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Oper und Neurowissenschaft: Ein historischer Ansatz und seine heutige Relevanz
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This article outlines the historical evolution and precursors of modern music therapy in Vienna from c. 1820 to 1960. The first section describes early attempts to purposefully integrate music into Viennese psychiatry and highlights the groundbreaking work of Bruno Goergen (1777–1842), who around the year 1820 deliberately incorporated music into psychiatric institutions based on his dedication to the ideals of “moral treatment” and “no-restraint” psychiatry. Shortly thereafter, the first medical dissertations on the therapeutic effect of music began to be published in Vienna. Around 1850, the emergence of an “active” form of “music therapy” (in the broadest sense) is recognizable; during the same time period, physicians began taking their patients’ musical preferences, education, and disposition into account. However, as university medicine became firmly rooted in the standards of experimental science, physicians increasingly lost their interest in music. The second section gives an overview of several cultural movements that emerged in the first half of the twentieth century and inspired the pioneers of music therapy in Vienna, paving the way for the foundation of modern Viennese music therapy in 1958. Among these were the life reform movement, the curative rhythm and dance movement, and anthroposophy, as well as psychotherapy and progressive music-educational concepts. At the conclusion of this article, the main traits of the history of music therapy in Vienna and some of the pervading premises of Viennese music therapy are summarized.
Purpose
The performing arts mirror the human condition. This study sought to analyze the reasons for inclusion of visually impaired characters in opera, the cause of the blindness or near blindness, and the dramatic purpose of the blindness in the storyline.
Methods
We reviewed operas from the 18th century to 2010 and included all characters with ocular problems. We classified the cause of each character’s ocular problem (organic, nonorganic, and other) in relation to the thematic setting of the opera: biblical and mythical, blind beggars or blind musicians, historical (real or fictional characters), and contemporary or futuristic.
Results
Cases of blindness in 55 characters (2 as a choir) from 38 operas were detected over 3 centuries of repertoire: 11 had trauma-related visual impairment, 5 had congenital blindness, 18 had visual impairment of unknown cause, 9 had psychogenic or malingering blindness, and 12 were symbolic or miracle-related. One opera featured an ophthalmologist curing a patient.
Conclusions
The research illustrates that visual impairment was frequently used as an artistic device to enhance the intent and situate an opera in its time.
Baroque religious music was composed and performed to stimulate devotion as well as the inspire passion through the theatricality of the religious ritual including the processional arrangements which worked in tandem with the performance practices based on strong emotional delivery. The current project aimed to re-imagine historical emotional affect through a pasticcio performance of Baroque works focused on the Easter Passion and Resurrection delivering the narrative with enactment. The project was also conceived to deliver broader social justice messages allied to displaced and misunderstood peoples of different religious and cultural backgrounds. In this paper, the audience is invited to spectate a performance of Passion, Lament, Glory, staged at St Paul’s Cathedral, Melbourne just before Easter 2017. They are invited to share in the background to the work and read about audience responses to the live performance. These responses are reflected upon in terms of the empathic, cathartic and applied outcomes of the performance on the audience.
Compiling a wealth of international evidence-based practice, this book offers detailed descriptions of clinical methods that are grounded in research. Chapters are grouped into structured and unstructured approaches for use with clients of all ages. This book will be invaluable for any student, practitioner or researcher exploring voicework.
Music listening and music making activities are powerful tools to engage multisensory and motor networks, induce changes within these networks, and foster links between distant, but functionally related brain regions with continued and life-long musical practice. These multimodal effects of music together with music's ability to tap into the emotion and reward system in the brain can be used to facilitate and enhance therapeutic approaches geared toward rehabilitating and restoring neurological dysfunctions and impairments of an acquired or congenital brain disorder. In this article, we review plastic changes in functional networks and structural components of the brain in response to short- and long-term music listening and music making activities. The specific influence of music on the developing brain is emphasized and possible transfer effects on emotional and cognitive processes are discussed. Furthermore, we present data on the potential of using musical tools and activities to support and facilitate neurorehabilitation. We will focus on interventions such as melodic intonation therapy and music-supported motor rehabilitation to showcase the effects of neurologic music therapies and discuss their underlying neural mechanisms.
© 2015 Elsevier B.V. All rights reserved.
