Harmony Music Thearpy

2Harmony Bulletin Vol 1 Issue 3 November 2012

Sri Balaji Vidyapeeth University

Archeological evidence of music in primitive human cultures dates back to between 36,000 to 82,000 years ago with the discovery of bone flutes. The above figure depicts flutes fashioned from bear thigh bones made by Neanderthal men (our hominid cousin species) who had to adopt efficient survival and adaptive techniques to counter the ever-challenging task of surviving in a hostile and dangerous world, which, in turn, was based on effective emotional functioning communicated by way of both music and verbal language (vide the case study of Music Medicine Unit on “Prognosis in music therapy interventions…). Canadian musicologist Bob Fink has studied the 4 inch artifact and concluded that it was based on the same 7-note scale in modern Western music. The flute, as it survives, could play 4 notes- Mi, Fa, Sol, Lah in a minor key. In its original form, it would have been 15 inches long and capable of producing the entire scale.These findings prove the fact that music and emotions have been central to human functioning and to the process of adaptation over the course of our species existence ( John Pellitteri,2009).

Music aids in adaptation and survival by facilitating emotional expression & communication

Vol 1 Issue 3 November 2012 3 Harmony Bulletin


Editorial

The theme of the current issue is ‘Emotional Processes involved in Music Therapy Interventions’, illustrated by means of two case studies performed in the Music Medicine Unit, MGMC&RI. Affect has been equated with emotion, but in the research literature, it is used to refer to expression of emotional states. Affective modification by music has been extensively studied by Sutherland et.al, who have stated that music has the capacity of modifying the negative affect aroused during anxiety- provoking situations, since it stimulates affective schemes that undo or cancel the experience of anxiety. Music also stimulates positive affect which will boost cognitive- congruent schemes, and generation of positive cognitions is effective in reducing anxiety. Music is a deeply rooted part of our human history, and has been used as an efficient tool for expressing emotions and communication, as shown in page 2.

ContentsMusic aids in adaptation and survival by facilitating emotional expression & communication 2

The “ Right” Music For The “Right” Situation 4

Prognosis in Music Therapy Interventions is associated with the Emotional Intelligence-Alexithymia Spectrum 9



THE “ RIGHT” MUSIC FOR THE “RIGHT” SITUATION -A case study from the Music Medicine Unit, MGMC&RI Mrs. X was referred to the Music Medicine Unit from the post-operative ward, for the complaints of agitation, aggression, and restlessness. She was administered a piece of music based on Rag Neelambari through the head-phones, for a period of 30 minutes. She calmed down after sometime, and reported that she felt peaceful and relaxed. The music administered was sedative in nature, and had a sustained melodic nature, lacking in strong rhythmic and percussive elements.

Helen Bonny (1986) has stated that “sedative music has an easy flowing melody, and a tempo similar to the resting heart beat. It is pleasing to the ear, not dissonant, and it has no major changes in pitch, dynamics, or rhythm. It supports its listeners. It makes no demands on them.” According to her, people who are seriously ill need sedative music. Hence it is important for health professionals, when assessing a client’s musical preferences, to take into consideration the client’s current health status also.

How to assess the musical preferences of the patient? The initial step consists of reviewing their “musical listening” using relevant questionnaires (Le Navenec & Slaughter, 2001). This is followed by asking them to describe their responses to a particular piece of music.

Aldridge (1996) warns for the quantitative approach in music research. He holds that we should be careful not to organize nature according to concepts imposed on it and demonstrates the need for a more phenomenological, holistic understanding of musical experiences through qualitative research.

Factors that affect one’s musical preferences:1) Health Status: According to Helen Bonny, one’s preference for stimulating music may change when ill. She emphasizes the need for sedative music at such times. Furthermore, depending on one’s hearing status, certain types of music (e.g., with high pitches) may be a source of discomfort.

2) Alertness or fatigue level: Just as when we are ill, we prefer sedative music, so too, when we are very tired, the sounds of silence may be preferred.

