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© Borgis - New Medicine 4/2010, s. 171-172
*Ewa Ogłodek, Aleksander Araszkiewicz
Music therapy and kinesiotherapy in medicine
Chair and Clinic of Psychiatry of the Nicolaus Copernicus University,
Collegium Medicum in Bydgoszcz, Poland
Head of Department: prof. Aleksander Araszkiewicz, MD, PhD
Music therapy is a promising approach widening the potential applications of psychotherapy. Music influences both psychological and physiological parameters. Music therapists primarily help people improve their observable level of functioning and self-reported quality of life in various domains (e.g., cognitive functioning, motor skills, emotional and affective development, behaviour and social skills) by using music experiences (e.g., singing, song writing, listening to and discussing music, moving to music) to achieve measurable treatment goals and objectives. Dr. Paul Dennison is an internationally known educator and authority on cognitive skills and reading achievement. A pioneer in the field of applied neuroscience, Dr. Dennison has conducted years of research at his learning centres into reading achievement and its relation to brain development. He has developed the movement-based learning known today as Educational Kinesiology. Educational Kinesiology combines intentional movement and the body?s natural intelligence to enable stress-free learning. People who use it have obtained benefit in reading, writing, mathematics, co-ordination, organisation, communication, focus and attention. The authors carried out research on the influence of music on the process of patients? rehabilitation. Introduction of music therapy and kinesiotherapy to the process of motor and psychological rehabilitation of patients makes the process more efficient and fosters quicker recovery.
The impact of various domains of art, including music, on the human psyche has been examined many times and for a very long time. Aboriginal people used music as a therapeutic measure. During ritual, religious ceremonies it was a means of releasing emotions ? ecstasy, crying, trance ? and was purifying to the psyche. In addition, people believed that it freed them from somatic diseases. The first references to the influence of music on the human body date back to the 5th century BC, to Pythagoras, who believed that external harmony expressed through music affected the creation of internal harmony of a person and shaped his or her moral attitude. Democritus pointed out the significant role of pleasure in aesthetic experiences. In addition, Plato and Socrates emphasized educational aspects of music, believing that music aroused various moral feelings ? positive and negative. In the 17th century in Italy was written the first dissertation discussing therapeutic properties of music for certain afflictions, such as podagra, subfebrile body temperature, and rheumatic afflictions. In the 19th century observations were made concerning the impact of music on the psyche, and hence its influence on blood circulation, pressure, pulse, breathing, and muscle tone (1, 2, 3). Nowadays, one pays attention to the fact that music is a type of communication, as universal as other fields of art. Music intensifies some feelings and creates conditions for transmitting and disclosing various emotional conditions. This quality of music (emotionality) is used in therapy. It provokes deeper experiencing and expression of emotions, such as laughter, crying, anger, irritation, joy, etc. (4, 5). Therefore, one may say that experiencing music enriches the internal life of a person and is a means for shaping the psyche, correction of interpersonal relations, inspiring exchange of views with other people, facilitation of the patient?s contacts with the environment (the therapist, fellow patients) and the therapist?s contact with the patient. It helps to find common language through analysis of a piece of music that one has listened to. Additionally, music supports intellectual development, and, at the same time, the sense of self-esteem, as well as better understanding of life values, its purpose and sense (6, 7).
Types of music therapy
Music therapy can be divided into:
RECEPTIVE ? it consists in listening to fragments of music pieces, discussing, sharing emotions, impressions, interpretation of symbols. It has the following roles: stimulates emotional activity; makes a person aware of various experiences (pleasant and difficult) and helps to name them; strengthens mutual contacts (the purpose connects the participants); and releases such reactions as understanding, trust, and tolerance.
Music, through common experiencing of emotions, aims at breaking some previous patterns, such as: ?I do not know?, ?I do not remember?, or ?I do not feel?. It leads to neutralization of the condition of tension ? causing muscle relaxation, maintenance of calm breathing, and regular heartbeat (8, 9).
ACTIVE ? consists in creating the so-called sound productions. We use the following elements in it: dancing (with an instrument or with a partner); motor games (change of places in a circle, rhythmic chain, music domino); non-verbal communication (conversation on instruments or in pairs, functioning as conveying emotions); pantomime with instruments (presented at, for example, a festival, kindergarten, orchestra, or family); role-play etudes (scenes of an argument, settling one?s matters at the office); elements of callisthenics (walking along a circle while beating a rhythm, changing the rhythm on a signal, changing direction, pace, beating one?s own rhythm); painting a given subject with an instrument (play a disease, your favourite animal, happiness). The tasks of active music therapy include: to encourage one to act and be creative; to create an atmosphere of understanding, acceptance, tolerance; to abreact emotions (both pleasant and difficult ones); to acquire the ability to deal with situations of exposure to unpleasant stimuli ? the ability to discuss and share impressions and opinions without judging other people (10, 11, 12).
