Music Therapy

Music Therapy Today
a quarterly journal of studies in music and

music therapy from the Chair of Qualitative
Research in Medicine
Volume VII, Issue 4 (December 2006)
David Aldridge & Jörg Fachner (eds.)

Chair of Qualitative Research in Medicine
Published by MusicTherapyWorld.net
UniversityWitten/Herdecke
Witten, Germany
ISSN 1610-191X
Editor in Chief/Publisher
Prof. Dr. phil. David Aldridge
Managing Editor
Dr. Jörg Fachner, joergf@uni-wh.de
Translation and editorial assistance

Christina Wagner, cwagner@uni-wh.de
Book review editor and dissertations archive

Annemiek Vink, a.c.vink@capitolonline.nl
“Odds and Ends, Themes and Trends”

Tom Doch, t.doch@t-online.de
International contacts
Dr. Petra Kern, PETRAKERN@prodigy.net
Scientific Advisory Board

Prof. Dr. Jaakko Erkkilä, University of Jyväskylä, Finland
Dr. Hanne Mette Ridder, University of Aalborg, Denmark
Dr. Gudrun Aldridge, University Witten/Herdecke, Germany
Marcos Vidret, University of Buenos Aires, Argentinia
Dr. Cochavit Elefant, Bar-Ilan University, Israel
Prof. Dr. Cheryl Dileo. Temple University in Philadelphia, USA
Prof. Dr. Marlene Dobkin de Rios, University of California, Irvine,
USA
Dr. Alenka Barber-Kersovan University of Hamburg, Germany
Prof. Dr. Tia DeNora, University of Exeter, UK
Dr. Patricia L. Sabbatella, University of Cadiz, Spain
ii
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Table of contents
Music Therapy Today i

a quarterly journal of studies in music and music therapy from the
Chair of Qualitative Research in Medicine i
Volume VII, Issue 4 (December 2006) i
Table of contents vii

Editorial Music Therapy Today Vol. VII, Issue 4 (Online December
22, 2006) 775
Fachner, Jörg 775
Research in practice 781

Smeijsters, Henk 781
Beyond Body, Beyond Words: Cognitive analytic music therapy in

forensic psychiatry - New approaches in the treatment of Personal-
ity Disordered Offenders 839
Compton Dickinson, Stella 839
Melody and Rhythm – ‘Indianness’ in Indian music and music ther-

apy 876
Sairam, T.V. 876
If you can’t beat them, join them! Long-term music therapy with an
“autistic savant” man 892
Graham, Janet 892
Just sing… 913

Boymanns, Britta 913
vii
„Painting is good for your soul!“ 932
Merz, Regine 932
Report on a research meeting 2006 in Berlin: “Music Therapy as Ap-

plied in Neurology” 939
Pfeffer, Karolin 939
“My Top Ten” 944

Aldridge, David 944
Odds and ends - themes and trends 947

Tom Doch 947
viii
Music Therapy Today
Vol. VII (4) (December)
Editorial Music Therapy

Today Vol. VII, Issue 4
(Online December 22,
2006)
Fachner, Jörg
Welcome to the new issue of „Music Therapy Today“!
In our last issue for 2006 we present articles on the debate about music
therapy and evidence-based research, Indian music therapy, a case study
with an autistic person, about group singing in a psychiatric day clinic
and a developing study on HIV and art therapy.
PDF SITE INDEX Since January 2005, we have numbered pages consecutively in Music
Therapy Today. The intention was to offer an opportunity to cite articles
or quotes from “Music Therapy Today” by page numbers. Now we have
managed to build a PDF Site Index of Music Therapy Today. All past
issues (eBooks as PDF) and articles (single PDFs) from 2005 and 2006
are available as references for download from this page. This page will
be updated after release of a new issue. Be aware that some PDF-Files,
like conference proceedings, will be large and may take time to down-
775
load according to your Internet connection and the limits set by your
Internet provider.
THE ISSUE Our first article comes from Henk Smeijsters on “Research in practice”.
This article continues a series of articles discussing the pros and cons of
integrating evidence-based ideas into the practice of researching and
doing music therapy. “This article illustrates, that, with respect to
research, there are many ways to reach evidence, and also, that there are
different sorts of evidence.” As David Aldridge has pointed out in several
other publications since the late 1980’ that music therapy needs its own
research methodology, Smeijsters also stresses the need for reflective
practitioners to develop - as their own peers - suitable approaches to
research. For the original idea see Aldridge (1996; 2004). “The profes-
sional himself does the road to science of the profession. The investment
in professionals’ research in practice is the motor of knowledge-produc-
tivity that bridges the theory-practice gap.” This article is based on a
chapter of a forthcoming book by Henk Smeijsters on research into art
therapies.
Stella Compton Dickinson leads us into her work in Rompton Hospital in

the UK. Those who ever had the chance to visit or work in a high-secu-
rity hospital in forensic psychiatry know how hard it is to get permission
to publish in-depth work done with a client. Her article “Beyond Body,
Beyond Words: Cognitive analytic music therapy in forensic psychiatry -
New approaches in the treatment of Personality Disordered Offenders”
presents a case study of a man with psychopathic and borderline person-
ality disorders. “The aim was to provide a twenty-four-week time-limited
Editorial Music Therapy Today Vol. VII, Issue 4 (Online December 22, 2006) 776
psychotherapy intervention that included attuned musical improvisation

as a central component. The treatment has been developed with personal-
ity-disordered patients who have offended and who are in high-secure
hospital treatment. The author considers the phenomena of dissociation
in relation to the aetiology of self-states (Ryle and Kerr 2002) and with
reference to the creative arts. Within the therapeutic context she consid-
ers the potential of music as a mediating tool for emotional regulation in
the transition between self-states.”
The article “Melody and Rhythm – ‘Indianness’ in Indian music and

music therapy” by T.V. Sairam continues another series of articles pub-
lished in “Music Therapy Today” by scholars from India and their reflec-
tion on the richness of Indian music used in a therapeutic context. “The
3000-odd year old Indian genre of music is basically melodic, is based on
the principle of resonance, sruti and rhythms, laya, regarded as ‘mother’
and ‘father’ respectively. The Indian system of music is an individualis-
tic, subjective, and spiritual art, aiming not at symphonic elaborations but
at personal harmony with one’s own being. Sruti, the very backbone of
the Indian music, plays a vital role in rendering a specific identity and
individuality to a raga that distinguishes it from an ocean of ragas.” T.V.
Sairam who works at the Nada centre for music therapy in Chennai is an
expert on Indian music and here he shares his long experience and
knowledge.
The paper “If you can’t beat them, join them! Long-term music therapy
with an “autistic savant” man by Janet Graham is based closely on a pre-
sentation given at the 3rd International Symposium of Nordoff - Robbins
Music Therapy, which was held in Germany in June 2006. It focuses on
stages in the music therapy process with a middle-aged autistic man with
moderate learning disability and savant calendrical skills. He had become

very ritualistic and inflexible over the years and this impinged not only
on his own social life, but also on that of the sister with whom he lived.
Reference is made to parallels between his progress in music therapy and
changes in his social skills as perceived by his sister, friends and day cen-
tre staff.
Another article based on a presentation at the 3rd Nordoff/Robbins Music

Therapy Symposium comes from Britta Boymanns. The article “Just
sing…” will give a view into seven years of music therapy at the Day
Clinic for psychiatry and psychotherapy in Witten. Her experiences from
the past seven years of practical work have shown that singing simple
songs and canons can have a deep therapeutic effect at various levels of
human existence, and encourage social growth in the community. To do
this, it needs an exact choice of songs and preparation of the material, a
free but friendly inviting approach towards individuals, exact and tar-
geted musical-artistic work on the songs spiced with much humour and
joy – and an openness towards all dimensions of humans and music. Just
sing…
Regine Merz, a certified art therapist and leading researcher in this study
report “Painting is good for your soul!”, intends to provide HIV and
AIDS patients as well as breast cancer patients with art therapy. In her
current doctoral studies at the University Witten/Herdecke she addresses
the question whether HIV-specific parameters are visible in patients’
paintings, and how these may be interpreted.
On 19 November 2006, the IMB, International Music Therapy Institute

Berlin, arranged a research meeting on the subject “Music Therapy as
References
Applied in Neurology”. Karolin Pfeffer reports on presentations by

Mechthild Jahn-Langenberg, Hans Ulrich Schmidt Jane Edwards, Wolf-
gang Schmid, Kathrin Mertel, Anna Hinkelmann, Stefan Mainka, and
Annkathrin Pöpel.
David Aldridge and Lutz Neugebauer have initiated a new research

project called “My Top Ten”. “My Top Ten” is an international research
project that will gather qualitative information about what music people
aged 60 years and over remember and how that is associated with events
in their lives. Reminiscence is seen as an important factor in various ther-
apeutic interventions and this project will concentrate on musical remi-
niscences. Similarly, giving voice to the elderly is seen as an important
factor in establishing the worth of the elderly in modern western industri-
alised societies.
And finally, Odds and ends presented by Tom Doch.
Merry Christmas and a happy new year
Jörg Fachner
References
Aldridge, D. (1996). Music therapy and research in medicine - from out

of the silence. London: Jessica Kingsley Publishers.
References
Aldridge, D. (2004). The reflective practitioner in a community of

enquiry: case study designs. Journal of Holistic Healthcare 1(2), 19-23.
Music Therapy Today
Research in practice
Smeijsters, Henk
Smeijsters, H. (2006) Research in practice. Music Therapy Today (Online 22nd

December) Vol.VII (4) 781-838.
‘The novel The curious incident of the dog on the Night-Time

tells a lot more on Asperger’s syndrome than the case descriptions
in the medical textbook DSM-IV.’
Douwe Draaisma (2004)
Abstract
This article1 illustrates, that, with respect to research, there are many
ways to reach evidence, and also, that there are different sorts of evi-
dence. The road to science for the Arts Therapies requires research on
the full breadths of the spectrum, from systematic case studies to RCTs. It
is important that Arts Therapists and Arts Therapeutic researchers reflect
on the typical characteristics of each research paradigm, research type
and research method and select what is appropriate with regard to the
particular research question. Questions rather differ. Finding out
whether a certain intervention has a particular effect with a large group
of clients differs from wanting to know which change occurs at which
moment by which interventions in the treatment of this individual client.
1. This article is based on a chapter in the forthcoming book ‘Research in the arts thera-
pies’, a translation of ‘Praktijkonderzoek in vaktherapie’ (2005a), with chapters on
research in drama therapy, music therapy, art therapy and dance/movement therapy.
781
Smeijsters, H. (2006) Research in practice. Music Therapy Today (Online 22nd December) Vol.VII (4) 781-
838. available at http://musictherapyworld.net
Research in practice remains close to questions encountered by Arts

Therapists in their daily practice. It concerns questions Arts Therapists
have about their lived experience of acting due to the complexity and
variability of practice. By carrying out research in practice that links up
with those questions, evidence evolves; evidence that enables the profes-
sional to proceed and that makes explicit what often remains implicit and
unsaid. What is explicit can be communicated, can be criticised and
tested. The professional himself does the road to science of the profes-
sion. The investment in professionals’ research in practice is the motor of
knowledge-productivity that bridges the theory-practice gap. Research in
the Arts Therapies should lead to ‘knowledge’ in which neither the ‘art’,
nor the ‘subject’ of therapist and client have been lost.
Introduction
Douwe Draaisma’s quote illustrates that a narrative description of a phe-
nomenon can tell a lot more than scientific analysis. Theoretical knowl-
edge does not always lead to understanding and removes professionals
from the ‘lived experience’. This originates mainly in the fact that theo-
retical knowledge is of generalising nature and abstracts experiences. The
experience from which the particular knowledge is deduced, however, is
concrete, variable, rich in nuances, knows width and depths. A novel
does not explain such an experience by the means of general regularities,
but describes the phenomenon in a way that the reader becomes
immersed in the experience. However, the question whether abstract
knowledge is worth more than concrete knowledge is an absurd question.
Both forms of knowledge help us to understand reality.
Social science, as it has developed from traditional physical scientific

thinking, enables us to describe phenomena systematically and objec-
tively, to standardise, classify and generalise. The DSM-IV serves as a
collection of items that tells us what a depression is. A questionnaire used
to measure depression helps us to grasp this phenomenon. However,
sometimes it is only then that we understand, if we enter into the role of
Introduction 782
the client, even more, if we have experienced something similar and enter
the role of the client based on empathic counter transference. Objectively,
we know things, and subjectively we comprehend and feel what it is
about.
In research on therapy, this difference in approach is expressed in differ-

ent research paradigms that are at times specified as ‘quantitative’ and
‘qualitative’, at times as ‘positivistic’ and ‘constructivistic’. A quantita-
tive researcher searches for general regularities that are generally valid. A
qualitative researcher seeks to describe the complexity, the subtle differ-
ences, width and depth of a concrete experience. A quantitative
researcher unravels, the qualitative researcher tells a story.
In addition, those approaches are expressed in different opinions on evi-

dence: on the one hand the Evidence Based Medicine (EBM), which puts
the emphasis on controlled experimental research. On the other hand the
Evidence Based Mental Health (EBMH), with a strong emphasis on sys-
tematised experience knowledge.
This article pursues the question how practice-relevant knowledge can

evolve through research. Practice relevant knowledge is knowledge that
improves, renews and develops professional competences of acting. Or,
in the terminology of Wierdsma & Swieringa (2002), that leads to ‘single
loop, double loop and triple loop learning’. It is knowledge that by excel-
lence is suited for the research domain of research centres established at
universities where mental health professionals are trained1. This article

tries to describe different paradigms, research types and research meth-
1. In the Dutch system there are two types of universities: the scientific universities in
which fundamental and applied research is done and the universities of professional
education (hogescholen) in which professionals are trained and research is used in
practice .
Introduction 783
ods. It is meant to work out typical characteristics of different

approaches in order to clarify which approach leads to which kind of out-
comes. It is not about demonstrating that one paradigm is better than the
other, it is about demonstrating that they are different, that they ask dif-
ferent questions, deliver different outcomes and score differently with
regard to focussing theory or practice. However, practical relevance acts
as criterion and it is investigated critically which form of research is more
or less appropriate to improve, renew and develop practice-relevant
knowledge.
Research results are not applied in practice automatically, this is meant

by the term theory-practice gap. On the one hand, this originates in pro-
fessionals’ lack of competence in the evaluation and application of
research results. On the other hand research results often are far from
practice. Preventing this to happen by choosing a practice-relevant prob-
lem and research method is the red line of this article.
The university of professional education as a “gate of

knowledge”
Franssen (2004), Chair of the Dutch Foundation for Knowledge Devel-
opment at Universities of Professional Education (SKO), sees universi-
ties of professional education changing from ‘education factories’ into
institutions of expertise, regarded by the outside world as a centre for
renewal with regard to contents and professional aspects. According to
Franssen, pure educational transfer belongs to the past. The university of
professional education needs to take into account the curiosity of students
and train students to become professionals equipped optimally for devel-
oping their professionalism continuously. Franssen points out that this
has to happen on a larger scale than before. Universities of professional
education need to contribute to the development of the profession by car-
The university of professional education as a “gate of knowledge” 784

rying out research in practice. According to Franssen, it is difficult to

think of an educational institution that does not perform research.
In order to realise this, universities of professional education need to

transform into institutions in which professional development, research
in practice, concepts like ‘learning organisation’ and ‘gate of knowledge’
are subsequent aspects. In today’s professional practice, it is more than
ever desired to improve, innovate and develop standards1 and services

and to validate professional acting. In this respect, criteria like transpar-
ency, efficiency and efficacy are valid within the Health Services.
Research in practice is the tool par excellence for making the profes-
sional performance of Arts Therapists transparent, efficient and effective.
This requires that the current reflective practitioner grows into a scien-
tific practitioner, who does not merely reflect upon his own actions but
has the ability to improve, innovate and develop his performance based
upon research (if possible carried out by himself).
In a parallel process, the purely (re)producing organisation will evolve

into a learning organisation. A learning organisation is characterised by
the fact that it improves its standards and services, innovates and devel-
ops in a continuous dialogue with its external environment and antici-
pates developments in the external environment. A learning organisation
aims to engage internally and externally in variable expertise-intensive
coalitions in order to mobilise its creative and problem-solving poten-
tials.
1. In the Dutch system a standard (product) is a description of goals, interventions, out-

comes and rationale used with a particular health problem that is part of a distur-
bance or handicap. The treatment by means of the standard is limited in time and part
of a total treatment program.

The university acts as ‘gate of knowledge’ if it turns into a learning

organisation that enters into dialogue with practice, among others
through performing research in practice. University and health organisa-
tions together develop the profession and the training programmes by the
means of research in practice and influence each other, based upon their
own expertise, over and over again. Together, they sustain intensive traf-
fic through the ‘gate of knowledge’.
At universities of professional education students should gain compe-

tences in carrying out research in practice. The university of the future is
a dynamic institution in which research in practice and the development
of competences go hand in hand. The university of professional educa-
tion offers students the opportunity to acquire the most up-to-date profes-
sional competence based upon the results of research in practice. In
addition, this designated university enables students to gain competences
regarding research so that they can contribute to the development of the
profession after their training.
At the university of professional education, educational processes and the

development of the profession are integrated. By the means of the educa-
tional model called ‘reflection on learning’ the student learns how he can
direct his learning processes in such a way that he can develop and test
his own professional performance. Universities of professional education
create changing internal and external co-operations in order to develop
student’s competences. Students develop their competences, their profes-
sion in dialogue with the professional field.

Research in practice in universities of professional

education
Research in practice is connected with concepts that describe the univer-
sity as a ‘gate of knowledge’ and a ‘learning organisation’. The research
is preferably research in the service of the community of practice
(Wenger & Snyder 2000). In those forms of co-operation, people who are
confronted with the same problems work together in order to exchange,
intensify and develop their knowledge by the means of interaction. Com-
munities of practice are focused on creating and sustaining the body of
knowledge with the help of participants holding expertise, interest and
commitment. In so-called ‘ateliers of innovation’, different parties meet
in order to work on complex and creative solutions (Krogh, Ichijo &
Nonaka 2000).
The cooperation between university and practice institution can be

regarded as a community of practice where professors, students and pro-
fessionals from the area of work develop the profession together. By
means of a systematic dialogue, they may analyse problems, consider
strategies of solution and develop standards. If this happens by using
research techniques, we could talk about a research based community of
practice. Central to the interaction between professor, students and pro-
fessionals is the cycle of learning: analysing a problem, designing a solu-
tion, applying a solution and evaluating the solution. What is developed
in the research community becomes applied in practice and included in
training. This two-direction traffic between practice and training illus-
trates the operation of a ‘gate of knowledge’.
A question that has been discussed during the past years was whether
there is a particular research methodology for universities of professional
education. Through the discussions that have been conducted on this
topic, I came to the conclusion that an exclusive research methodology
Research in practice in universities of professional education 787

for universities of professional education does not exist, but that in these
universities certain research methods are used more often, because these
methods are closely linked to the lived experience in practice. In other
words: scientific universities carry out research in practice as well, and
scientific and professional researchers use the same research methods
(qualitative and / or quantitative). However, to a high degree, in universi-
ties of professional education a practice-focused and practice-relevant
research methodology is used. The acknowledgment of its practical
applicability in the field of work and the way of co-constructing results
together with the field of work are the most important features.
The Arts Therapies as a learning profession

Corresponding to the idea of a ‘learning organisation’ I see a ‘learning
profession’ in front of me in which experiential knowledge (implicit
knowledge) is made explicit, is analysed, combined, improved and devel-
oped and optimises practical acting by the means of education and train-
ing. It is about defining the client’s problems, the appropriate aims,
specifically arts therapeutic interventions and expected results based
upon practice (see Hutschemaekers 2003a). By monitoring process and
results, knowledge about delivery and results develops. Figure 1 on
page 789 demonstrates how the cycle of externalising and internalising
leads to theoretical and practical innovation. Research in practice is, as
we will see later, the motor that keeps the cycle going.
The Arts Therapies as a learning profession 788

FIGURE 1. The Arts Therapies as a learning profession: making

explicit and internalising
Paradigms
Within the thinking on the topic of research, it is currently differentiated
between so-called paradigms, that is essentially different opinions on
how research is to be done. Especially the difference between quantita-
tive and qualitative paradigm can be found back in a lot of research
projects and manuals on research. Those paradigms are based upon philo-
sophical conceptions of reality: the way knowledge can be gathered and
how reality needs to be studied, respectively ontology, epistemology and
methodology. The following description is based on Lincoln & Guba’s
publication (2000) as starting point. First publications, among others Lin-
coln and Guba (1985), was talked about naturalistic inquiry. Naturalistic
inquiry, with its emphasis on non-manipulative, open, context-specific,
holistic, ‘subjective’ characteristics of research, formed the counterpart
to (post-)positivism. Later, the term naturalistic was replaced by the term
Paradigms 789
constructivistic in order to demonstrate that it is a matter of constructing

knowledge in dialogue with respondents.
ONTOLOGY Ontology is defined as ‘theory of reality’. It answers questions with

regard to what we comprehend as reality. Positivism is often referred to
as ‘naïve realism’. Positivists are strongly influenced by traditional
nature scientific thinking before quantum physics. They assume that an
independent reality outside human beings exists that can be depicted by
research. Post-positivists slightly abate this point of view and suggest
that the depiction cannot be perfect, but certainly plausible. In the latter
we recognise the origin of statistics that calculate probabilities (think of
the statistic test that calculates whether a hypothesis is true or not).
Constructivists, on the other hand reject the assumption that reality can
be depicted objectively. They join in with philosophic currents like for
instance phenomenology and hermeneutics which assume that meaning
is not located outside the human being but is given by the human being,
therefore it is definitely ‘subjective’. Constructivists, however, go a step
further than phenomenologists and hermeneutici. Whereas phenomenolo-
gists assume that they can get through to the essence of a phenomenon, to
the core of the subject, constructivists, strongly influenced by post-mod-
ernistic thinking, advocate the idea of relativism. By that, they emphasize
that there is nothing like a general meaning, but that meaning always
depends on a specific context that determines what meaning people
ascribe. Think of a therapist saying that results of experimental research
are nice and pleasant but not applicable for individual clients.
In addition, Lincoln and Guba (2000) differentiate between constructivis-

tic and participant research within the constructivistic paradigm.
Paradigms 790
Participant research consists of different forms, among them action

research, which aims at an improvement of the practical action by means
of research in practice (Kemmis & McTaggart 2000). An example from
Arts Therapies is a practice researcher who is in constant dialogue with
the Arts Therapist during the treatment of the client, aiming to optimise
the treatment of the client by means of a dialogue on an equal level from
different perspectives.
Research at universities of professional education, aimed at the improve-

ment of practical acting, innovation and development, benefits from a
research methodology in which researcher and professional learn from
each other, in which intervention and research, practice and theory fruc-
tify each other critically. Research in practice carried out at universities
of professional education can by excellence meet the characteristics that
Kemmis and McTaggart mention for participant research:
• a social process
• in which respondents with their knowledge participate on an equal
level
• focussed on the joined development of practical acting
• by means of a (self)critical and dialectic dialogue
• that runs in a cycle of doing, evaluating, thinking, planning, doing, etc.
• in which both practice and theory transform.
This form of research goes further than learning from practice or learning
in practice as it is about research that aims at innovating theory and prac-
tice in a continuous circle.
EPISTEMOLOGY Epistemology is the ‘theory of knowing’ and tries to answer the question
how we can get to know reality. Positivists handle a dualistic/objectivis-
tic approach, based on the assumption that the researcher is able to state
objective truths regarding the reality around him. The researcher posi-
Paradigms 791
tions himself independently and is no more than an observer of the - in

his eyes - objective reality. He is positioned opposite to the reality that he
researches (dualistic).
Post-positivists share this opinion, but dilute it by assuming that as inde-

pendent researchers, they will not find absolute but plausible truths.
Constructivists, on the other hand, propagate that it is only possible to

acquire knowledge by entering into a transaction with the environment,
which in this case are respondents, and creating knowledge together with
them. Therefore, it is not about a dualism between researcher and
research.
METHODOLOGY Methodology is defined as ‘theory of methods’ and describes how we

approach the acquisition of knowledge. Positivists use a theory from
which they deduce a hypothetic causal connection which they try to ver-
ify by the means of an experimental design. The experiment is designed
artificially in order to be able to research exactly the influence of the
independent variable. It is aimed to control all other variables by elimi-
nating them or measuring them so as to be able to state the effect of the
independent variable. Dependent variables, that are expected to be influ-
enced by the independent variable, are measured by the means of stan-
dardised and objectified measuring instruments to which the researcher
applies statistic procedures. Since Karl Popper’s example of the impossi-
bility to prove definitely that all swans are white, the verification princi-
ple, implying the search for evidence to prove the hypothesis that all
swans are white, has come under pressure. Popper introduced the falsifi-
cation principle, suggesting that one needs to try to refute the hypothesis
(thus search for a black swan). If one does not find a black swan, the
hypothesis suggesting that all swans are white, is probably true. In induc-
tive statistics, probability procedures are developed in order to determine,
Paradigms 792
based on a sample, whether a hypothesis is true (this can be seen in the

p-value of statistic tests). Therefore, by means of an experimental design
based on a sample, post-positivists are able to determine the probability
whether the results found in the sample are valid for the population.
Thus, post-positivistic research methodology unfolds reality in standard-

ised variables. They enable different situations to be studied with the
same instruments. Many clients, therapists and treatments are observed in
the same way. The advantage: in the end, it becomes possible to say
something in general about a large quantity. In order to make this possi-
ble, phenomena are simplified and expressed in figures so that they are
statistically comparable. Averages, standard deviations, t-tests, analysis
of variance, factor analysis, regression analysis etc. are operations that
combine a great quantity of simplified phenomena. This form of research
is merely possible if phenomena are simplified.
(Post)positivistic research methodology works with comparable facts

occurring a lot as particular phenomena have been reduced to comparable
variables. Exactly because data are comparable, a great quantity of the
same data arises.This makes statistical processing possible. In other
words: reduction and standardisation are conditions for statistical analy-
sis. If this does not happen, it is about unique phenomena that cannot be
analysed statistically.
Therapists working with individual clients often oppose themselves sus-

piciously to the results of quantitative research. However, this form of
research is very useful in the medical world and for therapies that are
more standardised and therefore measurable in this way. A problem
arises if this way of researching is declared as the one and only true and
other forms of therapy that, on the contrary, draw their strength from less
standardisation, are left aside. As clients differ and problems are com-
Paradigms 793
plex, treatments often are different. Therapists do not work with abstract
regularities, but with a complicated interaction process full of nuances
and levels (Buchholz, 1999). The individual, subjective experience of
pain, angst or grief withdraws from quantification (Aldridge 2004b).
A political-social problem that arises from standardised forms of research

possessing the highest status is, that therapies for which standardisation
is possible, are considered for funding, both with regard to treatment and
research. By this, a reduced picture of effective therapies develops. Ald-
ridge (2004c) criticises the fact that a technocratic elite with a deficit in
practical experience set themselves up as inquisitor, judging that merely
one form of research leads to evidence.
He claims that inexperienced researchers think that they can set up guide-
lines based upon reductionistic research outcomes, prescribing experi-
enced professionals how they could act in a better way. Positivistic
research however, is not able to resolve the quandary of action that arises
for the professional in an un-standardised context.
Constructivistic researchers do not think in terms of samples and statistic

probabilities. For them, the specific context is the starting point, which
they describe in full breadth. Whether or not outcomes are usable in
another context, this is something that people from another context can
find out for themselves based upon a comparison. Striking in constructiv-
istic methodology is the equivalence of researcher and respondent. The
researcher is not the one who, based on theories, formulated questions
and research tools, considers himself able to discover truths on his own.
He enters in an equal dialogue with respondents. In this way, a learning
process develops which involves three criteria: the researcher learns from
the respondent, the respondent learns from the researcher and together
they create new practice-focussed knowledge. Equivalence, by the way,
Paradigms 794
does not mean equality, as researcher and respondent enter the dialogue
based upon their peculiar competence. This implies dialectics: question-
ing each other critically from different backgrounds. There is no theory
set up in advance, there are no measuring instruments. Research tech-
niques merely serve as support in co-creating subjective knowledge con-
cerning the practice situation as it occurs under normal circumstances.
Experimental manipulations are not applied.
One research methodology is not better than the other. It is essential for
the researcher to choose a method that fits to his question. Aldridge
(2004c) pledges for methodological pluralism: one story can be told in
different ways. Manipulations, standardisations and measuring variables
deliver other knowledge than the description of natural situations. Cer-
tainly in the Arts Therapies, the medium1 tells its own story, too. Science
and profession are two different, but equivalent sources of knowledge
(Buchholz, 1999), and within science, different research methods pro-
duce different, equivalent sorts of knowledge.
Quantitative and qualitative

The above paragraph demonstrates that quantitative and qualitative para-
digms are narrowly connected with views on ontology, epistemology and
methodology. Terms like qualitative and quantitative are currently mainly
used in the service of methodology, but we realise that quantification
mainly belongs to positivism and post-positivism, whereas qualitative
research belongs to constructivism. Qualitative research and constructiv-
ism however are not identical. As mentioned before, traditional research
methods (think of phenomenology, hermeneutics and grounded theory)
1. In the Dutch arts therapies the concept ‘medium’ refers to drama, music, art, dance
and movement.
Quantitative and qualitative 795

assume that it is possible to describe the essence of a phenomenon. Con-

structivism, on the other hand, assumes that there is no general truth, and
‘truth’ is relative, depending on the human beings who construct (their)
truth together. Within the qualitative paradigm, which is therefore wider
than constructivism, a lot of methods are known and used frequently by
Arts Therapists, e.g. phenomenology, grounded theory, hermeneutics,
morphology (see among others Kenny 1989, 1996, 1998; Wheeler 1995/
2005; Langenberg, Aigen & Frommer 1996; Tüpker 1996a; Smeijsters
1997b; McNiff 1998; Grainger 1999; Kaplan 2000; Petersen 2002; Ald-
ridge 2004a). Discussing them here in detail leads us too far away from
the subject. Therefore I merely refer to relevant literature.
The quantitative versus qualitative research debate is carried out in the

Arts Therapies internationally, as well. All positions can be recognised:
researchers who swear by quantitative methodology, those who swear by
qualitative methodology, those who aim to bridge the gap between both
paradigms by connecting them or disapprove speaking of ‘paradigms’.
As mentioned before: problems arise if it is forgotten that quantitative
and qualitative researcher have a different view on reality, that they ask
different questions, use other methods and therefore find other answers.
Condemning each other as heretic does not make sense if one person
wishes to examine apples and the other one looks at pears. Ignoring the
fundamental differences in perspectives and acting as if it is merely about
different methods and techniques that fulfil the same quality criteria does
not make much sense either. Perspectives differ so much, that it is very
much about different quality criteria. This implies that, regardless which
form of research is chosen, each research methodology has to fulfil the
quality criteria valid for it. Who carries out experimental research needs
to meet the quality criteria valid for this kind of research and someone
Quantitative and qualitative 796

who does hermeneutic research needs to stick to criteria valid for herme-
neutic research.
As it is a matter of different approaches, there are different sorts of evi-

dence as well. As a result of the propositions above, neither qualitative
nor quantitative researchers can claim ‘truth’ and ‘certainty’. Knowledge
that is gained through experimental research by the means of standard-
ised measuring instruments is no closer to ‘the truth’ than knowledge
gathered by the means of in-depths-interviews in the natural context
(Kemmis&McTaggard 2000).
Sorts of evidence
In this paragraph, I will examine the ‘sorts of evidence’ possible. It is a
very recent perspective in which a lot of the matters discussed before,
will be raised again. We will see that EBM is of a (post)positivistic-quan-
titative nature. EBMH is of a constructivistic-qualitative one. In addition,
we will find that a third form of evidence, CBM, is possible, a form that
is naturalistic (without being a matter of constructivism) and can exist in
a qualitative or quantitative design.
With the call for evidence currently being so strong, this paragraph corre-
sponds to the question that confronts Arts Therapists in practice: ‘Does it
really work?’
Ansdell, Pavlicevic&Proctor (2004) describe six forms of evidence that

can be developed by professionals in practice:
• An expert’s opinion: let your work be validated by a practitioner from

another profession (e.g. a psychiatrist) who is able to evaluate your
work from a close distance. Such an expert’s opinion influences poli-
cymakers.
Sorts of evidence 797

• A review of your treatment: make a review of the dossiers of your cli-

ents, describing the target group (age, diagnosis, etc.), how clients
have been referred and how assessments have taken place, how many
clients you treated individually and in groups, how you evaluated your
work and results of your evaluation (intervision, supervision, other
professional’s and client’s feedback etc.).
• Evaluation studies: apply a number of methods (‘triangulate’) that
demonstrate that in practice, there is a relationship between aims and
results (e.g. questionnaires filled in by clients and staff, participant
observation).
• Using assessments: in this case, an Arts Therapeutic assessment model
accompanies all stages of treatment (e.g. an assessment at the begin-
ning is related to the problem and the expected results; an assessment
at the end is compared to an assessment carried out at the beginning
and to expectations).
• Qualitative effect study: make an extensive description of practice,
among others from the client’s perspective (e.g. using client inter-
views).
• Systematic case study: a Case Control Study in which the client is
matched with a control client, the Case History (the most common
case study) and Case Series (several Case Histories). By using the
same format (problem – intervention – process) it becomes possible to
compare cases to each other and to reveal patterns.
• Experimental research: research by the means of an experimental and
a control group; randomisation.
By this, they demonstrate that each professional can gather evidence in

practice – apart from experimental research. This is important with
regard to legitimating indications in practice: it is not about results of
experimental research. It is about the credibility the Arts Therapies pos-
sess in the eyes of care managers, members of the multidisciplinary team,
clients and people from the clients’ environment.
I will not discuss all variants proposed by Ansdell et al. I restrict myself
to the sorts of evidence I encountered in the course of years and that get a
lot of attention in literature.

EVIDENCE BASED EBM is mainly applied in medical science. From there, it gradually swept
MEDICINE (EBM)
through to psychotherapy as well. It is applied frequently within Cogni-
tive Therapy and Behavioural Therapy, hardly in psychoanalysis. This
already tells us something about those therapist’s view on reality.
The golden standard of EMB is the Randomised Controlled Trial (RCT).

In medical research, EMB is regarded as the very best way to investigate
the effectiveness of a certain treatment. The approach is ‘objectivistic’
and ‘experimental’, which means that the researcher is an outsider who
designs an experiment in which he can observe what happens without
interpretation. There is a control group that does not receive treatment
and an experimental group that does. Members are placed in groups at
random in order to guarantee that groups are comparable at the start. The
experimental group receives a certain medication, the control group
receives a placebo. Participants of each group do not know who receives
the proper medication and who does not. Even doctors do not know
which one is the genuine and the simulated medicament. This is called
‘double-blind’-research. It is meant to prevent doctors and patients – if
they could identify the genuine medicament - from suggestive thinking
that it helps. The effect is recorded by means of a measuring instrument.
The measuring instrument neither leaves space for interpretation nor sug-
gestions. The treatment (the medication) is exactly prescribed (standard-
ised). The client’s problems are recorded precisely. In that way, it
becomes possible to draw conclusions that the particular medicament in a
certain dose and administered for a certain time (the independent vari-
able) for this symptom (the dependent variable) has this kind of effect.
This is a very strong research design from the point of view of post-posi-
tivistic methodology. It’s strength is, that to a certain extent of statistical
probability, it is possible to state whether one treatment I (intervention),
compared to another intervention C (comparison, co-intervention) leads

to an effect O (outcome) for a large groups of patients presenting the

problem P. This ‘PICO’ line of reasoning can be found in Cochrane
Reviews and evidence based guidelines. It enables you to find out
whether a standardised treatment leads to a standardised effect for a stan-
dardised group of patients. Therefore, this design is regarded as ‘golden
standard’. Wesseley (2001: 49), a supporter of this design, declares: “If
we hadn’t carried out clinical experiments, we still would give insulin to
schizophrenic patients”. A convincing argument from medical books is
that RCTs detect differences between medicament and placebo and
whether treatments have positive or negative effects.
Try to imagine that this is what you need to manage in psychotherapy or

the Arts Therapies. You need to form two groups, both of them including
clients with exactly the same problem and the same level of departure;
without co-morbidity, because otherwise you won’t be able to find out
exactly how therapy works for a specific problem. You need to divide
them into a treatment group and a control group at random. Subsequently,
you need to apply the same treatment to every client (same interventions,
same intensity, same duration), because only then will you be able to
state whether treatment I leads to effect O for client P. The client must not
know whether he receives treatment or placebo; nor may the therapist
know whether he carries out treatment or placebo. Afterwards, all clients
are measured by the means of the same instrument. From this, we can
deduce that this research design involves a variety of problems. Do you
get clients whose presenting problems are clear, specific and equal? Is it
possible in an institution to take clients out of their community and
divide them at random in an experimental and a control group? Is it pos-
sible to provide the same treatment for every client? Is it therapeutically
justifiable for the client not to know what kind of treatment he receives?
How do you manage for the therapist not to know whether he actually

treats? This raises questions. By the way, this does not mean that it is not
possible to answer some of those questions. It usually leads to some kind
of deviation from the original design.
However, as a result of the questions raised just before, carrying out this
form of research encounters many critics within psychotherapy. In the
previous text, Buchholz (1999) has already been quoted. He clarifies that
experimental research provides a simple psychology that cannot replace
the complex psychology needed by the professional. In the same way,
Seligman (1995) and Rustin (2001) conclude that RCTs cannot demon-
strate the effects of psychotherapy as many crucial factors are left out of
consideration. In reality, clients are complex; there are no two clients
alike; there are no two treatments that can be alike and therefore, there
can’t be two effects that are the same. Every experimental group forms a
selected, specific ‘non-random’ group; its results cannot be generalised
(Aldridge 2004b). The most important criticism of RCT is therefore that
it is not representative and possesses little external validity (Slade en
Priebe 2002).
According to Seligman, the strong internal validity of RCT (randomisa-

tion, protocol-led treatment, delimited time and standardised effect mea-
sures) does not provide insight on the way how the process between
therapist and client develops and what actually happens. ‘Internal valid-
ity’ means that you can state whether the effect is caused by the treat-
ment.
RCT is a technical-formalistic way of recording the effect of a treatment.

It seems unimportant to know how the treatment took place; every
researcher can do the methodological work without having a look at the
process of treatment. In reality, insight on why something changes how-
ever merely develops by investigating the process, by paying attention to

little changes and by recording what is influenced by what. RCT provides

laws for big numbers, but no insight in where and why something
changes. In addition, the RCT shows afterwards whether there is a statis-
tical effect on an average score for a standardised treatment. We then
know that on average, something influences something, but we do not
know when, how and why the individual client changes. Thus, RCT does
not tell us how a treatment works, for whom it works and for whom it
does not work (Marshall 2002, Aldridge 2004b). That is why this kind of
research is interesting for care managers and care insurances, as they can
deduce from results where to spend their money - but less interesting for
therapists who want to know how they need to act when confronted with
the complexity of the individual client. Arts Therapies is not the perfor-
mance of standardised interventions. Every therapeutic relationship is
different and it is a matter of working focussed on the presenting problem
(the treatment package approach, Edwards 2002).
The quantitative single case design was developed in order to meet the
individual process; it is flexible, focussed on practice and ethically justi-
fied (see e.g. Aldridge 1993, 2004b; Smeijsters 2005b).
COGNITION BASED The criticism of RCT originates from the medical perspective. Clinical
MEDICINE (CBM)
physicians and specialists wonder whether they are merely allowed to
treat after a RCT has taken place. This approach condemns physicians to
the computer where they can search for what is or is not investigated. I
think, in this context a distinction needs to be made between the prescrip-
tion of pills and other medical actions. The first one, I consider as a mat-
ter for RCTs. This is different for the other medical actions.
What is practice like? A doctor possesses the competence to formulate

individual diagnoses that meet the individual set of problems of the
patient. Based on that, he assesses what he needs to do. Naturally, he will

prefer prescribing medicaments that are tested extensively, but what to do

if the decisive answers of the RCTs is unsatisfactory? The physician nev-
ertheless needs to act, even more, he needs to invent a combination of
remedies and measures that are appropriate for the individual client; no
single RCT is able to provide an answer for this. The doctor is supported
by two things: his insight in the way the human body works and his expe-
rience. In order to obtain these insights, he does not necessarily require
research with an experimental and a control group. The physician gains
insight by thoroughly mapping and following a large number of phenom-
ena and combinations of measures in the case of the individual client. He
is able to reliably state for an individual client whether the treatment
leads to the desired effect. This may happen qualitatively or quantita-
tively (see Smeijsters, 2005b). To a certain degree, the individual doctor
‘experiments’ with the individual client, whereas in RCT, this is done
with groups. This is even more observable in the case of a surgeon who
acts based upon his competence and not based upon RCTs. Imagine a
surgeon only then to be permitted to carry out an operation after an
experimental group has been subjected to the same operation and a con-
trol group has not. Firstly, not a single fracture of patients from the exper-
imental group is the same; the surgeon needs to adjust his work and needs
to figure out per client how he needs to do it. Secondly, you can’t let cli-
ents from the control group wander about with broken bones. This may
be a ridiculous example, but it demonstrates clearly that the surgeon
needs to act; he does it by using his experience and competence adjusted
to the situation and by developing it on the spot. This, by the way, charac-
terises a true professional: he is able to act in diverging situations instead
of merely being able to carry out standard procedures. Here, we can rec-
ognise a discrepancy between EBM and thinking on professionalism.