3) Mood at the time of listening: The iso-moodic principle ( Katsh and Merle- Fishman, 1985) implies that we need to match the music to the



current mood we are in and that a person’s mood state may be altered on exposure to music that evokes or tends to evoke a similar mood state. The iso-moodic principle of music therapy assumes that individuals attend to music selectively that is relatively congruent with their current mood state. If we wish to change our mood, we need to change the selection of music gradually by choosing music that evokes emotional responses in an adjoining category of Hevner’s Mood Wheel(1937). Fig.1 shows the moods depicted in Hevner’s Mood Wheel.

4) Age: Musical preferences of the elderly has been extensively studied ( Moore et.al., 1992). Pittigio (2000) suggests that music from childhood and adolescence may be helpful for older people with dementia during reminiscence group sessions because long-term memory is often preserved.

5) Socio-Cultural and environmental characteristics: Examples in this category include how familiar the music is to the listener, cultural and ethnic background, and related contextual features (e.g., whom you are with, the physical environment in which you are listening to the music, etc.)

6) Musical background

7) How one uses music in everyday life: Compensatory: e.g., diversion, relaxation; emotional: e.g., whether music supports the expression of emotions or moods; background: e.g., background music stimulates some people while working and it fills the silence when one does not feel at ease with others.

8) Availability of various categories of preferred music.The above facts underscore the importance of assessing the musical preferences of the persons for whom you are administering music. According to Scartelli, Lloyd ( 1987) and other investigators in the field of psycho-neuro-immunology (PNI), there is a constant reciprocal communication between the mind and body which is accomplished via the secretion of various types of neuro-transmitters that are triggered in an individual by ”environmental ,emotional, physical, social, and even spiritual changes”. These changes in turn affect the functioning of one’s autonomic nervous system, endocrine, and immune systems.

Exposure to carefully selected music produces the following effects:1) Positive physiological outcomes; 2) Effects on cognitive and psychological functioning; 3) Social and spiritual well-being of people,



and 4) The emotional sphere. Scartelli (1989) implies that this emotional sphere is“the prime target of music”. Hevner concluded from her study that “the perception of emotion in music was most influenced by the tempo, modality, and pitch level of the music, and less by the harmony, rhythm, and melodic direction”.

The Hevner Mood Wheel consists of 8 clusters of related emotions organized in a counter clockwise direction along a solemn-exalting continuum, and has been used extensively in research on music and emotions ( Bonny & Savary,1973; Gabrielsson & Lindstrom,2001). The moods within each cluster of the Hevner Wheel are closely related (sad, mournful, gloomy) and adjacent clusters are moderately related ( cluster 6-happy and cluster 7-excited). Hence mood transitions between adjacent groups are made without abrupt changes. Diametrically opposite clusters reflect opposite moods that are more distantly related (cluster 8-vigorous, and cluster 4-serene). Hevner also includes descriptive qualities of moods and not just distinct emotions (for example, heavy and dark are included in the same cluster as depressed, melancholy, and mournful).

Fig:1 HEVNER’S MOOD WHEEL (Arrangement of adjectives for recording the mood effect of music)Kate Hevener: “An experimental study of affective value of sounds and poetry”

Eight different groups each with differences within. Different responses are elicited when participants listen to the same music excerpt.

Such aesthetic verbal descriptors can be useful in the expression and understanding of emotions, particularly as they arise in musical experiences.



How to use the Mood wheel? The participants are asked to describe what they think about the music that is played. They are shown the adjectives in the various groups, and advised to circle the adjectives that really reflect how the music makes them feel, and to leave all of the adjectives blank if the music did not affect them at all. They listen to a musical selection, then check the mood adjective group that they feel most corresponds to the mood of the music. The Mood Wheel essentially asks listeners to attribute emotional affect in relation to the musical pieces that they are listening to. At a subconscious level a process of identification occurs to the extent that one’s moods may, by degrees, be modified. Variations in certain musical properties, including tempo and dynamic intensity, encourage or reproduce variations in an individual’s mood state. At its most potent, the vectoring power of music is such that mood states may actually vary, not simply by degrees across the same mood state, but also across altogether different mood states, from one affective pole (anger) to its opposite (joy), for instance.

