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, although given specific circumstances, perhaps it could. 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.
(P.S. Don’t forget that an extra-loud TV for one resident equals over-stimulation for another resident. See #1 above.)
#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.
Yes, there are ways that music can be harmful, but by seeking intervention from or consultation with a music therapist, you can learn ways to avoid harm for yourself and for those in your care.
We’ll cover four more ways music can be harmful in the next post, but until then, would you let me know where you have seen music causing harm to someone? It can certainly happen, even when we have the best intentions! Please leave your comments below.