After being diagnosed with breast cancer last year, Kathy Winter searched for ways to help ease her fears, boost her spirits and get her through treatment. "I was facing weeks of chemotherapy and was dreading the whole experience," she says. "I was anxious and wanted something to support me."
She discovered the therapeutic power of music. Winter scheduled sessions with a music therapist to coincide with her treatments at the Ireland Cancer Center in Cleveland. Her therapist brought along an electronic keyboard, sang soothing songs and played classical compositions chosen by Winter.
"There was less discomfort," Winter says. "When you're anxious, your whole body is tense and you feel more pain. I don't know how I would have gone through that without the music therapy. It was a long, dark tunnel, and the music therapy helped bring some light to it."
Winter is among a growing number of people who are tapping into the healing powers of music. Health care professionals recognize its value too, embracing a new modality — music therapy — for an array of medicinal purposes, from helping to ease anxiety to helping stroke victims in physical rehabilitation.
Music therapy has been shown to be valuable in pain reduction, coping with stress, easing depression, aiding memory loss and stimulating the immune system, according to the American Music Therapy Association. It is used in conjunction with conventional medicine, functioning largely as a psychological aid.
Music therapy can involve rhythmic drumming, singing, instrument playing, or listening to recorded or live music — experiences that engage a person musically and socially. Deforia Lane, Ph.D., director of music therapy for University Hospitals Health System in Cleveland and associate director of the Ireland Cancer Center, started that institution's music therapy program 15 years ago, after she was diagnosed with breast cancer and used music to aid in her own recovery. She listened to classical such as Beethoven, Chopin and others to help her sleep; hymns to lift her spirits; and jazz saxophonist Kenny G to relax. "I found it helped me to sleep and to maintain my sanity. It also was energizing."
Lane also facilitated music therapy sessions at her hospital's cancer support group to help other patients deal with depression, anxiety, insomnia and lack of appetite. Her sessions were so successful that she was invited back to the hospital to set up a permanent program. Today, she and others use music therapy for all kinds of patients, from helping to ease a woman's labor pains to assisting cardiac patients. "People need some empowerment to help themselves," she says. "Sometimes it's just to tap into a person to show them they are not just a patient."
In her research, Lane has found that participating in one music therapy session increased levels of S-IgA, or salivary immunoglobin A, an immune system booster. She measured the levels of S-IgA in children before and after music therapy treatments. "Those who received music therapy experienced a significant increase in IgA," she says.
In physical rehabilitation, rhythm can act as an external timekeeper, helping patients with muscle movement by stimulating the brain's motor systems. Rhythmic sound helps patients with repetition and movement, aiding the brain to time and sequence movement properly.
Rhythmic auditory stimulation — such as the use of a metronome — has been shown to enhance the ability of stroke victims and Parkinson's disease patients to train their walking patterns more effectively during rehabilitation. At Colorado State University, researcher Michael Thaut, Ph.D., has been using music therapy with stroke victims as part of their rehabilitation. Those who listen to 30 minutes of music during their rehab showed significant improvements in their ability to walk faster and more steadily than those whose rehab doesn't include music. Another Colorado State study with Parkinson's patients showed a similar improvements.
Thaut, who heads the Center for Biomedical Research in Music, says the brain's motor system has a strong capacity to use rhythm as a timekeeper to guide and organize physical functions. In working with stroke and Parkinson's patients, he found that the effect of rhythm on the brain's motor system suggests that rhythm as the time structure of music is the essential element that relates music to motor behavior. Listening to metronomes or music with appropriately timed rhythms can give patients a structure to pace and coordinate their movements.
He believes that the brain has a special sensitivity to rhythmic cues. "Rhythm gives very clear time information which can help to stabilize movement performance," he says. "Rhythm creates advanced time information to plan movement. There is a very strong synchronization effect between the auditory perception of rhythm and physical movement."
Researchers Found Music Therapy Effective in Other Areas
Helping control patients' breathing and heart rate. Several studies have shown that music and rhythm work in sync with people's circulatory and respiratory systems. A University of Iowa study of patients needing ventilation assistance found a single music therapy session was effective in decreasing anxiety and promoting relaxation, indicated by decreases in heart and respiratory rates.
Helping premature infants recover faster. At Florida State University's Center for Music Research, researchers found that premature infants exposed to lullaby singing and multimodal stimulation helped reduce the number of days to discharge and helped increase weight gain. Lane also says preliminary results from a study at Children's Hospital Medical Center in Akron, Ohio, have yielded similar results.
Helping ease pain and discomfort for children during hospital stays, and aiding breathing for young asthma patients. At Beth Israel Medical Center in New York City, music is used to help ease the anxiety of the hospital experience by relaxing children when staff draw blood, insert IV needles, and perform spinal taps or other painful procedures. A pediatric music therapy program also is being used for asthma treatments, enhancing patients' ability to breathe while playing music through a recorder.
"We've been using it to calm and soothe children. We also use it to sedate babies and toddlers for medical tests in place of, or in conjunction with, pharmacological sedation," says Joanne Loewy, director of music therapy and the Armstrong Music Therapy Program and editor of the book, "Music Therapy and Pediatric Pain." "We'll try different kinds of music depending on what kinds of music the children are attracted to."
