Music Therapy: Defining a concept of entrainment and it application to the goals for music therapy group conducted with adult clients in psychiatric settings.
Clayton et al. (2005) define entrainment as a phenomena of two or more rhythmical processes synchronizing with each other. Christian Huygens discovered a phenomenon called entrainment through synchronization tendency among pendulum clocks where two pendulums clocks swung the pendulums at different rates are placed near each other are eventually end up swinging in at the same rate due to their mutual influence on one another. The concept of entrainment id defined through two principles: 1) two have autonomous nature independent of one another, 2) there must be interaction among two in order to influence one another, for example. The concept of entrainment is not narrows down to physiological process only, this is a concept, a maxima that describes a shared tendencies of physical and biological systems, for example, pheromones – odours substances which are released by one animal or human and detected by another, causing some sort of physiological reaction. Among various studies, synergy, from ancient greek means “working together” examines second principle of entrainment, where in a context of organizaitonal behavior, synergy is the ability of the group to outperform even its best individual member. Clayton et al. (2005) state that the concept of entrainment, in the context of the view on the brain functioning, brought to the attention two principles: 1) almost all brain functions can be described as “ cooperative, synchronized activity of a large distributed ensembles of neurons” (p. 4), 2) a significant part of this synchronized activity has cycling nature. These neurons that consist of cooperative, synchronized and cycling properties in the central nervous system as a result of their electrochemical properties and these reconciling and synchronized activities of these neurons can be seen among others, as the “basis for the timing of sensory-motor coordination” (Clayton et al., 2005, p. 4). Thus the new view of the brain functioning allow us to examine the concept of entrainment as a rational (model) for human interaction at the interpersonal and social levels.
The goal of this paper is to examine various physiological, cognitive, sociocultural, musical aspects when one conducting a music therapy group through the concept of entrainment with mentally ill patients and to create a discussion of what aspects a music therapist should look for during the music therapy process, how music should be used and what qualities music consist of.
In order to conduct a music therapy group, a therapist usually defines several goals that hopefully will be addressed within given population. For the high functioning adult clients in psychiatric inpatient setting music therapy goals are: to increase motivation, to increase task investment, to increase relatedness, to improve frustration tolerance, to increase impulse control, to improve self- expression and to improve self-esteem. (Woodhull hospital, CAT group protocol, 2010). For the low functioning adult clients in psychiatric inpatient setting music therapy goals are: to increase awareness of self and others, to express one feelings musically or verbally, to increase socialization skill, to increase coping skills, to increase body awareness through the use of movement combined with vocal sounds, to increase self-esteem through continuous mastering of musical tasks. (Woodhull hospital, CAT group protocol, 2010).
Music therapy group, in a social context, represents a model of society with its own dynamic. Huczynski et al. (2007 ) draw their attention to the number of laboratory based group ranking and predictions task conducted by Jay Hall where he found that effective group was defined thought activities looked for the points in which disagree and the consequences encouraged conflicts among participants in early stages of discussion (pp. 275-280). In contrast, the ineffective group felt a need to establish a common view quickly used simple decision making methods such as averaging, and focused on completing the task rather than on finding solution they could agree on and as a result group cohesion influence group decision and influence group effectiveness (Huczynski et al., 2007, p. 280). This finding is in accord with goals that established for the music therapy group applied for both high functioning and low functioning clients. However, with mentally ill clients, the goals that established needs to be understood and clarified due to mental and developmental stages of each client, for example, following goals can be achieved: increase of self-awareness, coping and socialization skills for high functioning clients through allowing disagreement on personal goals and expectation for each member of the group by addressing them in the group and to allow the group to solve individual issues in healthy and safe way, which will be considered as effective group. The concept of ineffective group can be applied to low functioning clients, where the goal is to provide a common ground, known in music therapy as musical container, where the clients are able to work on increase of body awareness, self -esteem, through mastering musical tasks. Due to mental illnesses, heavy sedations, physical and cognitive state where low functioning clients are, the concept of ineffective group is not applicable due to client’s various limitations. According to entrainment concept, in context of social and interpersonal relationship, one client can affect the group process, therefore, group members cooperation process can be a fist goal for the music therapy group where depending on the mental, cognitive and physical stage of a client, other goals may or may not be addressed.
