Interview: The Integration of Music Therapy in Mental Health

In this mh4all piece, we had a chance to sit down with Mr. Samay Ajmera, a music therapist, based in Mumbai.

Samay Ajmera, a trained Music Therapist, has studied, researched and worked at the Mahatma Gandhi Medical College and Research Institute in Pondicherry. A certified musician from the Institute of Contemporary Music Performance in London, he is passionate about music and it’s impact as an integrated health service. Having witnessed the psycho-physiological benefits of Music Therapy on patients in varied health departments such as cardiology, dermatology, paediatrics, palliative care, psychiatry ,in the pre and post operative departments and also in the Music Therapy OPD,  he continues to work in Mumbai, primarily in the field of mental health and developmental disabilities. Samay believes that and allied health service like music therapy can uplift, transform, and positively affect the mind, body, soul and strive to improve the quality of life of every individual.

Q1. When did you decide to become a music therapist and why?

Ever since I was a teenager I have always been passionate about music and the human mind. I always wanted to study psychology but for some reason I pursued a degree in Mass Media instead. However, the music stayed. After college I found myself doing odd jobs in marketing and event management, but I felt a void. Halfway through 2016 I discovered that I could use music to connect and understand people in a more profound way.. Instantly something inside me clicked and this revelation took me to Pondicherry, Tamil

Nadu, where I got the opportunity to learn, study and research Music Therapy, under Dr. Sumathy Sundar, at the Mahatma Gandhi Medical Hospital and Research Institute. Working and doing research at the hospital boosted my belief in the power of music as a medical intervention. I believe that it is important to not only treat the disease but the whole self. Researchers are discovering each day how one’s emotions, psychological well-being and soul play a major role in an individual’s physical health. Around the globe Music Therapy is changing the world one person at a time. My dream is to bring this awareness in my country, India and support people suffering from illnesses one person at a time. Music has always been a very big part of my life and I will never forget that it has helped me through some of my darkest days, and continues to do so. To spread the magic of music in any way possible is the least I can do.

Q2. What kind of age-group have you worked with?

All human beings no matter their age, have innate tendencies to make and appreciate music at their own developmental level. Regardless of their age, all individuals have a basic capacity for musical expression and appreciation. I have worked with a diverse age spectrum, from prenatal birth, to children and adolescents, adults and older adults (seniors).

Q3. What are the different types of music used for various mental health problems as an intervention and why?

Music Therapy is a largely complex service. There is a misconception that one piece of music may be used as a general prescription for different illnesses. I have not come across any research saying that a particular piece will work with a particular disease. Music is highly subjective. In fact my sessions are a two way process. Once I do an initial assessment with the client , I devise a treatment plan, evaluate progress and adjust the plan as needed. Some of the basic techniques consist of improvisation, recreating musical experiences, composing music, receptive music listening and verbal discussions, music and imagery, interpreting song writing , and other activities with a musical base, to achieve non-musical goals. These techniques provide people who have illnesses with a safe and non-judgemental platform for treatment. For instance music improvisation, especially in a group allows for creative participation that induces spontaneous self-expression and the use of intuition. During this time participants are living in the present and are using multiple sensory processes such as listening, thinking and feeling in and even beyond the music. With consistency, the participant’s ability to listen may become enhanced. The carry forward here is that they may be able to take this enhanced listening ability from a musical environment to a non-musical environment where in they become more sensitive in relationships with others in and listen in the moment without worrying about the future. A technique like song writing can have positive effects on individuals dealing with anxiety and depression. The process involves writing down thoughts that can be instructive and challenge dysfunctional thoughts that may hamper constructive feelings. It may also provide validation and can aid in building self-worth. Music and guided imagery is a great vehicle for the a client to explore deeper states of consciousness. The client verbalizes images, feelings, memories, sensations and various other types of awareness that may be evoked by the music. At the end of the session, the therapist assesses the client’s insights, revelations and personal reflections. Active music listening is another method used to regulate mood. Rhythm and repetitiveness of the music affects the neocortex of the brain which can calm and reduce impulsivity. Different techniques are used based on the diagnosis of the individual. These techniques may change as the sessions and treatment progress.

Q4. What kind of mental health problems have you dealt with? What changes have you witnessed in your patients?

I have worked and continue to work with people suffering from depression, schizophrenia , post-traumatic stress disorder, psycho somatic disorders, obsessive compulsion disorder, generalized anxiety disorders, bipolar disorder, substance abuse, and developmental disorders such as autism, and intellectual disability. Most often than not people with acute schizophrenia find it difficult to express themselves using words. During a session they are able to interact through music in a way that is constructive, creative and enjoyable too. One of my clients who has Schizophrenia is often disorientated, and unable to communicate or socialise. As his sessions progressed, I witnessed him expressing feelings through instruments. He is also able to participate in group improvisation sessions in which he plays the instruments given and is able to maintain rhythms with other participants. This indicates his heightened state of awareness of himself as well as others around him. These interactive sessions provide feelings of unity and self-confidence. He can now greet me verbally and his affect during sessions changes from blank stares to smiles. I was treating a patient with PTSD, experiencing Symptom Cluster B : Intrusion and Symptom Cluster C : Avoidance. Familiar music as well as guided imagery through music provided him with a safe environment through which he was able to face certain feelings and memories by letting the music ground him in the present moment. Through this he was verbally able to express deeply repressed emotions. Gradually the sessions provided him a platform for cathartic release .

Q5. What is the impact of music as an intervention on patients? Please share your experience.

Music therapists around the world have been working since the mid 1900’s with people suffering from all kinds of illnesses whether in hospital environments or private practice. Apart from clinical work there is also an abundance of research depicting the benefits and efficacy of music therapy on various illnesses. During my time at the hospital I witnessed the benefits of music therapy, such as enhancement in memory and cognition, improvement in communication and expression of feelings, reduced stress , improved sleep , and overall improved quality of life, including the ability to alter pain perceptions . I had the opportunity to witness its benefits in the Neonatal intensive care unit, pre and post-operative care, Palliative care, Psychiatry, Geriatrics, Paediatrics, and Neurology,, to name a few. Although music can have a positive effect on anyone, Music Therapy is used for people with physical, emotional , social and cognitive deficits. It has a great impact in assisting behavioural therapy, motor skills, attention span, developmental delay and brain injuries. I have had the privilege to conduct a research study that showed positive effects on psycho-physiological parameters like blood pressure, heart rate, respiratory rate and anxiety levels in individuals in the preoperative ward awaiting Angiogram surgeries. Currently I work primarily with individuals suffering from mental illnesses and I see changes in orientation, social communication , self-expression, self-awareness, boosted self-confidence and mood alteration, to name a few. I believe an allied health service like Music Therapy can uplift, transform and positively affect the mind, body and soul. Although there is a universal understanding of the passion and connection people have to music, there is still a lack of awareness around music therapy, especially in a country so rich in culture and art like India. Music therapy is still a very misunderstood field in India and once established health care professionals support this field, it will be easier for people suffering from illnesses to be open to this kind of alternative therapy.