specialists — called music therapists- to work out appropriate music inputs to care and console not only their patients, but also their highly tense surgeons and care-givers!
As music stimulates interaction, memory, and affective response, it can be the next best option to any human company, which is badly needed when you are alone and suffering. Unlike the human company, music never demands anything from you other than your love or indulgence. It encourages healthy and positive interaction between listeners as it develops such interactions between the listeners and the performers. This active and healthy stimulation in a way, lends certain confidence to the listeners, which no other system or person readily offers. There is a presumption that the clients are awake and capable of response, which can be used to stimulate energy if the patient is lethargic. On the contrary, if the patient is hyperactive and there is too much energy in them, music helps in calming them down with its love-patterns: the pats of talas and hugs of ragas. Thus music therapy pre-supposes that a positive change in moods and behavior can be brought about in all listeners – unless they themselves are reluctant to have such changes in them!
The Hospital Music
We cannot standardize any music as fit for the hospital atmosphere. It is the individual patient’s condition which should be taken into account while prescribing any music.
For instance, when a patient is in critical condition, writhing in pain, it is better not to disturb him with any kind of music. Silence in such cases, no doubt, is golden!
However, the patients who have undergone surgery and recuperating may need some healthy soundscape. Very soft, gentle, and non-rhythmic music in the lowest decibels could be of use in bringing them back to their normal conditions. Such music should also not be played for long. At a stretch, in any case not more than 10 minutes, unless they themselves demand for a longer period. While deciding such music, their musical background has to be taken into account. Only for musically initiated persons, classical music can be selected. For others popular music which suits their musical preference can alone work therapeutically.
The two aspects of music viz., cheering and melancholic forms can be made use of in a discrete fashion. To overcome depressed patients, initially one starts with a melancholic music to which the patient is attracted. Slowly but steadily, this music genre should give way to cheerful and joyful tunes and rhythms. This transition has to be brought in subtly by the music therapists with their skill and knowledge about the musical structures and their functions. For instance, music to uplift the spirit incorporates a moderately fast tempo with frequent flashes of rhythms and changing percussion effects. It should be borne in mind that although joyful, music would be rejected by people who are totally depressed or who are fighting for life in most serious conditions. In such cases, as we have discussed, silence is preferable to music. After all, discretion is the better part of valor!
Like incorporating the blood-group of the patient in their medical identity cards, there should also be data indicating their musical choice. At the time of admission itself, this should be known to the music therapist of the hospital, so that the ‘treatment’ can be worked out well in advance and kept ready.
Music for Healing and Transition Program
There is a popular Music for Healing and Transition Program (MHTP) conducted in advanced countries, which ensures training in the use of music and voice, particularly in the care of the sick and dying.
MHTP students use a variety of sounds and intonations, using their own voice modulations besides different musical instruments to arrive at psychologically acceptable tones and tonal combinations for the sick and the suffering.
It takes a minimum of two to three years for the students to graduate in this field, during which they work as interns attached to a medical facility. Such graduates could (through advanced research and post-graduate work) eventually be qualified as full-fledged music therapists with work experience and research.
We should start such programs in India too, as there is a growing demand for music therapists from various medical organizations and institutes. Though India is well-known for its musical heritage we have lost the music therapy heritage, as propagated in the Sanskrit texts such as Raga Chikitsa and the literature pertaining to the concept and practices of Nada yoga.
It is high time we revive and restore what is lost by us, while simultaneously aligning ourselves with the modern developments in music and the brain research (neurology).
As a first step, we should focus on proper training for our aspiring music therapists. While doing so, it is essential to take the trainees both from the streams of music as well as medicine. While training musicians, greater emphasis has to be given for the medical aspects and for medicos, emphasis should be on the music aspects.
The discipline of music therapy needs to be systematically developed to bring into fore the tremendous young talents available in the form of musicians who are at present unemployed or underemployed.
Government and the general public have to come forward to make this discipline MT (music therapy) as a right successor to the IT (Information Technology) revolution witnessed in recent years. While IT could contribute to the wealth of the nation, MT promises for its health.
This article was published ‘AYURVEDA AND ALL’, October 2006, Pages 25 to 28
Edited by Geeta Shreedar, April 26