Through the treatment of individual patients, the physician gathers a trea-

sure of experiential knowledge that enables him to formulate diagnoses
and to develop an appropriate treatment for the following patient more
quickly. In RCT, the doctor is somebody who interprets and applies stan-
dardised knowledge; in CBM the doctor is a practice researcher who tries
out things in a variable practice.
Kiene (2001), Kienle e.a. (2003) and Petersen (2003) emphasise that
EBM underestimates the person of the therapist as a trustworthy research
instrument.
The key question in effect research is about whether an effect actually

occurs and whether one is able to state with certainty that the effect is a
consequence of treatment and not one of other factors (e.g. the weather,
the physician’s personality, another treatment etc.). It is, as we have seen
previously, the question regarding internal validity.
This is solved in EMB by means of an experimental design. Experimen-

tal group and control group are alike. Imagine the treatment being suc-
cessful for the experimental group but not for the control group. Do you
then know with certainty, that this effect is a consequence of the treat-
ment? Yes, according to the reasoning: if anything else had been
involved, it would have occurred in the control group, as well and would
have caused an effect there, too. The difference of effects between exper-
imental and control group is merely regarded a consequence of a differ-
ence in treatment. Ergo: the treatment has caused the effect.
CBM follows another line of reasoning in order to state causality. It is an

individual and experimental model and based on recording similarities
(morphologic and analogous). Adapted to the Arts Therapies, it means
that changes visible in therapy, both in and outside the medium, corre-

spond to changes outside therapy in a way that makes it very likely that
they are caused by the therapeutic process. Take the example of a client
who takes more initiative during an Arts Therapeutic session and does the
same in his community during the following week, whereas before this
was not at all the case before; in addition this phenomenon was only visi-
ble in other therapies after it had been observed in the Arts Therapies for
the first time. Or, let’s turn back to the surgeon, if bones grow together,
this is caused by the surgeon who set them well. There is no need for an
RCT in order to state this. The causal relationship between the surgeon’s
therapeutic action and the growing together of bones is evident. The
same can be said for processes happening inside and outside the Arts
Therapies. If a client, who was withdrawn before gradually takes more
initiative in Music Therapeutic improvisation, there is a direct relation-
ship to his behaviour in a discussion group if he takes initiative in this
group too.
EVIDENCE BASED One way to cluster professional knowledge was shaped by what is called
MENTAL HEALTH
(EBMH) Evidence Based Mental Health (EBMH ) (Hutschemaekers 2003a/b). The
word already demonstrates that a distinction is made between ‘medicine’
and ‘mental health’. This results from the fact that, in mental health, the
psyche of the client is the centre of attention; this implies that it is impos-
sible to merely carry out standardised treatments that are the same for
everybody. In EBMH, therapists’ and clients’ knowledge from experi-
ence is made explicit, it is analysed and integrated to best practices. This
concerns all parts of the therapeutic process as observation and diagnosis,
aims, interventions, results and rationales. EBMH is interactive and
searches together with experts (from experience) for the collective sense
of the profession. EMBH owns to a smaller or greater extent characteris-
tics of the qualitative paradigm (Lincoln & Guba 1985; Reason & Rowan
1991; Denzin & Lincoln 2000).

The research method is frequently ‘open’, theories set up in advance

move to the background during the research, there is attention for the
totality of occurrences; in addition a construction of intrasubject and
intersubject experiences takes place. Within EBMH, all sorts of specific
qualitative research methods are applied, including phenomenology
(Giorgi 1985), hermeneutic (Gadamer 1975), grounded theory (Glaser &
Strauss 1967; Strauss & Corbin 1998; Charmaz 2000), constructivism
(Gergen 1985, 1994; Denzin 1997) and morphology (Salber 1965).
Instead of the criteria customary within the quantitative paradigm (as

internal validity, external validity, reliability and objectivity), criteria of
relevance within the qualitative paradigm are:
• Credibility (results need to be credible for respondents)

• Dependability (results need to be as complete as possible)
• Confirmability (an outsider needs to be able to comprehend how
results came about)
• Transferability (results are processed in a way that facilitates assess-
ment regarding to what is different or similar in a new context)
• Authenticity (respondents have had a fair chance to contribute their
point of view)
In order to fulfil those criteria, a qualitative researcher has a large amount

of research techniques at his disposal; among those are best known: thick
description, memo’s, iterative analysis, member checking, peer debrief-
ing, auditing and triangulation. A detailed discussion of these methods
and techniques would lead too far from the subject. A short description is
included in the tables (see page 812) at the end of this article.
In this article, I would like to deal with Miller and Crabtrees’ notions
(2000) on clinical research at more length. Just like other researchers,
they criticise the biomedical paradigm and the RCTs deduced from it;
according to both authors, the consequence is that the complexity of suf-
fering becomes suppressed and the treatment of suffering is given shape

in standardised procedures. What is interesting in Miller and Crabtrees’

notion is that they pledge for a research method in which storytelling,
associations and metaphors take up a central role.
If we follow this line, the notion links up to voices within the Art Thera-
pies, pointing out that it is possible to describe the therapeutic process by
taking the medium process as a measure of outcome. What happens dur-
ing therapy after all is visible and audible ‘in’ the medium. Therefore,
there is no need to ‘translate’ the medium into another language. As it
frequently is difficult for outsiders to ‘read’ the medium, work needs to
be shifted aiming at an ‘intermediary language’ that does justice to both
medium and psyche (Smeijsters 2005c).
Miller and Crabtree mention three criteria for a qualitative clinical story:
• Methodologically convincing as the ‘story teller’ gives an account to

the reader of how he gathered and processed his material.
• Rhetorically convincing as the reader, based upon personal experi-
ences, becomes convinced that the story is credible.
• Clinically convincing as therapists get convinced that the story is clin-
ically credible.
By this, Miller and Crabtree in a certain sense re-establish the position of

the case study, which takes up a very humble rank in EBM. But they add
something as well: the author needs to use a research method and
accounts for the method. Case studies, as we know them, often do not
fulfil the criteria valid for research. However, they may be rhetorically
and clinically convincing. Their value would increase if authors of case
studies made use of research techniques.

Scientific practitioner and reflective client

In Hutschemaekers’ opinion (2003a/b) the original principles of EBM
stressed the collective sense of the profession, building also upon the
implicit knowledge of reflective practitioners when setting up guidelines.
Aldridge (2004b) emphasises that it is important to listen to the experi-
ence of both therapists and clients.
FROM ‘REFLECTIVE’ TO It is important that the reflective practitioner can develop himself to sci-
‘SCIENTIFIC’
PRACTITIONER entific practitioner. Entering into a critical dialogue with colleagues and
practice researchers facilitates this. With that, among others, it is impor-
tant to connect theory with a small letter t (work models from practice)
with the theory with a capital letter T (scientific evidence). This will be
worked out further in chapter 3 of my forthcoming book.
THE ‘REFLECTIVE Within psychotherapy, research methods have been developed in which
CLIENT’
the client’s experience gets a lot of attention (Elliott, Slatick & Urman
2001). In a Change Interview, the therapist/researcher asks whether the
client realised changes, what may have caused those changes, which fac-
tors facilitated or hindered the therapeutic process and what had been
missed.
The Helpful Aspects of Therapy Form (HAT) is comparable to that, but is

held at the end of a session. The therapist asks which event has helped
most during the session, how strong this help had been, when it happened
and for how long it lasted.
In a Brief Structured Recall (BSR), tapes of the session are looked at or

listened to; the therapist helps the client to describe specific events. The
client localises the event, describes what helped most during the event,
and how the event passed off, explores possible relationships to other sit-
uations from every-day reality, describes what was experienced during
Scientific practitioner and reflective client 808

the event, the most important parts of the event and the effect of the
event.
Characteristics of qualitative research in practice in

EBMH
This paragraph accentuates and specifies the preceding with respect to
qualitative research in practice in EBMH.
CYCLE OF PRACTICE Within EBMH, there is no big difference between the reflective practitio-
AND CYCLE OF
RESEARCH IN EBMH ner who discovers gradually what the problem is, who develops work
methods and tests every moment what is appropriate and what is not, and
the qualitative practice researcher who by means of qualitative research
methods supports and analyses the individual process of the reflective
practitioner and integrates it with other reflective practitioner’s implicit
knowledge as well as findings from theory and research. Qualitative
research in practice is focused on the action process as it unfolds in prac-
tice. This form of research shows, with regard to the process, similarities
with the action process in practice. Practice and research both focus on
what the problem is and what needs to be investigated. The research
methods are not neatly put together in advance, but get shaped gradually
based upon feedback from the practical context. Qualitative research in
practice often is as flexible and varied as practice itself.
EBMH INFORMED In qualitative research in practice in the Arts Therapies, the following
QUALITATIVE
RESEARCH IN PRACTICE questions are central:
IN THE ARTS
THERAPIES
• How is the client’s set of problems expressed in the medium?
• What sort of diagnostic model do arts therapists use with regard to a
certain set of problems?
• For which sub-problems, related to the client’s set of problems, do arts
therapists consider their medium indicated?
Characteristics of qualitative research in practice in EBMH 809

• Which goals are chosen by arts therapists, in the light of the problems
they want to focus on?
• Which work modalities, methods, activities and techniques are used
by arts therapists to achieve those goals?
• How do they phase their therapy?
• Which effects are perceived by the arts therapists as a consequence of
the application of the chosen work modalities, methods, activities and
techniques?
• Is there a clear relationship between the client’s set of problems, the
goals, work modalities, methods, activities, techniques and results?
• How do arts therapists explain the effects occurring? On which theo-
retical current do they base themselves?
The quality criteria for qualitative research in practice are related to the
question whether the facts reflect practice adequately; whether they are
understandable, usable, acceptable etc. (see the preceding paragraph as
well as Verhoef et al 2004 and Proot et al 2004).
Competences of a practice researcher in the Arts

Therapies
A practice researcher is someone who is able to pursue a dialogue in
which he enters into discussions with respondents, listens well, follows
their traces of thinking and clarifies. The researcher creates an atmo-
sphere that enables questioning each other constructively and critically as
well as bringing up assumptions for discussion. The discussion enables
respondents to develop from reflective to scientific practitioners who
integrate theory and practice, who make implicit knowledge explicit, and
bring it up for discussion based upon extern sources (theory, research,
other experts). A safe atmosphere facilitates letting go of potential con-
ceptions that don’t provide psychological, therapeutic or medium-
focussed trustworthiness.
Competences of a practice researcher in the Arts Therapies 810

Considering the fact that both respondent and researcher use the clinical
process of reasoning in which observation, aims, indication, method,
effect and rational are related to each other, this form of research in prac-
tice requires the researcher to know about the subject he talks about and
therefore to have an understanding of the arts therapies. He needs to have
at his disposal a wide knowledge concerning the arts therapies he wishes
to investigate, so that he is able to drop one-dimensional theoretical and
ideological assumptions. Based upon insight, the researcher needs to be
able to (re)construct experiential knowledge and to create action knowl-
edge together with the arts therapists; in this, it needs to become clear
what can be generalized and what cannot.
Then a content-directed, many-sided dialogue between professional and

researcher develops.
FIGURE 2. Dialogue between researchers and professionals
At the end of this article, I provide a systematic overview of types, meth-

ods and techniques of research. The overview in the next paragraph is not
complete, however it gives an impression of the options among which
researchers can choose.
Competences of a practice researcher in the Arts Therapies 811

Tables - Types, methods and techniques of research
TYPES OF RESEARCH • Inventory research: in an inventory research, an inventory is made of

how often a phenomenon occurs, which phenomena occur; e.g. which
target groups and methods arts therapists work with.
• Need research: A need research assesses people’s needs. This may
include needs for education, facilities and, with regard to clients,
needs for treatment (the client’s ‘question for assistance’).
• Development research: A development research project focuses on the
development and improvement of (one’s own or somebody else) pro-
fessional action by the means of research. The outcome can be assess-
ment tools, a formulation of indications, a description of goals,
treatment methods, standards, interventions, rationales etc. A develop-
ment research goes further than an inventory research as it brings
about new knowledge through analysis and integration.
• Process evaluation: A process evaluation aims at investigating how
therapy actually takes place. In other words: does actually happen
what is put down on paper? For this purpose, it is necessary to
describe and analyse the actual acting, with regard to what was sup-
posed to happen, as well as to compare it to the starting point. A pro-
cess evaluation is both related to the quality concerns (‘Do we really
do what we say we do?’) and effect evaluation. As, after all, a treat-
ment turns out not to be effective, it is important to know whether it
has been carried out the way it was meant to.
• Effect evaluation: Effect evaluation aims at evaluating the output of
activities.
Tables - Types, methods and techniques of research 812

TABLE 1. Research designs:

• Survey: by the means of a closed questionnaire, structured in advance,
information in figures is collected from a big number of respondents. For
instance, respondents record whether something does or does not exist and
to which degree. This research is of an inventory-making character.
• Correlational: a research aimed at investigating the correlation between
variables; it is observed whether one variable scores high or low, in the
Quantitativ same direction or the opposite one, or on the contrary, independently if
e: another variable scores high or low.
Experimental Randomized Controlled Trial (RCT): effect research in
with groups which randomised groups are compared to each other; the
experimental group receives treatment whereas the control
group does not get treatment or receives a placebo.
Controlled Clinical Trial (CCT), cohort studies: effect
research in which non-randomised groups are compared to
each other.
Outcomes Effect research by the means of a pretest-posttest measure-
research ment of the treatment group; without control group.
Experimental Case Control Study: a client is matched with a control cli-
single-case ent or with himself:
design • Randomised single-case design: treatment and placebo
are applied at random to an individual client.
• Reversal design: according to a plan set up in advance,
(e.g. ABABA) treatment and placebo alternate in the
treatment of an individual client.
• Multiple baseline design: a research in which the effect
of the treatment is measured in several individual cli-
ents. Treatments and measurements proceed parallel to
each other, but start and end at different points in time.
Non-experi- Quantitative single-case study: here, by the means of
mental single assessments during all stages of treatment, data in figures
case design are gathered for one client. The research can be describing
or evaluating in nature (e.g. an assessment at the beginning
is related to the set of problems and the expected out-
comes; an assessment at the end is compared to the assess-
mentfrom the beginning and the expectations).

TABLE 1. Research designs:

• Qualitative effect study: by the means of several methods (e.g. observation,
client interview), effects of the treatment in practice for comparable client
groups are described; it is demonstrated that there is a relationship between
aims and results.
• Multiple qualitative case study (Case series): a combination of several
qualitative case studies. The term multiple case study in the narrow sense
of the word is used if results from the original case studies remain visible.
In a consensus-based multiple case study, data of separate case studies
finally become integrated.
• A treatment review: a review of the dossiers of treated clients in which the
client group is described (age, diagnosis, etc.), how clients had been
referred how assessments have taken place, how many clients had been
treated individually, how many in groups, how the work has been evalu-
ated and the results of this evaluation.
• Qualitative case study (case study, Case History): a systematic description
of a client’s therapeutic process.
• An experts opinion: a validation of the work by a practitioner from another
professional group (e.g. a psychiatrist) who is able to judge the effective-
Qualitative: ness of the treatment from a close distance.
TABLE 2. Techniques for data collection

• Literature study • Observation
• Questionnaire • Participant observation
• Interview, among others: • Group technique
Change interview
Helpful aspects of therapy form
Brief structured recall

TABLE 3. Techniques in which data collection and data-analysis go hand in hand
• Member checking: this technique involves that data collection and data
analysis take place in close cooperation with the people from the context
to which both data collection and data analysis refer (client and therapist)
• Peer debriefing: method of data collection, data analysis and first results
are presented to independent experts during the research process.
• Repeated analysis: based upon newly collected data, the proceeding anal-
ysis is regularly compared to the original data and former analyses.
• Triangulation means that different sources are used for data collection
(e.g. arts therapists, psychologists, managers), that different types of data
Naturalistic collection are applied (e.g. interview, participant observation, question-
constructivis naire) and that several theoretical perspectives are given a chance in data-
tic analysis (e.g. creative-process theory, analogous-process model, analyti-
inquiry cally-orientated arts therapies etc.)
• In the occurrences you describe, look for concepts that give you some-
thing to hold on to and describe those concepts.
• Present concepts and original data to independent reviewers.
• Look for new material, using the already developed keywords as sensitis-
Grounded ing concepts.
Theory • Carry out interviews in order to complete the concepts.
• Selecting experts, stake holders, clients (diversity of expertise).
• Exploring the theme by the means of literature study and interviews.
• Developing topics for the purpose of interviews and questionnaire.
• Holding interviews and filling in questionnaires (individually and anony-
mously).
• Content analysis of responses.
• Feedback to respondents: asking respondents to comment earlier answers.
• Several rounds in which respondents are confronted with their own
answers and those of others.
• Indirect communication (via researcher).
Delphi- • Similarity to naturalistic/ constructivistic inquiry: application of member
method checking, peer debriefing and triangulation.
QUANTITATIVE • Meta-analysis of research results

METHODS FOR DATA
ANALYSIS
• Data-analysis:
TABLE 4. Table of frequencies, diagram
Mean, modus, median, variance, standard deviation

Cross table, correlation coefficient, linear regression,

Parametric and non-parametric tests
Logistic regression
Analysis of variance
Factor analysis and cluster analysis.
TABLE 5. Qualitative methods for data analysis

• Select: scrap unimportant passages.
• Paraphrase: drop superfluous words in important passages.
• Synthesize: integrate passages belonging to each other on a higher level
of abstraction.
Content • Analyse: determine relations between kinds of phenomena (e.g. cause –
analysis effect, stipulations, conditions, stages etc.)
• Coding: divide the text into paragraphs dealing with one subject, mark
similar paragraphs with the same colour or term (e.g. paragraphs on the
diagnosis, the therapeutic relationship, the client’s reaction, etc.)
• Categorizing: put all corresponding passages into the same category and
give a name to this category (e.g. the category ‘diagnosis’).
• Conceptualising: within the categories, develop concepts referring to
important topics (e.g. ‘depressed mood’, ‘relational problem’).
• Axial coding: determine main- and subcategories (e.g. for the main cate-
gory ‘work modality’ the subcategories ‘general work modality’ and ‘art
therapeutic work modality’; for the main category ‘treatment’ the subcat-
egories ‘cognitive therapy’ and ‘drama therapy’; within the subcategory
‘drama therapy’ the sub-subcategory ‘role method’).
• Selective coding: look for relations of topics within and between catego-
Grounded ries (e.g. within the category ‘treatment’ the phasing; between catego-
theory ries: the relation between problem, aims, treatment, effect and rationale).
• Departs from phenomena as they are experienced by people and the
meaning that is given to them.
• Existing theories are bracketed.
• By adding or deleting characteristics, the researcher determines what
belongs to the essence of a phenomenon.
Phenomenolo • This happens by the means of rational reflection, intuition or imagination
gy whether or not in dialogue with others or through document study.

TABLE 5. Qualitative methods for data analysis

• Scrutinizing a phenomenon by the means of a strong form of engage-
ment.
• Projecting characteristics onto a phenomenon based upon counter-trans-
ference; that way, the phenomenon becomes better comprehensible.
• Searching for the latent, deeper (unconscious) causes and meaning of a
phenomenon.
Hermeneutics • Matching the meaning of one part with the entity (hermeneutic circle).
Data-analysis methods suitable for Change Interview, Helpful Aspects of
Therapy Form (HAT) and Brief Structured Recall (BSR):
• Grounded Theory analysis of Change Interview and HAT.
• Task analysis of texts concerning significant events.
Qualitative • Discourse analysis.
change
process • Conversation analysis.
research • Comprehensive process analysis.
Auditing: presenting the data-analysis to independent experts who control
Naturalistic the chain-of-evidence and who determine whether the research methodol-
constructivisti ogy is appropriate and results and conclusions can be deduced from the
c inquiry data.
For the purpose of this table, the following sources were used: Ansdell,
Pavlicevic & Proctor (2004), Baarda & De Goede (2001), Baarda, De
Goede & Theunissen (2000), Berger, Imbos & Janssen (2001), Denzin &
Lincoln (2000), Frommer & Rennie (2001), Giorgi (1985), Hutjes & Van
Buuren (1992), Imbos, Janssen & Berger (2001), Lincoln & Guba (1985,
2000), Mayring (1990), Migchelbrink (2001), Smeijsters (1997b),
Smeijsters (2005a/b), Smeijsters & Aasgaard (2005), Stake (1995),
Swanborn (1994), Wester (1995), Wheeler (1995/2005), Yin (2003).
These tables are meant to provide an overview that facilitates a first

choice, suitable for the presented problem and the formulated question of
inquiry. After this choice being made, the researcher needs to work out
the research design according to the criteria valid for it with the help of
specific manuals.

The research projects carried out by KenVaK1 concern several of those

research types. For instance, it is a question of an inventory research if an
inventory is made of how the set of problems are expressed in the
medium. If, based upon those facts, an observation scale is developed by
the researcher, it is a matter of development research. Research projects
concerning the inventory of competences, e.g. how art therapists have
been trained and what kind of methods and target groups they work with,
belong to the type of inventory research.
A need research has been carried out by KenVaK, preparing the master
programme ‘Arts Therapies’. Managers and arts therapists were asked for
which themes they consider themselves most in need for in a Master
training programme. KenVaK-researchers frequently use development
research. They mainly invent observation instruments and treatment stan-
dards. Effect evaluation is a matter of two sorts: it is either about asking
arts therapists which effects they perceive or about carrying out experi-
mental research, whilst measuring effects.
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Author information
Prof.dr. Henk Smeijsters
Prof.dr. Henk Smeijsters is head of research of KenVaK, an advanced

research centre for the arts therapies (drama therapy, psychodrama, music
therapy, art therapy and dance-movement therapy). KenVaK is a joint
venture of Zuyd University, the University of Professional Education
Utrecht, the ArtEZ Conservatory Enschede, and the partners Oostvaard-
ersclinic (forensic clinic), the School for Psychodrama and the Papageno
Foundation (music therapy for autism).
MAILING ADDRESS: Zuyd University, KenVaK, P.O. Box 550, 6400 AN Heerlen, The Nether-
lands
Phone: 0031-45-4006483
Fax: 0031-45-4006069
Author information 837

E-mail: h.smeijsters(at)hszuyd.nl
Homepage: www.smeijsters.nl and http://kenvak.hszud.nl
This article can be cited as:
Smeijsters, H. (2006) Research in practice. Music Therapy Today

(Online 22nd December) Vol.VII (4) 781-838. available at http://music-
therapyworld.net
This article can be cited as: 838

Music Therapy Today
Beyond Body, Beyond Words:

Cognitive analytic music therapy in
forensic psychiatry - New approaches
in the treatment of Personality
Disordered Offenders
Compton Dickinson, Stella
Compton Dickinson, S. (2006) Beyond Body, Beyond Words: Cognitive analytic

music therapy in forensic psychiatry - New approaches in the treatment of
Personality DisorderedOffenders. Music Therapy Today (Online 22nd December)
Vol.VII (4) 839-875.
Is it not plain that breath conveys even the words that go out from
our lips to the ears of the hearer? The voice is breath. The word is
breath. Without breath speech cannot be produced.” Hazrat Inayat
Khan. The music of life. 1988 Omega Press
839
Compton Dickinson, S. (2006) Beyond Body, Beyond Words: Cognitive analytic music therapy in forensic psychiatry - New
approaches in the treatment of Personality Disordered Offenders. Music Therapy Today (Online 22nd December) Vol.VII (4) 839-875.
available at http://musictherapyworld.net
Abstract
In this paper the author presents a case study of a man with psychopathic
and borderline personality disorders. She demonstrates the application
of dynamic music therapy skills and training integrated with those of
cognitive analytic psychotherapy (CAT). The aim was to provide a twenty
four week time limited psychotherapy intervention that included attuned
musical improvisation as a central component. The treatment has been
developed with personality disordered patients who have offended and
who are in high secure hospital treatment. The author considers the phe-
nomena of dissociation in relation to the etiology of self states (Ryle and
Kerr 2002) and with reference to the creative arts. Within the therapeutic
context she considers the potential of music as a mediating tool for emo-
tional regulation in the transition between self states. The paper demon-
strates some of the therapeutic functions of music in feeling, thinking,
acting and behaving and in accessing unspeakable areas of emotion. It
explains the interaction between the cognitive analytic tools and con-
cepts and dynamic music therapy.
Background
Over the last five years I have considered whether or not it may be possi-
ble to develop an integrated approach in which the skills of a qualified
music therapist may be combined with those of a cognitive analytic ther-
apist. The organizational and treatment demands of high secure hospital
treatment require robust and acceptable forms of arts therapy. Multi dis-
ciplinary treatment requires a Patient to undertake specific offence
related group or individual psychology sessions. The Patient may also be
referred to music or art therapy to promote emotional relatedness through
which offence related issues might also be addressed. Individual thera-
pists and psychologists therefore have to work cohesively within the
overall treatment programme. The twenty four week time limited model
is not expected to achieve the depth of long term ongoing therapy, but
rather to be delivered at an optimum time in the treatment pathway.
Abstract 840
PART 1 Introduction.
I describe the model that I continue to develop as follows:
Cognitive analytic music psychotherapy is an integrated approach devel-

oped towards helping Patients with severe and dangerous personality dis-
orders to access, recognize and work with difficult to access feelings. It
incorporates the skills of dynamic music therapy which includes jointly
created musical improvisation with the structures and training of cogni-
tive analytic therapy.
The latter involves collaborative work between Patient and Therapist in

which symbolic 'tools' are created. These take the form of a reformulation
letter which identifies the target problem of the therapy and a sequential
diagrammatic reformulation (SDR) which helps the Patient to recognize
and understand his particular 'reciprocal roles' (Ryle and Kerr 2002). The
aim of this diagrammatic work is to develop the patients ability for scaf-
folded learning.(Vygotsky 1978) Through this process he learns non
didactically from the more experienced other. i.e. the therapist. Together
the therapist and patient work diagrammatically to map out and recognize
where the patient is in relation to his responses to others, his thoughts,
feelings and behaviors, and how he arrives and moves from one state of
being to another. (See Figure 1 on page 866)
Reformulation in CAT is developed usually over the first eight sessions

of therapy. It is a skill that is learnt throughout training and within weekly
group supervision. The aim is two fold: The therapist focuses his
thoughts on how the patient's problems developed and where the roots of
these began in childhood in reference to object relations attachment theo-
ries. He then reframes these cognitively by identifying and clarifying the
relating procedures of patient. A written explanation in the form of a let-
PART 1 Introduction. 841

ter is produced and read in the session . Within the reformulation letter
an achievable target problem is identified which will be addressed in the
pre agreed time limited model. The reformulation is further illuminated
through collaborative diagramatic work in which therapist and patient
work collaboratively to build up the SDR. This diagram should also aid
the process of recognition within the patient, hence promoting self reflec-
tion, self awareness and insight. This provides an aide memoire for the
patient to work with between sessions and after therapy in order to help
him to think about where he is within his relating procedures.
These reformulation tools should identify the reciprocal roles that oper-
ate within the patient : internally (self to self) as well as interpersonally
(self to others)and others to self For example: perceived rejecting behav-
iors from another may elicit feelings of rejection in the patient and sub-
sequently lead to self isolating behaviors indicative of being rejected.
This may be followed by an acting out of being rejecting as a retaliation.
Hence the reciprocal role of rejecting to rejected is learnt initially from
others but both polarities can operational internally.
Through the therapy process the patient may recognize the roots of his
relating procedures as learnt in childhood . The reformulation should
then help him to consider and revise learnt procedures that are no longer
effective in the current situation which is generally hold very different
circumstance to childhood. In this way the patient may revise his relating
procedures hence finding new and effective exits to difficult interactions
and situations. At the end of the twenty four week treatment the Patient
and Therapist create and swap 'ending letters' to summarize and promote
resolved closure to the agreed episode of treatment. The overall process
involves facilitated self-reflection on significant past events in a support-
ive therapeutic environment. The development of healthy therapeutic
PART 1 Introduction. 842

attachment and separation is central to the process by which mitigation of

damaging past experiences can occur.
Prequel
This paper considers the application of cognitive analytic music therapy

to Patients diagnosed in the International classification of diseases
(ICD10) within the F60 descriptions of personality disorder, therefore
primarily cluster A diagnoses according to the diagnostic and statistical
manual (DSM1V)
My thinking as a C.A.T Therapist is strongly underpinned by my philos-

ophy, and training as a registered music therapist. This integrated
approach uses CAT tools and techniques and the concept of collaborative
music making through which the music becomes an artifact that repre-
sents the culture of the sessions. The collaborative relationship involves
explanation of some processes thereby translating them into cognitive
terms and aiming to provide less of a gulf of knowledge between what
the analyst holds and what the patient does. One of the aims of jointly
created improvisation within this model is to ensure that the reciprocal
roles of overwhelming and superior to overwhelmed and inferior are not
re enacted within the therapeutic relationship. This may occur if the
patient's perception of the music therapist is that he/she holds a superior
power demonstrated through the use of perceived 'clever' musical skills.
For the forensic patients that there is commonly a risk of feeling humili-
ated due to past abuses experienced in childhood. Should this inadvert-
ently occur, the risk of violent acting out is increased.
The therapist therefore requires comprehensive subtle music therapy

skills to ensure that aroused states can be musically contained, affect
Prequel 843
regulation maintained and that manipulation does not occur. Through

an agreed collaborative process of creative self expression and cognitive
understanding the Therapist and Patient can work together towards the
patient's zone of proximal development (ZPD) (Vygotsky1978).This con-
cept refers to the potential for development of inner growth by employing
the structures of scaffolded learning i.e. the CAT Tools. The ideal is to
discover how to use the skills and techniques learnt in therapy when
alone.
In this pre agreed time limited intervention the formulation or realistic

goals is central along with acceptance of the patient's inner potential and
rate of change. The pace may be intensified in a time limited therapy but
the objective is to achieve a realistic and sustainable outcome that is not
forgotten after closure.
The development of an integrated model has involved the support of the

organization in providing two forms of supervision:
1. Music therapy supervision: To consider the therapeutic relationship

and how it is expressed within jointly created musical improvisation.
This is objectively explored in relation to the patient's projections the
transference and counter transference and within the overall psycho-
therapeutic process.
2. Cognitive analytic supervision: With a view to developing an inte-
grated model of the two therapies. To include a detailed reformulation
and other 'outside of session' written work. Supervision also considers
from the CAT perspective the manifest procedures and behaviors as
well as the feelings expressed in music, words and actions .These are
mapped onto a Sequential Diagrammatic Reformulation. This supervi-
sion has intensified the focus of the ongoing nature of psychodynamic
music therapy in which themes may emerge towards a time-limited
structure which expects a commitment of jointly created work from
the patient with the therapist.
One of the challenges in treating the forensic client group is how to pro-
vide a Multi disciplinary treatment model that is compatible with concur-
Prequel 844
rent treatments and cost effective. I suggest that in music therapy

emotional abreaction is central to the process of internal change: the
patient remembers or enters a state of reverie and may experience the
associated feelings to a past event. Clinical experience to date suggests
that this can be incorporated into a robust cognitive analytic treatment
model which recognizes but does not encourage regression.
Freud and Breuer (1991) in the case of Anna O discovered that abreaction
occurred when powerful emotions relating to a remembered event were
expressed with feeling. The significant point being that feeling the emo-
tion internally was considered necessary for the symptoms to disappear.
Macdiarmid (1996) enlarges on this case pointing out that the symptoms
started when Anna O had a powerful emotion that she couldn't express,
thereby suggesting an internal resistance to the feeling which creative
expression could possibly access. This difficulty in expression is I sug-
gest particularly central in treating, redeeming and incorporating disso-
ciative states in personality disordered patients because those feelings
have frequently been unconsciously cast out as unbearable. As a result
these patients are frequently highly articulate but their words may not
hold any underlying feeling or meaning.
It is well documented and commonly experienced that music can be the

catalyst for feelings (Sloboda 1985). There are however inherent risks
with pre-recorded music, because difficult or unmanageable feelings
associated to powerful memories may be accessed. By developing impro-
vised music, the music therapist can facilitate an accurate encapsulation
of the Patient's here and now affect and through this promote the ability
to self reflect on the emotional qualities of the music by listening to what
has been created and recorded.
Prequel 845
Bliss's approach (1980) to the treatment of multiple personality disorder

(MPD) was to explain to the Patient, (perhaps not dissimilarly as in a
CAT therapy), that as an adult, he can 'flush out, remember and defeat
unwanted personalities.' In the case of MPD the Patient may be unaware
of his other personalities; who's function may be to say what the person
can't say, or feel what the person finds unbearable to feel.
Not dissimilarly, patients with borderline and psychopathic personality

disorders may be unaware of their state shifts (Ryle and Kerr 2002). Sud-
den and unpredictable mood changes are symptomatic of state shifts and
there may be no recognition or awareness of this process.
This occurs when the feelings associated with the experience become
intolerable and the unconscious defense mechanism of dissociation
comes into operation. This constitutes a risk factor through resulting
behaviors which have to be considered for the delivery of safe treatment.
Whilst Bliss worked with hypnosis, I suggest that his explanation has
some relevance in the development of music psychotherapy because
music used in certain ways can create quasi hypnotic states and altered
states of consciousness which could be either helpful or abusive if mis-
used. Bliss also states that tactics that reduce emotional intensity can be
helpful in reducing anxiety and panic. This supports the use both of the
C.A.T cognitive tools and the central facilitative properties of the role of
affect attunement (Stern 1987) to mediate emotional relatedness. In
music therapy affect attunement occurs in the process of using the cre-
ative medium for empathic emotional recognition through mirroring and
containment in spontaneously created musical improvisation. In my ear-
lier paper (Compton Dickinson 2001) in which I compare and contrast
dynamic psychotherapy with CAT, I explain in greater depth the link
between affect attunement and sign mediation (Ryle and Kerr 2002). To
Prequel 846
summarise: musically expressed affect attunement is effected through

working with elicited counter transference, i.e. the therapist chooses
whether to identify with or reciprocate to the musically expressed recip-
rocal role of the Patient: hence tuning into the non verbal reciprocal roles
that are perceived, seen and heard through musical and physical actions,
gestures and behaviors. The therapist aims to meet, match, mirror and
make recognizable the unrecognized mood or need of the patient as
expressed or enacted through their reciprocal roles or self states.
The Cognitive Analytic Therapy (C.A.T) split egg diagram (Ryle and
Kerr 2002) see appendix, is a visual aid to understanding the psychic
split that can occur between good and bad part states of varied individual-
ized descriptions. It is a useful tool in CAT by which orientation to the
real world is supported, hence promoting recognition of potentially
escapist elements. This diagrammatic work may take place at any time
during a session; for example prior to improvisation to help locate what
state a patient is in at that time; alternatively to aid recognition when a
Patient has used music defensively to avoid a difficult feeling through
musical flight into an idealized state.
This case study aims to demonstrate appropriate use of therapeutic musi-

cal interaction in improvisation to facilitate the reclamation of dissoci-
ated states.
PART 2 Musical developments towards treating

personality disordered Patients
In reformulation issue 21 Steve Potter asks ‘Where do states come from?
And where are they when they are gone? He continues:
“States can mediate our experience and come and go like head-
aches. They can be fleetingly or chronically endured. States once
PART 2 Musical developments towards treating personality disordered Patients 847

fleetingly embraced are subsequently fragile when achieved or

pined for helplessly. States can saturate, or haunt, or empower our
sense of self and other. They can be dreadfully avoided as can the
people, or persons, or memories of place and time that are associ-
ated with them, We can get stuck in them; be triggered by events
into or out of them. We can set our freedom of will and conscious-
ness’ against them and ride over them. We can lose ourselves in
them” (Potter2004)
This description triggered a considerable journey of exploration in which
I reflected on Potter’s observations and the potential for links to non
verbal creative expression.
THE ROLE OF JOINTLY I suggest that the Patient must also accept the recognized feeling, rather
CREATED MUSICAL
IMPROVISATION IN THE than simply acknowledge it. The music may otherwise become dissoci-
RECOGNITION OF SELF
STATES AND AS A ated, outside of himself or attributed to the therapist alone.
MEDIATING TOOL FOR
THE TRANSITION
BETWEEN SELF STATES. When a jointly created artifact in the form of a musical improvisation is
produced, it may be felt as part of the Patient’s own self-expression. It
can be experienced as part of him. According to Vygotsky’s (1978) activ-
ity theory, the artifact is created with the help of the more experienced
other i.e. the therapist. In the musically therapeutic context as the work
proceeds the therapist may gradually offer less musical structure i.e. scaf-
folding. This would occur in response to the Patient’s developing abilities
to explore, express himself and relate reciprocally in dialogue.
Within this process, I suggest that the nature and qualitative effect of the
vibrations absorbed into the body through the specific sounds produced
are crucial towards the development or otherwise of the sense of thera-
peutic connection. It is in this way that recognition of the affective quali-
ties of the music may occur.
The sensitivity of the therapist’s musical skills should ensure that the
Patient feels empowered rather than inferior or without any skill so that
he can take ownership of his music. Subtle musical techniques support

the creation of jointly created music so that the Patient can recognize his
own musical self expression as well as build up his relating abilities
through recognition and value of the support provided by the therapist.
When self-states have been identified diagrammatically, the Patient can

be musically and therapeutically supported to feel these through the
musical interaction. The therapist may carefully initiate the associated
quality of feeling whilst maintaining containment. The patient is in a safe
relating situation that has the potential to challenge his old fears and
bring forth the need to invest trust. In the primary abusive situation he
may have been alone and terrified, in the therapeutic situation he may
instead gradually tolerate and internalize the feelings rather than acting
them out.
There are situations where I suggest the music therapist can validate
starting the musical interaction or even playing alone, rather than wait-
ing. The use of the observing eye, (as if outside oneself looking at one-
self,) informs this process. This enables decisions to be made about how
to respond to what is perceived. Particularly with regards assessing
whether the patient’s anxiety levels are bearable or unbearable, therapeu-
tically containable and useful or otherwise contraindicated in the global
sense.
To ascertain and express what is felt implicitly from the patient rather
than what is explicitly said is useful because the personality disordered
patient’s words may not be felt sincerely as such they may not be congru-
ent to the therapists counter transferential experience of the patient. It is
in this way that the therapeutic process is informed.
I suggest this technique can be helpful in gently shifting the focus of the
therapy. For example where the sense of being stuck may have been thor-

oughly felt by therapist and patient but has become counter productive:
The counter transference may inform the therapist of a blank sense of
emptiness, as if the Patient is struggling to identify any feeling at all. Ini-
tiating the music can sometimes create greater intensity than simply
going with what the Patient presents. I have considered that a purely psy-
chodynamic approach in some circumstances leaves the therapist open to
manipulation from personality disordered Patients. Without appropriate
structures in place the therapist requires is vulnerable to becoming an
object through which a patient could sadistically re- enact abuse. Musical
improvisation instead be incorporated into the containing and facilitative
structures of cognitive analytic psychotherapy.
A psychoanalytic approach in music therapy with offenders is demon-

strated by Glyn (2003). He explains how a Patient’s choice to play certain
songs and the meaning of their words, through accurate analytical inter-
pretation promoted insight into the offence. The patient shifted from
denial to being able to see what he had done to his victim. I understood
Glyn’s description as ‘two people dynamically engaged but with the
capacity to view what they are doing as if from a third external position’
as not unlike the CAT concept of the observing eye. There are many dif-
ferent therapeutic means to an end and this example is highly relevant to
the development of victim empathy.
Glyn strengthens the argument for music psychotherapy with this client
group as opposed to a softer form of music therapy in which transference
and counter transference are not primary tools. Without recognition and
understanding of these processes the meaning of psychotic and erotic
transferences may be missed, thereby loosing sight of the symbolic
nature of the therapeutic relationship. The complexities and difficulties of
addressing the index offence that brought the patient into treatment
through the criminal justice system can be accessed through creative use

of metaphor and non verbal expression. Recognition and understanding

of deeper meanings may then follow.
I suggest that psychotic defenses can be mitigated through further devel-

opment of collaborative and cognitive music therapy processes that do
not include psychoanalytic interpretation in the CAT time limited model.
The patient may discover an acceptable musical medium through which
he can find his own musical voice. In this way he may portray repressed
or suppressed feelings relating to his offence. The musical interaction
may also reveal aspects of how he related to significant others. The
improvisation can then be objectively analyzed at deeper levels in super-
vision. In the following session the Patient and Therapist can reflect col-
laboratively on its meaning, hence promoting greater recognition and self
awareness through self reflection rather than interpretation. The patient
can feel directly and equally involved, empowered and can take owner-
ship of his feeling. In this way analytic levels may be recognized but
mindfulness of the closer nature of a collaborative therapeutic relation-
ship has to be addressed.
PART 3 Case Study: Beyond Body, Beyond Words
HISTORY Colin is a British citizen in his forties, born of immigrant parents.. He is

diagnosed with psychopathic and borderline personality disorders. He
was a victim of childhood sexual abuse at the age of eight years old. Dur-
ing early childhood his grandparents brought him up because his mother
‘abandoned’ the family ‘to live with another man’. At age seventeen
years Colin found his mother and threatened to kill her. Colin has been
detained in prison and then high secure hospital for over 18 years in all.
He has undertaken comprehensive psychology treatments including
advanced dialectical behavioral therapy and anger management. He has
PART 3 Case Study: Beyond Body, Beyond Words 851

had some musical education but no formal musical training. His index
offence is assault and wounding with intent. He has also been convicted
of indecent assault and burglary. He has attempted to poison a woman
and has a history of violence towards women.
DESCRIPTION Colin is slightly built but can be large in presence. He is physically very
fit but has several physical ailments that cause him a lot of bodily pain.
He has a bright and amenable nature and a good sense of humour. He pre-
sents as articulate and intelligent. He is meticulous about his appearance,
cleanliness and routine. He has a broad smile and natural bright eye con-
tact. He is creative in song writing, drawing and painting.
REASON FOR REFERRAL Colin was referred to music therapy to promote his engagement with
feelings through music and to relate to a female therapist. I understood
that the Team considered that he could talk convincingly but his words
were not sufficiently related to his feelings.
THE PSYCHOTHERAPY This is a standard CAT Tool in the form of a questionnaire that identifies
FILE
different problematic ways of relating in the forms traps, snags and
dilemmas. Colin felt unable to complete this early in the therapy. We
therefore worked on it gradually in the sessions. Colin did not identify
with the traps, snags and dilemmas but the page of different self states
provided rich material: I have written Colin’s comments in italics.
He identified the Zombie state,

Feeling bad but soldiering on,
Rage:‘ Definitely! but not out of control’
In control of self, cheated by life and others. Untrusting,
Fearing abandonment (If asked when a child, Yes,) I noted that
this could
not be acknowledged in present relationships.

