Presented at MedArt International World Congress on Arts and Medicine, February 28, 1992
Proceedings: Current Research in Arts Medicine, A Cappella Books, 1993
Abstract: Southern Medical Journal, 85:2, Supplement 1
Copyright ©1991,92 by Barbara S.J. Balch and Dennis Báthory-Kitsz
The potency of musical memory, especially early musical memory, is undisputed. Fully orchestrated musical material is stored in the minds of people with little or no musical training; such music can be drawn complete and undisturbed from childhood, as Sacks1 has popularly discussed.
We propose the development of a new branch of diagnosis and therapy offering music as a replacement for lost language, and using music to assess type and depth of loss, the progression of loss in disease, and as a prognostic indicator following injury.
Such a proposal is sweeping, and with serious obstacles at the very level of the definition of music. Stravinsky2 called the song of a bird the promise of music, where Ohno3 playfully suggests that both bird and human tunes are governed by a "heirarchy of periodicities." Peretz4 claims that autonomous brain systems process the melody and rhythm of music, but Laudon5 speaks only of the magic of music and healing. Of course, therapeutically, via music per se there is participation, human contact, and a renewed or new language. Music is joy, capability, and power -- these ideas exquisitely expressed in Dennisonís novel6. Largely because of these strengths (and these mysteries), many have attempted to use music as therapy (alas, too often by playing music at people) with almost no understanding of music, its therapeutic mechanisms, or, indeed, what it communicates emotionally or conceptually.
To understand music as a replacement for lost language, then, a deeper respect for musicís communicative substance is essential. Music, while culturally dependent, is a singular model in universality of emotional expression. Clynes7 has demonstrated the rudiments of a biological, cross-cultural melodic expression, in a convincing manner far from Ohnoís amusingly irreverant DNA-to-Bach transformations. Referring to emotionally communicative music, Clynes states, "The more precisely you perform it, the more it conforms to a biologic form, the more convincing, the more eloquent, the more contagious it is to convince others to change the state of feeling in the other person."
We counterpoint Clynes, Laudon, Peretz and Stravinsky to suggest that, first, through music it is possible to explore the relationship between expression and cognition, which will in turn provide some sense of what exists inside one who has lost the usual, measurable cognitive functions; in other words, "whatís it like in there?". From a practical viewpoint, music is heard even in a comatose state.
Several researchers (for example, LaBarba8, Peretz and others) have noted clear shifts in brain hemisphere dominance and ear advantage among trained musicians. Secondly, then, we propose that learning music both as music and as language be explored through these questions: Can music retard the march of senility? Can music differentiate depression from organic disintegration? Can music touch those reaches of human experience remaining after horrifying injury, and invite recovery? Our premise is that music can, and further, that music, alone, can.
The potential is both diagnostic and therapeutic. Research assumes that disorganization/disorientation of dementia happens by stages, at a different rate and following a different path for each person (except when due to trauma, stroke, or other paroxysmal insult).
One possibility is that implementing this approach would retard the process of disintegration. If enough of a pattern can be evolved -- and such patterning is supported by LaBarba -- from an individual in the early stages of loss, perhaps it can be retarded before the onset of advanced senility. If loss of function happens little by little, then based on responses it might be possible to tell not only how far but in what areas this loss progresses. Further, it might be useful to differentiate physiologic disintegration from depression and other psychiatric kinds of deviations. With a human approach, this may yield surprising cultural enlightment about our age that we are so sickeningly missing.
There is the possibility that the "recentness" of the cognitive or memory loss would not be important, as musical memory is stored wholesale. Thus the diagnosis and therapy may help with, for example, a 16-year-old accident victim. (However, it is possible that life experience and maturity may be required before certain musical material could be integrated, as Peretz states in her methodology.)
Studies have shown the integrity of an individualís musical memory despite severe physiologic assault. Gardner9 has called music a "relative island of preservation in a sea of impairments," in speaking of retarded or autistic children. While many studies have sought to identify, usually via "fractionalized" assays, the human brainís means for integrating music into experience, our purpose is to discover how to let music substitute wholesale as an individual language. In fact, Gardner states, "Music seems, sui generis, just like natural language."
To implement the subsititution of music for lost language, we propose the following methodology:
Preparation: Progress in equipment used for virtual reality as reported by Stedman10 will guide the somewhat simpler requirements of this proposal, i.e., the equipment used will be for the manipulation of real people (musicians) -- manipulated, if you will, by people who have no other means to do it. Initially, the requirements will be for the most appropriate among hand sensors (gloves, balls), comfortable EEG equipment, galvanic skin sensors, eye switches, and cardiovascular sensors.
Following the development of this new hardware and the modification or adaptation of existing virtual reality equipment, the research would proceed in three steps.
Stage One: A single-blind routine is established to test the validity of sensing and feedback equipment, the viability of the premise where conditions are known, and the sensitivity of musicians and composers to the client. Among the musical techniques employed will be familiar music, voices, acoustic instruments, perfect-fifth resonances, and improvisation. Synthesizers (in the guise of "virtual musicians") will form a part of Stage Two.
Stage Two: Personal history is researched on the clientís contact with music, a menu of simple orchestrated musical material (together with bridges and modulations) is developed, a group of live performers is organized, and the feedback equipment and sensors (especially gloves) are provided. The playing is done in a comfortable, familiar environment. The musicians play through the menu, checking responses (as learned in Stage One). The menu is narrowed based on the responsive "participation"; eventually, a composition is developed with the main themes and bridges that are specific to the client. This is the music of communication to the client, who is then provided with comfortable controllers (foam balls, eye switches) which may be used to control virtual-reality synthesizers (i.e., virtual musicians); the client can play along with this music. As it progresses, all play together. Musicians gradually yield "solos" to the client, and a call-and-response pattern is evoked. Eventually the client can improvise and compose as a method of communication, totally replacing the damaged verbal, visual or other motor responses.
Stage Three: As the individual communication is perfected from client to client, the "noise" may be analyzed and dropped out, and common cultural/musical experiences remain from which to create communal music and communication. The group vs. individual dichotomy is bridged as this form of language becomes more common.
The authors wish to point out that this research must be done with care and be extremely personal or it will be both unsuccessful and inhumane. It is proposed so that those with language loss may be given back, in an alternative way, the power of communication and community. The musicians will have to understand the clientsí life and experience, and through this new language, they will be as strangers suddenly becoming close friends. There must be no experiment-on, play-at mentality at work; the participants will share memory and a unique language. What each knows, all will know of each other. This is not just "old people making music together" -- it is new life.