Music as therapy: A brief history

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<ul><li><p>Music as therapy: a briefhistoryFrancis C. Biley</p><p>Confuciusbelieved that thenature of themusic in asociety reflectedthat very societyand if it changed,so did society.</p><p>Francis C. BileyPhD MScBNursRMN RGN PGCE FETCert.Senior Lecturer in Nursing,University of WalesCollege of Medicine,School of Nursing Studies.UWCM, Heath Park,Cardiff, Wales CF4 4XN,UK.Tel/fax:0044 (0) 1222743734(work)Email: Biley@d.ac.uk</p><p>It could be argued that the current interest andpopularity of complementary therapies devel-oped as a result of a desire to treat, and betreated, holistically. This implies that the focus oftreatment is not merely the complaint that aperson has, but the focus should be on the personas a whole and the environment in which theyexist.</p><p>Creating an optimum healing environment haslong been recognized as critical by complemen-tary therapists, who go to great lengths to choosehealing colour schemes, furnishings and lighting,and often supplement this with soothing 'newage' background music. This indirect use ofmusic as therapy, which should not be confusedwith music therapy, has a long and interestinghistory.</p><p>Music therapy has a relatively recent history,having developed since the mid-20th century. Itis usually performed in structured sessions byappropriately qualified musicians or practi-tioners and aims to develop motor skills,interaction and sheer enjoyment of music bythe active participation in the creation of musicby the therapist and group members or indivi-duals. It has been formally defined as 'asystematic process of intervention wherein thetherapist helps the client to achieve health usingmusical experiences and the relationships thatdevelop through them as dynamic forces ofchange' (Bruscia 1989). Music as therapy, how-ever, does not depend on active participation inmusic making, being essentially unstructured ormore informal listening to music as a consciousor unconscious activity. As such, music astherapy has a history of many thousands ofyears. Its potential effects are summarized mosteffectively in the following quote:</p><p>Under the effect of music, the five social dutiesare without admixture, the eyes and the earsare clear, the blood and the vital energies arebalances, habits are reformed, customsareimproved, the empire is at complete peace.</p><p>(Yo Ki, cited in Tame 1984)</p><p>During the 1970s and 1980s there was a con-siderable increase in interest and exploration ofthe therapeutic potential of music. In order toplace this continuing interest in perspective, thewide and considerable history of the thera-peutic use of music, which is rooted in antiquity(Mem-ory 1993) and pervades every age andcivilization, needs to be briefly recounted andexplored.</p><p>Early evidence of the existence of music, or atleast music instruments, goes back to perhaps10000 BC, with the existence of clay flutes orocarina (McClellan 1991). At sometime aroundthis period 'our earliest ancestors began toattribute magical powers to sound' that wereperceived to be able to control the spirit andnatural worlds and to create and sustain life(Cowan 1992, McClellan 1991).The existence ofthese musically induced powers are evidentthroughout known history, where early man'used music in the form of incantations, songs,rhythms, and sounds to ward off evil spirits,absolve sins, or placate the Gods' (Alvin 1966).</p><p>In ancient Egypt, where music was regardedas the 'physic of the soul' (Cook 1981), it wasthought that music brought about particularphysical sensations and that it also created a poweror spell known as a heka (Farmer 1957) and couldinfluence the fertility of women (Cook 1981).</p><p>The early Chinese thought that music hadsimilar powers (Picken 1957) and that it also hadthe ability to please (Folta 1993). Indeed, musicwas considered to be a reliable indicator of thestate of a nation and as a result, rather thantravel around listening to what the people had tosay, the Emperor Shun would listen to theirmusic and test the exact pitches of the notes ofChinese musicians (Tame 1984), believing thatmusic was the basis of everything, includingunity. Similarly, Confucius believed that thenature of the music in a society reflected thatvery society and if it changed, so did society. Itwas thought that music could 'convey eternaltruths' (Tame 1984) and control the elements(Tame 1984).</p><p>Compfementary Th~rcpjes inNcrsing &amp; Midwifery (1999) 5. 140-143 1999Harcourt Publishers ltd</p></li><li><p>Plato believedthat music hadtile ability topromote healthill body andmind.</p><p>Musicas therapy</p><p>In early history, healers were often alsomusicians (Heitz et al. 1992). The Greek god ofhealing and music, Apollo, and his servantOrpheus 'applied remedies to body and soulthrough poetry, music, and medicine, andreturned his beloved Eurydice to life with hissong' (McClellan 1991).