Merritt et al.,(1996) indicate that if one is feeling irritable, hyper activated, or edgy, the music therapist starts with music that is not too quiet so that the listener may transfer some of his or her anxiety over to the music ( the transference effect, in which individuals in therapy often transfer feelings of anger about others to the psycho therapist). If a person is feeling depressed, then a quiet piece of music would be played at a slow tempo. If he or she is feeling joyful or wants to celebrate, then a melody based on Rag Hamsadvani is recommended ( in the case of Indian Music therapy, which has been tested and tried on several participants). If Western Music is preferred, Vivaldi’s Four Sessions can be used. If a person is feeling angry, a melody based on Rag Bageshree can be used for Indian Music lovers, or Mozart’s Eine Kleine Nachtmusik or the first or third movement of his symphony No.41 in C can be used.

But a distinction has to be made between mood and emotion. In music psychology, both emotion and mood have been used to refer to the affective effects of music, but emotion seems to be more popular. Researchers tend to choose mood over emotion. In addition, existing music repositories also use mood rather than emotion as a metadata type for organizing music. The music psychologists focus on human’s responses, the latter focus on music. It is human who has emotion. Music does not have emotion, but it can carry a certain mood. Therefore, Hevner’s methodology adopts the term music mood rather than emotion.



What We Know about Music Mood:1. There does exist mood effect in music. It is also agreed that it seems natural for listeners to attach mood labels to music pieces

2. Not all moods are equally likely to be aroused by listening to music. In a study conducted by Schoen and Gatewood (1927), human subjects were asked to choose from a pre-selected list of mood terms to describe their feelings while listening to 589 music pieces. Among the presented moods, sadness, joy, rest, love, and longing were among the most frequently reported while disgust and irritation were the least frequent ones.3. There do exist uniform mood effects among different people. Sloboda and Juslin (2001) summarized that listeners are often consistent in their judgment about the emotional expression of music. Early experiments by Schoen and Gatewood (1927) have shown that “the moods induced by each (music) selection, or the same class of selection, as reported by the large majority of our hearers, are strikingly similar in type”. Such consistency is an important ground for developing and evaluating music mood classification techniques.

4. Not all types of moods have the same level of agreement among listeners. Schoen and Gatewood ranked joy, amusement, sadness, stirring, rest and love as the most consistent moods while disgust, irritation and dignity were of the lowest consistency. The implication for researchers is that some mood categories would be harder to classify than others.

5. There is some correspondence between listeners’ judgments on mood and musical parameters such as tempo, dynamics, rhythm, timbre, articulation, pitch, mode, tone attacks and harmony (Sloboda and Juslin (2001). Early experiments showed that the most important music element for excitement was swift tempo; modality was important for sadness and happiness but useless for excitement and calm; and melody played a very small part in producing a given affective state ( Capurso et. al.,1952). Schoen and Gatewood pointed out the mood of amusement largely depended upon vocal music: “humorous description, ridiculous words, peculiarities of voice and manner are the most striking means of amusing people through music”. Such correspondence between music mood and musical parameters has very important implications for designing and developing music mood classification algorithms.

Perhaps no one, be he a music expert or casual listener, would deny the fact that music and mood can never be separated. Some music may



not describe a story, but all music must express, strongly or softly, a certain emotion or a mixture of emotions. In consequence, music listeners often experience some sort of affective responses. Just as Juslin and Sloboda [15] stated :

“Some sort of emotional experience is probably the main reason behind most people’s engagement with music. Emotional aspects of music should thus be at the very heart of musical science.”