Also at Beth Israel, Stephen Heaton, M.D., and music therapist Heather Fischer are conducting weekly music therapy sessions with HIV-positive children and their parents. Loewy says that research suggests music therapy can be an effective immune system booster.
Pain management. Music has been shown to help relieve pain and perception of pain by distraction, altering mood and promoting relaxation. In one study at Yale University, patients undergoing urologic procedures with spinal anesthesia who listened to music with headsets had decreased needs for sedatives and analgesics.
Mental health. Music helps improve mood and eases depression. A study based at Michigan State University showed that older people who take keyboard lessons significantly improved anxiety, depression and loneliness — three factors that are critical in coping with stress, stimulating the immune system and improving health, says Frederick Tims, Ph.D., who was the principal investigator. In the same study, he found these lessons also had a significant increase on existing levels of the human growth hormone, which has been linked to osteoporosis, energy levels, wrinkling, sexual function, muscle mass, aches and pains.
Helping Alzheimer's patients and people with dementia. Music therapists are working in nursing homes to help the elderly with memory recall, depression and anxiety. Lane has worked with patients who have spoken for the first time in years after music therapy sessions.
Although there is widespread agreement on the benefits of music therapy, much of why it works still remains a mystery. "The social and emotional aspects of why it works are relatively unknown," says Thaut. "There is very little scientific understanding of the mechanisms in that area. We know much more scientifically about the influence of music on cognitive functions and the control of movement for therapy."
Music perception and music production are not linked to one specific area of the brain. "The processes in the brain that are involved in our perception of music are distributed over many centers in the brain and can even change with learning, experience, or in different contexts of listening or playing," says Thaut. "There is really no single center in the brain for music. There is an interaction of networks across many, many areas."
Still, health care professionals are seeing that music can be a valuable aid to conventional medicine. "There's been quite a lot of interest in this area, and we've noticed that a growing number of music therapists are working in hospitals and health care," says David Smith, Ph.D., president of the American Music Therapy Association and associate professor of music at Western Michigan University.
Today, there are more than 5,000 music therapists working in the United States, and about 70 universities have degree programs in music therapy approved by the AMTA. Still, its acceptance by the medical establishment is slow to come, and insurance reimbursement is not guaranteed.
"This brings a strong response from many music therapists who clearly see what we do as mainstream. However, in terms of reimbursement, there is some debate as far as where our home should be," Smith says. "It just isn't clear. We've seen the benefits of cooperative research projects with individuals outside the field of music therapy as means to gain greater credibility. I'm sure that will also help us come to grips with the alternative label."
Music Therapy in Other Areas of Life
Many of us listen to music to relax, lift our spirits, inspire us to dance or create a special mood. Whether it's Mozart or Madonna, we're treating ourselves to our own brand of music therapy.
"Most of us have ways in which we use music for our own health, whether it's selecting which CDs we play or what radio stations we listen to," says Frederick Tims, Ph.D., chairman of Music Therapy at Michigan State University. "It can have an amazing effect."
Deforia Lane, Ph.D., director of music therapy at University Hospitals Health System in Cleveland, offers ways to bring music therapy into our everyday lives:
-Take a personal musical assessment. Pay attention to the type of music you listen to and how it makes you feel. What kinds of music change your mood? What makes you feel happy or blue?
-Try waking up to music in the morning. For some, a Sousa march may be the best thing to rouse you out of bed. For others, something more mellow. Music in the morning can lift your spirits for starting the day fresh. Experiment with soothing music at night if you have trouble sleeping. "Once you determine what agitates you or what calms you, then you can choose what works," says Lane.
-Sample a variety of new music. Lane recommends going to a library first to sample different kinds of music before buying something. She suggests some environmental sounds or new age music for relaxing. "Also try listening to different instruments such as the harp or the flute, a man's voice or woman's voice," she says. "See what works for you."
-Try musical meditation. Once a day, for at least 20 minutes, turn off the lights, disconnect the phone, turn off the television and enjoy music. "Drink in that music," she says. "If you could do this once a day, in three or four weeks you will achieve that relaxation response sooner because your body will have practiced."
-Use music to distract you during difficult times. For example, if driving to the hospital or doctor's office makes you anxious, put on a cassette of something soothing or upbeat. "Program yourself to use music conscientiously."
Pierce J. Howard, Ph.D., author of the "Owner's Manual for the Brain," says music seems to have more powerful effects when it is music the patient chooses, especially in helping relieve stress.
"The general rule is, choose your music, especially music you grew up with, and it will have emotional value," Howard says. He cites research by Michael Rohrbacher of Shenandoah University, Winchester, Va., as an example. Rohrbacher found that by listening to music of their own choosing, especially music they grew up with, brain-injured patients showed an increased ability in emotional empathy, increased lucidity, and increased recovery and rehabilitation time.
MORE INFORMATION
To learn more about music therapy, contact the American Music Therapy Association, 455 Colesville Road, Suite 1000, Stover Spring, MD 20910; (301) 589-3300; or check out the Web site at www.musictherapy.org
Music without words means leaving behind the mind. And leaving behind the mind is meditation.
Meditation returns you to the source. And the source of all is sound. — Kabir
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