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Cultural Foundations in Psychotherapy
Psychotherapy and Music
The neurotic is the artist manque. an artist who cannot transmute his conflict into art…
- Otto Rank
For: Dr Alan Bishop
Madhu Sameer
Track B1
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Psychotherapy and Music
Introduction
“Music is spiritual and is a doorway into that world. Its power comes from the fact that it
plugs directly into the soul, unlike a lot of visual art or text information that has to go
through the more filtering processes of the brain.” —Peter Gabriel
Human brain functions in the continuum between polarities posited by opposites, between eros and
logos, arts and mathematics, sympathetic and parasympathetic nervous system, right and left hemispheres,
conservative tendencies guided by instinctual self preservation and expansive tendencies that propel us
towards risk and novelty – to name a few. Creativity falls within the realm of the last, and demands the
courage to risk, for man’s need and his will to create transcends all other needs (May, 1976; Malchiodi,
2002). Infants as young as 4 months of age have known to react to music affectively (Zentner & Kaan,
1996, 1998). This paper discusses creativity in general and musical creativity in particular and its place in
psychotherapy.
The following explores the metaphorical and the biological relationship between creativity, music
and psyche. The terms creativity, musical creativity and musical receptivity are used interchangeably in
this document. The paper is divided into four sections. The first section explores the philosophy and
psychology of creativity. The second part details the mythological dimensions of creativity. The third
section explores the musical receptivity, its association and interaction with psychic states. The concluding
section discusses psychotherapy and its relationship with music.
Section I
Philosophy of Musical Creativity
In his thesis The Psychology of Imagination, Sartre (1991) describes “feeling” to be a process of
becoming conscious of organic changes. For Sartre, feeling, is a living state, a flux of subjectivity with
inexpressible qualities, and a string of such affective states is associated with representations of objects in
the external world. He believes that mental images represent surrounding objects and physical sensations
attenuate rather than enhance this representation. Consciousness “takes in” a sign or a symbol as a hybrid
– half meaningful, half imaginative. Restating this in constructivist language, perception hastens to fill the
gaps that our observation leaves unfilled, but perception itself leaves gaps, or distorts reality, and
imagination is then used to refine an understanding of this reality (Sameer, 2007).
Sartre (1991) believed that the illusion of immanence consists of transferring externality to the
transcendent psychic content which does not possess, but merely represents those qualities in its own way.
This mental content is used to envision a real thing that exists in the world of perception. However, all
external objects including the mental content are objects for consciousness – hence our awareness of an
awareness. This necessity of content to be represented as an object is called transcendence of
representation. When Sartre’s imaginative consciousness wanes, there remains a sensible residue which is
describable.
Sartre’s (1991) deductions are important because they provide a philosophical validation that in
permitting art to act upon us, the analogue can be reconstructed from the sensible residue without totally
forming the imaginative consciousness again. What this posits is that any forms of art - music included -
evokes imagination that reconstructs from the psychic residue. Thus Sartre appears to validate the notion
that all art provides us with a way, a means of reconstructing our psychical content not the way it is in
reality, but in the way that we experienced and perceived it.
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He further states that when the imaginative consciousness is destroyed, its transcendent function is
destroyed; no describable residue remains and we’re confronted by another synthetic consciousness which
has nothing in common with the first. We cannot get to this content thru introspection. Freud would say
that such “consciousness” may have a component in the unconscious repression. It seems highly likely that
the music breaks thru this barrier on a cellular level, and “reaches” (and stirs) the repressed imagination
and the transcendent function in the unconscious. However, in the mental image there is a psychic factor
that functions as analog, but when we wish to ascertain more clearly the nature and components of this
factor, we are reduced to conjectures. Hence the fleeting feelings evoked by images, and music, a feeling
that cannot be fully captured or quantified. Sartre’s theory of imagination provides a philosophical
grounding that attempts to explain the surreal experience of music.
