Music as a coping strategy

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Music as a coping strategy involves the use of music (through listening or playing music) in order to reduce stress, as well as many of the psychological and physical manifestations associated with it. The use of music to cope with stress is an example of an emotion-focused, adaptive coping strategy. Rather than focusing on the stressor itself, music therapy is typically geared towards reducing or eliminating the emotions that arise in response to stress. In essence, advocates of this therapy claim that the use of music helps to lower stress levels in patients, as well as lower more biologically measurable quantities such as the levels of epinephrine and cortisol. [1] Additionally, music therapy programs have been repeatedly demonstrated to reduce depression and anxiety symptoms in the long term. [2]

Contents

Major theories

In the context of psychology, a coping strategy is any technique or practice designed to reduce or manage the negative effects associated with stress. While stress is known to be a natural biological response, biologists and psychologists have repeatedly demonstrated that stress in excess can lead to negative effects on one's physical and psychological well-being. [3] Elevated stress levels can lead to conditions including mental illnesses, cardiovascular conditions, eating disorders, gastrointestinal complications, sexual dysfunction, and skin and hair problems. [4] The variety and potential fatality from these conditions push the need for a coping mechanism to reduce the manifestations associated with stress.

While there are hundreds of different coping strategies, the use of music is one specific example of a coping strategy that is used to combat the negative effects of stress. [5] Due to the substantially large number of strategies to choose from, psychologists break down coping strategies into three types: [6]

  1. Appraisal-based - Intended to modify the individual's thought process Stress is typically eliminated through rationalization, changes in values or thinking patterns, or with humor.
  2. Problem-based - Targets the cause of the stress. The process could either involve eliminating or adapting to a stressor in order to cope. An example of a problem based strategy is time management.
  3. Emotion-based - Geared towards influencing one's emotional reactions when stressed. Meditation, distractions, or the release of emotion are all forms of emotion-based coping strategies. Mindfulness-based stress reduction is another example of this, as it is a more personal reflection based aspect of coping. [7]

Since music-based coping is designed to modify an individual's emotional reactions to a certain event, it is best classified as an emotion-based coping strategy. Rather than attempting to directly influence or eliminate a particular stressor, music-based coping relies on influencing an individual's emotional and mental reaction to the stressor. Music assuages stress by either reducing or altering emotional response or alleviate some of the physiological effects of the stress response.

Major empirical findings

Psychologists and medical practitioners have recently focused more time and attention on the concept of music as a coping strategy and the effects of its use on patients. In literature linking music and stress, empirical findings are typically grouped together according to the method in which they are gathered. For example, some methods may include studies like survey questions or more invasive methods of study like invasive psychoacoustic observations. Despite the fact that different methods are used, most of these studies demonstrate the impact different types of music have on human emotions. [8]

Patient response-based findings

One of the more popular methods used to collect data on coping strategies involves the use of non-invasive, patient response-based methods. This method is directed more towards the psychological realm, in that the methods used to collect data were not very invasive but more of a “tell me how you feel” type of question/response system. [9] Once the findings had been gathered, statistical analysis was performed in an effort to discover a correlation between the coping mechanism and its effect on the stress response. These non-invasive treatments are more popular among children and elderly patients, since they prevent the results from being altered due to the patients's nervousness. Proponents of these methods claim that if children are prompted with general, unthreatening questions, they are much more comfortable and willing to provide accurate accounts of their levels of stress. In several studies using non-invasive methods, music has been documented as being effective in reducing the subject's perceived level of stress.

Music and effects on psychological trauma

Posttraumatic stress disorder (PTSD) is a psychological stress disorder that involves the experience of strong emotional reactions due to traumatic events in an individual's past. PTSD is almost always a result of a traumatic experience. Certain triggers, such as images, sounds, or other significant sensory details associated with the experience can evoke extreme stress responses, panic attacks, or severe anxiety. PTSD is commonly experienced by veterans of armed conflicts, and can be frequently diagnosed in victims of rape or other violent assaults. [10]

If an individual diagnosed with PTSD associates a certain song with a traumatic memory, it typically triggers a stronger stress/anxiety response than the individual would otherwise have otherwise experienced when listening to the song. [11] While one cannot assume that music is the only factor that triggers PTSD-influenced stress and panic attacks, these can be especially memorable because of music's rhythm, beat, and/or memorable lyrics. However, associating music with psychological responses is not necessarily guaranteed to bring up bad memories, because music can often hold psychological connotations to very happy memories. For example, it has been demonstrated that supplying the residents of nursing homes with iPods that feature nostalgic music is a means of reducing the stress of the elderly. [12]

Music has been used to treat dementia patients by utilizing methods similar to the treatments that are used in the management of PTSD. However, in the treatment of dementia, more emphasis is placed on providing the patient with music that triggers pleasant memories or feelings, rather than avoiding music that triggers negative emotions. [11] After the music is listened to, one sees the change in mood and attitude from closed and distant to joyful, open and happy.

