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by Jenna Shin
When you’re at work, driving, studying, with friends, or even getting ready for a good night’s rest, you may find yourself playing a few of your favorite tunes on the speaker. With the COVID-19 pandemic, many individuals fought difficult times with isolation and a change in their everyday routines. Through this period of isolation, music has become a significant aspect in healing those who were suffering from stress and concern. We may often find ourselves turning on songs and feeling just a little better than before. But what really happens to our brains when we hear music? It is important to understand the process in which our brains absorb music and how it changes our emotions. Psychiatry colleague Samantha Sharma, MD, states that the process begins when “sound waves [enter] the ear, striking the eardrum, and [cause] vibrations that are converted into electric signals. These signals travel by sensory nerves to the brainstem, the brain’s message relay station for auditory information. Then they disperse to activate auditory (hearing) cortices and many other parts of the brain” (neuro.hms.harvard.edu). As these signals are activated, the brain is activated based on the type of song it absorbs and can correlate certain songs with events in their lifetime. For example, one may remember a song that their mother always used to sing when they were a child, and feel at ease when it plays. These correlations cause us to feel sensations and relive memories due to the association of the music and the mind. In addition to relating music with events in our life, research has shown that music can assist mental health struggles in various aspects and features. It can be difficult expressing our inner thoughts and emotions, especially when those around us do not expect it. Molly Warren, MM, states that musical lyrics allowed an individual to express their emotions and experiences in a more therapeutic method rather than opening up to others directly. This option allows those battling mental health obstacles to feel less of a burden while opening up about their thoughts and hardships. Another example of the bond between music and mental illness is evident in those with Alzheimer’s disease, as they are easily able to recognize songs like the alphabet. This is possible because familiar songs like these are engraved into our memory since childhood, meaning it is difficult for one to forget them even with mental struggles. It’s fascinating to learn about the functions of our brains and how simple melodies can change our mood so fast. So the next time you find yourself stressed in a hectic schedule, remind yourself to turn on your favorite playlist and relax for a moment. Sources: neuro.hms.harvard.edu
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by Sheena Bautista
The viral album, Everywhere at the End of Time, gained notability for its six-hour run time and auditory representation of dementia’s stages. Its creator, called “The Caretaker,” used samples from songs created in the Jazz Age, which was the period of time that current dementia patients grew up in. As each stage progressed, the samples of the songs would deteriorate until the final stage, where the music could no longer be recognized as a melody. The album succinctly encapsulates the ignorance, confusion, and eventual anosognosia that accompanies the loss of memories and the sense of self. Currently, the emotional impact of this album still weighs heavily upon the internet. Critics continue to praise The Caretaker for his immersive project that brought awareness to the tragedies of dementia. Thus, I wondered if music was ever used in the treatment of dementia rather than merely depicting it. Today, music is used as a tool for learning in school and is especially helpful with memorization. If these auditory tools are engaging and entertaining for school aged kids, then there is a chance that dementia patients could share similar benefits. When used in conjunction with visual and kinesthetic activities, auditory learning has lots of potential deeper memory retention and learning. One of the key aspects of dementia is the deterioration of key memories over the course of the disease’s progress. This, unfortunately, cannot be reversed as there is no cure for dementia. However, there is a plethora of treatments that patients with dementia undergo. None of them are perfect, but they are effective in ensuring that these patients remain safe and secure. Some treatments have been proven to trigger memories within dementia patients, even if they last temporarily. Although there is no cure or verified prevention system for the onset of dementia, it captivates me that there are so many ways that dementia symptoms are managed. When I discovered that music therapy was used to help patients in care homes, I was excited to see a connection between Everywhere at the End of Time and the reality of care homes. In 2013, researchers in the United Kingdom developed a study in which they tested the feasibility of a weekly music therapy program. A few significant goals included reducing the agitation of dementia patients and improving both verbal and nonverbal communication between each caregiver and the patient. Dementia patients and caretakers were gathered from two different care homes and randomized into either the experimental or the control group. In total, seventeen care home patients and ten care staff made up the participants of this program. Although the patients and caretakers were randomized, 94% of the patients were female. However, the female gender is more prone to developing dementia as opposed to males. The trial was set to run for five months, but an additional two months was added to assess post-therapy symptoms and interactions. Throughout the researchers’ study, both qualitative and quantitative data was recorded, as well as personal feedback from each willing participant. Before they carried out the study’s processes, the researchers hypothesized that if dementia patients underwent music therapy, then their caretakers could manage their severe symptoms more effectively. The music program itself was one-to-one and occurred once on a weekly basis. Each dementia patient continued their medications and received standard care in conjunction with the music therapy. All sessions lasted for thirty minutes and were recorded for additional