Can Music Cause Harm? (Part Two)

my last post, I talked about how music as a sound stimulus can contribute to overstimulation, increased anxiety, and hearing loss. Many times, people experiencing this kind of music- or sound-related stress show their discomfort in negative behaviors rather than communicating verbally, so it is especially important to be aware of the how the sound environment is affecting the person you care for if they can’t tell you what’s bothering them. Music can also potentially cause harm in the form of unexpected emotional or physical responses that could defeat a person’s coping mechanisms. There can, in fact, be negative responses to music that you might not expect, and not being aware of and prepared for these negative responses can lead to harm. Here are four areas of concern:

#1. Unexpected emotional responses.

We know that music is closely tied to our emotions; in fact, brain research shows quite clearly that music lights ups parts of the brain that are connected to emotion, including the limbic system. What is less clear is how specific musical elements and aspects of a person’s own life history affect the person’s experience of a musical selection. We tend to think that certain songs are “sad” and others are “happy,” and to some extent, this is true. Music that is at a moderate to quick tempo and in a major key is often perceived as upbeat or positive, while slower tempo songs in minor keys might come across as sad or contemplative. The thing is we all have different experiences with various songs, and you can’t always predict how a particular song might be perceived by a listener. “Mairzy Doats” might seem like a silly song to celebrate April Fool’s Day, or it might remind someone of a beloved mother who just died a few weeks before. “Danny Boy” might seem like a sad, sentimental song for funerals, or it might bring a smile to the person with Irish ancestry. You can’t be sure whether a song will bring someone to great joy or to deep sadness. To complicate things further, we sometimes don’t even know how our own feelings will be stirred up by music. Someone might even request a song just because they like it, and then find themselves in tears, with emotions boiling over. If grief or anger or sadness comes and you can’t help the person process these feelings or cope effectively, this could cause harm.

#2. Unexpected physical responses.

Of course, we must remember that our bodies, minds, and spirits are all connected, and sometimes our reluctance to acknowledge emotional pain can cause physical distress. Some of us were taught to stuff the difficult emotions inside rather than process and express them in healthy ways. This can lead to physical pain. You might know this feeling on a basic level if you’ve ever tried to hold back tears for a long time. You might get a headache, or tense up your shoulders, or grit your teeth. If you multiply the effect of that minor physical discomfort for someone who already has a medical condition, then you find music could cause some unexpected physical responses. I wrote about one such situation in my last post. Music has even been known to cause seizures in rare circumstances. All of this means you need to be aware of physical responses to music.

#3. Feeding into confusion or delusions.

Music can contribute to the confused thinking of a person with dementia or someone who has hallucinations or delusions because of schizophrenia or other forms of psychosis. Many of my clients have dementia, and I often choose songs to bring back pleasant memories and foster social interaction. Sometimes, though, a song might lead a person down a line of confused thinking in a way that can add to their distress. For example, one client of mine, a widow, joined with me in singing, “Let Me Call You Sweetheart” and talked about her sweetheart along with other members of the group. Then, she asked, “where is John? Is he dead?” How do you answer this question? There are various ways of figuring out the best response in this kind of situation, but it is important to remember that you could add to a person’s grief and pain by getting into a pattern of music that reminds them of their loved one’s death, over and over again. I’ve also seen music contribute to a person’s confusion in a way that increased agitation. For example, singing particular songs reminded one of my clients of her children. In her confusion, this reminded her that she was supposed to pick them up from school. Then, because they weren’t there, she became very worried, thinking her kids had been kidnapped. While in this situation I couldn’t predict her response, I did know how to soothe her worries and redirect her attention to the group’s music. Now I know which songs could feed into her confusion.

#4. Communicating unhealthy messages.