Confused, misunderstood, rejected and abandoned.

Contemptuously dismissive of myself-he described this ‘as the
worst place’ this reminded him of his nightmares in which he was
unable to
scream.
Needy’: to get out of here!’
Hurt by others.
Secure in myself and able to be close to others. I was not con-
vinced about his ability to get close to others, particularly as it
opposed his final comment:
Frightened of others ‘how long have you got? Aren’t most peo-
ple?’
This last comment was particularly significant to the frightening
to frightened reciprocal role and how C subsequently created dis-
tance between us.
BEGINNING THERAPY Colin firstly played The Tam Tam. This is a very large Chinese gong. He
responded ”It feels like something is going to happen”. Having used a
soft mallet to produce the sound, I showed him how to put his hand close
to the gong by which he could physically feel the resonance of the result-
ing sound vibration without actually touching the gong. In this way
Colin made a link between listening and feeling. I suggest that this sense
of feeling without being touched was significant for Colin to create safe
distance and yet still communicate and develop trust.
Colin initially described ‘deep’ and ‘bright’ tones but nothing between
the two polarities. Through some simple diagrammatic work with the
split egg design, we linked these contrasting qualities of sound to Colin’s
‘demon’ and ‘normal’ states. These two states were all he could recogn-
ise about himself. With some surprise he said: “there’s nothing in the
middle! Its blank.... Blankety blank! There was limited emotional
expression and my counter transference was of shocked emptiness.

At the end of this session he asked if he could bring his own guitar. The
following week I was introduced to ‘Bessie’ the bass guitar. I perceived
Colin’s sense of attachment to Bessie as similar to that of a transitional
object and we noted that her voice was low and muted in quality, rather
like his own voice. He said ‘she does what I want…at least... most of the
time”. The latter seemed to have a hesitant quality. I wondered if this
remark and his apparent need to be in control also reflected how he felt
about the therapeutic relationship. I considered that his final remark may
really be expressing his doubts about whether I would do what he
wanted.
Even if Colin could not yet articulate this to me directly, it became clear
that the development of trust would take time. I had explained the struc-
ture and time limit of the therapy but I had insufficient material for a
reformulation letter by session four. The first few sessions had been less
directive than a purely verbal CAT therapy. This was my first application
of CAT with the high secure hospital client group so I was cautious to
consider the differences from community patients as well as the index
offence. In supervision we reflected that an optimum point for the refor-
mulation letter would probably evolve. This occurred after a significant
improvisation in session thirteen. I will now describe how the therapy led
up to this point.
SESSION 7 Colin announced ruefully that he couldn’t bring Bessie because she was
‘poorly’. As the session progressed Colin described how he himself felt
poorly and that he was ‘hurting’ both physically and mentally. He was
having recurrent bad dreams. He shared that in the dreams he was the
victim of the crime that he had in real life perpetrated. In supervision we
recognised that he may have left Bessie behind as indeed he was also in
the habit of leaving his dissociated feelings behind, but he had brought
these back into the room via Bessie in order to look at the hurt parts of

himself. Colin seemed to be able to talk about his own body by projecting
his feelings into his guitar. By telling me his nightmares I was holding
and containing these feelings and so he was trusting me. We were con-
necting as two human beings as well as non verbally in musical interac-
tion.
Colin left session seven saying that he had come to the session ‘feeling
little’. At the end he drew himself up to his full height and said, with what
I experienced as a slightly puzzled and surprised sense of satisfaction,
that he felt bigger than when he had arrived. Consistent orientation to the
present reassured Colin that he would not be treated as a child even when
we were exploring childhood issues and he presented as somewhat
regressed. This may have given him permission to explore his own inner
child within the therapeutic relationship without feeling ‘silly’ and to go
back to the ward able to cope with the custodial environment .
I discovered that I could work constructively with potentially regressed

aspects of Cs personality. Various different ‘boy’ states surfaced, these
were recognised and then contained within the maternal transference. In
this way a dialogue began both from myself to each ‘boy’ state and then
within Colin to that part of himself: quiet boy, sad boy, bully boy, happy
boy etc. he then conveyed this connection to me. Trying to locate all of
these states onto a cohesive diagram became a challenge as they were ini-
tially so compartmentalised that no links could be found in how he
shifted between them.
I view this as the key problem in personality disorder and dissociation.
When Colin next brought Bessie to the session he too was feeling better.
He related to the notion that his voice had been heard through the bass
guitar and that ‘Bessie’ had helped him to talk about himself. In the next

session he chose to play the six string electric guitar. He did so very qui-
etly in an introverted and isolated manner. I perceived a distant quality. I
responded that this sounded like quite a different voice that I hadn’t heard
before. I described it to him as tiny and rather weak, continuing that I
experienced this small voice as like a little flower struggling to grow.
Colin engaged with this idea of a vulnerable flower and a little voice that
needed to be nourished in order to survive.
The following week he arrived highly motivated and with a clear plan.
He had brought another of his own guitars. He said he had tuned it espe-
cially for the session.
THE HEART OF THE I will describe the two significant Improvisations that occurred and led to
THERAPY: SESSIONS 11-
14 the reformulation letter.
Improvisation 1 retrospectively named by C as ‘Energy Child”

Duration 6 minutes. (Session 13).
I chose to play the Piano as I thought it would be less threatening for
Colin than if I were to play the oboe on which I am a skilled player. I ini-
tiated a simple, modal melody. Colin played his Electro Acoustic Guitar.
This was not in tune with the piano, yet he was very definite that he had
tuned it as he wished it to be. I had chosen the piano to create harmony
but I subsequently felt that I had been cleverly controlled as I could not
provide harmony because of the fixed pitch of the piano. I could not
adjust its tuning to that of the Guitar in the way that I would have done if
I had chosen to play the oboe. Hence harmony in relating also became
difficult because of the distance created.
It was only after the therapy finished that Colin explained that he had
tuned the guitar in this way on purpose to keep me at a safe distance.
There was an abrasive edge to the music which was an agonising experi-
ence, yet also deeply moving and connected because he had allowed me

to enter his world. The out of tune aspect added to the emotional content.
I reflected that there was a powerful parallel in how Colin succeeded in
making me feel something of the agony, frustration, trappedness and
unreality of the childhood situation that he subsequently described in the
imagery of this piece of music:
“Energy Child”Description . 1st section I play introductory notes on the

piano to set the scene, aiming for a spacious open and non descript feel
which was based on the counter transference experience. Thereby invit-
ing Colin to initiate his theme.
2nd section I initiate a 6/8 dotted rhythm at the Piano. Colin listens then
engages with chords, the piano melody is added, each time returning to
the same home note. Colin accompanies this and it becomes a genuine
dialogue. I then play as if treading water whilst Colin decides what to do
next. I use a questioning motif leading to a moment’s silence then:
3rd section is initiated by Colin. This is clearly connected playing. I add

to and support Colin’s theme and this is harmonious, together and
accepted by Colin. Finally he becomes more adventurous harmonically.
Silence follows then Colin adds his own resolved ending. At the end
Colin said as if to himself ‘speak to me, speak to me!’
Colin listened to the recording and said it reminded him of when he was a
child of eight years old. He began to describe his place of refuge where
he would run away and hide after suffering childhood sexual abuse. The
imagery was so vivid that I asked him if he would like to draw this place.
(See Figure 2 on page 867). I only had a piece of A4 paper and a biro.
Colin drew a straight river across the page and described how ‘boy’
would sit on a fallen tree trunk and cast out part of himself into the river’
like a boy mermaid’ to swim about freely. I noted that ‘boy’ was a word

and did not have a body and that mermaids are female. Retrospectively
recalling that in myth a mermaid cannot survive away from water and nor
could Colin’s innocent state survive it had been taken from him. In his
disclosures Colin explained that as a child he had been confused about
his gender. In this scene we together recognised that he had cast out the
shamed part of himself and all the intolerable feelings that it held. In his
desire to be cleansed by the water of the river he had lost this voice
because that part of him was no longer in his body. He had released this
unacceptable, vulnerable, abused boy state and set him free into the river.
Colin then realised how his ‘bully boy’ state has been able to take over
and rule supreme within him, unchallenged and able to survive the hard-
ships of youth with a tough protective mask.
I have considered that this collaborative musical interaction took us to the

place where Colin’s dissociation began as a coping mechanism and as a
result of the unbearable feelings initiated through the traumas of child-
hood sexual abuse. Unlike his real mother, I had been there for him. He
had developed trust sufficient to take me to his secret place. If he had
allowed us to be in tune I believe we would have been too close which
may have led him to feel a negative loss of control through the reciprocal
role of powerful, frightening, dangerous parent to vulnerable, frightened
weak child where the degradation had originally occurred. Instead he
took control but in a dialogue of equals because it was more the real him
to be out of tune. He was assertive in making his dissonant voice heard
and therefore he gained recognition on his own terms.
Colin brought a pastel drawing to the next session; it was of a flower with
four petals. He asked me to tell him what was wrong with it. I said that I
could see that one petal was paler than all the others. He was pleased with
this response and explained that this represented his sad, silenced boy
state and that he had surrounded it with prickles to keep people away. Of

course on a deeply unconscious level prickles also draw blood and cause
pain. The quality of the interaction was not hostile. I considered after the
ending of treatment that it was too intolerable for Colin to own his hostil-
ity towards me and the world.
The next improvisation was called ‘happy boy’ in which on listening to

the recording he recognized that his playing of the bass xylophone
sounded ‘like a frightened rabbit beating its feet as a warning.’ I had
responded on the descant recorder which gave the piece a childlike qual-
ity. However, the piece seemed to grow up and developed from these ten-
tative, frightened childlike interactions into a rhythmically consistent and
energetic reciprocal dialogue with sections that developed into a melody
with four equal sections. Colin listened to the recording and reflected ‘
we are back in the flower’ with its four petals. I responded that this time,
the four part music had individual petals that were equal in quality. At the
time there was a sense of healing and integration. In retrospect I look at
the flower (see Figure 3 on page 868) which has been perceived by some
to resemble female genitalia and as I think of how the strength of his
music developed I wonder whether Colin was in fact attacking me. It is
indeed difficult to keep in mind both the cruelty and the helplessness of
these patients. I probably preserved the split at the time because in paral-
lel process to Colin’s experience, the holding of the domineering and
threatening aspects can be almost intolerable for the therapist.
The reformulation letter crystallised in words what had happened in the

musical interaction. Colin had reclaimed some parts of his life story and
personality. It also brought recognition of Colin’s need to be rescued, just
as he used to be ‘rescued’ from his place of refuge by ‘a nice policeman
who carried me home’. But in reality there was no real rescue because
the policeman took him back to the home where the abuse continued to
occur.

Self states and their Reciprocal Roles. Colin was able to recognise and
locate his reciprocal roles and gradually to work with target problem pro-
cedures to link his self states. This began with diagrammatic work in
which each ’boy’ state had a separate and unconnected box of its own. As
the links were made collaboratively, Colin discovered through the guitar
the different voices that linked to his different states. He developed the
ability by the end of therapy to be able to sustain ‘play’. Like a child
there was fun and laughter between us. He also realised that healthy
musical interaction between a male and a female was acceptable and at
times joyful. These experiences were recognised as ‘normal’ rather than
his childhood experience of ‘being shaken like a doll’ by his mother. He
exclaimed this discovery as coming “ after thirty one years of neglect
...by Mum”. I considered that this increased the pressure to effect a
resolved ending, so that Colin could be normally sad without feeling
abandoned.
The Ending. Colin did not engage consciously with anger or fear about
ending. I had been idealised as another person who had rescued him, hav-
ing helped him to retrieve quiet, sad, abused boy from the river. Colin
had drawn a representation of himself as a damaged flower with prickles
to defend the damaged part. I had been expected like a good mother, to
understand what the picture meant without his prior explanation. Colin
had also spoken very explicitly about the sexual abuse from his father,
but he has never told his mother, and she still does not know. Colin stated
in his ending letter that bully boy demon state can’t rule him any more
because abused boy with all his qualities has been recognised, seen,
heard and can hold his own’. Abused boy can ‘forgive but not forget.’
Exits: Session 22

Ongoing diagrammatic work led to a major revelation when Colin dis-

covered that feelings lie centrally in the body. He had not realised that
feelings were different to thoughts and that they could be felt safely
within his body. In this way he discovered that feelings reside in the heart
and not in the head. The heart could be conveniently located on the SDR
between the two halves of the split narcissistic egg so that he could locate
his feelings on his map and work out how to access them. This was help-
ful in mitigating his ability just to ‘talk the talk’.
Final session
Colin chose to play the electric Guitar, the music was reminiscent of
‘Energy child’ except this time I vocalised without words. There was a
lamenting quality but with acceptance and the reciprocal role of control-
ling to controlled was not present. Bessie the Bass Guitar was reflected
on as an object: The low voice of a man, the body shape of a woman. I
consider that Bessie represented potentially dissociated aspects of Colin’s
relating to himself and to others.
Colin brought a second flower picture (see Figure 4 on page 869). He

presented this to me as representing his healed self. He was clearly
pleased with his creation which is dynamic and virile, strong and mascu-
line in quality but it left me ill at ease. It was only later that I could
acknowledge the barbed anger and potential power to harm that it might
represent. Perhaps this was an unspoken, unconscious gesture of anger
that we were finishing our weekly contact. I had been the woman who
had witnessed his place of abuse and now I may be perceived to be aban-
doning him after he had opened himself up.
Colin’s ending letter said that he can be soft, gentle boy because angry
boy is at peace. He indicated some acceptance and reconciliation that I

consider may have occurred because he abreacted aspects of the trauma

in his relationships both to his mother and father. Colin discovered that
he had the ability to invest trust enough to show me ‘the real me. He had
gained some acceptance and the ability to love his own inner child rather
than to hate himself and others.
SEQUEL Colin achieved his aim and moved on from Rampton Hospital. However
a year further on this proved unsatisfactory and he returned. Colin had
denied that the abuse ever took place. This had lead to mistrust in his
team. I reflected on this in supervision. Perhaps Colin could not hold the
therapy experiences within him just as he had no control over the appall-
ing bodily experiences resulting from the physical pain and damage of
childhood sexual abuse. Nothing could stay inside any more then than
now. His containment as an adult had been provided by high walls and
outer security. It was behind those high walls that Colin discovered some
inner security and good enough symbolic parenting figures through the
attentive care of his named nurse, his psychologist and his music psycho-
therapist. Perhaps it was too much that through the development of trust
in the therapies that Colin exposed his inner self, thereby risking vulnera-
bility. However all that he was unable to control as a child, all that made
him vulnerable and degraded could be given temporary respite through
identification with the aggressor and the re enactment of this abuse in the
violent penetration of his offence. Perhaps when Colin was unable to
employ the techniques learnt in his therapy in his new ‘home’ he felt
intolerably abandoned by us all. He turned the tables on us by indicating
through his dissociation from the childhood abuse that whilst we thought
we knew him, we didn’t really. This may be viewed as tantalizingly pro-
vocative as if we see him but do not reach him. His isolation and terror
would therefore be perpetuated. When ‘home’ alone without either inter-
nal or external controls he sought unconsciously perhaps to penetrate and

return to the confinement of high security. The powerful rescue fantasy

that began with the policeman by the river took him back in his mind so
that he may have hoped for rescue from his named nurse and myself. But
this may also be viewed as yet more of the same: whilst dissociated and
unconscious there are both sadistic and masochistic elements in both his
past experience and his response to recent perceived abandonment. The
bully boy had reinvented himself because he discovered that there was no
safe home. The ongoing work would be about true integration over the
longer term, the split between the two boy states is still too useful to
relinquish and twenty four sessions of therapy is a drop in the ocean in
terms of time in comparison to Colin’s compounded problems over many
years.
Conclusions
The therapy was evaluated with the PROQ2 Person relating to others
questionnaire (Birtchnell J. Institute of Psychiatry). At closure and follow
up this scored sufficiently low to indicate that there was no evidence of
active psychopathology. I suggest that this indicated a dynamic process
of change that occurred during the therapy. However this and the sequel
to treatment indicate that in personality disordered patients who are not
receiving anti psychotic medication, their relating may be influenced by
environmental factors and the responses of others. As such the patient’s
ability to relate to others may fluctuate and is not necessarily sustainable
on a balanced equilibrium. An internalised ability to recognise the state
that he is in at any given time, the ability to continue to use the therapy
tools to that end after treatment has finished, and a range of useful proce-
dures of self management are all required towards sustaining inner
growth and positive change.
Conclusions 863
Jointly created musical improvisations when recorded can become an

artefact which represents the meaning and nature of the therapeutic rela-
tionship. The music has a ‘body’ in which the individual, with help from
the more experienced other can find lost parts of himself. Bessie the Gui-
tar was recognised as being like a transitional object, representing a part
of Colin from which he could both dissociate and connect. The musically
created component can take the personality disordered patient beyond
words or to where words have not yet been possible.
Colin discovered that all his states resided in his one body. Mildly regres-
sive aspects were present, this could have lead to vulnerability if not
carefully contained. Without ongoing support and containment the
intense recall of some experiences facilitated through musical interaction
could have led to overwhelming emotional pain and therefore further dis-
sociation which would have been counter productive. The aim was to re-
integrate split off aspects of Personality. Music making helped to create
the links between these self states. Hence this model was manageable and
has a place in the context of high secure hospital multi disciplinary treat-
ment.
The ending of time limited therapy in the high secure environment

requires careful management particularly because the therapist may be
seen in passing after treatment has finished. I have discovered that this
can be usefully addressed in a shorter piece of follow up work by gradu-
ally increasing the time between planned sessions to fortnightly then
monthly then three monthly sessions. Within the Multi Disciplinary Con-
text, attendance at ward rounds can mitigate aspects of abandonment and
aid healthy separation after ending.
A creative world of symbolism can sometimes be difficult for patients

who think in quite a concrete way. However, the symbolic use of music
Conclusions 864
created a bridge across the split between Colin’s demon and normal
states. This enabled him to struggle with and relate to his demon bully
boy state and his lost innocent boy state. More work is required for Colin
to accept both his polarised states as inseparable but manageable parts of
the real him. Through inner and outer dialogue with another person rather
than alone, the whole of his being may be understood further, forgiven
and reintegrated.
Acknowledgements
• To the Patient in thinking about and giving consent.
• To the Responsible Medical Officers for their support and consent.
• To the Named Nurse for his support to the Patient and this project .
• Michael Knight, Helen Odell-Miller, Averill Williams and Anna Motz.
• To Nottinghamshire Healthcare NHS Trust and Rampton High Secure
Hospital
• Therapies and Education department, Rampton Hospital for support-
ing the development of Arts Psychotherapies.
• Jaadu and Dorabella.
• * Dr B Brend
• Mrs N and Professor John Bessant.
Acknowledgements 865
Appendices
FIGURE 1. Sequential diagrammatic reformulation
Appendices 866
FIGURE 2. First Drawing of the River and ‘Boy’
Appendices 867
FIGURE 3. Energy Child Flower
Appendices 868
FIGURE 4. Flower child flower.
Appendices 869
AN EXPLORATION OF What happened to the Demon state?

SOME LINKS BETWEEN
THE CREATIVELY
DRIVEN THERAPEUTIC Colin expressed that by reclaiming and integrating his abused, silenced
PROCESS AND SOME
CULTURAL state and finding his voice that he could now manage his demon bully
EXPRESSIONS OF
DEMONS. boy state. I was interested to explore some cultural examples of how our
demons are represented as part of ourselves.
Demons, angels, dragons, mermaids, the phoenix and the unicorn all
have in common some human and some other world quality; whether
divine or monstrous. This is also the case, past and present in how ‘mad’
bad and dangerous people are portrayed in popular culture and the tabloid
press. This is witnessed when patients are sent to a locked hospital to be
treated in an environment where the public cannot easily access or see
them. They may then become portrayed as monsters. Yet in a clinical set-
ting, they are real people with real problems who look like any ‘normal’
person.
Whilst writing this paper it seemed to be synchronistic rather than coinci-

dental that I had the opportunity to see at the Royal National Theatre in
London “His Dark Materials”: the dramatisation of Philip Pullman’s
book ‘Northern Lights”.
Also, that I was accompanied by an expert on Persian culture and art to

‘The Turks’ exhibition at the Royal Academy of Art.
I will describe the influence of these two events.
Both feature different concepts of ‘demons’ which led me to question

how the arts therapies might embrace these notions and promote a wider
acceptance and integration of the term ‘demon state’ that in not uncom-
mon in the forensic setting
Appendices 870
In the play ‘His dark materials’ each character has a ‘familiar’ which
refers to the ‘daemon’ in Pullman’s writing. This represents a different
but inseparable part of that individual’s personality in the form of their
‘Daemon’. The demons were represented in the play as different animals
in the form of discreetly operated marionettes. These were manipulated
by a puppeteer who was clothed to look like a shadow, thereby enhancing
the effect. Within the mythology of the story the demon does not ‘settle’
in its form until the child has reached adolescence. This reminded me of
the diagnostic criteria for the onset of personality disorder. ICD 10 F60
diagnostic guideline (d): “ the above manifestations always appear in
childhood or adolescence and continue into adulthood” The link that I
drew was that of personality development, the influence of life experi-
ences during formative years, and how habits may become compounded
and ingrained in adult personality.
Pullman’s story states that each individual must remain connected to his
daemon. If the connection is severed when under threat then the individ-
ual himself is also under threat. This is seen to be the case if we consider
that under extreme threat the most profound defence mechanism is disso-
ciation in which the individual does indeed become disconnected.
My understanding was that the demon has to be worked with and listened
to in much the same way as in therapy. This in CAT would be described
as a self to self dialogue.
The demon represents the shadow state as an integral part of the self.
In the Turks exhibition there are several images of demons with humans,
and demons fighting each other. Notable were those of the fourteenth and
fifteenth century that were dark in colour and masculine in form. They
had teeth, horns, tails and skirts. It is thought that these images may relate
Appendices 871
to central Asian ideas of shamanism: people who were believed to be half

animal in form and who danced into a trance thereby entering another
world. Perhaps these entities initiated fear in so called ‘normal’ people.
However, these pictures acknowledge and even celebrate the presence of

the demon state.
They may acknowledge internal conflict rather than invoking a fear of

the darkly unknown, half human half animal aspects of human personal-
ity.
In the later fourteenth to fifteenth century images, these human like

demons are depicted as literally harnessed, industriously pulling the car-
riage of the newly married king Sulayman and his Queen across the sky.
The demons carry his treasures whilst being shackled together, so they
cannot run away. They generate energy and they are under the control of
the benignly portrayed King. The Islamic view being that he can speak to
and control demons and is frequently portrayed presiding over angels,
animals and demons.* The demons are enslaved in chains and subservi-
ent. I conclude that this may be viewed as an effective and strong rela-
tionship for an individual who hopes to be master over his own inner
demons and thereby gain untold riches.
It may not be coincidental that within Turkish society, boys were taken to
court as slaves, and could rise to the status of being a king. The metaphor
and symbolism that this suggests is that through suffering and hard work
in that society there was the hope of improvement and freedom.
Cultural sources of creative work such as the examples above demon-

strate subjective feeling and thought absorbed through vision and culture
and through the movement and integration of people. Many of the images
in this exhibition are drawn as taking place along the journey of the silk
Appendices 872
route. The inner conflict is depicted with demons and externalised in art.
My perception was that the difficult and bad parts of human existence
could be interpreted morally through the epic stories that these manu-
scripts describe. A parallel may be drawn to the inner journey of self dis-
covery which can be equally rich.
The art and drama that I have referred to provided inspiration through
which I have considered that the hope is that different and opposing parts
of the personality may develop and gradually be integrated. This is a
gradual process that occurs through the challenges faced and the individ-
ual’s responses that provide the meaning of life’s journey.
Copyright Stella Compton Dickinson
25.11.06
References:
Birtchnell, J. (1999) Relating in Psychotherapy. The Application of a

New Theory. Ed. Crown S and Lee A. Westport: Praeger.
Birtchnell J.1; Shine J.2 (2000) British Journal of Medical Psychology

73 (4), 433-448.
Bliss, E. (1980) Multiple Personalities A report of 14 cases with implica-

tions for schizophrenia and hysteria Arch Gen Psychiatry 37, 1388.
Compton Dickinson (2001) Compare and Contrast the practice of C.A.T

with dynamic psychotherapy. Ch.1 An overview past and Present. Ch. 4
The musical application of C.A.T principles in attachment and develop-
ment Kings College Library: Academic Psychiatry, Guys Campus and
Institute Of Psychiatry (IOP)
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Compton Dickinson, S J (2003) Community, Culture and Conflict: The

role of creativity British Society of music Therapy. Conference Proceed-
ings 2003
Compton Dickinson (2004) "Changes" - Community, Culture and Con-

flict: The role of Creativity. Music Therapy Today (online) Vol. V, Issue
5, available at http://musictherapyworld.net
Freud, S. (1991) Case history Fräulein Anna O. Penguin Books
Glyn, John (2003) New York Mining Disaster. British Journal of Music
Therapy 17(2) 97.
ICD-1O (1992) International Classification of mental and behavioral

disorders. Geneva: World Health Organization.
Macdiarmid, D. (1996) KCL M.Sc. Mental Heath studies. Dynamic psy-

chotherapy Lecture Notes 6 Guys Hospital London: Dept of Academic
Psychiatry.
Potter, S. (2004) Untying the knots: relational states of mind in cognitive

analytic therapy A.C.A.T journal: Reformulation (issue 21) London:
Dept of academic psychiatry. St Thomas’ Hospital.
Pullman, P. 1995 His dark materials “Northern Lights”. London: Scho-

lastic Point.
Ryle, Anthony and Kerr, Ian (2002) Introducing cognitive analytic ther-
apy. Chichester: John Wiley and Sons.
Sloboda, J. (1985) The Musical mind. The cognitive psychology of music.

Oxford: Clarendon Press.
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Stern, D. (1987) The interpersonal world of the infant. New York: Basic
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Vygotsky, L.S.(1978) Mind in Society, The development of higher psy-

chological processes. Cambridge: Harvard University Press

Compton Dickinson, S. (2006) Beyond Body, Beyond Words: Cognitive
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This article can be cited as: 875

Music Therapy Today
MELODY AND RHYTHM

– ‘Indianness’ in Indian
music and music therapy
Sairam, T.V.
Sairam, T.V. (2006) Melody and rhythm – ‘Indianness’ in Indian music and music
therapy. Music Therapy Today (Online 22nd December) Vol.VII (4) 876-891.
Indian Systems of Music

The 3000-odd year old Indian genre of music is basically melodic, is
based on the principle of resonance, sruti and rhythms, laya, regarded as
‘mother’ and ‘father’ respectively. It is impossible to perceive any musi-
cal piece without their intermingling. Sruti, the very backbone of the
Indian music plays a vital role in rendering a specific identity and indi-
viduality to a raga that distinguishes it from an ocean of ragas.
Indian system of music is an individualistic, subjective, and spiritual art,

aiming not at symphonic elaborations but at personal harmony with one’s
own being.
MUSIC OF THE VEDAS Indian music reflects the delightful blend of the exploring intelligence of
the Vedic Aryans, with the imploring emotions, prevailing in the sub-con-
tinent’s music for millennia before their arrival.
876
Sairam, T.V. (2006) Melody and rhythm – ‘Indianness’ in Indian music and music therapy. Music Therapy
Today (Online 22nd December) Vol.VII (4) 876-891. available at http://musictherapyworld.net
Indian System: The ‘Improvisation’ Music (Manodharma Sangita).
Spontaneous and intuitive improvisations in melody as well as rhythm

constitute the sublime underpinning of the Indianness characteristic in
Indian music.
While unfolding a highly moody raga with full freedom so as to scale the
highs and lows of emotion, the artist is never expected to deviate from
the full rigour of the rhythm. The entire exercise -which involves a cease-
less and continuous compromise between the freely meandering melo-
dies (ragas) and the beats (talas) that bridle them, immensely
contributes, in real life situations, towards developing an attitude of
acceptance of contrasts, contradictions or dissent. It also imparts confi-
dence in coping with such situations till they are resolved as pleasantly as
in a musical piece.
Swara: The Indian Note. While the western classical system insists on a
machine-like precision in determining frequencies for its notes, its Indian
counterpart, on the other hand, shows a liberal and human approach
while dealing with the rendering of swaras in raga elaboration. In the
south Indian Carnatic system of music, for example, the selected Swaras
undergo oscillations with a view to heighten the emotions (Bhava). Raga
is determined not by a sonic meter but by the human experience. Accord-
ing to a definition of raga by Matanga (the 7th century author whose work
briahaddesi described raga in its technical sense for the first time), what
is pleasant alone can be a raga. Raga, referred to as the ‘miracle of micro-
tones’ is built by a choice of a minimum of five and maximum of seven
swaras, all of which cover 22 srutis in an octave. The selected ones show
a sustained quality of a definite single frequency or a combination of
related frequencies, aesthetically suitable to the human voice range, ears
Indian Systems of Music 877

and hearts. It is this human quality in indian music which promises a

direct impact on the listeners in therapeutic settings.
It is the usage of quarter tones that play up the Indianness in Indian

music. Unlike the western note, Indian Swara is known for its flexibility.
Its frequencies can even reach the territories of its neighbouring Swaras,
thus intensifying the emotional content (Bhava) of the raga. The thera-
peutic role of the raga appears to lie in its oscillating Swaras. The lis-
tener’s attitude too could, over a time become less rigid and more flexible
in synchronization with the raga system. Like a treadmill for trimming
the body, the raga system can trim and shape a person’s mind and his
behaviour pattern. The quarter tones celebrated in Indian music is not
quite unknown to the western school. Piano made with 24 keys used in a
whole opera employing quarter tones in Germany is a significant exam-
ple. The European composers Ivan Vïshnegradsky (1893-1979) and Alois
Hába found a firm Grotrian-Steinweg in Berlin and prepared to work on
the development of a quarter-tone piano for their quarter tone composi-
tions. Some experts in acoustics are of the view that a well-trained ear
becomes capable of perceiving 50 notes in an octave!1 Various pitch pat-

terns are believed to help us in shattering rigid energy patterns that limit
our growth, Chakras awareness and health. For ages, there has been a
belief that specific pitches affect specific Chakras in the body and that it
is the pitch that has potency to bring back the Chakras back to their nor-
mal vibration pattern as and when disease occurs in the body. It is the
under-activity or over-activity of the Chakras that is believed to cause
disease or discomfort in the body.
1. According to a yogi whom I met sometime back such an experience is possible by

coordinating one’s sense of hearing with his ‘inner’ (anahata) hearing capabilities.

From time immemorial, in India, there has been a tendency to associate

the seven notes (Swaras) to seven Chakras identified in the human body.
Thus, the musical scale (c,d,e,f,g,a,b) is often associated to the seven
chakras (c being associated to the 1st and b to the 7th). Singing the scale
(or do, re, mi etc.) everyday is said to be beneficial to maintain the bal-
ance and harmony in the body. Listening to a piece of music that is writ-
ten in the key associated to be unbalanced using harmonica in the key of
c for root chakra, and using a chromatic pitch instrument (which can be
bought in a music store and are very inexpensive) for all pitches. Learn-
ing to sing or tone pitches is said to be a traditional method to restore
energies to their natural level.
EVOLUTION OF SEVEN The primitive musical structure consisted in using a single tone, repeat-
SWARAS
edly causing veritable monotony! This practice was also common in the
Vedic days and it was referred to as eka swari gayana, ‘singing with the
help of one note’. Most of the sacred hymns were chanted in this fashion.
Endless repetition of the tone could exercise the mind to get into the
‘track’ and remain focused on the object of meditation. From here, dilu-
tion started and a system of two notes called gatha gayana came into
vogue, which consisted of two notes, one higher than the other. Gathas,
or anecdotes containing poetically described stories from the lives of the
Bodhisatva monks were sung with two notes. Use of three notes came to
stay with saamagaayana chants. They were distinguished and named as
udatta or raised (equivalent to N-G), anudatta or lowered (equivalent to
R-D) and swarita or level (equivalent to S-M-P). It is these three swaras
that form an important base for the evolution of seven swara system. The
arrangement of these three basic tones formed the structure called graa-
mas and with this, the solfa syllables in Indian music (S,R,G,M,P,D,N)
came into existence. The Sanskrit dictionary has coined a word
swaraghat, to represent these three essential notes. A liberal- rather than

literal – translation of this term would read somewhat like this: ‘three
positions of graded effective potency of sound’!
Laya: The Indian interpretation of a rhythm

It is interesting to note the affinity that exists between the musical and
life patterns and rhythms. In an unconscious and in an unintended man-
ner, the creators of music present their art akin to life processes and pat-
terns. In a workshop conducted at Delhi a few years back, an enlightened
audience, comprising of diplomats, civil servants, yoga teachers and
music lovers could appreciate the magic of rhythms that emanate from
the Tabla and a manjira as one felt descending to alpha levels of `relax-
ation’, `happiness’ and `peace of mind’ (as remarked by the audience) by
sheer concentration on them!
The ancient Sanskrit works indicate a classification system for rhythms,

which distinguishes 120 types of talas (beats) distinct from each other.
Sage Bharata is said to have isolated 32 varieties of Tala from the song of
a lark.
The term laya has multiple meanings: musical time, fusion, melting, dis-
sonance, exclusive concentration on one object, repose, unison, universal
dissolution, the Supreme Being – just to mention a few. The beauty about
Laya is that it exists in between one’s experience of sound and that of
silence.
Time is always present whether there is a sound or not. In fact, when the
sound is not there, time still lingers on in the centre-stage. When a singer
holds a note for a long time (karvai) it may give an illusion as if time had
ceased altogether! Laya at this point depicts qualities of vishranti the
quiet bliss.
Laya: The Indian interpretation of a rhythm 880

The ancient Greeks too had made subtle distinction between ‘rhythmos’
(rhythm) and arithmos (calculated Time), which is akin to the relation-
ship which exists between Laya (rhythm) and Tala (calculated Time).
Laya Prajna is the perception of Laya, the ability to perceive the most
minute divisions of time, the aesthetics of tempo and spacing of notes in
any pattern. Here mathematics has turned into an art indeed!
IMPACT OF LAYA ON Different rhythm and tempo, (e.g., Vilambit (slow), Madhyam (medium)
RAGA EMOTION
or Dhrut (fast) may influence variously the effect of raga on moods and
emotions. While the slow-paced rhythms and tempo slow down the men-
tal pace, leading towards calmness, they are also found to be capable of
diverting the thought processes in mind, thus enhancing relaxation. Fast-
paced tempos and rhythms, (especially as we come across in African
Drums) on the other hand, preferably in combination with high frequency
notes (as may be found in shrieks and catcalls of the tribal participants)
are noted for their influence in stimulating and rejuvenating the mind and
body. In his research work with severe cases of mentally retarded chil-
dren of Visakhapatnam this author has noticed that it is such rhythms and
metallic noises in music which enable them to shake off their passivity
more easily than the regulated compositions in Gitam or Varnam.
Evolution of raga system

The sheer lack of chronology or historic sense with regard to the rich sys-
tem of music itself represents `Indianness’! One has to, therefore `guess-
timate’ that the Vedic age in India is somewhere pegged between 2000
and 1000 B.C.E. Evolution of raga in that period is yet another area for
guess-work. Vedas mirror meaning with sound vibrations and fine-tune
the brain to establish harmony and peace. Ek Swari Gaayana or archika
which means singing with the help of one note, as was done with regard
Evolution of raga system 881

to chanting of several sacred hymns, could be closer to the primitive style

that could have existed in the sub-continent from the time immemorial.
Then there was the Gatha Gaayana Gathika system of singing with two
notes, one high and one low. Gathas, or anecdotes containing poetically
described stories from the lives of the Bodhisatvamonks, were sung in
these two notes. The swara-structures here being incomplete to be called
as a raga has been termed proto-raga by Sairam (2005a+b +c) in his
works.
From here, there is a gradual progress. Saamagaayana chants were sung

in three notes: Udatta (raised) (equivalent to Ni-Ga), Anudatta (lowered)
(equivalent to Ri-Dha), and Swarita (level) (equivalent to Sa-Ma-Pa)
positions, which according to Mandukay Shiksha, a music treatise of that
period, evolved into seven notes. The Sanskrit dictionary interprets these
three sound positions in a word called Swaraghat, arrangement of these
basic tones formed the nucleus of scales called Graamas, and with that,
the Sargam syllables or note names – S, R, G, M, P, D, and N – came into
existence (there are comparable to the Western sofa syllables _ Do, Re,
Mi, Fa, So, La Ti). Other authorities like Panini (520-460 B.C.), a San-
skrit grammarian1 who gave a comprehensive and scientific theory of
phonetics and phonology and Naarada2, a legendary personage and celes-
1. About Panini: A treatise called Astadhyayi (or Astaka) is Panini's major work. It con-
sists of eight chapters, each subdivided into quarter chapters. In this work Panini dis-
tinguishes between the language of sacred texts and the usual language of
communication. Panini gives formal production rules and definitions to describe
Sanskrit grammar. Starting with about 1700 basic elements like nouns, verbs, vow-
els, consonants he put them into classes. The construction of sentences, compound
nouns etc. is explained as ordered rules operating on underlying structures in a man-
ner similar to modern theory. In many ways Panini's constructions are similar to the
way that a mathematical function is defined today.
2. About Naarada: A legendary figure, he is said to be the author of Naaradasmriti,
Naarada Shiksha (on the principles of grammar and phonetics), Naarada Bhakti Sutra
(aphorisms on the concept of Bhakti or devotion and Naaradiya Dharma Shastra (a
work on law and morality)
Evolution of raga system 882

tial musician in the Hindu mythology both accepted the principles under
which the seven notes were positioned around the three notes of the Vedic
period, which are the graded sound positions noted above.
Study of the Vedic culture reveals the pre-eminence and high esteem
enjoyed by music in every family. Hardly any item of religious activity
would be conducted without music Songs, dances and playing on instru-
ments were all done in strict rhythms. The infinite variety of gods and
goddesses representing various forms of the forces of nature were also
linked to certain melodies depicting their powers and forces. Their wor-
ships were also associated with appropriate musical instruments that
impart such effects. Between thundering tones of masculine drums, Dam-
arus and Mridangams and gently flowing feminine strings and Veenas, a
wide variety of instruments existed in the sub-continent, which helped in
‘balancing the mind’ and lending harmony between the individual and
his society.
Raga Chikitsa: The Indian Music Therapy

Long before acoustics came to be understood in Europe as a subject of
study, the ancient Arab, Greek and Indian civilizations were already
familiar with the therapeutic role of sounds and vibrations and the later
day concepts pertaining to them. While music as a whole is well recog-
nized for its entertainment value, the Indian civilization had gone a step
forward to attribute the curative aspect to music (Sairam 2003).
The ancient system of Nada Yoga, which dates back to the time of
Tantras, has fully acknowledged the impact of music on body and mind
and put into practice the vibrations emanating from sounds to uplift one’s
level of consciousness. It is the Indian genius that recognized that ragas
are not just mere commodities of entertainment but the vibrations in their
Raga Chikitsa: The Indian Music Therapy 883

resonance could synchronize with one’s moods and health. By stimulat-

ing the moods and controlling the brain wave patterns, ragas could work
as a complementary medicine (Sairam, 2004 a, b, c).
WHAT IS A RAGA? Raga, we all know is the sequence of selected notes (swaras) that lend
appropriate ‘mood’ or emotion in a selective combination. Depending on
their nature, a raga could induce or intensify joy or sorrow, violence or
peace and it is this quality which forms the basis for musical application.
Thus, a whole range of emotions and their nuances could be captured and
communicated within certain rhythms and melodies. Playing, performing
and even listening to appropriate ragas can work as a medicine (Bagchi,
2003). Various ragas have since been recognized to have definite impact
on certain ailments (Sairam, 2004b).
HISTORIC REFERENCES The ancient Hindus had relied on music for its curative role: the chanting
ON RAGA CHIKITSA.
and toning involved in Veda mantras in praise of God have been used
from time immemorial as a cure for several disharmonies in the individ-
ual as well as his environment. Several sects of ‘bhakti’ such as Chait-
anya sampradaya, Vallabha sampradaya have all accorded priority to
music. Historical records, too, indicate that one Haridas Swami who was
the guru of the famous sixteenth-century musician Tan Sen1 in Emperor

Akbar’s (1542-1605 AD) time, is credited with the recovery of illness of
one of the queens of the Emperor with a selected raga.
The great composers of classical music in India called the ‘Musical Trin-
ity’, - who were curiously the contemporaries of the ‘Trinity of Western
Classical Music, Bach, Beethoven and Mozart– were quite sensitive to
the acoustical energies. Legend has it that Saint Thyagaraja brought a
dead person back to life with his Bilahari composition Naa Jiva Dhaara.
1. Some people call Tan Sen an “Hindustani Monteverdi”)
Raga Chikitsa: The Indian Music Therapy 884

Muthuswamy Dikshitar’s Navagriha Kriti is believed to cure stomach

ache. Shyama Sastry’s composition Duru Sugu uses music to pray for
good health.
Raga chikitsa was an ancient manuscript, which dealt with the therapeu-
tic effects of raga. The library at Thanjavur is reported to contain such a
treasure on ragas, that spells out the application and use of various ragas
in fighting common ailments.
Raga Chikitsa: Raga Therapy in India