Clayton et al. (2005) argue that the concept of entrainment, in the context of physiology, appears when two subjects are close “behavior of our endogenous cardiac rhythm ought to be predictable when stimulated by a pacemaker, but if the period of the pacemaker were set outside a certain range, the behavior of the cardiac rhythm would be for practical purposes unpredictable”. Fraisse (1982) states that there is strong link between rhythm perception and production justifying his argument with the fact that people can easy synchronize their movement with the regular sequence of sounds, by tapping their foot to the beat. Clayton et al. (2005) and Fraisse (1982) findings are in accord with music therapy group protocol, where clients are placed in a room, fairly close to one another, and creating a rhythm or a groove results in affecting group’s members to built a cohesion through movement synchronization. For music therapist, based on their intuition and work experience, should come naturally to decide when one should bring in the rhythm and when the group members will initiate their own rhythm, however, it is very difficult to know for sure what group needs and what goals music therapist should have in mind for the group.
Clayton et al. (2005) argue that the concept of entrainment, in the context of the view on the brain functioning, that there is a relationship between external stimuli and brain waves, where external stimuli are rhythmic noises (p. 9 ). Thaut (1999) states that physiological entrainment occurs through the relationship between two elements “ Internal oscillator (internal time keeper) entrains to a more powerful external oscillator (metronome music)” (p. 29). Thaut (1998) examines the use of rhythmic auditory stimulation (RAS) to restore physical movement properties with patients traumatic brain injury.
RAS defined as:
A neurologic technique using the physiological effects of auditory rhythm on the motor system to improve the control of movement in rehabilitation and therapy. RAS is mostly used in
gait therapy to aid in the recovery of functional, stable, and adaptive walking patterns in patients with significant gait deficits due to stroke, Parkinson’s disease, traumatic brain injury, effects of aging, or other causes. (Thaut, 2005, p. 139)
Participant were asked to walk along a 10-meter walkway, and to accelerate after 2-meters and to decelerate after 8- meters. At first, participants were asked to walked in their normal speed, second time participants were asked to walk on the beat of presented RAS, “… a metronome pulse sequence imbedded into rhythmically accented music” (Thaut, 1998, p.82). When participant needed additional guidance, therapist provided additional verbal or tactile cuing. This study shows significant improvement of walking patterns, patients were able to move to the RAS throughout entire ten meter walk .
Clayton et al. (2005) states that not all entrainment involves external stimulus, either environmental or inter-personal. Further they define self-entrainment concept as a process where “ two or more of the body’s oscillatory systems, such as respiration and heart rhythm patterns, become synchronized “ (p. 9). Port et al. (1996) defines self-entrainment as a process when one part of the body tends to entrain gestures by other parts of the body, for example. when a client playing a drum, according to the concept of self-entrainment, his shoulders, will start moving accordingly to the client’s hands actions. Another example of self-entrainment is kinesthetic listening where music listeners experiencing muscle contractions while they watch others playing instruments or singing. This phenomena is significant for the high functioning and low functioning clients, it shows that just by listening and observing others in the group during the music therapy, clients will experience “self-entrainment ” which can be beneficial and significant due to their mental illnesses.
The official protocol describes goals only on social and behavioral context, where due to the clients mental illnesses, music therapist should mediate between social and behavioral goals and music therapy goals that is not discussed in the protocol. Another problem occurs while one define goals for music therapy group is that there is often two levels of cognitive functioning clients are present in the same group, therefore, the goals becomes flexible therefore, it is effects music therapy group effectiveness. As results, music therapist ends up meeting clients where they are, providing strong containment for the group which is more suitable for low functioning clients and individually addresses clients needs. More studies should be done regarding music therapy groups, the common language should be found between music therapy goals and the goals defined in protocol.
Clayton, M., Sager, R., & Will U. (2005). In time with music: the concept of entrainment and its significance for ethnomusicology. European Meetings in Ethnomusicology, 11, pp. 3-142. Fraisse, P. (1982) Rhythm and tempo. In the psychology of music, edited by D. Deutsch. New
York: Academic Press.
Huczynski, A., Buchanan, D., & Dunham, R., (2007). Organizational Behavior: An Introductory Text. London and New York :Financial Times/ Prentice Hall.
Port, R., Cummins, F., and Gasser, M. (1996). A dynamic approach to rhythm in language: Toward a temporal phonology. In B. Luka and B. Need (Eds.), Proceedings of the Chicago Linguistics Society, 1995 (pp.375-397). Department of Linguistics, University of Chicago.
Thaut, M.H. (1998). Rhythmic auditory stimulation in gait training for patients with traumatic brain injury. Journal of Music Therapy, 35(4), p. 228-240.
Thaut, M.H. (1999). Techniques of neurologic music therapy in neurologic rehabilitation. In M.H. Thaut (Ed.). Training manual for neurologic music therapy. Fort Collins, CO: Colorado State University.
Thaut, M. H. (2005). Rhythm, music, and the brain: scientific foundations and clinical applications.New York: Routledge.