There is a wealth of anecdotal evidence demonstrating the effectiveness that music can have as a coping response in this regard. For example, if a patient of either PTSD or dementia were to have a loved one die, he or she might associate a certain song with the person being mourned for, and hearing that song could bring about feelings of happiness or deep sadness. In addition, if there was a certain connection between them, such as in marriage, and their wedding song came on, an overly powerful emotional reaction could occur. These overly emotional situations trigger memories and a stress response that anguishes the person remembering these hurtful memories. A certain song that pertains to that memory can trigger nearly any emotion.

Music's effects on dementia patients have shown to bring them out of their shell, and engage them in singing and being happy, opposed to their usual closed and distant personalities. [13] The patients have been shown to sing and perk up, even cry out of pure joy of the music that they loved in their youth. After the patients listen to their music they were interviewed and actually engaged, because of how happy the music had made them. The patients talked about how much they loved the music and the memories that the music invoked. [11]

Stress and music in the medical field

The use of music as a coping strategy also has applications in the medical field. For example, patients who listen to music during surgery or post-operative recovery have been shown to have less stress than their counterparts who do not listen to music. [14] Studies have shown that the family members and parents of the patient had reduced stress levels when listening to music while waiting, and can even reduce their anxiety for the surgery results. [15] The use of music has also been proven effective in pediatric oncology. [16] Music therapy is mainly used in these cases as a diversion technique, play therapy, designed to distract the patient from the pain or stress experienced during these operations. The focus of the patient is directed at a more pleasurable activity and the mind shifts toward that activity creating a “numbing” effect founded on an “out of sight, out of mind” type approach. This can even transcend to elderly patients in nursing homes and adult day care centers. Music therapy in these places have shown reductions in elder aggression and agitated moods. [15] However, because several of these studies rely mainly on patient responses, some concerns have been raised as to the strength of the correlation between music and stress reduction. [17]

Music as a form of coping has been used multiple times in cancer patients, with promising results. A study done on 113 patients going through stem cell transplants split the patients into two group; one group made their own lyrics about their journey and then produced a music video, and the other group listened to audiobooks. The results of the study showed that the music video group had better coping skills and better social interactions in comparison, by taking their mind of the pain and stress accompanying treatment, and giving them an outlet to express their feelings. [18]

Another study done at UNC showed remarkable improvement in a young girl who was born without the ability to speak. A therapist would come in and sing with her, as the only thing she could do was sing. Miraculously, the singing allowed to her gain the ability of speech, as music and speech are similar in nature and help the brain form new connections. [19] In the same hospital, the therapist visits children daily and plays music with them, singing and using instruments. The music fosters creativity and reduces stress associated with treatments, and takes the children's minds off of their current surroundings.

It also cannot be ignored the importance of coping strategies in families and caregivers of those going through serious and even terminal illness. These family members are often responsible for a vast majority of the care of their loved ones, on top of the stress of seeing them struggle. Therapists have worked with these family members, singing and playing instruments, to help them take their minds off of the stress of helping their loved ones undergo treatment. Just like in the patients themselves, the music therapy has been shown to help them cope with the intense emotions and situations they deal with on a daily basis. [20] [ self-published source? ]

Physiological findings

Other studies, which use more invasive techniques to measure the response of individuals to stress, demonstrate that the use of music can mitigate many of the physiological effects often associated with the stress response - such as a lowering of blood pressure or a decrease in heart rate. [14] [21] Most research associated with the use of music as a coping strategy makes use of empirical measurements through devices like an EKG or heart rate monitor in order to provide a stronger correlation between music and its proposed effects on the stress response. [14] In these studies, subjects are typically exposed to a stressor and then assigned music to listen to, while the parties conducting the study measure changes in the subjects' physiological status.

Some studies, using more invasive physiological research methods, have demonstrated that the use of sedative music or preferred sedative music cause a decrease in tension and state-anxiety levels of adult individuals. [22] This decrease in tension or feeling of anxiety is more prevalent and noticeable in the attempt to return to homeostasis, and shows far less effectiveness during the actual stressful event. [14] Other studies expose their subjects to an immediate physical stressor, such as running on a treadmill, while having them listen to different genres of music. These studies have shown that the respiratory rates of the participants are increased when they listen to faster, upbeat music while running in comparison to no music or sedative music. [23] In addition to the raised respiratory frequency caused by the initial stressor "running" music still had a noticeable physiological effect on the participants.

