Oh Sing, Can't You See?!
Imagine that you are in a situation where there are many tasks at hand. You try to organize and formulate an efficient manner in which to expedite this agenda but the thinking process is constantly diverted to an equally important aspect of rationale: Your current disposition. How can you do two things at once. Seems very difficult. Combine this with background noise and you can develop an affect called stress. This affect may someday become dangerous to your health. For a significant number of people that suffer from psychological disorders, this is the least of their worries. Normally we have the ability or control to stop things from getting away from us while for others, total mental efforts are concentrated in adjusting to everyday living. Due to their dysfunction, the luxury of "stopping" is completely out of their grasp. Background noise is an important factor because we are susceptible to it at all times. Although us "normal" people discern this auditory stimuli, it can nonetheless affect our state of being. Forces of nature such as tremors, gravity, wind and solar irradiation also provide unwarranted stimuli. Together the aforementioned "noises" contrive the rudimentary elements of music. Everyday noises going to work, such as the sound of your car engine or the ambulance screaming by, provide the pitch and dynamics (loud and soft). Forces of nature such as tremors, wind and gravity (earth and moon) provide the resonance and frequency (tempo/rhythm). We, being natural creatures, are indeed connected to all of this. This illustrious concept is used in music therapy for mental patients as to affect their physiology, cognitive behavior, and group involvement.
Music therapy is the use of music to facilitate the physical, psychological and effective integration of self or in treating an illness or disability. The aim of any treatment is to successfully be able to deal with certain disorders. Some of these disorders are schizophrenia, depression, attention deficit disorder (ADD), bipolar disorder and dual diagnosis. Music can be a therapeutic tool to augment an individual's ability to shape and change one's own behavior. It's immediate use is to catharsize anti-social emotions. A case study in which I visited the psychiatric ward of an inner city hospital on numerous occasions between 1992-1997, clearly demonstrates this effect.
I frequented the ward weekly or biweekly. The staff on the ward felt a need to stimulate the patients in a different manner. They requested "a cappella" singing. I made my way to the recreation room after warming up and was surprised to see many patients (approx. 15-20 people) in their seats, arranged in a semicircle. They ranged from 20 to 40 years in age, and were of Hispanic, African-american and Oriental ethnicity. The floor was a clean, bright white, while the walls were a soft linen color. They all appeared rested if not relaxed. Their demeanor demonstrated enthusiasm. Their hair was neatly groomed. They were dressed up with no where to go except the world they allowed me to reach. As soon as I started singing, a female patient joined me without change in her pitch. She knew the song I sang. Although she was told by the staff to stop, she did not. As a volunteer, I did not mind since I was there for their benefit and certainly not to impose rules or discipline. Some others began to smile. Some cried. Mixed responses to the popular hymn "Amazing Grace." The group did not move for another couple of songs, which were livelier. When I switched to a more dynamic style of singing, operatic, their expressions changed. All eyes widened and smiles ceased. They clapped as I walk away.
Subsequent weeks later, I was able to establish a rapport with the patients. I had earned most of their trust. An instrument was introduced to accompany my voice. Successful as it was, the patients were more enthused when I sang unaccompanied. I wondered why. The staff had a hunch that the patients preferred listening to singing without other distractions. I also sang in other languages, which they enjoyed as well. I then mixed my singing with an audiotape so I could get them to interact and sing along. The response was overwhelming. They all quickly picked up the photocopies of lyrics I copied for them, and began to sing. It is important to note that although I recognized some of the patients, there was a large turnover every few weeks. Sometimes, certain familiar patients could not attend our sessions due to their heavy drug treatments. Some patients would have extreme responses to their session or even become non-responsive. These varied responses to our sessions made it difficult to assess the actual long-term effect of the music therapy. Obvious effects were the signs of peace and comraderie amongst themselves. After I had sung, the patients were feeling good, helping each other with their robes, holding doors and offering refreshments to one another. Ms. M. Anderson, C.C.N. (clinical coordinator nurse) who often proctored the sessions stated "the effect of having music in their lives was enormous. The patients learned to deal with others better than they had before the singing sessions", especially the schizophrenics. The music interrupted their delusions for long periods.
Another case study that supports the theory that music may alleviate problems that interfere with an individual's personal and/or social adaptation to society is by Ms. Selina I. Glator, M.A., R.M.T. (Registered Music Therapist). Ms. Glator refers to a schizophrenic patient she calls "Lee" to demonstrate positive feedback to keyboard improvisation. The development in Lee's concentration and level of trust greatly increased, which was due to his ability to relate to the therapist (and hence, to others on the unit). She further states that he responded strongly in areas of emotional expression, self image, and though psychotic delusion were still present, they were beginning to be replaced by more appropriate interaction at the end of music therapy.
