Music for the Mind: Neurological Disorders and Music Therapy

Nearly every individual has been touched or moved by music at some point in life. Whether you have felt the unburdened freedom that comes with a sunny day, a happy song, and a fast car, or you have felt the breathtaking pain of a love song after losing someone you thought would never be gone, chances are you have experienced music as something more than the sensory perception of waves traveling through air. Music is a powerful force, and just as it can make us feel and grow, it can have profound benefits for those individuals who, without music, are unable to find peace or structure in our chaotic world.

Oliver Sacks was a famous neurologist who understood and was fascinated by the restorative and transformative power of music for his patients. Born in 1933, Sacks was most famous for the descriptive, personal way he chose to study and interact with his patients. The culmination of Sacks’ most famous patients are recounted as case studies in his book The Man Who Mistook His Wife for a Hat . In this book, we hear several reports of patients who are described as having neurological conditions that would, in many cases, be considered debilitating, but with the help of music we see how these patients are able to maintain a greater level of functionality and independence.

Patients with visual agnosia may or may not be able to draw a reproduction of what they are being shown. However, all patients with visual agnosia will be unable to name the object they are seeing.

Mr. P is the case study that brought about the title of Sacks’ book. Mr. P was a man who was perfectly healthy other than his problem with identify visual images. Mr. P had agnosia, which is an inability to interpret sensations and hence, recognize things. Mr. P couldn’t recognize faces, and he had trouble with understanding the “big picture” of a visual field. Small visual small details became prominent to him, like a persons teeth or a mole, but he was unable to construct a full picture of the face. When Mr. P took off his shoes, he was no longer able to distinguish between his foot and his shoe. He might even mistake his wife for a hat. As you might expect, Mr. P’s trouble with visual distinction created some challenges with daily tasks like eating, dressing, and washing. It’s a lot harder to put your pants on one leg at a time when you can’t be sure your pants aren’t actually a bra or a hat or your wife. Despite Mr. P’s apparent deficits, he found a unique way to navigate unconscious tasks like getting dressed. When Mr. P paired his routines with music, his ability to successfully accomplish everyday tasks drastically improved. Mr. P, who spent most of his time surrounded by ambiguous stimuli, was somehow able to make sense of his shadowy world with the help of music.

In the years since the initial publication of Sacks’ book, research surrounding music therapy as potential treatment for neurological disorders has expanded considerably. In particular, studies exploring the beneficial effects of improvisational music therapy (IMT) have been largely conducted with individuals with autism. Improvisational music therapy has taken a variety of forms during in popularization over the past decade. The characteristics of IMT that can be found universally involve principles like providing a secure environment, facilitating musical and emotional attunement, following the patient’s lead, setting treatment goals, facilitating enjoyment, and scaffolding interactions. Despite the absence of a singular IMT structure, the use of this therapy has been consistently growing and the results of this work continue to look promising.

Studies exploring the effectiveness of IMT have revealed how this therapy improves communicative and attentional behaviors, as well as, emotional, motivational, and interpersonal responsiveness in patients with autism. Traditionally, patients with autism suffer from impairments in communication and social interactions making the specific areas IMT targets particularly relevant for patients with this disorder. Though Mr. P’s “music therapy” may not have been as intentional or structured, the way he used music to compensate for what he lacked showed that we must have an intuitive sense of the peace, order, and comfort music is able to create.

Now, in addition to Sacks’ anecdotal reports of the benefits of music for patients with neurological conditions, we have a growing body of empirical evidence that is refining our understanding of this complex relationship. Studies involving patients with autism are useful to show us one of the ways music is able to transform the world for individuals who otherwise struggle with expression. However, more research will need to be done to understand the limits of musics seemingly magical abilities. How, for instance, does music help Mr. P distinguish between his wife and a hat. Music is a treatment that, in my opinion, is under appreciated. Though the study of music as therapy has grown drastically in the past few decades, the mysterious effects that music seems to have over all of us leave a lot of unanswered questions. It is clear that music can have powerful effects to organize and transform people’s lives. In the future, understanding the limits of what music can and cannot do may influence the standard way in which we treat neurological disorders.

References:

Edgerton, C. L. (1994). The effect of improvisational music therapy on the communicative behaviors of autistic children. Journal of music therapy, 31(1), 31-62.

Geretsegger, M., Holck, U., Carpente, J. A., Elefant, C., Kim, J., & Gold, C. (2015). Common characteristics of improvisational approaches in music therapy for children with autism spectrum disorder: Developing treatment guidelines. Journal of music therapy, 52(2), 258-281.

Kim, J., Wigram, T., & Gold, C. (2008). The effects of improvisational music therapy on joint attention behaviors in autistic children: a randomized controlled study. Journal of autism and developmental disorders, 38(9), 1758.

Kim, J., Wigram, T., & Gold, C. (2009). Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy. Autism, 13(4), 389-409.

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