A recent review from the widely respected Cochrane library compared ‘the effects of music therapy and music medicine interventions for psychological and physical outcomes in people with cancer’. Music medicine is when a medical professional provides pre-recorded music for the patients to listen to. While both have positive results, music therapy is preferred by patients and has a greater impact on their quality of life.
But what makes music therapy different?
Let’s start by thinking about why music is a powerful tool. We use music to narrate events in our life, help form our identity and to process our feelings. Whether it be music we sang in a choir, raved to at a festival, or heard at a funeral; music has the power to evoke emotion and remind us of specific times, events and people from our lives.
Our emotional reactions to pieces of music are not the same- whilst I experience most heavy metal as angry, a friend of mine uses it to wind down after a tough day! Similarly, I was once told an analogy about a boy who had been paralysed. His heart rate was high and in an attempt to relax him he was played classical music through headphones. Unfortunately this did not have the desired effect and his heart rate rose. His parents were then asked what music he preferred to listen to at home-hip hop. This time they played him hip-hop music through the headphones and his heart rate lowered. We all respond differently to music, which makes it very difficult for the scientists trying to figure out what is going on in our brains.
That analogy demonstrates how music medicine can be effective and how import it is to think about the individual. However, music medicine is about listening to music in isolation whereas music therapy is inherently interactive.
In music therapy, thinking about the person as an individual is the starting point. In my work I find out about the person’s background and musical preferences so I can personally tailor the sessions. From that starting point I have a lot more flexibility within the session than recorded music ever could. Whether I am working with someone who is articulate or completely non-verbal, I am observing how people respond to music. I look at what my patient says, how they play with instruments or more subtle changes such as a change in skin tone or a clenched fist. I then use my improvisation skills to change how I play from moment to moment, trying my best to meet that person where they are at.
I think about the therapeutic processes going on in the room, for example how a patient’s way of interacting with me might reflect relationships in their own life, and how what I’m doing might affect them. I do my best to offer emotional support to the person- that might be playing supportive music alongside them; supporting them to write a song; or simply being there and offering a creative way of listening.