Music Therapy

The Art of Healing

The link between music and healing has been known and recorded across cultures and through the centuries, but it is only over the last fifty years that music therapy has developed as a profession. In 1999 music therapy, along with art and drama therapy, received official recognition from the state regulatory body, the Health Professions Council, putting the arts therapies on an equal footing with other professions allied to medicine, such as physiotherapy.

Shantha P. Gunasekera

Why music?

In all societies and cultures, music is an integral part of public and private life, and is also the basis of ritual, whether social, spiritual or ceremonial. Music adds another dimension to occasions of national importance or personal significance, and supports or transcends the spoken word in worship, celebration and mourning. Few people would deny the important part music has played in their lives from infancy to old age, and that it is a powerful medium for communication. It is important, however, not to view music simply as a vehicle for the emotions, but also as a complex creation of the intellect.

Few people would deny the important part music has played in their lives.

The music therapist has the opportunity to use not only the social, spiritual and emotional aspects of music, but also its inherent form, structure, and logic, thus linking the artistic and the scientific, the intuitive and the intellectual. Powerful tools indeed!

The music therapist is working on the premise that inborn in every human being is the capacity to respond to the elements of music, and that this innate responsiveness remains intact and accessible despite damage or trauma to other organs.

Researchers have shown that in the womb before birth, the foetus reacts to rhythm and pitch, while a new-born baby can already distinguish the tone of its mother's voice, as well as being calmed or aroused by different rhythmic sounds or movements.

Psychologists have observed that the baby's earliest attempts to 'talk' to the mother are in many ways closer to a musical dialogue than to speech. The innate need or drive within us to communicate, even at this early pre-verbal level, is used and developed by music therapists as part of their clinical techniques.

What is therapy?

Having accepted that music provides a universal language, or means of communication, the question may be raised as to how music therapy differs from other forms of musical activity. The uplifting experience of singing in a choir, the satisfaction of performing with fellow musicians, the enjoyment of listening to music, live or recorded, or the inspiration given by a gifted teacher, are all therapeutic, since they promote feelings of well-being and enhance the quality of life. However, music therapy practised as a profession has certain features which separate it from more general musical experiences. Central to this is the relationship which is built up between therapist and client or patient (either word is use, depending on the work-place). This relationship is based on mutual trust and acceptance, and is explored within a setting offering regularity, consistency of the time and place of sessions and confidentiality. The therapist will also be prepared to work with difficult or negative emotions which may be brought up through the therapy.

Although pre-composed and recorded music may be use, the principle medium of the therapeutic relationship is clinical improvisation. This allows the therapist to be the listener, the reflector, the enabler and the supporter of the client, with the flexibility to move to new musical areas as the therapy demands. Therapist and client may speak, either about the music or feelings evoked during the session, but the music will retain its position at the heart of the therapy.

Where and how does music therapy take place?

Sessions, which may be one to one or in small groups, take place in medical and psychiatric hospitals, in special schools, nurseries and mainstream schools, in prisons and in residential homes, including hospices and those for older adults with Alzheimer's disease or other mental health problems. They can also be found in clinics and units for drug users and young offenders, for people with cancer, HIV or AIDS, and for children or young people with anorexia or sho have been abused.

The therapist will use his or her own instrument, and there will be a range of tuned and untuned percussion and ethnic instruments for both the client and therapist to play.

How do people benefit from music therapy?

Clients do not have to be musical or musically skilful to benefit from music therapy and for everyone the experience of therapy will be different. Unlike music teaching, there will not be clearly defined goals, tragets or a skills-based curriculum. The aims of the treatment will not be specifically musical, but will be in areas such as developing communication, confidence concentration, self-expression or creativity, as we can see in the following examples.

Mark: A withdrawn and remote autistic boy reaches out to play the piano with the music therapist, and so takes the first step out of his silent, isolated world. As the sessions progress week by week, shared pleasure in the musical experience leads into other forms of communication, improved eye contact, singing and the beginnings of speech.

Stacey: A suicidal teenager expresses her rage and despair through chaotic outbursts of drumming, and is supported by the therapist at the piano with strongly dissonant music. As trust develops Stacey is able to allow other feelings to emerge, of fear and insecurity, and these, too, can be expressed in the music.

Michael: Michael is terminally ill with cancer and uses his music therapy sessions to get in touch with the importance of music, both in his life and as his death approaches. At this point, words are no longer enough, and the music takes over.

Bindesh: Bindesh, who speaks very little English, is taken into a psychiatric hospital for assessment, after being found confused and disorientated, wandering in the street. A music therapy group on his ward gives him the opportunity to communicate in a language that everyone seems to understand.

Doris: An elderly woman, Doris, became depressed following the deaths of both her mother and her husband within a short space of time. She was admitted to hospital when it seemed she had lost the will to live. Her music therapy sessions became a place where she could reminisce about her past life through singing song with the therapist and this brought her some solace and hope.

Music therapy is still a young profession, and there is a long way to go before it is available to all who could benefit from it. Of vital importance is research to demonstrate the effectiveness of music as a means of healing, so that it can take its place alongside other medical and psychological forms of treatment.

Inborn in every human being is the capacity to respond to the elements of music.

The writer is a pianist/instructor trained in the UK and Country Coordinator for Bangladesh of the Associated Board of the Royal Schools of Music, London