You Are the Music: How Music Reveals What it Means to be Human (25 page)

Post Traumatic Stress Disorder

Some of the earliest recorded use of music therapy dates from the 1940s when musical interaction and listening was used to help veterans suffering from ‘shell shock’ after the Second World War. This kind of therapy was thought to help relieve the high state of anxiety in what is now recognised as Post Traumatic Stress Disorder (PTSD) and to encourage a sense of community out of the isolation that often results from leaving the armed forces.

Today we know that music can help trigger autonomic relaxation responses that can help lower the heightened states of anxiety and vigilance that people with PTSD often experience, even if only temporarily. Being able to escape from negative mind and body states plus the increase in personal sense of control over mental activity can all have measurable effects on quality of life. Music interventions can be incorporated as part of therapies designed to help with tension regulation and complex thinking, to assist the client with mental challenges like planning, assessing outcomes, and controlling impulsive behaviours.
⁷⁰

Depression

Music therapy is effective in depressive patients because active music making within a therapeutic framework offers a person the unique opportunity for new ‘aesthetic, physical and relational experiences’.
⁷¹

Practically, this means that music therapy provides an enjoyable way for people who are depressed to increase their level of basic physical activity in a social context with other people who may or may not be facing similar difficulties to themselves. Building on communication and interaction in
this way is seen as a primary goal of therapy for an individual in a serious state of depression where inward, negative-biased reflection can be distressingly dominant.

Another benefit of music therapy and music medicine for people with depression is that it gets a high degree of treatment compliance in a population that can often be resistant to interventions, especially in the initial stages of treatment.
⁷²
The fact that music listening is enjoyable and can be tailored to each individual to access pleasant life memories (see Chapter 7) also allows for a personal approach to interaction with a therapist and a flexible, portable form of mood regulation that a patient can learn to use by themselves.

Dementia and Alzheimer’s

Dementia is a wide-ranging term that encompasses a number of conditions that are characterised by a decline in a person’s mental faculties. Dementia-related illnesses, including Alzheimer’s, are associated with multiple cognitive, emotional and behavioural problems that are underwritten by a state of confusion and loss of connection with the social world. Music therapy and music medicine can provide not only a valuable source of cognitive stimulation but also a conduit through which carers, families and friends can re-learn how to communicate and interact with their loved one.

In Chapter 7 we talked about how music is strongly linked to our memories and how musical memories can often survive in cases where other forms of life memory seem inaccessible, including after brain injury and in dementia.
⁷³
This strong link to music in our memory can provide an invaluable link to a person’s sense of personal history and identity.

Music also provides a useful way for Alzheimer’s patients to learn new information.
⁷⁴
This finding may in time provide a basis for music-based practical memory training that would allow an individual to maintain their independence for longer.
⁷⁵

Music can be used to help patients in the later stages of dementia to re-engage with the people around them, after the point where verbal contact has been lost. Activities such as moving and singing to music encourage physical and mental engagement with loved ones and carers that can be beneficial for the patient’s state and bring about changes in quality-oflife measures for family and friends. Music therapy has been associated with significant reductions in both long-term anxiety and depression levels in these patients.
⁷⁶

Another issue with later-stage dementia is that the person can become distressed by changes to their environment or activities. These changes can be as simple as getting ready for bed after dinner or meeting a new doctor. In these cases music can be introduced as a cue for transition, in order to reduce associated stress reactions.
⁷⁷
Over time, music comes to act as a relaxed ‘primer’ for activities that the patient can come to recognise, meaning times of transition will be less of a stressful burden for them. When such stress reactions are minimised a person can have better access to their implicit, procedural memories for old habits (such as dressing and washing), allowing for a calmer and more successful, independent everyday routine.

Back in 2003 the Cochrane report found no strong evidence either in support of or against the use of music therapy and music medicine for individuals with dementia; the accumulation of evidence I have described in this section indicates how far research can come in a decade. Although no formal update of this 2003 report presently exists I am more convinced than ever about the benefits of music in this group of patients.

What kind of music?

As with many of the effects we have seen attributed to music throughout this book, when considering the best type of music for well-being, personalisation is crucial; there is no
one perfect genre or style of music for everyone. This point brings us right back to the ‘vitamin’ model of music that John Sloboda so wisely warned against at the start of this chapter. A good reaction and positive outcomes from music therapy or music medicine for any one person depends on the kind of music that they like.

