Music Therapy

Music is everywhere. From the womb, you experience sound: your mother's heartbeat, breathing and muffled voice. Growing up you sing songs and hear music being played--you may even make your own music. From the discordant, irritating noise of traffic in the street to the soft, soothing Muzak played in the elevator and at shopping malls, music surrounds you and, may impact you without your knowledge. The constant honking of a car horn will tend to irritate you; whereas, a string quartet playing classical music has the tendency to calm you. As music's calming powers are its most noticeable results, it would prove worthwhile to explore the benefits of listening to music as a means of relaxation as well as what possible applications music may have in relation to this phenomenon.

Countless studies have shown that music's relaxing effects can be seen on anyone, including newborns. Music therapist Janel Caine explored the effects of music on preterm babies and low-weight newborns as part of her master's thesis at Florida State University.1 Her research included music's effects on stress behaviors, weight, caloric and formula intake and length of hospital stay. Fifty-two preterm and low-weight babies served as subjects, and were split into control and experimental groups. The control group received normal auditory stimulation while the experiment al group received musical stimulation from a 60-minute tape containing vocal music, including children's music and lullabies, as well as the normal auditory stimulation.

The experimental group had much shorter stays in both the newborn intensive care unit and the hospital itself as well as lower initial weight loss than the control group. Resulting weight gain was also lower in the experimental group. The experimental group's formula intake was much lower than the control group, however their caloric intake wasn't significantly lower. The control group's mean stress behaviors were also much higher than those of their counterparts in the experimental group.Thus, it can be seen that the babies who listened to music became more relaxed and as a result, they left the hospital earlier and healthier than the babies who didn't listen to music.

Such relaxation from the use of music can also be demonstrated to lead to a decrease in experienced physical pain by offering a pleasant distraction which also serves as a mild sedative. Cynthia Allison Davis, a music therapist at Gaston Memorial Hospital in Gastonia, North Carolina completed a thesis while at Florida State University in which music was used in combination with relaxation techniques to help with pain and anxiety in gynecological procedures.2

Twenty-two subjects, ages 17 to 43, underwent medical treatment requiring instrumentation of the cervix by the same gynecologist: colposcopy (microscopic examination); cryosurgery (tissue removal by freezing); or punch biopsy (tissue removal by punch action instrument). The subjects were split into a control group, who received the usual medical procedure with no music, and the experimental group who were given relaxation instructions and their choice of music before the procedure.

Anxiety and pain levels were measured by observations of behavior (including movement of eyebrows, eyelids, mouth, lips , hands, feet, entire body, vocalizations, remarks, crying and perspiration), respiratory rates and pulse rates at five specific times during the procedure: after patient preparation and prior to the doctor's entrance, as the doctor entered, at the moment of the punch biopsy, during scraping or other instrumentation of the cervix and as the doctor exited. Subjects also gave input as their own experienced level of anxiety before the procedure and the level of pain experienced during and after the procedure.

The observed pain responses were consistently higher for the control group than they were for the experimental group, suggesting that the music was lowering the levels of pain in the experimental group. The greatest differences in pain between the groups were found during the cervical scraping, the most painful part of the procedure. At the moment of punch biopsy, the control group showed greater observable pain than their counterparts who listened to music during the proce dure. Overall, the control group had higher pulse rates and respiratory rates, as well. One may ask if it could be that the music serves only to distract the patient. Whether or not the listening to music simply serves as a distraction or if it actually goes so far as to trigger the brain to release pain-killing endorphins is irrelevant. Music helps lower anxiety levels, and as a result, pain seems to be lessened. In much the same way, loud noises, such as busy streets and rock concerts serve to raise anxiety levels.

Music can be of use in "canceling out" the irritating and loud sounds that we hear each day and the resulting stress caused by such sounds. In a study at the Children's Hospital of Milwaukee, Wisconsin, Jenifer Wincek, a clinical nurse specialist in pediatric critical care, worked with eight children (from ages two to fifteen) who suffered from cerebral edema.3 She concentrated on the sound range from 78 to 96-decib els in the pediatric intensive care unit (PICU), as a noise level of 70 decibels starts a stress-response initiated by the pituitary-adrenal axis. This stress response is manifested by a rise in heart rate, blood pressure, cerebral blood flow and peripheral vasoconstriction. Such stress would raise the intracranial pressure (ICP) of the children suffering from cerebral edema, so she experimented with methods of muffling the noise in the PICU. The first method tested involved placing earphones over the child's ears. In the second test, she played Bach's soothing Concerto in D through the headphones. For 15 minutes before and 15 minutes during earphone use, Wincek monitored fingertip temperature, heart rate, blood pressure and ICP.

Both interventions, she found, significantly lowered heart rate, blood pressure and ICP (ranging from a 16 to 29 percent drop) while also raising fingertip temperature. Whereas both methods worked, the music caused a temporary initial rise in he art rate, but was followed with a much greater net decline compared to the use of earphones by themselves. Again, one can see music's effects of reducing stress and anxiety levels even when the stress is caused by auditory stimulus.

Several other studies have shown music to be an effective way of relaxation to the point of sedation:

*At the Royal Victoria Hospital in Montreal, Canada, classical music has worked so well as a painkiller that many terminally ill cancer patients have been taken off analgesic drugs.4

*In a study involving patients in Poland who had severe headaches or

...