Music Therapy— Loose Ends Galore?

REAR WINDOW
Music Therapy— Loose Ends Galore?
1.
With the cost of allopathic medical treatment skyrocketing and the much-publicised side effects
of many so-called miracle drugs, there is a boom in the
citizens’ and practitioners’ interest in alternative systems
of medicine, particularly those which are non-invasive and
side-effect free. This is welcome and should normally spur
systematic research into such systems and produce a viable,
affordable system of medicines. But what is happening
is for hospitals to climb on to the new bandwagon and
prematurely start half-baked (or even unbaked) therapies
and claim magical, painless cures for various diseases. The
latest entrant into this field appears to be music therapy.
M. Balamuralikrishna and Kunnakudi Vaidyanathan are
reported to have been doing research on music therapy for
some years though, as far as I know, they have not formally
published their findings. A leading corporate hospital is
reported to have started diploma and degree courses in
music therapy with a Sangeeta Kalanidhi as their adviser
and applied to a university for affiliation and recognition.
Significantly, they have applied to a Vedic university and
not a conventional one! Is the subject ripe for a formal
degree and professional practice?
2.
Music therapy, accordingto one Ayurveda manual,
is defined as: “The prescribed use of music and
musical interventions to maintain, restore and improve
emotional, physical, physiological and spiritual health and
well-being. [What more can one ask for!] Goals of therapy
include communicative, academic, motor, emotional and
social skills.” Another manual defines meditation music
and sound therapy as: “An automatic process of deep inner
healing set in motion through the right combination of
sounds that resonate within and fill the space around us.
Since we are the product of our environment, the sound
aims to treat the environment first by the chemistry of
sound”. We know that sound has a physics. This is the
first time we hear of a chemistry of sound whatever that
may mean!
3.
From ancient times, not only music but even
certain sounds, such as one finds in the Vedas
and the so-called magical chants, have been believed to
have special effects not only on the listener but even on
the outside world. According to the Old Testament, King
David is supposed to have cured illness by playing on his
harp. Even Hippocrates is believed to have used music
to cure illnesses. Tansen is supposed to have set things
around him on fire by singing Deepak raga and his lady
friend quenched it by singing Megh which brought rain.
Dikshitar’s Amritavarshini bringing rain to a parched
land, Punnagavarali attracting snakes, teaching Varali
alienating the disciple from the guru, and singing Ahiri
making the singer go hungry are some other examples of
the belief in the extraordinary effects of music. Lalgudi
once narrated his experience when he visited the place
where Stradivarius violins were made. The wood for
making the violins was stored in a room where music was
being constantly played in the belief that the wood would
absorb the music and become more musical in quality. In
the West, one Dr. Tomatis claimed to have discovered
the Mozart Effect— that listening to Mozart resulted in
increased brain development in children below three years
and that rats exposed to Mozart developed better spatial
reasoning power and were quicker in finding their way
out of mazes. [This should help pallavi vidwans to safely
get out of the maze of their complicated tala-s!]. He was
able to sell thousands of cassettes of Mozart to schools
though most scientists disputed his claim. A question that
remained unanswered was: if there was a Mozart effect,
why was Mozart himself sick so often?
4.
Music, it is said, has charms to soothe the savage
breast. [But it did not seem to soothe the cruel
passions in the breast of Nero who is said to have fiddled
gleefully after setting Rome on fire!]. It must also have
originated in the ‘savage’ caveman breast and probably for
that reason continues to influence emotions whether it
is to calm or aggravate them. All arts like music, dance,
painting, architecture, etc. have a common quality— that
of deep emotional experience of a collective consciousness
which is social but individually and subjectively expressed.
It is, therefore, possible to think of art therapy as a generic
class though music may be more popular and easier to
try out. It is common to special schools teaching autistic
children through music, dance and painting.
5.