Living systems show sensitivity to specific radiant energies – be it acous-
tical, magnetic or electro-magnetic. As the impact of music could be eas-
ily gauged on emotions and thereby on mind, it can be used as a tool
believed to control the physiological, psychological and even social
activities of the patients
Indian classical music can be classified into two forms: kalpita sangita or
composition, which is previously conceived, memorized, practised and
rendered and manodharma sangita or the music extemporised and per-
formed. The latter can be equated to the honey-mooner’s first night as it
conceives both spontaneity and improvisation. It is fresh and natural as it
is created almost on the spot and rendered instantly on the spur of the
moment.
According to an ancient Indian text, Swara Sastra1, the seventy-two

melakarta ragas (parent ragas) control the 72,000 important nadis or
nerves in the body, which are believed to transmit life energy into every
cell of the body. It is believed that if one sings with due devotion, adher-
1. for more information see online resources in the reference section
Raga Chikitsa: Raga Therapy in India 885

ing to the raga lakshana (norms) and sruti shuddhi, (pitch purity) the raga
could affect the particular nerve in the body in a favourable manner.
While the descending notes in a raga (avarohana) do create inward-ori-

ented feelings, the ascending notes (arohana) represent an upward mobil-
ity. Thus music played for the soldiers or for the dancers has to be more
lively and uplifting with frequent use of arohana content. In the same
way, melancholic songs should go for ‘depressing’ avarohanas. Although
it is not a rule, most of the Western tunes based on major keys play joyful
notes, while those composed in minor keys tend to be melancholic or
serious.
Certain ragas do have a tendency to move the listeners, both emotionally

as well as physically. An involuntary nod of the head, limbs or body
could synchronize with lifting tunes when played.
SOME THERAPEUTIC Some ragas like Darbari Kanhada, Kamaj and Pooriya are said to help in
RAGAS
defusing mental tension, particularly in the case of hysterics. For those
who suffer from hypertension, ragas such as Ahirbhairav, Pooriya and
Todi are prescribed. To control anger and bring down the violence within,
Carnatic ragas like Punnagavarali, Sahana etc. do come handy. It is gen-
erally believed in music circles, though scientific endorsement doesn’t
appear to be forthcoming.)
Sairam (2005c) experimenting on the impact of raga on mentally-

retarded (MR) children has noticed that it is the right combination of
rhythms and tempo, which also affect the quality of a raga.
Not only psychological impact, but also somatic or physiological impact

of ragas has come to light in some recent works. (Sairam, 2004b). For
instance, digestion is reported to be activated with Hindustani ragas such
as Deepak which is believed to cure acidity. For constipation, the musical
Raga Chikitsa: Raga Therapy in India 886

folk remedy is Gunkali or Jaunpuri. Malkauns or Hindolam are said to

control fevers. Fevers like malaria are also said to be controlled by the
ragas like Marva. For headaches, relaxing with the ragas like Durbari
Kanada, Jayjaywanti and Sohni is said to be beneficial. The Chennai-
based tiny Nada Centre for Music Therapy has quite recently embarked
on raga therapy research to re-discover the therapeutic ragas by trial and
error methods and some modest progress is already visible giving green
signals. For want of logistics, the project is shelved down and we are
hopeful it will be revived seen with the support we get from music-lovers
and medical professionals all over India.
Conclusion
There is a growing awareness that ragas could be a safe alternative for
many medical interventions.
Simple iterative musical rhythms with low pitched swaras, as in bhajans

and kirtans are the time-tested sedatives, which can even substitute the
synthetic analgesics, which show many a side-effect (see Nickel et al.
2003; Bernatzky et al. 2005). They are capable of leading to relaxation,
as observed with the alpha-levels of the brain waves. They may also lead
to favourable hormonal changes in the system (Crandall, 1986).
It is therefore felt that there is an urgent need for further detailed enquiry
to be based on scientific parameters, which will go a long way in unearth-
ing the goldmine on which the Indian musical system is resting now.
For this purpose, it is necessary that a group of exponents in Indian ragas

join experts in medicine to help evolving a scientific system of raga ther-
apy for the most common illness of the modern times: stress and stress-
related disorders. Our leaders, professionals and managers all suffer from
Conclusion 887
stress, thanks to the ever-increasing man-machine interface, resulting in

the machine making the man to behave!
BIBLIOGRAPHY
Bagchi, Kalyan. (Ed) (2003) Music, Mind and Mental Health. New
Delhi.
Bernatzky, G., et al. (2005, March 27). Report on Research Series and
Clinical Studies on the Psycho-Physiological Effect of Music on
Patients with Musculoskeletal System Pain 2002 to 2005. Salzburg:
Landeskliniken Salzburg, Mozarteum. (Retreived 1st of June 2005
from http://www.mensch-und-musik.at/InfoIntern/
SchmerzStudie_05_gb.pdf)
Crandall, J. (1986) Self-transformation through Music. New Delhi: New

Age
Nickel, A. et al. (2003) Music therapy in the treatment of children with

migraine. Music Therapy Today (online) Vol IV, Issue 4, retrieved
from http://www.musictherapyworld.de/modules/mmmagazine/
index_dynamisch.php?issue=32&article=65
Sairam T V (2003) ‘From Nada Yoga to Neuro-musicology’. Indian Cus-
toms and Excise. New Delhi, 2nd Issue: 16-17.
Sairam, T. V. (2004a) Medicinal Music. Chennai: Nada Centre for Music

Therapy (http://www.nada.in/)
Sairam T. V. (2004b) Raga Therapy. Chennai: Nada Centre for Music

Therapy. (http://www.nada.in/)
BIBLIOGRAPHY 888
Sairam, T. V. (2004c) What is Music? Chennai: Nada Centre for Music

Therapy. (http://www.nada.in/)
Sairam, T.V. (2005a) Proto-Ragas and Pseudo-Ragas: The Precursors to

Ragas. Sadguru’s Blessings. (May) p.37-38
.Sairam, T.V. (2005b) Proto-Ragas: A Boon for the Mentally-challenged

People. Ayurveda and All. (August) p. 35-36.
Sairam, T.V. (2005c) Raga Therapy: A New Horizon in the treatment of

the Mentally Challenged ‘ In: My Doctor. (June) p. 31-34
ONLINE RESOURCES Sanskrit Dictionary (http://webapps.uni-koeln.de/tamil/)
Website with some details on Swara Shastra: http://www.members.optus-

net.com.au/skinbags/id50.htm )
SUGGESTED READINGS Bagchee, Sandeep. (1998) Nad: Understanding Raga Music. Mumbai:
Eeshwar.
Bhagyalakshmi, S. (2000) 'Concept of sruti and its application in ragas',

Shanmukha, Apr. 29-32.
Govindarajan, Alamelu A miscellany in Indian Music. Madras.
Menon, Raghava R. (1995). The Penguin Dictionary of Indian Classical

Music.
BIBLIOGRAPHY 889
Author details
T. V. Sairam, a senior member of the civil services in India, holds a doc-

torate in alternative medicine. He has several publications (10 books and
400 published articles) to his credit on an assortment of subjects, which
include alternative medicine, herbal remedies and music. He has under-
taken a pioneering research in Nada Yoga and Raga Therapy during his
spare hours and has presented several lecture-demonstrations in national
and international conferences. He currently guides a team of volunteers
drawn from musicians, social scientists, medical professionals, musicolo-
gists, and psychologists, which is concerned with a scientific evaluation
of Indian Ragas for their therapeutic role in mentally- retarded children.
(The author can be contacted at tvsairam@gmail.com)
Welcome to the author’s website: www.drsairam.com
Author details 890

THIS ARTICLE CAN BE Sairam, T.V. (2006) Melody and rhythm – ‘Indianness’ in Indian music
CITED AS: and music therapy. Music Therapy Today (Online 22nd December)
Vol.VII (4) 876-891. available at http://musictherapyworld.net
Author details 891

Music Therapy Today
If you can’t beat them, join

them! Long-term music
therapy with an “autistic
savant” man
Graham, Janet
Graham, J. (2006) If you can’t beat them, join them! Long-term music therapy
with an “autistic savant” man. Music Therapy Today (Online 22nd December)
Vol.VII (4) 892-912.
ABSTRACT
This paper is based closely on a presentation given at the 3rd Interna-

tional Symposium of Nordoff - Robbins Music Therapy, which was held in
Germany in June 2006. It focusses on stages in the music therapy process
with a middle-aged autistic man with moderate learning disability and
savant calendrical skills. He had become very ritualistic and inflexible
892
Graham, J. (2006) If you can’t beat them, join them! Long-term music therapy with an “autistic savant” man.
Music Therapy Today (Online 22nd December) Vol.VII (4) 892-912. available at http://musictherapyworld.net
over the years and this impinged not only on his own social life, but also
on that of the sister with whom he lived.
In sessions his playing was loud, fast and perseverative and, in order to
bring about any change or growth of flexibility in his musical responses,
it was necessary to try to get inside his routine-driven ways of doing
things and find new ways of working.
Audio examples from the sessions are given, including some demonstrat-
ing musical strategies which were developed from the client’s autistic
routines and rituals. Reference is made to parallels between his progress
in music therapy and changes in his social skills as perceived by his sis-
ter, friends and day centre staff.
1. INTRODUCTION: WHAT’S NEW?

When we were invited to submit proposals for the Nordoff-Robbins
Symposium in Nordhelle in 2006, it was suggested that we should focus
on new directions our work has taken since training, for instance on
broader connections with the clients’ community. Having chosen to
present a case study of a single client I started to ask myself how, if at all,
my therapeutic approach had changed or developed since 1990 when I
trained at the London Centre. What, if anything, was new about this pre-
sentation?
Firstly, words and phrases I remember most clearly from my training in

1989-90, and which are still central to the Nordoff-Robbins approach
today, include “working through the music” and “growth of flexibility”. I
have since come to believe that the music sometimes needs a degree of
help in order to bring about the flexibility, and it certainly did in this case.
Another factor is that the work covers approximately five and a half years
of one-to-one sessions at the London Centre. Such long-term work needs
justification and would not normally be possible in public-funded set-
1. INTRODUCTION: WHAT’S NEW? 893

tings such as the National Health Service. In fact it is very unusual at the
London Centre, but it did seem necessary for this client.
The client, Johnnie, is an adult. In 1989-90, unlike today’s students, we

were trained exclusively with children who had learning disabilities,
multiple physical disabilities or communication problems. Any work
with adults on which we embarked after training was largely learnt “on
the job”. Johnnie has a mild learning disability and is “autistic savant”.
Some people with autism have special abilities, for instance a photo-
graphic memory which enables them to draw buildings and scenes they
have seen only briefly with accuracy to detail, or to count cards like Rain
Man in the film of that title. (Baron-Cohen & Bolton 1993; Schopler &
Mesibov 1992; Williams 2003; Grandin & Johnson 2005). Some clients
show unusual musical abilities: I have worked with several children and
adults who seemed to have some sort of skill connected with memory,
including a kind of perfect pitch where they always sang at the same
pitches and ignored or protested at any attempts on my part to shift them.
Johnnie’s savant skills were not of this type, though musical memory was
important to him in ways which will be described later.
Johnnie’s savant skills and the rituals which went with them impacted on
his everyday life, and this made it important for me to maintain contact
with a wider network of people involved in his life. Throughout the ther-
apy I kept contact with Johnnie’s day centre, as well as talking every
week to his sister and occasionally to some of their friends too.
1. INTRODUCTION: WHAT’S NEW? 894

2. THE CLIENT
FIGURE 1.
Johnnie was 52 when I first met him. He had been referred to the Centre
by his sister, Maggie, because he had always responded to music and had
enjoyed taking part in a music class for people with learning difficulties.
He was undiagnosed when young and it was Maggie who found out that
he is “autistic savant” with calendrical calculation skills. This means that,
if you tell him the date, he can tell you the day of the week on which you
were born in what seems like a fraction of a second. He will remember
your birthday every year, too, and will draw you a card with your age
written in large numbers all over it! He can also remember what he was
doing on any day in the past. For instance, the first time I met him, hav-
ing told me I was born on a Friday, he said he had been horse-riding on
my birthday in 1996 (i.e. 4 years earlier). Johnnie also has a moderate
learning disability.
Johnnie shares a small flat with Maggie and attends several group activi-
ties in a day centre. He has a number of rituals and patterns of behaviour
2. THE CLIENT 895

which impinge on his, and Maggie’s, everyday life. For instance, he feels
compelled to allow his face cloth to drip 40 times, however long it takes,
before he will get out of the bath. He is very rigid in his routine; for
example, if the minibus driver brings him back from the day centre the
“wrong way”, he will have to walk the “right way” to compensate for it.
He has a fascination for doors and hinges and has sometimes been mis-
taken for a surveyor. Maggie recollects that, as a child, he played with
doors instead of toys.
The residential hospital in which Johnnie lived as a child left him with
emotional scars. When he went home at weekends he used to spread 28
sheets of newspaper on a window sill and bang it with a rolling pin, say-
ing that it was Mr. L.’s ledge. (All Johnnie’s acquaintances have specific
doors or ledges allotted to them by Johnnie). Over the whole five and a
half years of his therapy, all that Johnnie would say to me about Mr. L. is
that he was “very nasty”. It appeared to me that Johnnie had dealt with
the problem in his own way and, unless he chose to talk about it, it did
not seem appropriate to probe. I hoped, however, as would any self-
respecting Nordoff-Robbins-trained therapist, that any unresolved nega-
tive feelings which might emerge could be addressed within our interac-
tive musical improvisations.
2. THE CLIENT 896

FIGURE 2.
2. THE CLIENT 897

This is one of my birthday cards from Johnnie. Notice the precise word-
ing. “Music therapy side room door Janet Graham door on northbound
side next to eastbound side and ground floor at Kentish Town and Gospel
Oak Ward”.
Johnnie’s birthday cards always have a drawing of the recipient’s own

special door on the front. Recently he started giving us tunnels in the
London Underground system and bus routes, too. In the middle of this
card is a birthday greeting, including my age, and a reference to “my bus”
the Number 84, which goes from North London to St. Albans, where I
live.
3. OUR EARLY SESSIONS
3.1. DISCOVERING THE Making any headway was very difficult, especially with Johnnie’s play-
PROBLEMS
ing. He used 2 beaters simultaneously, regardless of the instrument he
was playing, and always played in the same way: very fast and very
loudly. He did not respond to endings and would carry on playing after I
had stopped. He tended to sit in a hunched position, elbows on knees, and
not looking at me. He seemed to enjoy coming, however.
I tried various strategies intended to increase his awareness and flexibil-

ity, e.g. introducing musical changes and surprises, or working side by
side, or opposite him, using similar instruments. Whatever I tried, how-
ever, he just kept playing in his usual way.
The main aims which emerged in Johnnie’s assessment were:
1. Encouraging more flexibility in his playing, which was perseverative,

extremely loud and at a fast tempo;
2. Encouraging him to use his voice more expressively and communica-
tively. His speech had little inflection of tone or pitch, and was often
3. OUR EARLY SESSIONS 898

difficult to understand. He sometimes hummed as he played, but did

not like the idea of singing.
3.2. EXTRACT 1 FIGURE 3.
The first extract is about 9 months into Johnnie’s therapy. He is playing a

drum with 2 beaters, while I play the piano. He is sitting in a hunched
position, with his elbows on his knees, not looking at me.
A major area of loss which Johnnie had to contend with was the death of
his parents, especially that of his father, who died when Johnnie was a
boy. In this extract, he is celebrating his father’s birthday, even though he
has been dead for many years. By now Johnnie is confident in the therapy
room, and this is how he likes to play. I try various musical strategies to
encourage more awareness and flexibility, but he seems oblivious.

Download AUDIO EXTRACT 1. (MP3 1.8 MB)
After that session, Johnnie asked me if I had a rolling pin. He was

remembering Mr. L.
3.3. SEARCHING FOR A Musically, Johnnie was very stuck, in spite of all my inter-musical efforts
SOLUTION
to get him out of his perseverative playing. I decided that the only way I
was going to get any sort of flexibility into his playing was to change the
instruments. (I had already banned cymbals and metal wind-chimes
because I was afraid he might damage his hearing).
I asked myself if Johnnie really needed to become more unstuck? Why, if

at all, did he need to change? He appeared to enjoy the sessions very
much: perhaps he just needed the experience of playing music with
another person. I thought about his inflexibility in his everyday life, and
came to the conclusion that his obsessions and rituals were severely
restricting his capacity for interacting with others, and that he (and Mag-
gie) might enjoy life more if he were less isolated. If he could become
more accepting of me and my musical structures, he might in time be
more trusting with others, and this would in turn lead to more opportuni-
ties for joining in various activities in the community.
I tried various strategies, both musical and verbal, with limited success.
His preference was to sit to play an instrument while I played the piano.
He was reluctant to share instruments, though he agreed to stand up to
play some of them and I noticed some bigger and more purposeful arm
movements. If offered a verbal prompt he would play more quietly, but
soon reverted to his usual way of playing.
It seemed impossible to bring about any significant change or develop-

ment solely through musical means, and I realised that I would have to
try to get inside Johnnie’s autistic ways of doing things. Maggie gave me

the clue I needed by telling me that he likes orders for things, e.g. he has
an order for what he has for breakfast on different days of the week, and
he wears 4 pairs of shoes in strict rotation. 4 and 8 are his “special” num-
bers. I did not know this when I devised a 4-week order with 8 instru-
ments for each week. Johnnie accepted this very well, and the new
combinations and restrictions of instruments offered possibilities for qui-
eter dynamics.

4. FINDING A WAY FORWARD
4.1. THE ORDER FOR FIGURE 4.

JOHNNIE’S SESSIONS
When I gave Johnnie a copy of the order, he immediately said that it

would be Drum Week on my birthday in two years’ time. I did not take
too much notice of this, because there would be holidays and sessions
missed for various other reasons, and I was not sure that he would still be
4. FINDING A WAY FORWARD 902

coming for sessions by then, anyway. Looking back through my notes,

though, I found that he was right.
Johnnie always insisted on playing every instrument in the room, one at a

time. Even if I arranged percussion instruments in groups, he would play
each of them individually, so that we always needed eight improvisations
in a session. The order worked well, however, and over the months I
added new instruments and variations such as softer beaters. This made it
possible for Johnnie to participate in quieter musical experiences and,
even if he played at his fast tempo, I could make the music slower by tak-
ing his beats as half or quarter beats. He also began using his voice more
strongly and spontaneously, although he still did not like singing songs
(apart from “Happy Birthday”).

This extract comes from about three and a half years into therapy.
Johnnie is playing a set of small tubular bells which I have placed on top
of the grand piano. He notices when I start singing “Here we are in the
music room”, and he smiles and vocalises. This turns into a playful duet.

The next extract is from later in the same session as the last. Johnnie par-
ticularly liked playing a long rain stick similar to the one third from the
right of this picture. He played it with a very slow side-to-side move-
ment, waiting until every single stone had got to the bottom before he
would invert it. Here, I improvise slow and rather romantic, expressive
music on the piano. It is in E-flat Major and in three-four time, which
might be a challenge for someone who likes multiples of four. With some
flexibility on my part, I can fit two bars into each side-ways movement of
the rain-stick.
5. THE LATER SESSIONS: NEW STRATEGIES
My next extract is from just over a year later than the last, almost five
years into therapy. It was “No pianos” week. Here, Johnnie is playing a
5. THE LATER SESSIONS: NEW STRATEGIES 905

conga, with two beaters, and I am playing the metallophone. He notices

when I start singing.
Download AUDIO EXTRACT 4. (MP3; 2,5 MB)
Previously, Johnnie had picked up phrase lengths if I had counted beats,

e.g. 123 4--, but now he was able to pick up rhythms and endings just
from my playing.
5.2. THE LISTENING I continued trying new ways of encouraging flexibility: for instance, I
SLOT
introduced a listening slot in each session. We listened together to a few
minutes of recorded music, and talked about it afterwards. Johnnie recog-
nised pieces he had heard before: one day, after we had listened to “Sum-
mer” from Vivaldi’s “Four Seasons”, he told me he had heard it on
Friday, April the 5th, 1991, in the Waffle House in Norwich (i.e. 13 years
previously). Afterwards, Maggie confirmed that this was likely to be true,
as they had lived in Norwich at that time and the Waffle House had cer-
tainly played classical background music including Vivaldi. He listened
attentively and enthusiastically to a range of music from Haydn to
Stravinsky and Takemitsu. He was particularly enthusiastic about Take-
mitsu’s “Rain Spell” and “Rain Coming”, and Maggie told me that “Rain
Man” is one of his favourite films.
Maggie tried to encourage Johnnie to include a wider range of music in

his listening at home, to offer more opportunity for emotional support,
and Johnnie’s day centre took note of this, too. Johnnie was very good at
pop music quizzes, because he could remember the songs and their dates.
He liked classical music, especially as his father had owned a large col-
lection of classical records, but would listen only to Radio 1 (a pop music
station) at home because that was what he had always listened to and he
was unable to change. If Maggie was playing classical music in the next

room, however, he would listen from the doorway. She started encourag-
ing him to listen to classical music at specific times of the week, as part
of his order at home.
5.3. COUNTING BELLS, Other strategies I tried included numbering the tubular bells from 0 to 11,
TAKING TURNS
and asking Johnnie to play the notes of various people’s birthdays within
the structure of the improvised music. Obviously this made him slow
down, as well as giving rise to some unusual rhythmic and melodic ideas.
I also introduced more turn-taking, for instance sharing an instrument
with him. He found it difficult, but would keep it up for a while with sup-
port and encouragement.
The final 2 extracts are from Johnnie’s last few sessions. In Extract 5 he
is playing a large ocean drum. When playing this instrument previously,
he would simply swish it quickly from side to side, but here he controls it
and produces a more continuous sound. The music is whole-tone / atonal
and also sometimes arhythmic. He no longer needs his driven, fast and
inflexible pulse.

After he had played the ocean drum, if I asked Johnnie whether the music
had reminded him of anything, he would say the seaside, and going to
Brighton with his father.
Johnnie’s playing still tended to be fast, but he was now often able to play
quietly and to pick up rhythms from me. This extract is from his penulti-

mate session, 2 months later than the last extract. He is playing the conga
with 2 beaters. Again, the music is in a slow triple time.
6. IN CONCLUSION
6.1. LOSS AND ADULTS As you have heard, it took a long time before I noticed any shifts in
WITH LEARNING
DISABILITIES Johnnie’s playing, and over the five and a half years I worked with him I
considered ending his therapy several times. Always, though, there
would be a change of events in Johnnie’s life which indicated to me that
he needed to carry on.
For instance, friends moved away, and one of them died. The minibus
service which took him to his Monday club was stopped, so he could not
get there so often. At these times I felt he needed the continued support of
his music therapy, not even more loss.
Loss seems ever-present in the lives of so many adults with learning dis-
abilities (Sinason 1992; Blackman 2003). Sometimes these events were
reflected in our music, even though Johnnie did not talk about them
much. When his favourite day centre worker went on maternity leave, we
acknowledged his apparent sadness about this in our improvisations.
Maggie later said she thought this had helped him and that he was accept-
ing the changes of staff more positively and cheerfully.
6.2. CHANGE AND Maggie noticed developments in Johnnie’s confidence and social skills
DEVELOPMENT IN
EVERYDAY LIFE since he had begun sessions. He appeared more at ease with people, and
they noticed that his speech seemed clearer and easier to understand. His
day centre workers said he was interacting much better, and felt that
music therapy was helping. He still found it difficult to empathise, for
6. IN CONCLUSION 909
instance he still laughed if he heard a baby crying, but he started showing

more interest in people’s feelings in the soap operas he liked watching on
television. He was sometimes able to tolerate breaks in his routine, such
as going somewhere with Maggie by train and coming back by bus. He
had previously insisted upon making the round trip by the same means of
transport.
FIGURE 10.
In her book “Exposure Anxiety – the Invisible Cage”, Donna Williams,

herself autistic with savant abilities, considers the creative arts therapies
effective for helping people with autism to connect with their emotions
through connecting with others in a safe space. She says:
6. IN CONCLUSION 910
Music, art and dance/movement therapy build a safe space, a meeting

place, somewhere to feel equal,… (Williams 2003, p. 308)
My therapeutic aims, as with any other client, depended on the develop-

ment of a trusting interactive musical relationship. In Johnnie’s case,
however, this needed more extra-musical help than usual, and I do not
think it could have happened without trying to get inside his ritualistic
ways of doing things and using them as a basis for our improvised music.
REFERENCES
Baron-Cohen, S. & Bolton, P. (1993). Autism: the facts. Oxford, New

York & Tokyo: Oxford University Press.
Blackman, N. (2003). Loss and learning disability. London: Worth Pub-

lishing.
Grandin, T. & Johnson, C. (2005). Animals in translation. London:

Bloomsbury Publishing.
Schopler, E. & Mesibov, G.B. (1992). High-functioning individuals with

autism. New York & London: Free Association Books.
Sinason, V. (1992). Mental handicap and the human condition. London:

Free Association Books.
Williams, D. (2003). Exposure anxiety – The invisible cage. London &

Philadelphia: Jessica Kingsley Publishers.
REFERENCES 911
Notes on the Author

Janet Graham studied Composition and Piano at the Royal Academy of
Music, after which she worked as a composer and piano teacher for many
years before training at the Nordoff-Robbins Music Therapy Centre in
London. Since then she has worked in London and Hertfordshire with a
wide range of client groups, most notably adults with autism and older
people with dementia. She is a senior therapist at the London Centre and
a tutor on the training course.
THIS ARTICLE CAN BE Graham, J. (2006) If you can’t beat them, join them! Long-term music
CITED AS: therapy with an “autistic savant” man. Music Therapy Today (Online
22nd December) Vol.VII (4) 892-912. available at http://musictherapy-
world.net
Notes on the Author 912

Music Therapy Today
Just sing…
Boymanns, Britta
Boymanns, B. (2006) Just sing…Music Therapy Today (Online 22nd December)

Vol.VII (4) 913-931.
Abstract
The article will give a view into seven years of music therapy at the Day
Clinic for psychiatry and psychotherapy in Witten. In the first section, I
will describe the setting and in the second section I will present the major
aspects of my work. My experiences from the past seven years of practi-
cal work have shown that singing simple songs and canons can have a
deep therapeutic effect at various levels of human existence, and encour-
age social growth in the community. To do this, it needs an exact choice
of songs and preparation of the material, a free but friendly inviting
approach towards individuals, exact and targeted musical – artistic work
on the songs spiced with much humor and joy – and an openness towards
all dimensions of humans and music. I can only recommend music thera-
pists to discover and continually develop this and put the therapeutic
dimensions and qualities of group singing to good use for those who are
ill.
The Day Clinic

The Day Clinic in Witten exists since December 1998. It is a department
of the Gemeinschaftskrankenhaus, the Community Hospital in Herdecke
and follows a holistic concept based on anthroposophy. The team at the
913
Boymanns, B. (2006) Just sing…Music Therapy Today (Online 22nd December) Vol.VII (4) 913-931. avail-
able at http://musictherapyworld.net
Day Clinic consists of 2 medical doctors, a psychologist, three nurses,

four art therapists, one social worker and a secretary. With the exception
of the doctors and nurses all colleagues have part-time positions of
between twenty and fifty percent.
At the Clinic, patients over 18 years of age and with a diverse range of
psychological illnesses are treated:
• psychosis
• neurosis
• all forms of depression
• personality disorders
• psychological crisis
• psychosomatic illnesses
Excluded from treatment at the Day Clinic are:
• acute suicidal individuals

• people with primary addictive disorders
• people with severe organic brain illnesses or severe mental disorders
as the Clinic’s concept does not provide for such cases, nor is the
required personnel available.
The medical and psychotherapeutic treatment is in the form of group and

individual therapy and the medication therapy covers anthroposophic
medication and psychopharmaceuticals. These are complemented by
physical treatment in the form of massage and balneotherapy. Alongside
the medical treatment, art therapies are provided in the form of drawing,
modeling and work therapy, healing eurythmia and music therapy. In
addition, the nursing staff offers further groups including storytelling,
role playing, sports, Tai Chi, relaxation group, gardening and cooking
group.
The Day Clinic 914

The daily structure is shown in the therapy plan. In the morning: arrival
and communal start in the ”Morgenkreis” or morning circle. After this,
the two basis groups begin, where patients together with one of the nurs-
ing staff recall events of the previous day or the weekend. On Wednes-
days there is a group meeting for the patients where they are on their own
to exchange thoughts and ideas and to organize minor duties. There are
therapy appointments before and after lunch until the joint end of the day.
And last not least: teatime at the end of the week on Friday afternoons.
Based on interaction with patients, the therapists develop individual ther-

apy programs. In the various team meetings there is intensive exchange
to make sure that the therapy aims, which are often formulated by
patients themselves, are pursued.
The official understanding of the concept in the Center is as follows, I

quote, ”Support the patients or persons in need of help to recognize their
possibilities, and in the interaction with their bodies, their fate and their
environment to achieve new possibilities of realization”.
MUSIC THERAPY AS Nordoff-Robbins Music Therapy has been practiced in the Gemein-
PART OF THE GENERAL
CONCEPT schaftskrankenhaus (GKH) since 1978, initially in the context of the two-
years mentor course which then grew to be the university-based training
course at the University of Witten/Herdecke. Even after the University
moved from GKH to new locations, GKH was and is the site for practice,
training and research. So in the conception of the Day Clinic, it was not
the question of whether music therapy would be included, but how. Out
of the work on the concept, four forms of music therapy emerged, along-
side the known individual and group therapy, the new forms ”Morgen-
kreis”, which translates directly as ”morning circle”, and ”Offenes
Singen” which means ”open singing”. These developed as a response to
the question about possibilities of musical activities with groups of
The Day Clinic 915

twenty to thirty participants and also reflects the ”tradition” of morning

and evening groups as a concrete element in the daily structure in anthro-
posophic institutions.
The ”Morgenkreis”
With the ”Morgenkreis” the communal day begins. Everyone who is at
the Clinic at this time takes part: patients, employees, students, guests
and so on. Participation in the Morgenkreis is obligatory as it is part of all
prescribed therapies.
The Morgenkreis has practical functions:
• to greet all who are in the clinic, particularly new patients

• to greet and introduce new students and guests
• to share general information of interest for everyone.
The Morgenkreis also offers an opportunity to assess the state and condi-
tion of patients, answers the question whether everyone is present and
provides a communal start to the day. In addition, all birthdays are cele-
brated in the large group with a birthday song, which is for some an
unusual and special event.
I lead the Morgenkreis on Mondays, Wednesdays and Fridays. On the

other days and in the afternoons, other colleagues lead these ten minutes
with a short dance, a communicative ball or word game, or the phrasing
of a motto or slogan and so on.
THE ”OPEN SINGING” Open singing takes place once a week on Wednesdays from 09.00 to
09.45. In the largest room of the Clinic the tables are put aside and the
chairs are formed in a half-circle, each with a songbook. Then the piano
is rolled in. As an invitation, I begin to play the first song and improvise
until all patients have arrived and get ready to sing with me.
The ”Morgenkreis” 916

THE OPEN SINGING IS 1. It is not obligatory, that means all participants are here as volunteers.
”OPEN” IN SEVERAL Most come initially out of curiosity. Furthermore, it is easier to over-
RESPECTS:
come inhibitions for this type of activity than in other settings, as all
patients know me and my activities from the Morgenkreis.
2. The room in which it takes place is open – architecturally open to the
staircase and entrance area. This means that patients can listen without
being noticed, and that visitors, waiting to go to the secretaries office
stand and listen to what is going on. In this way, there is an optimal
mixture of secure space and openness that allows the possibility of a
public appearance within a protected setting.
3. In addition, the open singing is a welcome opportunity for ex-patients
who enjoy coming to the clinic for singing. On average, five to seven
ex-patients with good voices and good spirit join in and support the
rest of the group. The singing is also open for all colleagues who may
come in for a favorite song or even manage to find time to take part in
the whole session. Guests and short-term students can experience a
part of my work without creating any difficulties for our patients.
CONCEPT OF THE Selection of songs. The songs are selected very carefully. As time has
MORGENKREIS AND
OPEN SINGING passed, various selection criteria have developed:
1. Well known songs: Mein kleiner grüner Kaktus

2. Seasonal songs: songs of May or summer
3. Swinging songs: Dubidu
4. Fun songs: Wüstenkanon
5. Gospel and other spiritual songs: We shall overcome
6. Day Clinic Hits: Zwei kleine Wölfe
7. International songs: Shalom chaverim
8. Patient requests: Heute hier, morgen dort
9. Canons: Come follow me
10.Miscellaneous:
The songs must be appropriate and understandable for patients both in

theme and content. They often have a direct reference to life, such as
birthday songs, morning songs (”Morning has broken”) or recreate a lost
link such as seasonal songs or prayer songs. Oftentimes spontaneous
comments are made about a song and lead to short general discussions in
which the patients’ themes and issues become clearer and generate mat-
ters for further thought.

The songs should not be too long, as, for example the 15 verses of ”Geh’
aus mein Herz”. The text and structure should be clearly presented and
well organized, hand-written notes are often problematic. A negative
example is the following two-part notation of ”Nun will der Lenz uns
grüßen”, which leads to confusion every time it is used.
The songs should be musically interesting. This means that they express
particular qualities such as ”Maienwind am Abend sacht”, a short but
musically clear and well-structured song. Then one usually comes
quickly into a musical experience.
The selection of songs is unique, demands careful preparation and makes

it impossible to purchase a songbook for each participant.
That is why I have created folders in various colours:
green– spring
yellow – summer
red – autumn
light blue – winter
dark blue – Christmas
purple – Collection 1
pink – Collection 2
The copies are ordered numerically. Over the years, a song collection has
grown that is based closely on practical use.

How do I introduce a song?

Normally I play a new song on the piano or sometimes sing straight
away. Then I try to find out how many can sing spontaneously. Finally, I
leave the piano and work on the song, part for part, through singing and
repeating. During this I do not only practice the right notes, but begin
directly with the musical expression. The practicing takes place in the
form of exact song presentation with the instruction to carefully observe
particular aspects, such as the lightness of the ”Fliederblütentöne” or the
portato of ”Apfelblütentöne” in the song ”Maienwind am Abend”. The
experience of different tempi, dynamics or other elements is simply a
good training, but also provides different experiences and trains the per-
ception of coherence: How fast do I have to sing ”Fliederblüten”, how
does a portato feel? We complete the work with a song when the feeling
”that worked well”, or ” that was lovely” or ”ahh, managed it!” arrived.
CANONS I work with canons often and with pleasure. They are mostly well struc-
tured (”Come follow me”). Most are relatively easy to learn. It becomes
exciting when the parts begin. There is an immediate social connection.
The canon only functions when we all manage to hold a pulse. Often I
use the resonance of the wooden floor and stomp not too gently but dis-
tinctly on the floor. Sometimes wild arm waving is enough and quite
often one feels like an animal trainer in the circus ring. These drastic
measures are mostly received with humor and the result can be enjoyed
without the loud stomping on the floor.
The number of parts is built slowly. Normally only two parts begin, the
third group listens and then we swap. Through the combination of sing-
ing and listening, the patients get quite confident in the parts and enjoy
the feeling ”I can” in an immediate way. ”I can sing”.
How do I introduce a song? 919

It is not unusual that someone has never, or only a very long time ago,
sung a multi-part song in a choir. This usually leads to spontaneous joy
and a reduction in inhibitions towards music, music therapy and the
music therapist.
For the three Morgenkreis sessions I prefer canons so that I can work on
three different aspects of the song, for example:
• Monday: Start practicing the canon, first attempt at two-part

• Wednesday: Practice the canon again, through listening move from
two-parts to three-parts
• Friday: After a short single-part repeats, go directly into three-part
singing, changing tempo and dynamics, often shifting the pitch a bit
higher, at the close to sing a little softer in order to hear the other parts
better. For me, the ”target is reached” when it sounds good, and when
after starting the canon I join one of the groups and sing along.
OTHER POSSIBILITIES Solo – Tutti. Some songs – for example gospels, are well suited for solo-
tutti versions, such as ”Swing low, sweet chariot”. After we have prac-
ticed the complete song, I sing the solo part and practice the correct tutti
entrance. For some this is difficult enough. Then comes the exciting
question: who is brave enough? In a small group of 4-5 singers we find
success. For the very adventurous they can try out a ”real” solo. Every-
one of us who has had to sing alone knows what that feels like…
Get into the ”swing”. Some jazzy swinging songs are very popular
(”Zwei kleine Wölfe”). Through clapping or light movements the singers
feel carried along by the music, start to move and become more free in
their soul.
Steps into life. One aim at the Day Clinic work is the individual reinte-
gration into the ”normal” everyday life, after long-term illness in many
cases.
Here are two examples:

Mr. M. came in the first year of the Day Clinic with a diagnosis of
depression and a severe problem of self-esteem to individual therapy. He
had no particular musical experience and no access to using his voice. We
discovered quickly however that he had a wonderful tenor voice and he
was interested to try it out. He made good progress, and he felt safe and
enjoyed his singing. He used the open singing to try himself out as a solo-
ist. With a great deal of excitement he sang the verses of ”Swing low”.
The impressed applause of his fellow patients left him with large smiles
and he obviously grew internally. A short time later there was a celebra-
tion of the Day Clinic’s first birthday. Many ex-patients came and the sit-
uation was public. We sang together, and with much excitement, but in a
beautiful voice he mastered his song. A wonderful achievement!
Second example:
On the fifth birthday of the day clinic in December (we like to party!)
there was a public celebration. Alongside the usual honored individuals
from politics and society, all ex-patients were invited to take part. At the
end in the early evening, we sang Christmas songs together. Without any
differences, the current and ex-patients stood equal with the guests and
therapists, and about eighty people enjoyed the full sound of emotional
Christmas carols, the experience of communal singing and the festive
mood of the coming Christmas celebrations.
Many patients discover a sense of deep joy and healing happiness

through communal singing. After the end of their time at the clinic I try to
help them to find a suitable choir.
Mr. H., who comes almost every Wednesday to sing, is, after much hesi-
tation and a lot of persuasion, active in the local Witten Bach choir.

Mrs. M. from Dortmund found a gospel choir in which she is getting to

enjoy community with others.
Mrs. S., who is chronically ill, sings in a choir once a week. After which
she says she has at least two symptom-free days. I suggested she sings
more often!
Further aspects that lead to success
• It is necessary to continually search for suitable new songs, so that one

does not fall into a pattern of routine, and also to find songs suitable
for the new and ever changing group of patients. This means, one can
hardly walk past a single new song book…
• One’s own routine and security is helpful and relaxing, as is the exact
preparation of the songs. Based on this, one is confident during the
sessions and can react in a flexible manner to the current situation and
mood of the patients.
• It is extraordinarily helpful to have my team who have been musically
trained over the past seven years. The team supports my work
unequivocally and with much fun. As we sang as a group at a col-
league’s wedding, someone asked if they could hire us for the next
party…
Therapeutic dimensions and aspects of singing in the

day clinic
In our society, singing is ”out”. Most people only use the radio, the CD
player and the television. In most families only ”Silent night” is sung on
24th December. On most birthdays you hear only ”Happy birthday” in 15

different parts, mixed with the sound of champagne glasses after the first
repeat. In football stadiums there is regular singing, sorry ”grunting”. In
kindergarten and primary schools some effort is made but mostly without
much competence or success. Later at school ”learning” is more impor-
tant than ”doing”. Continuous critical remarks on one’s singing and com-
ments like ”leave your mouth closed while we are singing” make many
people silent for the rest of their lives. In Witten for example, there is no
Therapeutic dimensions and aspects of singing in the day clinic 922

secondary school with its own school choir, with the exception of the
Steiner School.
Am I right or exaggerating?
I hope that some protest is stirring. Over the past two or three years there
is a contrary movement – through projects like, ”rhythm is it” – a large
music and dance program in inner city crisis areas in Berlin, a growing
awareness of the significance of music for people and particularly in the
development of children. Music schools have begun to cooperate with
schools and offer not only instrumental courses but also children’s choirs.
But these projects have not yet any significant effect – it is no exaggera-
tion to say that over 60% of our patients have not sung a song for
decades. Certainly 90% of the patients have no experience with a choir,
no shared experiences in singing.
This is obvious in those patients who arrive in the Morgenkreis on their

first day in the Day clinic. Anxious, often with negative experiences and
a lot of worry about what is about to happen, they see the music therapist
who comes along with her colorful folders and after a friendly hello starts
to sing an often unknown song. They see the doctors and secretaries in
the circle also searching for the right note and the beat. The commonly
strong reactions range between embarrassment, wonder, defense, inquisi-
tiveness, and also indignation and fear. Mostly the feelings are overrid-
den by inquisitiveness. Nobody attracts notice who tries tentatively to
join in singing. The social need to belong commonly leads the patients to
join in.
Concentration on the musical work often helps them to forget everything

else and to overcome the surprise or embarrassment of one’s own voice
easily. The ”success” after 10 minutes leads mostly to a feeling of sponta-

neous joy or at least comfort and relaxation: ”I have presented myself and
have belonged”. After one song, one is no longer a stranger, contact is
easier and a good start has been made. This makes contact with nurses
and therapists easier, too. It is easier to talk about one’s problems after
singing a canon with someone.
Much has been published about therapeutic work with the voice. In the
following section I will focus on those issues that I believe are most sig-
nificant for my work with these patients. I will complement these issues
with fitting citations.
1. SINGING DEVELOPS Some songs are simple, others unusual, for example very old melodies
PERCEPTION
from the Middle Ages (e.g. ”Maienzeit bannet Leid”). I sing the unusual
songs in short sections first, until all have entered this musical world.
Exact intonation and phrasing or rhythmical accentuation exercise the
perception of people with disturbed perception or with increased intro-
spection. Hereby, this ”exercising” is without orders and actually is fun.
”Perhaps no other activity (such as singing) is so healing… The

all inclusive discipline of rhythm and pitch develops the feeling
for coherence and solidarity” Menuhin
2. SINGING INCREASES After we have practiced a song or canon and gone into the two and three-
SOCIAL PERCEPTION
part I demand that the patients do not hold their ears closed, a favored
practice from school, but to keep their ears open, to listen to the other
voices, the resulting intervals and the resulting chords and to enjoy it,
even though it may seem difficult at first. When a three-part canon is first
practiced in changing two-part groups and one group has the opportunity
to listen, the perception is also trained, listening is practiced. Slow tem-
pos are good to practice listening, as are small intervals and chord exer-
cises, or to sing for someone first. The ”a-ha” experience when it works
and sounds good is always a big one. This trains intra- and interpersonal

perception. Success is apparent when everyone can listen to each other,

be involved with the other, but hold their own part.
” Singing develops as it unfolds from listening with attention. In

singing we refine our ability to really listen to people and to the
world surrounding us.” Menuhin
3. SINGING DEVELOPS Depending on the quality of the song, various social reactions can be
COMMUNITY
observed. An emotional song leads to a warm, loving atmosphere that
often leads to pleasant contacts and talks between the patients. A stronger
song brings the group into movement. After we once had finished a song
with gusto, the whole group came over to me, as if planned, and lay their
songbooks in my arms with eye contact full of smiles. I was surprised by
so much direct contact, normally they just leave the song books on a
chair.
The patients experience a direct pull in social interaction, they develop

basic social competencies which may have been lost through illness. At
the same time they experience togetherness in action instead of hierarchy.
Communal singing and breathing creates an internal sense of connected-
ness. After singing there is much more contact and conversations.
”When one person sings out of his soul,

He will heal his inner world.
When all sing out their souls And are one with the music,
They will as well heal the outer world.” Menuhin
4. SINGING AFFECTS Breath is not only the basis of singing but also the basis of emotional life.
THE BODY
A disturbed breath for whatever reason disturbs emotional experience.
Singing is a deep body process, and the body is my instrument. Singing
fills every thread of my body. And through this, the required breath links
my body with the world.