Psychology of Musical Creativity
Creativity occurs in an act of encounter and is to be understood with this
encounter as its center. . .[It] is the encounter of an intensely conscious
human being with his or her world. – Rollo May
All aesthetics and creative endeavors, especially music because it can be experienced in the
absence of all other senses, appear to be psychic efforts at stimulating the imaginative functions to help the
mind engage in a harmonic communication between the external and the internal world. Rollo May
describes the creative process as an encounter between the subjective and objective poles stating that
whereas the subjective pole is easy to comprehend, the objective pole, or the external world and its reality,
are difficult to define. However, if this space enabled by creative acts overcomes the polarity between the
subjective and the objective, new symbols that reveal new meaning are born along with an emotion of
ecstasy (May, 1997). McLeish (1930), quoting a Chinese poet who said: “We poets struggle with non-
being to force it into being. We must knock upon silences for an answering music” would say that music
struggles with the meaninglessness of silences of the world in an effort to create meaning that creates a
being out of a non being. This constitutes May’s subjective projection inherent in the creative act (May
1975). However, May is careful to point out his differences with psychoanalytic projection which Freud
posited to be essentially a regression in the service of the ego, and Adler’s compensatory theory of
creativity which he finds too simplistic and reductive. In fact May(1975) associates courage, and intensity
with creative acts and echo’s Jung’s assertion that there exists a bipolarity between the conscious and the
unconscious experience. It appears as if “the unconscious takes delight in breaking thru – and breaking up
– exactly what we wish to cling to most rigidly in our conscious thinking” (May, 1975, p. 59). In the
creative space, the genius and the psychosis have been closely interlinked throughout history, and
creativity appears to carry an inexplicable guilt that causes many artists to commit suicide at the very
height of their achievement. May holds that the creative anxiety and guilt arise from destruction of the
conscious, the known, the established, the conformed in the narcissistic psychic striving towards creative
joy which is the other pole that arises of gratification inherent in creativity. The insights thru music,
according to May, create a new vividness and clarity, a “state of heightened consciousness” (p. 61)
specifically in the area that we are most consciously committed to, it “complete(s) a Gestalt” (p. 61) with
which one is struggling in conscious awareness. May further elaborates on the nature of technical and
technological creativity, stating that the latter is incumbent on the courage and the intensity of artistic
creativity for its source and nourishment. When artistic creativity is bound and limited by rationalized
logic, spatial, quantitative and/or technical creativity becomes too mechanistic and all internal and external
progress stagnates - the individual, and the world, degenerates because new ways of meeting social and
personal challenges are arrested.
Conscious problem solving involves processing information in a linear, logical fashion whereas
artistic creativity allows for unconscious intuitions that are non-linear, abstract and multidimensional.
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Musical creativity is especially important in its impact on problem solving as it combines the spatial with
the non-spatial ways of problem solving (Csikszentmihalyi, 1996)1 appearing as the fuel, the nourishment
that propels the individual, and the world, psyche towards non-linear progress. The fuel fans courage, such
courage being not only the absence of despair but an ontological necessity (Tillich, as cited in May, 1975)
that embraces the courage to live, to love, to trust, to give of oneself in illogical, uncertain and chaotic
world. Musical creativity embodies the experiences of the collective unconscious, the buried dimensions
of our being – partly genetic, partly experiential – to give us a distant early warning of our cultural future
(May, 1965). These creative endeavors thus take us beyond our own death, these symbols and forms
creating and shaping our conscience and the ethical structure of the society and the individual. Creativity
enables Masterson’s (1988) Real Self to come alive, and thru this experimentation we find new, and
constructive ways to negotiate our everyday life and the courage to move beyond trauma and loss.
Masterson (1988) implicates the loss of creativity in disorders of the self. An Object Relationist, Andre
Green (1999) attributes all creative endeavors as being of sacrificial value, an outcome of a mourning
process that seeks revival and reunion with the dead mother.
Section II
Mythological Dimensions of Musical Creativity
The interrelationship between creative process, death and regeneration is echoed in the myth of
Prometheus who stole the fire from the gods and gave it to the mortals in a creative act of civilization,
albeit incurring the wrath of Zeus, who bound him in chains, and to Mount Caucasu where the vultures
tore his liver out every morning. Our lived experiences and perverse suffering inherent in everyday
journey thru life mirrors Prometheus’ tale, especially for the sensitive-souled artists. In them, the
metaphorical liver grows back every morning as they get back in the smithy of their souls, enabling them
to resume their Calcinatio in a hope for alchemical opus. May(1975) holds that Adam and Eve’s tale is
another metaphor for development of moral consciousness - every child is born as pure Adam or Eve - the
innocence of the womb is then traded for developmental achievement. What is lost cannot be recovered
and must be endured. Like Prometheus, creative artists pass thru their days fighting with the gods of
society – the conformist gods, gods of apathy, of materialism, of exploitation, injustice and hate (to name a
few), suffering the wounds inflicted on the Self. In the myth, Prometheus is promised freedom from
eternal torture provided an immortal sacrifices his immortality in exchange. Thus the sorrow and torture of
everyday wounds, and the creativity required for negotiating existence, is intractably linked to the problem
of sacrifice, selflessness and death. That Chiron, the Wounded Healer, would be the one to sacrifice his
immortality for Prometheus, is significant in psychotherapeutic context. Chiron here symbolizes the
purpose of creative endeavors and its salvation – perhaps all creativity arises of the necessity to heal the
soul that is repeatedly wounded in its everyday journey of life. And as therapists we are destined to a role
that demands that we sacrifice the power of immortality posited by the conscious ego, in service of our
patient’s well being.
