What is music therapy?

Music therapy is the use of music to promote wellness, relaxation, and healing. It has been used throughout recorded history and throughout human civilization. The Bible describes David as playing the harp for King Saul: “Whenever the spirit from God came upon Saul, David would take his harp and play. Then relief would come to Saul; he would feel better, and the evil spirit would leave him” (I Samuel 16:23). Apollo, one of the gods of Ancient Greece, was the god of the Sun, Music and Medicine. Apollo is often depicted playing the lyre, an ancient harp, and it is told that he taught healing to man.

Music and medicine – the early recordings

Until modern times, papers written on the effect of music and healing consisted largely of reports describing what the authors witnessed or believed they were witnessing when they “administered” music to their patients. They also described the personally unwitnessed, i.e., other people’s experiences. In 1749, Richard Brocklesby, a London physician wrote a treatise called “Reflections on the Power of Music.” Dr. Ann Rorke, in an excellent review of the Treatise, noted that Brocklesby observed beneficial effects of music on patients with mood disorders (“melancholia”), the elderly, and the pregnant. She credits Brocklesby for recommending “simple music” for treatment, except for those who are educated in music. Those patients reportedly responded “better to more complex music, and particularly that known to them before their illness (1).” It is not clear how Brocklesby came to his conclusions. It is doubtful they are anything more than his own observations and experience. Many great scientific discoveries, however, originated with a casual observation. These early observations provided the seeds for later growth. For example, an astute medical student/cellist from Case Western Reserve School of Medicine observed in 1993 that another student sneezed at approximately the same time every day. This led to a landmark paper published a year later in the prestigious medical journal Neurology describing the phenomenon of circadian sneezing (2).

Edward Atlee, in 1804, completed a work entitled “An Inaugural Essay on the Influence of Music in the Cure of Disease.” According to William B. Davis, Ph.D., and music therapist, Atlee advanced two music therapy concepts that are still accepted today. He was a proponent of using music favored by the patient, and he developed a therapeutic program relative to the patient’s interests and background (3). This makes intuitive sense. An opera lover probably would not respond favorably to Heavy Metal and vice versa. It should be noted that the caliber of most medical research during these times was on par with the medical/music research. Music may very well have had a more beneficial effect on human ailments than the widely used ‘snake-oil’ tonics which were extremely popular.

Thomas Edison’s brillante idea

In 1877, Thomas Edison invented the phonograph, and commercially available recordings were available 20 years later. This was a landmark in music therapy. Until then, it was virtually impossible to standardize any experiment involving music. The advent of the record player brought the ability to bring music to almost every clinical situation. The first reports of the effect of music on breathing rate, pulse, and blood pressure began to surface at the turn of the 20th Century. In 1914, Evan O’Neill Kane began using a phonograph in the operating room for calming patients prior to the application of anesthesia (4). A year later, New York’s Columbia University announced a new course called “Musicotherapy,” which was taught by Margaret Anderson, a British musician who had experience with orthopedics and paralysis (4).

Music in the hospital

Momentum for music therapy increased when the National Association for Music in Hospitals was formed by Isa Maud Ilsen. Ilsen, in a 1926 issue of Musician, stated that hospital music must “arouse the vital functions of the body [which] are all rhythmic when in a state of perfect health; to this state the rhythm of the music should accord (5).”

Duke University Hospital is credited with being the first hospital to commit to having music in every patient room. All inpatients, including children, were able to receive radio broadcasts through headphones or free-standing units (6). Soon afterward, music was studied for use in the surgical suite and the delivery room to help lessen the effects of pain and reduce the amount of anesthesia with its unpleasant side effects of nausea, vomiting, and lung irritation. Some readers may recall that for much of the 20th Century, general anesthesia was the norm for women giving birth. Mothers typically awoke in a recovery room and were presented with their child. It is likely that music was used mainly as a diversion, or for calming purposes, up until the point the patient was rendered unconscious by the powerful anesthetics.