My bodily condition is reflected in my voice, everyone knows this. I

often explain to the patients that a major part of singing, like sport, can be
trained. Many, in particularly the younger patients have experienced
sport and easily understand and accept this comparison. People with
emotional illness are always not fully incarnated – or connected with
their body. When the body is in balance, the soul is also in balance and
vice versa. All body therapies are therefore helpful for emotional disor-
ders. Singing works both physically and emotionally, and through this we
come closer to the term ”holistic” in therapy.
”Perhaps, no other activity is as healing as singing is, because it

requires our whole movement apparatus – breath and blood circu-
lation, lungs and heart.” Menuhin
5. SINGING LEADS INTO In former times, there were no important events in the life of a person
THE WORLDS OF SOUL
that were not accompanied by music and song. Songs, particularly tradi-
tional songs were sung often. All emotions of life were included, joy at a
wedding, sadness at a burial, a lullaby at night, love songs and so on. In
this way, all emotions of human life rang out in song, the variety of the
internal world of emotions became expressed.
I begin Open Singing with one or two well-known songs to invite, warm-
up and arrive. Then I ask if anyone has a favorite song. The various
patients’ wishes comprise a wide range of songs, from their own emo-
tional world. The range of emotions is, in turn, a possibility to recognize
one’s own emotional world. The facets of emotional experience are simi-
lar to taking a walk through the most diverse and deep human emotional
states and touch each individual person with their own themes and prob-
lems. Through the experiences and forms, blockages and hardness are
touched, feelings are re-discovered and the emotional flexibility of the
soul and the heart is expanded. Sometimes patients are overwhelmed by
feelings suppressed and dried-up for a long time, may cry a little or go

outside, smoke a cigarette or look for a conversation. The next time, they
may be a step further, and may sing along for a song, or at least manage
to cope with the situation.
In this manner, everyone experiences during their stay, not only the diver-
sity of other emotional worlds, but the various emotional worlds in them-
selves. This leads to more self-knowledge and more social tolerance.
”Teach your soul to sing.

Each state has its songs.
May singing be with you in all you do
Love this singing and watch over it.” Arvo Pärt
6. SINGING MAKES IT Many of the patients come with ego structure disorders, commonly
POSSIBLE TO
EXPERIENCE LIVING beginning in their childhood. Daily structure, day and night rhythm, and
STRUCTURES
body rhythms are often disturbed, they are not able to form their every-
day life. A given song offers a structure in the form of support and orien-
tation. It is not a fixed unchanging structure, but a living one. The melody
is given, but we can sing it as a two-part or canon. We change pitch,
tempo or dynamics. Some verses have a different text structure or the
accompaniment changes. One can hold on without being fixed, it is pos-
sible to stay in movement.
“The Rhythm of music, proportions and movement in all other

arts grant stability, a sense of purpose and consistency in our
daily life. Without these guarantees, life would be chaos; it would
seem senseless and with no reason to the individuum, confused
by noise and chaos.” Menuhin
7. SINGING MAKES THE Everyone who has been on a psychiatric ward knows the paralyzing,
JOY OF LIFE
ACCESSIBLE mostly somber, joyless atmosphere that commonly characterizes these
wards. Singing, regardless how quiet and unimpressive it may be,
changes this atmosphere. The patients experience, while singing, that
even though there is much internal joylessness and heaviness, there is a

spark of the joy of life. They can feel this once again and gather hope that
this joy can and is allowed to grow. I use every chance that a song or sit-
uation offers to say something humorous. And in fact, fun songs are
repeatedly chosen. I often tend towards comic effects, by emphasizing
some expressions, or make jokes at my own cost, for example in the
desert canon "Sum gali gali" I am very intense with the portrayal of the
camel… This is when the last start to laugh or at least begin to grin.
Through the concentration on the music, we repeatedly experience life
energy, and the joy of life.
"I praise music,

As it frees people
from the heaviness of things and
connects the individual within
the community"
St.. Augustine
8. SINGING Through singing, patients come in direct contact with themselves, with
ENCOURAGES
PERSONALITY their "Self" or ego personality. Many are ashamed, and don't want to hear
INTEGRATION
their voices, are shocked by their own voice and hide themselves in the
sound of the choir. Through the shared musical work they manage to
overcome this. They feel themselves grow within the community and
grow in their ability and possibilities. Suddenly the difficult passage is
managed, or one manages to stay in a shared rhythm.
Through singing, patients come into contact with aspects of their person-
ality, in their own form of reacting within the world. Those habits and
behavior patterns that have developed in their biographical experience
are reflected in their singing and in contact with the therapist. Sometimes,
I sing the melodies a little differently than they are transcribed. If I do not
mention this at the outset there is often loud protest. "You are doing

something wrong there!" I take it with humor and cite the "artistic free-
dom" or we try various possibilities so that we can decide upon a final
version together.
“In those who do not love,

music banishes all hatred.
To the restless one it gives peace,
And the crying will be consoled.
Those who don´t know how to proceed
Will find a new path,
And for those who reject everything
A new certainty and hope will grow.”
Pablo Casals
9. SINGING TO Singing touches the "Self" of a person, understood as his or her most
STRENGTHEN THE
”SELF” internal being, which lives, forms and also suffers; this Self that stands as
a unique individual in front of me, this individual that must accept that it
is ill, and does not manage its life; this deepest core of the person
expresses itself through singing.
“Singing is a direct expression of the self, that lives at the same

time in its emotional and mental aspects as well as in its physical
and vocal organism. Singing is one of our most integrated activi-
ties, at the same time a most revealing and expressive act.” Paul
Nordoff
This Self that initially says, I cannot sing, and such a difficult song too,
this Self begins gently to move and express. It experiences in singing a "I
can", "I can sing, I can create form, I can change something, move some-
thing, I can sing together with others. I can even stand up and raise my
voice before others, I can!"

Mrs. M. discovered singing for herself. It was her element. She used
every chance to work and try out solo parts. In individual therapy she had
the wish to sing "O happy day". It was her song. She bonded so strongly
with the song that she found her own individual expression. In open sing-
ing she presented her song and the group sung the repeating chorus.
Through this she attained a range of freedom in musical expression with
an almost stage-ready performance. Everyone was delighted. Often the
patients are surprised about their inner growth through contact with
music, with the experience of the "you" and the community.
10. SINGING INCREASES According to the strength and security of a group, the tasks increase in
WILLPOWER
difficulty. We even managed an eight-part canon once! A second voice is
initially sung by three or four stronger voices. Then all the other voices
have to concentrate on the first part. For some, this is a challenging task.
Things that don’t function are practiced again, no one is evaluated as
right or wrong, behaviour and person are not, as often experienced,
unfortunately linked to each other. In contrast, an unconditional "yes" to
a person with their errors is experienced. Errors are allowed, I make
errors too – and often more audible ones! Errors are not negatively
judged, but are accepted as part of practice better and repeatedly take us
closer to the musical expression. It is a healing atmosphere, when errors
are accepted; the inner tension of avoiding mistakes can be released.
Through this, I can be free to become involved with something and to
focus my willpower on one aim. My inner strength does not get lost in
the group, but is important for the success of the songs.
11. THE INNER SOURCE The surprise and joy, when after repeated hard work, a canon unexpect-
edly comes together and also even sounds good, is often large. Through
experiencing a musical figure or form we experience "beauty", whole-
ness, and maybe a feeling of being healed. I experience musical-artistic

activity as a dimension of human existence, which extends over daily life

and opens artistic and spiritual experiences in life. These experiences can
reactivate inner resources that have been buried and unused, and also
address and answer the question of sense, particularly with psychiatric
patients. The state of being touched or moved through beauty in music,
the experience of music as art can be a direct experience of music as a
path, a bridge into the spiritual world.
“God honors me,

When I work,
But loves me,
When I sing.”
Tagore
Summary
Singing has many aspects and has been widely discussed and researched
in terms of its effects on people and on a community. Singing has found
various forms in therapeutic work. To discuss both would have been out-
side the scope of this presentation.
….just sing!

Boymanns, B. (2006) Just sing…Music Therapy Today (Online 22nd
December) Vol.VII (4) 913-931. available at http://musictherapy-
world.net
Summary 931
Music Therapy Today
„Painting is good for your

soul!“
Merz, Regine
Merz, R. (2006) “Painting is good for your soul!” Music Therapy Today (Online
22nd December) Vol.VII (4) 932-938.
Regine Merz, certified art therapist and leading researcher in this study,
intends to provide HIV and AIDS patients as well as breast cancer
patients with art therapy. Creative art therapies, specifically for HIV and
AIDS patients, should be covered by health insurance.
„Painting is good for your soul, stimulates the senses and has a steadying
effect on emotions“, confirms Isabella. She attends the therapeutic paint-
ing group HIV-ART established by Regine Merz in the Ruhr area several
years ago. For the art therapist, the positive response of participants and
also of visitors to the exhibitions organized by HIV-ART are a confirma-
tion that art therapies are a highly meaningful complementary interven-
tion, specifically for HIV and AIDS patients, and therefore should be
covered by health insurance. Regine Merz has started her doctoral studies
on art therapies and AIDS in order to provide a solid academic basis in
support of this demand.
932
Merz, R. (2006) “Painting is good for your soul!” Music Therapy Today (Online 22nd December)
FIGURE 1.
When Isabelle appeared at the art therapy sessions she was rather quiet
and absorbed in her painting. Her first water colours show much insecu-
rity in brushwork. Frequently she asked the art therapist for advice and
933
support when she had practical problems putting her ideas on paper.
Water colours cannot be painted over. This increased her insecurity, and
she changed over to more expressive acrylic paints. This also changed
her artistic expression; now she was able to change and paint over what
she wanted to cover.
FIGURE 2.
She needed less and less help. She kept to her favourite colours, warm
earthen shades. Gradually, still lives emerged on her canvas. Her com-
ments on her first paintings were: „I don’t know what I am painting.“
Today her themes are clearly recognizable. Also she was less reticent to
934
get involved with the others in the group. She was all in favour of meet-
ing not every third, but every second week. Her paintings document her
artistic as well as personal development, where the HIV infection does
not seem to be in the foreground.
FIGURE 3.
For other participants the disease and the exclusion experienced as a con-
sequence are the core theme of their artistic endeavours. The title of the
very expressive painting by Volker is „The better human being“ and
refers to the yellow figure on the left. This work is an expression of his
relationship and solidarity with the excluded person, as yellow was his
favourite colour. He extended his commitment to solidarity with HIV
patients and their families beyond the art therapy sessions. As his disease
progressed his artistic abilities faded with his degenerating immune sys-
tem. The final point is visible in his last painting shortly before he died,
as a red burning sun in the sky above a village. Volker’s paintings, like
935
those by Isabelle, reveal the relation between the works of art and the art-
ist in his entirety, with all his individual traits and his outlook. Volker’s
paintings reflect his physical condition and the way he copes with the dis-
ease in a very immediate manner.
FIGURE 4.
In art therapy sessions, emotions and moods are taken down on paper
more or less consciously; the person who paints envisages himself and is
enabled to reflect his personal situation, using the canvas as a projection.
The patient is no longer the passive person who just endures what others
do to him – a role he associates with loss of control. The physical activity
936
of painting ideally stimulates active ways of coping with the disease and
the new situation in life.
In 2006, more than 20 years after the first cases of AIDS occurred in Ger-
many, HIV infection remains a medical problem and a highly complex
phenomenon. Antiretroviral drugs were developed over the past ten years
and improved medical treatment considerably. AIDS today does not nec-
essarily mean a degenerative process, but a return to a normal daily life
has become a possibility under new and better conditions. AIDS has
become a chronic disease with individual forms of progress. This change
may also be seen from the patients’ artistic expressions. Death and grief
are no longer the most distinct subjects. Today we find landscapes, still
lives and abstract compositions in such paintings. These works of art are
as individual as their creators and their situations in life. Looking closely
at the cycles of paintings by Volker and Isabelle and the contrary devel-
opment of these cycles, we must wonder whether the paintings created in
art therapy document, in addition to personal development, also changes
in the pathological progress. Are HIV-specific parameters visible in
patients’ paintings, and how may they be interpreted?
This is the research question for this study. One day per week, people
with an interest in art therapies may attend art therapy sessions for one
hour. Dates are by appointment either in the morning or afternoon.
After an introduction to techniques of acrylic painting, participants

receive continued professional support in realizing the tasks set to them.
A total of four different subjects have to be illustrated, and this requires
four appointments of one hour respectively. Clients are supposed to pro-
duce one picture per art therapy session. Art therapy sessions are group
sessions with a maximum of four participants and take place at the lec-
ture centre of the St. Josef Hospital in Bochum. The study is a combined
937
project monitored by the HIV/AIDS competence network and conforms

to the pertinent data protection regulations.
Attendance does not require previous training or artistic skills.
Author details
FIGURE 5. Regine Merz
Regine Merz is a certified art therapist. In 1999 she founded the art ther-
apy group HIV-ART. As a member of AIDS-Hilfe NRW she coordinates
meetings of HIV positive patients in NRW.
In her current doctoral studies at the University Witten/Herdecke (super-

vised by Prof. Dr. David Aldridge, Chair of Qualitative Research in Med-
icine) she addresses the question whether HIV specific parameters are
visible in patients’ paintings, and how these may be interpreted.
CONTACT DETAILS Individuals with an interest in the above-mentioned study may contact
Regine Merz at: (phone) 0174-56 14 897 or e-mail: merz(at)hiv-art.de
THIS ARTICLE CAN BE Merz, R. (2006) “Painting is good for your soul!” Music Therapy Today
CITED AS:
therapyworld.net
Author details 938

Music Therapy Today
Report on a research
meeting 2006 in Berlin:
“Music Therapy as
Applied in Neurology”
Pfeffer, Karolin
Pfeffer, K. (2006) Report on a research meeting 2006 in Berlin: “Music Therapy as

Applied in Neurology”. Music Therapy Today (Online 22nd December) Vol.VII (4)
939-943.
On 19 November 2006, the IMB, International Music Therapy Institute

Berlin, in close cooperation with the DGMT, arranged a research meeting
dealing with the subject “Music Therapy as Applied in Neurology”.
The IMB is an Institute of the University of the Arts, Berlin. It supports

music therapy in practice, research and training and contributes to the
public health care on a non-profit basis. Apart from the organisation and
realisation of international symposia, it cooperates with institutions of
psychosocial care to build up outpatient treatment possibilities. The next
symposium will take place as a conference from 3.-7. September 2007 at
the meeting point of the UdK in Sauen / Brandenburg (www.udk-ber-
lin.de/musiktherapie/IMB).
939
Pfeffer, K. (2006) Report on a research meeting 2006 in Berlin: “Music Therapy as Applied in Neurology”. Music Ther-
apy Today (Online 22nd December) Vol.VII (4) 939-943. available at http://musictherapyworld.net
On this Sunday, about 50 participants gathered in the UdK at Mierendor-

ffplatz for lectures and discussions on the subject of music therapy as
applied in neurology.
Spirits were high while final preparatory works were accomplished. To

start with, Prof. Dr. phil. Jahn-Langenberg gave a comprehensive survey
over the course of the meeting, introduced the speakers and accentuated
the importance of the interplay between research and practical operation.
She pointed out that present health politics seem to ask for developing,
examining and advancing both present and new fields of practice. Fur-
thermore, new aspects of the concept of psychotherapy should be rede-
fined. According to Prof. Jahn-Langenberg, there seems to be a need for a
comparing examination of practices as applied in Germany and USA.
Also, this day’s meeting was to treat the subject of polarity between
humane arts and natural science in lectures held by Prof. Dr. Jane
Edwards, guest professor of the institute, and Kathrin Mertel, Dipl.-
Mthp. (FH), MM Master of Music.
At the outset, Prof. Dr. med. Hans Ulrich Schmidt discussed the subject
of music therapy as applied in neurology. To an increasing extent, music
therapy develops into an interesting interdisciplinary medical treatment.
Improvements in the complex data capture in cerebral research permit-
ted, within the past 5 years, the development of neurological music ther-
apy as a methodically systemized as well as scientifically established
therapeutic method. In using music therapy within the scope of neurol-
ogy, psychotherapeutic settings are often modified. What is more, to
some extent, treatment methods are applied that cannot really be defined
as psychotherapeutic, but rather reach into the domain of functional
music. (See M. Thaut, www.colostate.edu/dept/cbrm/publications.htm).
He lectured on a “soft movement away from a therapeutic relationship”
and suggested focusing on the impact of the object – of music and its
940
components, rather than on a therapeutic relationship. After all, as he puts

it, one is finally always confronted with the question: What makes music
therapy work?
The following lecture was contributed by Prof. Dr. Jane Edwards on the
subject of “Research in Context – a Response to the Evidence Based
Medicine (EBM)”. She gave a survey over the EBM framework, which
one might describe as a series of levels of evidence. (See MU 25,3
(2004), p. 221-232). EBM was thoroughly discussed and defined as a
complex topic in music therapy serving as an element of objectification.
As it is quite useful in maintaining or even creating posts, music therapy
should get more deeply involved in EBM concerns. Furthermore, Jane
Edwards pleads for openness towards the multitude of “Levels of Evi-
dence” and for better appreciation. The point is to identify the wide range
of research work being accomplished, and to find out which method
might be the most efficient in pursuing which target of research. Her sug-
gestion was not to consider EBM as a restriction to music therapy, but
rather recognize the opportunity to build up a clearer position in interna-
tional comparison and within medical contexts.
Dr. rer. medic. Wolfgang Schmid presented „Functionality and Aesthetic

– a Pilot Study of Music Therapy in the Treatment of People with Multi-
ple Sclerosis”, this illness being the most widespread and incurable
inflammatory disease of the central nervous system in young adults
within the western industrialized countries. Since it includes stigmatiza-
tion and heavy primary and secondary diseases (reactive depression, con-
tinually varying self-perception), a comprehensive treatment should not
proceed from functional considerations. A full range of therapeutic meth-
ods should be offered, including the enhancement of the patient’s creative
abilities. Those concerned desire improved psycho-social care and
increasingly express an interest in alternative and complementary thera-
941
pies in addition to medical treatment. (See: Neurologie & Rehabilitation

2005; 11(3): 131-138); Music Therapy Today, Vol V (5) Nov 2003).
Kathrin Mertel presented the connection between scientific evidence and

music therapeutic training as for example the American master studies
offered by the Colorado State University. Here, neurological music ther-
apy (NMT) stands for music therapy as an application of music to treat
cognitive, sensory and motor dysfunction brought about by neurological
disease of the central nervous system. It is based on the neuro-scientific
model of perception and production of music. Clinical studies in context
with quality assurance deal with the question whether music is capable of
influencing behaviour beyond musical comportment, and why music
therapy is employed in neurology. Studies include music, therapy and
research. Studies focus on empirical research in music and medicine.
After 2 full-time semesters, the study ends with a Master of Music (MM)
degree – with focus on neurologic music therapy. Costs amount to
approx. 7,000.00 USD per semestre (http://www.colostat.edu/Depts/
cbrm).
At this meeting, the catalogue of indications for music therapy in neuro-

logical rehabilitation published in May 2005 was presented for the first
time by Anna Hinkelmann, Dipl.-Mthp. (FH) and Stefan Mainka, Dipl.-
Mthp. (FH). After approximately 2 years’ work, she presented the results
of the study group consisting of 6 persons. The project was supported by
the DGMT and accompanied by Dr. med. Hans Ulrich Schmid. The cata-
logue is a contribution to scientific discussion and teaching. It is designed
to serve as a professional account to externals, as information to physi-
cians and sponsors, also to facilitate communication with the interdisci-
plinary team. (To be ordered: www.musiktherapie.de, Webshop/Beiträge/
Nr. 455).
942
Dr. Annkathrin Pöpel, who works as a doctor, music therapist and neurol-
ogist, moderated the meeting. See her Study “Evaluation of music ther-
apy in Germany neurorehabilitation – starting point for European
comparability” (http://musictherapyworld.net).
The final discussion was mainly focussed on the significance of thera-

peutic relationship, ways to deal with EBM and its influence on music
therapy as well as on the essential exchange between functional therapy
and psychotherapy. Thus, at the end, all subjects and lectures of the
research meeting were summed up in conclusion. The participants sepa-
rated with a sense of having experienced an interesting and successful
day.
Author information
Karolin Pfeffer
Dipl.-Mthp. (UdK)
Kopenhagener Str. 13
10437 Berlin
030-48494926
THIS ARTICLE CAN BE Pfeffer, K. (2006) Report on a research meeting 2006 in Berlin: “Music
CITED AS: Therapy as Applied in Neurology”. Music Therapy Today (Online 22nd
December) Vol.VII (4) 939-943. available at http://musictherapy-
world.net
Author information 943

Music Therapy Today
“My Top Ten”
Aldridge, David
Aldridge, D. (2006) “My Top Ten”. Music Therapy Today (Online 22nd December)
Vol.VII (4) 944-946.
David Aldridge and Lutz Neugebauer have initiated a new research

project called “My Top Ten”.
For German readers they can see the first responses on the website http://
www.mytopten.de and also read details of their new CD collection
“Meine Musik”, a set of four CDs designed specifically for relatives and
carers of the elderly. The four CDs cover four differing musical styles
and are original recordings, an important feature of reminiscence work.
For general readers there is more to read on the Nordoff Robbins Centre
website at http://www.nordoff-robbins.org
“My Top Ten” is an international research project that will gather qualita-
tive information about what music people aged 60 years and over remem-
ber and how that is associated with events in their lives. Reminiscence is
seen as an important factor in various therapeutic interventions and this
project will concentrate on musical reminiscences. Similarly, giving
944
This article can be cited as: Aldridge, D. (2006) “My Top Ten”. Music Therapy Today (Online 22nd December
) Vol.VII (4) 944-946. avialable at http://MusicTherapyWorld.net
voice to the elderly is seen as an important factor in establishing the

worth of the elderly in modern western industrialised societies.
The educational intent is inter-generational in that the project will

encourage younger people in schools, colleges and graduate courses to
gather the project data, with appropriate supervision, by partnering a
younger person with an older person.
In addition, this project will provide information infrastructures for net-

based international research cooperation, musical resources for practitio-
ners, patients and carers, and an e–learning resource.
The educational aspect has two parts. One, for the further education of
practitioners and carers involved in working with the elderly as an e –
learning resource. Two, an intergenerational aspect linking younger peo-
ple with the elderly. This may be at senior school or at college level and
could be incorporated in training schemes as a specific module of work-
ing with the elderly in health care, occupational therapy or nursing stud-
ies; as a music ethnology module; or as a qualitative research module. At
school level, this would be suitable for scholars needing a community
contact, with an interest in the healing and caring professions, as a local
history project or a music project.
Author Information
Professor David Aldridge has the Chair of Qualitative Research in Medi-
cine at the University Witten Herdecke in Germany and is also Visiting
Professor for the Creative Arts Therapies, Bradford Dementia Group at
the University of Bradford, UK. Together with Prof. Lutz Neugebauer, he
is Director of Nordoff-Robbins Zentrum, Witten, Ruhrstrasse 70, 58452
Witten in Germany, which is a centre specifically for research and prac-
tice into the arts in the community.
Author Information 945

This article can be cited as: Aldridge, D. (2006) “My Top Ten”. Music Therapy Today (Online 22nd December
) Vol.VII (4) 944-946. avialable at http://MusicTherapyWorld.net
THIS ARTICLE CAN BE Aldridge, D. (2006) “My Top Ten”. Music Therapy Today (Online 22nd
CITED AS: December) Vol.VII (4) 944-946. available at http://musictherapy-
world.net
Author Information 946

Music Therapy Today
Odds and ends - themes

and trends
Tom Doch
Anything under odds and ends, themes and trends is linking to existing work on
the net – we cannot claim responsibility for the content of other websites (it may
become outdated quickly).
Sense of Humor and Aurvival among a County

of Cohort of Patients with End-Stage Renal
Failure
A Two-Year Study
By SVEN SVEBAK, BJØRN KRISTOFFERSEN AND KNUT
AASARØD
Source: baywood.metapress.com/Volume 36, Number 3 / 2006
http://baywood.metapress.com/(dm1gyz2ku4t0yr45fxtr3q45)/app/home/
contribution.asp?referrer=parent&backto=issue,2,10;journal,1,139;linkingpublic
ationresults,1:300314,1
The International Journal of Psychiatry in Medicine
Abstract:
Objective:
To explore the significance of sense of humor for survival in a county
cohort of patients diagnosed with end-stage renal failure. This diagnosis
is a life-threatening condition that calls upon coping skills and regular
dialysis.
Method:
All patients receiving dialysis in the county of Sør-Trøndelag during
February of one year (N = 52) were invited.
Forty-one completed the survey and had complete data (78.9%).
947
The discordant eardrum
Predictors were related to survival status two years later.

Three blocks of predictors were tested:
1) age, gender and education;
2) duration of disease, number of dialyses per week, and co-morbidity;
and 3) quality of life and sense of humor.
Confounding effects of variables in blocks one and two were controlled
for using Cox survival analysis.
Results:
Nineteen patients (46.3 %) died over the 2-year observation period.
Survival decreased with higher age at time of survey (p < .044), but was
not significantly predicted by variables in block two.
A highly significant increase in survival was due to the psychological
variables of block three (p < .001) essentially accounted for by sense of
humor (p < .005).
Those who scored above the median in sense of humor increased their
odds for survival by on average 31%.
Conclusions:
Sense of humor appeared to mediate better coping and, therefore,
protected against detrimental effects of disease-related stressors upon
survival.
OutDoorLinks:
Sven Svebak
http://www.hint.no/Adresseboka/adresse/vc/index.php?uid=svs&vis=S
---

By Jonathan P. Fay, Sunil Puria and Charles R. Steele
Source: www.pnas.org/ December 14, 2006
http://www.pnas.org/cgi/content/abstract/0603898104v1?etoc
Published online before print December 14, 2006
Proc. Natl. Acad. Sci. USA, 10.1073/pnas.0603898104
At frequencies above 3 kHz, the tympanic membrane vibrates
chaotically.
By having many resonances, the eardrum can transmit the broadest
possible bandwidth of sound with optimal sensitivity. In essence, the
eardrum works best through discord.

The eardrum's success as an instrument of hearing can be directly

explained through a combination of its shape, angular placement, and
composition.
The eardrum has a conical asymmetrical shape, lies at a steep angle with
respect to the ear canal, and has organized radial and circumferential
collagen fiber layers that provide the scaffolding.
Understanding the role of each feature in hearing transduction will help
direct future surgical reconstructions, lead to improved microphone and
loudspeaker designs, and provide a basis for understanding the different
tympanic membrane structures across species.
To analyze the significance of each anatomical feature, a computer
simulation of the ear canal, eardrum, and ossicles was developed.
It is shown that a cone-shaped eardrum can transfer more force to the
ossicles than a flat eardrum, especially at high frequencies.
The tilted eardrum within the ear canal allows it to have a larger area for
the same canal size, which increases sound transmission to the cochlea.
The asymmetric eardrum with collagen fibers achieves optimal
transmission at high frequencies by creating a multitude of deliberately
mistuned resonances.
The resonances are summed at the malleus attachment to produce a
smooth transfer of pressure across all frequencies.
In each case, the peculiar properties of the eardrum are directly
responsible for the optimal sensitivity of this discordant drum.
To read fulltext go to attached PDF

To whom correspondence should be addressed.
Sunil Puria, E-mail: puria(at)stanford.edu
OutDoorLinks:
Charles R. Steele
http://me.stanford.edu/faculty/facultydir/steele.html
---

Mozart's entire musical works now free on Net
Mozart's entire musical works now free on Net

Site hosting complete oeuvre of the classical composer, backed by
Packard Humanities Institute, is being flooded with traffic.
By Reuters
Source: http://news.com.com/Mozarts+entire+musical+score+now+free+on+Net/
2100-1027_3-6142845.html?tag=html.alert
Wolfgang Amadeus Mozart's year-long 250th birthday party is ending on
a high note with the musical scores of his complete works available from
Monday for the first time free on the Internet.
The International Mozart Foundation in Salzburg, Austria, has put a
scholarly edition of the bound volumes of Mozart's more than 600 works
on a Web site.
The site allows visitors to find specific symphonies, arias or even single
lines of text from some 24,000 pages of music.
"We had 45,000 hits in the first two hours...we would not have expected
that," program director Ulrich Leisinger told Reuters in a telephone
interview. CNET News.com was not able to reach the site Tuesday
morning, perhaps due to a traffic overload.
A user who types in "Pamina" from Mozart's opera "The Magic Flute"
will see the music for all five arias she sings, as well as critical texts
discussing those passages.
The version appearing on the Internet is a digitized copy of the "New
Mozart Edition" published by Barenreiter, of Kassel, Germany.
It is considered the "gold standard" of Mozart editions, and Leisinger
said Barenreiter was paid $400,000 for the digital-publication rights.
The financial backing came from the Packard Humanities Institute of Los
Altos, Calif.
"We hope we will be able to convince other people besides us to present
their original materials online as well," Leisinger said.
Story Copyright © 2006 Reuters Limited. All rights reserved.
OutDoorLinks:
Neue Mozart-Ausgabe/New Mozart Edition

Digitalisierte Version / Digitized Version
http://nma.redhost24-001.com/mambo/index.php
---

It's the thought that counts

Belief in placebos can release natural painkillers in patients
By Dennis O'Brien
Source: www.baltimoresun.com/ December 8, 2006
http://www.baltimoresun.com/news/health/bal-
hs.placebo08dec08,0,3278030.story?coll=bal-health-headlines
Using brain scans, acupuncture and the nasty stuff that puts the sting in
pepper spray, researchers are learning how placebos play out in our
brains.
These innocuous medications - long used as decoys in clinical drug trials
- aren't supposed to have real chemical effect on the body. But experience
over the years has taught doctors that some patients who take placebos
experience real relief.
Now brain scans show that when test subjects think a placebo is a real
medication or treatment, the expectation of relief can release natural
painkillers. That, in turn, can ease the discomfort of ailments from
overworked muscles to a stinging hand.
"I think what we've shown is that the effects of placebo are real. It's not
false pain relief at all. The body is releasing a chemical that induces pain
relief," said Dr. James N. Campbell, professor of neurosurgery and
director of the Blaustein Pain Treatment Center at Johns Hopkins
Hospital.
Campbell's tools are positron emission tomography (PET) scans and
capsaicin - the compound that makes hot peppers hot and puts the sting in
pepper spray. His tests show that when someone gets a placebo, a specific
region of the brain responds by activating neurotransmitters thought to
release morphine-like painkillers.
"The question we asked was, 'Is there a release of morphine that
corresponds to this placebo effect?' The remarkable finding was that
there is," Campbell said.
In initial tests, researchers applied capsaicin to the left hands of 30
volunteers. They also got injections that doctors described as a soothing
medication.
The injections were, in fact, a harmless inactive saline solution, but a
thermal device connected to the volunteers' hands reduced skin
temperature to about 80 degrees Fahrenheit. That eased the effects of the
capsaicin so that volunteers came to associate the injections with reduced
pain.

In follow-up tests, volunteers again got capsaicin treatments. Some also

got placebo "painkiller" injections, while others got no injections at all.
Meanwhile, researchers ran PET scans on subjects while they were given
the injections.
PET scans use positron emission tomography to trace the path of a mildly
radioactive substance through the body. It's typically used to identify
tumors or spot areas of brain function.
The tests showed that when given the placebo injections, volunteers
reported less pain from the capsaicin - even though the pepper treatments
were the same. More importantly, the scans showed they actually had
different reactions in the mid-brain area known as the periaque- ductal
gray (PAG).
The PAG released a class of painkillers known as endogenous opioids.
Scientists couldn't tell exactly which opioids were released - brain
scanning isn't that precise - but Campbell believes they were endorphins,
which reduce the sensation of pain.
Campbell reported his results last month at the annual conference of the
Society for Neuroscience in Atlanta. He said his goal is maximizing the
placebo effect by harnessing the body's ability to reduce pain naturally.
'Cognitive strategies'
That could happen through cognitive therapy, self-hypnosis or focusing
on the kind of distraction from pain experienced by someone watching a
gripping movie.
"You can't go around all the time in a state of self-hypnosis, but there
could be some kind of cognitive strategies developed to control pain,"
Campbell said.
Skeptics say the benefits attributed to placebos might stem from our
ability to heal without treatment or medication. Researchers at the
University of Copenhagen in Denmark concluded in 2001 that the
benefits attributed to placebos were largely the result of diseases running
their course.
Believers in placebos acknowledge that benefits are often hard to nail
down - if relief or healing occurs, it's hard to determine how much of it
was from the placebo and how much was part of the natural healing
process.
But scientists such as Campbell argue that brain scans don't lie - they
show that something physical is actually happening in our heads.

They note that placebos in controlled experiments produce the desired

effects about 30 percent of the time, and in clinical trials of drugs before
they're approved for market, placebos will sometimes be as effective as
the tested medication.
"Placebos are an inherent part of manipulation whenever a clinician gives
a medication. They work very well at blocking pain. That's why a doctor
will always talk up the effects of a medication - it increases the likelihood
it will help," said Allan Basbaum, a neuroscientist at the University of
California, San Francisco.
Expectation a key
Some experts say placebos are proof of the power of positive thinking.
"A patient who has pain - if you give them a medication and tell them it
will reduce the pain, that has a positive effect on the outcome," said Dr.
Jon-Kar Zubieta, a psychiatrist who studies the effects of placebos
on the brain at the University of Michigan.
Part of Zubieta's research is aimed at figuring out why some people are
more susceptible to the placebo effect than others. "There could be a
genetic component, but nothing is certain," he said.
Zubieta reported last year in the journal Neuroscience that giving
placebos to volunteers who thought they were getting painkillers released
natural compounds in several areas of the brain, including the prefrontal
cortex and the anterior cingulate. Those areas are believed to control our
expectations and how we regulate emotions.
Unfortunately for researchers, the brain has no single pain control center,
so pinpointing areas where placebos curb pain is a challenge. "There's an
entire system of circuits that become activated, at just the expectation of
pain relief," Zubieta said.
Researchers have been studying placebo effects for years. But many
placebo studies don't compare the outcomes from a placebo with those of
accepted drugs, said Ted Kaptchuk, an assistant professor of medicine at
the Harvard Medical School.
Comparisons
"One problem is there's been no controls in a lot of cases," Kaptchuk
said. "If I give 100 people with colds a sugar pill and two weeks later the
cold symptoms disappear, was that the placebo? A lot of what you see are
those kind of reports."

This year, Kaptchuk turned to acupuncture to try to determine whether

some placebos are more effective than others.
He divided 270 patients, all with chronic arm pain from repetitive stress
syndrome, into two groups. He gave one group either a dose of a pain
medication in pill form, or a placebo pill. Members of the other group got
either acupuncture or a sham acupuncture treatment involving needlelike
sticks that didn't penetrate deeply enough to hit the right pressure points.
Those given sham acupuncture reported a more significant decrease in
pain - about 10 percent - than those given a placebo pill, Kaptchuk said.
He reported the results Feb. 1 in the British Medical Journal.
One unexpected result: The placebo effect also boosted the volunteers'
chances of experiencing adverse reactions when they were warned in
advance that unpleasant side effects might occur. In fact, some 30 percent
of the patients who got acupuncture - but were told they might experience
more pain afterward - actually reported experiencing more pain as a
result, Kaptchuk said.
The same percentage of placebo pill takers reported getting drowsy and
experiencing dry mouths after they were warned about those side effects,
he said.
Kaptchuk is planning future research into the magnitude of placebo
effects on patients with a number of conditions, including irritable bowel
syndrome, asthma and chronic pain.
"I think there's an intrinsic scientific value in understanding how the
body reacts to what's going on in the mind," he said.
OutDoorLinks:
James Campbell
http://www.neuro.jhmi.edu/profiles/campbell.html
Jon-Kar Zubieta
http://www.umich.edu/~neurosci/faculty/zubieta.htm
---

Laugh and the whole world laughs with you: why the brain just can't help itself
Laugh and the whole world laughs with you:

why the brain just can't help itself
Source: www.alphagalileo.org/08 December 2006
http://www.alphagalileo.org/index.cfm?fuseaction=readrelease&releaseid=517119
Cricket commentator Jonathan Agnew's description of Ian Botham's
freak dismissal, falling over his own stumps – "He couldn't quite get his
leg over" – was all it took to send himself and the late Brian Johnston into
paroxysms of laughter.
Laughter is truly contagious, and now, scientists studying how our brain
responds to emotive sounds believe they understand why.
Researchers at UCL (University College London) and Imperial College
London have shown that positive sounds such as laughter or a triumphant
"woo hoo!" trigger a response in the listener's brain.
This response occurs in the area of the brain that is activated when we
smile, as though preparing our facial muscles to laugh.
The research, funded by the Wellcome Trust, Action Medical Research
and the Barnwood House Trust, is published today in the Journal of
Neuroscience.
"It seems that it’s absolutely true that 'laugh and the whole world laughs
with you'," says Dr Sophie Scott, a Wellcome Trust Senior Research
Fellow at the Institute of Cognitive Neuroscience, UCL.
"We've known for some time now that when we are talking to someone,
we often mirror their behaviour, copying the words they use and
mimicking their gestures. Now we've shown that the same appears to
apply to laughter, too – at least at the level of the brain."
The research team played a series sounds to volunteers whilst measuring
their brain's response using an fMRI scanner. Some of the sounds were
positive, such as laughter or triumph, whilst others were unpleasant, such
as screaming or retching.
All of the sounds triggered a response in the volunteer's brain in the
premotor cortical region, which prepares the muscles in the face to
respond accordingly, though the response was greater for positive
sounds, suggesting that these were more contagious than negative
sounds.
The researchers believe this explains why we respond to laughter or
cheering with an involuntary smile.

Brain functional near infrared spectroscopy in human infants: cerebral cortical
"We usually encounter positive emotions, such as laughter or cheering, in

group situations, whether watching a comedy programme with family or
a football game with friends," says Dr Scott.
"This response in the brain, automatically priming us to smile or laugh,
provides a way of mirroring the behaviour of others, something which
helps us interact socially. It could play an important role in building
strong bonds between individuals in a group."
OutDoorLinks:
Dr Sophie Scott
http://www.icn.ucl.ac.uk/Staff-Lists/
MemberDetails.php?Title=Dr&FirstName=Sophie&LastName=Scott
---
Brain functional near infrared spectroscopy in

human infants: cerebral cortical
haemodynamics coupled to neuronal activation
in response to sensory stimulation
By Marco Bartocci
Source: diss.kib.ki.se/8 december 2006
http://diss.kib.ki.se/2006/91-7357-034-6/
Abstract:
The assessment of cortical activation in the neonatal brain is crucial in
the study of brain development, as it provides precious information for
how the newborn infant processes external or internal stimuli.
Thus far functional studies of neonates aimed to assess cortical responses
to certain external stimuli are very few, due to the lack of suitable
techniques to monitor brain activity of the newborn.
Near Infrared Spectroscopy (NIRS) has been found to be suitable for
functional studies of the infant brain. By this method haemodynamic
changes coupled to cortical activity can be monitored.

The overall aim of the research is to assess how the brain is processing
sensory stimuli (pleasant and unpleasant) in infants using a non-invasive
technique such as NIRS.
Studies of smell perception (studies 1 & 2)

Olfaction was mainly used as the paradigm in these studies. Smelling is
essential for neonatal behavioural adaptation in many mammals,
including humans.
Methods
Study 1
Twenty-three healthy, full-term newborn infants were included in the
study at a postnatal age between 6 hours and 192 hours.
As odorant sources we used (i) the own mother's colostrum; (ii) vanilla
essence; (iii) distilled water as a negative control. The i NIRS optodes
were placed over left orbito-frontal gyrus of the frontal lobe.
Study 2
Twenty preterm newborn infants in stable condition at testing were
studied.
As odorant sources a disinfectant solution containing benzalconio
chlorate (0.25%), ethylic alcohol (66.29%), excipients such as lemon oil,
acetone, iso-propilic alcohol, camphor and a detergent containing
dipropylene glycol methyl ether, water and mineral essences were used.
The NIRS optodes were placed bilaterally over left orbitofrontal gyrus of
the frontal lobe.
Main findings and conclusion
Study 1
The main finding of this study was that the NIRS technique can be used
in the neonatal period to record activity in the orbito-frontal cortex - as
mirrored by changes in blood circulation during exposure to biologically
meaningful as well as artificial odors, colostrum and vanilla,
respectively.
The magnitude of the response in the illuminated region during
colostrum exposure was inversely related to postnatal age.
Study 2
This study demonstrated that the odors of solutions commonly used in
NICUs might elicit a decrease in blood oxygenation in an area likely to
include the orbito-frontal olfactory area.

