Introduction

What Is Music Therapy?

Music is defined as sound organised according to ‘pitch, harmony and timbre’.(1) Over the past few years, music has generated attention as a potential cure for illnesses relating to both the function of organs and cells (the physical) and the function of the brain and its networks (the psychological).(2) Music therapy is a practice in which a patient listens to or plays music in order to help alleviate the symptoms of illness.(3)

Typically a music therapist will help the patient by providing social interaction and encouraging the patient to engage with the music, through playing music or giving social cues.(4) Whilst some may criticise music therapy as being subjective and immeasurable,(5) there is increasing evidence that music therapy can have a dramatic positive impact on the treatment of and recovery from illness, which this paper will explore in further detail.

Typically a music therapist will help the patient by providing social interaction and encouraging the patient to engage with the music, through playing music or giving social cues. Whilst some may criticise music therapy as being subjective and immeasurable , there is increasing evidence that music therapy can have a dramatic positive impact on the treatment of and recovery from illness, which this paper will explore in further detail.

A History of Music Therapy

Music has existed in some form since the Prehistoric times, and the first likely use of music was a call used to communicate to other members of a family unit or group either for entertainment, spiritual purposes (for example, rain dance chants) or for survival in hunting or gathering situations.(6) Notably, the role of the shaman or healer has been well documented(7) and can be considered analogous to the role of the music therapist today. A healer ‘heals’ a member of the tribe, family or group like a music therapist ‘treats’ a patient. The first musical instrument was probably a flute of some description, made out of bone - some of those found are dated at 40,000 years old.(8) Certain cultures and locations have closer ties to music as a historical practice such as the Mayans of South America and the Indigenous peoples of North America.(10)

It is difficult to ascertain exactly when music therapy began in Prehistoric times. This depends on whether we consider singing to be a type of music. Singing is believed to predate the development of language(11) and there is ‘no culture that does not sing’.(12) Maternal singing (a mother singing to her child) may reduce agitation in babies and the ‘universal’ language of mothers, Motherese, has a ‘sing-song’ like quality with long and elongated sounds in order to be soothing to the baby.(14) Thus maternal singing to a child can be considered a type of primal and universal music therapy. This idea is supported by a study of singers who sang in order to reduce pain levels(15), although the sample size of the study is unknown and the effects were not large.

During the times of the Ancient Greeks, the priest used music to ‘restore the soul and body’ and convey specific emotions.(16) This purpose was also common in the cultures of China, Egypt and India.(17) Plato, an influential philosopher, wrote that ‘music is medicine to the soul’.(18) During early Christian times, especially in Europe, the role of the priest with respect to music was to give an uplifting spiritual experience in order to reduce pain.(19) After the Renaissance, the physician (no longer priest) used music in order to elicit psychological and emotional changes, often associated with the nervous system.(20) It is during the Romantic Era that music therapy as our current model takes hold, with a physician-musician playing music to a ‘patient’.(21)

Music Therapy as a Practice Today

Following the Industrial Revolution and urbanisation, mental hospitals became larger in size and more common.(22) After World War II there was increased interest in music’s therapeutic potential in treating the trauma that veterans were confronted with following their service.(23) Music therapy societies and organisations were established in the 1950s to 1970s in order to increase awareness about the field.(24) Music therapy has since become a recognised part of therapeutic practices around the world.

The Ethics of Music Therapy

Unlike a clinical psychologist who will need a doctoral degree to practice, a music therapist needs only a Master’s in music or music therapy(25), which raises the issue of whether music therapists are as qualified as a psychologist to provide therapeutic care to patients. Can we compare the results of a psychological therapist and music therapist with regards to mental illness, when standard psychology requires more intensive training? This is just one of the ethical questions that music therapy poses.

Another question to keep in mind is whether it is economically sound to fund music therapy, particularly in the context of larger health organisations and schemes like the National Health Service (NHS) in the United Kingdom(26) or Medicaid in the United States.(27) In contrast to music therapy, which requires only a music therapist, music and a patient, drug trials are known to cost large sums of money(28) and take a great deal of time in order to organise legislation and certify valid proof for a drug’s further clinical use.(29)

In general, few papers will produce results that are unfavourable or neutral and may exaggerate effects(30), particularly if the research is implicated in bias(31) - for example, if there is sponsorship from a tobacco company into the effects of smoking on the development of lung cancer. Whilst bias and exaggeration is possible in music therapy trials (as with all research), overall music therapy costs less than a drug trial - which often need millions of pounds in support.(32) In addition, drug trials are more likely to be implicated in pharmacological corruption(33), with consequences for patients by virtue of skewing or altering results - as seen with the understatement of the negative effects of Agent Orange, a carcinogenic (cancer-causing) herbicide used in the Vietnam war, by Monsanto.(34)

This issue is significant when we consider that homoeopathy - the use of herbal medicine in disease treatment and prevention - is funded by the National Health Service, despite having no or contradictory evidence with regards to beneficial effects.(35) As the National Health Service is funded by the taxpayer and owes a duty of care to all of its patients, should there not be more funding for music therapy, when music therapy was shown to be as effective as medicine in the treatment of cancer patients(36) in a trial? This trial consisted of thirty adult cancer patients participating in sessions with and without a music therapist, with pain measurements assessed by numerical scale(37). Whilst this was a small study (though arguably not small compared to those that have only ten participants for example) and numerical scaling can be subjective, this evidence should make the National Health Service - and any other organisation which funds ‘alternative medicine’ - consider further funding for music therapy, which does not involve the high costs of drug trials(38) or potentially life-threatening side effects.

This does not mean that clinicians should cease to produce drugs or use them in studies but that these large companies should consider using music therapy in addition to current medicinal care, especially considering 77 percent of the patients in the aforementioned study preferred the sessions with music therapy and this is important as the effect of a positive psychological stimulus (similar to the placebo effect) on illness recovery is well-documented.(39)

© 2017 Nat Barrett. Published by teoria.com


    
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