The management of patients with Alzheimer's disease is a significant public health problem given the limited effectiveness of pharmacological therapies combined with iatrogenic effects of drug treatments in dementia. Consequently, the development of nondrug care, such as musical interventions, has become a necessity. The experimental rigor of studies in this area, however, is often lacking. It is therefore difficult to determine the impact of musical interventions on patients with dementia. As part of a series of studies, we carried out randomized controlled trials to compare the effectiveness of musical activities to other pleasant activities on various functions in patients with severe Alzheimer's disease. The data obtained in these trials are discussed in light of the methodological constraints and requirements specific to these clinical studies. Although the results demonstrate the power of music on the emotional and behavioral status of patients, they also suggest that other pleasant activities (e.g., cooking) are also effective, leaving open the question about the specific benefits of music in patients with dementia. All these findings highlight the promising potential for nonpharmacological treatments to improve the well-being of patients living in residential care and to reduce caregiver burden.
© 2014 New York Academy of Sciences.
In striking contrast to the difficulties with new learning and episodic memories in aging and especially in Alzheimer's disease (AD), musical long-term memories appear to be largely preserved. Evidence for spared musical memories in aging and AD is reviewed here. New data involve the development of a Musical Engagement Questionnaire especially designed for use with AD patients. The questionnaire assesses behavioral responses to music and is answered by the care partner. Current results show that, despite cognitive loss, persons with mild to moderate AD preserve musical engagement and music seeking. Familiar music evokes personal autobiographical memories for healthy younger and older adults as well and for those with mild to moderate AD. It is argued that music is a prime candidate for being a stimulus for cognitive stimulation because musical memories and associated emotions may be readily evoked; that is, they are strong and do not need to be repaired. Working with and through music as a resource may enhance social and communication functions.
© 2015 New York Academy of Sciences.
Studies of musical abilities in dementia have for the most part been rather general assessments of abilities, for instance, assessing retention of music learned premorbidly. Here, we studied patients with dementias with contrasting cognitive profiles to explore specific aspects of music cognition under challenge. Patients suffered from Alzheimer's disease (AD), in which a primary impairment is in forming new declarative memories, or Lewy body disease (PD/LBD), a type of parkinsonism in which executive impairments are prominent. In the AD patients, we examined musical imagery. Behavioral and neural evidence confirms involvement of perceptual networks in imagery, and these are relatively spared in early stages of the illness. Thus, we expected patients to have relatively intact imagery in a mental pitch comparison task. For the LBD patients, we tested whether executive dysfunction would extend to music. We probed inhibitory skills by asking for a speeded pitch or timbre judgment when the irrelevant dimension was held constant or also changed. Preliminary results show that AD patients score similarly to controls in the imagery tasks, but PD/LBD patients are impaired relative to controls in suppressing some irrelevant musical dimensions, particularly when the required judgment varies from trial to trial.
© 2014 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals Inc. on behalf of The New York Academy of Sciences.
Dementia is now a leading cause of both mortality and morbidity, particularly in western nations, and current projections for rates of dementia suggest this will worsen. More than ever, cost effective and creative non-pharmacological therapies are needed to ensure we have an adequate system of care and supervision. Music therapy is one such measure, yet to date statements of what music therapy is supposed to bring about in ethical terms have been limited to fairly vague and under-developed claims about an improvement in well-being. This article identifies the relevant sense of wellbeing at stake in the question of dementia therapies of this type. In broad terms the idea is that this kind of therapy has a restorative effect on social agency. To the extent that music arouses a person through its rhythms and memory-inducing effects, particularly in communal settings, it may give rise to the recovery of one's narrative agency, and in turn allow for both carer and patient to participate in a more meaningful and mutually engaging social connection.
Music therapy research reports very limited repertoire resources for Chinese older adults who are a significant non-English speaking group in Australia. This small scale survey study established preferred songs in a group of Chinese older adults living in Australia, explored the relationship between demographic variables and the language of song preferences, and determined whether the most preferred songs were published in the participant’s young adult years (20-30 years) as found in past studies. Twenty-nine Chinese older adults (aged 65-94) were recruited from a senior community gathering in Brisbane, Australia. The data of the survey generated a list of 49 individual song titles which were categorised into six music style categories (popular, patriotic, religious, folk, Chinese opera, and others). A significant relationship was found only between the Cantonese as the first language and preference for songs in Cantonese (p<0.001). Participants preferred songs of their later life periods (31 years or above) instead of young adult years (20-30 years). The findings provide a useful expansion and refinement of the repertoire for Australian RMTs working with Chinese older clients in Australia. It also provides practical guidance for selecting songs with clients who are of Chinese origin and who speak Cantonese or other Asian languages.
The headache phenotype and neurological symptoms of the German composer Richard Wagner (1813-1883), whose music dramas count towards the most frequently performed operas across the world, are previously undocumented.
Richard Wagner's own descriptions of his headache symptoms in his original writings and letters are investigated, as well as the complete diary records of his second wife, Cosima Wagner.
There are manifold indications that Richard Wagner suffered from a severe headache disorder, which fulfils most likely the diagnostic criteria of migraine without aura and migraine with aura of ICHD-3 beta.
