Music Therapy Means Letting Go Of Language
Inside the emerging practice that’s using music as medicine
I’m sitting in an office on the edge of Manhattan’s Koreatown with a small marimba in my lap, stalling for time. I’m supposed to be using the mini-marimba to express how I’m feeling, but instead I look around the room, which is comfortable and bright and contains maybe a dozen or so throw pillows and about as many musical instruments; it’s like a world music café as envisioned by western clinicians. Another minute passes, and while I still haven’t figured out what to play, at least I know where the exits are.
I’m here for a session with Rachel Schwartz, a music and vocal psychotherapist whose work typically takes her to hospitals’ inpatient psychiatric units. Today, however, she’s arranged for us to spend an hour cycling through various treatments she uses in her practice, a kind of tasting menu of therapeutic modalities. I tentatively hit the marimba’s keys and wonder if maybe I should’ve chosen a different instrument.
Music therapy has been studied in a wide range of settings and with diverse populations: children with autism spectrum disorders; veterans recovering from PTSD; adults in recovery from substance abuse; and elder patients afflicted with dementia. The treatments have been linked to decreased anxiety and muscle tension, increased motivation and verbalization, and improved mood and self-esteem across all of these groups. In a 2008 study, breast cancer patients who listened to music after their mastectomies reported significant reductions in pain, and another study from 2013 found that after five weeks of musical therapy interventions, adults with acute schizophrenia showed fewer symptoms of psychosis and were less depressed than inpatients who didn’t attend music therapy.
And yet it may be precisely this heterogeneity in both methods and application that keeps the discipline from making more significant inroads into the medical establishment. It can be difficult to design and replicate studies, and the term “music therapy” itself gets applied to a vastly diverging set of practices, from prescribing playlists to more interactive treatments like the ones Schwartz will give me.
The field as a whole is also relatively quite young. While its first formal body, the National Society of Musical Therapeutics, was founded in 1903, the profession only really gained traction after World War II, when psychologists began to work with music and military populations; and most of the formal certification and licensing bodies didn’t come online until the early 1980s. Today the American Music Therapy Association provides listings for more than 5,000 members, which is how I found Schwartz.
In college, she majored in music and minored in psychology, and then applied for a graduate degree in music therapy at NYU “not totally understanding what was going to be involved.” Now she’s an MT-BC, a national certification that means she’s a Board Certified Music Therapist, and an LCAT, which makes her a Licensed Creative Arts Therapist.
Schwartz practices a specific treatment model called Austin Vocal Psychotherapy (or AVP), which she learned by spending two years training under Dr. Diane Austin, a music therapist and professor at NYU. AVP combines classical psychoanalytic concepts (theories of countertransference, intersubjectivity, and object relations, for example) with breath work and vocal improvisation.
When she articulates what appeals to her about what she does, she might as well be describing the exact qualities that will make me feel so freaked out. “Music just takes you to an emotional place so quickly.”
The array of options spread out around us includes a tambourine, a set of maracas, and a guitar; a triangle, bongos, and something that looks like a hand weight but is filled with sand; a full-sized rock-and-roll drum set, the scaled-down marimba I’m holding, and several African djembe of the kind one might hear 20 blocks south of here, down in Washington Square Park. There’s also a keyboard, which we’ll get to later, and something called an ocean drum, which Schwartz demonstrates while I’m still perseverating over my instrumental and life choices. The drum is cookie-tin sized but with a clear acrylic lid, and as she tips it back and forth the layer of silver beads on the bottom slides around, mimicking the sound of waves washing onto shore. I close my eyes and imagine myself transported to Montauk or, for that matter, Coney Island; I’m not feeling choosy about alternate destinations at the moment.
Schwartz decides to go for one of the tall djembe, settling it between her knees and testing its sound with a few good thumps. Sensing my discomfort, or maybe noticing the way my eyes keep darting over to the door, she starts us off.
“My name’s Rachel, and I’m feeling…” she starts, then raps out an energetic beat with the flat of her palms, building into a syncopated rhythm before trailing off at the end with a susurrus of fingertip taps. This clearly isn’t her first drum circle. She smiles and looks over at me expectantly. I take a deep breath and play another cautious note before finally admitting that I have no idea what I’m doing. She nods, empathetic. “It’s tough not to intellectualize,” she says. “As adults we’re so focused on wanting things to sound good, to be pretty or melodic, that we’ve forgotten it’s called playing music for a reason.”