</p><p>Pythagoras taught his students that certainmusical chords, melodies, melodic intervals andrhythms could produce particular responses inpeople such as improving health (Cook 1981),increasing the speed of wound healing andpositively changing behaviour (Lingerman1983). Similarly, Aristotle thought that flutemusic could 'arouse strong emotions and thusoften lead to a state ofcathartic release' (Watson&amp; Drury 1987), writing that:</p><p>Emotionsof any kind are produced by melody andrhythm; therefore by music a man becomesaccustomed to feeling the right emotions;music hasthus the power to form character, and the variouskindsof musicbasedon the various modes,may bedistinguished by theireffects on character - one, forexample working in the direction of melancholy,another of effeminacy; one encouragingabandonment, another self-control, anotherenthusiasm, and so on through the series.</p><p>(Aristotle, cited in Tame 1984)</p><p>More specifically, Cassidorus considered mu-sic to be important in the treatment of mentaldistress and that it could induce sleep (Watson &amp;Drury 1987). Beck (1991) stated that Platobelieved that music had the ability to promotehealth in body and mind. Homer thought thatmusic could help to avoid negative feelings suchas sadness, anger, worry and fear (Cook1981). However, it was Zenocrates, Sarpanderand Arion who were regarded as the first toregularly use music as a therapeutic intervention(Buckwalter et aL 1985).</p><p>Such approaches are typified by the healers ofancient Greece, Rome and Egypt who wouldchant whilst they administered to the sick(McClellan 1991). Similarly, the North AmericanObkibwa healers would sing songs to the sick(Radin 1957) and the native Australians usedsong as a form of oral history and the sound ofthe bullroarer enabled them to be contacted bythe gods (Cowan 1992). Buddhist belief andhealing practice centres around the singing ofmantra and sutra (Birnbaum 1979). AncientIndians (particularly Hindus) also attributedgreat power to music, believing, for example,that singing could bring about the relief offamine by inducing rain (Sachs 1944).</p><p>Persians used the lute to cure illness andbelieved that music was 'an expression of Ahura-Mazda (spirit of good)' (Buckwalter et al. 1985).Saul, in the Old Testament, gives witness to anearly example of the therapeutic use of music.</p><p>141</p><p>Having been troubled by an evil spirit, he wasadvised to:</p><p>... seekout a man, who is a wise playeron a harp:and it shall come to pass, ... that he shall playwith his hand and thou shalt be well.</p><p>I Samuel 16:16</p><p>Saul sent for David who played his lyre and:Saul was refreshed, and was well, and the evilspirit departed from him.</p><p>I Samuel 16:16</p><p>Similar evidence describing the therapeutic useof music can be found elsewhere in the Bible. Forexample, Folta (1993) identifies that in the NewTestament, St Paul's letter to the Colossiansurges them. 'to sing psalms and hymns andspiritual songs with thankfulness in your heartsto God' (Colossians 3:16). St Paul's letter to theEphesians urges them to 'address one another inpsalms and hymns and spiritual songs, singingand making melody to the Lord with all yourheart' (Ephesians 5:19). Furthermore, evengreater powers were vested in music in Joshua6:5, with the destruction of the walls of Jericho, a'city rampant with evil' (Tame 1984). Sevenpriests sounded seven horns once a day for sixdays and on the seventh day they circled the cityseven times and it was stated that:</p><p>And it shall come to pass that make a longblast with the rams horn and when they hearthe sound of the trumpet, all the peopleshallshout and the wall of the city shall fall down flat.</p><p>Jericho was destroyed by the sound of music.</p><p>COSMIC TONES</p><p>It has been shown that from the earliest times,peoples have recognized the great powers ofmusic. The influence and the power of sound andmusic was and is regarded as even greater thanhas been mentioned above. Sound and musicwere and still are regarded by some as the verybasis of life.</p><p>Kepler, in 1596, talked symbolically about 'theharmony of the universe', an idea mirrored byCapra (1991) who, when sitting on the beach oneday, heard the cosmic dance of the energy of theuniverse, the dance of Shiva. He later went on torecount a story of a Tibetan Lama who statedthat:</p><p>all things are ... aggregations of atoms that daneeand by their movements producesound. Eachatomperpetually sings its song, and the sound, at everymoment, creates dense and subtle forms.</p><p>Modern quantum physicists appear to beconfirming the beliefs of those that lived manymillenia earlier. Currently, it is believed that 'ifyou break down matter into smaller and smallerpieces you eventually reach a point where those</p></li><li><p>the first schoolsofmusic therapywere openedduring the 1940s</p><p>142 Complementary Therapies in Nursing &amp; Midwifery</p><p>pieces - electrons, protons and so on - no longerpossess the traits of objects ... it literallypossesses no dimension' (Talbot 1991). Similarly,quantum physicists have found that particlesappear to manifest themselves as ether particlesor waves (Grof 1985, Talbot 1991) and that whenit comes to measuring these, there is only 'onebasic substance or energy' (Tame 1984), that thewhole of the universe might be based onvibration (Tame 1984).