How exactly can this be achieved? California State University of Pomona, Education Department, has this narrowed down to three theories. First, is the Biochemical theory, which states that music is a sensory stimulus that is processed through the sense of hearing. Sound vibrations are chemically charged into the nerve impulses that activate the sympathetic or parasympathetic nervous system.
Another theory is the Entrainment theory, which suggests that the human energy field receives oscillations produced by music and various physiological systems entrain with or match the Kurtz (oscillation/frequency) of the music. In the introduction, I made a comparison of background noise to music. This analogy was made in the hope that the pattern of resonance and frequency found in everyday life, which ultimately affects our moods, becomes more lucid. As we clarify the relationship between noise and music so must we refine the relation between music and physiology. Rhythm or tempo is directly related to our heartbeat. Inevitably we synchronize to a pulse and follow its speed (momentum). Dynamics can be mostly attributed to respiration. The heavier the breath, the louder or stronger it is . This is closely tied to emotions.
A third theory is the Metaphysical theory that suggests music is divine in nature. Music is primordial. It provides for a non-threatening interaction that has positive effects on mind, body, and soul. Maria Von Trapp from the movie "The Sound of Music" explains that "music acts like a magic key to which the most tightly closed heart opens."
Contrary to this "humanistic" approach there is a bold move ahead for doctors who want to offer a pill for everything. Recently in the NY Times (article by Erica Goode), she writes how doctors are attempting to diagnose schizophrenia sooner. Challenging indeed, since the disorder is in full bloom by the time we may first see a sign. So to combat this, science will be indiscriminate in its impudence in attempting to start medication sooner by diagnosing children. A chemical imbalance does not solely have to be treated with chemicals. In my own case study, singing in the hospital, the therapy did not serve everyone. I must point out that even those who were receptive to the music were also being treated with different drugs (experimental, and established). There is a happy medium science and society can traverse.
I adjusted my singing program to fit a model for my goals. To initiate, stimulate and meditate. I eventually began with communal songs then moved up to more aggressive, cathartic and dynamic music, finally, ending with chants and peace. My program is similar to many doctors and surgeons who state that they prefer "no background music for the tense parts of the case (doctor-patient evaluation), classical for periods of concentration (therapy) and rock and roll beginning and (convocation and invocation)." Dr. Selina Glator states that her philosophy of music therapy is an eclectic one. This allows for her reasoning why the medical field has shown signs of shifting from prescriptive to preventative means in dealing with health. A strong aggressive program is necessary to upgrade the importance of music therapy from an ancillary status to the forefront, side by side with psychiatric medicine. Occupational therapy for the development of fine motor skills, can also be integrated to enhance the probability for an effective treatment of brain dysfunction.
Many psychiatrists rely exclusively on drugs to treat their patients. Instead they should rely on a combination of less drugs and more therapy. Music therapy in this example can offer wonderful benefits without the side effects.
Cognitive behavior can also be enhanced. Music therapy provides an environment in which patients can catharsize anger. In lieu of group therapy, music provides a warm fuzzy feeling of well being that can not be administered by injection or pills. No drug will give it to them. No amount of talking will be able to reach that.
Congenital or not, Dr. Meglashon states "Psychosis is not a benign state of mind." and therefore requires anti-psychotic drugs. If we are to deduce that chemically we can solve certain problems by ingesting more chemicals, then perhaps we should definitely look further into reaching an equilibrium physiologically as well as psychologically through more natural means; Music Enhanced Endorphins. The stimuli music therapy induces can therefore be the synthesizing strand between normalcy and disorder.
Bibliography
Anderson, M., A.N.C.C. Telephone interview, 10 Dec. 1999.
Baker, C.C., M.D. "What Your Surgeon Hums When You're Not Listening." New York Times 7 Dec. 1999.
Goode, E. "Doctors Try a Bold Move Against Schizophrenia." New York Times 7 Dec. 1999.
Glater, Selina I., M.A., R.M.T. "Music as Therapy." JOURNAL 10 Dec. 1999 Online Internet Sanctuary Psychiatric Center's Information Network.
Rev. of "How Music Promotes the Relaxation Effect." Online California State University @ Pomona Education Dept. 10 Dec. 1999.