Richard Wagner's life and opus can help to better understand the burden and suffering caused by migraine with its severe effects on the individual, familial and social life, the culture and community.
Carl Gobel and colleagues explain why listening to Wagner might give you a headache
Fig 2 Anthony Pilavachi’s stage direction of Siegfried at Theater Lubeck (2009) shows Mime as a laboratory scientist whose hammering leads to an intense headache
JORG METZNER
The medical problems of composer and poet Richard Wagner have been widely investigated. He is known to have had functional disorders, skin disorders, acute infections, and minor ailments, as well as heart disease.1 2 3 4 However, the condition that Wagner described as the “main plague of his life”5 was recurring headaches. The details presented in his writings and letters5 6 7 as well as the numerous diary records of his second wife, Cosima,8 9 confirm that Wagner had a severely disabling migraine disorder producing frequent migraine attacks, sometimes with aura.10 Here, we show how Wagner deeply interwove his migraine attacks and auras into his music and libretti, using the opera Siegfried (1876), the third part of the Ring Cycle , as an example.
The first scene of act 1 of the opera Siegfried provides an extraordinarily concise and strikingly vivid headache episode. The music begins with a pulsatile thumping, first in the background, then gradually becoming more intense. This rises to become a directly tangible almost painful pulsation (fig 1⇓). While the listener experiences this frightening headache sensation, Mime is seen pounding with his hammer, creating the acoustic trigger for …
Neuroimaging techniques, such as positron emission tomography and functional magnetic resonance imaging are essential tools for the analysis of organized neural systems in working and resting states, both in physiological and pathological conditions. They provide evidence of coupled metabolic and cerebral local blood flow changes that strictly depend upon cellular activity. In 1890, Charles Smart Roy and Charles Scott Sherrington suggested a link between brain circulation and metabolism. In the same year William James, in his introduction of the concept of brain blood flow variations during mental activities, briefly reported the studies of the Italian physiologist Angelo Mosso, a multifaceted researcher interested in the human circulatory system. James focused on Mosso's recordings of brain pulsations in patients with skull breaches, and in the process only briefly referred to another invention of Mosso's, the 'human circulation balance', which could non-invasively measure the redistribution of blood during emotional and intellectual activity. However, the details and precise workings of this instrument and the experiments Mosso performed with it have remained largely unknown. Having found Mosso's original manuscripts in the archives, we remind the scientific community of his experiments with the 'human circulation balance' and of his establishment of the conceptual basis of non-invasive functional neuroimaging techniques. Mosso unearthed and investigated several critical variables that are still relevant in modern neuroimaging such as the 'signal-to-noise ratio', the appropriate choice of the experimental paradigm and the need for the simultaneous recording of differing physiological parameters.
Interdisciplinary essays on central issues in cognitive science.
In the early 1960s, the bold project of the emerging field of cognition was to put the human mind under the scrutiny of rational inquiry, through the conjoined efforts of philosophy, linguistics, computer science, psychology, and neuroscience. Forty years later, cognitive science is a flourishing academic field. The contributions to this collection, written in honor of Jacques Mehler, a founder of the field of psycholinguistics, assess the progress of cognitive science. The questions addressed include: What have we learned or not learned about language, brain, and cognition? Where are we now? Where have we failed? Where have we succeeded? The book is organized into four sections in addition to the introduction: thought, language, neuroscience, and brain and biology. Some chapters cut across several sections, attesting to the cross-disciplinary nature of the field.
Bradford Books imprint
There is an increasing incidence of dementia in our aging population, and consequently an urgent need to develop treatments and activities that may alleviate the symptoms of dementia. Accumulating evidence shows that persons with dementia enjoy music, and their ability to respond to music is potentially preserved even in the late or severe stages of dementia when verbal communication may have ceased. Media interest in this topic has contributed to the public perception that music abilities are an "island of preservation" in an otherwise cognitively impaired person with dementia. In this chapter, we review the current literature on music cognition in dementia and show that there has been very scarce rigorous scientific investigation of this issue, and that various types of music memory exist and are differentially impaired in the different types of dementia. Furthermore, we discuss the recent development of music activities as a nonpharmacological treatment for dementia and highlight the methodological limitations of the current literature on this topic. While it has been reported that music activities can improve behavior, (particularly agitation), mood, and cognition in persons with dementia, recent large-scale randomized control studies have questioned the specificity of the effect of music and found that it is no more beneficial than other pleasant activities. Nevertheless, music is unique in its powerful ability to elicit both memories and emotions. This can provide an important link to individual's past and a means of nonverbal communication with carers, which make it an ideal stimulus for persons with dementia.