Section III
Musical Receptivity
Creating music presupposes listening to music as it is being created/played. However, this section
addresses the impact of music on those of us that are unable to create. I believe that an auditory
1
Czikszentmihalyi’s creative process folds over 5 distinct stages: 1) Preparation/immersion 2) Incubation when ideas churn
below threshold of consciousness 3) Insight – the aha moment 4) Evaluation – whether insight is worth pursuing 5)
Elaboration – translating the intuited ideas into work of music/art/innovation (Czikszentmihali, 1996, p.79-80)
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relationship with music is almost as fulfilling and follows the same philosophical and psychological rules
as creation of music entails.
In listening to music, the limits imposed by the form, and the mathematical structure of musical
composition provide a rigid container, much like the therapeutic container proposed by Winnicot. This
container serves a similar psychical function, the spatial character of external rhythms harmonizing with
the cellular circadian rhythms, resonating in synchronicity, begetting unconscious memories of mother’s
heartbeat and the safety, dependability and trust embodied in the womb, bringing order to chaos,
containing anxieties and heightening individual awareness of lack – lack that posits nothingness, as well as
lack of physical and musical freedom that resonates with and stirs the inherent repressions and other
defenses that contribute to individual intrapsychic structure - like the contained and restrictive existence in
the womb. New empirical evidence suggests that music and other rhythmic stimuli can alter mental states
in predictable ways and heal damaged brains. As this lack of freedom becomes apparent, in music and in
therapy, the conscious mind appears to constellate its opposite in order to center the self (Jung, 1974)
causing unconscious frustrations that must contribute to ego-strength – in the twilight where the sound of
musical rhythm beats against the infinite boundaries of silence, there are no obligations, no
responsibilities, no deadlines, no necessity for movement, and the psyche can remain still, linger, lounge,
and indulge unhurriedly. Romanyshyn (2007) would say that such musical interludes appear perfect
opportunities to cohere, to re-member the dis-embodied, dis-owned, dis-membered parts of our lived
experiences, the resulting insights and the psychic constellation being experienced as freeing and uplifting
– freedom from deterministic bonds causing libidinal energy to become freely available for living life.
Music therapy strives to achieve the goals of traditional talk therapy using music as a form of
communication and a tool for regression. According to Bruscia (1987), the therapist conveys empathy,
mirroring, understanding, grounding, conversation, and symbiotic oneness much the same way as
traditional talk therapy does, by utilizing musical instruments and music for intrapsychic and interpsychic
communication with the patient. This is done by improvisation – a technique similar to the unstructured
talk therapy – that involves imitating, reflecting, rhythmic grounding, dialoguing and accompanying the
patient’s melody. These aspects of music, much like traditional therapy, may enable rapport building and
psychical regression to a point of the developmental arrest, Balint’s basic fault. Music thus appears to
provide a neural pathway that short circuits cognition, moving emotional memories from the unconscious
to the conscious, from repression to feeling and sensations, often bypassing the thinking/cognitive
process. A similar containing function appears to be performed during meditation. Most forms of
meditation enables traumatic experiences stored in the unconscious to bypass cognition and manifest
themselves directly as sensations processed and expressed thru sensate bodily experience (Sameer, 2007),
the expression of these freeing up the psychic energy utilized in repressions. Though
images/visions/hallucinations may be encountered during the process of meditation, the meditators are
taught to discard the emotional and the imaginal experiences, remaining focused on the sensory
experiences. Theoretically speaking, if one were to ignore the imaginal and the emotional components of
the musical experience, these experiences may be redirected to the sensory realm, replicating results
similar to those achieved thru meditation. Only, music evokes outcomes at many more levels than does
meditation and thus may be experienced as an alternate and a more intense form of meditation, an intense
spiritual activity. Attesting to the power of rhythmic music, ritual drumming and rhythmic prayer are
found in cultures throughout the world and are used in religious ceremonies to induce trance states
(Sarmaan, 2006). Peter Gabriel, a musician and a songwriter, validates this assertion in his comment cited
in the introduction of this document (reproduced below):
Music is spiritual and is a doorway into that world. Its power comes from the fact that it plugs
directly into the soul, unlike a lot of visual art or text information that has to go through the more
filtering processes of the brain. (Peter Gabriel, n.d.)