Paul Dennison believed that many problems with intellectual and emotional functioning of a person result from bad interaction of both cerebral hemispheres and from the lack of balance between them. According to him, the brain is not a symmetrical organ ? each of the hemispheres has slightly different tasks. The left hemisphere is responsible for analysis of details, drawing conclusions and speech. The right hemisphere remembers familiar faces and controls our emotional life, and although it does not control speech, it provides our experiences with mimic expressions (in the case of left-handed persons the roles of both hemispheres are usually inverted) (13, 14, 15). A child whose development in unhindered naturally trains both hemispheres. Thanks to harmonious cooperation, the child easily absorbs subsequent skills and has a chance for full development of his or her talents. Lack of balance between the functioning of both cerebral hemispheres leads to various disorders. A child may have, for example, problems with concentration, learning to read and write, controlling his or her emotions. The name ?kinesiology? comes from the words kinesis (= Gr. movement) and logos
(= Gr. science). The method of educational kinesiology by Paul Dennison aims at simultaneous cooperation of the two cerebral hemispheres. Such a state is achieved as a result of regular exercises (16, 17) comprising a set of isometric and bioenergetic exercises. This method is supposed to: reduce tension (muscle relaxation, supply of oxygen through correct breathing); lead to better concentration; improve attention and motor coordination ? improve the possibility of learning; draw attention to proper hydration of the body; and improve functioning in situations of social exposure (especially in anxiety patients). Dennison?s method causes positive affirmations in thinking, such as: the sense of complacence, satisfaction, self-esteem, independence, freeing of the mind, self-acceptance, the sense of harmony, openness to changes, establishing new emotional bonds with other people, the sense of being appreciated by other people, and the sense of being involved in one?s life (18, 19). Regular exercises using Dennison?s method for at least 4 weeks contributes to improvement in: concentration on the performed tasks, visual-motor coordination, breathing, the ability to express oneself, reading and understanding, memorizing numbers, listening, forming thoughts, and writing. This method is particularly helpful in overcoming difficulties related to dyslexia, dysgraphia and dysorthography. It activates the left cerebral hemisphere responsible for the ability to synchronize cooperation of both cerebral hemispheres (20).
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7. Quinn DK et al.: Over the rainbow: a case of traumatic brain injury. Harv Rev Psychiatry 2010; 18(1): 56-66. 8. Anguera JA et al.: Neural correlates associated with intermanual transfer of sensorimotor adaptation. Brain Res 2007; 1185: 136-51. 9. Bauldoff GS: Music: More than just a melody. Chron Respir Dis 2009; 6(4): 195-7. 10. Mazzucco L, Borzini P, Gope R: Platelet-derived factors involved in tissue repair ? from signal to function. Transfus Med Rev 2010; 24(3): 218-34. 11. Bouteloup P: Music in the hospital. Soins Pediatr Pueric 2010; (255): 23-5. 12. Wakim JH, Smith S, Guinn C: The efficacy of music therapy. J Perianesth Nurs 2010; 25(4): 226-32. 13. Wakim JH, Smith S, Guinn C: The efficacy of music therapy. J Perianesth Nurs 2010; 25(4): 226-32. 14. Good M et al.: Supplementing relaxation and music for pain after surgery. Nurs Res 2010; 59(4): 259-69. 15. Austin D: The psychophysiological effects of music therapy in intensive care units. Paediatr Nurs 2010; 22(3): 14-20. 16. Brandes V et al.: Receptive music therapy for the treatment of depression: a proof-of-concept study and prospective controlled clinical trial of efficacy. Psychother Psychosom 2010; 79(5): 321-2. 17. Schmid W, Ostermann T: Home-based music therapy ? a systematic overview of settings and conditions for an innovative service in healthcare. BMC Health Serv Res 2010; 14, 10(1): 291. 18. Mrázová M, Celec P: A systematic review of randomized controlled trials using music therapy for children. J Altern Complement Med. 2010; 16(10): 1089-95.
19. Hodges AL, Wilson LL: Effects of music therapy on preterm infants in the neonatal intensive care unit. Altern Ther Health Med 2010; 16(5): 72-3. 20. Koelsch S: Towards a neural basis of music-evoked emotions. Trends Cogn Sci 2010; 14(3): 131-7.
otrzymano: 2010-10-07
zaakceptowano do druku: 2010-11-09

Adres do korespondencji:
*Ewa Ogłodek
Katedra Psychiatrii
ul. Kurpińskiego19, 85-094 Bydgoszcz
tel.: +48 52 585 42 60, +48 52 585 42 68
fax: +48 52 585 37 66
e-mail: maxeve@interia.pl

New Medicine 4/2010
Strona internetowa czasopisma New Medicine