BINDING AND SOLVING
SHORT EXPERIENCE OF MUSIC THERAPY AT AN INPATIENT
DEPARTMENT OF PSYCHIATRY
Zsuzsanna HEGYI MD
Central Outpatient Department of the National Railway’s Hospital
Consulting Psychiatry
1062 BUDAPEST Podmaniczky u.109-111.
e-mail: ugring@hdsnet.hu
ABSTRACT: Music is a non-verbal or prae-verbal way of communication.
Psychiatric illnesses have a special influence upon the contact between the
mood, the emotionality and the communicative ability – frequently that is
inhibition. We attempted music to dissolve this inhibition.
We had a small, open music therapy group of hospitalized adults with
mixed mental illnesses, various ages, and phases of severity. According to
the proof of simple anonymous self-valuing tests of the twenty sessions the
number of participants with impassive and negative or tensive mood at the
beginning decreased into halves to the end. By the view of the therapist the
final conversations changed from a forced and superficial to a dissolved
and personal tone. - Here are some of the beneficial effects of music
therapy of adults with mental illnesses.
INTRODUCTION
The famous Hungarian composer and pedagogue of the XX. century Zoltán KODÁLY said:
„Music is non-replaceable spiritual food”. And: „The musical education of a child begins nine
months before the birth of the mother…” He was a real precursor of modern psychology.
A new-born baby likes a rhythm of cca. 72/min (1/a), and recognizes his mother’s favorite
music (1/b). The new-born babies like peaceful music of Vivaldi or Mozart, and they kick
about the rock music (1/c). We all receive music with our subdominant hemisphere . Further
cortical functions of this localization are creativity, and the elaboration of emotions. The
dominant hemisphere deals with temporality – the rhythm! – numerating and verbalizing.
The communication of the dominant hemisphere is speech, the communication of the
subdominant one is music. We are ready to receive sounds and music already before our birth
(2).
What happens during a mental illness?
Perhaps there is a shift in the balanced communication between the two hemispheres. The
emotions become locked in their place, they start to cause psychosomatic diseases, negative
and tensive mood seize upon, and creativity decreases. The patient has poor words to talk
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about his feelings. There is some inhibition in draft. And he suffers. We have to listen to
the signs.
We may start to dissolve these signs with music therapy.
The definition of music therapy by the definition of the Canadian Association for Music
Therapy 1994 is as follows:
Music therapy is the skillful use of music and musical elements by an accredited music
therapist to promote, maintain, and restore mental, physical, emotional, and spiritual health.
Music has nonverbal, creative, structural, and emotional qualities. These are used in the
therapeutic relationship to facilitate contact, interaction, self-awareness, learning, selfexpression, communication, and personal development.
Music is an important channel of communication. Melody, rhythm, tempo, dynamics and
tonality together become a composition about the stream of emotions. Its non-verbality is an
advantage in psychiatric illnesses by the free flow of emotional charges. In the case of a
musically well-educated person, the knowledge about the composer and his age, the structure
of the composition, the musical expression and the interpretation switch on cognitive
influence, intellectual joy too. You can enjoy new elements with making music –first of all,
with singing. Happy ages, when everybody had to sing his own song every day! Because
singing produces changed consciousness, when we can live again, we can elaborate in an
adequate and regular form our suppressed emotions, and in this new dimension we can
contact our personal and collective unconscious (3).
Many of the music therapists found music therapy consistently effective with patients
considered poor subjects for traditional verbal group therapy, those who had difficulties in
expressing their feelings, especially with chronic mental illness in hospitalized situation (4)
In this way music therapy may be used in
- Primary prevention /development of creativity, coping, communication, mental
hygiene, pedagogy: development of personality/
- secondary prevention – healing / psychotherapy, reeducation for physical, psychical
and social disturbances/
- tertiary prevention – rehabilitation /correction and after an illness, subsequent
treatment for restore/ (5)
About the method itself Froelich and Marantano write that the therapeutic approach have to
be based on some premises:
- creativity is essential for enhancing self-expression
- the importance of offering hospitalized persons alternative, effective and nonthreatening modes of communications
- play „serves as a mediating activity that we offer to create a transitional space, a
dialogue between the patient’s inner experiences and the external events of
hospitalization and medical treatment”
- creative expression and play encourage verbalization
- verbalization precedes understanding and mastery of anxiety… (6)
They found „stress-related behaviors” responding more positively to music therapy than
others, even much of the research would more appropriately be described even more as
„functional music” or „music-medicine”, than music therapy.
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The primary type of music experience there was the use of passive music clinically.
Marantano’s review indicates that in this form patients’ preference and familiarity are
considered to be important [creative-like?] factors when selecting music for patients. (6)
MATERIALS AND METHODS
At the VI. General Psychiatric Department of the National Institute of Psychiatry and
Neurology of Hungary, in Budapest some years ago we had an open music therapy group of
hospitalized adults, assembled on twenty occasions.
The 6 -10 members of the group were mostly females. That was properly the consequence of
the regular admission of patients.
Regarding their diagnosis and the phase of their illness our group was mixed – there were
patients with depressive, anxious, schizophrenic and organic psycho-syndromes. Only a few
of them were regular participants.
To passive music therapy we joined singing in the first two thirds of the 20 occasions, and we
finished the sessions with informal conversation in the last two thirds.
At the beginning and at the end of our meetings we used a simple short list of queries about
the patients’ mood – signed nameless. /fig. I./
We have taken some notes about the titles of the songs, the discs we listened to, and the short
course of our meetings.
Fig.I. The short list of mood I:before (9 members) and II:after (8 members) one of the
sessions with nameless signs.
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The songs were drawn from the richness of Hungarian folksongs.
The records varied from instrumental folk music through some pieces by Bartók, Kodály,
Brahms, Chopin, Tchaikovski and Gershwin to Mozart, Haydn, Vivaldi and J. S. Bach.
At some occasions we used little instruments of percussion /Orff/ to play together with
singing or the instrumental music.
RESULTS
At first, everything went on by the initiative of the therapeute, afterwards the patients had
wishes of their own.
The final conversations after listening music were formal, forced and superficial at the
beginning, but later they became released and familiar about the life events of the good
old days, or about actual events of our lives, in the world, or at our department.
Sometimes we had members who were not able to remain with us and left the room before the
end of the session.
Neither changes in the sessions’ structure, nor the character of music did explain the
extremities of our results. Let us show our worst and our best session (fig. II)- by number of
participants:
WORST
BEST
Positive mood Indifferent
Negative mood Summa
before
before
5
5
After