These haemodynamic changes are likely to be the result of a dynamic,

physiological regulation of regional CBF based upon the olfactory- and
trigeminus-related areas of the brain.
Study of pain perception (study 3)

Supraspinal pain processing of pain in neonates and preemies is still
poorly understood.
Methods
Forty preterm neonates at 28-36 weeks of gestation and mean postnatal
age of 30.7 h were studied following standardized tactile (skin
disinfection) and painful (venipuncture) stimuli. Changes in regional
cerebral haemodynamics were monitored by near infrared spectroscopy
(NIRS) over both somatosensory cortices in 29 newborns, and over the
contralateral somatosensory and occipital areas in 11 newborns.
Main findings and conclusion
Painful and tactile stimuli elicit specific haemodynamic responses in the
somatosensory cortex, implying conscious sensory perception in preterm
neonates. Somatosensory cortical activation occurs bilaterally following
unilateral stimulation and these changes are more pronounced in male
neonates and preterm neonates at lower gestational ages.
Study of auditory perception (study 4)

The aim of the study was to assess differences in activation pattern in
response to auditory stimuli before and after the induction of anaesthesia
with sevoflurane.
Methods
The 'Water music", by Handel, was presented to 7 infants aged between
18 and 22 months. NIRS was recorded in different conditions: baseline
with no music when the child was asleep, during the music with the child
sleeping before anaesthesia, and during the music when the child was in
deep anaesthesia.
Main Endings and conclusion
We observed pronounced bilateral [HbO2] increase during sleeping,
similar to that previously reported in waken subjects and suggesting that
the infant perceives the auditory stimulus and likely processes it.
When the infant is anaesthetised and many neuronal circuits are not
functioning, the auditory stimulus can still be perceived as suggested by
the increase of Hb02 in one hemisphere, but processing might be altered.

New mechanism for smelling?
Overall conclusion
These studies and other studies that have been carried out in parallel by
other groups demonstrate that NIRS is a suitable technique to assess
cortical activation in response to varying forms of sensory stimulation in
human infants.
The technique is likely to play an important role in providing new
insights into the ontogeny of cortical function, as well as possibly
providing a sensitive means for the early detection of perinatal cortical
impairment.
OutDoorLinks:
Marco Bartocci
http://web.tiscali.it/marcobartocci/noflash.htm
---

By Zeeya Merali
Sorce: www.alphagalileo.org/06 December 2006
It kicked up a stink among sensory scientists when it was proposed a
decade ago.
Now a controversial theory that smell receptors in the nose respond to the
vibration of molecules, rather than their size and shape, has been
revitalised.
The theory, first proposed in the mid-1990s by Luca Turin, then of
University college London (UcL), was based on the observation that
some molecules with almost identical shapes can smell wildly different,
while others with the same vibrational frequency, but different shapes,
can smell similar.
Turin proposed that the nose may work like a particular type of
spectroscope that identifies molecules on the basis of the frequency at
which their atoms vibrate in response to an electron stream (New
Scientist, 18 November, p 74).

It wasn’t clear that this would work in the nose, however, allowing critics
to dismiss it as unfeasible.
“It was a pretty sketchy idea,” Turin admits.
Now Andrew Horsfield at UcL and his colleagues have entered the fray
by modelling how a nasal spectroscope might work.
The nose is thought to contain a wide variety of receptors, each of which
responds to a particular type of molecule, and it is the activation of
different patterns of these receptors that the brain recognises as different
smells.
In Horsfield’s model, smell receptors in the nose contain pockets. When a
smelly molecule, for example ammonia, docks into a pocket it stimulates
an electron on one side of the pocket to hop across the ammonia molecule
to the other side. As it does so, it sets atoms in the molecule vibrating.
“You can imagine the electron pinging the molecule like a violin string as
it hops over,” Horsfield says.
In the model, the electron only hops when certain molecules, which
vibrate at specific frequencies, dock in the receptor. A signal is sent to the
brain when the electron reaches the other side of the pocket.
One persuasive feature of Horsfield’s model is how well it reproduces the
speed of smell responses in the real world.
The group’s calculations show that such a signal would be sent within a
millisecond of an ammonia molecule entering the nose – on a par with
observations of how quickly the brain actually reacts to scents.
“It seems to be quite a complicated mechanism,” says John Mitchell, a
chemist at the University of Cambridge who has studied odours and
still prefers the established shape theory.
“But sometimes biology requires complicated mechanisms.” Mitchell
believes the next step is to test the mechanism experimentally. “It would
be great to conduct a huge trial that tests both rival theories’ ability to
predict odours against each other,” he says.
Turin, who now works for fragrance company Flexitral in chantilly,
Virginia, is currently examining the new mechanism to help improve his
smell prediction methods.
OutDoorLinks:
Luca Turin's Theory of the Sense of Smell

http://www.applet-magic.com/turin.htm
Andrew Horsfield

Cities Change the Songs of Birds
http://www.cmmp.ucl.ac.uk/~aph/
John Mitchell
http://www-mitchell.ch.cam.ac.uk/
---
Cities Change the Songs of Birds

By Hans Slabbekoorn and Ardie den Boer-Visser
Source: www.current-biology.com/5 December 2006
http://www.current-biology.com/content/article/abstract?uid=PIIS0960982206023086
Copyright © 2006 Cell Press. All rights reserved.
Current Biology, Vol 16, 2326-2331, 05 December 2006
Summary
Worldwide urbanization and the ongoing rise of urban noise levels form a
major threat to living conditions in and around cities.
Urban environments typically homogenize animal communities, and this
results, for example, in the same few bird species' being found
everywhere.
Insight into the behavioral strategies of the urban survivors may explain
the sensitivity of other species to urban selection pressures.
Here, we show that songs that are important to mate attraction and
territory defense have significantly diverged in great tits (Parus major), a
very successful urban species.
Urban songs were shorter and sung faster than songs in forests, and often
concerned atypical song types.
Furthermore, we found consistently higher minimum frequencies in ten
out of ten city-forest comparisons from London to Prague and from
Amsterdam to Paris. Anthropogenic noise is most likely a dominant
factor driving these dramatic changes.
These data provide the most consistent evidence supporting the acoustic-
adaptation hypothesis since it was postulated in the early seventies. At
the same time, they reveal a behavioral plasticity that may be key to
urban success and the lack of which may explain detrimental effects on
bird communities that live in noisy urbanized areas or along highways.
Corresponding author
Hans Slabbekoorn
h.w.slabbekoorn(at)biology.leidenuniv.nl

What you speak may affect what you hear
OutDoorLinks:
Hans Slabbekoorn
http://biology.leidenuniv.nl/ibl/S8/index_files/Page444.html
---

By Roxanne Khamsi
Source: www.newscientist.com/01 December 2006
http://www.newscientist.com/article/dn10689-what-you-speak-may-affect-what-you-
hear.html
What you speak may influence what you hear, a new study shows.
People perceive different patterns in the same sound sequences
depending on their native tongue, researchers have found.
The short, first note of “Greensleeves” may sound naturally elegant to
those who sing the tune.
But this type of “pick-up note”, as it is known to musicians, sounds
awkward to the ear of a native Japanese speaker, according to
researchers.
And they can explain why: people's preference for longer or shorter notes
at the beginning of a musical phrase apparently depends on their native
tongue.
Scientists already know that human hearing naturally group sounds
together.
A listener might, for example, hear identical clicks from a watch as “tick-
tock; tick-tock” and so on, hearing an emphasis on the first click – even
though all the clicks are identical.
Another may hear “tock-tick, tock-tick” with the emphasis on the second
click rather than the first.
Aniruddh Patel of the Neurosciences Institute in San Diego,
California, US, and colleagues wanted to know how people from
different cultures group non-identical sounds.
They recruited a group of 100 volunteers, half of whom were American
and the other half Japanese.

The volunteers listened to sequences of alternating long and short or loud

and soft tones (audio clips in wav format).
Preposition impact
Conventional musical principles predict that people perceive louder
sounds to mark the beginning of a group, and longer sounds to mark the
end of a group.
Nearly all of the American participants perceived exactly this.
However, when Japanese participants heard the tones, many of them
grouped them in reverse order, with the shorter tones at the end of each
sound pairing.
The researchers say this difference might result from the fact that, in
Japanese, shorter words – such as articles and prepositions – tend to
come at the end of a phrase. In English, these short words tend to come at
the beginning.
Previous studies by Patel have suggested that a composer’s native
language can influence how they write music (see Music: The
international language?). He says that while the previous study focused
on music production, the new findings about how Americans and
Japanese group sounds give insight in to musical perception.
Patel presented the new findings at a joint meeting of the Acoustical
Society of America and the Acoustical Society of Japan in Honolulu,
Hawaii.
OutDoorLinks:
Aniruddh D. Patel
http://vesicle.nsi.edu/users/patel/
Music: The international language?
http://www.newscientist.com/article.ns?id=mg18725071.200
---

Brand Perception—Evaluation of Cortical Activation Using fMRI
Brand Perception—Evaluation of Cortical

Activation Using fMRI
Source: http://rsna2006.rsna.org/rsna2006/v2006/conference/
event_display.cfm?id=66601&em_id=4429416
PURPOSE
The aim of the study was to evaluate the neural correlates of brand
perception with a special regard to the brand strength.
METHOD AND MATERIALS

20 HS (10 m / 10 f, mean age 27 y) were examined using a 3.0T scanner.
Prior to, during and at the end of the examination, subject’s perception of
the two different brands was tested by a questionnaire.
fMRI was block-designed with 2 active blocks consisting of 8 stimuli
each (pictures of a subjective strong and a subjective weak car brand
combined with the logo, presentation time 3.0 sec/stimulus).
Each picture was underlined of a short question to evaluate the
perception of the brand using a four-point scale ranging from “disagree”
to “agree strongly”.
As control condition, an abstract colored image was displayed. For
anatomical reference 3D-T1w images were obtained. Statistical analysis
was carried out using BrainVoyager QX™.
Neuropsychological data were analyzed by SPSS 13.0.
RESULTS
Significant increase of activation was found bilaterally in the inferior
frontal gyrus, anterior insula and the anterior cingulated while presenting
the strong brand.
A smaller cluster was detected predominantly left-hemispheric in the
precuneus. In contrast presentation of the weaker brand showed
activations in the precuneus bilaterally.
In general the clusters of activations were larger by presenting the weak
brand. No significant increase if SI was found using the contrast
strong>weak.
But we detected decrease of SI in parts of the inferior frontal gyrus and of
the anterior cingulated bilaterally as well as occipital.

Whale brains are part human
The opposite contrast (weak>strong) on the other hand showed

significant activations bilateral in the frontal gyrus and in parts of the
anterior cingulate as well as in the occipital lobe bilaterally.
CONCLUSION
The results may support the hypothesis that the perception of different
brand-strengths follows an all-or-non-effect with reduced activations in
areas of working memory and increased activation involved in
processing of emotions and self-identifying by presenting strong brands.
CLINICAL RELEVANCE/APPLICATION
The key idea of this approach is to employ recent neuroscientific
methods in order to analyze economically relevant brain processes.
QUESTIONS EMAIL:
christine.born(at)med.uni-munchen.de
OutDoorLinks:
Christine Born
http://www.radiologie-lmu.de/mitarbeiter/mitarbeiter_frames.php?id=3&lang=de
Annual Meeting of the Radiological Society of North America
http://rsna2006.rsna.org/rsna2006/v2006/conference/track.cvn
---

Source: Reuters/www.abc.net.au/28 November 2006
http://www.abc.net.au/science/news/stories/2006/1798885.htm
Humpback whales have surprisingly complex brains, which raises
questions about how these cetaceans evolved (Image: NOAA)
Humpback whales have a type of brain cell seen only in humans, the
great apes, and other cetaceans such as dolphins, US researchers report.
This might mean such whales are more intelligent than they have been
given credit for, the scientists say.

And it suggests the basis for complex brains either evolved more than
once, or has gone unused by most animal species.
The finding may help explain some whale behaviours, such as intricate
communication skills, the formation of alliances, cooperation, cultural
transmission and the use of tools, the researchers report in journal The
Anatomical Record.
Professor Patrick Hof and colleagues from the Mount Sinai School of
Medicine in New York discovered a type of cell called a spindle neurone
in the cortex of the whale brains.
They found the cells in areas comparable to where they are seen in
humans and great apes.
Although the function of spindle neurones is not well understood, they
may be involved in cognition - learning, remembering and recognising
the world.
Spindle cells may be affected by Alzheimer's disease and other
debilitating brain disorders such as autism and schizophrenia.
Complex social patterns
The researches found spindle neurones in the same location in toothed
whales with the largest brains, which the researchers say suggests the
cells may be related to brain size.
Toothed whales such as orcas are generally considered more intelligent
than baleen whales such as humpbacks and blue whales, which filter
water for their food.
The humpbacks also have structures that resemble 'islands' in the cerebral
cortex, also seen in some other mammals.
These islands may have evolved to promote fast and efficient
communication between neurones, the researchers say.
Spindle neurones probably first appeared in the common ancestor of
hominids, humans and great apes about 15 million years ago, the
researchers say. They are not seen in lesser apes or monkeys.
In cetaceans they would have evolved earlier, possibly as early as 30
million years ago, the researchers say.
How did these cells evolve?
Either the spindle neurones were only kept in the animals with the largest
brains or they evolved several times independently, the researchers say.
"In spite of the relative scarcity of information on many cetacean species,
it is important to note in this context that sperm whales, killer whales,
and certainly humpback whales, exhibit complex social patterns that

Words come easier after a singalong
included intricate communication skills, coalition-formation,

cooperation, cultural transmission and tool usage," the researchers write.
"It is thus likely that some of these abilities are related to comparable
histological complexity in brain organisation in cetaceans and in
hominids."
OutDoorLinks:
Patrick R. Hof
http://directory.mssm.edu/faculty/facultyInfo.php?id=21205&deptid=93
---

Source: www.newscientist.com/26 November 2006
http://www.newscientist.com/article/dn10657-words-come-easier-after-a-
singalong.html
If you have trouble finding the right words, maybe it's time to join a
choir. Singing in a group seems to help people with aphasia to speak
again.
Neurologists have long known that people suffering from aphasia, in
which brain damage disrupts the ability to produce and comprehend
language, can sing words that they cannot produce otherwise.
No one is certain why this is, but researchers had suspected it could be
because singing slows the rate of speech and makes word retrieval
simpler by limiting the number of syllables pronounced per beat.
Therapists have tried different methods of getting patients to "reawaken"
their powers of speech through singing, but these have met with only
modest success.
Isabelle Peretz and colleagues at the University of Montreal in
Canada gave people with aphasia familiar and unfamiliar songs to sing
on their own and with others. Singing alone did not improve speech, but
singing in a choir dramatically improved their ability to recall and
pronounce words, regardless of the song (Brain, vol 129, p 2571).

It is not the singing itself that helps language memory, but the sharing of
mood and experience between singers, Peretz says. She believes that
choral singing could be a potent method of speech therapy.
OutDoorLinks:
Isabelle Peretz
http://www.brams.umontreal.ca/plab/people/peretz_i
---
Tales of the unexpected: how the brain detects novelty

Source: www.alphagalileo.org/23 November 2006
When you sit down to watch a DVD of your favourite film, the chances
are that you are able to predict the exact sequence of events that is about
to unfold. Without our memories we would not only be unable to
remember our past but perhaps more importantly predict the future.
Dr Dharshan Kumaran and Dr Eleanor Maguire at the Wellcome
Trust Centre for Neuroimaging at University College London have
shown that the hippocampus, the area of the brain believed to play a
crucial role in learning and memory, makes predictions of what will
happen next by automatically recalling an entire sequence of events in
response to a single cue. Scientists believe they may have identified how
the brain allows us to anticipate future events and detect when things do
not turn out as expected.
The research is published today in the journal Public Library of Science
Biology.
Using an fMRI scanner, which uses changes in blood flow within the
brain to provide measurements of brain activity, Dr Kumaran and Dr
Maguire were able to show how the brain reacts to unexpected changes in
a sequence of images.
A subject is shown a series of four images which are then repeated in a
different order.
By changing the order of only the final two images, the researchers found
that the hippocampus appeared to be predicting which image would come
next and reacting when an unexpected image appeared.

Dyslexia and the failure to form a perceptual anchor
"These experiments indicate that the hippocampus acts as a sort of

comparison device, matching up past and present experience” says Dr
Kumaran.
"It does not appear to be reacting to novelty as such, but rather to
discrepancies between what it expects to see and what it actually sees."
The results imply that when the hippocampus is prompted by a cue, it
recalls a sequence of associated memories, a process that may explain
how seeing a particular person's face or listening to a piece of music can
trigger the recollection of an entire past experience.
Furthermore, the hippocampus would appear to perform a critical
comparison between our past and present experiences alerting us to
unexpected occurrences in our environment, such as changed layout.
"Patients with damaged hippocampi, such as those with Alzheimer's
Disease, often have trouble remembering sequences of events or finding
their way around" explains Dr Kumaran. "This would seem to be because
the damaged hippocampus is unable to rapidly bind together the many
different components of our experiences into a coherent whole.”
OutDoorLinks:
Dharshan Kumaran
http://www.fil.ion.ucl.ac.uk/Staff/
Eleanor Maguire
http://www.fil.ion.ucl.ac.uk/Maguire/
---
Dyslexia and the failure to form a perceptual

anchor
By Merav Ahissar, Yedida Lubin, Hanna Putter-Katz & Karen Banai
Source: www.nature.com/19 November 2006
http://www.nature.com/neuro/journal/vaop/ncurrent/abs/nn1800.html
doi:10.1038/nn1800
In a large subgroup of dyslexic individuals (D-LDs), reading difficulties
are part of a broader learning and language disability.

The Biochemical and Neuroendocrine Bases of the Hyperalgesic Nocebo Effect
Recent studies indicate that D-LDs perform poorly in many

psychoacoustic tasks compared with individuals with normal reading
ability.
We found that D-LDs perform as well as normal readers in speech
perception in noise and in a difficult tone comparison task.
However, their performance did not improve when these same tasks were
performed with a smaller stimulus set.
In contrast to normal readers, they did not benefit from stimulus-specific
repetitions, suggesting that they have difficulties forming perceptual
anchors.
These findings are inconsistent with previously suggested static models
of dyslexia.
Instead, we propose that D-LDs' core deficit is a general difficulty in
dynamically constructing stimulus-specific predictions, deriving from
deficient stimulus-specific adaptation mechanisms.
This hypothesis provides a direct link between D-LDs' high-level
difficulties and mechanisms at the level of specific neuronal circuits.
Correspondence should be addressed to

Merav Ahissar, Email: msmerava(at)mscc.huji.ac.il
OutDoorLinks:
Merav Ahissar
http://micro5.mscc.huji.ac.il/~ahissar/merav_page.html
---
The Biochemical and Neuroendocrine Bases of

the Hyperalgesic Nocebo Effect
By Fabrizio Benedetti, Martina Amanzio, Sergio Vighetti and
Giovanni Asteggiano
Source: www.jneurosci.org/November 15, 2006
http://www.jneurosci.org/cgi/content/abstract/26/46/
12014?lookupType=volpage&vol=26&fp=12014&view=short

The Biochemical and Neuroendocrine Bases of the Hyperalgesic Nocebo Effect
The Journal of Neuroscience, November 15, 2006, 26(46):12014-12022; doi:10.1523/

JNEUROSCI.2947-06.2006
Despite the increasing research on placebos in recent times, little is
known about the nocebo effect, a phenomenon that is opposite to the
placebo effect and whereby expectations of symptom worsening play a
crucial role.
By studying experimental ischemic arm pain in healthy volunteers and by
using a neuropharmacological approach, we found that verbally induced
nocebo hyperalgesia was associated to hyperactivity of the
hypothalamic–pituitary–adrenal (HPA) axis, as assessed by means of
adrenocorticotropic hormone and cortisol plasma concentrations.
Both nocebo hyperalgesia and HPA hyperactivity were antagonized by
the benzodiazepine diazepam, suggesting that anxiety played a major
role in these effects.
The administration of the mixed cholecystokinin (CCK) type-A/B
receptor antagonist proglumide blocked nocebo hyperalgesia completely
but had no effect on HPA hyperactivity, which suggests a specific
involvement of CCK in the hyperalgesic but not in the anxiety
component of the nocebo effect.
Importantly, both diazepam and proglumide did not show analgesic
properties on basal pain, because they acted only on the nocebo-induced
pain increase.
These data indicate a close relationship between anxiety and nocebo
hyperalgesia, in which the CCKergic systems play a key role in anxiety-
induced hyperalgesia.
These results, together with previous findings showing that placebo
analgesia is mediated by endogenous opioids, suggest that the analgesic
placebo/hyperalgesic nocebo phenomenon may involve the opposite
activation of endogenous opioidergic and CCKergic systems.
Correspondence should be addressed to
Fabrizio Benedetti, Email: fabrizio.benedetti(at)unito.it
OutDoorLinks:
Fabrizio Benedetti
http://www.personalweb.unito.it/fabrizio.benedetti/
---

Think of a concept, taste it on your tongue
Think of a concept, taste it on your tongue

Source: www.newscientist.com/22 November 2006
http://www.newscientist.com/article/dn10644-think-of-a-concept-taste-it-on-your-
tongue.html
New insight into one of the most intriguing word-associated conditions
may have been found, with the discovery that, for one type of
synaesthesia at least, the meaning of a word is key to the sensation
experienced.
For some people, the mere mention of a word can bring a very specific
taste to the tongue.
"Mountain" might elicit cold bacon, for instance, while "Michelle" might
conjure egg whites.
People who experience this have a rare condition known as lexical-
gustatory synaesthesia, and for many of them every word comes with an
appended taste. For some, even when the exact word cannot be recalled,
the taste of the word is there.
Synaesthetes tend to experience the same taste for words with similar
sounds. In one subject, for instance, not only does the word "mince" call
up a mince flavour, but "prince" and "cinema" do too.
This suggests that the taste is somehow tied to the sound or the spelling
of the word.
Tip of the tongue

Julia Simner at the University of Edinburgh and her colleague, Jamie
Ward, at University College London, both in the UK, showed 96
pictures of obscure items such as a gazebo, a geisha or a metronome to
six subjects with lexical-gustatory synaesthesia.
In all but one subject they managed to induce a "tip of the tongue"
condition, where the person recognised the object but could not
remember what it was called, what letter its name started with or how
many syllables the elusive word had. The researchers found that these
individuals could still identify what taste the item elicited.
One woman, for instance, unable to come up with the word
"gramophone", reported tasting Dutch chocolate, precisely the flavour
that the word is associated with for her.
This shows that it is the meaning of the word – not the sound or spelling
– that elicits the taste sensation in these people, Simner says. She
suspects the associations begin in childhood.

Singing whales make small talk too
Phil Merikle, at the University of Waterloo in Ontario, Canada, has

carried out research with synaesthetes that experience numbers as
colours. He found that those doing simple arithmetic can compute faster
when they see the colour they associate with the correct answer. "It's the
concept that elicits the synaesthetic experience," he agrees.
OutDoorLinks:
Julia Simner
http://www.psy.ed.ac.uk/people/jsimner/index_html
Jamie Ward
http://www.icn.ucl.ac.uk/Staff-Lists/
MemberDetails.php?Title=Dr&FirstName=Jamie&LastName=Ward
Jamie Ward
http://watarts.uwaterloo.ca/~pmerikle/
---

By Jennifer Viegas
Source: www.abc.net.au/20 November 2006
http://www.abc.net.au/science/news/stories/2006/1792754.htm
Whales have such a broad vocal repertoire that they can call to their
young, woo potential mates and even express emotions, according to
researchers who have identified 622 social sounds in humpback whales.
Their work will be presented at the upcoming joint meetings of the
Acoustical Society of America and the Acoustical Society of Japan in
Hawaii.
Social sounds are brief, unpatterned noises that are distinct from
lengthier, complex whale songs.
The new research adds to a growing body of evidence that whales convey
more meaning through vocalisations than previously thought.
"I wouldn't say (whales possess) language, as that's a human term," says
Dr Rebecca Dunlop, a researcher in the School of Veterinary
Sciences at the University of Queensland, who worked on the study.
"Whales don't string these sounds together like words and form
sentences. It's more like a simple vocabulary," she says.

The scientists visually tracked 60 pods of whales migrating along the east
coast of Australia.
The researchers used a static hydrophone array, sensitive equipment that
detects sound waves, linking the whale sounds to various activities and
contexts.
Wops, thwops and yaps

They identified 622 distinct sounds, which fell into 35 basic types.
These include "wops" made by females, "thwops" made by males, "yaps"
made when pods split, and high pitched cries that appeared to express
anger.
In addition to vocalisations, the researchers found that whales send
messages through body language, by breaching the surface, slapping
water with their tails and blowing underwater bubbles.
Famous for their long, complex songs, whales also sometimes "speak"
short song units individually instead of singing them.
Males especially seem to do this when trying to woo a female.
"Song is a loud broadcast signal and two singers singing at the same time
is bound to be confusing to the receiver," Dunlop says.
"If he's trying to attract a female, but doesn't want his signal confused
with another singer in the area, then using song units in this case might be
the way forward."
She thinks one reason whales are so vocal is because sound travels better
in water than light, and so sight is less useful to whales than hearing.
Human interference
Dr Christopher Clark, director of the Bioacoustics Research Program at
Cornell University, conducted a similar study on right whales.
He says that just as researchers are gaining a better understanding of
whale vocalisations, humans are creating so much ocean noise, through
shipping, oil and gas exploration, recreational traffic and more, that we
often prevent whales from communicating.
"Many whales have very traditional feeding grounds and their migratory
routes occur along shallow coastlines, which are now some of the
noisiest, most heavily impacted habitats," he says.
"The ocean area over which a whale can communicate and listen today
has shriveled down to a small fraction of what it was less than a century
ago."

AHA: The Heart Failure Waltz Leads to Improved Function
OutDoorLinks:
Rebecca Dunlop
http://www.uq.edu.au/vetschool/index.html?page=52357&pid=0
---
AHA: The Heart Failure Waltz Leads to

Improved Function
By Peggy Peck
Source: www.medpagetoday.com/ November 12, 2006
http://www.medpagetoday.com/Cardiology/CHF/tb/4488
Heart failure patients can waltz their way to improved function, and
dancing made them much happier than cardiac rehabilitation that relied
on treadmills and exercise bikes.
Patients randomized to waltz classes significantly improved functional
measures (P<0.001) compared with controls in traditional exercise
training, Romualdo Belardinelli, M.D., of Lancisi Heart Institute in
Ancona, Italy, reported today at the American Heart Association meeting
here.
What's more, the dancing patients posted significantly better quality-of
life scores than the traditional exercise group (P<0.05), Dr. Belardinelli
said.
Nieca Goldberg, M.D., chief of women's cardiac care at Lenox Hill
Hospital in New York, said the results are important because it is
difficult to get patients to complete cardiac rehabilitation faithfully, so a
program that patients consider "fun and enjoyable is likely to make
rehabilitation more palatable."
Dr. Belardinelli said he and his colleagues "chose waltz because it is a

universal dance, which means that the findings can be generalized to
other countries." He said, however, that other slow dances might be just
as effective.

AHA: The Heart Failure Waltz Leads to Improved Function
He and his colleagues studied 110 patients with stable congestive heart
failure and a left ejection fraction of less than 40%. Eighty-nine of the
patients were men and the mean age was 59 ± 11 years.
Forty-four patients were randomized to supervised exercise training on
cycles and treadmills at 70% of peak oxygen consumption (VO2) three
times a week for eight weeks and 44 to a dance protocol of alternate
slow-five minutes -- and fast-21 minutes -- waltz three times a week for
eight weeks.
Twenty-two patients served as a control group.
Both exercise training and dance classes were conducted at the hospital
and heart rate was monitored during the sessions. At baseline and at eight
weeks all patients underwent cardiopulmonary exercise testing until
volitional fatigue as well as two-dimensional echocardiography with
Doppler, and endothelium-dependent dilation of the brachial artery.
Quality of life was assessed by the Minnesota Heart Failure Living
Questionnaire.
Among the findings:

Heart rate during exercise training was 110± 15 beats/min and during
dancing it was 113±19 beats/min (NS)
Peak VO2, anaerobic threshold, minute ventilation (VE)CO2 production
/(VCO2) and VO2/Workload (W) slope were all similarly improved in
both the dance and exercise arms (NS, P<0.001 versus controls).
Ejection fraction was not significant changed by either exercise or
dancing, but E-wave to A-wave ratio was decreased in both the exercise
and dance groups compared with controls (P<0.05).
"As might be expected, the real difference between the two groups was in
quality-of- life scores," he said.
Noting that a higher score indicated a worse quality of life, he said the
patients randomized to the dance class improved scores from an average
of 56±18 years at baseline to 41±16 after completing the study versus
58±20 to 48±21 in the exercise group (P<0.05), he said.
Dr. Belardinelli concluded, "Dancing should be considered an alternative
to traditional cardiac rehabilitation for patients with heart failure."
OutDoorLinks:

Positive Emotional Style Predicts Resistance to Illness After Experimental
Nieca Goldberg
http://www.bigspeak.com/nieca-goldberg.html
---
Positive Emotional Style Predicts Resistance to

Illness After Experimental Exposure to
Rhinovirus or Influenza A Virus
By Sheldon Cohen, PhD, Cuneyt M. Alper, MD, William J. Doyle,
PhD, John J. Treanor, MD, Ronald B. Turner, MD
Source: www.psychosomaticmedicine.org/ November 13, 2006
http://www.psychosomaticmedicine.org/cgi/content/abstract/
01.psy.0000245867.92364.3cv1
Psychosom Med 2006, doi:10.1097/01.psy.0000245867.92364.3c
© 2006 by American Psychosomatic Society
Abstract
Objective:
In an earlier study, positive emotional style (PES) was associated with
resistance to the common cold and a bias to underreport (relative to
objective disease markers) symptom severity.
This work did not control for social and cognitive factors closely
associated with PES.
We replicate the original study using a different virus and controls for
these alternative explanations.
Methods:
One hundred ninety-three healthy volunteers ages 21 to 55 years were
assessed for a PES characterized by being happy, lively, and calm; a
negative emotional style (NES) characterized by being anxious, hostile,
and depressed; other cognitive and social dispositions; and self-reported
health.
Subsequently, they were exposed by nasal drops to a rhinovirus or
influenza virus and monitored in quarantine for objective signs of illness
and self-reported symptoms.
Results:

Net Music Makers.com Announces Launch Date for Revolutionary Music Website
For both viruses, increased PES was associated with lower risk of
developing an upper respiratory illness as defined by objective criteria
(adjusted odds ratio comparing lowest with highest tertile = 2.9) and with
reporting fewer symptoms than expected from concurrent objective
markers of illness.
These associations were independent of prechallenge virus-specific
antibody, virus type, age, sex, education, race, body mass, season, and
NES.
They were also independent of optimism, extraversion, mastery, self-
esteem, purpose, and self-reported health. Conclusions: We replicated the
prospective association of PES and colds and PES and biased symptom
reporting, extended those results to infection with an influenza virus, and
"ruled out" alternative hypotheses.
These results indicate that PES may play a more important role in health
than previously thought.
Address correspondence and reprint requests to:
Sheldon Cohen, PhD, E-mail: scohen(at)cmu.edu.
OutDoorLinks:
Sheldon Cohen
http://www.psy.cmu.edu/~scohen/
---
Net Music Makers.com Announces Launch

Date for Revolutionary Music Website
Groundbreaking Online Music Collaboration Website Set for March
2007 Launch
Source: http://www.netmusicmakers.com/bob/?p=news&news_id=6
Net Music Makers.com (“NMM”) today announced plans to launch its
online collaborative website in March 2007.
In preparation for its launch, NMM will make its site available in January
to allow bands to create a personal website and access a virtual studio

Net Music Makers.com Announces Launch Date for Revolutionary Music Website
that allows public and private collaboration to create new music available
for international podcast and internet radio broadcast.
The new site will represent a groundbreaking social networking venue
for musicians to create, collaborate, and broadcast their music.
A key feature of the new site will be the availability of downloadable lick
tracks provided by legendary artists and studio musicians, on a royalty
free basis.
“After six months in stealth mode, we are putting the finishing touches
on our new services that will change the music world,” stated Jeff
Tamelier, President of NMM.
“In the next few weeks, look for us to announce some legendary
musicians that have been in the studio creating a comprehensive library
of music licks and grooves. Our users will be able to ‘Frankenstein’
these into their original tunes.”
About Net Music Makers.com“We’re totally stoked about making
NMM the next generation in music making,” commented Zaq Whitnack,
NMM Creative Director. “Whether you’re an established band that
wants to find your audience or looking to round out your tune with an
international music community, NMM will be your one-stop shop. Our
Battle of the Bands contest, currently posted on our site, is getting
phenomenal response, with nearly 20,000 songs, covering 120 different
genres, uploaded in our first sixty days.”
Net Music Makers.com (“NMM”) is an online collaborative music
website, in the process of rolling out innovative musician services that
will revolutionize music-making. The new site provides a 360-degree
music making experience, including a 24x7 virtual studio connected to a
multi-channel fan-driven internet radio service. NMM is an interactive
media property of House of Hansen Productions, LLC, a privately held
company founded in April 2006 with headquarters in Sacramento,
California.
OutDoorLinks:
Net Music Makers (NMM)

http://www.netmusicmakers.com
Jeff Tamelier
http://www.jtfunkguitar.com/
Radiosender FM4
http://fm4.orf.at
---

Human Opiorphin, a natural antinociceptive modulator of opioid-dependent
Human Opiorphin, a natural antinociceptive

modulator of opioid-dependent pathways
By Anne Wisner, Evelyne Dufour, Michaël Messaoudi, Amine Nejdi,
Audrey Marcel, Marie-Noelle Ungeheuer and Catherine Rougeot
Source: http://www.pnas.org/ November 13, 2006
http://www.pnas.org/cgi/content/abstract/
0605865103v1?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Opi
orphin+&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
Mammalian zinc ectopeptidases play important roles in turning off neural
and hormonal peptide signals at the cell surface, notably those processing
sensory information.
We report here the discovery of a previously uncharacterized
physiological inhibitor of enkephalin-inactivating zinc ectopeptidases in
humans, which we have named Opiorphin.
It is a QRFSR peptide that inhibits two enkephalin-catabolizing
ectoenzymes, human neutral ecto-endopeptidase, hNEP (EC 3.4.24.11),
and human ecto-aminopeptidase, hAP-N (EC 3.4.11.2).
Opiorphin displays potent analgesic activity in chemical and mechanical
pain models by activating endogenous opioid-dependent transmission.
Its function is closely related to the rat sialorphin peptide, which is an
inhibitor of pain perception and acts by potentiating endogenous µ- and -
opioid receptor-dependent enkephalinergic pathways.
Here we demonstrate the functional specificity in vivo of human
Opiorphin. The pain-suppressive potency of Opiorphin is as effective as
morphine in the behavioral rat model of acute mechanical pain, the pin-
pain test.
Thus, our discovery of Opiorphin is extremely exciting from a
physiological point of view in the context of endogenous opioidergic
pathways, notably in modulating mood-related states and pain sensation.
Furthermore, because of its in vivo properties, Opiorphin may have
therapeutic implications.

Catherine Rougeot, E-mail: crougeot(at)pasteur.fr

Picture this: The Music Therapist
OutDoorLinks:
Institut Pasteur
http://www.pasteur.fr
Proceedings of the National Academy of Sciences
http://www.pnas.org
Rougeot Catherine
http://www.pasteur.fr/recherche/RAR/RAR2003/Prn.html
---

By THOMAS E. FRANKLIN
Homepage: www.tomdoch.de <http://www.tomdoch.de/>
Source: www.northjersey.com/ November 13, 2006
http://www.northjersey.com/
page.php?qstr=eXJpcnk3ZjcxN2Y3dnFlZUVFeXk5JmZnYmVsN2Y3dnFlZUVFeXk3
MDE4Nzk0
Josephine Tomea, 87, lies in her nursing home bed in an advanced state
of dementia. Under hospice care and ready to die, Tomea has been
ravaged by a stroke, Alzheimer's disease, arthritis and diabetes. Her body
remains constricted, her hands clenched tightly close to her body. She's
unable to eat, talk or walk; she lives a life of non-verbal social isolation.
But every week or so, Jennifer Knittel, a certified musical therapist,
shows up with her Washburn guitar and a voice so sweet, and suddenly
there is a flicker of life in Tomea. An eye opens. Her head lifts. Her
breathing becomes louder and more pronounced.
In her own limited way, Tomea is dancing, floating across the ballroom
floor, swaying to Knittel's dreamy lullabies. "Danny Boy" and "When
Irish Eyes are Smiling" were her favorites, says her daughter, Eleanor
Maurer. Knittel plays them to perfection. "My mother always loved
music," Maurer says.
Music therapy is a combination of music, social work, psychology,
counseling and anatomy.
"The music is able to bridge a gap," explains Knittel, who is from Warren
County. "The music tends to break down those barriers, barriers where
they can't speak with you anymore, but there is something about the
music that can connect you. You just have a sense of the person you are

visiting. She'll open her eye and look over at me. Whereas other staff
might say she's unresponsive, there's definitely a response I see out of
her. It benefits her family, too, knowing someone extra is here."
Hospices provide physical and mental comfort to patients diagnosed with
terminal conditions, and to their family and friends. They give palliative
care, providing comfort, not a cure. Music therapy is just a part of
hospice care.
"She's an angel," says Ron Owens, the volunteer coordinator for Hospice
of New Jersey, who supervises Knittel and other music therapists. "She's
a miracle worker. She can reach patients that others can't. She can relate
music like no other. It's remarkable. We don't know why it is, we only
know that it is."
Sometimes, physical contact is equally important, says Knittel. "I like to
place my hand under hers. Touch the head, touch and hum, and come
back to the guitar," says Knittel, brushing Tomea's cheek with the back of
her hand. "A lot of times, actually most of the time, it's not as much just
about the music, it's about the relationship you build with the person."
Maurer says her mother was loving, a person who "cared about others
more than herself." Tomea, a mother of three, lost her husband, Ted, in
1999. She called him Ace. "[But now] I don't feel like she has any quality
of life," Maurer says. "She can't enjoy food. No way to communicate,
sometimes she'll blink. I hope she has good dreams."
Knittel says it's a way of making a friendship. "I've had people who were
close to dying or on the very night that they died, look up and tell me
thank you. I don't remember your name, but I know you've been very
nice to me. It's nice knowing that you've given extra quality and meaning
in their life. It's a great gift. For both of us."
OutDoorLinks:
Hospice of New Jersey

http://www.americanhospice.com/hospicenj/
---

Episodic Encoding Is More than the Sum of Its Parts: An fMRI Investigation of
Episodic Encoding Is More than the Sum of Its

Parts: An fMRI Investigation of Multifeatural
Contextual Encoding
By Melina R. Uncapher, Leun J. Otten and Michael D. Rugg
Source: http://www.neuron.org/content/article/
abstract?uid=PIIS0896627306006337
Neuron, Vol 52, 547-556, 09 November 2006
Summary
Episodic memories are characterized by their contextual richness, yet
little is known about how the various features comprising an episode are
brought together in memory.
Here we employed fMRI and a multidimensional source memory
procedure to investigate processes supporting the mnemonic binding of
item and contextual information.
Volunteers were scanned while encoding items for which the contextual
features (color and location) varied independently, allowing activity
elicited at the time of study to be segregated according to whether both,
one, or neither feature was successfully retrieved on a later memory test.
Activity uniquely associated with successful encoding of both features
was identified in the intra-parietal sulcus, a region strongly implicated in
the support of attentionally mediated perceptual binding.
The findings suggest that the encoding of disparate features of an episode
into a common memory representation requires that the features be
conjoined in a common perceptual representation when the episode is
initially experienced.
∗Corresponding author
Melina R. Uncapher
Email: melina.u(at)uci.edu
OutDoorLinks:
Melina R. Uncapher
http://fnim.bio.uci.edu/Melina's_page.html
---

Music therapy may help schizophrenia
Music therapy may help schizophrenia

Source: www.irishhealth.com/01/11/2006
http://www.irishhealth.com/?level=4&id=10489
Music therapy may improve some of the symptoms of schizophrenia,
new research indicates.
The preliminary research marks the first time that this type of therapy has
been evaluated in relation to people with acute schizophrenia.
Schizophrenia is a serious mental illness characterised by disturbances in
a person's thoughts, perceptions, emotions and behaviour. Symptoms can
include delusions and hallucinations. The condition affects around one in
every 100 people - an estimated 41,000 people in Ireland are currently
affected.
Researchers at Imperial College London, along with therapists at the
Central and North West London Mental Health Trust, followed the
progress of 81 inpatients at four hospitals in London.
The participants were randomly divided in two, with one group receiving
music therapy and the other group receiving standard care alone.
Those receiving music therapy had between eight and 12 sessions, once a
week, for up to 45 minutes at a time. During these sessions, they were
given access to a wide range of musical instruments and encouraged to
use them to express themselves.
Initially the therapist listened carefully to the patient's music and
accompanied them closely, seeking to follow their emotional state in
musical terms. The therapist then offered opportunities to extend or vary
the nature of the musical interaction.
During this time, the researchers measured the patients' symptoms. They
found that improvements were greater among those who received music
therapy, compared to those who received standard care alone.
In fact, music therapy was associated with a reduction in general
symptoms, such as depression and anxiety and the negative symptoms of
schizophrenia, such as emotional withdrawal.
The researchers however warned that the study was small, therefore it is
possible that other factors, such as the severity of the illness, may have
influenced the findings.
"We have known for some time that psychological treatments can help
people with schizophrenia, but these have only been used when people
are fairly stable. This study shows that music therapy provides a way of

Evidence for large long-term memory capacities in baboons and pigeons and its
working with people when they are acutely unwell", said Dr Mike
Crawford of Imperial College London.
He explained that at certain times, patients may find it difficult to express
themselves using words, 'but through the skill of the therapist, it may be
possible to help people interact through music in a way that is
constructive, creative and enjoyable'.
The researchers believe that the findings so far provide sufficient
evidence to justify a further trial of music therapy for people with
schizophrenia. This, they said, should be designed to explore the effects
and cost effectiveness of this kind of therapy.
"Inpatient treatment is the form of care that people with schizophrenia
are least satisfied with. Music therapy may provide a means of enhancing
the effectiveness of inpatient treatment by reducing some of the
symptoms of schizophrenia that respond least well to drug treatment", Dr
Crawford added.
Details of this study are published in the British Journal of Psychiatry.
OutDoorLinks:
Mike Crawford
http://www1.imperial.ac.uk/medicine/people/m.crawford/
---
Evidence for large long-term memory

capacities in baboons and pigeons and its
implications for learning and the evolution of
cognition
By Joël Fagot and Robert G. Cook
Source: www.pnas.org/cgi/content/ November 6, 2006
http://www.pnas.org/cgi/content/abstract/
0605184103v1?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Fag
ot&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
Published online before print November 6, 2006

Evidence for large long-term memory capacities in baboons and pigeons and its
Previous research has shown that birds and primates have a rich
repertoire of behavioral and cognitive skills, but the mechanisms
underlying these abilities are not well understood.
A common hypothesis is that these adaptations are mediated by an
efficient long-term memory, allowing animals to remember specific
external events and associate appropriate behaviors to these events.
Because earlier studies have not sufficiently challenged memory capacity
in animals, our comparative research examined with equivalent
procedures the size and mechanisms of long-term memory in baboons
and pigeons.
Findings revealed very large, but different, capacities in both species to
learn and remember picture-response associations.
Pigeons could maximally memorize between 800 and 1,200 picture-
response associations before reaching the limit of their performance. In
contrast, baboons minimally memorized 3,500-5,000 items and had not
reached their limit after more than 3 years of testing.
No differences were detected in how these associations were retained or
otherwise processed by these species.
These results demonstrate that pigeons and monkeys have sufficient
memory resources to develop memory-based exemplar or feature
learning strategies in many test situations.
They further suggest that the evolution of cognition and behavior
importantly may have involved the gradual enlargement of the long-term
memory capacities of the brain.
Joël Fagot, E-mail: fagot(at)incm.cnrs-mrs.fr
OutDoorLinks:
Joël Fagot
http://www.incm.cnrs-mrs.fr/equipedephy.php
Robert G. Cook
http://pigeon.psy.tufts.edu/index.php?content=materials&cat=Research
---

Computer with Brain Connections Changing Quality of Life of Paralyzed
Computer with Brain Connections Changing

Quality of Life of Paralyzed
Source: www.blackwellpublishing.com/02 November 2006
http://www.blackwellpublishing.com/press/pressitem.asp?ref=957
Fundamental theories regarding consciousness, emotion and quality of
life in sufferers of paralysis from Amyotrophic Lateral Sclerosis (ALS,
also known as 'Lou Gerhig's disease') are being challenged based on new
research on brain-computer interaction.
ALS is a progressive disease that destroys neurons affecting movement.
The study appears in the latest issue of Psychophysiology.
The article reviews the usefulness of currently available brain-computer
–interfaces (BCI), which use brain activity to communicate through
external devices, such as computers.
The research focuses on a condition called the completely locked-in state
(CLIS, a total lack of muscle control). In a CLIS situation, intentional
thoughts and imagery can rarely be acted upon physically and, therefore,
are rarely followed by a stimulus.
The research suggests that as the disease progresses and the probability
for an external event to function as a link between response and
consequence becomes progressively smaller, it may eventually vanish
altogether.
Researchers have found that by implementing a BCI before the CLIS
state occurs, a patient can be taught to communicate through an
electronic device with great regularity.
The continued interaction between thought, response and consequence is
believed to slow the destruction of the nervous system.
The findings are also raising a number of new questions about the quality
of life amongst paralysis sufferers. Patients surveyed were found to be
much healthier mentally than psychiatrically depressed patients without
any life-threatening bodily disease.
Only 9% of ALS patients showed long episodes of depression and most
were during the period following diagnosis and a period of weeks after
tracheotomy.
“Most instruments measuring depression and quality of life are invalid
for paralyzed people living in protected environments because most of
the questions do not apply to the life of a paralyzed person. Special
instruments had to be developed,” says Niels Birbaumer, Ph.D., author
of the study.