I recall the conversation Schwartz and I had on the phone yesterday. Much of her discipline’s value, she had explained, is that “people aren’t able to hide in their verbal defenses as much when they’re making music.” I can confirm the discomfort that arises from this lack of defense mechanism. As a writer, I much prefer hiding my emotions behind a lexical Maginot Line, thanks very much. But for now I try to do as Schwartz instructs, which is to say, I attempt “to use sound to show how you’re feeling right now, in this moment.”
How I’m feeling right now, in this moment, is that I just finished moving to a new apartment, my entire life is packed away in boxes, and my previous work shift didn’t end until 9 a.m. I raise the wooden mallet in my hand and hit the marimba’s far-right bar, its highest pitch, then thwack it more and more insistently until I’m basically wailing away like a toddler. And maybe it’s because I’ve cathected some of my anxiety, or just that I’ve finally produced some sound — any sound — I start to laugh. I wouldn’t say I’m playing quite yet, but it’s a start.
We do the same exercise again but this time I trade the marimba for maracas, apparently on some kind of Buena Vista Social Club wish-fulfillment tour. As we improvise, I realize how much I’m still trying to do this right; as though rightness could be evaluated in the same way as playback quality. I want so badly to please. But this itself is telling, Schwartz says when we talk after the duet. “Not to oversimplify things, but in many ways when we’re making music together, what we’re recreating is our very first group experience, those initial parent-child relationships.”
For now though, we move on from my family of origin — clearly there’s more than a session’s worth to work through there — and take up seats at the keyboard. Schwartz starts to play chords until she hits on a pair that resonates with me, both literally and figuratively, a combination of A and D minor. Over the next few minutes she alternates between the two sets of tones while I breathe in and out, beginning to understand, on a level deeper than intellectual — more as a felt sense inside my body — why these treatments can be so effective.
She slows down her playing, finishing with a morendo; I open my eyes, teary but also feeling much calmer than when she began. We talk about the series of memories I cycled through during the exercise, most of them related to losing my mom when I was a teenager. Both of us also note that I’d been rocking back and forth to the music. “This exercise can take you back to a much earlier stage in your development,” she notes, explaining that this particular method can be a powerful means of working with trauma.
“Often we’ll use what’s called vocal toning or holding, where the client and I will both be vocalizing along with the notes. There’s also free-associative singing, in which they might tell a story from their past; for example we might revisit an incident of abuse, but through the voice we can transform it, find a way to help that person feel much more empowered.” I tell her how surprised I was by the strength of my own reaction. “It’s amazing how much you can get from just two chords,” she agrees.
We finish the session with something lighter: a sing-along that Schwartz uses when working with younger patients. If it feels like I’m on a children’s TV show, she says, that’s intentional. “It can be so thrilling for kids to hear their names used in a song.” Guitar in one hand and pick in the other, she asks me to think of a word for something I want to let go of, and then incorporates it into a simple melody. I listen with glee as she takes my can’t and throws it off the edge of the world. While I meant the contraction, that shorthand for “cannot” that we use to indicate impotence and negativity, I might as well have been referring to my cant — the over-reliance on language that I’ve felt losing its hold over the last hour.
Now Schwartz asks me to think of another thing I want to shed and, for this final song, something I want to gain. “This one’s sassy,” she says, and launches into the first verse. “I don’t want no more fear, no fear, no fear. I don’t want no more fear, I want some joy instead.” When she reaches the chorus I join in and we run through the whole thing together once more. “I want more joy, more joy, more joy,” I sing. “I want more joy, I want more joy instead.”
It’s this last song that stays with me on the subway ride back to Brooklyn and the walk home to my apartment; on my way into the building I cross paths with a new neighbor, who smiles at me. Only now do I realize I’ve been humming the joy song out loud the whole time. I’m sure if you asked anyone I passed they could have told you how I was feeling, just from the sound. Sometimes there’s no need for words.
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