Background:
This research aimed to analyse the opera repertoire in terms of contents of physician roles. Also to pinpoint significant characters and passages that exemplify the changing role and perception of Medicine in society during five centuries.
Methods:
A systematic search was performed. Musical characteristics and performing roles, and their determinants, were tabulated and formally analysed.
Results:
Out of 493 operas listed, 53 (10.7%) were identified with having either a patient and/or doctor as characters. They span 239 years, from 1777 to 2016. Beyond unspecified Family Medicine and Generalists, some operas could be attributed to medical specialties, including 3 (5.7%) to Respiratory. Most interestingly, the 34 (6.9%) operas with physician roles are all represented by male characters, distributed by voice register mostly in the grave chords. Overall, the composer that appears with the highest interest in reporting disease is Giuseppe Verdi, with nine operas including medical doctors. Finally, a trend can be observed on the evolving role of doctors. From mostly minor, buffal roles, either with magic or comical components in the XVIII century, to a professional/technical physician more recently.
Conclusions:
Opera depicts a changing perception of the roles of doctors throughout history, with a blatant gender bias that still persists.
Contrary to what is commonly believed, music therapy is an old cure, the use of which is lost in the mists of time. Music always has been perceived to have particular healing powers, and the entire history of civilization contains aspects that link music to physical and mental healing. It seems that the adoption of music for therapeutic purposes harks back to a distant past, probably since the Paleolithic period: it was believed that listening to music could affect the behavior of human beings. In later centuries, the concept of "musical organ-tropism" was born and developed, because according to the type of music, one may affect the cardiovascular, respiratory, and neuroendocrine systems. Studies have shown that music can powerfully evoke and modulate emotions and moods, along with changes in heart activity, blood pressure, and breathing. Indeed, the following findings arise from the literature: heart and respiratory rates are higher in response to exciting music than in the case of tranquilizing music. In addition, music produces activity changes in brain structures (amygdala, hypothalamus, insular and orbitofrontal cortex) known to modulate heart function. This article provides a careful overview of music therapy history from prehistory to the present and a review of the latest applications of music therapy in cardiovascular diseases.
Italian operas can provide relevant information on the medical knowledge during the Romantic Age, especially in the field of neuroscience. One of the most renowned operas, "Nabucco" by Giuseppe Verdi (1813-1901) may provide us with some information on the state of knowledge on neuropsychiatric diseases in the first part of the nineteenth century. The main character of this opera, the Assyrian king Nabucco suffers from delirium. Psychic signs and symptoms attributed to Nabucco in Verdi's opera could have been influenced by a better knowledge of neuropsychiatric diseases in the nineteenth century. Furthermore, the representation of Nabucco's mental illness in the opera could also have been influenced by direct experiences of Verdi himself, who seems to have suffered from recurrent depressive episodes in that period, and for the rest of his life.
As the world becomes increasingly global, music therapists have to develop cultural competencies to work with clients of different cultural backgrounds with appropriate sensitivity to encourage therapeutic growth. Just as there are differences in Western and Eastern cultures, it is necessary to integrate Western and Eastern methods when working with Asian populations, especially with those who are older adults. This may be difficult, if one is not familiar with the “hidden rules” in the client’s culture. This article shares one therapist’s clinical reflections on experiences in developing a music therapy program in a Chinese residential aged care facility in the state of Victoria, Australia. Consideration is given to the socio-cultural concepts such as guanxi, mianzi and linguistic diversity, and how these interact with Western therapeutic processes when working with Chinese clients.
This book is the first attempt to provide a basis for the interaction of the brain and nervous system with painting, music and literature. The introduction deals with the problems of creativity and which parts of the brain are involved. Then an overview of art presents the multiple facets, such as anatomy, and the myths appearing in ancient descriptions of conditions such as polio and migraine. The neurological basis of painters like Goya and van Gogh is analysed. Other chapters in the section on art cover da Vinci’s mechanics and the portrayal of epilepsy. The section on music concerns the parts of the brain linked to perception and memory, as well as people who cannot appreciate music, and the effect of music on intelligence and learning (the Mozart effect). The section on literature relates to Shakespeare, Dostoyevsky, Conan Doyle, James Joyce and the poetry of one of England’s most famous neurologists, Henry Head.
Romantic operas provide a useful tool for historians to understand the perception of some medical disorders that existed during the nineteenth century. Somnambulism was still a mysterious condition during this time, since its pathogenesis was unknown. Hence, it comes as no surprise that somnambulism features in a number of operas, the best known of which are Verdi's 'Macbeth' and Bellini's 'La Sonnambula', both the subject of recent scholarship. Here we examine a more obscure opera in which sleepwalking is depicted. Dating from 1824, 'Il Sonnambulo' by the Italian composer Michele Carafa is based on a libretto by Felice Romani. Although it shares some features with the Verdi and Bellini operas, it also presents original elements. Our analysis of this forgotten opera supports the contention that studying operas can shed light on medical theories and practices, and on how ideas about mind and body disorders were transmitted to the laity in times past.
