In the fifth and final part of this discussion, regarding the part that music plays in communication, let us examine how it can be used in therapy. The term “Music in Illness” was first heard in 1891 in a letter written to an editor by Frederick Harford, M.D. He noted that he had had a conversation with Florence Nightingale regarding the fact that music could be used in restorative therapy and should be more widely used. Less than 60 years later it became an organized profession in the United States and was being used to help our soldiers during WWI and WWII in veteran’s hospitals. Columbia University offered the first music therapy course in 1919 taught by Margaret Anderton. After WWII in 1950, the National Association for Music Therapy was formed and in 1971 the American Association for Music Therapy was founded.
In books that are written about groups that use the Social Model Approach (SMA) in therapy, they still refer to ‘them’ as, ‘people with learning disabilities,’ but Jane Williams states that she prefers to address ‘them’ as, ‘people with learning difficulties.’ All persons deserve to be treated with respect and be allowed to retain their dignity. The social value of an individual is known and perceived through language, and this can be accomplished through music, where otherwise many would be left out. Williams makes the case that everyone should have the same opportunities. Music should be available to all who need Occupational Therapy. Occupational Therapists are effective facilitators for healing.
Using music in therapy develops many musical and non-musical skills because music is intricate and involves many different components. It develops listening, performing, learning, communication, social skills and more. Some learning may be intentional while other lessons learned may be incidental. Although they may seem like an extra, accidental bonus, they are a well-known part of the Social Model Approach. Just as anything worthwhile in life takes time, so does learning. In fact, it is a lifelong endeavor even for those without learning difficulties. “Repeating, rehearsing the right things in the right way,” Williams says, “will always produce great dividends and a better performance.” Music is adaptable to individuals, is a multi-sensory activity, can be analyzed piece by piece and should be available to everyone.
Premature babies are born daily, therefore, new ways of helping them develop faster and more effectively are continuously being studied. One program that has been developed is Medical Music Therapy (MMT). Soft, gentle instrumentals, singing and humming are used by therapists who incorporate the parents in the process as well. Auditive Stimulation is another program that works hand in hand with the MMT, with the end goal being the bonding of parents with the infant. These programs facilitate healing for the parents, who may be having feelings of failure or anger. They are surrounded by nurses, tubes, bright lights, and the sounds of beeping that may be alarming and their stress levels are highly elevated. The infants are also in a state of panic because of the trauma and stress they have automatically been subjective to at birth.
Because the beginning stages of this research go back more than 50 years, they are now able to give care to these infants, concentrating on more than just survival. Getting infants, the proper care and therapy early on, can also prevent future neurological problems that could develop in the child later in life. Infants are creatures of touch and sound. Using MMT is always ‘live’ because the music can be changed at any time to meet their needs. Vaskus Churba notes that depending on the actions and reactions of the child, and by listening to their heart beats, you can adjust the therapy. The baby already knows the mother and father’s voices, because they have heard them speaking for a possible nine months of the pregnancy, so this is the natural place to start. Therapists begin by incorporating them into the music therapy so the child can develop a sense of safety and trust before they move on to any of the learning and skill developing aspects.
“Adolescence is a certain phase of life, not a disease” says Jaakko Erkkila. When doing music therapy with teenagers, you may be focused on learning, behavioral changes, a need to be accepted or just a need to gain experiences and exposure to life in general. It is a journey through the behavioral, cognitive, and psychodynamic. All of this and so much more wrapped into one package, is called adolescence. Often these clients do not open up and talk about the issues they are having in life. They are often overwhelmed, and their problems seem insurmountable and too complex to try to deal with. They do not know where to start or where to turn.
When music is introduced, that can be the game changer; everyone loves music and has their favorites. This is the first ‘contact’ step; when trust is built the therapist can move forward with treatments for whatever their issues are, small or great. When creativity is aroused in teenagers and the wheels in their heads start to turn, then you can move forward and have success. The healing process began without them even realizing it! “Song writing and composing has been by far the most often employed in the Medical Music Therapy Method with adolescents,” Erkkila stated. Time, methods, and strategies may vary from client to client, but they all engage when music is introduced. They can be challenging at this age, but the results are extremely rewarding.