Before
1
8
after


2
0
0
0
after


0
4
before
2
0
7
9
Music
after


3
8
Chopin
Brahms
Fig.II.: Number and mood of participants of two different occasions
A summary of the 20 occasions of our music therapy session shows remarkable changes
mainly in negative and indifferent mood: (fig. III)
Number of
members /summa
of 20 occasions/
Positive mood
Quiet, relaxed,
In good spirit
Impassive
Negative mood
Negative or
tensive
Before
149
102
8
39
After
138
116
4
18
Fig.III.: Effect of the therapeutic sessions on mood
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DISCUSSION
The elements of music are original phenomena of Nature.
From the beginning of our life even intrauterine months we may learn music: rhythm and voices.
That is hatched the maternal protection and emotions. Making rhythm, crying voices with or
without melody are early experience – and modern style of singing.
Quietness of music may remind babies of intrauterine calmness, and helps adults to relax.
Dramatic style of music gives the opportunity to understand hard life events, to elaborate our
suppressed emotions in an acceptable form, and to be delivered of previous psychic force.
In case of mental illness we can focus much better on these functions of music.
Using music as a tool in curative course is ancient practice and a new scientific method.
The experience and observations by our short cycle of music therapy sessions in open group of
mentally ill adults allow us some conclusions:
 It is good practice to have little thematic group-therapy experience at a general psychiatric
department to involve patients into learning a less formal connection with each another
and the therapist - against the rigidity of social connections and way of communication.
 The dynamics of our sessions may not always assign to local inside events or the effect of
music itself. We had some meetings with same type of music with different effects.
 More than a half of patients bound off with negative + impassive mood
(= 47 = 31,5 %) changed to relaxed and positive feelings (= 22 = 15%) during our
course of music therapy.
To summarize: music therapy in group for hospitalized adults with mental illness reduces
psychical and social disturbances, induces better communication and connection facilitating of
group cohesion and gives sure and repeatable psychical and spiritual food for our patients. These
are only some examples of the beneficial effects of music therapy.
Acknowledgement: This work would not come into existence without powerful influence of Prof.
Dr.Rózsa FRATER leading psychiatrist of the VI. Department of Psychiatry at the National
Institute of Psychiatry and Neurology in Hungary, Budapest some years ago.
REFERENCES
1./a. Salk L.(1973). The role of the hearth beat in the relationship between mother and infant,
Scientific American 288, 3, 24.29. Cit: Bagdy, Emőke Prof. of Psychology and
Psychotherapy: Intrauterine roots of psychic organization of musicality.
Voice and Psyche 43-51/2002. Budapest
1/b. Chamberlain (1996) Observations of behavior before birth. In: Time to Be Born, Dream
Publishing Cracow Cit: Bagdy, Emőke Prof.of Psychology and Psychotherapy:
Intrauterine roots of psychic organization of musicality. Voice and Psyche 43-51/2002.
Budapest
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1/c. Clemens (1997) Cit: Bagdy, Emőke Prof.of.Psychology and Psychotherapy: Intrauterine
roots of psychic organization of musicality Voice and Psyche 43-51/2002. Budapest
2./
Hámori, József PhD, Prof. of Neuroanatomy, University of Medicine Budapest: Human
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3./
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Budapest
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de l’Étoile, Shannon K. PhD MT BC: Music therapy program. School of Music
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adults with mental illness. Arts of Psychotherapy 29:2/69-78/2002.
5./
Urbánné, V.Katalin MT:“They built the wall of high castle Gyimó” in: Voices and
Psyche pp.09-30./2002. Budapest
6./
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