As a practice, music therapy sits somewhere between art, therapy, healthcare, and psychoanalysis; it ‘invites the art, science and craft of music and healing’ (Pavlicevic, 1999, p. 141). Its practice has been proven as having a ‘huge impact on confidence, and therefore improved wellbeing’ (Therapy Today, 2011, p. 5). Besides more common associations with mental health and children with special needs (SEN), music therapy has also proved to be of benefit on a much wider scale, including, amongst other areas, ‘physical impairments, people with hearing and visual problems, the institutionalised elderly, and people in the criminal justice system’ (North & Hargreaves, 2008, p. 298-299).
Within the field of music therapy, there is a history of deploying music to ‘alleviate chronic psychological disorders and problems associated with long-term physical impairment’ (North & Hargreaves, 2008, p. 298). There is evidence of music-based practices dating back prior to the beginning of recorded history. Being centered on music makes it one of the most accessible forms of treatment in terms of engagement:
Everyone has the ability to respond to music, and music therapy uses this connection to facilitate positive changes in emotional wellbeing and communication through the engagement in live musical interaction between client and therapist (British Association for Music Therapy)
The idea of creating music ‘out of thin air’ might seem like an alien concept to some. However, the process of music therapy sessions is to create something out of the patient’s feelings, situation and environment, with the assistance of the therapist (Williams, 2014). In the context of a music therapy session, there are ‘no ‘right’ and ‘wrong’ notes: all are part of possibility.’ (Pavlicevic, 1999, p. 143) Improvisation between therapist and client is key to allowing the client to experience music as a positive means of therapy:
Music therapy allows people to discover for themselves what is going on underneath, as well as allowing them to express repressed emotions or memories. If verbal communication has shut down, as with autism or stroke, it has a huge impact on a person’s confidence, which in turn affects every aspect of their life (Angela Harrison, quoted in Therapy Today, 2011, p. 5)
Just as the act of talking, or indeed writing, about one’s personal experiences can be seen as therapeutic and empowering (Newham, 1999, p. 32), so too can singing about it (Stige et al, 2010; Harrison, 2006). Due to the connections music makes with the brain and emotions, singing as a means of therapy can be seen to be even more cathartic:
To fill our memories with emotion requires us to use the full range of our voice to express the full range of feelings. And nowhere do we witness such a use of the voice more intensely than in the art of singing (Newham, 1999, p. 59)
Community Music Therapy
Such feelings of catharsis and empowerment which music therapy can provide are also useful in the context of a community. One’s place in their community has an effect on their overall wellbeing (Venkatapuram, 2013). According to Feld (1994, p. 77), ‘music has a fundamentally social life. It is made to be engaged – practically and intellectually and communally’. I agree that the main purpose of music is as a shared form of communication, much as it has been considered a language throughout history (Thaut, 2005, p. 171). This language reaches us at a level of understanding deeper than verbal communication (Harrison, 2006).
According to the National Health Service (2006) there are five evidence-based steps we can take to improve mental wellbeing:
- Get active
- Connect with others
- Keep learning
- Be aware of yourself and the world
- Give to others
(National Health Service, 2006)
I believe that the practice of community music therapy covers all five of these points, through a variety of styles. Modes of practice, including music workshops, which act to ‘foster active and collaborative music making’ are therefore an excellent way of fostering better community wellbeing (Higgins, 2012, p. 144). Harrison (2006) believed the power of singing lay in its power to move other human beings; its ‘transformative qualities’; the way it can allow others unable to sing to feel cathartic benefits through empathic listening (2006, p. 24). I am inclined to agree with this view. I believe this element of music therapy has in fact the most potential to affect overall wellbeing, through its inherently inclusive and group-based nature. Participants, in making music with others, can experience ‘one of life’s greatest pleasures’ (Green, 1986, p. 69).
Further examples highlight to me that community music therapy might be better thought of in more broad terms, such as ‘care’ and ‘service’ (Stige & Aarø, 2012, p. 14) Like Stige & Aarø (2012), I believe it represents a group musical ‘service’ which takes place outside of the private, confidential, one-on-one setting of the traditional music therapy session. It is a means of bringing the community, and neighbouring communities, together through local music-based activities, the kind of which I have witnessed throughout my life in one form or another, without ever having identified them as ‘therapy’. These activities can take place in ‘arts centers [sic], schools, prisons, health settings, places of worship, festivals, on the streets, and in a wide range of community contexts’ (Higgins, 2012, p. 174). They can be said to be having a beneficial effect on the wellbeing of the community, and therefore the individuals within those community groups (Choi, Lee & Lim, 2008).
