Can Music Cause Harm? (Part One)
Can music cause harm? This is a big question for music therapists. Of course, all of us are surrounded by music every day, and you’ve probably heard by now that music and music therapy can be a great help for people dealing with many different problems. But could it be dangerous? I won’t tell you that music could kill you. Rather, I wanted to tell you about some of the ways I’ve seen music cause harm, and suggest what to do about it. I’ll discuss three areas today, and four more in my next post.
#1. Too much sensory stimulation.
You know how you can feel kind of irritable when you’re at a really noisy restaurant, and there are kids whining and crying at the next table, and you can hear plates crashing in the kitchen, and there’s a really annoying recording of Dean Martin singing “That’s Amore” playing overhead? That’s what it feels like to be over-stimulated. For people who have dementia, autism, or psychosis (among other disorders), this over-stimulation can be too much to handle. Their coping skills get stretched too thin, and they start showing that they are uncomfortable, maybe by getting up from their chair and walking around the room, or making vocal sounds. The problem is that sometimes in our eagerness to share music with someone, we misinterpret some signs of over-stimulation (he’s dancing! She’s singing!), and we keep giving more and more music. Eventually, the overstimulation could lead to hitting, grabbing, screaming, or other aggressive behaviors.What to do:
- Keep the noise level down! That means minimizing overhead paging, call lights and alarms, tray carts in the hallways, and loud conversations by staff and visitors.
- NEVER leave more than one TV or radio on in a resident room. Utilize headphones if both residents want different programs.
- Pay special attention to residents who cannot tell you whether the music is too much or not, watching for signs that the music is too much.
#2. Exacerbation of hearing loss.
Hearing loss is common among older adults, and often the solution seems to be cranking up the volume on the TV or radio. Even if someone already has hearing loss, though, they should be taking steps to prevent further decline. That means finding better solutions that simply turning up the volume.What to do:
- Eliminate environmental noise. This means the person with hearing loss can more easily participate in a conversation and understand what’s going on without shouting.
- Be aware of how loud the music is during an entertainment event. I’ve seen very large speakers at some entertainment events. These can do more harm than good, letting sounds reverberate in a space, so it all sounds muddy anyway.
- Hold activities in the rooms/areas with the least amount of extraneous noise. Close doors when possible.
- Provide noise-cancelling headphones for residents to listen to the TV or iPod.
- Make sure all of your senior’s caregivers are on the same page in regards to keeping the noise down. Decide what your methods will be, and help your fellow caregivers know what to expect.
#3. Increased anxiety.
Yes, music can increase anxiety, even if you mean for it to be relaxing. I learned this the hard way as an intern in the hospital setting. I was leading a patient through a music-assisted relaxation exercise, starting with a focus on deep breathing. I noticed that instead of slowing her breath and looking blissful, she was actually breathing harder. I stopped the music and asked what was going on. It so happens this patient was dealing with chronic bronchitis in addition to the problem that had her on the inpatient unit at the hospital. By directing her to breathe deeply, I was actually causing her to worry about the fact that she couldn’t breathe deeply enough. Obviously, that increased anxiety was not the outcome either one of us wanted to see. So, I switched to another relaxation technique NOT focused on the breath, and she was able to relax. What did I learn? Music-assisted relaxation techniques can actually cause anxiety when not implemented appropriately.What to do:
- Don’t assume that a CD marked as “relaxing” will necessarily be relaxing for the person you care for.
- Watch for signs of anxiety when someone is participating in a music activity. Even if they are verbal, they might not tell you that they’re feeling anxious.
- Seek the advice of a music therapist for music-assisted relaxation techniques that will work best for the individual.
Nicely stated, Rachelle. The multiple sound source issue is one that is something staff and family members can all take part in correcting. I look forward to your next post.
Thanks, JoAnn! The multiple sound source issue is a particular pet peeve of mind. It’s usually so easy to correct.
Excellent point about not all music branded as “relaxing” necessarily having that effect! There’s an interesting article in the latest JMT about quantitative properties of “relaxation” music that would be a good resource for anyone looking for more info.
Yes! Thank you for that reference. (JMT = Journal of Music Therapy)
Great post. Important to be aware of overstimulation due too much sound. Also, being aware that individulas may respond differently to various types of musihc
Thanks for your comment, Arlene. Yes, it’s easy to forget that different people have different tolerance levels for sound, but it’s also a relatively easy problem to fix much of the time.
Another fantastic post Rachelle. MTs know it but thanks for the reminders. Enjoying all your posts.
Yes, Kirk, MTs do know it! That’s why healthcare agencies should have us around. 🙂 Thanks for your comment!
Rachelle,
I have often been the one overstimulated by multiple sound sources, so I really appreciated the thoughtful presentation you have here.
Warmly,
Ann
I’ve been in the position of being over-stimulated, too, so I am very protective of the folks I work with in that aspect. Thanks for your comment, Ann!
I really appreciate this post and look forward to the next one. This is topic is one I highlight with freshmen music therapy students. Every time I bring it up that first semester, students seem dumbfounded by the thought that something so wonderful (music) can harm. Really puts training music therapists in perspective.
Yes. I’m so glad that you make a point of teaching this to MT students. That’s a huge reason why MTs are important in so many clinical situations, because we have the expertise to recognize and prevent situations where music is making things worse!
Thank you for this post. As a parent of a child with sensory processing issues I am very grateful to you for bringing up these issues. One of the hardest things for her is loud environments and while she loves music, it can also be a completely overwhelming, overstimulating experience for her depending on the context.
Hi Allison,
I am often frustrated by music venues and entertainers whose emphasis is on being LOUD. I confess that I rarely attend popular music concerts, and when I do, I usually bring ear plugs. I hope you and your daughter are able to find places to enjoy music that aren’t so overwhelming!
Good advice here for family, friends, and professionals. I can remember my father who had hearing loss, getting very irritated by background noise. Thanks.
Yes, hearing loss is one of those things we tend to forget about. Even if it’s not profound hearing loss yet, it still affects how we receive the sounds around us.
This is so important for people to realize in just about any setting. Even mild hearing loss makes it difficult to follow conversations with too much background noise. Listen up, restauranteurs!
Yes, so true! Restaurants can be especially bad. Thanks for the note!