Melodic Intonation Therapy (MIT) is often used in helping adults who have sustained a head trauma, because it can be effective in re-learning speech, language, and motor skills, while still being sensitive to the psychological adjustments to new norms they are undergoing. Levels of assistance can be diverse, depending on the extent of the injury. Working with the patient as a team is often more effective, because they can incorporate the family, friends, and medical staff, which will interject a variety of stimuli that will facilitate recovery.
Besides the need to re-learn simple tasks that were once second nature to the client, they and their families are emotionally traumatized as well. They are in the process of grieving the loss of memory, independence, role in life, self-confidence, and physical appearance. They may also be dealing with feelings of self-doubt, guilt, self-blame, anger and more. An individualized, holistic approach is utilized to ‘bring them back.’ A regimen of sessions is planned, tailored for one individual’s progress in mind and executed.
It is now known, after many years of research, that the brain can self-modify, organize, and take on the ‘duties’ of the part of the brain that has suffered loss. This is known as Neuroplasticity. This is quite a marvel and great scientific discovery. Scientists have done extensive studies on the brains of musicians and have found that the more an instrument is practiced, the more the neural connections are strengthened. Building upon that theory, they have used this model for re-teaching adults’ skills. Repetition plays a key role in this process.
Using music allows the neuronal networks to distribute the desired messages throughout the brain. This inbuilt processing center overlaps with the functions of speech and language, therefore, when they all collide, you will have communication. Techniques are like those working with children, with a different approach. The most common being, setting everyday phrases to a musical score and repeating daily, and you will end up with functional speech, at a varied speed, depending on the injury and recovery time. It has been shown in research that anxiety and pain is substantially reduced in burn victims during their dressing changes, when music is being played. This allows the brain to focus on something other than pain. Relaxation techniques using music have also been effective in adults that have chronic pain.
The risk of developing Dementia increases with age and can also be linked to diseases, one major contributor being Alzheimer’s. Some of the symptoms will be a decline in memory, cognitive abilities decrease, loss of reasoning and judgement ability, language and speech skills diminish, frustrations with normal everyday tasks. In addition to these issues, they can deal with personality, demeanor, and behavioral changes. They may become moody and temperamental, pouting, yelling, emotionally distraught, show restlessness with pacing, delusions and hallucinations may show up. These new-found complications to life can be difficult for them as well as their caregivers. Just being aware of the symptoms of the disease does not make them less traumatic to deal with. The main concern when dealing with the elderly who are already showing signs of dementia, is to try to enhance their quality of life in their sunset years, seeing that there are no known cures.
Research shows that music may work as a drug to ameliorate many symptoms without the many side effects of a drug. Various methods, approaches and models of music therapy have been developed for working with the elderly. The more interaction they have with others the better, they can then make a personal, cognizant choice to connect with their environment the next time. Through repetition, cause and effects are learned. Music helps with mood behavior, emotions, and mood influences of the elderly. It motivates and prompts participation with others. In Behavior Music Therapy, external stimuli events, external reinforcement and cognitive mediational processes are used.
Music prompts activity and errorless learning (because there are no rights or wrongs with music), therefore, the patients desire to do more becomes apparent. Shapes and objects reinforce the activity and fading out of instructions, removing prompts gradually, can help their brains re-engage. They then become goal oriented and want to please. Musical activities improve and/or maintain cognitive skills, memory, language, praxis, and orientation, and improve the patient’s mood and state of mind. Instruments, dancing, singing, listening to music and musical games are used in therapy sessions in random order each time, for variety’s sake and added learning. Often music will spark memories that are a comfort to the elderly patient. It enhances their sense of community. Though their minds have almost withered away, they can often remember the lyrics of an entire old, familiar song. Music can often go where no one else is allowed in the recesses of their heart and mind.
Music therapists are called in by the first responders of the Red Cross in times of crisis on a regular basis. Crisis with kids in violent homes, storms like Katrina and more recently Harvey and Irma, and during acts of terror like 9/11. There are an estimated 7,000 accredited music therapists in America, and they are increasing, slowly and steadily, according to Al Bumanis, Director of Communication for the American Music Therapy Association. Music is used in pain management, schools, hospice care, hospitals, with learning disabilities, just to name a few. Music can help to restore normalcy and self-expression to an otherwise oppressed society, community, and nation. Katie Down, a New York therapist said, “…In putting on a record or playing a song, I am essentially queueing up emotions in a test tube…There is a ‘music’ part of our brain in all of us.” Music is used in trauma therapy to get the patient to first trust the caregiver, themselves, and others. They then should be made aware of the issues and problems they are having, so they can forge a path to recovery. Often it is a long journey and will have to be broken down into many smaller parts. It will involve many people and grueling sessions of many types, but all worth it in the end.
