Parimal, 35, had suffered a serious brain injury in a bike accident. He survived but with memory, attention, navigation and urinary problems. When the rehabilitation programme was started, it was difficult to get him motivated. Neena, Parimal’s wife, however identified his age-old passion for music. His favourite tunes were successful in garnering his interest to get back to a healthy life. Eventually, music therapy was incorporated into his rehab plan.
Athira has post-traumatic stress after surviving an earthquake. Nightmares, flashbacks and panic attacks were a regular ordeal. Besides medication, psychotherapy helped her a little but she slowly lost interest in attending the sessions. Music alone seemed to soothe her; this was harnessed by her therapist. The counselling sessions included music thereafter to boost Athira’s morale and help her navigate stress.
Such narratives highlight the intersection of music and the human psyche.
When we listen to a tune it makes us want to move, emote.
A tune usually brings with it a host of memories. Music in itself is a very innovative tool. It gives voice, quite literally, to what lies deep within. Beethoven himself moved away from the rule book and created music that spoke of innermost emotions. When we share music, we give away parts of our inner selves to others when words fail.
From the early years of development, mothers sing to their children. Lullabies have an acoustic feature that calms fussy babies and later in life helps to manage pain. Music helps us map these memories. The intrinsic elements in music such as pitch, timbre, dynamics can be altered to suit our emotional states.
Music helps in stress reduction. This comes to great use since the portion of the brain responsible for perceiving emotions and music happen to be close to each other. We have often experienced that light music reduces our heightened state of arousal than stimulating music. Moreover, listening to music in the company of others has been found to be more relaxing than solitary listening. Mind-body relaxation also depends a lot on the individual perception and choice of music.
Engaging in music helps in improving memory, regulates emotional states and paves the way to a healthier life. Brain imaging studies show that music touches parts of the brain because of its all-encompassing nature and also helps certain parts develop. This is based on neuroplasticity — a concept which helps us understand how our brain can be re-wired in response to external cues.
So, can music help an ailing brain or boost a learning one?
The use of the musical wisdom of Pythagoras dates back to the 1920s, when physical and mental problems were healed through songs and incantations. Thus, the elements of tone, pitch have been used sensitively to cure illnesses. Ancient shamanic rituals used repetitive music to induce a trance-like state. The changes in tempo, pitch and melody not only affect breathing and fatigue but also bring changes in emotional response.
Music interventions are purposeful music activities administered by healthcare professionals in a therapeutic context. These interventions are in the form of composing and listening to music or simply playing and interacting with music — like in the cases of Parimal and Athira.
Music therapy ranges from spontaneously improvising music to expressing emotion to listening to prerecorded music and reflecting on it. The basic idea is to make the client more aware of his/her emotions.
We generally listen to music that is in accordance with our mood or when we wish to change the emotional state. Music therapists make use of the iso principle where they match the music with the current state of mind and progressively modify the music to bring about desired effects in the mental state.
Music intervention holds much promise in reducing agitation in dementia patients. Studies have elaborated on the beneficial use of passive music listening in the agitated. Listening to familiar music with a pleasing sound can help patients recall the time before the onset of the disease. The use of music that has been chosen and is personalised provides space for arousing positive emotional memories, which help in attaining greater calm.
In pain management, music may help alter the experience as a whole, and diminish the pain. Music therapy provides non-intrusive opportunities for people in palliative care to increase their pain thresholds and foster feelings of support between patients and caregivers.
Music therapy also helps depression, anxiety and schizophrenia, alongside medicines and counselling. The notes of music — or the silence between them — heal and nourish the mind.
The writers are consultant psychiatrists based in Calcutta