Speaking Music, Raising Consciousness and Saving the World

An Alternative to a Clinically Oriented Conception of Music as Therapy

  by Rick Soshensky MA, LCAT, MT-BC, NRMT          

Abstract: This article will present a position that music therapy’s essence and efficacy cannot be fully understood or applied through non-musical clinical disciplines commonly applied to music therapy such as behavioral, biological, psychoanalytic and neuro-psychological models. Music is primarily a spiritual and artistic language, and while medical and psychiatric perspectives are valid, they also limit a comprehensive understanding and potential impact of music’s influence. The clinical and evidence-based view of music therapy may have been adopted by the field in an attempt to be accepted by the medical and psychiatric establishments, to establish music therapy as a legitimate field and to differentiate music therapy from music as entertainment. The article will offer the view that music, in and of itself, is a valid treatment modality and music’s unlimited expressive potential, its ability to encompass all human emotion in a non-judgmental manner and its metaphysical, consciousness raising capabilities, which are typically outside of the medical/psychiatric model, remain highly important in the benefits music has to offer as a form of therapy.

In the Beginning…

I have been a music therapist for over 30 years. Music has been a through-line and  defining feature of my life since childhood. I began my professional life as a guitarist/singer/songwriter in early adulthood but as time went on, my dreams of hitting the big-time did not seem to be panning out as I’d hoped. I started considering what else I could do. I lived in Brooklyn at the time and found out that New York University had a master’s degree program in music therapy. I didn’t really know what music therapy was or what music therapists did. I didn’t know there were different schools of thought or different approaches in the field. But as NYU was the only possibility I did know about, I decided to make an appointment to talk to somebody. When the faculty member I spoke with very kindly asked me which clinical population I might be interested in working with, I thought to myself I have no interest in referring to people as a clinical population. After many years as a conventional musician, I spoke music. Labeling people with psychiatric or medical terminology felt like a form of dehumanization to me. So when we finished our meeting, I walked out feeling this wasn’t for me. 

Obviously, I was able to find a way to get past that initial objection but I remained uncomfortable with the American Music Therapy Association’s definition of music therapy as “the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional” (AMTA website). I am in total agreement with the importance of credentialing and training however, there is also a question as the nature of the training students are receiving. Veteran music therapists and educators, Bill Matney, CharCarol Fisher, Anthony Meadows, Elizabeth Schwarts and Alan Turry critically evaluated the current university training of music therapists in an article titled, Philosophical Reflections on Music Therapy Musicianship (2024), writing: “we are concerned about the ways in which music therapy musicianship has (or has not)…been taught in academic training programs. We believe that in the US (and perhaps beyond), academic training programs may not be training music therapy students to fully develop and value their unique identities as musicians” (p.2).

I understand that the American Music Therapy Association, its predecessors, its regional organizations and many dedicated professionals have worked tirelessly over the years to establish music therapy as a legitimate, rather than fringy, field and it is not the intention of this article to disparage that enormous accomplishment nor am I intending to be critical of any other approaches, philosophies or techniques. This article is simply meant to consider whether the essence and efficacy music as therapy needs to be perceived from a clinical viewpoint in order to be valid. For me, music was a spiritual and artistic language that could not adequately be understood through a reductionist and scientific lens. As the renowned conductor and composer, Leonard Bernstein, characterized music: “No matter what rationalists we may profess to be, we are stopped cold at the border of this mystic area. It is not too much to say mystic or even magic.” (2004, p. 11). 

Music, throughout human history, has been deeply integrated into the rituals, ceremonies, and celebrations that related to the deepest needs of pre-industrial tribal communities. Instruments such as bone flutes more than 50,000 years old have been discovered (Tramo, 2001) and archaeological remains of prehistoric cultures indicate that music was associated with mating, battle preparation, celebrations, supernatural rituals and shamanistic practices and other survival-related and social functions (Nettl, 1956). Music is a transformer of human subjective experience, somehow providing a channel for our struggles, hopes, fears and conflicts and raising us above them so that we can live with them. However, as music therapy began to establish itself as a profession in the Western world during the mid-20th century, it tended to pattern itself itself after the dominant medical and psychiatric models, a point noted by the esteemed music therapist and professor emeritus at the University of Oslo and the Norwegian Academy of Music, Even Ruud (2008), wrote:

Most of music therapy is under the influence of a positivist paradigm, tending towards biological and neuro-psychological explanations of human behavior under the influence of music. Within a cognitive-behavioral and sometimes experimental paradigm, this conventional medical model approach tends to align with the evolving evidence-based regime in order to be accepted by the medical authorities (p.47).

