Exploring the links between Music and Health

by Anne McCarthy, Research Officer, Stewarts Hospital Services Limited, Palmerstown,

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I was fortunate to attend this highly informative and innovative conference in the University of Limerick last September. The conference was sponsored by the European Science Foundation and the University of Limerick and attended by 28 music therapists from 8 countries, 9 music therapy students and assorted Irish professionals. Dr Jane Edwards, Senior Lecturer and Head of the Music Therapy Department, hosted the day. Music therapy is one of eleven specialisations within the Irish World Academy of Music and Dance, University of Limerick.

Professor Mícheál Ó Suilleabháin, Director of the Academy, told us how music therapy, a mere idea in the Ireland of 1996, has developed into the thriving Limerick school of 2005. Student clinical placements were beginning to illustrate the profession in action. An example of the school’s involvement in the local community is their work at St Camilla’s, where music and art therapy have been used to reduce agitation in patients with dementia.

Music – transcendence – spirit = the emotions of healing

Professor Ó Suilleabháin commented that music therapy is well established in the US and Australia and that while they lean towards the scientific route, Europe is moving along a slightly different path. This conference was a meeting of the two strands of music therapy, ensuring excellent debate and new perspectives for all the participants.

Performance = the value of engagement

Professor Jane Davidson is a music psychologist and Professor of Music at both the University of Sheffield and the University of Western Australia. She is also Vice President of the European Society for the Cognitive Sciences of Music. Dr Davidson told us about vocalising the self, illustrating mother and child interaction and harmony’s affective influence in communicating together. Music is a direct form of communicating and sharing. It is also flexible and ambiguous. Her talk dealt mainly with the value of performance, which she described as an emotional and mood regulator in which the outer and the inner self coordinate by identifying with the voice and inviting engagement, leading to audience participation and take-up. She highlighted the fact that there is very little in the literature about THE VOICE and THE BODY in therapy. She stressed the tremendous value of practice and performing—performance and enabling (rather than just listening to a song). She maintained that cognitive psychology has done music therapy a great disservice because it takes away self-expression.

Making a musical space in the health environment

Dr Clare O’Callaghan is the music therapist at both the Peter MacCallum Cancer Centre and the Caritas Christi Hospice in Melbourne, Australia. She has worked as a music therapist within neurology, oncology and palliative care over a number of years. She described how unexpected and transient ward communities emerge through in-patient music therapy and that the involvement of families can be enriched. However, this activity is not for everyone and there will always be a certain number of patients who do not wish to participate in a musical activity.

A community is a group of people united by a cooperative spirit

Dr O’Callaghan told us how this programme often allowed the human spirit to triumph and how this also had a profound effect on staff. She agreed that music could be incorporated with opiates in terminal care. Music transcends the identity of ‘patient’. ‘Being alive while dying’ is NOT denial, as the more clinically minded would maintain.

A complementary therapy and a health Accessory

Dr Joanne Loewy is the Director of the Louis Armstrong Center for Music and Medicine at Beth Israel Medical Center in New York City. She directed the Caring for the Caregiver: Music in Grief and Trauma Programme in response to the attacks of ‘9-11’. She described the process of humanising the medical experience and how the music therapist is part of the clinical team in both medical practice and healthcare communities. She stressed the importance of looking at wellness and that music has healing components. Music therapy is becoming well established in the US, where the Center for Music and Medicine was officially opened on 1 November 2005. A centre specifically established for work out, in and with communities.

Music therapy is complementary to established medical practices

It is NOT alternative

The benefits of live music and performance, over CDs and Tapes was particularly interesting and illustrated some areas of therapy:

  • Asthma – blowing on a wind instrument for lung volume
  • Heart disease – rhythm
  • Pain and sedation were key areas of her work in which music provided an emotional response.

We saw a video that illustrated what can best be described as music psychotherapy for post-traumatic stress symptoms. Music therapy is regularly used to debrief psychologists, psychiatrists and social workers who have been victims of violence. The Louise Armstrong Center is at present working with displaced and traumatised victims of the Katrina hurricane.

Identity

Dr Norma Daykin from the Faculty of Health and Social Care at the University of West England at Bristol informed us that music therapy is now a state registered profession in the UK. The title of her paper was ‘Embodied creative identities: Towards an understanding of the impact of creative music making in health care settings’.

She discussed the challenge of evaluation and the importance of non-verbal expression, quality of life and enhanced communities. Many services use music more as a decorative and environment enhancer to create atmosphere etc. This could be described as diversionary therapy—but it is not music therapy per se.

Dr Daykin is doing considerable research involving health, community and policy studies and has thirteen musicians working with her on the health risk factors of their work. Her focus is on ‘narratives of disruption’, the pathways through chronic illness—for example, stigma/crises/identity and the need for an interdisciplinary conceptual framework. She told us about the factors addressed by music therapy in this process, i.e. choice and enrichment, empowerment, freedom and release.

