Music Therapy: Scientific Perspectives and Clinical Prospects

Wolfgang Mastnak
Shanghai Conservatory of Music, professor of music education and music therapy, member of the
research group “aesthetics in music education”

DOI: 10.5281/zenodo.7824678


Music and arts for healing purposes look back over a multifaceted evolution and a myriad of phenomena in various cultures. Interdisciplinary considerations suggest to distinguish five different, but partly overlapping stages. The first refers to historical roots and ethnological sources, which have also influenced modern meta-theoretical perspectives and practices. The next stage marks the heterogeneous origins of modern music therapy in the 20th century that mirror psychological positions and novel clinical ideas about the healing power of music and the arts. The following heyday of music therapeutic models and schools of thought yielded an enormous variety of concepts and methods such as Nordoff-Robbins MT, Orff MT, Analytic MT, Regulatory MT, GIM or Sound Work.
As music and arts therapies gained in international importance, clinical applications required research about their therapeutic efficacy. According to standards of evidence based medicine and with regard to clearly defined diagnoses research on music therapeutic practice became the core of stage four.
The present stage is characterised by an emerging epistemological dissatisfaction with the paradigmatic reductionism of evidence based medicine and the strong will to discover the ‘true healing nature’ of music. This trend has given birth to interdisciplinary hermeneutics for novel foundations of music and arts therapies. Epigenetics, neuroplasticity, regulatory and chronobiological sciences, quantum physical philosophies, universal harmonies, spiritual and religious views, and the cultural anthropological phenomenon of aesthetics and creativity have become guiding principles.
The present paper relates to the author’s EASA-speech on the 2nd of December 2022 about landmarks in the evolution of modern music therapy and its interdisciplinary perspectives.


complexity sciences, cultural evolution, cultural sensitivity, ethno medicine, interdisciplinarity, medical meta-theory, quantum mind, underlying mechanisms.

1. Introduction

The evolution of the human race is inextricably intertwined with symbolic, aesthetic and creative phenomena ‒ shortly, the arts, which are not only a vivid expression of cultural dynamics, but have also been serving as curative media for time immemorial.
Today’s clinical circles and public health systems apply the arts through approaches like music therapy or dance therapy ‒ or they use holistic models such as Sound Work, Orff music therapy or Inter-modal Expres-sive Therapy. In medicine, arts therapies are used in disciplines such as neuro-rehabilitation, paediatrics, psy-chiatry, geriatrics, psycho-oncology and obstetrics, while specific arts therapeutic techniques are precisely tai-lored to distinct medical conditions such as acquired brain injury, autism spectrum disorder, eating disorders, schizophrenia or Alzheimer’s dementia.
Clinical benefits call for research on underlying mechanisms ‒ in other words: Why and how can arts alle-viate symptoms or (help to) cure diseases? In this context, one of the most important support comes from neu-rosciences. By way of illustration, music is a vital promotor of neuroplasticity, which is important for psycho-therapeutic changes or the regeneration of affected neural networks. Moreover, the arts can importantly stimu-late the default mode network, an enormous information processing system, which is, however, not accessible to our conscious mind. Arts-based therapies also have a strong impact on the limbic system, which generates and modulates emotions, and even can boost the activity of the nucleus accumbens, the brain’s ‘joy centre’, hence its importance in mood disorders such as depression.
However, neurosciences are only one approach to explore the mechanisms underlying the therapeutic effect of the arts. Recent activities also involve quantum consciousness and quantum spirit, as well as cross-cultural and culturally sensitive medicine, e.g. traditional Chinese medicine or shamanistic rituals and associated myths. Arts-based therapies are likely to have a flourishing future, and interdisciplinary research is needed to get deeper insights into their complex dynamics, as well as to optimise their multifaceted methods.
The present article intends to contribute to the EASA’s profound communication between sciences and the arts and involves the author’s previous work about evolutionary characteristics of music therapy (Mastnak, 2015a). Relevant findings during the last ten years have importantly substantiated those perspectives and hy-potheses. Suggesting a theoretical framework, this new article encourages further interdisciplinary and trans-lational research and aims at increased compatibility of culturally sensitive arts-based therapies with high-standard clinical practice and public health systems, also in the sense of the World Health Organization.

