- Mental Health
Failure No Longer Has To Be An Option
In the past few decades, a light has developed for schizophrenics. For an extensive amount of time conventional therapy options have not helped the negative effects of schizophrenia. Schizophrenics were unable to connect with others through lack of social skills and commonly could not put their disorder into words, or even comprehend it in some cases. Often suffering from hallucinations and bullying from the voices in their head, there is no doubt how difficult it would be to form a bond with another human, nevertheless meet the standards set forth. Now there is music. Cervantes, author of “Don Quixote”, once said, “He who sings scares away his woes.” Though it may be different from person to person, humans do experience emotions and sometimes clarity through this art form. This is the light leading schizophrenics to coping with their disorder. The bond formed through therapist and patient is the top priority in cases of music therapy. Music therapy is revered as the top choice for those suffering from schizophrenia because it can improve their behavior and social interaction.
Schizophrenia is a mental disorder that affects nearly one percent of the adult population in the United States (Wu and Duan, 1). It is a common misconception that individuals will only develop schizophrenia through biological means. However, it has recently been proven that other factors can cause the development of this disorder. One leading non biological factor is child abuse, either physical or sexual. There was a mixed-gender study of both in and out patients who had the disorder, forty-five percent of these patients had suffered from either sexual or physical abuse as an adolescent (Read, Agar, Argyle, et. al, 3). John Read, a psychologist from New Zealand, mainly focused his research on the link between childhood trauma and the development of psychosis or schizophrenia. Connecting schizophrenia with childhood abuse is a relatively new study; however, it is said that the prevalence of abuse is likely to increase the positivity of developing schizophrenic symptoms. There was a study where each patient had three or more schneiderian symptoms, which are the first rank symptoms of schizophrenia, and forty-six percent of them had either childhood sexual abuse (CSA) or childhood physical abuse (CPA) (Read, Agar, Argyle, et. al, 4). Sexual abuse is the most common form of trauma leading to schizophrenia. It is not the only type there is also physical abuse, and emotional abuse, neglect, the death of a parent and bullying. Social isolation is an important factor when it comes to the development of psychosis. Those who showed a likelihood of developing schizophrenia were commonly withdrawn. If you look into the past of a schizophrenic you may discover they started to prefer to play alone at about the age of three. People throughout the world experience isolation and do not become engulfed by schizophrenia. This means biological factors are the most crucial for development of this disorder. If there is a high genetic risk of schizophrenia a stressful family environment can lend help to the development of this disorder. If there is a possibility of schizophrenia through genetic means than the individual may respond with schizophrenic symptoms if they are stressed. Said individuals may also seek out isolation and defeating-type of environments. Having schizophrenia and having the symptoms of the disorder are not necessarily the same thing. For instance, approximately eight percent of the population is affected by auditory hallucinations but do not have schizophrenia (Rosenfarb, 933). There is much more to schizophrenia than auditory hallucinations and delusions.
Those who have developed schizophrenia often experience what are called schneiderian symptoms. Hallucinations are defined by “any percept like experiences which occurs in the absence of the appropriate stimulus, has the full force or impact of the corresponding actual perception, and is not amenable to direct and voluntary control by the experiencer” (Hepworth, Ashcroft, and Kingdon, 239). Approximately seventy-four percent of those with schizophrenia are affected by auditory hallucinations, more commonly known as the voices. Hallucinations can develop to cope in instances where sadness, anger, and fear are prevalent, or through a period of social isolation. Being alone can increase the severity of these hallucinations. The patients tend to usesthis form of coping in instances where sadness, anger, and fear are prevalent. There was a study of ninety-four patients who were asked to describe their thoughts and feelings. The conclusion was that after an instance of anxiety the patient would generally experience an auditory hallucination (Rosenfarb, 933). Over time a patient will forge a bond with the voices at which point hallucinations can become destructive. Patients will rely on the voice to guide them through any predicaments that arise. This is because the voice has become the dominant party in the bond between it and the patient. This leaves the patient isolated and inferior to the auditory hallucinations. Therefore, voices serve the same function as self critical thoughts (Rosenfarb, 934).
