Music Medicine & Therapy

Music therapy effects and music treatment in ICU

Since there have been a few kind requests I thought I would blog a little more on some of the talks presented at Mozart and Science III – a conference on Music in Medicine and Therapy this year held in Krems, Austria. Here you can see my previous blog which gives more details about the conference itself and a summary of the first keynote speech given by Dr Julian Thayer.

There were a multitude of interesting talks at the conference and I could not possible attend them all, so many apologies to anyone not mentioned. You can find all details about the speakers here. In this blog I will mention 2 talks; one about the general effects of music therapy and one about a research study looking at music therapy use in an Intensive Care Unit (ICU).

I very much enjoyed the talk given by Suzanne Hanser who is presently Chair of Music Therapy at Berklee in the USA. Suzanne brought along a wonderful Native American wooden flute and played a little for us at the start of her talk. I can see why so many people get comfort from her music – it was very peaceful and calming, and that was only a 30 second snippet! She went on to discuss the ways in which music therapy can be effective. She focused on the way that music can provide modulation for a person’s locus of control: When ill patients can often see their condition as beyond their control and therefore experience low moods, whereas music can give them control over their environment and boost their mood state. She also commented on the effect of releasing dopamine as a result of peak experiences in music, something that has been much studied in music psychology (e.g. Salimpoor et al., 2009 and work on Strong Experiences with Music or SEM by Gabrielsson). Here is what she says on her website, which I think nicely summarises her philosophy.

Suzanne Hanser in action
Suzanne Hanser in action

Music therapy is the systematic approach to using music to meet the specific need of a person or group. Music has to come so naturally to the therapist that he or she can be totally with the client and tuned in to what he or she needs at the moment, totally empathizing and understanding not only what the person’s saying, but what they’re feeling”.

She also showed some inspirational videos of patients whose lives have been improved by the presence of music therapy. These included a video of some work with blues music in the case of a patient with depression and dementia, and a video of a patient with Parkinson’s disease whose gait seemed much improved with the help of musical guidance. The latter process is termed RAS or ‘rhythmic auditory stimulation’ and it is thought that the music can help a patient’s walking by replacing/substituting the lost internal signals for rhythm and entrainment. This was a very eye-opening talk for me and it was a pleasure to hear from such a well respected therapist.

Another talk I took notes on was about Intensive Care Unit (ICU) patients and music therapy. I am very sorry to say I did not take a note of the authors name (I seem to recall I rushed in late from the poster session), but it was a very unique and interesting case of applying music therapy so I thought I would share my notes with you. The speaker told us that life in an ICU was inherently stressful for both patient and carers: It is highly isolating and communication is difficult as a patient is invariably ventilated. Apparently, so the speaker told us, being on ventilation is like trying to breath through a toothpick. Often this stressful condition is managed through sedation but nevertheless patients who recover after long term ventilation can display symptoms of post traumatic stress disorder. There are also documented cases of the physiological and psychological impacts of sustained anxiety in this environment which have been termed ‘ICU psychoses’. The question is whether music could be a non-pharmacological based intervention to reduce these conditions?

The author has carried out a study of patient directed music (PDM) in an ICU environment– where the patient or close family/friends choose the preferred music – on three groups. One had the PDM course, one was given noise cancelling headphones (which may reduce stress in itself as ICU is very noisy with all the monitors bleeping away), and one had normal care. She reported positive effects on measured anxiety over time with the PDM compared to the controls. I think the research was in the early stages of analysis so I would look forward to hearing more results soon.