Background:
Music is one of the most sophisticated and fascinating function of the brain. Yet, how music is instantiated within the brain is not fully characterized. Singing is a peculiar aspect of music, where both musical and linguistic skills are required to provide a merged vocal output. Identifying the neural correlates of this process is relevant for both clinical and research purposes.
Case description:
An adult caucasian man with a presumed left temporal glioma was studied. He is a professional opera singer with an actual employment. A tailored music evaluation, the Montreal Battery of Evaluation of Amusia (MBEA), was performed pre- and post-operatively, with long-term follow-up. Intraoperative stimulation mapping (ISM) with awake surgery with a specific music evaluation battery was used to identify and preserve the cortical and subcortical structures subserving music, along with standard motor-sensory and language mapping. A total resection of a grade I glioma was achieved. The MBEA reported an improvement in musical scores after the surgery. ISM consistently elicited several types errors in the superior temporal gyrus and, to a lesser extent, in the inferior frontal operculum. The majority of errors occurred during score-reading; fewer errors were elicited during the assessment of the rhythm. No spontaneous errors were recorded. These areas did not overlap with eloquent sites for counting or naming.
Conclusions:
ISM and a tailored music battery enabled to better characterize a specific network within the brain subserving score-reading independently from speech with an actual long-term clinical impact.
In the Oxford Handbook of Music Therapy, international leaders in the field from 10 countries have contributed their expertise to showcase contemporary music therapy.
In nineteenth-century Italy, several scientists (e.g. Botta, Verga, Berti and Lussana) became interested in the coloured-hearing phenomena. They published their observations on a number of coloured-hearing cases and started a debate on the neurological features of the phenomenon. These were the first hypotheses on colour-sound localisation, influenced by Gall's theories (Phrenology). The observations were the result of important discoveries on the mechanism of hearing sound performed in the eighteenth and nineteenth centuries by Domenico Cutugno and Alfonso Corti. Like French, German and English contributions to early research on synaesthesia, these Italian scientists provided original ideas on the colour-hearing process.
Therapeutic Songwriting provides a comprehensive examination of contemporary methods and models of songwriting as used for therapeutic purposes. It describes the environmental, sociocultural, individual, and group factors shaping practice, and how songwriting is understood and practiced within different psychological and wellbeing orientations.
Music may not only improve quality of life but also effect changes in heart rate (HR) and heart rate variability (HRV). A greater modulation of HR and HRV was shown during musical performance compared to listening to music. Cerebral flow was significantly lower when listening to "Va pensiero" from Verdi's "Nabucco" (70.4±3.3 cm/s) compared to "Libiam nei lieti calici" from Verdi's "La Traviata" (70.2±3.1 cm/s) (p<0,02) or Bach's Cantata No. 169 "Gott soll allein mein Herze haben"(70.9±2.9 cm/s) (p<0,02). There was no significant influence on cerebral flow in Beethoven's Ninth Symphony during rest (67.6±3.3 cm/s) or music (69.4±3.1 cm/s). Music significantly decreases the level of anxiety for patients in a preoperative setting compared to midazolam (STAI-X-1 score 36) (p<0.001). Listening to music while resting in bed after open-heart surgery leads to significant differences in cortisol levels between the music (484.4 mmol/l) and the non-music group (618.8 mmol/l) (p<0.02).
Background: Prolonged Disorders of Consciousness (PDOC) describes a population where a consciousness disorder has persisted for at least
four weeks post injury but is still under investigation. Complex motor, sensory, communication, and cognitive impairments
cause challenges with diagnosis, assessment, and intervention planning. Developing sensitive, reliable, and valid measures
is a central concern. The auditory modality is the most sensitive for identifying awareness; however, the current standardized
behavioral measures fail to provide adequate screening and measurement of auditory responsiveness. The Music Therapy Assessment
Tool for Awareness in Disorders of Consciousness (MATADOC) is a recently standardized measure for assessment with PDOC; however,
psychometric values for two of its subscales require examination.
Madness served primarily as a form of amusement for the spectators in operas of the seventeenth century. This representation was far removed from clinical reality. This circumstance changed in the eighteenth century at the time when tragic madness emerged in numerous operas.
