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Music Therapy and its Effects on Dementia, Brain Development, and Depression
Callie R. Donovan
Abstract
This paper addresses research regarding the effects of music on the brain and its
application, through music therapy, on dementia, brain development, and depression. First, it
identifies physical and psychological impacts of music on the brain itself. Then, it recognizes the
two types of music therapy that researchers have distinguished, active and receptive. Under each
type, this paper discusses the many techniques identified by researchers, like lyric discussion or
free improvisation. Next, it analyzes the application of music therapy to the three conditions
listed above. Lastly, the conclusion discusses the agreements between researchers and potential
applications of the specified categories and techniques and addresses the difficulties of research
Introduction
Music therapy was fostered back in the early 1900s during World War I and II. Groups of
people would gather around the veterans, singing and playing their instruments in an attempt to
lighten the mood. Eventually doctors started noticing positive changes among the patients and
discovered musics true powers. In order to explore how music therapy helps individuals in
treating symptoms of diseases, it is important to understand the many types of music therapy and
the various techniques involved. Music therapy itself is a new, up-and-coming process therefore
researchers are still developing new ways to incorporate it into treatment plans for patients,
especially since treatment is very narrowly tailored to the individual patients themselves. Music
therapy is a complex system of forms and techniques which effectively and beneficially treat
Music has a positive effect on a wide variety of physical parts in the brain, broadening
the benefits of music therapy for patients experiencing a range of conditions or diseases. For
patients experiencing great amounts of pain, listening to music has been known to elevate ones
pain threshold, thus making the pain more tolerable. In Cleveland, Ohio, four studies have taken
place, from 2001 to 2010, concluding that burn patients experienced less pain during dressing
changes when they engaged in music therapy before and amid the changes (Theiss, 2011).
"You know they're going to pull and tug and scrape, so when you don't have the music,
that's all you can concentrate on, what they're doing," said Dobbs, [a previous patient].
"But when she was there, it was a huge difference. The pain, you just sing through it. It
The pain was not only measured by the patients communication, but also by their stress
The same areas in the brain that are active in processing language, auditory perception,
attention, memory, executive control, and motor control are also all areas that music can reach
and affect (McIntosh & Thaut, 2010). For example, Brocas Area is used for processing a
problem in a sentence or a musical piece, like a wrong note in a melody (McIntosh & Thaut,
2010). Also, the auditory nerve in the brain is directly connected to the fight-or-flight area of the
brain, the amygdala. As a result, right when a person hears a sound or music, they immediately
become aroused or suddenly pay attention (Geist, 2015). This explains a music lovers instant
jerk when hearing the beginning tune of their favorite song on the radio. Additionally, through
the link between the auditory complex and the limbic system in the brain, music and sounds are
Music Therapy & Effects 4
processed at hyper speed to these areas that are used for long-term memory and emotions (Music
It has also been discovered that music can aid in the development of reading and
language skills (Ulbricht, 2013). However, Music Therapy for Dementia (2015) declares that
music activates multiple parts of the brain at once while language activates only one side of the
brain. The combination of the two increases the chance of activating more neurological pathways
that language cannot do alone. Therefore, music gives the brain the opportunity to process in
chunks which also helps increase memorization skills (NeuroRhythm Music Therapy Services,
2017). This explains why children are taught the alphabet song and how some people find it
Additionally, researchers have found that learning, keeping, and creating rhythm can all
help coordinate ones motor skills (NeuroRhythm Music Therapy Services, 2017). Through the
use of fMRIs, researchers in Finland discovered that processing musical pulses recruits motor
areas in the brain thus tying music with movement (Cramer, n.d.). The Finns research would
explain why dancers are incredibly coordinated and why people who struggle with rhythm also
Furthermore, there are several psychological effects of music on the brain as music
Services, 2017). It is observed that, by raising feel-good hormones like serotonin, music
stimulates patients to reduce negative responses, which vary depending on the condition or
disease the patient is treating. (Theiss, 2011 & NeuroRhythm Music Therapy Services, 2017).