</p><p>In a similar way, throughout the world, it wasbelieved that sound was considered to be themanifestation, the very substance, the cosmogen-esis of the world. Invoking sounds, music,mantra and chants could alter or change theway of the world, indeed, they were regarded asbeing the very world themselves. It is hardlysurprising then, that peoples throughout theworld placed great importance in music. Hinduscalled this basic life force sound Om, theEgyptians called it the Word of the Gods, theGreeks called it the Music of the Spheres andthe Chinese called it the celestial energies ofperfect harmony (Tame 1984). Similar myths canbe found in Christian, Sumerian, Hebrew, Celtic,American Indian and Quechua Maya history(Tame 1984). Music was regarded as:</p><p>a releaserinto the materialworld of a fundamentalsuperphysical energyfrom beyond the world ofeveryday experience.</p><p>(Tame 1984)</p><p>It could alter and control the very world thatwe live in.</p><p>MUSIC AS THERAPY</p><p>Many centuries later, and as an indication of themore recent use of music as therapy, it is knownthat music was used to treat the mental healthproblems of notable figures from history such asKing Philip V of Spain, King Ludwig II ofBavaria and King George II of Great Britain(Podalsky 1954).</p><p>Early experiments into the therapeutic use ofmusic were published by Pargiter in the 18thcentury (Buckwalter et al. 1958) and Dogiel in1830 (cited in Campbell 1991). The lattersuggested that the physiological responses tomusic included an influence on the circulation ofblood, that it caused alterations in bloodpressure and that these alterations depended onthe pitch, intensity and timbre of the music.</p><p>An important early book on the subject wasentitled The Influence of Music 01/ Health andLife, written by Dr Hector Chomat in 1846(Alvin 1966, cited by Cook 1981). This bookdescribed the use of music in healing many cases,including that of epilepsy (Assaglioli 1991).</p><p>It was probably publications and findings suchas these that prompted Florence Nightingale torecognize the potential importance of music incaring for the sick. In 1895 she wrote that:</p><p>The effeet of musie upon the sick has been scarcelyat all noted ... wind instruments, includingthehuman voice, and stringed instruments, capable ofcontinuoussound, have generally a beneficial effect... The finest piano-forte playing will damage thesick ... whilean air ... will sensibly soothe them.</p><p>(Nightingale 1859)</p><p>Similar results to those indicated above,showing that the blood circulation to the brainwas slowed and reduced, were published byPatrici in 1896 (Walters 1954; cited by Cook1981) shortly after the founding of the Guild ofSt Cecilia (the patron saint of music) in 1891.This was an organization dedicated to providingmusic for those who were ill (Diserens &amp; Fine1939, cited in Buckwalter 1985).</p><p>Further research performed early in the 20thcentury showed that by 1926 there was:</p><p>agreement that music effectively increasesmetabolism; changes muscularenergy; acceleratesrespiration; produces marked but variable effectson volume, pulse and blood pressure; creates thephysiological basis for the genesis of emotionalshifts.</p><p>(Campbell 1991)</p><p>Perhaps as a result of some of these findings,the first schools of music therapy were openedduring the 1940s in Michigan State Universityand the University of Kansas (Cook 1981).</p><p>It was during the early 20th century that thenature of the therapeutic use of music appearedto begin to change. The development of medicalscience during the second half of the 19th centuryand the early 20th century led physicians tohold a predominantly functionalist, mechanistic,disease-oriented perspective in their work andthe previous holistic stance received less empha-sis. Music became a less important aspect of thephysicians catalogue of possible interventions.</p><p>However, as it has been stated, the 1940s sawthe development of the first school of musictherapy and the development of a professionconcerned with using music specifically to exploitits therapeutic effect. Whilst physicians aban-doned the use of music as therapy, musictherapists developed this aspect of healingindependently. The nature of the use of musicas therapy also appeared to change at aroundthis time.</p><p>Although the early use of music as therapyappeared to consist of merely listening to music,whilst this was not abandoned entirely by musictherapists, it was expanded upon and changed tothe music therapy as it is known in the later 20thcentury.</p></li><li><p>Musicas therapy</p><p>Finally, a brief summary of the history ofthe therapeutic use of music was written byCampbell (1991) who stated that:</p><p>The ancient healers are calling forth our deepersenses. Orpheus, Apollo, Tubal-cain, Aesclepius,David, St Gregory, St Francis, Saraswati andSt Cecilia are sounding their calls. How soon willwe be able to use the beauty of musical sound tocompose ourselves into perfect harmony in mind,body and spirit?</p><p>(Campbell 1991)Music is with us in almost every aspect of</p><p>everyday life, but with the exception of a fewclinical are...</p></li></ul>