Diseases fall roughly into the following kinds:
(a) surgical conditions
(b) infections
(c) systemic damage / dysfunction
(d) psychosomatic
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(e) auto-immune
(f ) degenerative
Ratipatipriya— improves married life;
Art, by its very nature, is a pleasant and deeply absorbing
activity and any such activity has always been known to have
a beneficial effect on the mind and its emotional state but
usually of a temporary, limited, tranquillising, positivising
kind. “Music influences the mind; the mind influences
the body; therefore, music influences the body”— to what
extent can this limited syllogism be blown up as a clinical
protocol for major pathologies? Music perhaps will have
some positive effect in the case of (d) above though whether
it can completely cure them is not certain. According to
some doctors, (e) and (f ) have a psychosomatic aspect and
certain mental states could make people more vulnerable
to them, but whether they can be cured by influencing the
mind once the pathology has set in is doubtful. In fact,
today even psychotherapy is no longer a lying-on-thecouch affair and is predominantly drug and high-tech
imaging-based. In other words, a music therapist could be
a therapist like the physiotherapist or speech therapist who
tries to remove or alleviate an existing limited disability
but does not seem to qualify to be called a doctor who can
totally cure major causative diseases.
Kharaharapriya— cures neurosis;
6.
Deep involvement in, and identification with, any
activity which eclipses one’s ego has a beneficial
effect on one’s mental and emotional state. In this sense,
there can be art therapy, work therapy, play therapy and
according to Osho Rajneesh, even love therapy. Playing
with the grandchild can have a magical mood-lifting
effect on any grandparent. Does it then become a fullfledged ‘grandchild therapy’?
7.
An Ayurvedic music therapy manual gives the
following list of Hindustani raga-s and their
beneficial effects / the diseases they can cure:
Ahirbhairav— indigestion, arthritis, hypertension;
Bagesree— insomnia;
Basant— gall bladder stones;
Bheemplas— hypertension, anxiety;
Darbari Kanada— asthma;
Pooria— colitis.
8.
Kunnakudi Vaidyanathan gives the following
Carnatic list:
Bilahari— creates love and affection;
Shanmukhapriya— sharpens intellect;
Sankarabharanam— soothes;
Charukesi— rejuvenates;
Anandabhairavi— reduces hypertension,
concentration;
improves
Kalyani— dispels fear (When the king of Tanjavur
wanted Tyagaraja to sing in his praise, the latter, instead,
sang, Nidhi chala sukhama and this is evidence of Kalyani
inducing courage, according to Kunnakudi).
9.
It is simple to talk of music therapy but when one
tries to pin it down in precise clinical treatment
terms, one runs into an ocean of ambiguity, such as:
l Whereas a drug is a chemically precisely defined and
standardised product, music is difficult, if not impossible
to define or standardise as a product.
l A drug has a prescribed optimum dosage arrived at
after extensive, rigorous trials. What does ‘dosage’ mean in
the case of music therapy— is it the frequency, amplitude
or timbre, or their combined package, or the duration of
play?
l Is it the ‘musicality’ which is perceived which cures, or
any specific arrangement of frequencies?
l If it is raga therapy, how is the raga to be administered—
just as a
scale or alapana, with or without gamaka-s
or embellishments, in which sthayi or speed, or as a kriti,
with or without tala?
l A drug is a homogeneous product. A raga is not so
and different sanchara-s cover different aspects of it.
Which phrases or sanchara-s would be most effective or
ineffective in particular cases?
l How well is music to be rendered— in other words,
what is the quality standard?
l A drug like penicillin will act independently of the
patient who need not know what he is taking or even that
he is taking it. Is it the same with music or should the
patient perceive the music being administered to him?
Should he also appreciate it?
l Some phrases are common to more than one raga. If
these are sung, which raga is to be taken as `administered’?
What if the therapist intends it to be one raga and the
patient perceives it as another? Will the disease be
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still cured? (T.N. Krishnan once narrated how, when
accompanying Chembai who sang Manji, he thought it
was Bhairavi and proceeded to do an elaborate Bhairavi
alapana! It took a visit to GNB for him to learn Manji).
l Should music, if classical, be in the Carnatic or
music as a specific category like a sonata or a symphony,
and immensely more complicated if he has to recognise
and appreciate it as a raga. One music therapist is of the
view that singing/ playing music by the patient is better
than passive listening. just as in other systems of medicine,
knowledge of medical science ought not to be necessary for
a patient to be cured. For music therapy to be recognised
as a scientific medical system, it should be possible for a
patient to be cured by it even if he is ‘music-deaf ’.
l Should music be vocal or instrumental or combined?