REFERENCES1. Aldridge D. (Ed.). (1996). Music Therapy Research and Practice in Medicine : From Out of the Silence. London: Jessica Kingsley.2. Bonny Helen (1986). Music and Healing. Music Therapy, 6A, I, 3-12. 3. Bonny H & Savary L (1975). Music and your mind: Listening with a new consciousness. New York: Harper & Row.4. Capurso, A., Fisichelli, V. R., Gilman, L., Gutheil, E. A.,Wright, J. T. and Paperte, F( 1952). Music and Your Emotions. Liveright Publishing Corporation.5.Gabrielsson, A. and Lindström, E. 2001. The influence of musical structure on emotional expression. In P. N. Juslin and J. A. Sloboda (Eds.), Music and Emotion: Theory and Research. New York: Oxford University Press.6. Hevner, K. 1936. Experimental studies of the elements of expression in music. American Journal of Psychology, 48: 246-68.7. Juslin, P. N. and Sloboda, J. A.( 2001). Music and emotion: introduction. In P. N. Juslin and J. A. Sloboda (Eds.), Music and Emotion: Theory and Research. New York: Oxford University Press. 8. Katsh S, Merle-Fishman C (1985). In The Music Within You: Barcelona Publishers. 2nd edition. Gilsum, NH.9. Le Navenec C., & Slaughter S. (2001). Laughter is the best medicine: Music, reminiscence, and humour enhance the care of nursing home residents. Nursing Times, 97(30), 42-43.10. Meyer, L. B. 1956. Emotion and Meaning in Music.Chicago: University of Chicago Press.11 Lloyd R (1987). Explorations in psychoneuroimmunology. Orlando, FL: Grune and Stratton.12. Moore RS., Staum MJ., & Brotons M. (1992). Music preferences of the elderly: Repertoire, vocal ranges, tempos, and accompaniments for singing. The Journal of Music Therapy, 29(4), 236-252.14 Pittigio L.(2000). Use of reminiscence therapy in patients with Alzheimer’s disease. Lippincott’s Case Management, 5(6), 216-220. 15. Scartelli, J (1987). Subcortical Mechanisms in Rhythmic Processing. Paper presented at the meeting of National Association for Music Therapy, November 1987, San Francisco.16. Schoen, M. and Gatewood, E. L.( 1927). The mood effects of music. In M. Schoen (Ed.), The Effects of Music (International Library of Psychology) Routledge, 1999.17. Sloboda, JA. and Juslin, PN.( 2001). Psychological perspectives on music and emotion. In P. N. Juslin and J. A. Sloboda (Eds.), Music and Emotion: Theory and Research.New York: Oxford University Press.



PROGNOSIS IN MUSIC THERAPY INTERVENTIONS IS ASSOCIATED WITH THE EMOTIONAL INTELLIGENCE-ALEXITHYMIA SPECTRUM

-A case study from the Music Medicine Unit, MGMC&RI Emotional processes are critical to understanding and promoting lasting therapeutic change in music therapy interventions (Kerr et.al.2001). Emotional experience is at the heart of many of the problems experienced by the patients attending music therapy sessions, and hence an understanding of these experiences and the corresponding changes in affective states is a prerequisite for successful music medicine interventions. When a person listens to music emanating positive emotions, it activates a set of organizing principles or “schemes” constructed from the individual’s innate response, repertoire and past experience which are collectively encoded in memory, and which later interact with the present situation and generate current experience through a form of associative memory networks (Bower,1981). This is the mechanism by which music modifies the negative affect aroused during anxiety-provoking situations- an affective modification by music. The role of emotions in the adaptive and survival mechanisms of primitive humans:

Emotions served to organize the psychological processes in adaptive ways right from primitive human existence, by activating certain responses and suppressing others. The fear reaction in response to an impending threat (for eg. the threat from a predator) would arouse the physiological systems (i.e. increase in heart rate, respiration), resulting not only in an inability to sleep, but in a focused, goal-directed series of decisions and actions to safeguard oneself. In an emotional state of fear, an individual has a sharpened perception, and decision

making and information processing shift to the area involved in reacting to the presumed threat, thus increasing the chances of escape if the threat



is real. But in many cases there is a “false alarm” which sets into motion a series of fear-induced reactions, which are physiologically harmful to the organism in the long run. Humans who acted in successfully adapted ways passed on their traits to their off springs through the process of Natural Selection. Primitive human groups underwent several adaptive behaviors to survive in their natural environments, and music and emotion are believed to have served important functions in this adaptive process to the natural world (John Pellitterri,2009 ). Thus we can understand that emotional traits and tendencies are deeply ingrained in our nature and are less malleable from those that are shaped by individual history, which are more amenable to change.

