Introduction

Remember a time when music lifted your spirits or brought you to a place of peace? Almost everyone can recount an experience with music that involved a profound shift in their emotional state. The powerful effect music has on the human psyche is well-established in the research literature and can be leveraged as a form of therapy. In general, music therapy is a therapeutic method for addressing the ‘physical, emotional, cognitive, and social needs’ of patients and clients using music as the primary medium. The goal is often to help the individual to a more peaceful or positive emotional state, which is something music does exceptionally well. A study by Swedish psychologist Alf Gabrielsson (2011) demonstrated music’s overwhelming ability to evoke positive feelings and images among listeners, a fact music therapists leverage to help their clients. Music therapy has four recognized general types: receptive music, composing, re-creative music, and improvisation. Composing therapy involves spontaneously creating music. Re-creative music therapy takes pre-existing compositions and uses them toward therapeutic goals. And in improvisation music therapy, the patient and therapist create collaboratively.

What is Receptive Music Therapy?

Receptive music therapy was initially known as passive music therapy. Later research revealed that even when a client or patient appears passive, there is extensive involvement of emotional systems and physiological systems when listening to music. Music therapists use receptive music therapy to address patient concerns and needs across three key issues:

1. pain relief and management

2. stress relief and management

3. management of psychiatric conditions and their associated symptoms

Receptive therapy sessions usually involve a board-licensed music therapist and a single patient or client. Music therapists may provide live musical renditions, so they can adaptively change the composition to meet their client’s needs at the moment or use pre-arranged arrangements. The client does not interact with the music directly; there is no composing or improvisation. The therapist may manipulate the music during a therapy session to move the patient through various affective states towards their overall goal while monitoring facial affect, body language, breathing rate, and other vital signs.

In Kenneth Bruscia’s influential 1998 book Defining Music Therapy, he outlined clinical goals for receptive music theory:

• Increase receptivity

• Evoke bodily responses

• Induce relaxation

• Further develop motor or auditory skills

• Elicit affective states (emotional changes)

• Explore ideas and thoughts of others

• Explore memory and reminiscence

• Evoke imagery and fantasies

• Develop links between patient and a specific community or group

• Stimulate spiritual experiences

It’s important to note that while music therapy is a recognized therapeutic practice involving trained therapists, there is another untrained part of music therapy that exists outside of the clinical realm. Nursing staff often play music for their patients with the same general goals: relax, calm, and distract. Because of the universality of music and the experiences music evokes, it doesn’t take a trained individual to understand what kinds of musical compositions are calming and distracting. While this does not occur in the same therapist-led format, it is nonetheless beneficial to patients, especially in a time of great need when laid in a hospital bed.

Music-Assisted Relaxation

In the 70s and 80s, musical research focused on music's physiological effects on our bodies. Measuring musical emotions in the human body revealed a wide range of affective responses to different styles and genres of music. Dozens of studies examined the effects of music on heart rate changes, biochemical processes, skin conductance, respiration, chills, and other psycho-physiological responses. These physiological responses were also tied to neurological changes, evidenced by PET, fMRI, EEG, and MEG scans. Both sides of our brains light up with activity when listening to music, including in ancient areas of the brain, suggesting a particular innate competency in musical cognition that we are all endowed with at birth.

Musical therapists started exploring how different genres and musical components affected their clients. Music familiar to an individual and in their preferred genre or style is the most effective at evoking positive affective changes. From these findings, therapists began developing individualized music programs. Before a session, clients are asked about their favorite kinds of music and what they would like to get out of the session.

Music-assisted Relaxation Sessions

Music-assisted relaxation is a specific branch of receptive music therapy, helpful in treating adults and children that are overly stressed. The stress may be induced by hospitalization, work, school, or other situations. Music therapists often assist patients in coping and relaxing in the following cases:

• Labor

• Before surgery

• Intensive Care

A music-assisted relaxation therapy session would start in a quiet environment with low lighting and a comfortable mat or chair. Music therapists evoke a warm, calming tone with a soft volume and little inflection to calm the client and build trust. The therapist might lead the patient through breathing exercises before the music segment of the session started to help patients regulate their breathing and ask clients to close their eyes for the best effect. Children respond especially well to story-telling during their sessions.

Music Choice for Relaxation

Then the music therapist would choose music based on the client's personal familiarity and preferences. Music that promotes relaxation most commonly has the following features:

• Stable tempo

• Gradual changes in volume, rhythm, pitch, etc

• Consonant harmonies

• Predictable cadences, structure, and form

• Gentle timbre and consistent texture

• Few changes in dynamics

While instrumental is a popular choice for relaxation, it isn’t the only style that is well-suited to this form of therapy. AllMusic is a massive online music database with over three million cataloged albums. You can use AllMusic’s Advanced Music Search to sort music by genre & style, mood, or themes if you want to find music to suit your particular mood (or the mood you’d like to be in). Using Advanced Search, you can see artists like Elvis Presley, Neil Young, Nat King Cole, Bob Dylan, Fred Astair, Frank Sinatra, and Willie Nelson are commonly referenced as calming or relaxing. These artists would be well-suited for music therapy sessions for relaxation.

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Music and Imagery

In addition to psych-physiological and neurological changes, music also evokes vivid imagery. The Music and Imagery branch of receptive music therapy uses this imagery to reach therapeutic goals, especially to soothe or distract from clinical pain. Clinical situations where Music and Imagery are commonly used include childbirth, following surgery, and during debridement procedures.

