Archita Sriram
Music has often informally been addressed as the crutch upon which one’s changing moods and emotions rest. Recently, it has even emerged as a possible form of therapy for various mental health disorders.
According to LaGasse et. al (2013), music as a form of healing is an ancient phenomenon. Documents have indicated their use in healing, rituals and religious practices (Davis, 2008). However, the term “Music Therapy” and its perception as a scientific system of treatment only emerged in the 20th century. (p.2)
World War 2 was a significant period of advancement for music therapy. By its end, the United States was employing musicians to assist in the rehabilitation of soldiers. By 1950, the National Association for Music Therapy was established, focusing on educating and training music therapists. (Davis, 2008). By the 1990s and early 2000s, in tandem with the rise of neuroscientific literature for music therapy, technologies such as EEG, MRI, EMG and PET were used to measure the efficacy of music therapy. (LaGasse, 2013, p.2)
Over the past 10 years, music neuroscience has grown tremendously, with several studies finding that music performance and processing activate networks of cortical and sub-cortical areas in the brain (Peretz & Zatorre, 2005). The core area of music therapy and neuroscience convergence is “neuroplasticity”. It is the phenomenon where the brain rearranges its neural pathway in response to stimuli. This phenomenon is harnessed by music therapists in using music to change or study changed pathways and treat a range of disorders. (O’Kelly, 2016, p.1)
Professor Hellicke put forward a heuristic model to understand how five modulating factors (attention, emotion, cognition, behaviour and communication) can contribute to the effects of music therapy.
Attention modulation: Given music’s ability to capture attention and distract attention from negative stimuli, this factor is used in treating attention deficiency disorders and partly reducing anxiety and pain.
Emotional modulation: Functional neuroimaging studies have shown that music can modulate all major limbic and paralimbic structures in the brain responsible for the regulation of emotion. Thus, harnessing this factor can help treat affective disorders such as depression, pathological anxiety and PTSD due to their relation to the dysfunction of these structures.
Cognition modulation: Music’s involvement in the memory process (encoding, analysis of music syntax and semantics) can be harnessed to treat degenerative diseases such as Alzheimer's.
Behaviour modulation: This factor accounts for the evocation and conditioning of movement-related behaviour patterns (walking, speaking, grasping, etc). Thus, it can contribute to alleviating speech-related disorders and improve motor rehabilitation.
Communication modulation: Music’s nature as a means of communication (active music therapy) can be used as a means of improving (non-verbal) communication and interpersonal competencies. It can be used in treating conduct disorders and autism. (Koelsch, 2009, p.1)
There is a range of disorders that utilise music therapy as a form of treatment and have been studied for efficacy, many of which have reported improvements in the patient’s condition. So why is it not more widely known? Why is it not yet an integral part of the rehabilitation process? Where is the popular scientific literature on this topic? Where are the university-level music therapy courses?
The answer lies in precisely that. Given its nascent growth, ambiguity regarding the scientific procedure of research and the inherent complexity that is people’s subjective preference and perception of music, the body of scientific evidence raised in support cannot be seen as conclusive. In fact, there are substantive limitations to many prominent studies in the field. Hence, every new paper only necessitates further study in new directions.
Firstly, every study that aims to study music and neural activity is faced with severe methodological limitations. (O’Kelly, 2016, p.1) In 2014, Schaefer and colleagues studied motor rehabilitation for stroke patients through Neurologic Music Therapy and MRI scans. While the study did see some improvement in motor activity, the correlation was not strong enough to make due to the fact that MRIs require stillness while the study wanted to measure movement due to music. Given that the neuroscience field predominantly relies on MRI scans requiring stillness, it does not allow the scope to study aspects of movement generated naturally through music.
