Medical ethnomusicology is a subfield of ethnomusicology. Medical ethnomusicology, similar to medical anthropology, uses music-making, musical sound, and noise to study human health, wellness, healing, and disease prevention integrating biological, psychological, social, emotional, and spiritual realms. Other fields involving the interaction between sound, culture, and health include medical anthropology, medical sociology, music therapy, art therapy, and sound studies.
In 2008, the Society for Ethnomusicology defined medical ethnomusicology as "integrative research and applied practice that explores holistically the roles of music and sound phenomena and related praxes in any cultural and clinical context of health and healing." Medical ethnomusicologists have applied music to autism, Asperger syndrome, dementia, HIV/AIDS, and cognitive therapy.Barz, Gregory, Benjamin Koen, and Kenneth Brunnel-Smith. 2008. "Introduction: Confluence of Consciousness in Music, Medicine, and Culture." The Oxford Handbook of Medical Ethnomusicology. Ed. Benjamin Koen et al. New York: Oxford University Press. 3-17.
Medical ethnomusicology blends "anthropological and ethnological, historical and literary techniques" and challenges Western notions of medicine with alternatives such as ethnomedicine. In many cultures, music is regarded as a form of healing, often in conjunction with other practices such as prayer and ritual. Musical ethnomusicology aims to explore their conjunction on a broader cultural scale.
Medical ethnomusicology is a modern field, first emerging into relevance in the 1990s. However, the interrelation of music and healing has been touched upon in past cultural research—for example, in Densmore’s 1918 study of the Teton Sioux. Much research in this field is specific to certain cultures studied, such as Roseman’s focus on the Malaysian Rainforest, Melchor-Barz in Uganda, and Koen in the Pamir Mountains.
One influential piece of writing is “The Oxford Handbook of Medical Ethnomusicology,” written by Benjamin D. Koen, Gregory Barz, and Kenneth Brummel-Smith. This novel was among the first to define the new field and explore its depths. In this book, they define medical ethnomusicology as the “integration of music and sound phenomena” within the “cultural clinical context of health and healing,” and discuss the true meaning of music, medicine, as well as how the two can interact in different settings. It accomplishes three main goals: to elucidate the relationship between health, illness, and disease; to encourage innovative, collaborative research to improve health and healing; and to document the current discourse involving music, culture, and healing.
Applications Nursing home communities Theresa Allison served at a nursing home in 2006–2007, studying the effects of music on the residents of the home. "The Home," as she refers to it in her publications, was rather unusual in that music was of utmost priority: the Home has over 60 hours of music and performing arts activities scheduled weekly, and dozens of residents actively participate in songwriting groups. The Home has produced a professional CD, Island on a Hill, and an award-winning documentary, A 'Specially Wonderful Affair, both in 2002. With such emphasis placed in the arts, Allison concludes that the creation and performance of music has increased the residents' quality of life by allowing them to remain active in their society through songwriting. Songwriting in the Home has fostered a sense of community among the residents and a means of transcending the institution by bringing in memories and experiences from outside their physical space.Allison, Theresa. 2008. "Songwriting and Transcending Institutional Boundaries in the Nursing Home." The Oxford Handbook of Medical Ethnomusicology. Ed. Benjamin Koen et al. New York: Oxford University Press. 218-245.
Spiritual healing Koen's research has also extended into the realm of the spiritual; he analyzed the role of music in maddâh, a form of prayer. Koen believed in music-prayer dynamics, which modeled the dynamic relationship between music, prayer, and healing. Maddâh is unique in that it encompasses all three elements of music-prayer dynamics over the course of a ceremony. Koen describes a maddâh ceremony as such: "during a maddâh ceremony, one experiences music alone, prayer alone, music and prayer combined, and unified music-prayer". In particular, Koen focused on the restorative properties of maddâh as it was utilized in Badakhshan, Tajikistan. Being the economically poorest region of Tajikistan, Badakhshan's culture of health care is precarious at best; there is no running water or plumbing in homes, satisfactory nutrition is hard to come by, and the psychological distress that comes with these factors leads to an abundance of health issues. As a result, maddâh is utilized to maintain health and prevent illness. Koen conducted an experiment of 40 participants from Badakhshan, in which Koen assessed the stress levels of those who participated in a maddâh ceremony using physical indicators of stress such as blood pressure and heart rate. In conclusion, Koen observed an overarching de-stressing effect in those who participated in maddâh, regardless of the role they assumed in the ceremony. Koen attributes this to familiarity: "there was enough familiarity to engage a cultural aesthetic and dynamic that allowed a person's consciousness to approach a flexible state, which here facilitated a state of lower stress". Koen also noted that participants had positive feelings regarding maddâh; many of the participants commented that maddâh relieves them of their emotional burdens.Koen, Benjamin. 2008. "Music-Prayer-Meditation Dynamics in Healing." The Oxford Handbook of Medical Ethnomusicology. Ed. Benjamin Koen et al. New York: Oxford University Press. 93-120.
