Friday, February 18, 2011

Music as Therapy: A Bio-Cultural Problem (A Review)

Music as Therapy: A Bio-Cultural Problem by Carol E. Robertson-DeCarbo discusses the application of music as a healing tool from a cultural perspective. The article also presents various views of mental illness, symptomotology and physiology, from social anthropology with the intention of validating the significance of cultural cognition as demonstrated by the role of music in psychotherapy. For the purpose of this article discussion, I will primarily centre the summary on the segments which discuss the diverse cultural approaches to music as a tool of therapy.

Robertson-DeCarbo writes that one may find difficulty in defining mental illness, (symptoms, treatment, and hospitalization) on a cross-cultural level. What may be viewed as acceptable behaviour in one society may have a different significance in another.

As we are living in a multi-cultural society, I, as a practitioner of music therapy, see the value and importance of validating the cultural beliefs of the client and then working with that client to deliver a program which is conducive to healing. This can be achieved by prescribing music therapy which utilizes musical elements with cultural relevance to the client.

Robertson-DeCarbo (1974) states that in order to relate music as therapy and its relevance to ethnomusicology and anthropology, the following criteria should first be considered:

a) Culture as the provider of series (or sets) of communication.

b) A system of neurological mediating schemata through which the individual selects appropriate behavioural patterns condoned by his society.

c) Culture as the provider of an “environment” or context for mental illness.

d) Culture as therapy through possible re-association and re-ordering of communication sets.

e) Methods (in this case, music) by which a series of communications can be restated for the reinforcement of the behavioural values set by the social context.

The brain is a powerful instrument; within the cortex of the temporal lobe, the knowledge of ‘how to respond’ is stored, says Robertson-DeCarbo (1974). She explains that extensive research has been performed on how information is filtered through the complex system of schemata in a constant flow of signals. Most psychopathic cases, according to Robertson-DeCarbo, not resulting from chemical alterations, point to a breakdown in communication, indicating that ‘traffic directions’ have been confused. She proposes the idea of the ability of music to help re-establish this lost communication.

Western therapists, as stated by Robertson-DeCarbo, are beginning to note that music is often the only effective stimulus for many psychotic patients, in particular those in a catatonic stage. She writes that a person who often refuses to eat, sit in more than one position, speak, or even open his/hers eyes will often respond to sound stimulus.

When I was a music therapy intern at a psychiatric hospital, I had the opportunity to work with a patient with similar “inhibitions” as described above. The patient was a young Haitian woman (between 17-19 yrs of age) who refused to eat the food provided by the hospital. The young woman complained several times that she was not familiar with the food.

During one of our weekly music therapy sessions, I paired music from her native Haiti with her dinner time. The music, as stated by Robertson-DeCarbo, created an environment which was familiar as well as safe for the young woman. The result was 4 spoons of mashed potatoes eaten.

While at the same internship facility, I had another enlightening encounter with a patient, an older woman from Korea with a pre-diagnosed psychosis, who refused to speak. She would often wander the halls, seemingly disconnected from her environment. Following some discussion with the music therapy supervisors, I took the initiative to create a music listening activity where Korean gospel music would be played for the music therapy group. The immediate response from the Korean patient was a smile of acknowledgment to me, followed by singing, as she recognized the music. Music is a powerful tool which can be effective in evoking verbal response.

Robertson-DeCarbo states that the music approach in therapy has been used in folk psychiatry for centuries. She says that the aim of music therapists in Western culture is to bring about changes in behaviour through music. The goal of the non-Western curing specialist is also to bring about change through external stimuli, one of which is music. In both cases, the music serves as the bridge to re-establish and reinforce the patient’s past social background and context to the world she/he has been disconnected.

This article has provided useful information as to the importance of music in therapy. It has also validated the application of music, when utilized in a cultural context, to create an atmosphere which promotes communication and participation. In short, the use of music as an intervention tool can be a great compliment to any helping profession.

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