The emotional state of fear creates the ‘flight response’, while the state of anger creates the ‘fight response’. Anger like fear, also focuses attention, increases adrenaline levels, and enhances goal directedness. Resources are mobilized to destroy the object of threat, and to feel less pain in the process of battle. The ‘fight or flight’ response underscores the notion that emotions are adaptive to the physical environment. The cognitive problem-solving strategies necessary to respond to threats or challenges are often triggered by affect, since affective cues inform us about the benign or problematic nature of the situation, which in turn, tune our thought processes to meet these situational requirements-emotions are placed at the intersection between the person and his or her environment.

What is Emotional Intelligence? Emotional Intelligence (EI) is concerned with the understanding of how individuals perceive, understand, utilize and manage emotions in an effort to predict and foster personal effectiveness. According to Salovey and Mayer (1990), individuals vary in their ability to process information of an emotional nature and in their ability to relate emotional processing to a wider cognition. This ability is seen to manifest itself in certain adaptive behaviors. Perceiving emotions, harnessing emotions to facilitate various cognitive activities such as thinking and problem solving, comprehending emotion language, and the ability to regulate emotions in both ourselves and in others are the four types of abilities included in Mayer & Salovey’s model.

Bar-On model of Emotional-Social Intelligence: Bar- On Emotional Quotient Inventory (EQ-i) can assess a client’s general degree of emotional intelligence, potential for emotional health, and psychological well-being ( Bar-On, 1997 ). Results can evaluate the successfulness of therapeutic



interventions and to decide when to terminate therapy. Bar-On hypothesizes that those individuals with higher than average EQs are in general more successful in meeting environmental demands and pressures. Deficiency in Emotional Intelligence can mean a lack of success and the existence of emotional problems.

What is Alexithymia? Alexithymia is a term used to describe people who appear to have deficiencies in understanding, processing, or describing their emotions. It is a complex mixture of personality traits which remains stable over time, even after distress or depression have diminished, and does not belong to any diagnostic category( Taylor &Bagby,2000).The alexithymia construct is strongly inversely related to Emotional Intelligence, representing its lower range (Schutte et.al.,1998). The Online Alexithymia Questionnaire (OAQ-G2) is a valid measure of alexithymia, and has been used in this study for scoring alexithymia.

The present case study was designed to compare the Emotional Intelligence of a patient who exhibited good response to music therapy after continuous music listening for 2 months, with that of another patient who refused to show any response at all from the very first session. The Bar-On EQ-i scores of both the responder and non-responder were compared with the EQ-I scores of the music therapist. The level of alexithymia of both the patients were computed using the Observer Alexithymia scale, and compared with the scores of the music therapist( since a music therapist is supposed to be endowed with psychological maturity and balance along with increased Emotional intelligence). The results are summarized graphically in fig.2a. The responder is seen to exhibit less stress tolerance, problem solving, optimism, happiness, independence, and assertiveness when compared to the non-responder, but shows more flexibility, impulse control, empathy, and emotional self-awareness when compared to the non-responder. According to Bar-On, problems in coping with one’s environment are thought to be common among those individuals lacking in the subscales of reality testing, problem solving, stress tolerance, and impulse control. Therefore we can presume that music is not used mainly as a coping strategy as stated by some authors (Ballard,1995; North,2004), since in the case of the patient who shows a good response, there is no difference in the subscales of reality testing, and he exhibits more impulse control than the non-responder. Factors like emotional self-awareness, flexibility and empathy seem to play important roles in enabling a good prognosis in music therapy interventions.