Music Therapy & Dementia
The term dementia, generally associated with old age or degenerative neurological diseases, is displayed as memory loss and difficulties with thinking, problem-solving or language, the most common form of which is Alzheimer’s Disease (Alzheimer’s Society). Alzheimer’s is characterised by changes in nerve cells and neurotransmitter levels, as well as destruction of synapses (Levitin, 2006, p. 231). In many cases, short term memory is largely absent, creating frustration among patients (Pavlicevic, 1999, p. 130). However, music therapy has proven to be of enormous positive effect in improving the wellbeing of Alzheimer’s patients (Lee & Thyer, 2013; Stige et al, 2010). Levitin goes on to report an interesting observation in the musical memory of Alzheimer’s patients:
As the disease progresses, memory loss becomes more profound. Yet many of these old-timers can still remember how to sing the songs they heard when they were fourteen. Why fourteen? Part of the reason we remember songs from our teenage years is because those years were times of self-discovery, and as a consequence, they were emotionally charged; in general, we tend to remember things that have an emotional component because our amygdala and neurotransmitters act in concert to ‘tag’ the memories as something important (Levitin, D. 2006, pp. 231-232)
Music’s innate ability to hone in on these ‘tags’ seems to almost reverse the symptoms of dementia for a brief time; play or sing a song from their past and they are once again ‘present’ (Sacks, 2008, p. 377). The practise of community music therapy has also been seen to have a positive effect in regards to Alzheimer’s patients, due to the added social factor involved (Stige et al, 2010, p. 266).
Music as alleviation to anxiety and depression
The frustration experienced by many people with dementia can often lead to frustration and agitation (Clare, 2004). While research on the subject is limited, music therapy has been proven as a noticeably effective, low-cost, non-pharmacological intervention (Blackburn & Bradshaw, 2014). Music-based interventions have yielded positive results in easing depression among adults without dementia (Chan et al, 2012). Occasionally studies note reduced anxiety as a by-product of alleviating another condition (Hargreaves & North, 2008).
There has been found to allow improvements to self-esteem and reduced depression in children and adolescents with behavioural and emotional problems, which were sustained over a prolonged period (Therapy Today, 2014, p. 6). One particular advantage of music therapy over talking therapies is that younger people seem more open to participation:
The most popular activity was song-writing or writing their own lyrics to music, which seemed to benefit their ability to communicate their feelings more generally, she said. Nearly all — 97 per cent — chose to write autobiographically about how they were feeling, where they were at. This age group tend to find talking therapies slightly more challenging but our psychology colleagues tell us that, as a result of the music therapy, these children are more open to engaging with them in their sessions and more able to express how they were feeling. (Therapy Today, 2014, p. 6)
The level of effectiveness music has in relieving stress varies ‘according to age, the type of stress in question, the means by which the music was used, the listener’s musical preference, and their prior level of music experience’ (Hargreaves & North, 2008, p. 307). This brief overview highlights to me that music therapy is of intrinsic value to our wellbeing. As well as the areas mentioned above, music therapy has seen measurable success relieving anxiety in a variety of settings (Hargreaves & North, 2008). It is also useful in treatment as therapy for drug and solvent abuse (Oklan & Henderson, 2014; Silverman, 2009).
(This article was first published in July 2015)
Alzheimer’s Society (2015) What is Alzheimer’s disease? Available at: http://www.alzheimers.org.uk/site/scripts/documents_info.php?categoryID=200171&documentID=100&gclid=CI_j59OHv8UCFYgIwwodCqUAPA (Last accessed: 06/05/2015).
Blackburn, R., & Bradshaw, T. (2014) ‘Music therapy for service users with dementia: a critical review of the literature’, Journal of Psychiatric & Mental Health Nursing, Vol. 21, No. 10, pp. 879-888. Available from: 10.1111/jpm.12165.