Auditory hallucinations are not the only symptom of schizophrenia, the other most commonly known symptom is delusions. One kind of delusion that affects schizophrenics is the persecutory delusion. These delusions convince the patient that another person has intentions to harm them. The idea that someone is after them impacts their daily life in a negative way. These persecutory delusions are an extreme form of paranoid thoughts. In one case a woman thought her neighbors were spying on her and removing her organs due to the fact that she did not have a boyfriend (Salvatore, Lysaker, Popolo et. al, 247). The most common reaction to persecutory delusions is to avoid the individual they perceive will harm them, but in some cases the patient will act out with aggression. Delusions in anyone, with or without schizophrenia, usually begin when a person needs to explain something out of the ordinary. Delusions are also bi-product of the feelings of isolation because there is no one to lend the individual an insight to understand why something absurd has happened. However, if these delusions are brought about they can be positive for the patient who is experiencing it. For instance delusions can cause an individual to have higher self-esteem because they procure they are important enough to be followed by a government agency (Rosenfarb, 935). Not only do these delusions allow a patient to feel superior but it can cause them to refuse to take responsibility for their actions. There is a form of delusion called thought insertion. This phenomenon is described as “ Inserted thoughts are thoughts the patient describes as being in him but as not being his (and usually, as being somebody else’s),” (Billon, 292). This means that the patient sees some of the thoughts in their head as not theirs. Auditory hallucinations, persecutory delusions and thought insertion are not only common among schizophrenics but also the general population. However, they are not the only symptom of this disorder. Schizophrenics also have to deal with an assortment of negative symptoms. Lack of motivation to achieve a set goal and the absence of expressing their emotions are both categorized as negative symptoms. These symptoms make it hard for the patients to have what we perceive as “normal” social interaction. Negative symptoms tend to develop in cases where the individual has experienced extensive rejection or failure. Once these symptoms have emerged, a schizophrenic may be less fearful of bad feedback due to their exposure to said feedback (Rosenfarb, 936). It can be hard to try to help schizophrenic patients cope with their disorder and the side effects previously stated (auditory hallucinations, persecutory delusions, thought insertion, and negative symptoms). This is why not much progress has been made with helping these individuals.
Conventional forms of therapy lend little help to those with schizophrenia. There are currently two types of treatment programs that try and help build positive social interaction for those who suffer from schizophrenia. First is acceptance and community therapy. This therapy tries to teach individuals to approach the symptoms of their disorder without judgement. Instead of succumbing to negative symptoms they want patients to focus and be persistent in achieving the goals they have set. Then there is functional analytic psychotherapy. In this instance they try to focus on developing living skills through reinforcement of socially acceptable behaviors. “The assumption is that new behaviors shaped within the context of a genuine interpersonal relationship will be maintained in the client’s natural environment.” (Rosenfarb, 938) There are many problems associated with these forms of therapy, including the fact that once the patient left the therapeutic environment their new behaviors were not supported. This is because a behavior naturally learned functions different than those learned through therapy, which is motivated by situational means.
In the words of musical therapist Kenneth Bruscia, “Songs express who we are and how we feel, they bring us closer to others, they keep us company when we are lonely. They articulate our beliefs and values, and they bear witness to our lives. Songs weave tales of our joys and sorrows, they reveal our innermost secrets, and they express our hopes and disappointments, our fears and triumphs. They are our musical diaries, our life stories. They are sounds of our personal development.” Recently it has been discovered through modern neuroscience that music is highly complex. The components of music interact with the brain in a way that can evoke memories and emotional or behavioral responses. Musical therapists, such as Kenneth Bruscia, understand that we are the music we produce. We “weave tales of our joys and sorrows” and it is not only an emotional connection,it is a mental one. The process the brain goes through to understand musical stimuli is extensive. It involves the participation of the auditory canal, eardrum, cochlea, and auditory nerve in order to reach the brain. Once it enters the brain it travels through the cochlear nucleus, superior olivary complex, medial geniculate body, thalamus, heschl’s gyrus, planum temporale, limbic circuit, insula, superior temporal gyrus, parietal lobe, middle temporal gyrus, frontal lobe and temporal lobe. All in an effort to understand music. Now once it has traveled the brain it will have some effects on the rest of the body also. In a study to measure the changes of heart rate and the respiratory system they gauged the effects of twelve musicians and twelve non-musicians of the same age. In this study they had the participants listen to six varying musical genres which were classical slow, classical fast, dodecaphonic, rap, raga, and techno. In between each song from the different genres there was a two minute pause. This study concluded that “music with a faster tempo significantly increased heart rate, minute ventilation, blood pressure, and sympathetic nervous activity, and that music with complex rhythms increased, through insignificantly, the same parameters.” (Lin, Yang, Lai, et. al, 37) This demonstrates that music works with the brain, different sections in different ways, and that music has a profound emotional, physical, and behavioral response. Psychologists have figured out a way to allow this intricate stimulus to help those who may suffer from depression, dementia, autism, anxiety, and even schizophrenia.