Open wide…

The dental field caught on to the possible use of music to help alleviate pain and anxiety. A dentist named E.S. Best designed a “radio chair” to introduce tunes through small speakers directly attached to the patient’s skull. Since bone conducts sound faster than air, Best hypothesized that music would reach the brain before the sound of the drill, thus overriding the unpleasant with the pleasant (7). The enthusiasm and success of the ‘radio chair’ seems to have evaporated; however, the dentist offices I have visited do play music, although not necessarily catered to my taste.

Marching towards better health

In 1938, the New York Times carried an article describing the use of “out-of-door” music to aid the breathing difficulties associated with tuberculosis, and marches to use to help “cripples (8).” It is unclear from the article if they found an out-of-door march to help cripples suffering from tuberculosis.

In 1950, K. L. Pickrell, et al, discussed the benefits of using headphone-supplied music to help comfort the surgical patient and distract him or her from the anxiety-provoking sounds of the operating room and the recovery ward. Nurses were encouraged to use music with stories to prepare children for their surgery and aftercare (6).

Please, fall asleep

The first large-scale investigation into the usefulness of music as medicine was undertaken by Light, et al., and reported in the 1954 issue of Current Researches in Anesthesia and Analgesia. Their research, involving 200 patients, found that music enabled the anesthesiologist to reduce the amount of potentially toxic anesthetics used during surgery (9).

The Registered Music Therapist is born

In 1944, Michigan State University established the first music therapy program in the world. It was specifically designed to train music therapists. In 1950, with assistance from the National Association of School of Music, the National Association for Music Therapy, Inc., was formed. Goals included creating educational programs to train music therapy students and furthering research in music therapy. Six years later, the Registered Music Therapist credential (RMT) was created to ensure education standards and internship requirements to those pursuing a career in music therapy.

According to the February 9, 2000, issue of Journal of the American Medical Association, there are 8,000 Board Certified music therapists practicing in the United States and Canada, perhaps 1,800 music therapists in Germany, 500 in the United Kingdom, 300 in Austria, and 1,000 in Brazil (10). The European Music Therapy Confederation lists 21 countries on its website which have active music therapy programs.

For information about music therapy in America, visit the American Music Therapy Association at www.musictherapy.org

For information about music therapy in Canada, visit the Canadian Association for Music Therapy at www.musictherapy.ca

For information about music therapy in Europe, visit the European Music Therapy Confederation at www.musictherapyworld.de.

We at E.R. Music are grateful to readers who let us know more about the history of music therapy, its applications, and future goals. Please join our mailing list if you would like to be informed of the latest developments.

Copyright 2008, E.R. Music, LLC

1) Rorke, “Music Therapy in the Age of Enlightenment,” Journal of Music Therapy, XXXVIII (1), 2001, 66-73

2) Grant AC, Roter EP, Circadian sneezing. Neurology. 1994 Mar;44(3 Pt 1):369-75

3) Davis, “Music Therapy in 19th Century America,” Journal of Music Therapy, XXIV (2), 1987, 76-87

4) Standley, “Music Research in Medical/Dental Treatment: Meta Analysis and Clinical Applications,” Journal of Music Therapy, XXIII (2), 1986, 56-122

5) Ilsen, I.M., “How Music is Used in Hospitals,” Musician, 1926, 31, 15

6) Pickrell, Metzger, et al, “The Use and Therapeutic Value of Music in the Hospital and Operating Room,” Plastic and Reconstructive Surgery, 1950, 6, 142-152

7) Best, E.S. “The Psychology of Pain Control,” Journal of the American Dental Association, 1935, 22, 256-267

8) “Healing” by music tried in hospitals, New York Times, March 20, 1938, 5

9) Light, Haymond, et al, “Use of Magnetic Recorder “Silent” Music During Operation,” Current Researches in Anesthesia and Analgesia, 1949, 28, 330-338

10) Marwick, “Music Therapists Chime in With Data on Medical Results,” JAMA, February 9, 2000, Vol 283, No. 6