British Association for Music Therapy (2012) What is music therapy? Available at: http://www.bamt.org/music-therapy/what-is-music-therapy.html (Last accessed: 12/05/2012).
Chan, M., Wong, Z., Onishi, H., & Thayala, N. (2012) ‘Effects of music on depression in older people: a randomised controlled trial’, Journal of Clinical Nursing, Vol. 21, No. 5/6, pp. 776-783. Available from: 10.1111/j.1365-2702.2011.03954.x.
Choi, A., Lee, M., & Lim, H. (2008) ‘Effects of group music intervention on depression, anxiety, and relationships in psychiatric patients: a pilot study’, Journal of Alternative & Complementary Medicine, Vol. 14, No. 5, pp. 567-570. Available from: 10.1089/acm.2008.0006.
Clare, M. (2014) ‘Soothing sounds: reducing agitation with music therapy’, Nursing & Residential Care, Vol. 16, No. 4, pp. 217-221.
Feld, S. (1994) ‘Communication, music, and speech about music’, in Keil, C. & Feld, S. (eds.) Music grooves: essays and dialogues. United States of America: The University of Chicago Press, pp. 77-95.
Green, B. (1986) The inner game of music. United States: Pan Books.
Harrison, P. (2006) The human nature of the singing voice: exploring a h basis for sound teaching and learning. Great Britain: Dunedin Academic Press.
Higgins, L. (2012) Community music: in theory and in practice. United States: Oxford University Press.
Lee, J., & Thyer, B. (2013) ‘Does Music Therapy Improve Mental Health in Adults? A Review’, Journal of Human Behavior in the Social Environment, Vol. 23, No. 5, pp. 591-603. Available from: 10.1080/10911359.2013.766147.
Levitin, D. (2006). This is your brain on music: understanding a human obsession. Great Britain: Atlantic Books.
National Health Service (2006) Wellbeing self-assessment. Available at: http://www.nhs.uk/Tools/Pages/Wellbeing-self-assessment.aspx (Last accessed: 11/05/2015).
Newham, P. (1999) Using voice and song in therapy: the practical application of voice movement therapy. United Kingdom: Jessica Kingsley Publishers.
North, A. & Hargreaves, D. (2008) The social and applied psychology of music. United States: Oxford University Press.
Oklan, A., & Henderson, S. (2014) ‘Treating inhalant abuse in adolescence: A recorded music expressive arts intervention’, Psychomusicology: Music, Mind, and Brain, Vol. 24, No. 3, pp. 231-237. Available from: 10.1037/pmu0000058.
Pavlicevic, M. (1999) Music therapy: intimate notes. United Kingdom: Jessica Kingsley Publishers.
Sacks, O. (2008). Musicophilia: tales of music and the brain. 2nd Edition. United Kingdom: Vintage Books.
Silverman, M. (2009) ‘A descriptive analysis of music therapists working with consumers in substance abuse rehabilitation: Current clinical practice to guide future research’, The Arts in Psychotherapy, Vol. 36, pp. 123-130. Available from: 10.1016/j.aip.2008.10.005.
Stige, B., Ansdell, G., Elefant, C. & Pavlicevic, M. (2010) Where music helps: community music therapy in action and reflection. Great Britain: Ashgate.
Stige, B. & Aarø, L. (2012) Invitation to community music therapy. United Kingdom: Routledge.
Thaut, M. (2005) ‘Rhythm, human temporality, and brain function’, in Miell, D., MacDonald, R. & Hargreaves, D. (Eds.) Musical communication. United States: Oxford University Press, pp. 171-191.
Therapy Today (2011) ‘NHS urged to pay for music therapy to cure depression’, 2011, Therapy Today, Vol. 22 (No. 7), p.5.
Therapy Today (2014) ‘Music therapy helps beat depression’, (2014) Therapy Today, Vol. 25, No. 9, p. 6.
Venkatapuram, S. (2013) ‘Subjective wellbeing: a primer for poverty analysts’, Journal of Poverty & Social Justice, Vol. 21, No. 1, pp. 5-17. Available from: 10.1332/175982713X664029.
Williams, T. (2014) ‘A journey to music therapy’, Exceptional Parent, Vol. 44, No. 4, pp. 30-32.