By and large, a collective review of these studies shows that music can be effective in reducing physiological effects that stress has on the human body. This can be anywhere from changing pulse rates, breathing rates, to even decreasing the occurrence of fatigue. This can even be seen in different tempo's and pitch, such as low pitch creates a relatively calming effect on the body whereas high pitch tends to generate stressors for the body. [15] Furthermore, it has been suggested that if a patient can control the music that he or she listens to in the recovery process, then the return to normalcy happens at a much faster, more efficient rate than if the subject was assigned a music genre that he or she did not find appealing. [1] With the use of the EKG monitor and other empirical methods of study, researchers are able to remove the superficial qualities associated with patient response-based findings and provide a more substantial correlation between the use of music and its effects on the human stress response. [14]

Specific techniques

One particular technique that uses music as a coping strategy is choosing and listening to music genres that have been shown to correlate with lower levels of stress. For example, it has been suggested that listening to classical music or self-selected music can lower stress levels in adult individuals. [1] Music that is fast, heavy or even dark in nature may produce an increase in these same stress levels, however many people also find the cathartic effects of music to be intensified with the listening of music that is intense in such a way. Ambient music is a genre of music that is often associated with feelings of calmness or introspectiveness. While listening to self-selected genres, an individual is provided with a sense of control after choosing the type of music he or she would like to listen to. In certain situations, this choice can be one of the few moments where stressed and depressed individuals feel a locus of control over their respective lives. Introducing the feeling of control can be a valuable asset as the individual attempts to cope with his or her stress.

With that in mind, there are a few specific techniques specifically involving the use of music that have been suggested to aid in the reduction of stress and stress-related effects. [9]

Another specific technique that can be used is the utilization of music as a “memory time machine” of sorts. In this regard, music can allow one to escape to pleasant or unpleasant memories and trigger a coping response. It has been suggested that music can be closely tied to re-experiencing the psychological aspects of past memories, so selecting music with positive connotations is one possible way that music can reduce stress. [9]

A technique that is starting to be employed more often is vibroacoustic therapy. During therapy the patient lies on his/her back on a mat with speakers within it that send out low frequency sound waves, essentially sitting on a subwoofer. This therapy has been found to help with Parkinson's disease, fibromyalgia, and depression. Studies are also being conducted on patients with mild Alzheimer's disease in hopes to identify possible benefits from vibroacoustic therapy. [24] Vibroacoustic therapy can also be used as an alternative to music therapy for the deaf.

Controversies

Several of the empirical studies carried out to demonstrate the correlation between listening to music and the reduction in the human stress response have been criticized for relying too heavily on a small sample size. [17] Another criticism of these studies is that they have been carried out in response to no stressor in particular. These critics claim that because no specific stressor is identified in many of these studies, it is somewhat difficult to identify whether the stress response was lessened by music or by some other means. [25]

A more theoretical critique of this coping strategy is that the use of music in stress coping is largely a short-term coping response and therefore lacks long-term sustainability. These critics argue that while music may be effective in lowering perceived stress levels of patients, it is not necessarily making a difference on the actual cause of the stress response. [26] Because the root cause of the stress is not affected, it is possible that the stress response may return shortly after therapy is ended. Those who hold this position advocate instead for a more problem-focused coping strategy that directly deals with the stressors affecting the patient.

Conclusion

The use of music as a stress coping strategy has a demonstrated effect on the human response to stress. The use of music has been proven to lower the perceived levels of stress in patients, while greatly reducing the physical manifestations of stress as well– such as heart rate, blood pressure, or levels of stress hormones. It seems as though different types of music have different effects on stress levels, with classical and self-selected genres being the most effective. However, despite demonstrated effectiveness in empirical studies, there are many who still question the effectiveness of this coping strategy. Nevertheless, it is still an attractive option for some patients who want an easy and inexpensive way to respond to stress.

See also

Related Research Articles

Stress management is a wide spectrum of techniques and psychotherapies aimed at controlling a person's level of stress, especially chronic stress, usually for the purpose of improving everyday functioning. Stress produces numerous physical and mental symptoms which vary according to each individual's situational factors. These can include a decline in physical health, such as headaches, chest pain, fatigue, and sleep problems, as well as depression. The process of stress management is named as one of the keys to a happy and successful life in modern society. Life often delivers numerous demands that can be difficult to handle, but stress management provides a number of ways to manage anxiety and maintain overall well-being.

