- Zahira Amir Ali Khalfan
This paper explores the relationship between music and human behavior and its role in treating the mentally ill patients for healthy recovery. Being a student nurse the topic is very significant for my learning. The paper is a part of my Behavioral Psychology Course at the Aga Khan University School of Nursing and Midwifery (AKU-SONAM), Karachi, Pakistan. The paper will begin with brief description about relationship between music and human behavior, its importance, bio-psycho-social perspectives and types of music in the light of literature reviewed. In the end, the paper will be summarized and will propose music therapy as a significant strategy in psychiatric recovery.
Key words: music, human behavior, music therapy
While observing the Creation of Universe and the evolution of human beings, music is basic, which is reflected in the chirping of birds, giggling of babies and lullaby of mothers or love of fathers. These emotions are predominantly expressed in the common language called music.
Music is everywhere, far and wide and it is not just contemplation but is a reality. Today in the world of enchantment, it is the means of entertainment (Parrott, 2009). Thus music has directly or indirectly influenced every human being in shaping his/her behavior.
Every person in this universe lives due to Almighty’s creativity and thereby religions are formed to praise Him. The impact of music on religions is boundless. Parrott (2009) while seconding Bhakthi Sankeertan in his book ‘Healing through Music’ says, “From ancient times, music is something that has put people in touch with their innermost feelings. Different kinds of music work upon different emotions of an individual and release the various incomplete emotions leading towards a total healing of body and mind”. Parrott (2009) cited Steven Fischbacker who writes in his paper “Music and Spirituality” that music helps to retrieve memories when you see an object which you had associated to form a memory. Cooling (1996) suggests three ‘E’ words viz. explore, engage and express which connects music with spirit. Music is played in festivals to express worship. In Judaism “Music is the pulse of Jewish spirituality – song charts the biorhythms of the Jewish Soul.” (Chief Rabbi Sir Jonathan Sacks cited in Cooling, 1996). In Christianity music unites people and everyone recites holy songs as being one. In Islam it is a harmony of life. It is inspired by the recitation of Holy Quran and Devotional Literature in Sufism in Islam. In Hinduism, music is considered as the tune and rhythm of the Lord (Parrot, 2009).
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Music on the one hand is a union of sound and lyrics. (Trappe, 2012). On the other hand it is an approach towards physical mental and social aspects of a human behavior which reflects throughout his life (Kagan, 2013). When a piece of music is composed by a human, it somehow or other, sways one’s behavior which ultimately gives rise to personality development.
Pursuant to Music theory, (Leibniz, 1712) a person who is able to play an instrument according to its learnt elements has truly understood the music, but the limitation to this theory is that, it does not explain what a brain perceives and how a person acts over it. Another explanation is that, music is subjective. You cannot tell the meaning of the word “music”, rather than that you simply play it and make others understand the essence of it. Some say that music is poetic (Leibniz 1712). According to scientific analysis, music is a way to socialize with others, to recreate sexual desires, to form a language and a way of communication for antenatal mothers with their babies. The most common view is that music is an effect of sound created by humans which rejuvenates the environment. (Dorrell, 2006). Psycho musicologist Aristoxenus cited in Butler (1982) says that music is a human effort formed according to one’s sensory abilities and its disclosure should be worthwhile. According to Pavlovian classical conditioning in Vedantam, 2007, when unconditioned stimuli e.g. any work that we perform, combines with conditioned stimuli like music, the conditioned response that we obtain is the desired behavior i.e. whenever we listen to that music we start performing our work. (Vedantam, 2007).
Music has a great importance on all accounts of human life including health. Music motivates to have greater self-reliance, confidence; help to form belongings and work in collaboration with others e.g. group of people giving efforts in an orchestra to make it an achievement. (Henley, 2011)
Music is a key to understand emotions and feelings. We start understanding the meaning of lyrics when we turn into a teenager which creates an enormous impact on our future. (Vedantam, 2007). A study was done related to lyrical music influencing individual’s mood and helping behaviors. People with prosocial lyrics had positive whereas people with antisocial lyrics had negative behaviors. No convincing statistics were found for helping behaviors but it does not mean that music can’t generate willingness to help. (Ganser et al, 2010).
Value of music in academic point of view is astonishing. It is the best way of communication by which children improve their social skills and learning and bring up their self esteem on a higher level. According to a research done by Henley (2012), it was reported that music enhances the reading skills to improve vocabulary. It also helps in solving mathematical problems and improves one’s IQ. It makes a child more imaginative and creative. It is not just for the sake of entertainment rather, it gives an opportunity to pursue it as a profession. For some students it helps to excess in their academics whereas on the contrary it’s a great distraction. (Fatima, 2013).
