The variety of music-based methods commonly employed for therapeutic purposes is quite extensive (Horden, 2000). On the one hand, music can be used to lead the patient to be in a physical and mental state that is not curative by itself, but that can enhance the effectiveness of other kinds of interventions. For instance, music can be utilized to induce a state of relaxation, to stimulate a positive mood, and to increase the level of self-awareness in the patient (Colombo & Antonietti, 2017), improving successful outcomes of psychotherapy. In this case, music only plays an ancillary role. On the other hand, music can be used to directly trigger changes that allow patients to restore or improve lacking skills (Antonietti & Colombo, 2012). In this case, sounds are effective thanks to something that is peculiar to music. Hence, it is crucial to comprehend the reasons why a specific use of music can result in the achievement of specific goals in the field of rehabilitation.
Three Mental Registers
A person who is listening to or performing music has a comprehensive experience in which several mind registers are activated simultaneously and synergically so that the coordinated action of multiple mental mechanisms occurs. This characteristic is the foundation for the efficacy of sound-based rehabilitation treatments. The mechanisms can be identified referring to three categories, which correspond to three relevant mental registers available to the human mind: motor, iconic, and verbal.
These three registers match an essential distinction within the psychological field that has been acknowledged by different theories and has been effectively systematized by Bruner. He identified three developmental stages. Each of them is matched with a specific system used for mental representation: enactive, iconic, and symbolic (Bruner et al., 1966). First, the childâs motor behavior reveals strategies behind each action, allowing us to assume that mental representations guide movements. These are what Bruner calls enactive representations, constituted by patterns that coordinate the sequence of different acts or segments in order to form a whole movement. Iconic representations are independent of actions, even though they are tied to perception since images or spatial schema are the basis from which iconic representations are generated. They allow representing states, relations, or transformations of events. To perform tasks that require abstract thinking one needs symbolic or verbal representations, which operate through abstract concepts.
The tripartition suggested by Bruner can be useful in making our point because it helps us to identify three registers, or lines, along which the mental processes activated by music unfold and to identify along these lines the likely reasons why music-based rehabilitation interventions are successful.
As a first point, music activates the motor register because music is naturally connected with the body. A body gesture always initiates music (blowing, beating, etc.). Moreover, often music is composed by thinking of specific actions or movements it is supposed to accompany (dance or military marches, for instance). Some cultures in Africa have no specific word to designate music; They use a single term signifying the presence of music and dance at the same time. In various contexts music accompanies working activities: In Ghana, gardeners work more speedily when accompanied by music; In the Hebrides, the activity of textile workers is accompanied by songs that change according to the movements to be performed; Some sailorsâ songs also change according to the required maneuvers (DeNora, 2000). Blacking (1973) emphasized the notion of music as being firmly embedded within body movements, a point supported by his long-lasting experience in studying African music. This author thought that adding a physical-motor experience makes the sounds take on a different meaning compared to when we only perceive the sound with our ears.
From an ontogenic point of view, the connection between music and movement develops very early. Philips-Silver and Trainor (2005) reported that at 7 months of age infants show the preference for a rhythm associated with a synchronized rocking of the cradle. At 18 months of age children, while they are listening to music, spontaneously perform rhythmical movements synchronized with the sounds (Sloboda, 1985). At a later age, the connection between music and movement does not require the involvement of oneâs own body. For example, Boone and Cunnigham (2001) asked 4 and 5-year-olds to make a teddy bear dance according to the emotional features of short musical segments while they were listening to them. Afterward, adults were presented the videotaped performance played by the children without the accompanying music track and were requested to identify the emotion that the body movement intended to express. Results showed that children were successful in moving the teddy bear coherently with the emotional meaning of the associated music. The detailed analysis of how children handled the teddy bear highlighted that upward movement, rotations, shifts, as well as the tempo and the force of the movements, differed significantly according to the expressive meaning of the corresponding music.
