The Study of Music Therapy: Current Issues and Concepts

Kenneth S. Aigen

• Publisher: Routledge
• Year: 2013
• Print ISBN: 9780415626408
• eBook ISBN: 9781134691906
• Topic: Media & Performing Arts
• Subtopic: Music

This book addresses the issues in music therapy that are central to understanding it in its scholarly dimensions, how it is evolving, and how it connects to related academic disciplines. It draws on a multi-disciplinary approach to look at the defining issues of music therapy as a scholarly discipline, rather than as an area of clinical practice. It is the single best resource for scholars interested in music therapy because it focuses on the areas that tend to be of greatest interest to them, such as issues of definition, theory, and the function of social context, but also does not assume detailed prior knowledge of the subject.

Some of the topics discussed include defining the nature of music therapy, its relation to current and historical uses of music in human well-being, and considerations on what makes music therapy work. Contemporary thinking on the role of neurological theory, early interaction theory, and evolutionary considerations in music therapy theory are also reviewed. Within each of these areas, the author presents an overview of the development of thinking, discusses contrasting positions, and offers a personalized synthesis of the issue. The Study of Music Therapy is the only book in music therapy that gathers all the major issues currently debated in the field, providing a critical overview of the predominance of opinions on these issues.

PART I

What is Music Therapy?

1

THE IDENTITY OF THE MUSIC THERAPY PROFESSION

Some readers of the present book may come to it with a career-long familiarity with music therapy and other readers may be encountering it for the first time. However, readers in the former group may not be in a significantly better position to provide an unproblematic definition of it than are those in the latter group because the nature of music therapy has been contested throughout its history. As an example of the complexity of defining music therapy, consider that Kenneth Bruscia (1989) devoted an entire book to this task, significantly revising and expanding his work in a second edition (Bruscia, 1998a). Given the quality and quantity of his scholarly work, Bruscia’s definition occupies a unique status in the profession.¹ Two of the more prominent, representative, and influential organizations in music therapy are the American Music Therapy Association (AMTA) and the World Federation of Music Therapy (WFMT). Considered together, the following three definitions provide a reasonably comprehensive portrait of how music therapists look at themselves and their work.

Bruscia’s definition evokes general conceptions of a health profession in its inclusion of systematic intervention; it references the practice of psychotherapy in the inclusion of the importance of relationship in change processes.

Music therapy is a systematic process of intervention wherein the therapist helps the client to promote health, using music experiences and the relationships that develop through them as dynamic forces of change.

(Bruscia, 1998a, p. 20)

The AMTA definition is narrower than Bruscia’s. Its reference to being evidence-based reflects a more strictly-defined notion of music therapy as a medical profession, not just a health-related one. It adds the claim that music therapy is the province of individuals with specific educational and professional qualifications.

Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.

(AMTA, 2013)

As befitting its status as an international organization with pluralistic allegiances, the language of the WFMT expands the focus of the previous two definitions from health to a more inclusive notion of quality of life.

Music therapy is the professional use of music and its elements as an intervention in medical, educational, and everyday environments with individuals, groups, families, or communities who seek to optimize their quality of life and improve their physical, social, communicative, emotional, intellectual, and spiritual health and wellbeing. Research, practice, education, and clinical training in music therapy are based on professional standards according to cultural, social, and political contexts.

(WFMT, 2011)

The different conceptions of music therapy underlying these three definitions will form the backdrop for the exploration of various issues throughout the present book. But even with their differences, they all represent the views of music therapy from inside the profession. Music therapy is considered to be a health profession that can only be implemented by individuals with specific qualifications determined by governmental, professional, or educational bodies. It has applications in a great variety of contexts, but the predominant social roles upon which the music therapist is modeled after are those of the medical professional, psychotherapist, or perhaps rehabilitation worker such as an occupational, physical, or speech therapist.

In recent years, for the first time music therapy has begun to be investigated by scholars from other areas. The rationale for beginning the present exploration into the nature of music therapy from these perspectives rather than from a detailed look from inside the profession is twofold: First, it will provide a more familiar entry point to the readers who are not music therapists; and second, it offers to music therapists a sense of the issues involved when those outside the field turn their scholarly lenses on music therapy.