Maybe the field gravitated towards this frame of reference in order to differentiate music therapy  as it was often considered (and still is to a degree) by the medical and psychiatric fields – as a form of entertainment or recreation in clinical and special-needs settings. Popular psychologist, Stephen Pinker (1997), called music “auditory cheesecake,” because obviously people liked it, but it didn’t seem  necessary or important to him.

A dictionary definition of the word, “clinical,” relates to the observation and treatment of disease and being dispassionately analytic. Can we make music that is dispassionately analytic? I’m going to say no. Can music be prescribed, standardized and managed like physical therapy, speech therapy or a medication? Again, I’m going to say no. In my experience, observable client progress arises because my focus was in helping my clients to find their unique form of musical expression. We can assess clients’ strengths and limitations; we can determine goals and document salient points of their sessions, but finding a way into music comes first. An overemphasis on non-musical approaches and perspectives may limit music’s full influence. This is not to say that disciplines outside of music have no relevancy to the practice of music therapy. They may contribute valid and illuminating ways to interpret music as therapy. My inclinations were influenced and supported by key ideas of pioneering theorists who had the courage to break from the prevailing conventions of their time, in particular:

• Nordoff and Robbins (2007) – Music itself, in all its forms; its range of expression and structural constitution as an artistic discipline provides the sphere of experience, means of intercommunication and basis for progress as therapy
• Carl Jung (1969) – The approach to the Divine is the real therapy
• Abraham Maslow (1968) – Fulfilling innate human need stems from shifting the focus from mental illness to human potential, centering on the positive qualities in people, as opposed to defining them by their symptoms
• Carl Rogers (1961) – The therapist’s role is not to cure, or change a person but to provide a relationship which clients can use for their own personal growth

• Carolyn Kenny (1982) Some of the processes inherent in music which can be used for healing have been ignored because of a strictly clinical orientation, one of which is ‘Music is Magic.’  
• Rudolf Steiner (Lamb. 2024) – Music originates from the spiritual world, helping individuals to transcend everyday consciousness, feel connected with the divine and experience unity with the cosmos

Goals

In most cases, a client’s primary motivation is to participate in music, not to achieve some non-musical clinical goal (Carpente & Aigen, 2019). If the primary function of music therapy is limited to a clinical approach, i.e. – assessment, diagnosis, treatment plan, interventions, and goals related to improving functional skills that have been determined to be deficient (i.e.- impulse control, expressive speech and speech prosody, gait training, eye contact, attention span), it may entail a truncated version of music; perhaps a structured activity or song that sets up a “correct” way to respond, or even less than a song –  a repeated phrase or a few bars used as a positive reinforcer or iterative exercise. The focus in that case is not really to play music but to use music as a tool or a stimulus to get to something else – an observable response the therapist is seeking. This may create the appearance of a successful and measurable outcome but it also may limit unforeseen possibilities, behaviorally and emotionally, in the unlimited expressive and artistic freedom inherent in music. Music is in-the-moment experience and it is not always possible to predict or control what is going to occur. Philosopher, Jerrold Levinson (2007) argued that a musical experience requires the participant to surrender to a present-focused attention where the unfolding notes, harmonies and rhythms become the entirety of our reality.

If the orientation is widened towards developing a musical relationship and seeking entrance into the language of music, we can still maintain an awareness as to the areas in which a client may need support or expansion but we also leave room for all the mystery and synchronicity inherent in music. I have witnessed the phenomenon incalculable times. Suddenly, through deep engagement in music, a client is “being who they aren’t and doing what they can’t” (to paraphrase prominent UK music therapist, Gary Ansdell (2005). In heading towards the music rather than the treatment goal, perhaps we will discover something new or unexpected; the beginning of a personally meaningful original song, a new insight, a previously unseen capability, a higher sense of joy, or a new way to relate to others. Music can lead us beyond the known, the predicted, the cognitive, the verbal, and into a higher realm of consciousness as we provide our clients with the space to expand without agendas, preconceptions and assumptions. It is incumbent upon the therapist to be as present and flexible as possible in the developing this musical relationship by exploring and discovering a client’s preferences and responses, utilizing principles such as: 