A music therapist would again select musical compositions familiar to the patient but more geared toward distraction and evoking imagery. Receptive music therapy sessions for stress relief and relaxation usually involve music with minimal or gradual changes and very predictable cadences, form, and structure, but pain relief sessions using imagery have a slightly different goal and hone in on different musical elements. The idea behind Music and Imagery is to distract the patients by helping them imagine other places, events, or imagery. Music therapists have found that the best music for this purpose has more variability and dynamic changes and is less predictable than music strictly for relaxation and stress relief:

• Tempo may vary

• Harmonic structure with more variance and possible dissonance

• Combination of legato, staccato, pizzicato

• More dynamic changes

• Less predictable in melodic, harmonic, and rhythmic features

Music that evokes imagery may be described as ethereal, cerebral, dreamy, spacious, or atmospheric. Plus, there is a strong component within the brains of patients for music that does not fall within those categories but is strongly linked to specific memories. Music with descriptive lyrics can be compelling in evoking vivid imagery for this therapeutic method. Here are some of the artists that are linked with dreamy and atmospheric moods:

During one of these clinical sessions, a music therapist may present a starting image, often nature or other calming scenes. Throughout the session, the therapist prompts the patient about the imagery they see in their mind's eye. This mental exercise and imagery help distract the patient from their pain and provide a mental escape. It’s important to note that the overall success of this method may be limited by the creative capacity of the patient to create images in their mind. Ability to create images in the head could be greatly increased by using psychedelics, especially LSD.

Psychedelic-assisted Music Therapy

The effects of psychedelic-assisted music therapy are more tangible because LSD increases emotional response to music, and psychedelics can be an especially powerful mediator for patients that lack the creativity to participate in the imagery-led sessions. Other substances that increase the visual perception of music are marijuana, psilocybin (magic mushrooms), and some plants like melissa.

These substances contain psychoactive properties that awaken the brain, activating new areas. The combination of music and psychedelics help carry listeners to new realms of awareness, opening new lines of thought and allowing their inner selves to take an uninhibited look at their life and issues. Patients often report life-altering or spiritual experiences when led through psychedelic-assisted music therapy with trained therapists. It can be a fantastic tool for treating depression and PTSD, with patients reporting a renewed lease on life or a deeper understanding of the world.

Guided Imagery and Music (Bonny Method)

The following method of receptive music therapy is Guided Imagery and Music (GIM), also known as the Bonny Method. GIM was developed by a Dr. Helen Bonny in the 1970s. This specialized form of therapy evokes imagery through a guided experience while the participant is in a deeply relaxed state.

GIM has proved an effective treatment for various psychiatric conditions and other illnesses, including depression, PTSD, dissociation, cancer, hypertension, rheumatoid arthritis, and cardiac surgery. Following GIM sessions, patients report lessened depression, reduced mood disturbances, lower levels of fatigue, and lower cortisol levels. These improvements in symptoms resulted in a higher quality of life for patients with psychiatric conditions. These changes aren’t superficially transient and remain reduced for 7-8 weeks, demonstrating the Bonny Method’s long-term therapeutic effects. It’s believed that GIM is effective because it draws a person to realize their inner strength and resourcefulness.

There is not a specific musical style best suited for the Bonny Method, although it’s common for selections to be similar to the two other methods. It’s a highly individualized form of therapy, so the musical selections are personalized.

A Guided Imagery and Music Session has four primary segments:

1. Pre-Music Discussion

The therapist and client have an open discussion about the patient's issues and concerns and decide the specific focus for the session, including the Music and Imagery component.

2. Relaxation Induction

The musical therapist helps the client reach a state of deep relaxation. The client is in a reclining position or can sit on a mat if preferred. This segment will continue until the patient is sufficiently relaxed. A focus image may be used to encourage relaxation and focus.

3. Guided Listening + Imagery

Depending on the client's needs, the musical therapist plays a pre-arranged program or creates a program spontaneously. Dr. Bonny herself created 18 programs that are 30-45 minutes in length to cover a variety of goals. As the patient listens to the music, the therapist intervenes throughout to facilitate a deepening of the client’s experience. The music therapist does not try to direct the patient to specific thoughts or outcomes but asks non-directional questions like ‘How does that feel for you?’

4. Closing the Session

As the music closes, the therapist will no longer verbally intervene. They want the client to draw the imagery to a close by themselves. When the music is over, the two will discuss the session, but the therapist is careful not to interpret the imagery the patient describes because that would contaminate their mental ideas about the experience. Patients report that the sessions elicit a range of transpersonal experiences, including past life imagery, images of light and energy, positive emotions, spiritual experiences, insights into wisdom, and feelings of unity with the human experience.

In Conclusion

Even within a single category of music therapy, receptive music, there is an incredible variety in how humans perceive and experience emotions and affective changes through music. Musical therapists are trained to care for the well-being of their patients and lead them to a positive experience using the moving nature of music. Therapists report the best results when selecting music familiar to the patient or within their favorite genres. Musical therapists can attempt to alleviate pain, reduce anxiety, or reduce symptoms of physical ailments or psychological conditions.

In two receptive music methods, Music and Imagery and GIM, imagery is incorporated in the therapeutic sessions to distract patients or lead patients through an emotional journey. The most impressive thing about receptive music therapy is the clear clinical benefits realized without needing expensive medicines. For patients where traditional receptive music therapy has had limited success, psychedelic-assisted music therapy can open new doors and alleviate much of their mental distress and barriers. The power of music and imagery can transform the human brain and emotions, turning painful, confusing, or anxiety-inducing situations into calming, positive, and peaceful moments.