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Since most worship and religious ceremonies are meditative in nature, the therapeutic effects of
music, including the feeling of oneness with the world that leads to unitive consciousness, appear to be
similar to those experienced during religious or spiritual activity. In essence, it is my unsubstantiated
assertion that intense concentration in music must invoke the same neural circuits that are invoked by
processes involving a close personal relationship – love, intimacy, worship, and or sacrifice – and the act
of creating or listening to music essentially parallels intimacy, even sex, with all its intensity, dedication
and other relational aspects, with similar exchange of projects and introjects, including the daimonic
nature of Eros (discussed in the following paragraph) that gets invoked in any of these process.
Creativity and Mental Health
Although creativity is often associated with psychological problems, May(1975) insists that it isn’t
necessarily a by-product of neurosis and that any such reductive conclusion would interpret all acts of
creation as having pseudo value where talent would be a disease and creative endeavors a neurosis. He
holds that all creative acts are, instead, a sign of highest emotional health that enable self actualization
(May, 1975) a thought also echoed by Abraham Maslow who attributed human creative endeavor to the
highest transcendental function that emerges only when the lower needs are satisfied, the soul’s drive to
care for itself being tested in the most adverse human conditions. However, in contradiction to epigenetic
character of Maslow’s stages, the self actualization and transcendental striving may be observed in every
aspect of human existence and all living entities, including plants, appear to be responsive to the musical
creativity and receptivity.
May(1975) further states that the daimonic is any natural function which has the power to take
over the whole person (May, 1969). It is an archetypal function of human experience that may usurp the
total personality – psychosis being the contemporary name for such daimonic possession. Psychosis has
repeatedly shown its presence in the acts of creativity. Although the power to open ourselves to Eros lies
in the diamonic realm, it needs to be directed and channeled. It is this erotic chaos, the inability to contain
and limit the experience of ecstasy that associates depression and madness with music.
Nature draws no distinction between the individual and the collective, and man loses his
individuality, his diamonic, his shadow, to the collective. The creative aspects of the shadow, the vitality,
the energizing and individualizing aspects of shadow are given up in the process of civilization and
conformity (Zweig & Wolf, 1999). Robbed of this vitality, man castrates himself by losing himself in the
herd and displacing/projecting his inherent aggression onto external objects. The daimonic remains
impersonal, and man forfeits his claim to individuality and uniqueness thus choosing to remain
anonymous, unknown – leading to loneliness, isolation and alienation. Thus the daimonic is creative and
destructive at the same time, and assails the creative minds so often. Music individualizes the collective,
and is a means by which man is enabled to own his projections and externalizations.
Section IV
Music therapy has received recognition and validity thru The American Music Therapy
Association (AMTA) founded in 1998. It is used clinically - to address psychiatric disorders, medical
problems, physical handicaps, sensory impairments, developmental disabilities, substance abuse,
communication disorders, interpersonal problems, and aging. It is also used to improve learning, build
self-esteem, reduce stress, support physical exercise, and facilitate a host of other health-related activities.
(Wikipedia, n.d.).
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Contemporary Research
The following excerpt from a research paper by Boso et al (2006) provides further insight into
physiological and neurological correlates to music:
Musical stimuli have been shown to activate specific pathways in several brain areas associated
with emotional behaviors, such as the insular and cingulate cortex, hypothalamus, hippocampus,
amygdala, and prefrontal cortex. In addition, neurochemical studies have suggested that several
biochemical mediators, such as endorphins, endocannabinoids, dopamine and nitric oxide, may
play a role in the musical experience. A growing body of evidence also indicates that music
therapy could be useful in the clinical management of numerous neurological and psychiatric
disorders. Indeed, music therapy could be effective in patients with neurodegenerative disorders,
such as Alzheimer's dementia and Parkinson’s disease, as well as in psychiatric illnesses, such as
schizophrenia, depression, anxiety and autism spectrum disorders.