• Active and Responsive Listening to the musical offerings of the client, making immediate adjustments in development of shared music.
• Intention aimed at exploring and discovering the client’s preferences and positive responses in furthering the development of musical engagement and shared musical language.
• Trust in music, in the self as musician, and in the client’s musicality 
• Respect for the unique musicality and musicianship of the client, no matter the seeming level or function.
• Authenticity in what the therapist brings into the experience including their music skills, background, preferences, and their own vulnerable humanity

Jonah: Speaking Music

As an example, consider Jonah, an 11 year old boy with an Autism diagnosis. He said a few word occasionally but did not use sentences, exhibit conversational capability or engage in any conventional verbal communication. In his early sessions, he showed interest in various instruments but engaged with something for only a few seconds before moving on to something else. He did not give any indication of knowing or being interested in any particular songs and his family members could not offer any information about his musical preferences. He used instruments in novel ways such as tossing a drumstick in the air to strike a drum. He was interested in the electric keyboard but changed patches constantly, played glissandos and seemed more interested in experimenting with pure sound rather than playing with any apparent musical organization. From my point of view, it seemed as if he enjoyed sabotaging any music I was attempting by playing in discordant manner more so than making any attempt to join in.

In spite of our initial sessions being characterized by this type of behavior, I carried on playing in a spirited manner with a positive attitude, seeing it all as musical expression, experimental though it might be. I tried out different songs and styles using either guitar, piano, by singing or with any other instrument that occurred to me or in which Jonah showed an interest (harmonica, drums, boomwhackers, tone bars). I played melodies I thought he might have heard (famous classical themes, Twinkle Little Star, Jingle Bells, popular songs). Sometimes I played them straight, sometimes I took them in improvised directions, melodically or lyrically. I used my full musicianship in trying to interest him. I would reflect something he played whether it seemed musically organized or not.  Sometimes I continued with something I was already playing even if he seemed to be intentionally disrupting it so I wouldn’t feel too manipulated or disoriented by his short attention or chaotic playing and behavior. He would leaf through music books rapidly, sometimes landing on a particular song. I had no idea if this was intentional but I played it anyway. Sometimes it seemed to pique his interest briefly. He also seemed intrigued by the concept of time; what time it was, how many minutes were left in the session, etc., so I created or adapted several songs related to time. We also came up with an original greeting song that became “de rigueur” for the start of any session. 

At no time did I chastise him or attempt to compel him to play or behave in a way more to my liking. He did express an interest in my being “happy,” so if I became too frustrated I would say, “I’m not happy.” He would respond,”you are happy.” It didn’t really change his behavior but I also adapted songs about being happy such as “Happy Together,” “Don’t Worry, Be Happy,” or “Happy” by Pharrell Williams. In general, I accepted anything he did and tried to respond musically. I did not attempt to communicate verbally.

I spoke music to him.  

As I was to eventually discover, all this was not in vain. Jonah spoke music. In fact, he spoke it fluently. Over a period of approximately two years, he began to reveal himself as musically gifted. He had perfect pitch and, in spite of not having any previous training or experience, he displayed an extraordinary ability to hear the melodies and harmonies in any piece I was playing. He would join in, playing accurately and complex parts on the piano. As our musical relationship and repertoire grew, Jonah’s length of engagement increased, his disruptive style of playing diminished and he even began singing! These are the types of goals any music therapist would consider worthy but they were all accomplished strictly through musical communication, pure and simple. Although not every client is as musically gifted as Jonah, I have witnessed this phenomenon in infinite cases. My personal definition of music as therapy is:

Music is the language of spirit and a portal to the supreme creative power that is present in everything and everyone. It is a means of non-verbal communication and uplifting social interaction in which music therapy clients can find freedom and release from constraints due to illness, limiting stereotypes of identity and other restrictive conditions.

To witness Rick and Jonah having a music conversation, go to this link:

Mitakuye Oyasin – We Are All Related

Rather than  setting up a framework that divides people up into symptoms and diagnoses and seeks interventions to accomplish goals meant to address areas assessed as deficient, consider a worldview where no one is broken, unnecessary or less than anyone else. Everyone and everything comes from spirit with a purpose and a meaningful place. The Lakota concept known as “Mitakuye Oyasin,” translates basically as “we are all related.” From a this perspective, individuals with psychological and neurological differences typically referred to in Western culture as “disabled,” might be considered “Heyoka” in the Lakota language. This can translate directly as “sacred clown,” but not in the Western sense of clown, meaning someone comically tragic and ridiculous to be laughed at but, rather, as someone whose gift of a different reality challenges the community to see beyond entrenched cultural norms and beliefs. In this way, Heyoka bring new types of learning to the tribe that may be considered to come through a powerful connection to “Wakan,” the “Great Spirit” or “Great Mystery.” This portal to the supreme creative power that is present in everything energizes the community and helps it to evolve and grow. As such, Heyoka are honored and considered to serve an important role in their tribe (Ross, 1989).