The following tips are given by a music therapist
to patients undergoing music therapy:
l There are differences of opinion about the scales of
raga-s and the notes permissible, and the raga-s of certain
kriti-s in them. Which version is to be administered?
Hindustani style?
Or, do the two have specific contexts for use?
l Like allopathic drugs, can music therapy have side effects
in certain cases? (It would be an interesting situation if a
patient were to sue the therapist on the ground that an
apaswara or sruti lapse aggravated his condition! Mark
Twain once said, “A person who treats himself by reading
a popular book on medicine may die of a misprint!”).
l Is only classical music therapeutic or are all systems
of music? Classical music, by and large is calming and
tranquillising, whereas pop systems create frenzy and
restlessness.
l Is there a standard pharmacopoeia, or is prescription too
dependent on the subjective judgment of the therapist?
10.
There are broadly two views on the therapeutic
effect of music:
(a) it is the result of certain frequency patterns which act
independently of the patient’s awareness, perception or
appreciation of the music itself; and
(b) it depends on the patient perceiving the administered
sound pattern as music.
11.
(a) above makes therapy somewhat simpler, more
objective and capable of being converted into a
standard clinical protocol once the therapeutic effects of
various sound patterns are conclusively and objectively
established and codified into a scientific pharmacopoeia.
Theoretically, even a patient in a coma could benefit from
the therapy.
12.
(b) above makes therapy complicated, as the
patient’s
perception is difficult to ascertain
and could be highly subjective and vary from patient to
patient for the same sound pattern. The matter becomes
more complicated if the patient has to ‘recognise’ the
13.
l listen with your heart and not your mind,
l do not listen to music on an empty stomach.
The first appears to make sense because it shows that it is
the emotional involvement of the patient that produces
the beneficial effects and not the technical quality of the
music. But then this places classical music below pop music
because the former does involve the mind as much as the
heart, sometimes more (as in pallavi singing). The second
tip is interesting because it is what thousands of rasika-s
seem to be following instinctively already by dividing their
time equally between the concert hall and the canteen
during the music season!
14.
points:
The above somewhat rambling survey of the
field of music therapy throws up the following
l In the context of the rising cost of allopathic medicine
and the increasing adverse side effects of powerful
medicines, research into alternative systems is generating
a lot of interest which is good provided research is done
objectively and rigorously adhering to professional
research methodological standards. An organised body
of knowledge in any field will develop only by designing
systematic rigorous experiments, accumulating and
publishing data not only on the conclusions but also on
the methodology, followed by a lot of open debate on
them and ‘attempted falsification’ (to use Karl Popper’s
phrase). It is only thereafter that a clinical protocol can
be developed or the therapy administered. The present
music therapy research and the therapy appear to be
anecdotal and perfunctory and look more like a motivated
marketing effort than based on disinterested and welldesigned research.
l Listening to music has always been known to have
some positive effect on people’s emotions and it is
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believed by some that a positive emotional state may, if
nothing else, reinforce the effects of other treatments and
conduce to better recovery as well as an enhanced sense
of well-being. Perceiving or participating in music will
probably produce this beneficial effect even more strongly.
One gets the impression that this limited, long-known
effect is now being attempted to be palmed off as a
full-fledged music therapy capable of curing even major
pathologies.
l The questions raised in para 8 above can all be answered
by extensive empirical research studies provided they are
scientifically designed and interpreted objectively with a
mindset that is fully prepared even to accept that music
therapy doe not work if that is what the results finally
show.
other academicians and medical professionals and promote
an open debate. After the 2003 conference organised by
the Bombay Shanmukhananda Sabha, there seems to have
been no further serious debate on the topic.
l Merely because the so-called music therapy research
is claimed to be done by a leading musician or a leading
hospital, it cannot be assumed that it is being done
professionally, rigorously and according to well-established
standards of empirical and clinical research. Departments
of music of universities should do a survey of the work
being done in the field of music therapy and produce a
status report and the quality of research and clinical
practice being done and their credibility.
l If a formal, recognised academic course is sought
to be offered by any institution (like the one which
offers), then a strict scrutiny of
the syllabus and the body of knowledge on which it its
claimed to be based is essential so that gullible students
are not taken for a ride.
l Individuals and institutions claiming to do research Apollo Hospital
on music therapy, instead of remaining aloof and
claiming miracle cures, should share all the data they
have collected as well as methodological information with
Melody For Malady
“Many diseases can be cured by music therapy”, a wellknown musician said the other day.