Music Therapy & Effects 5
Instead, music activates the reward center of the brain, serving as a motivator and/or source of
encouragement (NeuroRhythm Music Therapy Services, 2017). Researchers have found many
ways to put these effects to good use, developing this new type of therapy to treat even more
Active music therapy or active doing is defined by patients physically interacting with
instruments, including singing (Crawford, Maratos, & Procter, 2011). Patients complete a
multitude of active therapy lessons in order to improve their motor skills as well as deepen the
connection with the therapist, opening up more room for conversation (Music Therapy for
Dementia, 2015). According to Crawford et al. (2011), there are three concepts within active
music therapy that each play a role in creating the overall experience for the patients. Those three
ideas include the aesthetic, physical, and relational properties of a single therapy session using
this method.
The mood of the session, referred to as the aesthetic, plays a key role in making the
patients feel comfortable sharing their thoughts and emotions. For example, using a low base
note can create suspense or using a harmonic progression can imply a direction (Crawford et al.,
2011). These particular actions help encourage patients to be more immersed in the session.
Additionally, the physical act of playing an instrument or singing allows patients to express
themselves in the set aesthetic. Researchers agree that most humans have a positive inclination
towards music, whether it be tapping the foot or moving with the beat. Therefore, diving deeper
into this feeling gives patients a sense of being part of something meaningful in the here-and-
now (Crawford et al., 2011). Lastly, the same researchers also imply the therapist plays a
Music Therapy & Effects 6
incomparable to that of talking (Crawford et al., 2011). Similarly, the co-created musical
relationship between the therapist and patient enables the latter to experience him/herself
differently (Crawford, Gold, Maratos, & Wang, 2008). While playing instruments, many times
a buzz is experienced between patients and therapists, often when they spontaneously come
together at a cadence point or even come to an end at the same moment (Crawford et al., 2011).
After the shared musical experience and trust is built, patients discuss with the therapist and
obtain a better understanding of any emotional or relational issues they may be going through
Researchers tend to agree on several of the techniques used to carry out active music
therapy, however the list continues to grow as new applications of instruments are discovered.
memories and images (Ala-Ruona et al., 2011). According to Intveen (2007), wind instruments
instill calmness, focusing on breath and thought. Percussion instruments are more physically
focused. For instance, a drum is often used to express inner pressure and feelings (Ala-Ruona et
al., 2011). And string instruments are tied to ones heartbeat and breathing as the process of
playing a string instrument bears a resemblance to the breathing process (Intveen, 2007).
Additionally, writing songs and lyrics, as well as playing pre-composed music are also options
Most research is consistent with recognizing that listening to music and playing music
have different effects on patients and therefore, provide different benefits, depending on the type
of symptoms being treated. Receptive music therapy is the process of listening to different types
of sounds and music, using them as a baseline for exploration and discussion of ones thoughts
and feelings. (All Psychology Careers, 2017). During a receptive session, patients take a moment
to pause and listen to the music. Some therapists choose to begin discussion while the music
plays in the background, others choose to start discussion after the song has finished (All
Psychology Careers, 2017). Researches recognize that this style of music therapy is focused on
the emotional well-being of patients, whereas active therapy provides many physical benefits as
well. Receptive techniques address thoughts, feelings, and emotions evoked by the music and
provide the opportunity for patients to reach states of deep relaxation and meditation (All
Psychology Careers, 2017). The same researchers claim that this type of music therapy
Psychology Careers, 2017). For example, one of Connie Tomainos (a music therapy pioneer)
Alzheimers patients who was deemed nonverbal, started speaking again in response to songs she
Researchers have tended to agree upon the types of techniques that fall under receptive
music therapy. These include but are not limited to: relaxation, lyric discussion, song
reminiscence, and imaginal listening. Within imaginal listening, there is the guided music
imaging method and the unguided method. Under the guided imaging method, patients are
presented with an image by the therapist and instructed to picture it while music is playing. This
process often incorporates some type of journey and the script that the therapist recites could be
Music Therapy & Effects 8
based on a place that is significant to the patient (Grocke, 2006). According to Grocke (2006),
this type of imaginal listening typically takes place when the patient is in an altered state of
consciousness. As for unguided music imaging, Grocke (2006) concludes that it fosters the
opportunity for patients to dig up images from their unconscious that could pertain to difficulties
they currently face in their life. Similarly, both Grocke (2006) and McCarthy (2016) support
song/lyric discussion, acting as a springboard for uncovering patient issues and feelings. The
patients seek out ways in which the lyrics parallel their own life and the discussion goes from
there.