Love Me for Who I Am

Another key difference between music and most clinical treatment is the concept of privacy. In medical or psychiatric treatment, patients engage with the practitioner in a personal process, or, at most, within a relatively small group, with the understanding that anything they say or that is revealed about them will be held in the strictest confidence. This is appropriate ethical and legal treatment. The Health Insurance Portability and Accountability Act (HIPAA), was passed in 1996 as a federal law to protect patients’ personal health information. If music therapy clients are going to share potentially personal information about themselves in creative work, we must ascertain that they or a responsible guardian have given appropriate consent. 

In music, we move into a wider field beyond personal identity and private pain. Why do serious musicians practice every day for hours? Why do composers struggle to find the right combination of notes, the right style, tempo and lyrics? Their greatest desire is for their music to encapsulate and communicate some truth, some feeling, that will be meaningful to others. Music is an act of sharing. Its deepest impetus is to connect; to heal; to respond to the needs of the present time as much as it illuminates the future.

Honoring people for who they are, as opposed to diagnosing, characterizing them and isolating them from the flow of everyday life is expressed in the song, “Love Me for Who I Am,” that was written during a group music therapy session in an in-patient residential institution. There were 12 participants and all had some significant form of impairment related to brain injury, psychiatric diagnosis, orientation impairment or memory disorder. Some could barely speak. Some hardly knew where they were. A germ of an idea started about a better world. People started suggesting lines. My job was to listen and take notes; to give everyone the respect of being heard and having a voice, even those whose voice was one word, a hesitantly articulated contribution from a seemingly disoriented person who, perhaps, is not used to having anyone listen. One line I will never forget came from a man who had been a successful businessman but following a catastrophic car accident, he was in a wheelchair with a very serious traumatic brain injury, barely able to move or speak. His contribution, offered in a quiet raspy whisper was the incredibly understated and poignant line: “Life is Risky.” As we fit the pieces together, little by little, our lyric took form. One lady who could play piano came up with a few simple chord changes and a melody; a Latin-Caribbean influenced Rock feel. And we had a song:

Love Me for Who I Am

I may not look like you 

I may not talk like you 

But I have feelings And my heart beats like you

If you take a little time 

Then you might find 

If you get to know me You might come to love me

Though ages may pass 

It must come at last When the lion lies down with the lamb

The miracle is revealed

And the world will be healed 

When you can love me for who I am

Ashes to ashes 

Dust to dust 

Life is risky 

But in God we trust

Sadness will continue 

To play it’s game 

Until we realize 

That we’re all the same

Though ages may pass 

It must come at last 

When the lion lies down with the lamb

The miracle is revealed 

And the world will be healed 

When you can love me for who I am

Could any song be more socially significant and have a more timeless message? ‘We have a right to be here. Our perspective is valid and our lives matter. We will not be condemned or pushed into the shadows.’ Mercedes Pavlicevek and Gary Ansdell, authors of the book, Community Music Therapy (2005) pointed out that music’s “ripple effect”- its tendency to spread outward, naturally attract people and move them into increasingly wider social contexts – can create links between people and foster well-being. In this case, the song connected multiple people – the clients who wrote the song in the original session and were proud of their accomplishment, those who liked it, learned it and performed it several years later, the audience that witnessed the live performance and since that performance was filmed and shared on social media (with participant’s consent, of course) it touched those who saw it later online. Peter Jampel (2011), a pioneer in building community and integrating performance in music therapy wrote that through this process, individuals can experience meaning, identity, engagement and ultimately belonging (p.173). Music’s ability to touch hearts and raise people’s consciousness is of supreme importance in this world. Here are a few public comments:         

“Thank you for sharing. Amazing message. We need music therapy everywhere!”

“Thank you for sharing. You made me smile and feel hope.”

“Awesome!!!! Beautiful song and so true.  You all did an amazing job. It brought me to tears.”

“I absolutely loved this song! The words and your performance is beautiful! Thank you so much. I love you all!” 