The opera buffa Arcifanfano-Re dei matti (Arcifanfano-King of fools, premiered in 1749 in Venice, text by Carlo Goldoni 1707-1793 and music by Baldassare Galuppi 1706-1785), which continuously enacts a realm of fools and is meant to appear amusing, is riddled with psychopathological abnormalities for which a retrospective diagnosis is methodologically rejected. However, the opera presents many subjects for working out a typology of fools based on outlasting personality traits of the protagonists. The libretto is investigated. A musical analysis is spared.
The conceptualized typology of fools in the opera, which is oriented towards the seven main vices or deadly sins serves, in the tradition of moral satire, to critically hold up a mirror to the audience to reflect their own vices by an amusing characterization of the latter. Historically classified, the treatment of fools by means of isolation, custody, locking up in cages as well as authoritarian measures of submission reflects the custom in those days before humanizing the treatment of people with mental illness in the course of the Enlightenment and the French Revolution.
The opera Arcifanfano is essentially characterized by continuous madness. A typology of the fools can be worked out from the precise depiction of the personalities. A mirror is held up to the spectators in terms of vices, in the tradition of the contemporary baroque opera. At the same time, the opera can be classified psychiatrically and historically as a seismograph of its time when in the seventeenth and eighteenth centuries people with mental illness were isolated and incarcerated.
On March 17, 1937, a panel of music therapists, psychiatrists and a corrections specialist convened to discuss the use of music therapy in New York City hospitals and correctional institutions. The conference was sponsored by the Federal Music Project, a New Deal white collar program that employed thousands of out-of-work musicians during the Depression. Programs of the Federal Music Project were carried out in urban areas and isolated rural areas. Music education and music therapy activities, though less numerous than orchestral, opera, and choral performances, were conducted in community centers, settlement houses, orphanages, hospitals, and prisons. The panel discussion on music therapy was part of Music Education Week 1937, in which numerous presentations and demonstrations celebrated and promoted the beneficial influence of music on the well-being of men, women, and children. The afternoon of Wednesday, March 17 was devoted to a discussion of music therapy. Each presenter contributed his/her personal view of how music could effectively be used with the sick, indigent, and incarcerated. Although the presentations were uneven in quality and in two cases very brief, it was apparent that strong support for music therapy existed in the New York City metropolitan area during the height of the Depression.
Opera is the most complete form of theatrical representation, characterized by musical accompaniment, both instrumental and vocal. It has played an important role in sociocultural spheres, affecting the various social strata and reflecting customs and ideas in different centuries. Composers have created pieces that have also shown the development of medicine. Since the birth of opera in seventeenth century in Italy, neuroscience has played an important role in influencing the representation of madness and neurological aspects. From the Folly of the Renaissance, a path toward a representation of madness was developed, initially linked to the myths of classical antiquity. In the seventeenth and eighteenth centuries, madness was represented as comical or funny, of a loving nature and influenced by the spread of the Commedia dell'Arte (Comedy of Art). In the nineteenth century, with the rise of the first scientific theories of the mind, insanity took more precise connotations and was separated from other psychiatric and neurological diseases. The operas of the twentieth century depicted psychiatric and neurological diseases, taking into account newer medical and scientific discoveries.
© 2015 Elsevier B.V. All rights reserved.
Neurological and neuropsychological aspects of folk music and traditional dance have been poorly investigated by historical and scientific literature. Some of these performances could be indeed the manifestation of latent pathological conditions or the expression of liberation rituals. This chapter aimed at analyzing the relationships between traditional dance, folk music, and neurological and psychiatric disorders. Since ancient times, dance has been used in the individual or collective as treatment of some diseases, including epilepsy and movement disorders (dyskinesia, chorea, etc.). Dionysia in Ancient Greece, St. Vitus dance in the Middle Age, tarantism and other traditional dances of southern Italy and of non-Western countries might be credited as curative rituals of these neurological and psychiatric conditions. During the nineteenth century, dance was also used for the treatment of psychiatric patients; the relationship between dance and insanity could also be reflected in classical ballets and music of that period. Nowadays, neuropsychiatric manifestations could also be evidenced in modern dances (mass fainting at rock concerts, flash mobs); some ballroom dances are commonly used for the rehabilitation of patients suffering from neurodegenerative and psychiatric conditions. Interdisciplinary research on these subjects (ethnomusicology and cultural anthropology, clinical neurology and dynamic psychology, neuroradiology and neurophysiology, and socioneurology and neuromusicology) should be increased.
© 2015 Elsevier B.V. All rights reserved.
