FOREWORD
In presenting a musician’s point of view on so specific a subject as “Music in Medicine”, it seems to me necessary at the outset to clarify the status of music as an independent aesthetic art, and its practical adaptation for definite utilitarian purposes. We must clearly separate the active individual process of artistic creation from the elements of passive perception and from effects such perception may have when applied for different realistic reasons.
Taken aesthetically, as an art, music is a social “superstructure”, which, as far as the individual creative act is concerned, remains an abstract manifestation of the human mind and imagination. Its existence as a creative art is possible only as long as the practical “possibilities” and potentialities of its effects in the phase of passive perception, do not intrude into and interfere with its character as an absolute non-utilitarian phenomenon in the processes of the creative art. Art, by its very nature is a product of individuality. As opposed to the anonymous craft, the main requirement of an aesthetically artistic product assuming the presence of professional skill and knowledge is that it be the work of a human organism, which possesses acceptable qualifications of vocation and expression. To this attribute we have given such names as talent, genius, imagination, and many others. This phenomenon of specific predestination must also be accompanied by a characteristic property which has received such names as personality, individuality or originality. It is obvious that these fundamentals of artistic creation prevent any general or universal approach to the creative processes which, with the exception of purely technical and formal elements of craftsmanship and common expression of specific style, exclude the pattern and definite utilitarian aims. All these factors are obviously concerned only with the living moment of the musical art in the essence and genesis of the individual creation.
Although music as a creative manifestation of the human mind does not aim at social or utilitarian function, its materialized results may yet find wide application in the manifold use of this aspect of passive perception. This passive perception stimulates an active participation by the listener in whom it may provoke definite emotional reactions and mental modulations. If we think of music as the completed creation of one mind, we can understand how its perception may have a genuine influence on the listener’s mood and that it may be channeled into desired directions which takes the forms of adaptation and adjustment. This, in spite of the variety of tastes and reactions, can certainly be generalized within limits by scientific methods.
Although I do not believe that music should be written for purely utilitarian reasons (and I am speaking not of the material advantages it may bring the artist, but of the aesthetics of creative art) I see no reason for not using any composition to such practical advantage as its application may offer. Music as an art appliqué has been known since ancient times in many different roles, not all as laudable and noble as its use in healing. Its property of melodical expansion, propulsive character, rhythmical vitality, nervous insistence, harmonic intricacy, development in time rather than space, its wealth of moods (which extend from static calmness to wild exuberance with an enormous range of intermediary impressions, even in its abstract character of pure organized sound) provokes in listeners a response which is primarily psychological and emotional, but which frequently influences physiology and the nervous system.
The use of music for work, marches, the stimulation of mass sentiment or emotional impact (patriotism, war, etc.), for entertainment, oblivion, mood change, mood creation, and background music for motion pictures, evokes realistic responses, where music is applied for its effect, rather than for its intrinsic value. It is therefore no surprise that the applied use of music (which has nothing to do with the active process of artistic creation) should be used in the care and treatment of the sick mind and body. I do not know what subjective responses result from such purely physical phenomena as vibration and harmonics but I am convinced that listeners are physiologically and psychically effected by such musical characteristics as mood, intensity, pitch and rhythmical outline. It seems to me that the right music should provoke remembrance and association of thoughts and situations more easily in a mental patient than methods using factual persuasion. Music can avoid the realistic approach and by its absolute progression abstractly recreate a familiarity of situation which may prove most useful in handling mental patients. By eliciting a desired mood it may offer the physician a method of handling disease as important as shock, and a result obtainable in no other way. To a musician, completely unfamiliar with medicine and pathology this use seems obvious and undeniable. Dr. Licht has made a thorough study of this subject and has indicated some of the many uses of music in mental and physical pathology. The work which has been based on scientific research and clinical experience is most impressive and encouraging. If we, as musicians, can bring our contribution to such a wonderful purpose as healing, it would certainly be our most glorious accomplishment for mankind, and the noblest use of our art.
But, as I have said, aesthetically it should not be the aim but the effect of art which should be considered. If applied use rather than creation were to assume greater importance, art would lose its essential characteristics and would become a social manifestation of mass production instead of an abstract phenomenon. It might work out usefully, perhaps for a time, but in losing those primordial elements which condition its own existence, it would also lose the effects which its use provoke not only in medicine but in other important directions. The effects of music will progress satisfactorily to the advantage of mankind only as long as it is permitted its normal development regardless of motivations and their justifications. In the long run it will find a greater and better use in the practical sense, if its creation continues along traditional lines, and is not diverted into the fallacious channel of anonymous mass production with consequent loss of proper utility and aesthetic raison d’etre.
It is likely that scientific research and clinical experience will motivate the production of musical compositions which are designed for certain classes of patients. This will require much skill, craftsmanship, gift of adaptation and assimilation of established patterns as well as disciplined imagination, but the creation of such planned utilitarian works would not be possible without the continuation of music as a self sufficient art activated by its own emotional and spiritual reaction and enjoyment. No derivative may exist and progress by suppression of the source which must aliment it continuously by its own growth and through the conservation of its individual characteristics.
Music as an art has its own internal laws of creation and traditional development. These laws are not casual but organic and they can not be violated without self destruction. Consequently, the beneficial effects of music can be applied for utilitarian purposes only if its integrity is safe from external intervention, even if only temporarily, and if the element of social usefulness does not influence the creative process.
The criteria of artistic and practical values do not necessarily coincide. Artistic value is defined only by time, the practical value is a matter of present usefulness. Works of great artistic value may be useful, whereas facile “hits” which fall into oblivion within a brief period may prove extremely useful, and that is why the two conceptions must be differentiated. Michelangelo’s Medici Tomb, or a Bach Mass are completely useless in the practical sense of the work, and most successful “hit-songs” are completely devoid of any artistic value or originality. Yet both kinds supply the specific wants of those who would lament the absence of either of them. This resolves itself into a question of taste, educational background, musical culture and other factors which I presume are of importance in the clinical use of music. Patients will show preferential response to the music they like regardless of the elements of mood, tempo, rhythm and pitch.
But classifications are always dangerous. Good music is not necessarily useless, and useful music is not necessarily bad music. The eternal principal of suum cuique is the principle of individual human taste which can be placed into approximate categories, but cannot be standardized without the artificial interference of external factors. The same principle certainly applies to music as a weapon of healing, where selection should be determined by science but at the same time we must strive to adapt the results of research of the individual preferences of normal subjects.
Alexandre Tansman
Los Angeles, January 1946