Just to make this point even stronger, we see the consequences of not taking a personal approach when researchers choose a particular generic type of music, with all good intentions, believing it to have good effects, only to find that this blanket introduction of music makes a situation worse.

In one case, classical music was played in the communal area of a home for people with dementia.
⁷⁸
Behavioural disturbances were found to be significantly worse during these musical periods, and many patients demanded that the music be removed. However good the intentions of such research, it goes to show that the most important person in any situation where music is introduced for well-being is the patient or client – their needs, likes and desires must drive the selection of music.

There are some general rules that can guide music selection beyond simply making sure it is enjoyed by the client. Where possible, patients should be encouraged to select music characterised by a slow tempo and that lacks abrupt harmonic changes and sharp timbres, in order to have the best chances of promoting autonomic relaxation. In addition, music that evokes strong emotional reactions, which may be caused by memories associated with the music, should be avoided when used for stress and anxiety-reduction purposes.

There is another caveat to the general conclusion that patient-selected music is best. In some cases unfamiliar music may be more helpful; emotional associations with music can disrupt and distract from a person’s attention to aspects of the music which may be critical for their therapy. For example, a therapist or a patient may wish to focus on the rhythm of
music in order to help movement but emotional music may distract focus from this part of the sound.

Finally, we must consider how we introduce music to medical and therapeutic environments. Listening to music through headphones may not be wise during painful procedures because it prevents the patient from hearing instructions or comments by the medical staff. This interference and lack of contact with staff who are administering treatment may increase patients’ anxiety and, consequently, their perceived pain. In the case of such procedures, it is probably better to listen to music without headphones.
⁷⁹

In our final chapter we have taken a tour through the various ways in which both music therapy and music medicine have been trialled as adjunctive treatments to support well-being through the whole of the human lifespan. The music of your life may one day have the power to support you through difficult and traumatic times, though I very much hope that these are few.

Music psychology research allows us to better understand how the brain and body react to music in clinical and care situations, and permits therapists and medical staff to optimise the use of music in these situations, always putting each individual at the forefront of planning.

Music is not a pill, a solution or a cure when it comes to times of trouble but it can be an important and flexible source of personal support, consolation, connection and inspiration.

Through the course of your life journey you have developed a wealth of musical skills, understandings and memories that are completely unique to you – a musical being that will never be recreated no matter how long the human race lasts.

Music will be your lifelong friend and personal companion, your reflection and your shadow. You really are the music.

Notes

Introduction

1
Mayle, P. (1978),
Baby Taming
. New York: Crown.

2
Changizi, M. (2011),
Harnessed: how language and music mimicked nature and transformed ape to man
. Dallas: Benbella Books.

Chapter 1: First musical steps

1
Ruthsatz, J., Ruthsatz, K., and Stephens, K.R. (2013), ‘Putting practice into perspective: Child prodigies as evidence of innate talent’,
Intelligence
,
http://dx.doi.org/10.1016/j.intell.2013.08.003

2
Pujol, R., Laville-Rebillard, M., and Lenoir, M. (1998), ‘Development of sensory neural structures in the Mammalian cochlea’, in: E.W. Rubel, A.N. Popper and R.R. Fay (eds),
Development of the auditory system. New York: Springer Handbook of Auditory Research
(pp. 146–193). Springer-Verlag.

3
Abrams, R.M., et al. (1998), ‘Fetal music perception: The role of sound transmission’,
Music Perception
, 15, 307–317.

4
Smith, S.L., et al. (2003), ‘Intelligibility of sentences recorded from the uterus of a pregnant ewe and from the fetal inner ear’,
Audiology and Neuro-Otology
, 8, 347–353.

5
Draganova, R., et al. (2007), ‘Serial magnetoencephalographic study of fetal newborn auditory discriminative evoked responses’,
Early Human Development
, 83(3), 199–207.

6
Richards, D.S., et al. (1992), ‘Sound levels in the human uterus’,
Obstetrics & Gynecology
, 80(2), 186–90.

7
Ando, Y., and Hattori, H. (1977), ‘Effects of noise on sleep of babies’,
Journal of the Acoustical Society of America
, 62, 199–204.