If we look towards the physical, mental and social aspects of a human being throughout his/her journey of existence for development and growth, effect of music is very far reaching. Music lowers blood pressure and improves heart rate variability to reduce stress, depression, anxiety, muscle tension, pain and sudden infant death (Trappe, 2012). A brief pause between two musical notes stimulates neural activity which sharpens cognition and memory and strong beats brings alertness when these beats synchronize with action potential. (Fatima, 2013).It decreases pre-surgery anxiety to the same extent as medications do. Association towards music changes with different stages of life. The most enjoyed music in adulthood improves mood, motivates for socialization and boosts energy. It has been observed that hearing is the last sense that remains for few seconds even when other body parts cease to work, therefore, music is a beautiful source of rejoice for chronically ill or dying patients in their end times (Trappe, 2012). It is also presumed that music runs in families; most of the time it is inherited, but it can be learned as well. (Henley, 2012).
There are manifold types of music that precipitates behavior. Classical music is the most beneficial in treating patients with variant diseases. Popular music increases motivation and mood. Meditative music is for spiritual upliftment and relaxation. Hip hop and rap music is less effective than Jazz music which is more pleasing to human senses. Latin-American music heightens positive mood, motivation and keeps active. Folk music adds to augment intelligence, protection and confidence. (Trappe, 2012). Sad music is the root of expression in depressed patients. (Bodner at el, 2007).
During my clinical rotation in one of the Psychiatric and Rehabilitation centers in Karachi, I, along with my other colleagues, arranged a musical therapy for patients with mental illness. In collaboration with the patients, they played different instruments and sang songs of their interests. Most of the patients sung depressed and displeasing songs as they were away from their homes. In consequence we concluded that music impacted their interaction, expression of feelings and helped us understand patient’s intrapsyche with the type of song they select to sing. Accordingly we concluded to select that strategy which could help them to recover fast.
Looking towards the historical background of music therapy, ÇamsarÄ±, (2009) seconds Tyson (1981) that after World War II, musicians went to the military hospitals to apply music as a therapy and this lead to the foundation of music as a profession.
One of the expressive therapies is music therapy that intends to show free extemporization for a therapeutic change in patients through patient-therapist interactions. It is a technique of ‘self-projection and free association’ to have connection with emotional memories (Erkkilä et al, 2011).It aids to achieve individual ambitions in assistance with a licensed professional. (American Music Therapy association, 2007). It is a nonverbal and verbal processing along with physical act (e.g. playing instruments) for expressing feelings by provoking unconscious psyche of an individual. (Erkkilä et al, 2011 & Malchiodi 2005). The essential of musical session includes composing, playing musical instruments and enjoying it fully (Fatima, 2013). It brings an insight in psychopathologies. (Erkkilä et al, 2011). Research confirms that it treats Parkinson’s disease by improving motor skills and emotional issues (Trappe, 2012). It reduces stress hormone (cortisol) in depressed adolescence. (Field at el, 1998). Similarly schizophrenic symptoms also improve after 10 therapy sessions for short term whereas long term effect should be further researched. (Gold, 2007, Pavlicevic et al, 1994 & You et al, 2002). Music has remarkably reduced patients’ negative thoughts and reduced isolation. It has no side effects and less expensive therefore should be extensively used. (Tang at el, 1994 & Ulrich, 2007).Group music therapy transmutes annoyances and anger into inventiveness and enables self-expressions. (Montello at el, 1998). It helps in treating physical handicaps and drug abuse (Fatima, 2013). ÇamsarÄ± (2009) seconds Gold et al 2009 that music improves communication in Autism.
Types of music therapies which help to modify human behavior include Background Music Therapy, Contemplative Music Therapy, Combined Music Therapy, Executive Music Therapy, Executive Iatromusic Therapy, and Creative Music Therapy. (ÇamsarÄ±, 2009).
According to Fatima (2013), clinical Psychologist Qudsia Mehmood states that Pakistani population lacks the awareness about the significance of music therapy. Fatima (2013) cited Mr. Sohail Khan as he had established Music therapy center in Karachi, Pakistan and has widely worked on “The Prism Project, A Multi-Dimensional Approach to Music in Education” .He states that he is the first music therapist in Pakistan and his goal is to establish such institutions where he can train psychologists related to how effectively they can use music therapy for the betterment of Pakistani society. (Fatima, 2013).
It is unpredictable to assume that the music chosen by the therapist is pleasing to the patient or not. Malchiodi (2005) seconds Feder (1998) that music therapy is given after assessing individual preferences and past experiences as, right type of music can alleviate and wrong type of music can aggravate the symptoms. Also, to take an account of music therapy into regular therapy programs for rapid recovery (ÇamsarÄ±, 2009). A role of therapist is to use music with reflective exercise. (Erkkilä et al, 2011).
The field of music is indispensable yet unexplored in Psychiatry and Psychotherapy. Music has a therapeutic power to heal many chronic patients, including those suffering from mental illness. My experience working with these patients at the Psychiatric and Rehabilitation Center, Karachi, states that there is a very close relationship of music with human behavior. There is a need to introduce music in nursing education, to enhance understanding of these professional care takers to help patients improve positive behavior. Also there is a need to include it as foremost priority in other educational institutions in our country, from the time of early childhood development till the education continues, because the behavior formed in the early childhood is crucial for future adult life.
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