Along with music, rhythm is incorporated as well. Breathing techniques to a slow beat can teach the client to relax and can dispel panic. Once they learn these, they can do them anywhere when panic strikes, to cope with their new-found difficulties. Though some may not even be able to speak or sing, if they feel the freedom to just throw their heads back and yell, or gurgle and get familiar with their own voice again, they are on their way to recovery. It is a confidence builder, a liberator. Walking may not be an option at first, but a little toe tap to the rhythm can be someone’s inspiration to cause them to have the ‘want to.’ “Our bodies react to sound,” says Katie Down.
The Psalms in the Holy Bible are filled with passages showing us that God is indeed the best listener, He is our audience when it comes to worship. To give one example, Psalms 9:2 says, “I will be glad and rejoice in thee: I will sing praise to thy name, O thou most High.” Worship is addressing the Creator directly and lifting Him up because of who He is, as in the Lord’s prayer. Luke 11:2-4 “And he said unto them, when ye pray, say, Our Father which art in heaven, hallowed be thy name. Thy kingdom come, thy will be done, as in heaven, so in earth. Give us day by day our daily bread. And forgive us our sins; for we also forgive every one that is indebted to us. And lead us not into temptation; but deliver us from evil.” Note the worship and ‘lifting Him up’ comes before the ‘asking’ for anything. God loves our worship because we were created for Him and by Him. Music can be a powerful tool in our worship unto God because it speaks directly from the heart and soul.
Praise on the other hand, though equally important, and it can incorporate speaking directly to God, it is usually speaking lyrically about God. The song can be a testimony of His goodness to us or telling of His charitable deeds in general. We use everything he has given us to make a joyful noise unto Him. Our voices, the clapping of our hands, stomping of our feet, dancing, and playing of instruments. When these acts are done as unto Him, it becomes praise.
Music affects and benefits us in numerous ways. Let us look at a couple of these in closing. Firstly, it identifies us. Whether we are the listener or the composer, we become identified by our choices in music. When one chooses a certain style, as mentioned before, they will usually be drawn to songs in that style, and may only deviate slightly, because music speaks to us individually. An entire generation or nation can be identified by its music. Altman stated, “A nation is understood as a group whose members share a substantial number of such cultural features as language, religion, values, traditions, dress, music, art, literature and current and ancestral territory.” For example, if someone overseas hears an Elvis Presley song playing on the radio, they will immediately recognize it as being from the United States. Voices, styles, and genres are identifiable. Music can also be identified as to which decade it is from. This is not wrong or right, it just takes on the persona of its era, composer and the artists who perform it.
Secondly, music transports us. We are transported back to the time we first heard a song, where we were or what we were doing. These memories can be good or bad but are usually involuntary. Music is stored in our brains and emotional core, and can come to the surface when recalled, often spontaneously. We can wake up with a song in our mind and not know why it is there. A song can change our mood for better or worse because of its tempo, lyrics, or memories. People love to sing karaoke because it takes them back to a time where they have fond memories. They try to live vicariously through the song.
In Conclusion to this long dissertation, music is an outward symbol or expression of the inner man. It is an outflow of what we may be feeling in a certain stage of life or just in the moment. It expresses our values, wants, desires, hopes and thoughts. Our past, present, and future can be portrayed in beautiful harmonies. It is an extension of our being and thus a work of art. There is one definite way that our choices in music will change, if necessary, and that is when God changes our heart. Paul tells us in 2 Corinthians 5:17, “Therefore if any man be in Christ, he is a new creature: old things are passed away; behold, all things are become new.” Jesus said in Luke 6:45, “A good man out of the good treasure of his heart bringeth forth that which is good; and an evil man out of the evil treasure of his heart bringeth forth that which is evil: for of the abundance of the heart his mouth speaks.” Music is absolutely a notable aspect of communication, let your voice be used in praise today unto the Lord, for His goodness and mercy endures forever.