Here at last is a pill-less, painless panacea for all our
illnesses, thought the Health Minister and decided to
introduce it throughout the State in all government
hospitals. After a couple of months, the Minister contacted
the Director of Medical Services and asked, “How’s the
scheme working?”
“Well, Sir, our experience is mixed, somewhat like a
rogamalika, I mean a ragamalika,” replied the Director.
“Doesn’t matter. After all, the scheme is new and we have
to play it by ear,” said the Minister unable to resist the
temptation to show off his capacity for musical metaphor.
“Give me some details”.
“Previously doctors used to quarrel about whether to
administer penicillin or streptomycin to a patient. Now
they are quarrelling about whether to play Kalyani or
Kharaharapriya.”
“You mean finally it has turned out to be kalahapriya,”
laughed the Minister enjoying his own joke immensely.
“That’s nothing. In some cases it has ended up in our
having to play Mukhari when the patient’s body was being
removed.”
“Well, tell me how the patients are responding to the
therapy.”
“They’re proving to be equally difficult, Sir. One patient was
adamant. He wanted only Balamurali’s Todi. When we
played Semmangudi’s Todi, the patient developed severe
allergy. Immediately we had to play some pop music.”
“But why pop? I want only typically Indian music,” said the
Minister. “It makes patients temporarily deaf and partially
dazed, you know,” replied the Director.
“What happened to our scheme of introducing music
therapy on call on telephones?” asked the Minister.
“We did it, Sir, but you know how our telephones work. One
blood pressure patient dialled for Anandabhairavi but got
Ahirbhairav and his BP shot up and he had to be rushed to
the hospital.”
“What about our scheme for improving industrial relations
in factories through music therapy?” asked the Minister.
“We tried it, Sir,” replied the Labour Commissioner.
“According to the latest reports, hand-to-hand fighting has
broken out in many factories between workers belonging to
rival unions. ”
“Why?” asked the Minister in surprise.
“One workers’ union wanted songs only from MGR films
and the rival union insisted on songs, from Sivaji films.”
“Whatever the problems, at least the music therapists do
not have to pay heavy capitation fees and join a medical
college,” said the Minister.
“I am not so sure, Sir. I am told that now all the music
colleges have started collecting capitation fees.”
P.K.D.
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15.
Considering the fact that even medical
systems like homoeopathy, ayurveda and herbal
medicine are not regulated and that music therapy is noninterventional and is unlikely to produce any harmful sideeffects, there is no need for any accrediting or regulating
agency. At worst, the patient may end up with a set of notso-good musical cassettes foisted by the therapist, and at
Formal Debut
Samir (C-vocal), son of Mrs. Leela and Mr. Venkat Rao,
and disciple of Padma Sundar & Madurai R. Sundar
(Trinity Academy of Fine Arts), 29 July, 2006 in Detroit,
U.S.A.
Vishnupriya (Bharatanatyam), daughter of
Mrs.
Lakshmi & Mr. Sridhar Samudrala, and disciple of
Sunanda Narayanan (Thillai Fine Arts Academy), 12
August, 2006 in Boston, U.S.A.
Keerthana (Bharatanatyam), d/o Mrs. Selvalakshmi
and Mr. Gnanapradeepan, and disciple of Sunanda
best he may end up with an enhanced interest in music!
16.
Finally, if music therapy works, there should be
at the end of the Madras music season every
year, a tremendous reduction in morbidity in the city and
reduced attendance at the hospitals. Is this true?
P.K. DORAISWAMY
Narayanan (Thillai Fine Arts Academy), 26 August,
2006 in Boston, U.S.A.
Inaugurated
Natyaveda, a non-profit organisation that “endeavours
to showcase Indian classical dance at the highest level,”
on 9 September 2006 by Prof. C.V. Chandrasekhar
and Jaya Chandrasekhar, at Dallas, Texas, U.S.A.
Died
Well known dancer-choreographer Chandralekha, after
a prolonged illness; 31 December 2006 in Chennai.
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