8
Granier-Deferre, C., et al. (2011), ‘A Melodic Contour Repeatedly Experienced by Human Near-Term Fetuses Elicits a Profound Cardiac Reaction One Month after Birth’,
PLOS ONE
, 6(2): e17304.

9
James, W. (1890),
The Principles of Psychology
. Cambridge, MA: Harvard University Press (1981).

10
Winkler, I., et al. (2009), ‘Newborn infants detect the beat in music’,
Proceedings of the National Academy of Sciences USA
, 106(7):2468–2471; info and stimuli available at
http://www.mcg.uva.nl/newborns/

11
Bull, D., Eilers, R.E., and Oller, D.K. (1985), ‘Infants’ discrimination of final syllable fundamental frequency in multisyllabic stimuli’,
Journal of the Acoustical Society of America
, 77(1), 289–295.

12
Nazzi, T., Floccia, C., and Bertoncini, J. (1998), ‘Discrimination of pitch contours by neonates’,
Infant Behavior and Development
, 21(4), 779–784.

13
Mampe, B., Friederici, A., Christophe, A., and Wermke, K. (2009), ‘Newborns’ Cry Melody Is Shaped by Their Native Language’,
Current Biology
, 19(23), 1994–1997.

14
Falk, D. (2004), ‘Prelinguistic evolution in early hominins: Whence motherese?’,
Behavioral and Brain Sciences
, 27, 491–541.

15
Cooper, R.P., and Aslin, R.N. (1990), ‘Preference for infant-directed speech in the first month after birth’,
Child Development
, 61(5), 1584–1595.

16
Werker, J.F., and McLeod, P.J. (1989), ‘Infant preference for both male and female infant-directed talk: A developmental study of attentional affective responsiveness’,
Canadian Journal of Psychology
, 43(2), 230–246.

17
Masataka, N. (2003),
The onset of language
. Cambridge: Cambridge University Press.

18
Boukydis, C.F., and Burgess, R.L. (1982), ‘Adult Physiological Response to Infant Cries: Effects of Temperament of Infant, Parental Status, and Gender’,
Child Development
, 53(5), 1291–1298. Swain, J.E., Lorberbaum, J.P., Kose, S., and Strathearn, L. (2007), ‘Brain basis of early parent–infant interactions: psychology, physiology, and in vivo functional neuroimaging studies’,
Journal of Child Psychology and Psychiatry
, 48(3–4), 262–287.

19
Werker, J.F., and McLeod, P.J. (1989), ‘Infant preference for both male and female infant-directed talk: A developmental study of attentional affective responsiveness’,
Canadian Journal of Psychology
, 43(2), 230–246.

20
Trainor, L.J., Austin, C.M., and Desjardins, R.N. (2000), ‘Is infant directed speech prosody a result of the vocal expression of emotion?’,
Psychological Science
, 11(3), 188–195.

21
Kuhl, P.K., et al. (1997), ‘Cross-language analysis of phonetic units in language addressed to infants’,
Science
, 277(5326), 684–686.

22
Burnham, D.K., Vollmer-Conna, U., and Kitamura, C. (2000), ‘Talking to infants, pets, and adults: What’s the difference?’, paper presented at the XIIth Biennial International Conference on Infant Studies, Brighton, UK.

23
Trainor, L.J., and Desjardins, R.N. (2002), ‘Pitch characteristics of infant-directed speech affect infants’ ability to discriminate vowels’,
Psychonomic Bulletin and Review
, 9, 335–340.

24
Kitamura, C., and Lam, C. (2009), ‘Age-specific preferences for affective intent’,
Infancy
, 14, 77–100.

25
Sakkalou, E., and Gattis, M. (2012), ‘Infants infer intentions from prosody’,
Cognitive Development
, 27(1), 1–16.

26
Pinker, S. (1994),
The Language Instinct: How the Mind Creates Language
. New York: HarperCollins.

Chapter 2: Music in childhood

1
This phrase refers to the use of the term in the academic literature and does not intend to refer to the copyright term ‘The Mozart Effect®’, copyright Don Campbell.

