The medical world is slowly discovering the power of music as an intervention for people affected by Alzheimer’s.
My grandmother was 85 when she began to forget. She couldn’t remember my name, never knew where she was, and barely recognised her own husband even when he sat right in front of her. But when we were at the piano, and I played Somewhere Over the Rainbow, she knew all the words.
Our healthcare systems imagine human beings to be incredibly complex machines with medicines to adjust the dials. We have pills to regulate blood pressure, blood sugar, even anxiety. We haven’t done anything to touch the heart of the patient. That’s where music comes in.
What is music therapy?
Music plays an important role in shaping our identity. Music connects people to who they are, who they have been. Music has the power to alter our mood; it can evoke joy, sorrow, despair, hope and love. Music can stir memories and powerfully resonate with our feelings. It allows us to connect with ourselves and with others. It is because of this connection between our minds and music, that music therapy is increasingly being used as a method of intervention for several mental health conditions.
Music therapy is the clinical and evidence-based use of music interventions to address physical, emotional, cognitive, and social needs of individuals. Music therapy also provides avenues for communication that can be helpful to those who find it difficult to express themselves in words. Usually, a trained therapist builds a therapeutic relationship with a patient or client, just the way people approach conventional therapists and psychiatrists to talk about a mental health issue.
There are four major interventions involved with music therapy:
1. Lyric analysis — While talk therapy allows a person to speak about issues that may be difficult to discuss, analysing lyrics is a less intimidating approach to unearthing thoughts and emotions. Analysing the words of a song allows an individual to identify songs which correlate to their own experiences.
2. Playing an instrument — Learning and playing music encourages emotional expression, socialisation and exploration of therapeutic themes (i.e. conflict, communication, grief, etc.). Improvisation in music is a way of expressing an emotion without talking about it.
3. Active music listening — Music can be utilized to regulate mood. Because of its rhythmic and repetitive aspects, music engages the neocortex of our brain, which calms us and reduces impulsivity. We often utilize music to match or alter our mood. While there are benefits to matching music to our mood, it can potentially keep us stuck in a depressive, angry or anxious state. To alter mood states, a music therapist can play music to match the current mood of the person and then slowly shift to a more positive or calm state.
4. Songwriting — Songwriting provides opportunities for expression in a positive and rewarding way. Anyone can create lyrics that reflect their own thoughts and experiences, and select instruments and sounds that best reflect the emotion behind the lyrics. This process can be very validating, and can aid in building self-worth. This intervention can also instil a sense of pride (as someone listens to their own creation).
Music and memory
Dementia is a general term for loss of memory and other mental abilities severe enough to interfere with daily life. It is caused by physical changes in the brain. Symptoms of dementia include the inability to remember recent events and names, disorientation, difficulty in speaking, and poor judgement. A natural effect of dementia should have been that such a person would not be able to recognise or remember music either. However, recent scientific studies with respect to music and dementia show different results.
Research shows that the seat of long-term musical memory is preserved, even when other areas of the brain degenerate due to diseases such as Alzheimer’s. The results of the study indicate that long-term musical memory is better preserved in Alzheimer patients than short-term memory, autobiographical long-term memory and speech. It can, therefore, remain largely intact even in advanced stages of the disease. In other words, the part of the brain which processes music remains unaffected in degenerative diseases such as dementia. This explains why, like in my grandmother’s case, people can remember the tune or the words to a song even if they have forgotten how to communicate effectively.
Music and depression
Our first experiences of relating (with our primary caregiver) are fundamentally musical. Developmental psychologists use musical vocabulary to describe the finely attuned interplay of gesture and sound between a parent and the newborn baby. It is in this pre-verbal interaction that we first learn who we are, how to think and to take pleasure in the possibilities that the world around us has to offer.
A music therapist is similar in that she nurtures a person in her quest for meaning and pleasure, through the portal of music. Music, with all of its riffs and chords and progressions, allows us to engage with the world in a way that makes us feel like we are part of something meaningful. While depression feeds on withdrawal and inactivity, music can engage a person, draw out their emotions while they participate. This is the power of music.
The action of playing an instrument involves movement. It enables people to think of themselves as physical beings. Music allows us to participate with others. This mirrors the experiences of musicians when playing in groups as can be seen in the coordinated movements of the players in a string quartet. Our participation, in turn, enables us to hear (and feel) ourselves in the context of the aesthetic experiences outlined earlier, and this lends a potent sense of being part of something meaningful in the here-and-now.
This is another potential benefit of music therapy. Often, mental illnesses cloud our ability to be truly present because we are stuck in the past. Music therapy allows us to communicate without words, in a way that talking cannot. Music therapy builds a system through which we engage through sound, relate to others and communicate our emotions in a very different way.
… music heard so deeply
That it is not heard at all, but you are the music
While the music lasts. (The Dry Salvages by T. S. Eliot)
Music and nature
The Chinese have been using music therapy for over 2,300 years. Music therapy is an aspect of the Five-Element theory, in which five musical notes correspond to the elements of earth, water, fire, metal and wood. The Chinese use the relationships between internal organs and five-element correspondences, such as musical notes, to achieve different healing purposes. For example, the “Zhi” note (corresponding to G) belongs to the fire element and is the sound of summer. It aids blood flow and nourishes the heart.
We hear music in nature, all the time. The reason why we feel calmer, more at peace with ourselves when we hear the rhythmic rolling of the waves, the myriad morning calls of the birds, the silence of towering mountains is the same — these are sounds of music which help us to listen inward. They are sounds that bring us closer to ourselves, and demand that we listen to ourselves.
Music therapy is an alternative that alleviates depression and anxiety and could potentially reduce dementia. It could also help with a host of other physical and mental illnesses because it goes beyond pill popping. Sound has the power to alter our state of being. It has the power to remind us of our happiest moments and draw us out into social engagement.
The exploration of music therapy as an alternative intervention while beneficial to medical science, reminds us of the incredible power of music to make us feel alive, inside.
Feature Image Credit: Providence Doucet on Unsplash
Sanaya Patel is the Assistant Editor and Research Associate (Legal Reform) at One Future Collective.