Creating balance between mind and body, fun and healing is a serious process involving the release of endomorphs.

Narratives of disruption

The question and answer session revealed that there is often a clash between the patient’s view and the consultant’s view of art therapy and music therapy. Music or music therapy—does it matter which? Service providers can often be unaware of the added value of music therapy and can misunderstand what music therapy can offer.

Participation

The only presenter to focus on intellectual disability was Dr Brynjulf Stige, Head of Studies and Associate Professor in Music Therapy in Sogn og Fjordane University College, Sandane, Norway. Music therapy improvisation, music education, culture-centered music therapy and community music therapy are the focus of his work.

Dr Stige spoke of the relationship between health and music and the establishment of health-promoting relationships. What has participation got to do with it? He referred to the participatory approach of music therapy, an organised structure that was co-shaping something. He saw music therapy as a cultural engagement involving integration, inclusion and the development of social networks. Individual strategies of participation as defined by Holgessen (2002) in his study on child music education are:

  • Reception
  • Imitation
  • Identification
Music therapists are participation specialists.

In Dr Stige’s own work in association with a music festival in Norway, he observed the following features of participation:

  • Silent
  • Conformist
  • Adventurous
  • Eccentric
  • [All the above are equal in value and are not a progression.]

Clients participated in all the above formats over the course of a performance, which also included participation diversifications, discrepancies and mutinies etc. Therapeutic strategies illustrated the ability to shift musical roles, a tolerance for diversity and a sense of humour was attained by giving space for this diversity and participation.

During the final discussion, ‘participation specialist’ was the term used to describe music therapists. The connection between music therapy and learning was emphasised. The danger of the media industry taking everything over was raised at the final discussion.

Conclusion

Do we need music therapy in our services for intellectual disability?
Music is a very powerful medium and one that is as yet untapped by our service providers for persons with intellectual disability. The potential would appear to be enormous, in particular for those with severe and profound intellectual disabilities, geriatric clients with dementia and those requiring palliative care. It is important to see music therapy as a therapy, and as such, an activity apart from music for leisure and recreation.

I suggest that we keep a clost eye on the Irish World Academy of Music and Dance in the University of Limerick; with a view to utilising this strong resource for the personal development of our clients. Music therapy is an interactive, primarily non-verbal intervention. It provides a process through which clients can express themselves, and become more self-aware, interacting more easily with others. Therapists work with all age ranges, in a wide variety of settings. Music therapists are employed in:

  • Adult Mental Health Units
  • Child and Adolescent Mental Health Teams
  • Community Settings
  • Day Centres
  • Hospitals
  • Prison Services
  • Private Practice
  • Schools
  • Specialist Palliative Care Units [Hospices].

Music therapists work with both individuals and small groups. Those who benefit from music therapy include people who experience:

  • Acquired disabilities [e.g. stroke]
  • Autistic Spectrum Disorders
  • Dementia
  • Depression
  • Emotional and Behavioural Difficulties
  • Impact of Old Age
  • Learning Disabilities
  • Life-limiting illness
  • Mental Health Difficulties
  • Neurological impairment
  • Trauma
  • Sensory impairment
  • Speech and Language Disorders.
Acquiring Professional status

To practise as a music therapist in the UK one must be registered with the Health Professions Council [HPC.] The Association of Professional Music Therapists [APMT] established in 1976, and the British Society for Music Therapy [BSMT], founded in 1958, represent the interests of the music therapy profession in the UK.

In Ireland it might be difficult to accommodate student placements within a service before a qualified music therapist is employed. In the course of the conference, I met a number of music therapy graduates who were employed by special schools in Northern Ireland.

The Master of Arts in Music Therapy course at the Irish World Music Centre, in The University of Limerick is the first programme of its kind in Ireland. The programme is offered in association with St Vincent’s Centre, Lisnagry in Limerick. The course requires a high level of music skills at entry with a primary degree (with first or second-class honours) in music or psychology or related disciplines. The two-year fulltime course includes a variety of clinical placements and includes theoretical and clinical modules.

And finally—

Let’s go for this new and exciting 21st century health accessory. Its potential for our less able clients is immense. Congratulations to the Limerick Team for taking the initiative to harness the deepest, most emotional art form of them all. Music therapy is, without doubt, a highly credible science. However, it is also the medium that can transcend the practical, the measurable and the limitations of the tangible world. Let the final word belong to G. Steiner [1971]:

Instead of serving human ends and spontaneities, ‘the positive truths’ of science and scientific laws have become a prison house, …to imprison the future…

A myth of objective, verifiable scientific evidence has overwhelmed the utopian fundamentally anarchic springs of humane consciousness…”

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