Dementia treatment Treatment of Alzheimer's was historically centered around a biomedical, classically mechanistic model of the disease, but doctors have increasingly taken on a "person-centered" approach, a model through which multiple academic disciplines can contribute to an increased quality of life. Biology, psychology, spirituality, sociology, and most recently, ethnomusicology have all been combined to find the most effective, integrative, complementary, and native interventions for dementia. Carol Prickett provides an overview of the current state of research into music therapy for dementia:Prickett, Carol A., and Randall S. Moore. "The use of music to aid memory of Alzheimer's patients." Journal of Music Therapy 28.2 (1991): 101-110.
Patients with dementia are capable of participating in structured music activities late into the disease. Instrument playing and dance/movement are preferred activities Modeling the patient's expected response increases patient participation Individual and small group settings/sessions are most beneficial Social and emotional skills, including interactions and communications, can be enhanced with music therapy Cognitive skills can be enhanced with music therapy Musical interventions can be an alternative to pharmacological or physical restraints
In 2008, Kenneth Brummel-Smith studied the state of care for those with Alzheimer's disease (AD) and found care to be largely unsatisfactory. Rather, Brummel-Smith looks toward music as the cure to Alzheimer's disease; he observes that nursing home residents with AD are capable of participating in structured music activities late into the disease, and that music can be used to enhance social, emotional, and cognitive skills in those with AD. Brummel-Smith calls for a more interdisciplinary approach to combatting AD, which may include music therapy if it may be suitable for a given AD patient.Brunnel-Smith, Kenneth. 2008. "Alzheimer's Disease and the Promise of Music and Culture as a Healing Process." The Oxford Handbook of Medical Ethnomusicology. Ed. Benjamin Koen et al. New York: Oxford University Press. 185-200.
In 2017, Bill Ahessy presented a music therapy case study about a 94-year-old woman with AD who participated in improvisation and song writing for 18 months, suggesting that person-centered therapy and music therapy theory and practice share valuable links and identifying song-writing as a powerful therapeutic technique for AD treatment. For the patient in the case study, music therapy helped with reminiscence and emotional self-expression, and assisted the client with experiencing herself in new ways to process her condition. Specifically, music helped her strengthen and validate her identify, verbalize her emotions, and reflect on her experience with AD.Ahessy, Bill. "Song writing with clients who have dementia: A case study." The Arts in Psychotherapy 55 (2017): 23-31.
HIV/AIDS treatment Kathleen Van Buren conducted fieldwork in Nairobi and Sheffield with the purpose of enacting positive change in the context of HIV and AIDS in each environment. Van Buren speaks about utilizing music as an agent of social change; in Nairobi, she witnessed individuals and organizing drawing upon music and the arts to promote social change within their respective communities. In Sheffield, Van Buren offered a new class on "Music and Health" at the University of Sheffield as well as World AIDS Day event with the theme "Hope through the Arts". After the conclusion of these events, Van Buren published her findings and offered a to-do list for the ethnomusicology of HIV and AIDS. Namely, she urged ethnomusicologists to research and engage with the music community in order to facilitate the development of educational and therapy programs to further the fight against AIDS.Van Buren, Kathleen J. 2010. "Applied Ethnomusicology and HIV and AIDS: Responsibility, Ability, and Action." Ethnomusicology 54(2):202–223.
Gregory Barz also investigates the usage of music in healing individuals with HIV/AIDS in Sub-saharan African communities like Uganda, where only 10% of the population has access to medical facilities, and there is only one doctor for every 20,000 people. In Uganda, less than 2% of those who need antiretroviral drugs can afford them. He concludes that music's contributions to HIV/AIDS intervention and palliative care are a valuable, human, and imperative option to shaping the treatment landscape for these individuals. Through participation in music, socioeconomic effects of illness are reduced by supporting caregivers, controlling pain, and providing counseling to caretakers and sick individuals.Barz, Gregory. Singing for life: HIV/AIDS and music in Uganda. Routledge, 2014.
Barz notes that one of the primary ways that music can play a role in the treatment of HIV/AIDS is through performances that help educate the listeners about the disease and make it easier for them to understand, interact with, and reconcile the role that HIV/AIDS plays in their lives. For example, Walya Sulaiman is a musical activist who lives with HIV; since his diagnosis, he has dedicated his life to educating and counseling other Igangan Muslims. There is often a communication barrier between doctors who understand the biological mechanisms behind HIV/AIDS and village people, who might not have as firm of a grasp on the implications of the disease. Therefore, in musical performances meant to educate his target groups about the affliction, Sulaiman uses the term kayovu, which is an insect that eats bananas from the inside out, to depict AIDS, and ene, which is jackfruit, to facilitate an understanding about how one can get stuck in the syrupy fruit, unable to wash or scrape HIV away. Thus, these linguistic localizations help facilitate a deeper, culturally relevant understanding of HIV/AIDS.
Autism-related therapy