The notion of music as therapy is based on ancient cross-cultural beliefs that music can have a "healing" effect on mind and body. Explanations for the therapeutic mechanisms in music have almost always included cultural and social science-based causalities about the uses and functions of music in society. However, it is also important to note that the view of music as "therapy" was also always strongly influenced by the view and understanding of the concepts and causes of disease. Magical/mystical concepts of illness and "rational" medicine probably lived side by side for thousands of years. Not until the late-nineteenth and early-twentieth centuries were the scientific foundations of medicine established, which allowed the foundations of music in therapy to progress from no science to soft science and most recently to actual brain science. Evidence for "early music therapy" will be discussed in four broad historical-cultural divisions: preliterate cultures; early civilizations in Mesopotamia, Egypt, Israel; Greek Antiquity; Middle Ages, Renaissance, and Baroque. In reviewing "early music therapy" practice, from mostly unknown periods of early history (using preliterate cultures as a window) to increasingly better documented times, including preserved notation samples of actual "healing" music, five theories and applications of early music therapy can be differentiated.
© 2015 Elsevier B.V. All rights reserved.
In 1749, the London physician Richard Brocklesby (1722-1797) published his Reflections on Antient [sic] and Modern Musick, an essay that not only sought to compare these practices in terms of their effects, but also to gather evidence supporting the use of music in treating mania and other mental diseases. As might be expected, Brocklesby's discussion of music therapy has already received attention by authors looking back to the origins of this practice, not least because he offers an account of a successful musical cure that took place in his own time (Rorke, 2001). My chapter, however, seeks to broaden the discussion of the Reflections, in order to show how Brocklesby's projected musical cures fit into his larger worldview, one that was influenced as much by Plato and other ancient philosophers as it was by modern thinkers such as Isaac Newton and his followers. Brocklesby's argument was essentially that music acted as a link between the mind and body and therefore could restore their intrinsic harmony, a connection that was mediated by the animal spirits, which also served as the vehicle of the passions. The movements and proportions of music could arouse or quell the passions by their effect on these (imaginary) spirits, which flowed through the nerves and brain and acted as the agent for the mind or soul. I show how his account of music in antiquity led him to reflect on the way that music was perceived and responded to in his own time, both as a stimulus to mental and bodily action, and as a source of esthetic pleasure through the cultivation of musical taste.
© 2015 Elsevier B.V. All rights reserved.
This article examines the treatment of madness as a theme in drama, opera and films, concentrating its attention for the most part on the period between World War II and the 1980s. These were the years in which psychoanalysis dominated psychiatry in the USA, and so Freud's influence in the broader culture forms the central though not the sole focus of the analysis.
Background:
Little is known about the therapeutic uses of music during the First World War. This historical study provides a biography of Paula Lind Ayers (1891-1974), a vocalist, actress, and YMCA Entertainer who became known as "the girl who could sing away shell shock."
Objective:
The purpose of this study is to describe Paula Lind Ayers' respite services during World War I and provide a contextual biography of her life.
Methods:
The author conducted an exhaustive search regarding Paula Lind Ayers' life and her activities during World War I. Numerous databases were used to locate print sources. Libraries, archives, and organizations were consulted to obtain unpublished primary sources. The author evaluated materials via a recursive process that included corroborating evidence, assessing source reliability, and contextualizing information. Data were synthesized and analyzed for emergent themes.
Results:
Findings suggest that Paula Lind Ayers developed a systematic approach using familiar, live singing that was effective in alleviating symptoms of shell shock. Her method was replicated by others overseas during World War I. After the war, she returned to a successful performance career until the Great Depression. No information was found about Ayers' life from the year 1929 until her death in 1974.
Conclusions:
Understanding Paula Lind Ayers' contribution to music therapy provides a deeper awareness of past therapeutic uses of music with soldiers who experienced shell shock. Such understanding helps shape the way we view the present conception of music therapy with veterans and how we might answer questions that will affect the future of the field.
Accessible summary
Dementia is a progressive illness that to date has no cure and currently affects over 35 million people worldwide. This figure is predicted to increase significantly over the next two decades.
There is growing interest in identifying non‐pharmacological therapies effective in improving quality of life and reducing challenging behaviours with a dementia client group.
Our objective is to identify if music therapy is a beneficial therapy for use with dementia patients.
We conducted a review of the literature and concluded that the studies show promising results, but because of poor methodological quality further research would be recommended.
Abstract
Dementia is an organic mental health problem that has been estimated to affect over 23 million people worldwide. With increasing life expectancy in most countries, it has been estimated that the prevalence of dementia will continue to significantly increase in the next two decades. Dementia leads to cognitive impairments most notably short‐term memory loss and impairments in functioning and quality of life ( QOL ). National policy in the UK advocates the importance of early diagnosis, treatment and social inclusion in maintaining a good QOL . First‐line treatment options often involve drug therapies aimed at slowing down the progression of the illness and antipsychotic medication to address challenging behaviours. To date, research into non‐pharmacological interventions has been limited. In this manuscript, we review the literature that has reported evaluations of the effects of music therapy, a non‐pharmacological intervention. The results of six studies reviewed suggest that music therapy may have potential benefits in reducing anxiety, depression and agitated behaviour displayed by elderly people with dementia as well as improving cognitive functioning and QOL . Furthermore, music therapy is a safe and low‐cost intervention that could potentially be offered by mental health nurses and other carers working in residential settings.
