Music therapy: benefits and clinical applications

Music Therapy

According to Gary Ansdell, the music "product" created through Creative Music Therapy is like a "magic mirror" that reflects "physical and emotional vistas," (128). The role of music in therapy has been explored in formal and informal contexts because, as Langer states, "most people connect feelings with music," (213). While listeners and musicians both undeniably and unavoidably associate emotions with music, music in itself is not necessarily emotive. Kivy describes the difference between expressing emotions that are actually there and being expressive of an objective emotional condition (257). Music by itself is a tool, and its instruments are means through which people can express their personal emotional states. However, the use of music in a therapeutic session works mainly because of the communication created through the client-therapist connection. Music is not just a form of self-expression, which would make music ego-centric and allow the client to remain insular. Ansdell emphasizes the importance of listening for the therapeutic process to be effective.

Langer describes the various potential functions of music in a therapeutic context. First, music can be a form of pleasurable sensation. However, as Langer notes, many musical expressions are deliberately discordant and therefore not purely pleasurable. Therefore, music cannot be used in a therapeutic context as a means by which to evoke pleasure in a depressed client. Second, music can evoke an emotional response, any emotional response (211). Music can cause the heart rate to increase or decrease depending on tempo, for instance. Yet the enduring emotional and physiological effects of listening to music are questionable at best. Referring to scientific experiments, Langer states that music's "somatic effects are transient, and its moral hangovers or uplifts seem to be negligible," (212). Thus, listening to music in a therapeutic setting may not evoke any healing results.

Two other potential functions of music in the therapeutic setting include playing music as a form of self-expression, and using the product of that self-expression as a symbolic code. Even here, Langer notes weaknesses in music therapy theory. For example, playing music allows for self-expression but more importantly, music demonstrates an "exposition of feeling," (221). The semantics underlying the musical composition may be as important, or more important, than the cathartic effects of self-expression that many music therapists advocate

Ansdell agrees and questions the "almost unquestioned assumption that music is a straightforward expression of feelings," (124). Kivy calls the same unquestioned assumption the tendency to describe music biographically, that is, to attribute certain emotional states to the composer. While the biographical description of music works in many cases, it is far from being universally applicable. Instead, Kivy urges music therapists to cease speculating about the composer's emotional state and reach a more objective means of appreciation and analysis. If the therapist hopes to "perceive something else" in the work other than the purely scientific elements of the music such as tone and notation, then the therapist must understand how music can be expressive of emotions (9). Music can be expressive of emotions in a fluid and flexible way, not in a definitive way. Music in the therapeutic context is, as Ansdell puts it, "neither pure feeling nor pure form," (128). Rather, music opens the door for a dialogue and communication between client and therapist that might otherwise never occur.

As with any form of creative expression, music ultimately depends on an audience. Otherwise, music cannot be used in a therapeutic setting because the medium is instrumental in helping the client "to get beyond this bubble of self," (126). Yet while the creator, or in the psychotherapeutic setting, the client, is undoubtedly using the medium of music for self-expression, the therapist should take care not to over-speculate about the "product." Music can be a symbolic "language of feeling," as Langer explains, but that language of feeling could take years to decipher (221). If the therapist infers that a drone piece created by the client denotes sadness then the therapist infers too much and does the client a disservice. Rather, the role of the music therapist is to provide an open setting in which therapist and client can communicate in non-verbal ways. Non-verbal communication is essential in some therapeutic settings, such as with clients who are catatonic, autistic, or otherwise emotionally inexpressive.

Music transcends the limitations of conventional language in fostering communication. Like the mother talking to her infant, music does not depend on pure understanding of form or even of feeling. For music to be therapeutically effective the therapist need only to listen to what the client has to "say" and respond to it in turn. The medium levels the playing field and loosens up possible areas of intimidation, mistrust, or shyness. Furthermore, the role of the therapist differs sharply from the role of the music critic, for which the "distinction between good and bad" is foremost (Langer 207). For the therapist, an "improvised dialogue" is the essence of the therapeutic process.