MUSIC AS MENTAL HEALTH TREATMENT
Therapies involving song help patients cope with stress, pain, more
The therapy session begins when Isobell, 17, picks up a guitar.
Her fingers, adorned with silver rings and black nail polish, are positioned to play the first chord of Lana Del Rey’s “Candy Necklace.”
Then she starts to sing, her voice a melancholy, breathy soprano:
“White noise coming out of my brain/ Turns off for nothing.”
Isobell’s therapist, Caitlin Bell, accompanies her on the piano.
They are actually sitting in a medical clinic — the Louis Armstrong Center for Music and Medicine at Mount SinaiUnion Square in Manhattan — but the space feels more like a musician’s living room, with sheet music on display and wooden bookcases that line the walls, each housing different instruments.
Music therapy, while still a relatively small field, has grown over the last decade. The practice helps people cope with ailments as wide-ranging as stress, chronic pain, limited mobility and hypertension, and is performed in a variety of settings, including psychiatric hospitals, outpatient clinics and schools.
Scientific research has begun to explore why music appears to have such a strong effect on health, particularly mental health, where sounds can serve as a conduit to lift someone’s mood, help them reflect and reduce stress, anxiety and depression.
When she was 14, Isobell’s treatment for anxiety looked very different. At the time, she was seeing a psychiatrist. But after trying a few medications, she felt that they “weren’t really doing anything.”
She was feeling discouraged, until her doctor — knowing that she loved to play the guitar and write songs — recommended that she try music therapy.
For the past two years, she has traveled to Mount Sinai nearly every week, despite her packed schedule as a high school senior.
Isobell, who asked to be referred to only by her first name to protect her privacy, no longer takes medication.
Singing creates space to release emotions that can be difficult to describe, she explained.
Even just listening to a song and interpreting the meaning “opens up so much in my mind,” she added. “I feel like I always draw a blank when people ask me, ‘What’s up? What’s going on?’ ” But music therapy helps her become more introspective.
Here’s a look at how music therapy is used as a psychotherapy tool. BENEFITS OF MUSIC THERAPY
Research has shown that adding music therapy to a patient’s regular treatment, like medication and psychotherapy, can improve depressive symptoms when compared with standard treatment alone. Studies also indicate that music therapy can decrease anxiety levels and improve day-to-day functioning in people with depression.
More studies are needed to better understand why, but scientists do know that music engages multiple regions of the brain, like the limbic system, which helps process emotions and recollections. This may be partly why music is known to bring back memories.
Different studies have found that music affects our bodies in other ways as well. Fast tempos can be arousing; and slow or meditative music may help people relax.
Both listening to music and singing can reduce cortisol, a hormone that the body releases when it is under stress. And the pleasure we feel when listening to music can produce dopamine, a neurotransmitter that influences the reward centers in the brain.
Finally, because music therapy is so interactive — clients will often play instruments with their therapist or write lyrics together — it allows for self-expression both individually and in a communal setting, said Dr. Kenneth Aigen, the director of music therapy at the NYU Steinhardt School of Culture, Education and Human Development.
Music has been a driving force throughout Aigen’s life — for the past 14 years, he has played keyboard in a Grateful Dead tribute band. He said he wants his clients to discover the power of collaborating with other people through music, just as he has, either in group sessions or one-on-one meetings with a therapist.
“When you join with other human beings through music, there’s no other experience like it,” he said. “I think it completely changes how you think of yourself.”
For Kerry Devlin, a senior music therapist who works with critically ill patients at the Johns Hopkins Hospital in Baltimore, music is a tool to share space with people during some of the worst moments of their lives.
A session can give patients a sense of autonomy and help them become “reconnected with their own humanity in what often feels like a really sterile and scary environment,” Devlin said.
When providing palliative care, for example, she uses a special stethoscope to record a patient’s heartbeat, then works with the person and sometimes their family to select a meaningful song and add lyrics. “We use that person’s heartbeat as the rhythmic pulse,” she said. “This is a piece of their life, recorded forever and ever, which is such a gift.” MISCONCEPTIONS
When Devlin arrives for her sessions, some people assume that they need to be musically proficient at playing an instrument in order to participate.
But that’s not the case.
“We might wail on a drum together or we might give them something that really vibrates and provides a grounding sensation to help them connect with their body and their breath,” she said. “There isn’t such a thing as a wrong note.”
Others prefer to listen to music rather than create it. It’s up to the patient to decide what feels right.
Another myth is that providers function as entertainers. A music therapist is not performing for an audience but rather using therapeutic techniques to help their clients meet goals and express themselves. FINDING A MUSIC THERAPIST
Contact the American Music Therapy Associations or search its online directory for music therapists in your area.
Insurance companies often do not include music therapists, but you may be able to get reimbursed for some of your out-of-network costs.
Devlin also suggested searching online for resources in your area.
The music therapy offered by Johns Hopkins in Baltimore, for example, is free of charge, including the support groups.