To hear Love Me for Who I Am, go to this link: 

Saving the World

Inspiring feelings of joy, connection, acceptance of self and others through music may go beyond facilitating personal growth, well-being, and inclusion. Dr. David Hawkins (1995), renowned spiritual teacher, psychiatrist, physician, and researcher, proposed that every thought, action, decision, or feeling creates a ripple in the interlocking energy fields of life and every improvement we make in our private world improves the world at large for everyone. All thoughts, ideas, decisions, actions and events are accompanied by energy fields, that not only influence the attitudes, interpretations, mood, and behavior of those directly involved but also move beyond their source and interact with the energy fields of others wherever they may be. In other words, Hawkins claims, thought-generated energy influences the whole of unified consciousness like the rising of the sea level effects all ships.  

The concept of a unified consciousness runs through ancient belief systems as well as modern physics. The Zen concept of “dependent origination,” describes all phenomena as arising, existing, and ceasing together in a web of interconnected conditions (Gunaratana, 2024). One of the most significant theoretical physicists of the 20th century, Erwin Schrodinger (1967), believed that the apparent separation between individual minds is an illusion, famously stating, “The total number of minds in the universe is one” (p.135), suggesting that the same consciousness experiences all of life; that what we think of as individual minds is actually a part of a single, universal consciousness, comparable to light from the same source streaming through many windows in a single house. Another prominent 20th century physicist, Dr. David Bohm (1980), also regarded the universe as a single, unified field of consciousness that he called the Implicate Order. Dr. Bohm felt that in music, one is directly perceiving and influencing this universal oneness and Dr. Kenneth Bruscia (2012), among the most eminent and respected authors and theorists in the music therapy field, also contended that music therapy offers its greatest meaning through contact with the Implicate Order. Dr. Bruscia proposed that music expands our consciousness as it connects with personal and transpersonal realms. 

Dr. Hawkins developed a “Map of Consciousness” (1995) that defines human emotions, attitudes, and energy levels. It charts high-energy states such as acceptance, reason, love, compassion, joy and peace down to low-power, destructive states such as shame, blame, hatred, hopelessness, fear, desire, anger and pride. The intentions of people interpreting and acting primarily from the lower states of consciousness, including, as we are all too painfully aware, many world government and business leaders, is a one of egotism, ruthlessness and ambition that has led to endless conflict, war, and poverty as well as the ravaging of our planet. 

The good news, according to Dr. Hawkins, is that people experiencing the higher states of consciousness act as a counterbalance to the destructive tendencies in the world. “Music is a higher revelation than all wisdom and philosophy” claimed Beethoven (Sullivan, 1936, p.193). As music therapists working with music’s capability to uplift, inspire and enlighten, we have the possibly the greatest asset of all at our disposal to influence positive states of consciousness. Hawkins held that making the effort to raise one’s state of conscious is the greatest gift anyone can offer the world for, as we move up the scale, the people experiencing and living from the higher states are, quite literally, saving the world from destruction.  

And In the End…

If we accept that true consciousness is unity consciousness, then music therapy is not only a modality for personal growth, facilitating an uplifting spiritual experience or even simply an enjoyable activity. In the words of Dr. Bohm, that is not actually the point at all: 

Individual salvation actually has very little meaning, because, as I have pointed out, the consciousness of mankind is one and not truly divisible. Each person has a kind of responsibility not, however in the sense of answerability or guilt. But in the sense that there’s nothing else to do, really, you see. There is no other way out. That is absolutely what has to be done and nothing else can work (Bohm in Weber, 1987, p.419

With our intention to honor and empower some of the most humble and downtrodden people on the planet, we work under the premise that as we access higher levels of spiritual energy through music, it brings a value to every human being; to, indeed, the whole world (and beyond?). The spiritual value and higher levels of consciousness generated through music are a gift to life and the love of mankind. Applied from this perspective, music therapy can be an inspiration and a medium for advancing socially progressive ideals, particularly for disenfranchised people:

• Rejecting Systems of Oppression and Stereotyping
• Creating Life-Affirming Community and Meaningful Purpose
• Enhancing Opportunities for Social Equity and Inclusion

As we can learn from the Lakota people, philosophers and contemporary scientists alike, the correct world view is one of interconnectedness. There is no hierarchy of importance. Superficial identities are not what matters.  As we project our music proudly into the world, we acknowledge and amplify the presence and power of those who might otherwise be marginalized. In so doing, we offer our contribution to humanity’s collective evolution toward higher states of consciousness.

References

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