2. Evolutionary and Anthropological Perspectives of Healing Music

“Now the Spirit of the Lord had departed from Saul, and an evil spirit from the LORD tormented him ... When-ever the spirit from God came on Saul, David would take up his lyre and play. Then relief would come to Saul; he would feel better, and the evil spirit would leave him” (1 Samuel 16: 14 & 23).
This famous narration is often considered the cradle and divine legitimisation of music therapy. Myriads of comments hypothesise crucial therapeutic factors of that stunningly efficient, though ‘non-professional’ music therapy. David played a kinnor, an ancient Israelite instrument that was probably similar to a lyre, but not a harp. F.D. Maurice (1805 - 1872) saw David’s music as a means to bring back the sense of true order and in-ward harmony (Ellicott, 2015, p. 362), an idea that also appears in several ethnological and modern concepts of music therapy.
While this Biblical tale does not mention “underlying therapeutic mechanisms”, Plato’s treatise Timaeus elucidates: “Music too, in so far as it uses audible sound was bestowed for the sake of harmony. And harmony, which has motions akin to the revolutions of the Soul within us, was given by the Muses to him who makes intelligent use of the Muses, not as an aid to irrational pleasure, as it now supposed, but as an auxiliary to the inner revolution of the Soul, when it has lost its harmony, to assist in restoring it to order and concord with itself” (Plato, 1925, section 47c-d).
2500 years ago, Plato – Πλάτων – opposed the attitudes of ‘fun societies’ and attached greatest importance to the harmonic principles of life. Nowadays, his critical argument applies to positions which narrow the effi-cacy of music therapy down to (superficial) pleasure. In order to avoid misinterpretation: music-evoked joy can serve as an essential agent of music therapy. And yet, complexity sciences suggest to understand music thera-py in a systemic and holistic way. Plato, however, was not the first to emphasise the healing power of music: in Jamblichos Pythagoras – Πυθαγόρας ὁ Σάμιος – pointed out that music is able to contribute considerably to individual wellbeing (Albrecht, 1963). Moreover, according to Damon, a music theorist of the 5th century BC, and teacher of Socrates and Pericles, music imitates the movements of the soul, hence its “psychological” power. Broadly speaking, music – in Ancient Greek understanding – has two faces: on the one hand it can suppress or control human desire and drive (Trieb), hence its educational and moral impact. On the other hand, it can soothe the disturbed “animal” part of the human soul, hence its therapeutic nature. Accordingly, Greeks of the classical period used to attribute the gift of music to both Apollo and Dionysos, highlighting its dual – educational and cathartic – puissance.
Orpheus – no matter whether he was a historical figure or a splendid invention of Greek mythology – was of seminal importance for Western music history: While Jacopo Peri's “Dafne” is usually regarded as the first opera (the earliest surviving opera, however, is Peri's “Euridice”), Claudio Monteverdi’s “L'Orfeo” has given rise to the heyday of this musical genre and is the earliest opera which is still regularly performed. And until today Orpheus has been inspiring operas such as Yiannis Markopoulos’s "Orpheus & Euridice". As myths tell, Orpheus’s music was so entrancing that animals and women naturally flocked to be in his presence. Today, vocal therapies are significantly in the ascendant, and Teresa Tièschky’s (today married Boning) Arion Psy-chovocal Therapy (Tièschky and Mastnak, 2016) afresh refers to Ancient Greek roots: Singing can save lives ‒ such as in suicidal psychiatric patients.
While the world of music therapy pays surprisingly little attention to Orpheus, the followers of the Orphic cult as well as Pythagorean philosophers clearly emphasised the music’s therapeutic potential. In combina-tion with ascetic lifestyles, music was seen as a technique to facilitate the soul’s therapeutic catharsis – and two purifying chant genres came into play: paeans and epodes. Regarding Ioannis Liritzis’s et al. (2017) pro-found work on archaeoastronomy, Apollo oracles and Apollo-Asclepius related cult, we are afresh faced with interdisciplinary and evolutionary challenges of music therapeutic research: the wealth of relevant sources in Ancient Greece.
From ancient times until today music therapeutic views have been a mirror of profound differences between scientific and spiritual approaches. By way of illustration, in 1316 the Council of Cologne declared that sing-ing the antiphon Media Vita for therapeutic purposes would require the bishop’s permission (Engel, 1968, p. 77), while in 1392 Eustache Deschamps (Raynaud, 1891) considerd music the medicine of the seven liberal arts. Kümmel (1977) unearthed the immense richness of music therapeutic theories and practices between 800 and 1800, which relate to obstetrics, paediatrics, geriatrics, digestion, sedation, fever, neurological conditions such as epileptic fits, psychiatric issues such as manic and depressive disorders, or the support of erotic feel-ings and sexual functions.