2
Rauscher, F.H., Shaw, G.L., and Ky, K.N. (1993), ‘Music and spatial task performance’,
Nature
, 365, 611.

3
Rauscher, F.H., Shaw, G.L., and Ky, K.N. (1995), ‘Listening to Mozart enhances spatial-temporal reasoning: Towards a neurophysiological basis’,
Neuroscience Letters
, 185(1), 44–47.

4
Rauscher, F.H., and Shaw, G.L. (1998), ‘Key components of the Mozart Effect’,
Perceptual and Motor Skills
, 86(3), 835–841.

5
Nantais, K.M., and Schellenberg, E.G. (1999), ‘The Mozart Effect: An Artifact of Preference’,
Psychological Science
, 10(4), 370–373.

6
Schellenberg, E.G. (2012), ‘Cognitive performance after music listening: A review of the Mozart effect’, in R.A.R. MacDonald, G. Kreutz and L. Mitchell (eds.),
Music, Health and Wellbeing
(pp. 324–338). Oxford: Oxford University Press.

7
Husain, G., Thompson, W.F., and Schellenberg, E.G. (2002), ‘Effects of Musical Tempo and Mode on Arousal, Mood and Spatial Abilities’,
Music Perception,
20(2), 151–171.

8
Steele, K.M., Bass, K.E., and Crook, M.D. (1999), ‘The Mystery of the Mozart Effect: Failure to Replicate’,
Psychological Science
, 10(4), 366–369.

9
Chabris, C.F. (1999), ‘Prelude or requiem for the “Mozart effect”?’,
Nature
, 400, 826–827.

10
Schellenberg, E.G. (2012), ‘Cognitive performance after music listening: A review of the Mozart effect’, in R.A.R. MacDonald, G. Kreutz, and L. Mitchell (eds),
Music, health and wellbeing
(pp. 324–338). Oxford: Oxford University Press.

11
Brandler, S., and Rammsayer, T.H. (2003), ‘Differences in Mental Abilities between Musicians and Non-musicians’,
Psychology of Music
, 31(2), 123–138.

12
Schellenberg, E.G. (2004), ‘Music lessons enhance IQ’,
Psychological Science
, 15(8), 511–514.

13
Schellenberg, E.G. (2006), ‘Long-term positive associations between music lessons and IQ’,
Journal of Educational Psychology
, 98, 457–468.

14
Weiss, M.W., and Schellenberg, E.G. (2011), ‘Augmenting cognition with music’, in I. Segev and H. Markram (eds.),
Augmenting cognition
(pp. 103–125). Lausanne, Switzerland: EPFL Press.

15
Trainor, L.J., Shahin, A., and Roberts, L.E. (2003), ‘Effects of musical training on the auditory cortex in children’,
Annals of the New York Academy of Sciences
, 999, 506–513. Shahin, A., et al. (2008), ‘Music training leads to the development of timbre-specific gamma band activity’,
NeuroImage
, 41(1), 113–122.

16
Krumhansl, C.L. (1990),
Cognitive foundations of musical pitch
. New York: Oxford University Press.

17
Strait, D., and Kraus, N. (2011), ‘Playing music for a smarter ear: Cognitive, perceptual and neurobiological evidence’,
Music Perception
, 29(2), 133–146.

18
Strait, D.L., Parbery-Clark, A., Hittner, E., and Kraus, N. (2012), ‘Musical training during early childhood enhances the neural encoding of speech in noise’,
Brain & Language
, 123, 191–201.

19
Kraus, N., and Chandrasekaran, B. (2010), ‘Music training for the development of auditory skills’,
Nature Reviews Neuroscience
11, 599–605.

20
http://www.soc.northwestern.edu/brainvolts/projects/music/music_video.html

21
Parbery-Clark, A., et al. (2011), ‘Musical Experience and the Aging Auditory System: Implications for Cognitive Abilities and Hearing Speech in Noise’,
PLOS ONE
6(5): e18082. Kraus, N., Strait, D.L., and Parbery-Clark, A. (2012), ‘Cognitive factors shape brain networks for auditory skills: Spotlight on auditory working memory’,
Annals of the New York Academy of Sciences,
1252, 100–107.

22
Moreno, S., and Besson, M. (2006), ‘Musical training and language-related brain electrical activity in children’,
Psychophysiology
, 43(3), 287–291.