The Emergence of Historical Perspectives on Music Therapy

So what is music therapy? Is it a primarily a modern health-care practice that emerged in the post-World War II era as suggested by some writings by music therapists, or is it the contemporary manifestation of the perennial use of music for healing purposes that reaches back to the dawn of humanity as tends to be argued by scholars from related disciplines? Moreover, what is the relation of the primarily Western form of professional practice to the contemporary indigenous models of the use of music to enhance human well-being? Do these indigenous practices represent cultural variations of professional music therapy or are they more accurately seen as something quite apart from it?

In the early 1980s, music therapists began considering the relationship of their work to historical precursors, such as shamanic healing. Since approximately the year 2000 there has been a trend toward more overtly incorporate thinking from fields such as anthropology, sociology, and ethnomusicology in creating music therapy theory. At around the same time, historians, anthropologists, and sociologists began to focus on music therapy to contextualize it, both historically and culturally. These related trends meant that there was a significant expansion in the range of disciplines used by music therapists to find supportive theory outside the medical and psychological frameworks that had been traditionally applied to music therapy.

The attention from outside the field, while potentially valuable for music therapy, has been problematic as some of the initial efforts have confused fundamental issues, as they are seen by music therapy scholars. It is important to clarify these issues so that multi-disciplinary interaction can proceed in a way that is based upon a solid foundation.

The collection of studies edited by Penelope Gouk (2000a), Musical Healing in Cultural Contexts, was one of the first publications to reference the modern profession of music therapy from the perspective of “scholars engaged in social, cultural and historical studies” (Gouk, 2000b, p. 1). Gouk’s choice of terms has, however, led to some confusion, especially in relation to the words healing and therapy. Her intention “is to promote interdisciplinary and cross-cultural discussion of the healing powers of music” by addressing questions such as “how do people use music to heal themselves or others” (2000b, p. 1). She acknowledges that the contemporary profession of music therapy involves assessment, treatment goals, and systematic evaluation, while being clear that her book does not cover these activities. However, her choice of the term music therapy to apply to any engagement with music for beneficial effect and her portrayal of professional music therapy as not including the notion of “making whole” are both problematic:

The type of ‘music therapy’ that this volume does take some account of, however, is the general, non-expert kind … In this context, the term ‘therapy’ is being used to denote the general therapeutic effect which can be gained from being involved in any form of musical/artistic performance, either as a participant or audience. The critical difference between this kind of activity and ‘proper’ music therapy … is that it does not need the intervention of a trained therapist, and is chiefly a form of recreation: that is, an act or experience selected by the individual to meet personal wants in his or her leisure time … Hence the choice of Musical Healing as the start of our book’s title: this reflects a bias towards thinking of music as a form of healing (i.e. making strong, whole again) rather than just in terms of therapy (i.e. techniques of intervention involving distinct goals and desired outcomes).

(Gouk, 2000b, pp. 2–3)

Gouk’s use of the terms healing and therapy and her means for distinguishing between them does not comport well with contemporary music therapy discourse. She puts the term music therapy into single quotation marks indicating perhaps not an ironic but a deliberately vague use of the term, and then says that her historical perspective covers uses of music that predate the modern profession. It is not clear why she uses the term therapy when she defines it to mean any use of music not requiring a trained therapist and that focuses on any therapeutic effect, items that distinguish it from what she terms proper music therapy. Gouk’s presentation suggests that for rhetorical purposes she is taking on the perspectives that contemporary music therapists would hold, but that she may not actually believe in such distinctions herself.

She goes on to explain that she chose the term musical healing for the title of her book because she is focused more on “making whole” than on the processes involved in contemporary professional practice. A few problems are present here. First is her use of the term “healing powers of music.” While this phrase has been present in music therapy discourse, it is not one in current parlance due to contemporary perspectives that argue against the view that music has essential qualities that transcend context. Rather than promoting the notion that music contains healing properties—such as a medicinal plant—there is a consensus building in music therapy around the idea that humans create the value of music through the way that they engage with it. As Lisa Summer (1995) asserts, “sound has power, but it is a power created and manipulated by human beings when used therapeutically” (p. 60).