Since music affects portions of the brain, and therapy is used to manage emotions and hence social
interactions of individuals, music therapy has been empirically associated with a decrease in depression,
improved mood, and a reduction in state anxiety (Nayak, et al., 2000), improvement in quality of life,
involvement with the environment, awareness and responsiveness, positive associations, and socialization
(Magee & Davidson, 2000), improvement in autism (Wigram, 2000; Magee & Davidson, 2000; Whipple,
2004; Hugh, 2008,), a positive effect on social and behavioral outcomes and encouraging trends with
respect to mood (Nayak et al., 2000), increased social interactions (Jeong & Kim, 2007) motivation and
positive emotions (Nayak et al, 2000; Magee & Davidson, 2002; Wheeler, 2003), recovery of motor
skills, walking, (Schauer & Mauritz, 2003; Schneider, Schönle, Altenmüller, & Münte, 2007), pain
reduction (Kim, 2005) and increased success rates in treatment of stroke victims (Kim, 2005; Schauer &
Mauritz, 2003; Wilson, Parsons, & Reutens, 2006; Schneider, Schönle, Altenmüller, & Münte, 2007;
Jeong & Kim, 2007). It is used in speech production in victims of Broca’s aphasia (Wilson, Parsons, &
Reutens, 2006), and enhanced mental state functioning for people diagnosed with schizophrenia (Gold et.
al., 2006). In experiments conducted at Stanford University (2006), rhythmic light and sound therapy
helped students achieve a significant improvement in their grades, and many seniors improved
performance on an array of cognitive tests (Sarmaan, 2006). Listening to music seems to be able to change
brain functioning to the same extent as medication, in many circumstances (Sarmaan, 2006). However,
despite the variety of physiological and psychological changes that occur when listening to music, broad
conclusions cannot yet be made concerning the relationship and the direction of the relationship between
music and emotion as various facilitating and mediating factors and placebo effects have been found to
counfound results (Vink, 2000; Boso et al., 2006).
Although it evokes several of the same emotions as other stimuli in life, music has been shown to
have a characteristic frequency distribution that is skewed towards positive emotions. These emotions vary
from simple to complex, from mere brain stem responses to cognitive appraisals in relation to goals in life.
(Juslin et. al, 2008; Juslin & Vastfjall, in press). Juslin et.al (2008) regard emotions as “brief but intense
responses to change in the environment featuring a number of subcomponents. In addition to emotional
response, there are self reported feelings (Gabrielsson, 2001) physiological response (Gomez & Danuser,
2007), activation of cortical as well as subcortical brain areas previously associated with emotions (Blood
& Zatorre, 2001), expression of emotion (Witvliet & rana, 2007), action tendency (Fried & Berkowitz,
1979), and regulation (Becker, 2004). They maintain that individuals listen to music for a variety of
reasons – to alleviate boredom, to relax, to get energized, to influence feelings. Yet in their research, the
listeners who had no choice but to listen to music were affected as well. However, listeners’ intent was
related to experienced states – thus calmness and contentment is associated with an intention to relax, and
sadness and melancholy is related to intention to influence one’s feelings. Hence the reasons for listening
to music will often reveal the effect that a particular piece of music has on an individual.
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Justin et al also found prevalence of musical emotions and Big Five personality factors. In their
study, “pleasure-enjoyment was positively correlated with neuroticism” - musicians tend to be more
neurotic than general population (Kemp, 1996) - and negatively correlated with openness, whereas fear-
anxiety was related to conscientiousness. They also found that emotions of happiness-elation and
nostalgia-longing were more prevalent with musical emotional episodes, while anger-irritation, boredom-
indifference and anxiety fear were more common during non musical episodes. According to Zentner,
Grandjean & Scherer (2008):
music is an effective means of mood induction in the laboratory (Vastfjall, 2002; Westermann,
Spies, Stahl, & Hesse, 1996), a means of mood manipulator to alter consumer behavior (Alpert &
Alpert, 1990; Bruner, 1990), tool or treatment of emotional disorders (Gold, Voracek, & Wigram,
2004). It is used for mood and emotional regulation (Laukka, 2007, Saarikallio & Erkkila, 2007;
Sloboda & O’Neal, 2001).
Empirical research has found that although there exists a physiological aspect to emotional
response elicited by music (Chapados & Levitin, 2008), negative emotions are rarely experienced by
music (Juslin & Laukka, 2004; Laukka, 2007; Zenter, Granjean & Schere, 2008) although they may be
“perceived as an expressive quality of music.”(Zenter, Grandjean & Schere, 2008). Active Music
Engagement treatment has been correlated with increase in effective coping behaviors for children
diagnosed with cancer.
Although more research is needed to understand how auditory stimuli is received, stored and
disseminated by the brain, given all the above, music, much like meditation, appears to be poised to
become a cost effective and easily available and admissible adjunct to psychotherapeutic interventions.
Musical interventions may be effectively used to recreate developmental trauma in the here and now, that
can then be processed in therapeutic sessions, or for stress reduction, mood disorders, psychiatric issues
and in other ways discussed above.
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