<span class="mw-page-title-main">Dialectical behavior therapy</span> Psychotherapy for emotional dysregulation

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that began with efforts to treat personality disorders and interpersonal conflicts. Evidence suggests that DBT can be useful in treating mood disorders and suicidal ideation, as well as for changing behavioral patterns such as self-harm and substance use. DBT evolved into a process in which the therapist and client work with acceptance and change-oriented strategies, and ultimately balance and synthesize them—comparable to the philosophical dialectical process of thesis and antithesis followed by synthesis.

<span class="mw-page-title-main">Nightmare disorder</span> Medical condition

Nightmare disorder, also known as dream anxiety disorder, is a sleep disorder characterized by frequent nightmares. The nightmares, which often portray the individual in a situation that jeopardizes their life or personal safety, usually occur during the REM stages of sleep. Though most people have experienced at least one nightmare during their life, subjects with nightmare disorder experience them with a greater frequency. The disorder's DSM-IV number is 307.47.

Psychological trauma, mental trauma or psychotrauma is an emotional response to a distressing event or series of events, such as accidents, rape, or natural disasters. Reactions such as psychological shock and psychological denial are typical. Longer-term reactions include unpredictable emotions, flashbacks, difficulties with interpersonal relationships and sometimes physical symptoms including headaches or nausea.

Coping refers to conscious strategies used to reduce unpleasant emotions. Coping strategies can be cognitions or behaviours and can be individual or social.

Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy developed by Francine Shapiro in the 1980s that was originally designed to alleviate the distress associated with traumatic memories such as post-traumatic stress disorder (PTSD). In EMDR, the person being treated recalls distressing experiences whilst doing bilateral stimulation, such as side-to-side eye movement or physical stimulation, such as tapping either side of the body.

<span class="mw-page-title-main">Art therapy</span> Creation of art to improve mental health

Art therapy is a distinct discipline that incorporates creative methods of expression through visual art media. Art therapy, as a creative arts therapy profession, originated in the fields of art and psychotherapy and may vary in definition.

Acute stress disorder is a psychological response to a terrifying, traumatic or surprising experience. It may bring about delayed stress reactions if not correctly addressed.

<span class="mw-page-title-main">Emotional reasoning</span>

Emotional reasoning is a cognitive process by which an individual concludes that their emotional reaction proves something is true, despite contrary empirical evidence. Emotional reasoning creates an 'emotional truth', which may be in direct conflict with the inverse 'perceptional truth'. It can create feelings of anxiety, fear, and apprehension in existing stressful situations, and as such, is often associated with or triggered by panic disorder or anxiety disorder. For example, even though a spouse has shown only devotion, a person using emotional reasoning might conclude, "I know my spouse is being unfaithful because I feel jealous."

<span class="mw-page-title-main">Acquired brain injury</span> Brain damage caused by events after birth

Acquired brain injury (ABI) is brain damage caused by events after birth, rather than as part of a genetic or congenital disorder such as fetal alcohol syndrome, perinatal illness or perinatal hypoxia. ABI can result in cognitive, physical, emotional, or behavioural impairments that lead to permanent or temporary changes in functioning. These impairments result from either traumatic brain injury or nontraumatic injury derived from either an internal or external source. ABI does not include damage to the brain resulting from neurodegenerative disorders.

Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the target patient to the anxiety source or its context without the intention to cause any danger (desensitization). Doing so is thought to help them overcome their anxiety or distress. Procedurally, it is similar to the fear extinction paradigm developed for studying laboratory rodents. Numerous studies have demonstrated its effectiveness in the treatment of disorders such as generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), and specific phobias.

Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children with mothers who have experienced traumatic or stressful events during pregnancy can increase the child's risk of mental health disorders and other neurodevelopmental disorders. Kaiser Permanente and the Centers for Disease Control and Prevention's 1998 study on adverse childhood experiences determined that traumatic experiences during childhood are a root cause of many social, emotional, and cognitive impairments that lead to increased risk of unhealthy self-destructive behaviors, risk of violence or re-victimization, chronic health conditions, low life potential and premature mortality. As the number of adverse experiences increases, the risk of problems from childhood through adulthood also rises. Nearly 30 years of study following the initial study has confirmed this. Many states, health providers, and other groups now routinely screen parents and children for ACEs.

Memory and trauma is the deleterious effects that physical or psychological trauma has on memory.

