Music Therapy in a Multi-Cultural Island

By Dr Koomar Surrun

 After an unusually hard day I finally lowered myself in my favourite sofa feeling completely drained out. I closed my eyes for a few minutes and out of the blue an old Hindi tune came to my mind. I could picture my grandmother humming it while stroking my head on her lap. The picture lingered on and soon I found myself murmuring the lyrics that were deeply buried in my mind and completely forgotten. After some time, I opened my eyes. I was completely transformed. I was happy, my level of energy had shot up and I was ready to face the challenges of the remaining part of the evening, and the tune kept coming back.

Music is as old as mankind and though it is invisible it cuts across geographical and social barriers. It has the uncanny power to suddenly change the mood, perspective and behaviour of a person. It is a type of communication that trancends all languages – the change in notes, the variation in tempo, the crescendo and decrescendo, the climax, all blend beautifully to express and convey feelings, moods and emotions. These musical vibrations touch human beings deep inside and each musical experience is personal and unique and evokes different emotions.

The ability of music to vehiculate such strong emotions is made use of in all its varieties, from lullabies to funeral marches. Bhajans, chants and incantations are sung to promote healing or wellness and to help in meditation. Participants in these musical activities, alone or in groups, and others attending live shows, release such a lot of the “feel-good hormone” endorphin in the brain that it gives them a great feeling of peace, wellness and happiness that may last for days.

Music therapy, vocal and instrumental, is a growing discipline used by a therapist to achieve a specific goal in health, health promotion, wellness, and as an addition to modern medical treatment. Over the past few years, music therapy has taken giant steps; over 100 music therapy schools are now functioning in America alone. Numerous countries in Europe, China and South East Asia have started regular PhD courses. Music therapy schools are mushrooming worldwide, and the Chennai School of Music Therapy even offers online music therapy courses. In contrast with certain European and American institutions, the Chinese and South East Asian countries adopt a culturally and ethnologically sentitive music therapy approach.

Scientific research in music therapy has shown that music therapy is beneficial in many medical, psychological, psychiatric, neurological, stress and motor disorders. It is also helpful in the treatment of mentally handicapped persons, those with autistic disorders and others requiring special needs education. It is being offered as an addition to medical treatment in many centres worldwide. The challenges are: it is time consuming, there are few trained therapists, and in many countries medical insurance does not cover this type of treatment yet. Furthermore the public is not fully aware of such a treatment option.

With our growing middle-class looking for “wellness” as evidenced by the growing number of spa centres, Mauritius is ripe for music therapy. The demand for music therapy will no doubt increase once public awareness of its is spread via social media and other platforms. Many big organisations already have in place a “wellness” philosophy to address the problems of stress, stress-realted disorders and impending burnout due to excessive pressures and deadlines that must be met. Adding music therapy to “wellness” programmes will be of minimal cost but employers will reap the added benefits of the boosted-up morale of employees, such as increased productivity and decreased stress-related absenteeism. Music therapy should be offered by institutions at affordable cost, and may take a little longer to be available in the public sector for lack of a policy and adequate resources.

Music therapy should preferably be imparted by trained music therapists, starting with a small pool and gradually scaling up to meet the expected growing demand. A course can be easily conducted, and attendance certificates delivered upon successful completion. It would be especially apt for nursing personnel, health assistants, music teachers, general teachers and special needs teachers. These persons need not be musically trained but must enjoy music, have a good sense of logic and a good knowledge of our cultural diversity . It would also be easy to identify the common illnesses in Mauritius that may be addressed by music therapy.

In a music therapy session, the therapist initially tries to tease out the client’s problem, then offers appropriate music listening or allows the client to sing or play an instrument to achieve a desired outcome. The help of a doctor to screen patients may be needed to ensure that serious and treatable medical conditions are not missed, and appropriate treatment given. For example, a depressed patient with suicidal tendencies should be referred to the psychiatrist urgently as delay in treatment may be catastrophic.

It stands to reason that in a multi-cultural society like ours, the therapist will need to know in depth the culture of the different sections of society and the different genres of melodies and songs that may be used – ranging from Bhojpuri and Bollywood songs to segas, seggae, and different types of western popular music, hindustani, qawali as well as carnatic music. This is not unrealistic, as the majority of Mauritians have been exposed, directly or indirectly, to most of these musical genres through radio, TV and musical performances. It is just a matter of compiling the appropriate list of tunes and songs to be used according to circumstances. One can fully appreciate that a labourer who has been exposed only to Bhojpuri and Bollywood songs, or a fisherman who is moved only by segas to not readily connect with a Bach’s sonata. Thus, music therapy must be tailored individually by a logical approach, taking into consideration numerous sensitive factors present in our society.

Developing music therapy by Mauritians for Mauritians, taking into consideration our multi-cultural heritage and different ethnic goups, is probably the best way forward. This is exactly what is being done on a voluntary basis by Jean-Clair Seevraz who is using music therapy with mentally handicapped children at the “Foundation Georges Sand” since September 2019. Guided by Prof Wolfgang Mastnak, an international authority in music therapy, Seevraz does not use any imported materials. All sessions are conceived locally and are of international standard. His innovative approaches if disseminated through international journals would probably be copied by other countries. Accreditation of a music therapy course and copying models of other countries is a very sensitive issue as imposition of a foreign culture will probably be conter-productive in our culturally sensitive populace. Music therapists trained abroad will, anyway, have to adapt to our cultural norms in order to practise locally.

A therapy session, done individually or in groups usually lasts 30 to 45 minutes. Sessions may range from 8 to 15 depending on the problem and the clients. The latter must be informed of all these details in advance so as to win their co-operation. In some countries music therapy is coupled with other therapies such as dance therapy to give additional benefit to the patients. The risk involved in music therapy is minimal but negative influences have been noted in some research studies when using certain types of music such as hard rock and heavy metal.

Music therapy has come to stay. It’s up to us to take the opportunity to board the bandwagon and go for a wonderful musical journey in our multicultural society while reaping its full benefits.

Dr Koomar Surrun, MBBS, MPH, MRCP(UK), FRCP(Lond) is Chairman, Clinical Research Regulatory Council, Mauritius. He is presently a Senior Consultant Physician, and had previously served as Ag. Head & Senior Consultant Department of Internal Medicine, Singapore General Hospital, and as Adj. Asst. Professor, Duke-NUS Graduate Medical School, Singapore

References:

1. Wigram T, Pedersen I.N, Bonde L.O. A comprehensive guide to music therapy – theory, clinical practice, research and training. Jessica Kinsley Publishers, UK.
2. Hosany, K. (2013) The need to introduce Music Therapy in Mauritius. https://busybeekatsy.blogspot.com/2013/06/the-need-to-introduce-music-therapy-in.html
3. Mootosamy, M. (2017). Music therapy – Let the music play

https://defimedia.info/music-therapy-let-music-play

4. Passeport Santé, (2018) Musicothérapie. https://www.passeportsante.net/fr/Therapies/Guide/Fiche.aspx?doc=musicotherapie_th

* Published in print edition on 31 January 2020