Sunday 23 January 2022
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Music Can Be Therapeutic

Music as a therapy is still in a nascent stage of research and development; there is a need for rigorous exploration to advance the field


Sahithya BR
Dr Sahithya BR., MSc, MPhil, PhD. is a Clinical psychologist working in the mental health sector with vulnerable children, adolescents and adults. She is also actively involved in research and training. She is currently working as an assistant professor of clinical psychology at DIMHANS, Dharwad

Music is commonly defined as an art form intended to express emotions, ideas, experiences or stories through a combination of vocal or instrumental sounds. Music is old and may have been with us from when humans first evolved. Paleontological studies of fossilized skulls have revealed that our early ancestors of Neanderthals and modern humans had the vocal anatomy to sing, however, it is not known if they actually did sing at that time. Nevertheless, the earliest musical instruments that have survived till date are between 39,000 and 43,000 years old. Music has been part of every throughout the world, and reflect the religious and cultural aspects of the region. For instance, in India, the Vedas which are the oldest Hindu scriptures are considered to be the origins of Indian classical music. Ancient Vedic scholars considered sound to have an important impact on the governance of the cosmos. Wherein, the correct chanting of the Rigveda, and the singing of the Samaveda were thought to be fundamental to maintaining order in the Universe and in the human world (Robinson, 1989).

Music throughout the world has many purposes which range from entertainment, pleasure, to religious and other ceremonial use. In recent years, music has been explored as a potential therapeutic medium, with researchers exploring how music can improve health outcomes among a variety of populations. Several forms of music such as singing, listening to music, musical improvisation, and other musical activities have been used as Music Therapy in a structured format. The music here is not just recreational, rather a therapeutic approach.

Music Therapy is being used as an early intervention technique for children with delayed developmental milestones after researchers found music to be beneficial among this population. For instance, Dr David Aldridge in 1995 evaluated music therapy for children who were developmentally delayed. He observed a continuing improvement in hearing and speech, eye-hand coordination, and social interaction among children after they received music therapy. Another group of researchers from Germany (Grob et al.) in 2010 used music therapy in children with delayed speech.  They recruited 18 children aged 3.5 – 6 years with delayed speech development and gave them music therapy for 8 weeks. When these children were compared to their baseline level as well with as a group of children who did not receive any therapy, it was found that among the children who received music therapy, their phonological capacity, understanding of speech, cognitive structures, action patterns, and level of intelligence increased post-treatment.  Music therapy is also gaining attention for potential therapeutic use among children diagnosed with an autism spectrum disorder. Several randomised control trials (Eg: Geretsegger, et al., 2014; Gattino et al, 2011, etc.) have demonstrated music therapy to be helpful for children with this condition to improve their skills in social interaction, verbal communication, initiating behaviour, and social‐emotional reciprocity.

Music therapy has been found to be an effective intervention also for stress reduction in both medical and mental healthcare settings among adults. Nilsson et al (2005) conducted a randomized controlled trial to examine if intra- or postoperative music therapy could influence stress and immune response during and after general anaesthesia on 75 patients who were undergoing open hernia repair surgery. They found that intraoperative music decreased postoperative pain, and reduced anxiety and morphine consumption. Another RCT involving 209 participants examined if music therapy could help in reducing pain and anxiety in women undergoing transvaginal ultrasound-guided oocyte retrieval, a procedure in which eggs are taken from ovaries. The researchers found that music therapy was effective in reducing pain scores, and increasing satisfaction with pain control during the procedure.

Music is increasingly being used as an adjunct therapy in the treatment of mental disorders such as depression and anxiety disorders. Hosseini and colleagues in 2019 probed the results of over 100 published studies and found that music had positive effects on pain, sleep disorders, learning, memory, depression, anxiety and even serious disorders such as schizophrenia. Erkkilä and colleagues in 2018 conducted an RCT where 79 participants who met the diagnostic criteria for major depressive disorder received individual music therapy for 3 months. The researchers found that the patients who received music therapy showed improvements in depression symptoms, anxiety symptoms and general functioning when compared to others who did not receive music therapy. In a review study, Raglio and colleagues (2015) examined the effects of music therapy on the mood among neurological patients such as Dementia, Stroke, Multiple Sclerosis, Parkinson’s Disease, etc., and found that musical interventions had a positive impact on mood, depressive syndromes, and quality of life of neurological patients. Overall, there is strong research-backed evidence to support the claim that music therapy has a significant positive impact on mental health. More recently, Witte et al (2020) reviewed 47 studies and found that music therapy was efficacious on most stress-related outcomes.

Even in India, the therapeutic effect of Indian classical music is being explored in the treatment of mental disorders. Indian music therapy involves the use of specific ragas to address the physical, emotional, cognitive, and social needs of individuals. Darbari Kanada, or Raga Darbari, is a raga in the Kanada family, which is thought to have originated in Carnatic music and is popular in southern India. Brindavani Sarang or Brindabani Sarang, also known as Vridavani Sarang or raga Sarang, is a Hindustani classical raga that has originated in North India.  Both Carnatic music and Hindustani music are currently being researched for their therapeutic value on various mental health disorders. In 2012, Dr Shantala Hegde from NIMHANS, and colleagues conducted an electroencephalogram study, where 20 participants who were musically untrained, listened to the north Indian classical music tradition. The researchers found that the brain activity of the participants was different from the eyes-closed rest condition, with an increase in alpha, delta and theta waves. In 2016, Uma Gupta and BS Gupta studied psychophysiological responses to music listening in healthy males and females. They made the participants listen to rāga Desi-Todi on a flute for 30 minutes a day, for 20 days. They reported that music listening reduced stress, anxiety and depression, enhanced life satisfaction, optimism and hope in both males and females. Interestingly, a decrease in blood pressure (both systolic and diastolic) and heart rate was only seen in females. In 2019, researchers Samarpita Chatterjee and Roan Mukherjee investigated the effect of raga Darbari Kanada on psychological variables such as depression, anxiety and stress among elderly adults. They asked the participants to listen the instrumental version of the raga every day before sleeping at night for a total of eight weeks. The results revealed that two months of music therapy intervention progressively and significantly lowered depression, anxiety, stress, as well as sleeping problems in the participants.

Research evidence clearly indicates that music has a powerful impact on the human mind and can be therapeutic. But how does it work? One mechanism is that music modulates attention, and can distract a person from negative experiences such as worry, pain, anxiety, and thereby protecting the person from stress and mental disorders. Music has clear and measurable effects on emotional experiences and can regulate brain regions such as the amygdala, hippocampus, anterior cingulate cortex, etc., that are involved in the initiation, generation, maintenance, termination, and modulation of emotions. Emotion regulation abilities when using music may improve, especially with happy and pleasant feelings (Hou et al., 2017). It has been reported by researchers such as Raglioet al (2015) that music engages a variety of brain areas that are involved in emotion, motivation, cognition, and motor functions, which justifies the use of musical interventions to increase socialization and cognitive, emotional, and neuromotor functioning. Thus, it appears that music affects the emotion and behaviour of the person by regulating the activities of several brain centres.

Throughout history, music has played an important role in people’s way of life and has a key role in religious rituals, marriage and death ceremonies, as well as social and cultural activities. What was perhaps intended as entertainment or ritualistic has recently been discovered to have a powerful impact on the human brain and behaviour. However, recent research has pointed out that music is therapeutic only if it matches the personal preferences of the individual. Music as a therapy is still in a nascent stage of research and development, and there is a need for rigorous scientific research to advance the field further. In the meantime, people may engage in music knowing that apart from pleasure and entertainment it is perhaps healing them too.

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