“His music mads me, let it sound no more,
For though it helps madmen to their wits,
To me it seems it will make wise men mad.”
Richard III, Shakespeare
Gaston[31] believes that
“The basic reason for the arts throughout the history of mankind has been the resultant mental hygiene benefits. The common creative urge, desire for diversion, and search for satisfactory expression exist in all people. Music—above all arts—guarantees the fulfillment of these elemental urges, and therein lies its greatest value.”
The suggestive power of music has given rise to a series of legends which go back to the very origin of civilization. But the methods of experimental physiology, so precise in the study of organic function, lead to no clear and easy picture in the presence of reactions as complex and subjective as those of esthetic emotion and artistic pleasures. The task of evaluating the effect of music on the mind is made increasingly difficult by the personal equation, and when to this is added the distortion of mental disease, great caution must be used in the approach, technique, and recommendations to be followed in the use of music as applied to psychiatry[27]. Altschuler[3] finds that music stimulates the libido, which he defines as
“the great amorphous power, the vital spark, out of which the will to pleasure, the longing for love or passion for procreation take their origin.”
He believes that music is the only “medicine” which helps to convert instinctual forces into socially acceptable forms.
“Stimulated by music, man can still offer his lowly instincts free expressions, camouflaged by jitter-bugging and boogie-woogieing.... Indeed there is therapeutic acumen to an agent which is capable of reconciling the instinctual with the social, and the sensual with the spiritual.”
The relationship between music and the mind is obvious, but the nature of the relationship which has led some musicians to facile claims of artistry remains for most psychiatrists a tempting but obscure field. Most of the writing on this subject has been done by musicians and so-called results obtained with music in mental patients have been evaluated without medical guidance or the use of scientific method. Physicians are hesitant to accept new ideas which are not founded on unquestionable evidence. Enthusiastic laymen might call this reactionary, and they would not be entirely wrong. It is the reaction to the too rapid spread of folklore, cults, and nostrums which physicians have had to combat to keep medicine on the highest possible plane. It is the only tool with which they can protect the sick from unscrupulous or even well-meaning people who, for personal gain or with ill-founded conviction, promise cures by the citation of accidental or falsified results. By custom, ethics, and state laws the treatment of disease is the province of the licensed physician.
The term “musical therapy” has been applied almost exclusively to the treatment of mental disease with music. The term “therapy” is derived from a Greek verb which means to cure. A cure can be practiced and determined only by a qualified physician, or under his direction. Claims can be made by anyone. To establish the curative value of any procedure, certain criteria must be observed. In the first place, the disease must be accurately classified so that the affliction of a series of patients can be scientifically grouped for study. Next, the therapeutic agent must possess qualities of constancy which permit controlled dosage. Last, the proper administration of the agent in the same disease condition must show a reasonably high percentage of results which can be proved to be of value in the control or elimination of symptoms or disease.
Until a relatively short time ago, the causes of most disease conditions were unknown and illnesses were named according to their superficial characteristics. Most newly named diseases are designated by the agents which cause them or by the variations from normal found in the tissues of the body they affect (pathology). In psychiatry, most diseases bear the names applied to their outward appearances.