Second, there is a whole discourse in music therapy—such as is exemplified in Broucek (1987)—dedicated to including in contemporary clinical practice the very goals that Gouk reserves for healing. These perspectives reflect holistic, resource-oriented, and community practices. Music therapists would generally not accept Gouk’s distinction that music therapy precludes a focus on “making whole” for a preference on “distinct goals and desired outcomes.” It is not congruent with contemporary thinking to place this type of orientation outside the sphere of music therapy.

Third, the use of the word healing is somewhat discredited among scholars in music therapy. Summer’s (1996) discussion and analysis of contemporary music healing practices clearly paints as a charlatan anyone using the word healer as a self-appellation:

Practitioners, best described as New Age music healers, have created amongst themselves a philosophy which lacks clarity and logic. It has grown out of myths and legends, converted into ‘facts’ in a parody of how science progresses. The foundations and axioms of New Age music healing are based upon wishes and fantasies which the practitioners in the field have agreed, perhaps unwittingly, to believe are facts.

(Summer, 1996, p. 7)

Summer’s work is an extraordinarily well-researched study exposing how music is the “new age elixir” peddled by individuals seeking to take advantage of their customers’ gullibility. However, Summer does not critique shamanic or other healing uses of music used by pre-scientific or non-Western cultures. In fact, the new age healers that are the target of Summer’s analysis clothe their approaches in the language of science. What Summer does is expose how nearly every assertion claimed by these healers related to music, vibrations, sound frequencies, the structure of the universe and its supposed parallels with the structure of music, is fundamentally misconstrued or just plain wrong. She debunks these approaches based on the scientific foundations that they claim for themselves.

Thus, for a variety of reasons it will not do to either consider healing as a type of music therapy or to distinguish between the two activities by the types of goals that Gouk suggests. Instead, it would be more accurate to reserve the label music therapy for practices and practitioners that stem from the emergence in the second half of the twentieth century of the modern profession with its attendant emphasis on explanation and accountability.

In an effort to establish historical continuity between forms of music healing and contemporary music therapy in the book Music as Medicine: The History of Music Therapy since Antiquity, Peregrine Horden (2000a) makes the same fundamental error as Gouk. The subtitle of this edited collection suggests that music therapy has existed for thousands of years and Horden makes clear that he considers any use of music from any place or time “that maintains or restores the health of mind and, even, body” to be music therapy (2000b, p. 1). He says that “the term ‘music therapy’ is to be understood broadly as a convenient label, rather than in the narrower terms to which modern professionals might adhere” (2000b, p. 2). No rationale is offered for this choice, which would certainly be a problematic one for the modern professionals to whom he refers.

Horden’s title notwithstanding, considering “music as medicine” is antithetical to a significant portion of theory and practice in music therapy. And asserting that music therapy has existed since antiquity is not consistent with how music therapists use the term and only serves to add to confusion over the nature of music therapy. Papering over important distinctions like this in the service of establishing historical continuity just does not serve any good scholarly purpose.

Horden’s perspective on music in general does not inspire confidence that his analyses will provide a perspective on music therapy which reflects current sensibilities. His critiques of the pervasiveness of music and the attributes of popular music echo the dramatic pronouncements of the end of music that accompanied the birth of rock and roll in the 1950s (as well as the birth of jazz in the 1920s) as he invokes the composer Constant Lambert writing in 1934 to buttress his perspective:

We live in an age of tonal debauch where the blunting of the finer edge of pleasure leads only to a more hysterical and frenetic attempt to recapture it. It is obvious that second-rate mechanical music is the most suitable fare for those to whom musical experience is no more than a mere aural tickling, just as the prostitute provides the most suitable outlet for those to whom sexual experience is no more than the periodic removal of a recurring itch.

