Music Therapy: An Introduction
Recent years have witnessed the flowering of music therapy all over the world. With the increased uncertainties, migration, globalization, divisive politics, environmental degradation, selfishness, competition and terrorism the world is becoming a more difficult place for healthy living. Thanks to its growing popularity – as more and more people are opting for it — music known for its pleasant impact and the zero side-effects, is being adopted to overcome the tension caused by the present lifestyle and people’s behaviour.
Every one of us who is capable of hearing, responds to music — from the newborn, to patients on their deathbeds, from the physically or mentally strong to those who are weak or impaired. The literature on music therapy is fast building up, confirming that long-term musical involvement reaps cognitive rewards — in terms of linguistic skills, reasoning and creativity for enhancing social adjustments, love and peace. Music exercises the brain and playing the instruments for instance, involves vision, hearing, touch, motor planning, emotion, symbol-integration — all of which go to activate different areas of brain-functioning. It has been observed that some Alzheimer patients could display music even long after they had forgotten their near and dear.
In the deepest and most general level, the forms of music stimulate the forms of adaptation (that is assimilation and accommodation) which are deeply rooted in our autonomic nervous system. These intimate connections between our life-processes and music can remain despite illness or disability and are never dependent on our musical skill or mastery. Because of this, the emotional, cognitive and developmental needs of people with a wide range of problems arising from such varied causes such as learning difficulties, mental and physical ailments, physical or sexual abuse, stress, terminal illness etc., can be rationally addressed by selecting appropriate music.
What makes music therapy different from every other form of therapy is its reliance on music, which has been an inseparable part of human existence right from the day the homo sapiens appeared on this planet. It has been a dependable mental companion not only to the aboriginals who feared Nature’s fury but also to the modern man who is in constant threat by his own tribe. Even the science that usually shows scepticism over the very concept of God is dumb before the power of music. No scientific work could question its impact on mind and consciousness or could deny its role in soothing the mind or elevating the moods, thereby, relieving tension and pain. Rather, a formidable body of research has been built, all confirming its therapeutic and prophylactic role. In this process, people who have sole faith in modern medicine have also started coming out openly to accommodate music as a “complementary medicine” having recognized its role in a wide-ranging disorder including epilepsy, mental ailments, speech-related disorders, and terminal illness such as cancer and AIDS. The patients who have undergone such treatment would vouchsafe that they had experienced a neo-sense of dignity with music, not only during their struggle for survival but also even while awaiting their exit as the passage to the other world became less rough and smoother.
Very much like music, music therapy is easily recognized, but hardly understood!
In this lesson we will however, make an attempt to appreciate the various dimensions in music therapy, which are at times hard to describe or analyse with our binary computer-like logic. It is actually the pattern involved in music — the very same pattern we find in nature- has made music therapy a highly subjective area of study as we may be seeing in detail.
Ethnomusicology is a subject documenting and researching musical knowledge and training in ancient communities. It recognizes the important role played by music not only in binding the human communities but also making them vibrant as music is known to provide strength to cope up with all unfavourable situations encountered in one’s life.
Though musical indulgence has been a part and parcel of all human societies for centuries, it was only during the Second World War that Americans re-discovered the positive role of music especially when played to the wounded soldiers and disabled war veterans in their hospital premises. Positive reactions were noticed in their physical as well as emotional levels. The notable patient responses to music led the doctors and nurses to request hospital administrators for hiring of musicians. It was at this point that the hospitals realized the need for selecting the musicians who had undergone training prior to entering medical establishments.
It is increasingly recognized these days that music therapy cannot be a stand-alone system to fight illness and miseries of humans. On the other hand, in combination with other systems of intervention music seems to be highly effective. Even in music therapy sessions, it is found essential to have a variety. Improvisation conducted using more than just one or two methods and techniques has been found useful. It is also critical to maintain flexibility during the improvisation. For example, the music therapist can preserve a flexible session flow by incorporating several methods, such as imitating, accompanying, dialoguing and rhythmic grounding.
A music therapist is the one who is entrusted with designing, conducting, auditing, evaluating and documenting every therapeutic music session with his or her clients. Working with a client usually begins before the first session. The first measure is to collect all possible background material about the patient/ client and prepare a permanent dossier. An assessment is done to determine the client’s basic strengths and weaknesses — the therapeutic needs. In a music therapy assessment, information on how the client makes, responds to, and relates to music is collected and analysed, and then related to other aspects of the client’s life. Based on the assessment findings, the music therapist formulates goals, sometimes with input from the client, the client’s family, other professionals, or an interdisciplinary team of clinicians. Care has to be taken that the goals are realistic enough to be accomplished within a time frame. Once goals have been set, the music therapist makes a treatment plan outlining possible strategies and music experiences that might be helpful in meeting the client’s needs. In institutional settings, a meeting is usually held to coordinate treatment efforts and to formulate a program plan. As a result, the client is placed in individual, family, or group sessions, and the treatment phase of music therapy begins. Then after working with the client for a sufficient time, the music therapist conducts periodic review/evaluations to determine whether the methods of treatment adopted so far have proved effective and whether the client is making any progress towards the prescribed goal. As and when necessary, a music therapist has to be flexible in making adjustments in the goals or methods tried. Finally, when the time comes for bidding adieu, the music therapist prepares the client mentally to indulge in self-music therapy by leaving clear instructions on the choice of music and their duration.
Apart from designing such treatment procedures, music therapists have other responsibilities, depending upon their work setting, the client populations, and the therapist’s job requirements. In hospital settings, music therapists can develop listening programs to meet various patient needs. He or she may mount a musical show or a session by involving the participation of their clients/patients besides organizing musical concerts to be attended by the patients.
In educational institutions music therapists coordinate with the class teachers to develop group programmes. There can also be such group programmes involving both normal and special students to develop bondage between the two.
Music therapists may work in groups and may consult with psychologists or psychiatrists, while providing musical instruction to special children. Music therapists working in institutions also have other duties such as ordering musical instruments and other necessary equipment and supplies, and maintaining them. As will be discussed later, music therapists may also have positions which require administration, supervision, consultation, or teachings.
Normal work routine of a music therapist is somewhat like this: (a) assessment of individuals and groups to establish their needs, in consultation with members of the-team working with an individual or group (b) plan, design and implement: a musical session with the selected “appropriate” musical piece, either com-posed exclusively or borrowed from the pre-set musical compositions and (c) documentation. and evaluation programmes to review and re-assess the results/ goals reached.
Now we will have a look at the way modern music therapists use music to obtain therapeutic results. It may be borne in mind that none of these approaches could be perfect or a final word. It is important that a music therapist has to test them vis-à-vis the client’s requirement and through trial and error select one or several of them.
Though no hard and fast rules regarding the music treatment sessions have been laid down, a daily session at a fixed timing is recommended by some Western, therapists. Basically, it is the convenience and the need of patients that counts. The session could last for anywhere between 1 to 2 hours and with a few intervals for optimum results. Higher frequency is always better and would in no way, be harmful unlike other medications or drugs, which exhibit significant side-effects.
This article was published in AYURVEDA AND ALL – March 2009, Pages 29 to 31
Edited by Geeta Shreedar, August 3, 2021