23
Moreno, S., et al. (2009), ‘Musical training influences linguistic abilities in 8-year-old children: More evidence for brain plasticity’,
Cerebral Cortex
, 19(3), 712–723.

24
Ibid.
: ‘Music training was based on the following aspects: Rhythm—children were trained to produce and improvise rhythms in different tempi and meters; Melody—exercises comprised the production and improvisation of melodies as well as inner audition. Children were taught
to classify pitch contour and intervals [e.g., going up and down; low, middle and high tones; relative music reading]; Harmony—children listened to harmonic progressions like I--IV--V--I, I--V--IV--I, or I--IV--V--VI, which they were trained to recognize, discriminate and produce; Timbre—recognition of timbres from different instruments and voices; Form—children listened to classical music and to children’s melodies.’

25
Anvari, S.H., Trainor, L.J., Woodside, J., and Levy, B.A. (2002), ‘Relations among musical skills, phonological processing, and early reading ability in preschool children’,
Journal of Experimental Child Psychology
, 83(2), 111–130.

26
Strait D.L., Hornickel. J., Kraus. N,. (2011), ‘Subcortical processing of speech regularities predicts reading and music aptitude in children’.
Behavioral and Brain Functions
, 7, 44.

27
Hallam, S. (2010), ‘The power of music: Its impact on the intellectual, social and personal development of children and young people’,
International Journal of Music Education
, 28(3), 269–289.

28
Sloboda, J.A., and Howe, M.J.A. (1992), ‘Transitions in the early musical careers of able young musicians: choosing instruments and teachers’,
Journal of Research in Music Education
, 40(4), 283–294.

29
Sosniak, L.A. (1985), ‘Learning to be a concert pianist’, in B.S. Bloom (ed.),
Developing talent in young people
(pp. 19–67). New York: Ballantine.

30
Sloboda, J.A., and Howe, M.J.A. (1991), ‘Biographical precursors of musical excellence: An interview study’,
Psychology of Music
, 19(1), 3–21.

31
Davidson, J.W., et al. (1998), ‘Characteristics of Music Teachers and the Progress of Young Instrumentalists’,
Journal of Research in Music Education
, 46(1) 141–160.

32
Ibid.

33
Austin, J., Renwick, J., and McPherson, G.E. (2006), ‘Developing motivation’, in G.E. McPherson (ed.),
The child as musician: A handbook of musical development
(pp. 213–238). Oxford: Oxford University Press.

34
Hallam, S. (1998),
Instrumental Teaching: a practical guide to better teaching and learning
. Oxford: Heinemann.

35
Ericsson, K.A., Krampe, R.T., and Tesch-Römer, C. (1993), ‘The Role of Deliberate Practice in the Acquisition of Expert Performance’,
Psychological Review
, 100(3), 363–406.

36
Marcus, G. (2012),
Guitar Zero: The New Musicians and the Science of Learning
. London: Penguin Press.

37
McPherson, G.E., and Renwick, J. (2011), ‘Self-regulation and mastery of musical skills’, in B. Zimmerman and D. Schunk (eds),
Handbook of self-regulation of learning and performance
. New York: Routledge.

38
McPherson, G.E. (2005), ‘From child to musician: Skill development during the beginning stages of learning an instrument’,
Psychology of Music
, 33(1), 5–35.

39
Sloboda, J.A., and Davidson, J.W. (1996), ‘The young performing musician’, in I. Deliège and J.A. Sloboda (eds.),
Musical Beginnings: Origins and development of musical competence
(pp. 171–190). Oxford: Oxford University Press.

40
Pitts, S., and Davidson, J. (2000), ‘Developing effective practise strategies: Case studies of three young instrumentalists’,
Music Education Research
, 2(1), 45–56.

41
Ibid.

42
Sloboda, J.A., Davidson, J.W., Howe, M.J.A, and Moore, D.G. (1996), ‘The role of practice in the development of performing musicians’,
British Journal of Psychology
, 87, 287–309.

43
Trainor, L.J., et al. (2012), ‘Becoming musically enculturated: effects of music classes for infants on brain and behavior’,
Annals of the New York Academy of Sciences
, 1252, 129–138