A meta-analysis conducted in 1996 by Anna Maratos on the effect of music therapy on depression and a recent meta-analysis conducted in 2021 by Amparo et.al on autism found very similar methodological and fundamental limitations, indicating the inherent challenge of study in the field (p.15). Maratos (1996) reviewed 5 case studies and found that the results were not fully conclusive due to small sample sizes (p.12). Amparo reviewed over 35 studies as part of a meta-analysis and found the limitations to include small sample sizes, inappropriate experimental methods and lack of objective measurements. However, music and its perception are inherently subjective, and personal and require attunement to individuals’ cultures and interests. Thus, it will remain reductive to study the effects of music through objective, randomised, repetitive trials.
Thus, the future of understanding and utilising music therapy lies in working beyond these “limitations”. Technological advancements such as wireless EEG may allow for a more natural means of capturing nuances in neural activity due to music. Heart-rate variability is an emerging, non-invasive method that can provide insights into behavioural assessments related to cognitive, physiological and emotional aspects of the practice. Finally, there have been discussions about misunderstandings between therapists and researchers regarding the skills and knowledge of either group (Magee, 2015, p.1). Bridging this gap by using neuroscience methods concurrently with clinical makers and therapists and exploring the field through non-quantitative methods may help uncover a holistic picture and get closer to understanding the true efficacy of music therapy in clinical treatment. (O’Kelly, 2016, p.1)
References
De l'Etoile, S. K. & LaGasse, A. B. (2013). Music Therapy and Neuroscience From Parallel Histories to Converging Pathways. Music Therapy Perspectives, 31(1), 6–14. doi:10.1093/mtp/31.1.6 https://sci-hub.hkvisa.net/10.1093/mtp/31.1.6
Davis, W. B. (2008). Music therapy: Historical perspective. In W. B. Davis, K. E. Gfeller, & M. H. Thaut (Eds.), An introduction to music therapy: Theory and practice (3rd ed., pp. 17–40). Silver Spring, MD: American Music Therapy Association.
Koelsch, S. (2009). A Neuroscientific Perspective on Music Therapy. , 1169(none), 374–384. doi:10.1111/j.1749-6632.2009.04592.x. https://nyaspubs.onlinelibrary.wiley.com/doi/full/10.1111/j.1749-6632.2009.04592.x
O’Kelly, J. (2016). Music Therapy and Neuroscience: Opportunities and Challenges. Special Issue on "How Music Can Change Your Life and the World" / Music Therapy and Neuroscience: Opportunities and Challenges. 16(2). https://voices.no/index.php/voices/article/view/2309/2064
Bigand, E., Tillmann, B.,Peretz, I., Zatorre, R.J., Lopez, L., & Majno, M. (2014). The Neurosciences and Music V: Cognitive Stimulation and Rehabilitation1 (Vol. 337) Annals of the New York Academy of Sciences, vii–ix, 1–271.Blood, A. J., & Zatorre, R. J. (2001). Intensely pleasurable responses to music correlate with activity in brain regions implicated in reward and emotion. Proceedings of the National Academy of Sciences, 98, 11818–11823.
Maratos, A. (1996). Cochrane Database of Systematic Reviews (Reviews) || Music therapy for depression., 10.1002/14651858(), –. doi:10.1002/14651858.CD004517.pub2. https://sci-hub.hkvisa.net/10.1002/14651858.CD004517.pub2
Amparo V. M; Magnuson, J; Morris, J; Iarocci, G; Doesburg, S & Moreno, S. (2021). Music Therapy in Autism Spectrum Disorder: a Systematic Review . Review Journal of Autism and Developmental Disorders, (), –. doi:10.1007/s40489-021-00246-x. https://sci-hub.hkvisa.net/10.1007/s40489-021-00246-x
Magee, W.L & Stewart, L .(2015) The challenges and benefits of a genuine partnership between Music Therapy and Neuroscience: a dialog between scientist and therapist. Front. Hum. Neurosci. 9(223). doi: 10.3389/fnhum.2015.00223. https://www.frontiersin.org/articles/10.3389/fnhum.2015.00223/full
Comments
Post a Comment