The results of the Online Alexithymia Questionnaire are graphically depicted in Fig.2b.

The responder has a score of 104 (95-112 represents possible alexithymia), in contrast to the non-responder who has a score of 142 ( greater than 113 denotes the presence of alexithymia), and the music therapist who has a score of 60 (94 and below- non-alexithymia). The non-responder is found to have difficulty identifying feelings, difficulty describing feelings, externally oriented thinking, restricted imaginative processes, and problematic interpersonal relationships.

An insight into the probable etiology of alexithymia can throw some light on the reasons behind the emotional unresponsiveness which make these individuals resistant to music interventions. A neuropsychological study has indicated that alexithymia may be due to a disturbance of the right hemisphere of the brain which is largely responsible for processing emotions ( Jessimer & Markham,1997), while another neuropsychological model suggests that alexithymia may be related to a dysfunction of the anterior cingulate cortex ( Lane et. al.,1997). The French psychoanalyst Joyce McDougall(1985) introduced the alternative term ”disaffectation” to stand for psychogenic alexithymia, stating that the disaffected individual had at some point “experienced overwhelming emotion that threatened to attack their sense of integrity and identity”, to which they applied psychological defenses to pulverize and eject all emotional representations from consciousness. He also suggested that since all infants are “by reason of their immaturity inevitably alexithymic”, the alexithymic part of an adult



personality could be “an extremely arrested and infantile psychic structure”. The above findings make it clear that emotional processes should be taken into account while evaluating the outcome of music therapy interventions. More exploration involving large number of cases is needed to reinforce these findings.

REFERENCES

1.Ballard M. E., & Coates S. (1995). The immediate effects of homicidal, suicidal, and nonviolent heavy metal and rap songs on the moods of college students. Youth & Society, 27(2), 148-168.2. Bar-On, R.(1997). Bar-On Emotional Quotient Inventory: Technical Manual. Toronto, ON: Multi- Health systems Inc.3. Bower, GH.(1981). Mood and memory. American Psychologist, 36(2), 129-148.4. Jessimer M & Markham R (1997). “Alexithymia: a right hemisphere dysfunction specific to recognition of certain facial expressions?” . Brain and Cognition 34(2): 246-58.5. John Pellitterri (2009). In Emotional Processes in Music Therapy. Barcelona Publishers, New Hampshire6. Kerr T, Walsh J, and Marshall, A.(2001). Emotional Change Processes in Music-Assisted Reframing. Journal of Music Therapy,38(3), 193-211.7 .Lane RD, Ahern GL, Schwartz GE, Kaszniak AW (1997). “Is alexithymia the emotional equivalent of blindsight? ”. Biol.Psychiatry 42(9):834-44.8. McDougall,J (1985). Theatres of the mind: Truth and illusion on the Psychoanalytic Stage. New York: Basic Books.9 .North, AC., Hargreaves D.J. & Hargreaves J.J. (2004). The uses of music in everyday life.Music Perception, 22, 63–99.10. Paula-Perez,I.(2010). The Online Alexithymia Questionnaire (OAQ-G2). Alexitimia y sindrome de Asperger, Rev Neurol.;50 Suppl 3:S85-9011.Salovey P.,& Mayer JD.(1990). Emotional Intelligence. Imagination, Cognition, and Personality, 9, 185-21112 .Schutte, N. S., Malouff, J. M., Hall, L. E., Haggerty, D. J., Cooper J. T., Golden, C. J., & Dornheim, L. (1998). Development and validation of a measure of emotional intelligence, Personality and Individual Differences, 25, 167-177.13.Taylor, G.J., Bagby, R.M., Luminet, O.: Assessment of alexithymia: Self-report and observer-rated scales. In Handbook of Emotional Intelligence, edited by R. Bar-On and J.D.A. Parker. Jossey-Bass: San Francisco, 2000, pp. 301-319.



Fig : 2a

Fig : 2b

Prof. GUNASEKARAN D R

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