Music has been known to be therapeutic almost as long as mankind has existed. You can see it evident in ancient civilizations. However in the 1920’s Australia began the exploration of music therapy by the founding of the International Society for Musical Therapeutics (ISMT). Their goal was to “advance the cause and practice of musical therapeutics, being a system of treating the sick by means of music” (Grocke, Bloch, Castle 442). Since that time Australia and music therapy have had a long standing relationship, ISMT did stop operating during the Second World War, but there have been others. In the 1940’s Americans began to investigate music therapy for themselves. Music as therapy was first introduced in Veteran hospitals and then spread to other areas such as special education and rehabilitation. Today music therapy is described as “the planned and creative use of music to attain and maintain health and well-being. It may address physical, psychological, emotional, cognitive, and social needs of individuals (and groups) within a therapeutic relationship” (Grocke, Bloche, Castle 442). To improve the probability for success therapists are encouraged to create a bond with their patients. This bond will allow the patient to be open with their feelings and thoughts. Not only will it create a flow of trust between therapist and patient but it will also give the patient feelings of support and encouragement from their therapist. One way to strengthen the bond is for the therapist to respect the musical preferences of the patient. Whichever form of music therapy the patient is a part of this bond is important. If a healthy bond is not maintained the therapy will most likely be unsuccessful.
There are two kinds of music therapy, active or receptive. Depending on the needs of the patient both active and receptive music therapy may be used. Active music therapy can involve the patient making music and music improvisation. However, it is not limited to that. It could also mean the patient composes their own music, which is different than just making music. Active music therapy can also include the performance of music. Receptive music therapy entails listening to music and reacting. There is no other participation besides the discussion with their therapist. The kind of music therapy a patient receives all depends on what fits their needs. Emphasis on playing improvisational music is sometimes better because it does not constrict a patient to music already written. The whole point is for them to express their feelings in an effort to cope with their disorder. Through the freedom of improvisation a patient can overcome trauma and explore their emotions. “Music therapy has been shown to affect the global state, general symptoms, depression, anxiety, functioning, and musical engagement.” (Hannibal, Pedersen, Hestbæk, et. al, 376) Since engaging in music is said to be more helpful, therapists generally use active music therapy or a mix between the patients. Either form could be used, it all depends on what the patient needs.
Oliver Sacks, a neurology professor in New York, captures the importance of music, specifically in therapy but applicable to everyday life, “Music can lift us out of depression or move us to tears - it is a remedy, a tonic, orange juice for the ears. But for many of my neurologic patients, music is even more - it can provide access, even when no medication can, to movement, to speech of life. For them music isn’t a luxury but a necessity”. (2007) Sacks has analyzed that music has a profound and therapeutic effect on those suffering from disorders. He realizes the exact thing that many music therapists are trying to prove through their patients. Schizophrenics need music therapy. It is the most common and most helpful form of therapy for those who are afflicted by this disorder. This is not the only disorder that benefits from music therapy. The mood of someone who is depressed can be improved when combining music with standard therapy. Those with autism are impaired in the ability to interact with others. Music gives them a voice because it can be both nonverbal and verbal. The positive effects of music therapy are immense. It allows dementia patients to decrease their amount of confusion. In some cases the effects are positive but how they occur is unknown. Some dementia patients regain parts of their memory but the how is a puzzle to therapists. Though they don’t understand, it is good to know that it can happen. The positive effects of music therapy on schizophrenics is well known and well received. It is the most revered version of therapy to help these individuals.
Music therapy is most widely used for those suffering from schizophrenia. The development of this disorder most commonly occurs through biological factors but some can be attributed to environment, including abuse in childhood or the loss of a parent. Schizophrenics endure many trials, including hallucinations and self-harming voices. They also tend to be goal-less. Isolation can increase the severity of these symptoms. Music therapy allows schizophrenics to cope with such symptoms. This new light in psychology and therapy has many benefits. They come to understand the chaos of their disorder through the active creation of music. Music therapy is still a relatively new form of therapy. It has only been used since the 1940’s in America. As time has progressed therapists have begun to understand how to use it more effectively for all disorders, including schizophrenia. For now it is more than enough to help those with schizophrenia. It means that failure no longer has to be an option. The helpless can finally achieve help, and that is what is important. Every new breakthrough that can help those who need it is a giant leap for mankind. We may not have cured schizophrenia but every new advancement could lead us in the direction of a cure. Macklemore said that “Music is therapy. Music moves people. It connects people in ways that no other medium can. It pulls heart strings. It acts as medicine.” This is the legacy of music therapy. It is a medicine, an aid to those who are suffering. There is now a light to lead us through the darkness of schizophrenia.
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