Music Therapy: A Melody for Mental Health
For over centuries, health practitioners have argued over treatment of mental illnesses, with some advocating medication, and others rejecting it in favour of alternative therapies. Certain therapies encourage and aid clients in communicating their thoughts and feelings. One such approach is music therapy.
Music therapy is “the controlled use of music, its elements and their influences on the human being to aid in the physiological, psychological and emotional integration of the individual during the treatment of an illness or disability” (Munro and Mount, 1978 pp. 1029).
Music is considered a vital tool in mental health practice. It is meaningful in various dimensions. Considering its significance in all religions, it is a symbol of expression (Lundberg, 2010). Various religions incorporate music in their worship in several forms.
Neither can its socio-cultural importance be neglected: music has long been recognized as the life and soul of social events. To illustrate, take the example of events such as wedding ceremonies, birthday parties and different family gatherings; music and songs represent the occasion’s denotation and connotation.
Above and beyond, from nursery rhymes to Quranic recitations, from romantic songs to old age sad songs, from Adhan given in a newborn’s ear to Adhan that summons the public to prayer – all these require use of melody. However, some worries over its designation as ‘halal’ or ‘haram’ put limitations to its use.
I was compelled to write this paper to highlight the importance of music therapy together with other therapies. Although pharmacotherapy may control symptoms, music improves the connections between mind, body, emotion and spirit. Moreover, music is an effective, non-invasive nursing intervention that promotes well-being (Wall and Duffy, 2010). It is a safe and inexpensive nursing strategy (Lai, Li and Lee, 2012).
This paper recognizes music therapy as a useful nursing intervention to improve mental and psychological symptoms of mental disorders, sparing the physiological and physical side effects of medications. In an investigation of music therapy for psychiatric patients, all clients were scheduled on mornings for light exercise accompanied by music. The healthcare staff reported that it positively affected patients, helping them engage better in activities.
The following describes a similar case. A 45 year old female client, admitted in the psychiatric unit with complaints of decreased concentration span, paranoia, delusions and increased suspiciousness was diagnosed as schizoaffective. She showed a keen interest in music and dancing, and would always carry a tape recorder in her purse, of which she was very conscious.
It was noticed that her concentration span increased after listening to music – evidenced by increased eye contact during conversation. Not only was she better able to verbalize changes in her mood after listening to music, but her face lit up all the while that she danced or sung.
Music has a profound effect on body, mind and spirit. It synchronizes brain waves, modifies behaviour and stimulates physiological responses. More to the point, it is fruitful in decreasing anxiety, pain, fear, depression, and boosts self-esteem and the immune system (Sharma and Sharma, 2012).
According to Holism Model (Maloof, 1996), well being lies in four components: physical, emotional, spiritual and psychological. A state of complete wellbeing is achieved when a person is stable in all four components. In the earlier scenario, the patient’s physical component through music was achieved, reflected in her increased range of motion with the help of physical activities, exercises and dancing.
This enhanced her physical activity, thus establishing wellness in physical component. Secondly, patient’s emotional component was achieved which showed in her increased social interaction and subjective and objective responses of positive mood changes.
Thirdly, her spiritual satisfaction and comfort had improved, as patient reported decreased pain and depression and increased satisfaction with self. Lastly, the psychological component with music was attained by improved cognition, better eye contact and decreased responses of negative thoughts and marked distraction from negative stimuli. In a nutshell, the patient achieved all the four components with the help of music therapy.
A study by Silverman and Rosenow (2013) demonstrates that participants reported higher coping skills after music therapy. Different types of music induce various neuro-endocrine changes in the body. In an experiment performed by Hsu and Lai (2004), effects of two types of music were studied.
The results concluded that the use of techno-music (instrumental music e.g. guitar, violin) was associated with significant increase in systolic blood pressure, heart rate and emotions, whereas classical music increased plasma nor epinephrine, growth hormone, prolactin, adrenocorticotropic hormone and beta endorphin levels.
Use of classical music and techno music together can increase both neuronal and endocrinal responses. Soft music can decrease restlessness and agitation in manic clients. The scenario previously referred to, relates to a schizoaffective client, a disorder related to mood disturbances. Research suggests that music elevates mood and arousal.
These positive outcomes increase if the music is self-selected. It changes individual’s mood in a positive direction (Saarikallio and Erkkila, 2007). In the above case, the patient used to sing her favourite Indian songs (popular music) which increased her enjoyment. Conversely, she would not relate to songs of anyone else’s choice that showed that only self-choice increased her pleasure.
Pop, rock and dance have been shown to enhance mood (TerBogt, Mulder, Raajimakers and Gabhainn, 2011). Besides plain music, negative emotions are also released through air drumming and dancing. Clarification of thoughts and increased insight development are achieved with understanding of lyrics (Anderson, 2011).
Additionally, group singing is beneficial as it creates positive feelings, emotionally uplifts patients and improves upon their social bonding (Anderson, 2011). This was evident in the psychiatric unit as the patients admitted there had increased social connection among themselves, especially while morning exercises which were carried out with music.
Integration of music therapies for clients with mental illnesses can have an intense restorative benefits. According to a survey by Jamieson and Ahonen-Eerikainen (n.d), psychosocial therapies showed 45% effectiveness whereas antipsychotics developed 25% harmful side-effects. Thus, music therapy can sidestep the adverse effects of medications. Additionally, music in Pakistan (Eastern world) is restricted in some aspects due to specifications of halal and haram which limits the benefits of music therapy on mind and body.
However, these limitations do not apply to western society (Pennanen, 2010). Religious scholars and mass media programs can help clarify concepts of halal and haram for Muslim community. Religious programs may be arranged to demonstrate the importance of music in scientific studies with reference to religious aspect. Moreover, the use of melody for good is acceptable in Islam, indicated by its use in Naat and by Muezzins.
Furthermore, nurses can collaborate with music therapist to encourage music of patient’s choice. On the other hand, psychiatric units should glimpse the effects of music therapy in practice. Some steps should be taken by institutions by collecting music and providing it in different forms e.g. CDs, DVDs and cassettes to make it accessible to inpatients and outpatients both.
There should be regular music classes for clients with the relevant music according to individual’s disorder. In addition, several exercises done with music e.g. occupational therapy, morning exercises and yoga can be fruitful. Music therapy can be an effective nursing strategy for clients to improve their coping skills, to decrease pain and anxiety etc. In a nutshell, to achieve all the four components of health discussed above.
In conclusion, music is effective for mind, body, spirit and emotion. However, because of misconceptions in Muslim countries about music, many beneficial outcomes are limited. Therefore, some steps should be taken on individual, institution and community level to clarify the concepts and make this therapy accessible to everyone so more people may benefit. Music therapy is a need for mental health to outfit the holistic approach.
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