Music holds a ubiquitous role in our society (McDermott & Houser, 2005) and the creation and consumption of music represents a universal human activity (Rentfrow & Gosling, 2003). Of note, the role of group music making as an evolutionary advantage has long been considered and questioned (Darwin, 1859). Specifically, acoustic synchronization likely served as a mechanism to enhance likelihood of reproductive success (Cross, 2009) and as a way to communicate, build cohesion, and foster cooperation with others (McDermott & Houser, 2005; Disanayake, 2009).
There is a long and rich tradition of using music to cultivate resilience and facilitate healing in the wake of violence and oppression. Songs and chanted hymns often accompanied physical labor endured by American slaves to coordinate movement and boost resolve to complete arduous tasks (Gregory, 1997). The introduction of communal music-making activities to adolescent groups in post-apartheid South Africa led to self-reported reduction of anxiety, stress, and fear in the wake of community violence (Pavlicevic, 1999). These historical accounts of healing with music are complimented by research demonstrating that emotional responses to music are neurally mediated, such that listening to music activates brain structures involved in reward, pleasure, and emotional processing (e.g. insula, ventral medial prefrontal cortex, ventral striatum, amygdala, hippocampus; Koelsch 2009). Further, group music making has been shown to help solidify an individual’s sense of identity within their perceived social group (Gregory, 1997). More recently, trauma researchers and clinicians have been promoting the use of alternative and less verbally-intensive treatment modalities for trauma survivors involving body movement and creative arts (e.g. Garrido, Baker, Davidson, Moore, & Wasserman, 2015; Van der Kolk, 2014; Van Westrhenen & Fritz, 2014).
Music therapy has been employed as a therapeutic intervention to facilitate healing across a variety of clinical populations. There is theoretical and empirical evidence to suggest that individuals with trauma exposure and Posttraumatic Stress Disorder (PTSD), a condition characterized by enduring symptoms of distressing memory intrusions, avoidance, emotional disturbance, and hyper-arousal, may derive benefits from music therapy. The current narrative review describes the practice of music therapy and presents a theoretically-informed assessment and model of music therapy as a tool for addressing symptoms of PTSD. The review also presents key empirical studies that support the theoretical assessment. Social, cognitive, and neurobiological mechanisms (e.g., community building, emotion regulation, increased pleasure, anxiety reduction) that promote music therapy’s efficacy as an adjunctive treatment for individuals with posttraumatic stress are discussed. It is concluded that music therapy may be a useful therapeutic tool to reduce symptoms and improve functioning among individuals with trauma exposure and PTSD, though more rigorous empirical study is required. In addition, music therapy may help foster resilience and engage individuals who struggle with stigma associated with seeking professional help. Practical recommendations for incorporating music therapy into clinical practice are offered along with several suggestions for future research.
Emotional responses to music correlate with physiological functioning, a response that has been measured by changes in the sympathetic (Iwanaga & Tsukamoto, 1997) and parasympathetic nervous systems (Krumhansl, 1997), and by changes in neural activity (Panksepp, 1997). Studies have also shown that music activates changes in the mesolimbic dopaminergic system, an area of the brain that mediates the experience of pleasure, reward, and arousal (Goldstein, 1980; Swanson, 1982; Wise, 2004). Indeed, fMRI neuroimaging studies have found that music increases the cerebral blood flow to areas of the brain associated with reward and reinforcement of pleasurable behaviors (e.g., nucleus accumbens and ventral tegmental area; Goldstein, 1980; Menon & Levitin, 2005; Swanson, 1982; Wise, 2004).
Accordingly, negative feelings such as anger, guilt, shame, fear, and anxiety may be addressed by music’s ability to activate reward pathways in the brain and suppress the release of stress hormones (Chanda & Levitin, 2013; Cepeda, 2006, Thayer & Levenson, 1983). Music may also help those with anhedonia or muted emotional experiences, as it can access neural pathways to emotion previously down-regulated in response to the index trauma (DeNora, 2002; Saarikallio & Erkkila, 2007).
Music can increase the release of endorphins to the brain, boosting positive feelings while reducing fear, self-awareness, and sadness, improving one’s overall emotional state (Chanda & Levitin, 2013; McNeil, 1995). The sense of community and group cohesion fostered in group music therapy can reduce feelings of isolation and estrangement (McNeil, 1995). Indeed, while threat of social rejection has been shown to activate neural “alarms” (e.g. the amygdala), cues that indicate safety, group care, integration, and support activate areas of the brain affiliated with reward (e.g. ventromedial prefrontal cortex and posterior cingulate cortex) and increase the production of stress reducing hormones (e.g. oxytocin and endogenous opioids; Eisenberger & Cole, 2012). Studies have also shown that engagement with music is correlated with increased self-esteem and the reduction of feelings of worthlessness, particularly in younger populations (Haines, 1989).
SOURCE: Landis-Shack, N., Heinz, A. and Bonn-Miller, M. (2017) “Music Therapy for Posttraumatic Stress in Adults: A Theoretical Review”
MUSIC PSYCHOLOGY RESEARCH
ADVISORY BOARD
Maestra Celeste S. Sanchez, MT
Ms. Maricel G. Morales, Viva Artist
Prof. Shedy Dee C. Mallari, RPm, LPT
Ms. Karen M. Atendido, Seiko Artist
Ms. Maria Blessilda M. Bascon, RN, LPT
Maestro Conrado Manuel N. Del Rosario
Dr. Peter Charles Kutschera, PhD, LMSW
Dr. Homer J. Yabut, PhD, RPsy
Prof. Alain Bernard A. Andal, MA, LPT, RPm, RGC
Pastor Robert Albios
Atty. Francisco S. Yabut
Instructor John Vernon Nuguid
Instructor Manuel S. Cordero
Instructor Dareen L. Bonzon
Prof. Jose Maria G. Pelayo III, MASD, MP-MT
Music Psychology Research (2010), Angeles City, Philippines, aims to update empirical data that is essential for music psychology research. This group of academic researchers is committed to ensure a creative and dynamic approach that utilizes music in any form of program development and psychotherapy. The Advisory Board Members are academic professionals contributing their specific expertise in Psychology, Neuroscience and Music.
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