In psychology, avoidance coping is a coping mechanism and form of experiential avoidance. It is characterized by a person's efforts, conscious or unconscious, to avoid dealing with a stressor in order to protect oneself from the difficulties the stressor presents. Avoidance coping can lead to substance abuse, social withdrawal, and other forms of escapism. High levels of avoidance behaviors may lead to a diagnosis of avoidant personality disorder, though not everyone who displays such behaviors meets the definition of having this disorder. Avoidance coping is also a symptom of post-traumatic stress disorder and related to symptoms of depression and anxiety. Additionally, avoidance coping is part of the approach-avoidance conflict theory introduced by psychologist Kurt Lewin.

The management of traumatic memories is important when treating mental health disorders such as post traumatic stress disorder. Traumatic memories can cause life problems even to individuals who do not meet the diagnostic criteria for a mental health disorder. They result from traumatic experiences, including natural disasters such as earthquakes and tsunamis; violent events such as kidnapping, terrorist attacks, war, domestic abuse and rape. Traumatic memories are naturally stressful in nature and emotionally overwhelm people's existing coping mechanisms.

<span class="mw-page-title-main">Effects of stress on memory</span> Overview of the effects of stress on memory

The effects of stress on memory include interference with a person's capacity to encode memory and the ability to retrieve information. During times of stress, the body reacts by secreting stress hormones into the bloodstream. Stress can cause acute and chronic changes in certain brain areas which can cause long-term damage. Over-secretion of stress hormones most frequently impairs long-term delayed recall memory, but can enhance short-term, immediate recall memory. This enhancement is particularly relative in emotional memory. In particular, the hippocampus, prefrontal cortex and the amygdala are affected. One class of stress hormone responsible for negatively affecting long-term, delayed recall memory is the glucocorticoids (GCs), the most notable of which is cortisol. Glucocorticoids facilitate and impair the actions of stress in the brain memory process. Cortisol is a known biomarker for stress. Under normal circumstances, the hippocampus regulates the production of cortisol through negative feedback because it has many receptors that are sensitive to these stress hormones. However, an excess of cortisol can impair the ability of the hippocampus to both encode and recall memories. These stress hormones are also hindering the hippocampus from receiving enough energy by diverting glucose levels to surrounding muscles.

PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.

For patients with Alzheimer's disease, music therapy provides a beneficial interaction between a patient and an individualized musical regimen and has been shown to increase cognition and slow the deterioration of memory loss. Music therapy is a clinical and evidence-based intervention that involves music in some capacity and includes both a participant and a music therapist who have completed an accredited music therapy program.

Psychosensory therapy is a form of therapeutic treatment that uses sensory stimuli to affect psychological and emotional health. In addition, psychosensory therapy is a group of therapeutic techniques that involves applying sensory inputs to treat various behaviors, mood, thoughts, symptoms, and pain. Psychosensory therapy has its roots in traditional Chinese medicine in addition to energy psychology. Some important figures in psychosensory therapy include chiropractor George Goodheart, psychiatrist John Diamond, clinical psychologist Roger Callahan, and Ronald Ruden.

Post-traumatic stress disorder (PTSD) can affect about 3.6% of the U.S. population each year, and 6.8% of the U.S. population over a lifetime. 8.4% of people in the U.S. are diagnosed with substance use disorders (SUD). Of those with a diagnosis of PTSD, a co-occurring, or comorbid diagnosis of a SUD is present in 20–35% of that clinical population.

References

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  12. ↑ Music and Memories[ full citation needed ]
  13. ↑ "For Elders with Dementia, Musical Awakenings". NPR.org.
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  15. 1 2 3 Kent, Dawn (1 April 2006). The Effect of Music on the Human Body and Mind (Thesis).
  16. ↑ Standley, Jayne M.; Hanser, Suzanne B. (1 January 1995). "Music Therapy Research and Applications in Pediatric Oncology Treatment". Journal of Pediatric Oncology Nursing. 12 (1): 3–8. doi:10.1177/104345429501200103. PMID   7893459. S2CID   24722146.
  17. 1 2 Thoma, Myriam V.; La Marca, Roberto; Brönnimann, Rebecca; Finkel, Linda; Ehlert, Ulrike; Nater, Urs M. (5 August 2013). "The Effect of Music on the Human Stress Response". PLOS ONE. 8 (8): e70156. Bibcode:2013PLoSO...870156T. doi: 10.1371/journal.pone.0070156 . PMC   3734071 . PMID   23940541.
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  23. ↑ Brownley, Kimberly A.; McMurray, Robert G.; Hackney, Anthony C. (April 1995). "Effects of music on physiological and affective responses to graded treadmill exercise in trained and untrained runners". International Journal of Psychophysiology. 19 (3): 193–201. doi:10.1016/0167-8760(95)00007-f. PMID   7558986.
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