(Lambert, as cited in Horden, 2000c, p. 4)

Horden admires Lambert’s anachronistic view, even finding virtue in contemporary theocracies insofar as they protect their citizens from the ubiquity of music:

Music is omnipresent, and worse—mechanized to an extent that he [Lambert] could scarcely have envisaged. Only within certain fundamentalist Muslim states is there any escaping it dictatorship over the acoustic environment, its unvarying and literally inhuman rhythm … With the mechanical beat and harmonic banality of most popular music, profundity, even of the fleeting kind furnished by the latest technology, is seldom in question.

(Horden, 2000c, pp. 4–5)

In opposition to the worthlessness of popular music, Horden juxtaposes “the minority for whom listening to classical music is life itself” (2000c, p. 5). Horden cites a paper that purports to demonstrate that rock music promotes the growth of human cancer cells in vitro to make the point that all is not lost in the battle against rock music because as this research becomes better known “the finding that plants or cell cultures have better musical taste than people will presumably lose its shock value” (2000c, p. 7).

In his exploration of the historical use of music to enhance human well-being, it is inexplicable why Horden engages in such gratuitous and anachronistic critiques of popular music. The purpose of his investigation does not warrant this critique and it only serves to cast doubt on his historical conclusions as being fair ones rather than being motivated by a lurking philosophical agenda. He seems to want to use the historical occasion to advance a position that is discredited by researchers in a number of disciplines that include musico-logical, sociological, and psychological studies of the role of popular music in establishing identity and supporting cohesiveness for individuals and communities.

In considering different domains of practice regarding music and human well-being, Horden introduces a tripartite conceptualization consisting of “the ‘heteredox’, the ‘professional’, and the ‘historical’. The professional is mainstream music therapy in Europe and America; the heterodox represents a variety of nonmainstream currents; history is the domain to which they both variously appeal for precedent or legitimacy” (2000c, p. 8). Horden’s elaborated description of the heterodox renders it nearly identical to the new age healing practices discredited by Summer, and, as such, his consideration of that area is not particularly relevant to the present discussion.

However, in discussing the professional domain of contemporary music therapy Horden goes awry. He claims that rhythm is the fundamental component of professional practice. His support for this claim is a single quotation from Paul Robertson, who is not a music therapist: “Pieces [or music] composed to create specific physiological change … are designed to lock into the innate neurophysiological and biological rhythms that underlie the vital functions of the body” (Robertson as cited in Horden, 2000c, p. 12). In his discussion, Horden seems to be referring more to music medicine than to music therapy, a distinction explored further in Chapter 2. Also, it is not as apparent why a single quotation from a person outside the profession would have any bearing in determining the characteristics of music therapy practice.

Horden’s argument then makes a dizzying 180-degree turn. After engaging in a critique of the ability of music therapists to provide adequate descriptions, explanations, and justifications for what they do, Horden claims that “the social anthropology of music and healing” (2000c, p. 16) can assist music therapists with issues of evaluation with which they have struggled. Horden criticizes music therapists for not having written extensively about the relationship between their own social function and that of music healers in non-Western cultures, and yet his knowledge of the music therapy literature in this regard is highly deficient, not referencing any of the publications in this area that predated his own, such as Kenny (1982), Aigen (1991a), or Moreno (1995a). Moreover, his stance directly contradicts his previous point that contemporary professional music therapy has inadequate foundations. Does he really assert that applying the worldview of non-technological societies will help music therapists to formulate a more solid foundation for professional practice? His citing of music healing practices in northern Malawi that invoke notions of spirit afflictions and healing trances as potential sources of explanation for professional music therapy serves as his sole support for this highly debatable point.

Horden appears to be arguing both sides of an issue here, so much so that...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• List of Tables
• Preface
• Acknowledgments
• Introduction
• PART I What is Music Therapy?
• PART II How is Music Considered in Music Therapy?
• PART III How are the Nonmusical Aspects of Music Therapy Considered?
• PART IV How does Music Therapy Relate to other Uses of Music in Society?
• PART V How are Psycho-Biological Concerns Addressed in Music Therapy?
• PART VI How is Music Therapy Theory Developing?
• Conclusion
• References
• Author Index
• Subject Index