video analysis. Before the sessions would begin, the researchers would attach heart monitors and Q-sensors to the dementia patients. Some patients were not comfortable with having these devices attached to them, but the majority were tolerant (Hsu et al., 2015). In these sessions, the music therapists were looking for both auditory and visual cues from each patient they were working with. All patients had the opportunity to sing along with familiar melodies, such as nursery rhymes. They were also given instruments to freely improvise with or explore the sounds of. At the end of the music-making sessions, the patients were interviewed through basic psychotherapy techniques to gauge communication levels and acceptability. This interview, although structured simply to make it easy for the patient to reply, assesses twelve areas of neuropsychiatric functioning. Each of the twelve areas were on a scaled spectrum. The measures included functions like delusions, hallucinations, vexation, depression, anxiety, euphoria, apathy, impulsivity, irritability, abnormal motor behavior, night-time behavior and poor appetite (Hsu et al., 2015). In total, residents were offered 22 weeks of music therapy and most of them were attended, with an average of 5 sessions being missed. Only the data from those who completed the program were taken into account for the music therapy research. A case study of an 89 year old female patient, referred to as “B,” was detailed within the article. Her behavior improved immensely from the music therapy, despite being in the later stages of dementia. This patient experienced symptoms such as hallucinations, high levels of agitation, and paranoia; thus, she posed a challenge to the caretakers whenever she was in an irritable mood. When the caretakers brought the patient to the music therapy session, her attitude was belligerent and hostile, as she refused to let them monitor her skin and heart. At times, verbal cues used by the patient’s music therapist exacerbated her mood. Despite this, playing the piano engaged the patient’s attention in a positive, peaceful way. To elaborate on this further, this music therapy session even helped Patient B to recall an old memory. As documented by the researchers, “The therapist reinforced B’s positive verbal expression by humming the tune again whilst moving her body and shoulders and smiling at B. At this time, no sign of agitation could be observed... Towards the end of the session, B appeared good spirited whilst recalling other children coming by her window calling out B’s name and asking her to play them a tune” (Hsu et al., 2015, pp. 10-11). Essentially, Patient B’s memories were stimulated positively through auditory associations and cues. The memories she made as a young girl resurfaced as a result of the piano-playing in the music therapy session. To produce such results in a patient with severe dementia is an incredible feat; even more so, considering that Patient B’s memory was from her childhood. Overall, the music therapy for all participating patients was beneficial and improved their agitation levels alongside their communication skills. In addition to this, each therapist and staff member regarded the project’s result with high remarks, claiming that they would recommend music therapy for dementia intervention (Hsu et al., 2015). Statistically, there were improvements in the symptoms of the dementia patients. Compared to the control group, who did not receive music therapy, their disruptiveness and wellbeing levels decreased over the sessions. The differences between the control and experimental groups are not astronomical, but are present nonetheless. According to some caretakers, the effects of the music therapy went beyond milder temperaments and improved motor behaviors. For some dementia patients, they became more emotionally expressive and communicated their feelings more clearly to their caretakers. Some patients communicated their memories and made connections between the music to their lives before dementia. Therefore, the results of the study support the hypothesis forming the backbone of this research. As demonstrated, music therapy positively affects dementia patients’ problematic symptoms and is a viable method for facilitating stable behaviors. It is significant to note that the experienced caretakers indicated that they gained a more thorough idea of what their patients were like as people. They were able to carry out their work on a more sensitive and personal level because music therapy elevated their relationships. Because the caretakers were more attuned to the needs and personalities of their patients, their work in soothing severe symptoms became easier (Hsu et al., 2015). This not only made their work more appealing, but more rewarding and impactful. I found it surprising that such an implementation was so effective in increasing empathy on both sides of the study. Considering how numerous care homes have been accused of neglect, it is comforting to know that these efforts are supportive of these senior citizens. It is very interesting to me how this study utilized technology and psychological techniques to create a fun environment, especially one that is adapted to elders. In the future, more people will be admitted into care homes and there will be a rise in demand for caretakers. The precedent that this study set will influence the future of psychology and neurology; upcoming treatments may become far more enjoyable than they are in the present. Moreover, the field of psychology can take a step further into pursuing different approaches to dementia. As of now, the possibility of eliminating or reversing dementia is unclear. Despite this, efforts such as music therapy show that there are ways to emotionally support dementia patients. Endeavors such as this bring significant awareness to dementia, and inspires others to see this as a relevant issue. To close on a final note, pursuing treatments that facilitate memory associations, emotional stability, and innovation will benefit dementia patients― even as their place in the world fades away. References: Hsu, M. H., Flowerdew, R., Parker, M., Fachner, J., & Odell-Miller, H. (2015). Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: A cluster randomised controlled feasibility study. BMC Geriatrics, 15(1). https://doi.org/10.1186/s12877-015-0082-4 |
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