Dementia
Researchers have found that music therapy significantly decreases aggressive and
agitated behavior amongst dementia patients (Ulbricht, 2013). This allows for the possibility of a
greater breakthrough during therapy sessions, especially since NeuroRhythm Music Therapy
Services (2017) found that music often captures and maintains peoples attention. Likewise,
musics ties to historical events or peoples own significant experiences acts as a strong stimulus
to engage responses in dementia patients (Music Therapy for Dementia, 2015). Patients are often
observed wak[ing] up when listening to familiar songs they enjoy or did enjoy previous to
Often, after months or even years of not speaking at all, they begin to talk again, become
more social and seem more engaged by their surroundings. Some begin to remember
Music Therapy & Effects 9
names long forgotten. Some even do what Alzheimer's patients often cannot do as their
In a 45-person test, the same researchers recognized that dementia patients who regularly sang
had an increase in mental acuity, meaning sharper focus, memory, and understanding. This
was measured by the Mini Mental State Examination over a four-month period (Geist, 2015).
Additionally, Geist (2015) discovered that, as soon as the majority of nursing homes in
Wisconsin began a program using personalized playlists of music during a caretakers daily
routine, the entire states use of psychotic drugs dropped. By listening to and playing music,
patients have the opportunity to remember more and even regain speech, notably due to musics
ability for the brain to process it in sections, thus making it easier to memorize (Music Therapy
Brain Development
Research has shown improvements of language, cognition, and motor control as a result
of music therapy (McIntosh & Thaut, 2010). Due to natural inflection and tone, speech naturally
has a rhythm and meter, therefore singing enhances these functions (NeuroRhythm Music
Therapy Services, 2017). Also, when patients with brain development issues learn to keep
rhythm in music, they are further improving their motor control (McIntosh & Thaut, 2010). The
act of singing relies primarily on the right side of the brain while language is primarily processed
on the left. However, the same researchers have discovered that singing has the power to bypass
injuries on the left hemisphere of the brain in order to help people produce speech (McIntosh &
Thaut, 2010). Therefore, this explains why people with lisps often sound completely clear when
singing, since the process of singing makes up for their speech impediment. Lastly, music
Music Therapy & Effects 10
therapy can activate the attention network on both hemispheres, which can help overcome
attention problems cause by a stroke or traumatic brain injury (McIntosh & Thaut, 2010).
Depression
According to Kumar & Singh (2013), music brings changes in the brain waves which in
turn create alterations in the bodily functions controlled by the autonomic nervous system. Such
functions include breathing, blood pressure, and heart rate. For patients suffering from
depression, these positive effects aid in the overall recovery process, allowing patients to turn
their focus on psychological help. Just like serotonin, music has been found to increase dopamine
levels, which influences our drive to seek awards and obtain a sense of pleasure (Kumar &
Singh, 2013). Although this research supports the use of music therapy as a form of treatment for
depression, the same researchers have found that it is most effective on patients with mild and
moderate depression rather than severe depression. Additionally, Crawford et al. (2008) found
that, as long as patients are thoroughly trained by the therapist, active music therapy can be
Conclusion
Research has illustrated the complexity of music therapy as a means for treating
symptoms of various conditions. It is not a simple system, rather it can be broken down into very
specific techniques, based on the type of recovery patients require. This could range from an
improvement of motor skills to discovering the root of issues behind sadness or anxiety. Because
music therapy is narrowly tailored and personalized to fit each individuals needs, researchers
have found it difficult to conduct random, controlled trials and develop statistical evidence
(Music Therapy for Dementia, 2015). Majority of the literature appears consistent with the
Music Therapy & Effects 11
notion that music therapy can be either active or receptive and individuals needs determine the
right course of action. Overall, most techniques revolve back to the relationship between the
therapists and patients and the patients abilities to feel catharsis. As a result of these techniques,
music therapy effectively treats symptoms and effects of dementia, brain development, and
depression.
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