Secondly, music has an iconic, i.e., a visuospatial, component. Music, at least under some circumstances, seems to translate spontaneously into images. For example, it is proven that musicians, when compared to nonmusicians, have higher capacities of visuospatial memory and their hippocampusâa cerebral structure connected with this kind of memoryâis more developed (Sluming et al., 2005). Practicing music develops visual mnestic abilities, probably because of the inherent figural nature of sound patterns. Even people without any musical training think about music in spatial terms. In an experiment, Halpern (mentioned in Krumhansl, 1992, p. 202) presented one word, by selecting it from the lyrics of a song, and subsequently another word from the same song. The task of the subjects was to compare the pitch of the notes corresponding to the two words. The reaction time recorded during this task increased as a function of the distance (in terms of the number of bars) between the two words in the song. This suggests that the listeners scanned an image of the melody mentally. Hence, music seems to promote a mental activity similar to the one that happens when we mentally scan visual images.
Thirdly, music comes with a verbal component. Similarities between music and verbal language concern mostly the syntax of music. Some authors (for example, Lerdhal & Jackendoff, 1983) identified some broad cognitive principles can be used as the foundations for musical listening. As happens for the syntactic structure of verbal language, music implies abstract structures that meet the laws of generative grammar with a set of recursive analytical rules. However, the verbal dimension of music appears not only at the level of syntactic structures, but involves narrative structures as well. Heinrich Schenker (1954)âan author who anticipated the ideas advocated by Lerdhal and Jackendoffâsuggested that the diatonic triad is the Ursatz, that is to say, the basic structure, where the tonic represents the initial balance, the dominant introduces tension, and the return to the tonic reestablishes the balance. It is possible to find a correspondence between this harmonic pattern and the grammar of stories. Fairytales and other narration quite often introduce early on a transition from an initial, calm, situation to a problematic one, to end with the resolution of the conflict or tension.
Furthermore, the verbal dimension of music appears at the phonetic-prosodic level, well exemplified by the attempts to reproduce the inflections of the spoken language through musical sounds, and at the pragmatic level, when the dynamic of roles, entrances, and alternations of the interlocutors in the development of the discourse is at play.
We can conclude that music activates in the listener and the performer some mental processes in all three registers (motor, iconic, and verbal) and we can find the reasons of its therapeutic-rehabilitative efficacy in the synchronized activation of these registers. In the following paragraphs, we will develop further this last point.
Relationships Within and Between Registers
The motor register is activated at different levels. First we have the neurovegetative responses modulated by sounds (e.g., variations of the heart and breathing rates), then gestural responses (exemplified by the tendency to accompany music by tapping the feet or drumming the fingers), and finally more complex patterns of action (e.g., those implied in the art of dancing).
The iconic register is linked to visual synaesthesia: visual, synesthetic-like experiences may be elicited by sounds, which are perceived as dark, shining, and so on. Furthermore, the visual features of music appear in the topological relations that sounds remind us of. For instance, music can be compared to or described as continuous or broken lines, or it can inspire a sense of closure or opening, and so on. Finally, music takes shape in visuospatial isodynamic (it suggests upward or downward jumps, approaching or departing trajectories, etc.).
The verbal register is involved at a primary level through the usage of onomatopoeic symbols (e.g., musical sounds can be used to imitate natural or artificial sounds) and at a more sophisticated level through the use of prosodic intonations, that can be achieved by using accelerations and decelerations, variations of rhythm and intensity, or by changing the overall âtoneââsolemn, whining, peremptory, friendly, etc.âwith which the musical discourse is pronounced. These strategies allow building a discursive structure, better-organized thanks to the distribution of parts, entrances and relative turns, repartition of topics introduced in the discourse, and so on.
What relationship exists between the different registers? The registers are interdependent and synchronized. They are activated by the same musical stimulus and mirror the same characteristics of this stimulus, even if with a different emphasis. For example, an aspect of the piece will be better reflected or expressed by the ...