This article describes and introduces a new innovative tool for bioethics education: a rock opera on the ethics of genetics written by two academics and a drummer legend. The origin of the idea, the characters and their development, and the themes and approaches as well as initial responses to the music and the show are described, and the various educational usages are explored.
This paper presents the findings from an evaluation of a creative musical project led by Scottish Opera. The project included people with dementia and their carers in the development, writing, design and performance of a musical production about their experiences of love. The project involved professional singers, artists and choreographers from the opera company. Activities involved practice sessions and performances. People with dementia and their carers reflected on positive outcomes from the project including improved confidence; being part of a group; improved physical strength and people seeing them in a new way. Within the evaluation framework they also reported on how the project had been run and gave ideas for future development. Key elements in the success of this project were the involvement of professionals, the kudos of working with a national organisation and the performances that, while daunting, provided unique and rewarding experiences.
The Lion's Face is an opera about Alzheimer's disease, with music by the Russian composer Elena Langer, a graduate of the Moscow Tchaikovsky Conservatory and London's Royal Academy of Music, and libretto by the award-winning poet, dramatist, and novelist Glyn Maxwell. The opera engages with dementia, and the treatment of and research into dementia, from the perspectives of a patient, a relative, a caregiver, and a clinician-scientist. It was premiered at the Brighton Festival in May 2010 and closed its initial run with a series of performances at the Linbury Studio of the Royal Opera House at Covent Garden, London.
The title is taken from John Bayley's memoir of the novelist Iris Murdoch, in which "lion's face" is represented (erroneously) as a clinical term, because "the features [of Alzheimer's sufferers] settle into a leonine impassivity." In this view, the sufferer's face becomes a mask indicative of an absence. There may also be resonances of the observer's fear of an illness that, through the disintegration of memory, strikes at the continuity of personality fundamental to the human sense of identity.
The opera was commissioned by The Opera Group (London) and developed with medical input from Professor Simon Lovestone and his colleagues at the Institute of Psychiatry, King's College London, and the Biomedical Research Centre for Mental Health at the South London and Maudsley National Health Service Foundation Trust, UK. Through the Institute of Psychiatry, Elena Langer and Glyn Maxwell were given access to researchers, clinicians, and care workers, and to a particular Alzheimer's sufferer in her late fifties, with whom they discussed her condition. Public showings of sections of work in progress, including at the Royal Institution of Great Britain in 2009 and the Brighton Science Festival early in 2010, also allowed responses from the scientific and medical communities and from the general public, including people directly affected by the illness, to be fed into the work's evolution. The health care professionals involved often saw arts portrayals of psychiatrists as characteristically either godlike or demonized, and they wanted a presentation that was more neutral. Beyond this, the broad aim actuating the engagement of the scientific and medical communities was to contribute to the public understanding of Alzheimer's disease. By so doing they hoped to reduce the stigma attached to the illness that may prevent early treatment and compounds the difficulties inherent in being a caregiver, and to foster the cultural awareness that underpins the needs of research.
Central to the opera is the Alzheimer's sufferer, Mr. D, a patient in a care home whose dementia has reached an advanced stage. While the case of Mr. D is presented specifically, he also assumes a representative status. Certain typical problems are made to arise, particularly language dysphasia (partial aphasia) and the sufferer's inability to recognize himself in a mirror (autoprosopagnosia), because he thinks of his appearance as he was when young. Mr. D is a speaking role: his speaking amid everybody else's singing is a way of representing the gulf between him and the other characters, and his alienation from what, in an operatic context, is the normal discourse. It may also help the audience to identify with Mr. D: his mode of expression is theirs.
Around Mr. D are four other characters, all individuals but all also representing typical responses to his condition, and all defined by their relation to Mr. D. They are his wife, Mrs. D; a Clinician-Scientist, for whom Mr. D is both a patient and a research subject; a Nurse, Mr. D's Caregiver; and the Caregiver's Daughter (who is in the care home illicitly because of an enforced day off school caused by a snowfall, and so has to be kept hidden by her mother). The three women are somewhat conventional figures: the daughter representing youth—neither trammeled nor informed by preconceptions, encountering and making sense of new experiences; the nurse, middle age—working, with responsibilities; the wife, old age—witnessing or experiencing ill health and disintegration.
While all the characters assume a degree of typicality, none is represented as ideal. Mrs...