Songs get stuck in our heads. We play the music we like over and over. Thus, the messages that these songs repeat get stuck in our heads, too, even the negative ones. No, I don’t advocate an outright ban on hip hop or heavy metal, but I do think it’s important to pay attention to the words that we find ourselves singing to ourselves in the shower, and to help the people we care for understand and reframe these lyrics before they become part of their automatic thinking. Think this only applies to music for teenagers? Nope, I don’t believe that’s true either. In fact, I think the message of the Dean Martin song, “You’re Nobody ‘Til Somebody Loves You” can be harmful. What if you’re singing for someone who never married or who had an abusive relationship? I don’t want anyone to think they’re “nobody.” Repeating these messages – learning them through the music – makes them part of your being, and that can be harmful.

Pay attention!

Music can be cause for great joy, but it can also cause pain and distress. Music therapists are trained to be aware of all of these concerns, and are experienced in recognizing the effects that music is having on a person and how to adapt the music for a healing experience. Please talk with your music therapist about these situations. This is our area of expertise, and we want to help! Where have you seen music cause unexpected responses?]]>


  1. Stephanie Bolton on August 2, 2012 at 1:47 pm

    Excellent points, Rachelle! Thank you for so eloquently illustrating the potential pitfalls in music choices. So much goes into picking a song/music for someone!

    • soundscapemusictherapy on August 2, 2012 at 6:41 pm

      Yes, Stephanie! Music choice seems simple, but it really does take some clinical expertise much of the time.

  2. Anne Vitort on August 2, 2012 at 2:06 pm

    Great information! Thanks for addressing this difficult topic!

    • soundscapemusictherapy on August 2, 2012 at 6:41 pm

      Thanks, Anne!

  3. Allison Andrews, PsyD on August 3, 2012 at 11:07 am

    This is so interesting. Thank you for deepening our understanding of the power of music.
    Especially the reminder that all sorts of emotions can be stirred up. Warmly, Allison

    • soundscapemusictherapy on August 3, 2012 at 1:50 pm

      Thank you, Allison!

  4. musicsparks on August 7, 2012 at 10:02 am

    Well said, Rachelle. Music is powerful in ways many are not aware. Your posts are a great resource to which we can direct people.

    • soundscapemusictherapy on August 7, 2012 at 10:05 am

      Thank you for your feedback, JoAnn!

  5. Soffía Fr. Rafnds. on August 8, 2012 at 5:26 am

    Hi Rachelle. I found your articles through a twitter post. Music therapists in Iceland (where I live) are trying to get musictherapy recognized as a health profession and you have just given us lost of arguments for why you should need state certification to call yourself a music therapist 🙂 Thank you!

    • soundscapemusictherapy on August 8, 2012 at 9:51 am

      I am so glad to help! Good luck with your recognition work!

  6. Ann Becker-Schutte (@DrBeckerSchutte) on August 8, 2012 at 3:08 pm


    I have learned so much through reading your posts. You do a wonderful job of highlighting how valuable music can be, but also of educating about the importance of solid clinical training before using music with vulnerable populations.


    • soundscapemusictherapy on August 8, 2012 at 9:51 pm

      Thanks, Ann!

  7. Andrea B. Goldberg, LCSW on August 10, 2012 at 12:24 pm

    Hi Rachelle,

    You make some excellent points about ways music can be harmful. Your point about unhealthy messages reminds me of the song Follow Me by Uncle Kracker. it has a great beat and melody that is contagious and fun to sing, but the words bother me even as I am swept up in singing them because it is glorifying having an affair.

    I really enjoy your posts.


    • soundscapemusictherapy on August 10, 2012 at 1:00 pm

      Yes! I feel the same way about that song. It doesn’t sound like a cheatin’ song, does it? Another song in that vein that came out around the same time is “It Wasn’t Me” by Shaggy. That one gets stuck in my head, and the lyrics are awful!

  8. Lynda Buitrago on August 21, 2012 at 2:45 pm

    Thank you for this valuable insight. We really don’t know how music will affect someone and we need to keep that in mind as we care for others.

    • soundscapemusictherapy on August 22, 2012 at 9:33 pm

      I agree. Music is much more complex than we sometimes consider.

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