It goes without saying that Plato’s explanations ranks among historical roots of music therapy. In many other cases, however, it is quite impossible to differentiate between historical and ethnological perspectives. In 1976 Oruç Güvenç (1948 - 2017) (Güvenc, 2006) founded the research group Tümata ‒ and a new movement of Turkic music therapy was born (Tucek, 1977; Tucek and Mastnak, 1998). Investigations shed light on the rela-tionship between ancient and modern pathological conditions and clinical practices alongside the issue how findings would apply to differently acculturated populations. The more research focused on the mystery of music therapeutic efficacy, the more emerged epistemological inconsistencies between spiritual and scientific positions, hence the challenge of finding a balance between Sufism and Western medical sciences in today’s school of Ancient Oriental Music Therapy.
From a European point of view, practices of Chinese healing music may be regarded as ethno music thera-py. Nonetheless, Chinese medicine is also applied in the Western world and several models of Chinese music therapy, e.g. Musical Qigong (Wu, 2001), have gained a foothold in Western music therapy. Other Chinese techniques, such as Five-Element Music Therapy, take core elements of Chinese health traditions, design new methods, and study them according to standards of evidence based medicine (Liao et al., 2013; Liu et al., 2014). Recent clinical research in China focused on the benefits of an intermodal use of the cither Guqin 古琴 in on-cology, e.g. to alleviate sleep in gastric cancer patients (Mao and Mastnak, 2022).
How to distinguish adequately historical, ethnological and contemporary aspects, and constituents of mu-sic therapeutic developments deserves complex in-depth investigations. This also relates to traditions which encompass multiple health-related functions but are not referred to as ‘music therapy’. For instance, tradition-al folk music of Carinthia or the Bavarian Alps may have positive impact on mental catharsis or emotional stabilisation, although these vivid traditions are not (primarily) regarded as music therapy (Mastnak and Astner, 2017). Akin to these phenomena, traditions of North Vietnamese shamanism, which importantly comprises chant and instrumental music, can be regarded as culturally sensitive psychotherapy and psycho-somatic treatment (Mastnak, 2023). Arts-based healing traditions and modern clinical and public health prac-tices are about to converge and require new ways in interdisciplinary understanding of health promotion.
Cross-cultural transferability of ethnic therapeutic practices represents one of the cardinal issues in the global scene of arts-related therapies. As regards cultural sensitivity, anthropological constants have to be dif-ferentiated from indigenous cultural phenomena. Multidisciplinary research is called to distinguish ethno music and arts therapeutic elements which relate to common principles in the human race from those which are inseparably connected with regional cultural evolutions. In this domain, the French dance therapist, psy-choanayst and reseacher France Schott-Billmann (2014) has essentially contributed to the understanding of anthropological invariants and specific cultural features of arts-based therapies, and dance-rhythm therapy in particular.
Experiences with traditional microtonal music therapy inspired research on therapeutic aspects of classical Indian Music. In this context, the author of this article found in Nepal a paper from Pakistan associating fol-lowing rāga with clinically relevant phenomena: Pīlu – melancholia, Bhimpalāsī – worldliness, Darbari (Dar-bari Kanada) – insomnia, headache, fever, Malhar – low blood pressure, Kalyān – high blood pressure. In her PhD-research, Lasanthi Manaranjanie (2010) discovered relevant effects in European cardiac patients. While these results point to possibilities of cross-cultural clinical application, e.g. indigenous music healing rituals of Sri Lanka may not be rooted out and “transplanted”. Nevertheless, some general principles also apply to ther-apeutic issues of “today’s modern city life environment” (Lasanthi Manaranjanie, 2013, pp. 107-109).
The wealth of historical and ethnological applications of the arts for healing purposes substantiate the hy-pothesis of the profound curative power of entities such as music, dance, drama or the visial arts. On the first Asia Pacific Congress of Music Therapy in Beijing in 2019, ethno musicologist La Verne C. Dela Peña from the University of the Philippines emphasised that the healing potential of music belongs to the whole mankind. Its reliable practice calls for interdisciplinary research, though....please continue with pdf

PDF Download

Copyright: © 2023. This is an open-access article distributed under the terms of the Creative Commons Attribution License. (

Share this article