Neural Correlates of Self-distraction from Anxiety and a Process Model of
This contrasts previously accepted notions as many doctors believe that

the quality of life in total paralysis is extremely low and continuation of
life is a burden for the patient. The study challenges the myth of
helplessness, depression and poor quality of life in paralyzed persons that
lead to hastened decisions on euthanasia.
OutDoorLinks:
Niels Birbaumer
http://www.mp.uni-tuebingen.de/mp/index.php?id=62
---
Neural Correlates of Self-distraction from

Anxiety and a Process Model of Cognitive
Emotion Regulation
By Raffael Kalisch, Katja Wiech, Katrin Herrmann and Raymond
J. Dolan
Source: http://jocn.mitpress.org/cgi/content/abstract/18/8/1266
(Journal of Cognitive Neuroscience. 2006;18:1266-1276.)
© 2006 The MIT Press
Cognitive strategies used in volitional emotion regulation include self-
distraction and reappraisal (reinterpretation).
There is debate as to what the psychological and neurobiological
mechanisms underlying these strategies are.
For example, it is unclear whether self-distraction and reappraisal,
although distinct at a phenomenological level, are also mediated by
distinct neural processes.
This is partly because imaging studies on reappraisal and self-distraction
have been performed in different emotional contexts and are difficult to
compare.
We have therefore investigated the neural correlates of self-distraction, as
indexed by a thought suppression task, in an anticipatory anxiety
paradigm previously employed by us to study reappraisal.
Brain activity was measured by functional magnetic resonance imaging.
We show that self-distraction recruits the left lateral prefrontal cortex.

Self-recognition in an Asian elephant
Based on a review of the existing data, we develop a process model of

cognitive emotion regulation.
The model posits that both self-distraction and reappraisal attenuate
emotional reactions through replacement of emotional by neutral mental
contents but achieve replacement in different ways.
This is associated with a dependence of self-distraction on a left
prefrontal production function, whereas reappraisal depends on a right
prefrontal higher order monitoring process.
OutDoorLinks:
Katja Wiech
http://www.fmrib.ox.ac.uk/pain/people.html
---
Self-recognition in an Asian elephant

By Joshua M. Plotnik, Frans B. M. de Waal and Diana Reiss
Source: www.pnas.org/ October 30, 2006
http://www.pnas.org/cgi/
search?fulltext=Plotnik+&submit.x=0&submit.y=0&submit=GO
www.pnas.org/cgi/doi/10.1073/pnas.0608062103
Considered an indicator of self-awareness, mirror self-recognition
(MSR) has long seemed limited to humans and apes.
In both phylogeny and human ontogeny, MSR is thought to correlate
with higher forms of empathy and altruistic behavior.
Apart from humans and apes, dolphins and elephants are also known for
such capacities.
Animals that possess MSR typically progress through four stages of
behavior when facing a mirror: After the recent discovery of MSR in
dolphins (Tursiops truncatus), elephants thus were the next logical
candidate species. We exposed three Asian elephants (Elephas maximus)
to a large mirror to investigate their responses.
(i) social responses,
(ii) physical inspection (e.g., looking behind the mirror),
(iii) repetitive mirror-testing behavior, and

Anomalous Transparency of Water-Air Interface for Low-Frequency Sound
(iv) realization of seeing themselves.

Visible marks and invisible sham-marks were applied to the elephants'
heads to test whether they would pass the litmus "mark test" for MSR in
which an individual spontaneously uses a mirror to touch an otherwise
imperceptible mark on its own body.
Here, we report a successful MSR elephant study and report striking
parallels in the progression of responses to mirrors among apes, dolphins,
and elephants.
These parallels suggest convergent cognitive evolution most likely
related to complex sociality and cooperation.
To whom correspondence may be addressed at:

Joshua M. Plotnik, E-mail: jplotni(at)emory.edu
Frans B. M. de Waal, E-mail: dewaal(at) emory.edu
Diana Reiss, E-mail: dlr28(at) columbia.edu
OutDoorLinks:
Joshua M. Plotnik
http://www.emory.edu/LIVING_LINKS/Plotnik.html
Frans B. M. de Waal
http://www.emory.edu/LIVING_LINKS/de_Waal.html
Diana Reiss
http://maxweber.hunter.cuny.edu/psych/faculty/labs/reiss.htm
---
Anomalous Transparency of Water-Air

Interface for Low-Frequency Sound
By Oleg A. Godin
Source: http://scitation.aip.org/getabs/servlet/
GetabsServlet?prog=normal&id=PRLTAO000097000016164301000001&idtype=c
vips&gifs=yes
Phys. Rev. Lett. 97, 164301 (2006)
©2006 The American Physical Society
Sound transmission through a water-air interface is normally weak
because of a strong mass density contrast.

Tame your brain to keep your cool
We show that the transparency of the interface increases dramatically at

low frequencies.
Almost all acoustic energy emitted by a sufficiently shallow monopole
source under water is predicted to be radiated into air.
Increased transparency at lower frequencies is due to the increasing role
of inhomogeneous waves.
For sources symmetric with respect to a horizontal plane, transparency is
further increased by a destructive interference of direct and surface-
reflected waves under water.
The phenomenon of anomalous transparency has significant geophysical
and biological implications.
OutDoorLinks:
CIRES in Boulder
http://cires.colorado.edu/
---
Tame your brain to keep your cool

Source: www.newscientist.com/28 October 2006
http://www.newscientist.com/channel/being-human/mg19225755.000-
tame-your-brain-to-keep-your-cool.html
IT SEEMS that emotional self-control really does come from within.
Previous studies have shown that people can learn to control the activity
levels of specific brain regions to alter, for example, pain levels, when
shown real-time "neurofeedback" from fMRI brain images. Now a
similar approach may help psychopathic criminals increase their
emotional fluency.
Niels Birbaumer and Ranganatha Sitaram from the University of
Tübingen in Germany found that by showing healthy volunteers the
activity levels of the insula, a brain region important in emotional
processing, represented in real time as a thermometer bar on a screen, the
volunteers could control their emotional responses.
After four training sessions they had learned to raise and lower their
insula activity levels, in turn changing how they rated the emotional
quality of disturbing or neutral images.

Nonlinear auditory mechanism enhances female sounds for male mosquitoes
Three psychopathic prison inmates who lacked a normal insula response

trained the same way. After four days, one appeared to have learned to
raise his insula activity towards more normal levels. It opens a potential
avenue for treating emotional disorders such as psychopathy or social
phobia, the team told a meeting of the Society for Neuroscience in
Atlanta, Georgia, last week.
OutDoorLinks:
36th Annual Meeting of the Society for Neuroscience

http://apu.sfn.org/am2006/
Niels Birbaumer
http://www.neuroscience-tuebingen.de/research-groups/
display.php?type=Department&id=37&search=dep_list
Ranganatha Sitaram
http://www.mp.uni-tuebingen.de/mp/index.php?id=160
---
Nonlinear auditory mechanism enhances

female sounds for male mosquitoes
By Joseph C. Jackson and Daniel Robert
Published online before print October 26, 2006/Proc. Natl. Acad. Sci. USA, 10.1073/
pnas.0606319103
Sound plays an important role in the life history of mosquitoes.
Male mosquitoes detect females by the sound generated by their
wingbeat. Because female wings are weak acoustic radiators, males have
been driven by sexual selection to evolve sensitive acoustic sensors.
Mosquito antennae are very sensitive acoustic receivers, featuring up to
16,000 sensory cells, a number comparable with that contained in the
human cochlea.
The antennal sound receiver exhibits frequency selectivity, input
amplification, and self-generated oscillations, features that parallel the
functional sophistication of the cochlear amplifier.

Photoacoustic detection of metastatic melanoma cells in the human circulatory
Although arguably the male antenna is well suited to receiving weak

female sounds, the role of active mechanisms in mosquito hearing is far
from understood.
Previous mechanical studies on mosquito hearing largely focused on the
steady-state antennal response to harmonic sounds, mostly evaluating the
data through conventional Fourier transforms.
Here, we report on the time-resolved mechanical behavior of the male
antenna in response to female sounds. Crucially, stimuli were designed to
reflect the temporal acoustic profile of a female flying by. With these
stimuli, several previously unreported nonlinear features were unveiled,
involving amplification, compression, and hysteresis.
The time-resolved analysis reveals that, through the active participation
of the sensory neurons, the antenna mechanically responds to enlarge its
own range of detection.
This behavior augments the capacity of the antennal receiver to detect
female sounds, enhancing the male's chance to successfully pursue a
passing female.

Joseph C. Jackson, E-mail: j.c.jackson(at)bris.ac.uk
OutDoorLinks:
Joseph C. Jackson
http://www.bio.bris.ac.uk/people/staff.cfm?key=930
Daniel Robert
http://www.bio.bris.ac.uk/people/staff.cfm?key=726
---
Photoacoustic detection of metastatic

melanoma cells in the human circulatory
system
By Ryan M. Weight, John A. Viator, Paul S. Dale, Charles W.
Caldwell, and Allison E. Lisle
Source: http://ol.osa.org/abstract.cfm?id=111347

Photoacoustic detection of metastatic melanoma cells in the human circulatory
Optics Letters, Vol. 31, Issue 20, pp. 2998-3000

© 2006 Optical Society of America
Abstract
Detection of disseminating tumor cells among patients suffering from
various types and stages of cancer can function as an early warning
system, alerting the physician of the metastatic spread or recurrence of
the disease.
Early detection of such cells can result in preventative treatment of the
disease, while late stage detection can serve as an indicator of the
effectiveness of chemotherapeutics.
The prognostic value of exposing disseminating tumor cells poses an
urgent need for an efficient, accurate screening method for metastatic
cells.
We propose a system for the detection of metastatic circulating tumor
cells based on the thermoelastic properties of melanoma.
The method employs photoacoustic excitation coupled with a detection
system capable of determining the presence of disseminating cells within
the circulatory system in vitro.
Detection trials consisting of tissue phantoms and a human melanoma
cell line resulted in a detection threshold of the order of ten individual
cells, thus validating the effectiveness of the proposed mechanism.
Results imply the potential to assay simple blood draws, from healthy
and metastatic patients, for the presence of cancerous melanoma
providing an unprecedented method for routine cancer screening.
OutDoorLinks:
John A. Viator
https://fsb.missouri.edu/BE/viator.htm
---

Early verbal abuse may reduce language ability
Early verbal abuse may reduce language

ability
Children who are verbally abused may suffer lasting negative effects
in their brain’s ability to process language, researchers report
Source: www.newscientist.com/19 October 2006
http://www.newscientist.com/article/dn10332-early-verbal-abuse-may-reduce-
language-ability.html
They say the new findings illustrate the seriousness of this type of abuse
and should encourage greater action to combat it.
Brain scans of people who were verbally abused as children showed that
they have 10% less grey matter in the part of their brains involved in
language, compared with non-abused adults.
Martin Teicher at Harvard Medical School in Boston,
Massachusetts, US, and colleagues used an exhaustive questionnaire to
select 17 people who had suffered severe verbal abuse in childhood but
not other forms of abuse.
Experts define verbal abuse as frequent disparaging or critical comments
that are intended to demean and diminish the victim’s self-esteem, he
explains.
The team recruited 17 additional participants for the trial, matched for
age and socioeconomic status, who had suffered no such abuse.
Tone of voice
Brain scans revealed that those who had experienced verbal abuse had a
10% reduction in the size of a brain region known as the right superior
temporal gyrus, compared with those who had not been abused.
This part of the brain contains a section responsible for auditory
processing and is believed to help the brain understand the tone of
speech.
The scans also showed a significant reduction in a small part of the left
superior temporal gyrus, which is thought to be involved in
understanding the syntax of speech.
Teicher speculates that verbal abuse might inhibit development in the
superior temporal gyrus, perhaps by triggering a pathway that stops
growth hormones from reaching it.
Causal link?

Early verbal abuse may reduce language ability
The new experiment does not necessarily establish a causal link: the
abnormalities could be a genetically inherited trait. But Teicher suspects
the relationship is causal.
For example, previous research has shown that victims of sexual abuse
by non-relatives have decreased development in the visual processing
parts of the brain, compared with people who have not suffered such
abuse.
The brain abnormalities seen in the verbal abuse victims appear to be
related to reduced language skills, Teicher adds.
The subjects in the study who had experienced verbal abuse scored about
112 on a test of verbal IQ, on average, while their control counterparts
had a score of about 124.
“I think they didn’t reach their full potential,” he says of the students who
suffered verbal abuse and scored lower on the test.
Incredible anger
The results are important because they contribute to a growing body of
evidence that the stress caused by early abuse – including neglect – can
disrupt the normal development of brain "circuits", says Barbara Rawn
of Prevent Child Abuse America, in Chicago, Illinois, US.
Teicher believes that parents have begun to grasp the negative effects of
physically reprimanding their children, but he fears that parents may feel
that no harm is done by frequently reprimanding their children with
disparaging comments.
“Verbal abuse really has a long-term effect on a child,” says Rawn.
“There’s a lot of incredible anger that shows up in kids that have been
told they are worth nothing.”
She adds that some children who have been verbally abused sometimes
develop behavioural traits such as extreme aggression, or instead become
overly compliant.
Teicher presented the new findings this week at the annual Society for
Neuroscience meeting in Atlanta, Georgia, US.
OutDoorLinks:
Martin Teicher
http://www.mclean.harvard.edu/about/bios/detail.php?username=mteicher
Barbara Rawn Prevent Child Abuse America, in Chicago, Illinois, US.

More than 90 mins plugged-in music harmful
http://www.preventchildabuse.org/events/conference/downloads/
PCAAmerica_Staff.pdf
---
More than 90 mins plugged-in music harmful

Source: news.yahoo.com/18.10.2006
http://news.yahoo.com/s/nm/20061018/hl_nm/
hearing_music_dc;_ylt=AsJpaQf4Z3Ey_hr8QDDm7c0Q.3QA;_ylu=X3oDMTA5aHJv
MDdwBHNlYwN5bmNhdA--
Listening to loud music with earphones on a digital music player for
more than 90 minutes a day can damage your hearing, according to a new
U.S. study.
The study of 100 doctoral students concluded that people who listened to
music at 80 percent of volume capacity, at which point the sound is
considered loud, should stick to under 90 minutes a day.
"If a person exceeds that on one particular day and happens not to use
their headphones for the rest of the week, they're at no higher risk," study
author Brian Fligor told Reuters.
"I'm talking about someone who's exceeding 80 percent for 90 minutes
day after day, month after month, for years."
The study also found no problems for people who listened to music at 10
percent to 50 percent of maximum volume for extended periods.
It found, however, that anyone who listened at 100 percent for more than
five minutes faced the risk of hearing loss.
The findings of the study, co-authored by doctoral candidate Cory
Portunff, applies to children and adults.
The researchers do not know if children are more susceptible than adults.
The scientists found no differences in sound levels between brands of
digital music players or between the genres of music tested which ranged
from rock, R&B, country, to dance.
Fligor, an audiologist at the Children's Hospital of Boston and faculty of
Harvard Medical School, said people who consistently listen to high
levels of volume don't realize that hearing loss can take up to 10 years to
show up.

When listening to music, your brain is “moving” even if you are not
"I worry about the teen-ager who's going to be 23, 24, 25 years old and
has a measurable noise-induced hearing loss and now has another 60-
something years to live with his hearing which is only going to get
worse," said Fligor, who will present his study on Thursday to a
conference in Cincinnati.
Fligor will also present the findings of another study, co-authored by
Terri Ives of Pennsylvania's College of Optometry's School of Audiology,
that found in-ear earphones, which broadcast sound directly into the ears,
are no more dangerous than headphones that are placed over the ears.
Both studies are being delivered to a "Noise-Induced Hearing Loss in
Children in Work and Play" meeting.
OutDoorLinks:
Brian Fligor
http://www.asha.org/pressevent/experts.htm
---
When listening to music, your brain is

“moving” even if you are not
Source: web.sfn.org/10/15/2006
http://web.sfn.org/index.cfm?pagename=news_101506d
Recent findings have uncovered that when listening to a rythmic sound,
the motor region of our brain is active even if our body isn't.
Research also shows, for the first time, activation of another area of our
brain, the visual center, when temporarily blinded individuals recognize
an object by touch.
Other new reports include an understanding of how neurons are arranged
in the visual cortex, how evolution gave human vision an advantage by
being sensitive to three primary colors instead of just two, and a new
understanding of synesthesia, a rare condition of crossed senses, such as
tasting sounds.
While you listen to music, the areas of your brain that enable your body
to move are active, even if you are not. Recent research shows that you

don't have to think about the music's rhythm or tap your feet to the beat to
engage your brain's motor control areas.
"This finding goes against the traditional view that the brain's motor
regions are involved only in executing body movement," says Robert
Zatorre, PhD, of McGill University in Montreal.
Does this research help explain the irresistible urge to dance, or at the
least, to tap your fingers, when music is played?
"Research carried out in our laboratory and in others have already shown
that both auditory and motor regions of our brain become engaged when
we listen to a musical rhythm and concurrently tap our fingers with it,"
says Joyce Chen, who collaborated with Zatorre.
"More interestingly, we also know that when we listen to a musical
rhythm and just think about, or imagine ourselves, tapping along with it,
motor regions of our brain are also engaged," she adds.
Using functional magnetic resonance imaging (fMRI), Zatorre and Chen
pinpointed the brain areas in which neurons became active when the
human volunteers listened to music.
The fMRI measures the changes in blood flow that occur when neurons
are active.
The researchers used fMRI to monitor the volunteers' brains during three
conditions. In the first, they asked the volunteers just to listen to the
music.
Next, the volunteers were instructed to anticipate, as they listened to the
music, that they they would tap their fingers to the beat of the music.
In the third condition, they actually tapped their fingers while listening to
the music.
"The results revealed that the brain's motor regions were involved in all
three conditions, surprisingly, even when the volunteers were listening to
a sequence of sounds that had no explicit association to movement,"
Chen says.
"The sounds we used sounded like a wood block, that is, they had no
pitch, so there was no melody per se.
So we really think it's the complex time patterns involved in rhythm that
engage the motor system."
Hearing is only one of the senses with previously unknown links in the
functional architecture of the brain. Tactile inputs, associated with the
sense of touch, exist in the visual brain areas of people who can see, says
Amir Amedi, PhD of Harvard Medical School.

"Our findings are important because they reveal that even in people with
normal vision, there must be non-visual inputs into the primary visual
cortex of their brain, and these inputs can undergo rapid, dynamic
changes in strength if a person's sight is lost," said Amedi.
Such research may help identify the brain mechanisms that can allow
blind people to become extraordinarily adept in one or more of the other
senses.
Using fMRI and transcranial magnetic stimulation in his research, Amedi
discovered that the sense of touch encroached into the brain's visual
centers in volunteers whose vision is normal but who were blindfolded
for five days to simulate sudden, total blindness.
"Because humans rely heavily on visual information to understand the
world, large portions of our brain appear specialized to process vision,"
Amedi says. "Therefore, it is not surprising that the brain of a blind
person undergoes changes in order to adapt to the sensory loss by
processing tactile, auditory or other sensory information from other
senses."
However, Amedi's study showed for the first time that robust and
significant activation occurs in the brain visual centers when temporarily
blinded individuals recognize an object by touch.
"The extremely rapid time-course of the brain's recruitment of the visual
cortex for tactile processing suggests that the visual cortex of sighted
people have tactile inputs that can be rapidly unmasked by sudden and
complete visual loss," he added.The activation of the brain's primary
visual cortex, which was absent during the baseline fMRIs, declined
dramatically soon after the volunteers removed their blindfolds. Two
days later, it was negligible.
New research results show for the first time that pinwheel centers are the
convergence site for the orientation domains in the visual cortex, and that
that these singular points in the cortical map exist at the finest possible
scale: individual cells.
This finding suggests that cortical circuits can be built with tremendous
precision.
Even when we are viewing a very simple scene -- for example, a paper
clip on a piece of white paper -- the visual signals from our retina must be
processed by roughly 30 visual areas, or zones, of the brain.
Each area is responsible for interpreting certain defining attributes such
as contours of specific orientations. In the visual cortex, neurons that

respond to contours of specific orientations are arranged in well-

organized orientation maps.
One of the best-studied features in orientation maps is known as a
pinwheel, a small region in which all orientations are represented in
segments that appear to come to a point. "A long-standing question is,
'How are neurons arranged in the pinwheel centers?'" says R.C. Reid,
PhD, of Harvard Medical School.
Reid provided the answer by using two-photon calcium imaging, which
determines the physiological response of hundreds of cells
simultaneously as well as their precise location in the cortical circuit.
"By recording from hundreds to thousands of neurons at each pinwheel
center, we demonstrated that pinwheel centers are remarkably well
organized," he says.
"Neurons selective to different orientations are arranged in an orderly
manner even in the very center," he adds. "There was virtually no mixing
of cells with different orientation preferences even at the center. Thus,
pinwheel centers truly represent singularities in the cortical map." This
finding is suggesting extraordinary precision in the development of
cortical circuits.
Over evolutionary time, color perception has given humans an
advantage. "It is known that color facilitates object perception and
improves memory of these objects," says Hans-Peter Frey, PhD, of the
University of Osnabrueck in Germany.
Many humans and some non-human primates are trichromatic because
their eyes contain three types of cones that are sensitive to red, green, and
blue. These three cone types work together to convey information about
all visible colors. Some humans and most primate species are
dichromatic -- with cone types sensitive to only two of the three colors.
Although our visual system allows us to see colors, our ability to
perceive movement, depth, perspective, the relative size of objects,
shading, and gradations in texture all depend primarily on contrasts in
light intensity rather than in color.
Supporting this concept, Frey describes an "ongoing controversy" in
color perception: Did trichromacy evolve to enable humans and some
non-human primate species to detect ripe fruit embedded in foliage?
To answer this question, he determined whether trichromatic human
volunteers took advantage of their ability to discriminate red and green
colors. He recorded eye movements of human subjects while they were
looking at images of the Kibale rainforest in Uganda. The images showed

foliage with embedded fruits. Previously, researchers observed non-

human primates in the Kibale rainforest for several months and recorded
the color of their food with a spectrometer, Frey explains. They found
that ripe fruits could be discriminated from unripe fruits using the blue-
yellow color channel, or the red-green color channel.
"This result suggests that there is no advantage of being trichromatic," he
says.
In his studies of human volunteers, he did not evaluate the opponent
color channels themselves, but instead the color contrast in these
channels. He determined that the color contrast of the red-green visual
inputs enables trichromatic individuals to detect fruit among foliage,
because this color contrast is especially high in parts of the visual scene
that contain fruit.
"Thus, dichromatic non-human primates should be less efficient in
finding fruit by visual inspection," he points out. " This prediction could
also apply to some of the dichromatic humans."
Imagine that when you think of Wednesday, you experience the color
magenta. Or when you hear the name Susan, you taste cinnamon in your
mouth. Or when you hear a Beethoven symphony, you smell gardenias.
"You may be one in a hundred otherwise normal people who experience
the world this way," says David Eagleman, PhD, of the University of
Texas, Houston Medical School, referring to the neurological condition
called synesthesia.
"In synesthesia, stimulation of one sense triggers an experience in a
different sense," says Eagleman. "For example, a voice or piece of music
are not only heard but also seen, tasted, or felt as a touch. Synesthesia is a
fusion of different sensory perceptions, and most synesthetes are unaware
their experiences are in any way unusual." Synesthetic perceptions are
involuntary, automatic, and generally consistent over time.
Eagleman will describe a new, large scale genetic study -- called a family
linkage analysis -- to map the gene or genes that correlate for color
synesthesias.
"Understanding the genetic basis of synesthesia yields insight into the
way normal brains are wired," he explains. "And it demonstrates that
more than one kind of brain, and one kind of mind, is possible."
OutDoorLinks:

5th AMRC Susan Porter Symposium: Music and Health in America American
Robert J. Zatorre Montreal

http://www.psych.mcgill.ca/faculty/zatorre.html
Amir Amedi
http://tmslab.org/faculty/?id=15
R.C. Reid
http://neuro.med.harvard.edu/site/faculty/reid.html
Hans-Peter Frey
http://www.home.uni-osnabrueck.de/hfrey/
David Eagleman, PhD
http://www.uth.tmc.edu/nba/resources/faculty/members/eagleman.htm
---
5th AMRC Susan Porter Symposium: Music

and Health in America American Music
Research Center presents 5th AMRC Susan
Porter Symposium Music and Health in
America
June 28-30, 2007Boulder, Colorado
Source: http://ucblibraries.colorado.edu/amrc/musichealth2007/index.htm
A Rich Multi-disciplinary Symposium:
Exploring the historical, medical, therapeutic and spiritual ways that
music affects healthy individuals and societies.
Featuring nationally recognized speakers and performers from both

music and health disciplines. With keynote talks, panel discussions,
concerts, experiential workshops and post-symposium intensives.
Who Will Attend:

music therapists, ethnomusicologists, medical and healthcare
professionals, composers, musicians, spiritual healers, historians and the
general public.
To read more go to
<http://ucblibraries.colorado.edu/amrc/musichealth2007/index.htm>
To read the schedule go to

5th AMRC Susan Porter Symposium: Music and Health in America American
<http://ucblibraries.colorado.edu/amrc/musichealth2007/schedule.htm>
---
New Book:
Music Therapy Methods in Neurorehabilitation
A Clinician's Manual
Felicity Baker and Jeanette Tamplin
Foreword by Barbara Wheeler
www.tomdoch.de
+49 (0) 221-58 91 95 33
With a contribution from Jeanette Kennelly

Quelle: http://www.jkp.com/catalogue/book.php/isbn/9781843104124
The value of music therapy in neurological rehabilitation is increasingly
recognised and this practical manual provides comprehensive guidance
for clinicians on the application of music therapy methods in
neurorehabilitation.
Felicity Baker and Jeanette Tamplin combine research findings with
their own clinical experience and present step-by-step instructions and
guidelines on how to implement music therapy techniques for a range of
therapeutic needs.
Photographs clearly illustrate interventions for physical rehabilitation,
for example through the use of musical instruments to encourage targeted
movement. The chapter on cognitive rehabilitation includes resources
and lists suitable songs for use in immediate memory or abstract thinking
tasks, among others.
In her chapter on paediatric patients, Jeanette Kennelly demonstrates
how procedures can be adapted for working clinically with children. A
comprehensive list of terminology commonly used in neurological
rehabilitation is also included.
Music Therapy Methods in Neurorehabilitation will prove an invaluable
reference book for music therapy clinicians and students. It is also
suitable for work with other populations, in particular for work in special
education.
Music Therapy Methods in Neurorehabilitation

A Clinician's Manual

Friends for Life: An Emerging Biology of Emotional Healing
Paperback,
ISBN-10: 1-84310-412-1
ISBN-13: 9781843104124,
256pp, 2006,
£29.99, $55.00
OutDoorLinks:
Felicity Baker
http://www.uq.edu.au/music/index.html?page=27266
Jeanette Tamplin
http://www.austin.org.au/Content.aspx?topicID=303
Barbara Wheeler
http://www.louisville.edu/music/bios/b_wheeler.html
---
Friends for Life: An Emerging Biology of

Emotional Healing
By DANIEL GOLEMAN
Source: DANIEL GOLEMAN/www.nytimes.com/ October 10, 2006
http://www.nytimes.com/2006/10/10/health/psychology/
10essa.html?_r=2&oref=slogin&ref=health&pagewanted=print&oref=slogin
A dear friend has been battling cancer for a decade or more. Through a
grinding mix of chemotherapy, radiation and all the other necessary
indignities of oncology, he has lived on, despite dire prognoses to the
contrary.
My friend was the sort of college professor students remember fondly:
not just inspiring in class but taking a genuine interest in them — in their
studies, their progress through life, their fears and hopes. A wide circle of
former students count themselves among his lifelong friends; he and his
wife have always welcomed a steady stream of visitors to their home.
Though no one could ever prove it, I suspect that one of many ingredients
in his longevity has been this flow of people who love him.
Research on the link between relationships and physical health has
established that people with rich personal networks — who are married,
have close family and friends, are active in social and religious groups —

recover more quickly from disease and live longer. But now the emerging
field of social neuroscience, the study of how people’s brains entrain as
they interact, adds a missing piece to that data.
The most significant finding was the discovery of “mirror neurons,” a
widely dispersed class of brain cells that operate like neural WiFi. Mirror
neurons track the emotional flow, movement and even intentions of the
person we are with, and replicate this sensed state in our own brain by
stirring in our brain the same areas active in the other person.
Mirror neurons offer a neural mechanism that explains emotional
contagion, the tendency of one person to catch the feelings of another,
particularly if strongly expressed. This brain-to-brain link may also
account for feelings of rapport, which research finds depend in part on
extremely rapid synchronization of people’s posture, vocal pacing and
movements as they interact. In short, these brain cells seem to allow the
interpersonal orchestration of shifts in physiology.
Such coordination of emotions, cardiovascular reactions or brain states
between two people has been studied in mothers with their infants,
marital partners arguing and even among people in meetings. Reviewing
decades of such data, Lisa M. Diamond and Lisa G. Aspinwall,
psychologists at the University of Utah, offer the infelicitous term “a
mutually regulating psychobiological unit” to describe the merging of
two discrete physiologies into a connected circuit. To the degree that this
occurs, Dr. Diamond and Dr. Aspinwall argue, emotional closeness
allows the biology of one person to influence that of the other.
John T. Cacioppo, director of the Center for Cognitive and Social
Neuroscience at the University of Chicago, makes a parallel proposal:
the emotional status of our main relationships has a significant impact on
our overall pattern of cardiovascular and neuroendocrine activity.
This radically expands the scope of biology and neuroscience from
focusing on a single body or brain to looking at the interplay between
two at a time. In short, my hostility bumps up your blood pressure, your
nurturing love lowers mine. Potentially, we are each other’s biological
enemies or allies.
Even remotely suggesting health benefits from these interconnections
will, no doubt, raise hackles in medical circles. No one can claim solid
data showing a medically significant effect from the intermingling of
physiologies.

At the same time, there is now no doubt that this same connectivity can
offer a biologically grounded emotional solace. Physical suffering aside,
a healing presence can relieve emotional suffering.
A case in point is a functional magnetic resonance imaging study of
women awaiting an electric shock. When the women endured their
apprehension alone, activity in neural regions that incite stress hormones
and anxiety was heightened.
As James A. Coan reported last year in an article in Psychophysiology,
when a stranger held the subject’s hand as she waited, she found little
relief. When her husband held her hand, she not only felt calm, but her
brain circuitry quieted, revealing the biology of emotional rescue.
But as all too many people with severe chronic diseases know, loved ones
can disappear, leaving them to bear their difficulties in lonely isolation.
Social rejection activates the very zones of the brain that generate, among
other things, the sting of physical pain.
Matthew D. Lieberman and Naomi Eisenberg of U.C.L.A. (writing in a
chapter in “Social Neuroscience: People Thinking About People,” M.I.T.
Press, 2005) have proposed that the brain’s pain centers may have taken
on a hypersensitivity to social banishment because exclusion was a death
sentence in human prehistory. They note that in many languages the
words that describe a “broken heart” from rejection borrow the lexicon of
physical hurt.
So when the people who care about a patient fail to show up, it may be a
double blow: the pain of rejection and the deprivation of the benefits of
loving contact. Sheldon Cohen, a psychologist at Carnegie-Mellon
University who studies the effects of personal connections on health,
emphasizes that a hospital patient’s family and friends help just by
visiting, whether or not they quite know what to say.
My friend has reached that point where doctors see nothing else to try.
On my last visit, he and his wife told me that he was starting hospice
care.
One challenge, he told me, will be channeling the river of people who
want to visit into the narrow range of hours in a week when he still has
the energy to engage them.
As he said this, I felt myself tearing up, and responded: “You know, at
least it’s better to have this problem. So many people go through this all
alone.”
He was silent for a moment, thoughtful. Then he answered softly,
“You’re right.”

Programming social, cognitive, and neuroendocrine development by early
Daniel Goleman is the author of “Social Intelligence: The New Science

of Human Relationships.”
OutDoorLinks:
Daniel Goleman
http://www.danielgoleman.info/
Lisa M. Diamond
http://www.psych.utah.edu/people/faculty/diamond/
Lisa G. Aspinwall
http://www.psych.utah.edu/people/faculty/aspinwall/
John T. Cacioppo
http://psychology.uchicago.edu/people/faculty/cacioppo/index.shtml
James A. Coan
http://www.people.virginia.edu/%7Ejac3zt/people.html
Matthew D. Lieberman
http://www.scn.ucla.edu/people_liebermanm.html
---
Programming social, cognitive, and

neuroendocrine development by early exposure
to novelty
By Akaysha C. Tang, Katherine G. Akers, Bethany C. Reeb, Russell
D. Romeo and Bruce S. McEwen
Mildly stressful early life experiences can potentially impact a broad
range of social, cognitive, and physiological functions in humans,
nonhuman primates, and rodents.
Recent rodent studies favor a maternal-mediation hypothesis that
considers maternal-care differences induced by neonatal stimulation as
the cause of individual differences in offspring development.
Using neonatal novelty exposure, a neonatal stimulation paradigm that
dissociates maternal individual differences from a direct stimulation
effect on the offspring, we investigated the effect of early exposures to

Task-modulated "what" and "where" pathways in human auditory cortex
novelty on a diverse range of psychological functions using several

assessment paradigms.
Pups that received brief neonatal novelty exposures away from the home
environment showed enhancement in spatial working memory, social
competition, and corticosterone response to surprise during adulthood
compared with their home-staying siblings.
These functional enhancements in novelty-exposed rats occurred despite
evidence that maternal care was directed preferentially toward home-
staying instead of novelty-exposed pups, indicating that greater maternal
care is neither necessary nor sufficient for these early stimulation-
induced functional enhancements.
We suggest a unifying maternal-modulation hypothesis, which
distinguishes itself from the maternal-mediation hypothesis in that (i)
neonatal stimulation can have direct effects on pups, cumulatively
leading to long-term improvement in adult offspring; and (ii) maternal
behavior can attenuate or potentiate these effects, thereby decreasing or
increasing this long-term functional improvement.
To whom correspondence may be addressed at:
Akaysha C. Tang, E-mail: akaysha(at)unm.edu
Bruce S. McEwen, E-mail: mcewen(at)rockefeller.edu
OutDoorLinks:
Akaysha C. Tang
http://www.unm.edu/~atlab/
Bruce S. McEwen
http://www.rockefeller.edu/research/abstract.php?id=109
---
Task-modulated "what" and "where" pathways

in human auditory cortex
By Jyrki Ahveninen, Iiro P. Jääskeläinen, Tommi Raij, Giorgio
Bonmassar, Sasha Devore, Matti Hämäläinen, Sari Levänen, Fa-
Hsuan Lin, Mikko Sams, Barbara G. Shinn-Cunningham, Thomas
Witzel and John W. Belliveau
Source: www.pnas.org/September 26, 2006

Task-modulated "what" and "where" pathways in human auditory cortex
http://www.pnas.org/cgi/content/abstract/103/39/14608?etoc
Published online before print September 18, 2006, 10.1073/pnas.0510480103
PNAS | September 26, 2006 | vol. 103 | no. 39 | 14608-14613
© 2006 by The National Academy of Sciences of the USA
Human neuroimaging studies suggest that localization and identification
of relevant auditory objects are accomplished via parallel parietal-to-
lateral-prefrontal "where" and anterior-temporal-to-inferior-frontal
"what" pathways, respectively.
We found a double dissociation in response adaptation to sound pairs
with phonetic vs. spatial sound changes, demonstrating that the human
nonprimary auditory cortex indeed processes speech-sound identity and
location in parallel anterior "what" (in anterolateral Heschl’s gyrus,
anterior superior temporal gyrus, and posterior planum polare) and
posterior "where" (in planum temporale and posterior superior temporal
gyrus) pathways as early as {approx}70–150 ms from stimulus onset.
Using combined hemodynamic (functional MRI) and electromagnetic
(magnetoencephalography) measurements, we investigated whether such
dual pathways exist already in the human nonprimary auditory cortex, as
suggested by animal models, and whether selective attention facilitates
sound localization and identification by modulating these pathways in a
feature-specific fashion.
Our data further show that the "where" pathway is activated {approx}30
ms earlier than the "what" pathway, possibly enabling the brain to use
top-down spatial information in auditory object perception.
Notably, selectively attending to phonetic content modulated response
adaptation in the "what" pathway, whereas attending to sound location
produced analogous effects in the "where" pathway.
This finding suggests that selective-attention effects are feature-specific
in the human nonprimary auditory cortex and that they arise from
enhanced tuning of receptive fields of task-relevant neuronal
populations.
To whom correspondence should be addressed at:

Jyrki Ahveninen, E-mail: jyrki(at)nmr.mgh.harvard.edu
OutDoorLinks:
Jyrki Ahveninen
http://www.nmr.mgh.harvard.edu/martinos/people/showPerson.php?people_id=205

Forget 'emoticons' – use your own smiley face
John W. Belliveau
http://www.nmr.mgh.harvard.edu/martinos/people/showPerson.php?people_id=8
---
Forget 'emoticons' – use your own smiley face

By Tom Simonite
Source: www.newscientisttech.com/29 September 2006
http://www.newscientisttech.com/article/dn10190-forget-emoticons--use-your-own-
smiley-face.html
Software that contorts an image of a person's face to express different
emotions could enrich text-based internet chat.
The researchers behind the system say it can quickly transform a user's
face to convey any of six emotions, ranging from anger to happiness.
A user first uploads a picture of their face with a "neutral" expression.
Then they use their mouse to mark the ends of their eyebrows, the
corners of their mouth and the edges of their eyes and lips.
The software uses these points to morph the face to express different
emotions: happiness, sadness, fear, anger, surprise, and disgust. A user
can select an emotion and one of three intensity levels when using the
system.
"We think it could be an improvement on the crude emoticons [ :-) ]
instant messaging programmes use now," says Anthony Boucouvalas
who created the system with colleagues at Bournemouth University in
the UK. "It isn't perfect but it gets the message across and is very
convenient."
Reduce misunderstandings
The software uses a facial image database to determine the correct spatial
relationship between different facial features for different emotions. It
distorts the points and areas marked by the user to shift them for a desired
emotion.
In tests, a group of 35 volunteers were able to correctly recognise
morphed emotions 60% of the time. Boucouvalas believes this is high
enough to be used with internet chat, where the text could help reduce
misunderstandings.

Talent vs. Practice
In future, the researchers may integrate the face morphing software with
a program that uses a dictionary of 18,000 words and basic grammatical
phrases to identify the emotional content of a message.
This could help internet chat rooms function more like group
conversation in real life, says Boucouvalas. "If I enter an online
environment I've got no idea what kind of mood you are in," he says.
"This tool could give me an idea based on what you have been saying
before I arrived."
OutDoorLinks:
Anthony Boucouvalas
http://dec.bournemouth.ac.uk/staff/tboucouvalas/tony1.htm
---
Talent vs. Practice

by Joyce Gramza and Victor Limjoco
Source: www.sciencentral.com/3. Oktober 2006
http://www.sciencentral.com/articles/view.php3?article_id=218392857
Is talent something you're born with or can practice really make you
perfect? Experts on expertise -- who've studied the minds of experts in
fields from sports to medicine -- have the answer. As this ScienCentral
News video explains, they're applying it to life or death situations.
Thinking Like an Expert
In the Human Performance Laboratory at Florida State University's
Center for Expert Performance Research, a nursing student is told to
care for a simulated patient admitted for chest pain. The dummy patient's
vital signs, as well as his voice, are controlled by a nursing professor
behind a two-way mirror. When the "patient" suddenly can't breathe, the
student gets to experience a novice nurse's nightmare -- a life-or-death
situation with no one to take over and rescue the patient, or coach her
what to do.
Putting both experts and novices through critical scenarios like this,
cognitive psychology researchers K. Anders Ericsson and Paul Ward
don't just observe the differences in subjects' performance. They also use

Talent vs. Practice
interviewing techniques they've developed to understand the differences

in their minds.
"We’re looking at how people think and how that thinking affects how
they perform," says Ward.
Ericsson Ward Researchers
Before a novice or expert participates in the simulation, Ward prepares
them for how they will be debriefed afterward. He teaches them how to
give a "think-aloud" report of their performance, in which they simply
recount what they were thinking throughout the scenario without trying
to evaluate or explain it.
"That’s when we uncover the expert superiority: their ability to perceive
more information, and also, after the fact, remember more of the thought
processes than the novices," says Ericsson.
"Some key differences would be the way in which they pick up
information from the environment," Ward says, "and the way in which
they comprehend that information such that they could then use it to good
effect."
In fact, even in sports, where we tend to think that successful athletes
have not only natural abilities, but also superior physical skills, Ward's
research on top soccer players has shown that mental processes are a
much better predictor of performance than physical attributes. Elite
players not only make better decisions than less-skilled players, they do it
by more accurately perceiving and analyzing cues around them and
anticipating consequences of their actions. "These are skills that are
intangible," says Ward, "because you can’t touch or feel them but they
result in a difference in your performance."
Ericsson and Ward have used techniques like this to compare thousands
of experts with novices in fields from music, sports, medicine and law
enforcement. They've found no evidence that experts are born with any
more natural "talent" than other people. "We have yet to find any
compelling evidence that any talent matters," says Ericsson.
Instead, the key to dramatic improvement in any field is -- that's right --
practice. But, it has to be what Ericsson calls "deliberate practice."
"A lot of people like to do things that they’re already good at, but what
deliberate practice says is you need to find those things that you are weak
at and that there’s room for improvement and that’s the activity you
should focus on," Ericsson says.
Nurse

Talent vs. Practice
"The interesting finding is that experts in any domain seem to share very,
very similar attributes," he says, "and they are acquired through extended
practices, not just mere experience. They actually are doing a lot of
thinking work that would allow them now to acquire the skills that are
necessary for superior performance."
Ericsson and Ward say their findings suggest that any novice can become
an expert with enough of the right kind of training. "It suggests that
anyone with the right kind of practice will be able to dramatically
improve their performance and it looks like they would be able to
become experts with sufficient practice," Ericsson says.
They suspect that what many people think of as "talent" may just be the
motivation and commitment to continually challenge yourself.
Future research is focusing on healthy people who fail to reach expert
levels, exploring the idea of individual limits. They're looking at
individuals who prematurely stopped practicing and don't know how far
they would've reached at a particular skill. "We are actively searching for
people who can help us find those kinds of individual limits that would
not allow somebody to become proficient in a language or proficient in
some profession," Ericsson says. "If we could understand that, it would
allow us to help a lot of individuals hopefully reach much higher levels
of performance."
Their research was funded by the Office of Naval Research and featured
in Scientific American, August 2006. Ericsson and others edited The
Cambridge Handbook of Expertise and Expert Performance in 2006.
OutDoorLinks:
Human Performance Laboratory at Florida State University's Center for Expert

Performance Research
http://www.lsi.fsu.edu/cepr/
K. Anders Ericsson
http://www.psy.fsu.edu/faculty/ericsson.dp.html
Paul Ward
http://www.lsi.fsu.edu/cepr/people7.html
---

Train your brain to hear your friends at a party

Source: www.alphagalileo.org/05 October 2006
A major science prize was today awarded to a researcher who is looking
for the region of the brain that helps us to hear someone in a noisy place,
such as a party or bar, and is responsible for “training” the brain to hear
better in these situations.
Not being able to hear a person’s voice in a noisy room and follow
conversations is one of the most common problems for Britain’s nine
million people with a hearing impairment.
Deafness Research UK, the leading medical charity, has awarded the
2007 Pauline Ashley Prize to Sam Irving, a young researcher at the
MRC Institute for Hearing Research in Nottingham.
The Pauline Ashley Prize, established in memory of the charity’s
founder, Lady Ashley of Stoke, is awarded annually to a talented young
scientist near the beginning of their career and undertaking research into
deafness, or a related condition such as tinnitus.
Most people with a hearing impairment have trouble picking out what
someone is saying when they’re in a noisy room. Parties or bars are some
of the worst places because the level of background noise is high, and so
scientists call this the “cocktail party effect”.
To see what this was like, Irving wore an earplug in one ear for a week
which gave him a one-sided hearing loss.
He said: “It was hell - especially when I was in the pub with friends. The
background hubbub of the bar seemed to be the same level as the people
I was talking to so I could barely hear what they were saying and it took a
huge effort of concentration to follow any conversation. During the
week, I gave up and spent a lot of time at home on my own because it
was so distressing and tiring to be with lots of people or in a noisy place.”
Our ability to detect a particular sound in the middle of lots of noise
relies on the fact that we have two ears, and each detects an individual
sound at a slightly different time (a sound coming from the left will reach
the left ear slightly faster than it reaches the right ear).
This is known as binaural or “spatial” hearing because it helps us identify
where a sound is coming from and to concentrate or focus our hearing on
that particular sound.
But, if you have some form of hearing problem in at least one ear, this
ability is disrupted and the brain struggles to tell one sound from another.

The key to understanding this ability lies in the brain. Scientists are
currently trying to work out exactly what part of the brain is responsible
and how it allows us to distinguish one sound from lots of noise. Early
research has had some remarkable results.
Most mammals also have this ability and in 2006, scientists working in
the Oxford Auditory Neuroscience Group found that spatial hearing in
ferrets has the ability to bounce-back or adapt to a hearing loss over time.
Their brains are being “trained” to cope with the hearing loss and
distinguish sounds much better.
The Oxford study placed healthy ferrets in a “ring of sound” where a
sound is played from one of 12 speakers placed in a circle around the
ferret and their response is monitored to see if they can detect which
speaker the sound is coming from. Ferrets with normal hearing are very
good at this and have excellent spatial hearing.
The team then fitted each of the ferrets with a small earplug in one ear
which blocks some of the sound and so mimics a hearing loss.
They then got the ferrets to perform the same task twice a day for two
weeks and made a startling discovery.
At first, the ferrets’ ability to identify where the sound was coming from
was dramatically reduced (because their spatial hearing had been
disrupted by the earplug) but after two weeks they regained their ability
and by the end of the period were as good at detecting the location of the
sounds as they were before being fitted with an earplug.
Something in their brain was changing or adapting to the new situation
and they were learning to compensate for the hearing loss.
Irving said: “When we switch on a bright light our eyes detect the
increase in light levels and the brain sends a message to the eye to tell it
to contract the pupil and let in less light.
This is a feedback system where the brain is getting information from the
eye about its surroundings, processing that information, and sending
messages back to the eye to help it cope with different situations. We
think something very similar is happening with the ear in spatial
hearing.”
“The brain is constantly monitoring the sounds around us and so knows
what normal sound levels it would expect. When we introduce an
earplug, it can detect the reduction in sound being received and we think
it is actively sending messages back to the ear telling it how to cope with
the new hearing loss, perhaps by stimulating or increasing the signal

which is being blocked. It’s compensating for the problem in a really

clever way.”
Irving is trying to locate the place in the brain which is channeling these
feedback messages back to the ear.
“We already have a likely candidate called the OCB, the Olivocochlear
Bundle, which is a part of the brain that we know is a centre of feedback
information being transmitted from the brain back to the ear. We’re now
trying to work out if the OCB is responsible for spatial hearing in
ferrets.”
The Pauline Ashley Prize will allow Irving to work with a team led by
Professor Charles Liberman at the Eaton Peabody Lab at MIT/
Harvard, leading experts on the OCB system.
His study will compare the performance of ferrets which have had their
OCB removed with normal ferrets in the “ring of sound”.
At the same time, Irving is conducting a study with human subjects who
have volunteered to wear an earplug for five days. These subjects will be
tested in a similar ring of sound and their performance measured over
time.
Early results show that humans also have the same ability to train their
brain to cope with the hearing loss and become better at the task the
longer they’re wearing the earplug.
Irving said: “Understanding how this system works is fairly basic
science, but will be vital in the future for engineering new ways of
helping people with hearing impairment cope with difficult situations.
They could be helped by computer generated training programs which
run like regular computer games, but can target weaknesses in listening
skills. By incorporating training exercises much like those performed by
the ferrets, they can lead to auditory learning and an improved ability to
listen.”
OutDoorLinks:
Deafness Research UK
http://www.deafnessresearch.org.uk/
Sam Irving
http://www.ihr.mrc.ac.uk/staff/
Charles Liberman
http://hst.mit.edu/servlet/
ControllerServlet?handler=PeopleHandler&action=viewOne&id=HST000678
---

When Just One Sense Is Available, Multisensory Experience Fills in the Blanks
When Just One Sense Is Available,

Multisensory Experience Fills in the Blanks
By Liza Gross
Source: http://biology.plosjournals.org/perlserv/?request=get-
document&doi=10.1371%2Fjournal.pbio.0040361
Published: September 26, 2006
DOI: 10.1371/journal.pbio.0040361
Copyright: © 2006 Public Library of Science.
Citation: Gross L (2006) When Just One Sense Is Available, Multisensory Experience
Fills in the Blanks. PLoS Biol 4(10): e361
Our brains are wired in such a way that we can recognize a friend or
loved one almost as easily whether we hear their voice or see their face.
Specialized areas of the brain — in this case, the visual and auditory
networks — are specially tuned to different properties of physical
objects.
These properties can be represented by multiple sensory modalities, so
that a voice conveys nearly as much information about a person’s identity
as a face.
This redundancy allows rapid, automatic recognition of multimodal
stimuli. It may also underlie “unimodal” perception — hearing a voice on
the phone, for example — by automatically reproducing cues that are
usually provided by other senses.
In this view, as you listen to the caller’s voice, you imagine their face to
try to identify the speaker. In a new study, Katharina von Kriegstein
and Anne-Lise Giraud used functional magnetic resonance imaging
(fMRI) to explore this possibility and understand how multimodal
features like voices and faces are integrated in the human brain.
Studies using fMRI have established that when someone hears a familiar
person’s voice, an area of the temporal lobe called the fusiform face area
(FFA) is activated through temporal voice areas (TVAs), suggesting early
interactions between these cortical sensory areas.
von Kriegstein and Giraud wondered whether these cortical ensembles
might lay the foundation for general “multisensory representation”
templates that enhance unimodal voice recognition.

When Just One Sense Is Available, Multisensory Experience Fills in the Blanks
To explore this question, the researchers analyzed changes in brain

activity and behavior after people learned to associate voices with an
unfamiliar speaker.
One group of participants learned to associate voices with faces and a
second group learned to associate voices with names.
Though both types of learning involve multimodal associations, voices
and faces provide redundant information about a person’s identity (such
as gender and age), while voices and names provide arbitrary
relationships (since any name could be associated with any voice).
To further explore the contribution of redundant stimuli from the same
source, the researchers added an additional set of conditions in which
participants associated cellular phones with either ringtones or brand
names. In this case, both cell phone and brand name were arbitrarily
associated with a ringtone.
In the first phase of the fMRI experiment, participants listened to and
identified either voices or ringtones.
In the second phase, one group of participants learned to associate the
voices and ringtones with faces and cell phones, while another group
learned voice–name and ringtone–brand name associations.
In the third phase, participants again heard only the auditory signals and
identified either voices or ringtones as in phase one.
The brain scans showed that learning multisensory associations enhanced
those brain regions involved in subsequent unimodal processing for both
voice–face and voice–name association. Recognizing people on the
phone: Does knowing the face help?
But at the behavioral level, participants could recognize voices that they
had paired with faces much more easily than they could recognize voices
they had linked to names.
Participants who had learned to associate voices with faces were the only
ones to show increased FFA activation during unimodal voice
recognition.
The fMRI results show that even a brief association between voices and
faces is enough to enhance functional connectivity between the TVA and
FFA, which interact when a person recognizes a familiar voice.
In contrast, voice–name association did not increase interactions between
voice and written name sensory regions.
Similarly, people did not recognize ringtones any better whether they had
learned to associate them with cell phones or brand names.

Morphometry of the amusic brain: a two-site study
Nor did their brain scans reveal any interactions between auditory and
visual areas during ringtone recognition.
Altogether, these results show that learning voice–face associations
generates a multimodal sensory representation that involves increased
functional connectivity between auditory (TVA) and visual (FFA)
regions in the brain and improves unimodal voice recognition
performance.
When only one sensory modality of a stimulus is available, the
researchers conclude, one can optimally identify a natural object by
automatically tapping into multisensory representations in the brain —
cross-modal ensembles that are normally coactivated — as long as the
stimulus provides redundant information about the object.
Given that faces and voices are the major means of social communication
for nonhuman primates as well as for humans, the reliance of multiple,
redundant sensory modalities likely has deep roots in our evolutionary
history.
OutDoorLinks:
Katharina von Kriegstein

http://www.science.mcmaster.ca/~IMRF/2005/viewabstract.php?id=117
Anne-Lise Giraud
http://www.cogmaster.net/cogmaster_files/identiteCP.html
---
Morphometry of the amusic brain: a two-site

study
Krista L. Hyde, Robert J. Zatorre, Timothy D. Griffiths, Jason P. Lerch
and Isabelle Peretz
Source: brain.oxfordjournals.org/August 24, 2006
http://brain.oxfordjournals.org/cgi/content/abstract/awl204v1
Abstract

Morphometry of the amusic brain: a two-site study
Congenital amusia (or tone deafness) is a lifelong disability that prevents

otherwise normal-functioning individuals from developing basic musical
skills.
Behavioural evidence indicates that congenital amusia is due to a severe

deficit in pitch processing, but very little is known about the neural
correlates of this condition.
The objective of the present study was to investigate the structural neural
correlates of congenital amusia.
To this aim, voxel-based morphometry was used to detect brain
anatomical differences in amusic individuals relative to musically intact
controls, by analysing T1-weighted magnetic resonance images from two
independent samples of subjects.
The results were consistent across samples in highlighting a reduction in
white matter concentration in the right inferior frontal gyrus of amusic
individuals.
This anatomical anomaly was correlated with performance on pitch-
based musical tasks.
The results are consistent with neuroimaging findings implicating right
inferior frontal regions in musical pitch encoding and melodic pitch
memory.
We conceive the present results as a consequence of an impoverished
communication in a right-hemisphere-based network involving the
inferior frontal cortex and the right auditory cortex.
Moreover, the data point to the integrity of white matter tracts in right
frontal brain areas as being key in acquiring normal musical competence.

Krista L. Hyde, E-mail: krista.hyde(at)mcgill.ca
OutDoorLinks:
Isabelle Peretz
http://www.brams.umontreal.ca/plab/
Montreal Neurological Institute der McGill Universität
http://www.mni.mcgill.ca
Universität Newcastle
http://www.ncl.ac.uk

Silent night: adaptive disappearance of a sexual signal in a parasitized
Fachzeitschrift Brain
http://brain.oxfordjournals.org
---
Silent night: adaptive disappearance of a

sexual signal in a parasitized population of
field crickets
By Marlene Zuk, John T. Rotenberry and Robin M. Tinghitella
Source: Biology Letters/DOI: 10.1098/rsbl.2006.0539
http://www.journals.royalsoc.ac.uk/(nhnfjunzn33vrjjyjoeq02e5)/app/home/
contribution.asp?referrer=parent&backto=issue,3,37;journal,1,8;linkingpublicationresu
lts,1:110824,1
ISSN: 1744-9561 (Paper) 1744-957X (Online)
Abstract:
Sexual signals are often critical for mate attraction and reproduction,
although their conspicuousness exposes them to parasites and predators.
We document the near-disappearance of song, the sexual signal of
crickets, and its replacement with a novel silent morph, in a population
subject to strong natural selection by a deadly acoustically orienting
parasitoid fly.
On the Hawaiian Island of Kauai, more than 90% of male field crickets
(Teleogryllus oceanicus) shifted in less than 20 generations from a
normal-wing morphology to a mutated wing that renders males unable to
call (flatwing).
Flatwing morphology protects male crickets from the parasitoid, which
uses song to find hosts, but poses obstacles for mate attraction, since
females also use the males' song to locate mates.
Field experiments support the hypothesis that flatwings overcome the
difficulty of attracting females without song by acting as ‘satellites’ to
the few remaining callers, showing enhanced phonotaxis to the calling
song that increases female encounter rate.
Thus, variation in behaviour facilitated establishment of an otherwise
maladaptive morphological mutation.
OutDoorLinks:

U.S. study finds fear on-off switch in brain
Marlene Zuk
http://www.biology.ucr.edu/people/faculty/Zuk.html
John T. Rotenberry
http://www.facultydirectory.ucr.edu/cgi-bin/pub/public_individual.pl?faculty=849
---

Quelle: news.yahoo.com/20.9.2006
http://news.yahoo.com/s/nm/20060920/hl_nm/
science_fear_dc&printer=1;_ylt=Ary9ldcDhJBLBtckLA7a0ZAR.3QA;_ylu=X3oDMT
A3MXN1bHE0BHNlYwN0bWE-
U.S. researchers said on Wednesday they had identified an "on-off"
switch in the brain that controls the emotional response to fear, and said it
might some day be manipulated to help patients with anxiety disorders.
The team at Columbia University Medical Center used a simple
attention test and a type of real-time brain scan called functional
magnetic resonance imaging, which can catch the brain in action.
It showed an area in the rostral cingulate or rACC region of the brain was
involved in turning on or off the fear response in the amygdala -- the
almond-shaped brain center where emotional responses to fear are
processed.
"People are exposed to an ever-increasing amount of stimuli in our
everyday lives, and so we realized that the brain must employ a
processing mechanism to prioritize and refine responses -- we don't run
away from every loud sound or unexpected sight," said Dr. Joy Hirsch,
who led the study, published in the journal Neuron.
They used a test called the Stroop test to try to activate whatever region
must be involved.
The Stroop test measures mental flexibility by forcing people to choose
between a word's meaning and its color. For instance, someone may be
asked to read a list of words such as "red," "yellow," or "green" in which
the word "red" might be written in blue ink, "yellow" in pink ink and so
on.
People usually respond more quickly if the color and word match.

Hirsch's team adapted this test, using photographs of fearful and happy
faces, with "FEAR" or "HAPPY" written across the images. They gave
the test to 19 healthy volunteers and ran the brain scan at the same time.
The rostral cingulate seemed to light up just before the amygdala was
activated, they reported.
For instance, the amygdala activated at first if FEAR was written across a
happy face, and then the rostral cingulate would activate, apparently as
the image of the smiling face registered, after which the amygdala would
calm down, they said.
But the amygdala stayed activated for longer, and the rostral cingulate
stayed unlit longer, if a fearful face also carried the "FEAR" label.
Hirsch said it is important to have a circuit to control the fear response.
Some patients with anxiety disorders and depression may eventually be
helped by the findings, said Dr. Eric Kandel, a Howard Hughes Medical
Institute senior investigator and professor in brain sciences who worked
on the paper.
"For example, if someone with anxiety has a disturbed functioning of
part of the amygdala or a disturbed functioning of rostral cingulate
control mechanism, and treatment could be based on the individual's
specific problem," Kandel said.
OutDoorLinks:
Columbia University Medical Center

http://www.cumc.columbia.edu/
Dr. Joy Hirsch
http://cumc.columbia.edu/dept/radiology/fmri.html
Dr. Eric Kandel
http://www.columbia.edu/cu/biology/faculty-data/eric-kandel/faculty.html
---

The effect of anticipation and the specificity of sex differences for amygdala
The effect of anticipation and the specificity of

sex differences for amygdala and hippocampus
function in emotional memory
By Kristen L. Mackiewicz, Issidoros Sarinopoulos, Krystal L. Cleven
and Jack B. Nitschke
Source: www.pnas.org/September 19, 2006
http://www.pnas.org/cgi/content/abstract/103/38/14200?etoc
© 2006 by The National Academy of Sciences of the USA
Prior research has shown memory is enhanced for emotional events. Key
brain areas involved in emotional memory are the amygdala and
hippocampus, which are also recruited during aversion and its
anticipation.
This study investigated whether anticipatory processes signaling an
upcoming aversive event contribute to emotional memory.
In an event-related functional MRI paradigm, 40 healthy participants
viewed aversive and neutral pictures preceded by predictive warning
cues.
Participants completed a surprise recognition task directly after
functional MRI scanning or 2 weeks later. In anticipation of aversive
pictures, bilateral dorsal amygdala and anterior hippocampus activations
were associated with better immediate recognition memory. Similar
associations with memory were observed for activation of those areas in
response to aversive pictures.
Anticipatory activation predicted immediate memory over and above
these associations for picture viewing. Bilateral ventral amygdala
activations in response to aversive pictures predicted delayed memory
only.
We found that previously reported sex differences of memory
associations with left amygdala for women and with right amygdala for
men were confined to the ventral amygdala during picture viewing and
delayed memory.
Results support an established animal model elucidating the functional
neuroanatomy of the amygdala and hippocampus in emotional memory,
highlight the importance of anticipatory processes in such memory for
aversive events, and extend neuroanatomical evidence of sex differences
for emotional memory.

INTERNATIONAL CONGRESS OF MUSIC & CONTEMPORARY TECHNOLOGIES
To whom correspondence should be addressed. E-mail:

jnitschke(at)wisc.edu
OutDoorLinks:
Jack B. Nitschke
http://psych.wisc.edu/Nitschke/
---
INTERNATIONAL CONGRESS OF MUSIC &

CONTEMPORARY TECHNOLOGIES
Seville, 12 to 16 December 2006
Source: http://www.congreso-musica.org
Presence and implication in current society
State of the question
* The preservation and restoration of the heritage
* Pedagogy and analysis
* Available technologies
* Interpretation and perception
* Sociology and aesthetics
Music technology experienced one of its most notable changes in the
20th century: from the era of mechanics and sound production through
the human body it evolved, firstly, towards electronic sound production
and later, towards digital technology. The first stage consisted of the
invention of musical instruments using the possibilities of electricity and
electronics (Theremin, Ondes Martenot, etc.) and later the use of
recording and reproduction methods for manipulating sound and
organising it in music that at first dispensed with the instrumental
presence. From this came the different currents that marked musical
thought as from the late 1940s: Concrete Music, Electronic Music, Tape
Music, Electro-acoustic music, Live-Electronics, Acousmatic Music,
Digital Music …
The second stage began with the possibility of producing digital sound, a
process that began in the late 1950s. This stage made what had
previously been a laborious task of controlling the performance of
frequently unstable machines that much easier, resulting in a more

precise control of the parameters that make up the sound and the
possibility of repeating the actions.
We had to wait for the technology to develop so as to be able to work on
the sound in all its complexity before digital technology would replace its
predecessor, analogue technology: in the early years we had to wait
several days to obtain the sound, but gradually we went from Recorded
time (as it was called) to Real time, in which the composer’s aims were
immediately audible.
In the long journey from the early sounds until today, the computer has
gone from being a tool difficult to control and confined to high
technology centres to being an everyday, accessible tool, adapted to all
spheres of human activity and easy to use.
This evolution, however, brought significant and in some cases
irreversible changes in the way we think and work in our society:
pedagogy, the role of music in science, music in practice, composition
and aesthetic concepts have all experienced changes and developments
that enable us to identify a clear turning point. Perhaps the most
significant fact is that, for the people who want to, it has never been
easier to be able to invent, create and compose music, or simply have fun
with sound.
This first congress provides us with not only a general introduction to the
technological problems in the musical field, but also the analysis and
understanding of the impact that technology has had and is having on
music today in all spheres of musical activity. It will also give us the
chance to get a glimpse of future perspectives and of the possible
challenges and needs that we will have to face.
The preservation and restoration of the heritage

Music is a richness that is valued with time, so it is therefore necessary to
preserve it, study it and restore it. Digital technologies have simplified
and aided in the preservation, cataloguing and restoration of this
accumulated richness. However, we run the great risk of losing the
greater part of this rich heritage that took shape as from the 1940s.
What are these risks? The selfsame fragility of the means by which the
information is preserved, the unstable technologies, the lack of
preservation centres and the difficulty in defining what should be
preserved. Which should be preserved: the recorded concert or the
computer program that enabled the final result to be obtained?

Music forms a unique patrimonial, cultural and educational asset: we

need to ensure that it becomes part of the process of the development of
society. There are initiatives, foreshadowing of centres and above all
musicological questioning, about which it is necessary to both preserve
and define the essential setting so that a modern piece of work, created
with innovative technology, can be preserved and restored in the future.
Herein lie two problems: how to ensure the long-term preservation of
almost 30,000 works composed since the 1940s and how, within the
framework of constantly evolving technology, to integrate the problem of
preservation of the works as a full part of its production process.
The ideal situation would be for the piece of work, on being created, to
produce its own memory, preserve the traces of its evolution, enabling at
the same time the preservation of the development of the composer’s
ideas.
What is at stake today is our memory, our comprehension of the past to
be able to project ourselves into the future, as well as the possibility of
being able to interpret and rediscover essential works for understanding
our current musical world. Alongside effective actions to ensure what
already exists is saved, it is necessary to undertake actions that enable
preservation to be something simple that does not interfere with the
creative process but which ensures perpetuity.
Pedagogy and analysis

Analysing and transmitting is the key to understanding and the
development of pleasure in music. Analysis enables the study of the ideas
and structures of music; pedagogy is the essential element for sharing and
developing auditory skills and the discovery of new musical worlds. Both
aspects are traditionally structured around the representative element of
the music, the score.
Musical practice, within the school setting, is mainly instrumental and
directed at developing the relationship between writing and playing. The
use of new technologies in music has had two major consequences: the
growing separation between the music that is heard and the music that is
studied, as well as the fact that musical practice using digital technology
has spread greatly among young people, something that, given that
practice is rudimentarily linked to creation, requires training related to
their concerns.
This has resulted in a big question: how can we analyse and teach when
the score disappears or when it is replaced by other means of

representation? The roots of musicological analysis are eroded, given that

the parameters of the object to be analysed are not the same and the
existing terminology and concepts cannot be easily applied. Inversely,
the object of teaching is much wider and teachers need new educational
concepts and analytical tools.
Music teaching becomes more interesting for educationalists and
students when technology is integrated into it. The contemporariness of
the object studied renews the position of music teaching, which has to
seek out complex compromises between music teaching of the past and
the modernity of musical practice. A similar situation arises in the field of
musical analysis, in which the study of contemporary works and
tendencies enables a greater understanding of the musical phenomenon
and greater integration into musical practice.
Available technologies
Technology is the central axis of the massive evolution of music over the
last sixty years. Technology in itself does not cause evolution, but rather
musicians include it in their work and propose new uses and functions. In
many cases, during the first decades, it was the musicians who proposed
new technological developments and it was they themselves who
produced them (synthesizers, computer programs, dedicated processors).
Technological innovation took place in the 1980s, when digital
technology began to be within everyone’s reach, in the centre of thought
and communication of musical creation, so much so that often the
technological device was better presented and described than the actual
piece of music.
Nevertheless, the fact that there is an extremely diversified technology
and that its use is relatively simple and within the reach of all has resulted
in evolution in the aesthetic field and in the richness of the work
produced; the technology is no longer more an element for judging the
work but rather an essential element in its existence.Today the situation
has changed dramatically: the technology is increasingly more complex
and its development increasingly in the hands of specialised companies,
with large technical set-ups and with commercial ends in sight.
It is in this context that the evolution of technology must be critically
thought about. There are very few centres specialising in contemporary
music today that are capable of conceiving, developing and above all
commercialising specific products in the long term.

This results in a growing separation between those that develop (big

companies) and those that use (composers and players). What are the
expectations of the creators in the technological setting? Do they agree
with the current situation regarding technologies or are they looking for
new tools? If this is the case, how can the conception of new systems be
brought closer to the innovative ambitions of the creators?
Interpretation and perception

The phenomenon of playing music is historically based on the fact that
on the one hand there is the creator and on the other, the listener, or the
audience.
This relationship has changed between them over the last decades: the
emergence of music created with new technology caused a situation
whereby the composer directed the work straight at the listener, without
intermediaries, in “acousmatic” concerts at which the listener attended a
show for the hearing.
In more recent cases, it is the listener, often called the “user”, who will
play a decision-making role in the way in which a musical phenomenon
passes. This is what is known as interactivity. In other words, the method
and the scope with which a user relates to a computer system.
However, this did not mean that the player disappeared: on the contrary,
new forms of playing were developed as traditional writing became more
complex, as a result of the integration of technological devices by the
players themselves, and due to the appearance of players of machines,
devices, computers and decks, in which the player function is doubled up
with that of the creator.
Alongside the evolution in the ways that the creator transmits to the
listener and the evolution in the concept of the concert, changes are
taking place in the way we perceptively face the musical phenomenon.
The universe of possible sounds for music has continually expanded to
the point where any sound is potentially useable in music. Our way of
listening and playing sound phenomena has changed dramatically: by
listening to music, our mind is open to all kinds of situations, sound or
visual, in which there are no distinctions between musical sounds and
noises, but acceptance, rejection, attraction or repulsion.
Philosophy has taken part in this situation: starting from the first ideas
regarding phenomenology, many thinkers, musicians and philosophers
have become interested in the problem of what we hear, how we hear and
how the brain goes from perception to sense, particularly in situations of

expansion and enrichment of possibilities in sound. Despite this, hearing

continues to be a mystery, particularly in matters relating to the creation
of the sense and the generation of pleasure.
Sociology and aesthetics

Technology, and the changes that have been introduced through it in
music production and transmission, has influenced the behaviour of
listeners and particularly the role of music in society. Music is not only
omnipresent, but it is consumed in any situation and circumstance and,
above all, consumed at all times. Sound reproduction systems surround
us in all the situations of daily life: to this is added the immediate legal or
illegal access to any type of music, which poses the question about a
change in the function of music and in its role in the development of
society.
Access to music is made through players and recordings: attendance at
concerts, although still important, is very small compared to the
circulation of recorded music. Perhaps this evolution can be interpreted,
the beginning of which would be situated with the appearance of music
created with recorders, as a development towards the listener’s autonomy
and their capacity to create the world of sound they yearn and dream for.
Nevertheless, while autonomy is developing, the need for and presence
of referents, myths, trends and other forms of identification and
differentiation are becoming increasingly more significant. The listener
often knows the technology required and is capable of controlling it, but
needs more the figure that goes beyond the technology, that which
expresses desires, longings and hopes.
As well as looking into the phenomena of popular music, we will be
discussing a multitude of musical theories, aesthetic currents and
attitudes towards sound and music. Despite the massive fragmentation of
musical currents, are there common denominators, identifiable
tendencies, currents of philosophical thought or aesthetic communities?
The answers will be contradictory, will depend on the cultural context,
the social context or simply the understanding that the listener has of
Music as an infinite universe.
OutDoorLinks:
Congress Website
http://www.congreso-musica.org
---

Empathy and the Somatotopic Auditory Mirror System in Humans
Empathy and the Somatotopic Auditory Mirror

System in Humans
By Valeria Gazzola, Lisa Aziz-Zadeh and Christian Keysers
Source: www.current-biology.com/19 September 2006
http://www.current-biology.com/content/article/abstract?uid=PIIS0960982206021178
Current Biology, Vol 16, 1824-1829, 19 September 2006
Summary
How do we understand the actions of other individuals if we can only
hear them?
Auditory mirror neurons respond both while monkeys perform hand or
mouth actions and while they listen to sounds of similar actions.
This system might be critical for auditory action understanding and
language evolution.
Preliminary evidence suggests that a similar system may exist in humans.
Using fMRI, we searched for brain areas that respond both during motor
execution and when individuals listened to the sound of an action made
by the same effector.
We show that a left hemispheric temporo-parieto-premotor circuit is
activated in both cases, providing evidence for a human auditory mirror
system.
In the left premotor cortex, a somatotopic pattern of activation was also
observed:
A dorsal cluster was more involved during listening and execution of
hand actions, and a ventral cluster was more involved during listening
and execution of mouth actions.
Most of this system appears to be multimodal because it also responds to
the sight of similar actions.
Finally, individuals who scored higher on an empathy scale activated this
system more strongly, adding evidence for a possible link between the
motor mirror system and empathy.
Corresponding author
Christian Keysers, Email: c.keysers(at)med.umcg.nl

Researchers find first evidence that musical training affects brain development
OutDoorLinks:
Christian Keysers
http://www.rug.nl/bcn/education/researchMaster/teachers/trackN/keysers
Valeria Gazzola
http://www.rug.nl/bcn/research/phdProjects/gToL/valeria-gazzola
Fachzeitschrift Current Biology
http://www.current-biology.com
---
Researchers find first evidence that musical

training affects brain development in young
children over the course of a year under
embargo
Source: www.alphagalileo.org/19 Sep 2006
Researchers have found the first evidence that young children who take
music lessons show different brain development and improved memory
over the course of a year compared to children who do not receive
musical training.
The findings, published today (20 September 2006) in the online edition
of the journal Brain (to get more, please read the attached PDF), show
that not only do the brains of musically-trained children respond to music
in a different way to those of the untrained children, but also that the
training improves their memory as well.
After one year the musically trained children performed better in a
memory test that is correlated with general intelligence skills such as
literacy, verbal memory, visiospatial processing, mathematics and IQ.
The Canadian-based researchers reached these conclusions after
measuring changes in brain responses to sounds in children aged between
four and six.

Over the period of a year they took four measurements in two groups of
children – those taking Suzuki music lessons and those taking no musical
training outside school – and found developmental changes over periods
as short as four months.
While previous studies have shown that older children given music
lessons had greater improvements in IQ scores than children given drama
lessons, this is the first study to identify these effects in brain-based
measurements in young children.
Dr Laurel Trainor, Professor of Psychology, Neuroscience and
Behaviour at McMaster University and Director of the McMaster
Institute for Music and the Mind, said:
“This is the first study to show that brain responses in young, musically
trained and untrained children change differently over the course of a
year. These changes are likely to be related to the cognitive benefit that is
seen with musical training.”
Prof Trainor led the study with Dr Takako Fujioka, a scientist at
Baycrest’s Rotman Research Institute.
The research team designed their study to investigate how auditory
responses in children matured over the period of a year, whether
responses to meaningful sounds, such as musical tones, matured
differently than responses to noises, and how musical training affected
normal brain development in young children.
At the beginning of the study, six of the children (five boys, one girl) had
just started to attend a Suzuki music school; the other six children (four
boys, two girls) had no music lessons outside school.
The researchers chose children being trained by the Suzuki method for
several reasons: it ensured the children were all trained in the same way,
were not selected for training according to their initial musical talent and
had similar support from their families.
In addition, because there was no early training in reading music, the
Suzuki method provided the researchers with a good model of how
training in auditory, sensory and motor activities induces changes in the
cortex of the brain.
Brain activity was measured by magnetoencephalography (MEG) while
the children listened to two types of sounds: a violin tone and a white
noise burst.
MEG is a non-invasive brain scanning technology that measures the
magnetic fields outside the head that are associated with the electrical
fields generated when groups of neurons (nerve cells) fire in synchrony.

When a sound is heard, the brain processes the information from the ears
in a series of stages.
MEG provides millisecond-by-millisecond information that tracks these
stages of processing; the stages show up as positive or negative
deflections (or peaks), called components, in the MEG waveform.
Earlier peaks tend to reflect sensory processing and later peaks,
perceptual or cognitive processing.
The researchers recorded the measurements four times during the year,
and during the first and fourth session the children also completed a
music test (in which they were asked to discriminate between same and
different harmonies, rhythms and melodies) and a digit span memory test
(in which they had to listen to a series of numbers, remember them and
repeat them back to the experimenter).
Analysis of the MEG responses showed that across all children, larger
responses were seen to the violin tones than to the white noise, indicating
that more cortical resources were put to processing meaningful sounds.
In addition, the time that it took for the brain to respond to the sounds
(the latency of certain MEG components) decreased over the year.
This means that as children matured, the electrical conduction between
neurons in their brains worked faster.
Of most interest, the Suzuki children showed a greater change over the
year in response to violin tones in an MEG component (N250m) related
to attention and sound discrimination than did the children not taking
music lessons.
Analysis of the music tasks showed greater improvement over the year in
melody, harmony and rhythm processing in the children studying music
compared to those not studying music.
General memory capacity also improved more in the children studying
music than in those not studying music.
Prof Trainor said: “That the children studying music for a year improved
in musical listening skills more than children not studying music is
perhaps not very surprising. On the other hand, it is very interesting that
the children taking music lessons improved more over the year on
general memory skills that are correlated with non-musical abilities such
as literacy, verbal memory, visiospatial processing, mathematics and IQ
than did the children not taking lessons.
The finding of very rapid maturation of the N250m component to violin
sounds in children taking music lessons fits with their large improvement
on the memory test.

It suggests that musical training is having an effect on how the brain gets
wired for general cognitive functioning related to memory and attention.”
Dr Fujioka added: “Previous work has shown assignment to musical
training is associated with improvements in IQ in school-aged children.
Our work explores how musical training affects the way in which the
brain develops.
It is clear that music is good for children’s cognitive development and
that music should be part of the pre-school and primary school
curriculum.”
The next phase of the study will look at the benefits of musical training in
older adults.
OutDoorLinks:
The Study:
One year of musical training affects development of auditory cortical-evoked fields
in young children
Read Attached PDF
Laurel Trainor
http://www.psychology.mcmaster.ca/ljt/
Takako Fujioka
http://www.zoominfo.com/search/PersonDetail.aspx?PersonID=1061574593
Suzuki method
http://www.suzuki-music.com/

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Music Therapy Today

a quarterly journal of studies in music and

Volume VII, Issue 4 (December 2006)

David Aldridge & Jörg Fachner (eds.)

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Music Therapy Today i

Volume VII, Issue 4 (December 2006) i

Table of contents vii

Research in practice 781

Beyond Body, Beyond Words: Cognitive analytic music therapy in

Melody and Rhythm – ‘Indianness’ in Indian music and music ther-

Just sing… 913

Report on a research meeting 2006 in Berlin: “Music Therapy as Ap-

“My Top Ten” 944

Odds and ends - themes and trends 947

Editorial Music Therapy

Welcome to the new issue of „Music Therapy Today“!

Stella Compton Dickinson leads us into her work in Rompton Hospital in

psychotherapy intervention that included attuned musical improvisation

The article “Melody and Rhythm – ‘Indianness’ in Indian music and

moderate learning disability and savant calendrical skills. He had become

Another article based on a presentation at the 3rd Nordoff/Robbins Music

On 19 November 2006, the IMB, International Music Therapy Institute

Applied in Neurology”. Karolin Pfeffer reports on presentations by

David Aldridge and Lutz Neugebauer have initiated a new research

And finally, Odds and ends presented by Tom Doch.

Merry Christmas and a happy new year

Aldridge, D. (1996). Music therapy and research in medicine - from out

Aldridge, D. (2004). The reflective practitioner in a community of

Smeijsters, H. (2006) Research in practice. Music Therapy Today (Online 22nd

‘The novel The curious incident of the dog on the Night-Time

Research in practice remains close to questions encountered by Arts

Social science, as it has developed from traditional physical scientific

In research on therapy, this difference in approach is expressed in differ-

In addition, those approaches are expressed in different opinions on evi-

This article pursues the question how practice-relevant knowledge can

universities where mental health professionals are trained1. This article

ods. It is meant to work out typical characteristics of different

Research results are not applied in practice automatically, this is meant

The university of professional education as a “gate of

The university of professional education as a “gate of knowledge” 784