Orff music therapy

orff music therapy

Orff Music Therapy was developed by Gertrud Orff within the specific clinical setting of social pediatrics in Germany for use with children with developmental problems, delays, and disabilities.

“At the beginning of my work as a music therapist, the first two concepts I considered to be ‘key’ were ‘initiative’ and ‘imitation’: did a particular child’s behaviour tend more towards the initiative or imitative side? A further concept was ‘emotion’: does the child show any at all? Does he show too much, or too little? Further, does the child show aggressiveness, and if so, why? What are the reasons for his stereotype behaviour? Using such concepts I tried to approach a child by means of an objective understanding of his condition”. (Orff 1989)

Following are some key principles used in the Orff method:

  1. Musiké, which is a total usage of the word and sound elements together with movement. The children will play with rhythmic or melodic elements and role play using this principle.  
  2. Improvisation is a key tenet in the Orff method. There is spontaneous free play as well as making music together. Improvisation can be a stimulus towards creativity for the child and in this, the music can also provide structure through the arrangement of the various musical elements including silence.
  3. Instrumentarium includes string instruments, keyboard instruments and also percussive instruments. Such a varied range of instruments encourage the child to participate actively and also become a way for the child to interact socially through joint music making.
  4. Multisensory music making where other senses are also engaged during the therapy. For example, “letting marbles roll along a metallophon into a hand drum or playing a drum so that balls will fly off it – can also serve to motivate a child to interaction”. (Voigt, 2017) “Music was believed not just as an inner soul experience but also a sensory experience for the children”. (Voigt, 2017)

Responsive interaction in the context of Orff therapy is when “the therapist is willing to accept the child’s ideas and initiative and to interact with the child at this level”. (Voigt, 2017) Provocation is another behavioural strategy used by the Orff therapist. “Provocation is used when it is necessary to support the child by bringing new ideas and impulses into the therapy situation when difficulties arise in the child’s action or interaction. In this case it is necessary for the therapist to adapt her support to meet the needs of the child and to involve the child actively in acquiring new competencies”. (Voigt, 2017)    

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Sound/ music therapy in Germany

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Music/ sound therapy has a long history in Germany, dating as far back to the 1940’s which is around the same time in America where music therapy developed in a rigorous and methodical approach.  There are many varied approaches and music therapeutic models within Germany. In the book “Schwingung und Gesundheit” or translated into English as “Vibration and Health” (Bossinger & Verres, 2010), the latest music therapy approaches in Germany were presented. The following are key concepts extracted from this book.

Health means being in harmony, resonance with one’s own being and with the surroundings. Life is a swinging system and music which is also swinging in nature can be a tool to support life. The body is constantly in a swinging motion and rhythms from the outside is causing an echo in the body. Seen in this context, the therapist’s work is primarily rhythmical in nature.

There is the usage of a therapy tool called sound cradle which is a huge wooden bed for the individual to lie in. There are lyre-like metal strings stretched under the wooden bed which the therapist will play. The sound and vibrations will move upwards to the individual’s body and through it. There are also people surrounding the cradle who are singing to the individual in the cradle. Sound and music surrounds the individual and one can feel the vibrations all over the body like a sound bath and hear the music from all around. This is believed to have a strong impact on the body and soul. Sound cradle brings one in connection with the body and soul. Currently, people are too much in the thinking stream in today’s media saturated information age and the sound cradle can bring one to the present moment back into the body. Individuals in the sound cradle have their brain waves measured and it has been found that their brains are in theta wave stage just like during sleep.

Dance and music therapy is also practiced where individuals come in a group to sing and dance to have an uplifting social experience. Many have shared on the positive emotional experiences after such group sessions.

Singing is believed to affect the soul. Singing the consonants and vowels enhance one’s own voice. In group singing, one can experience a sense of community. It is also a form of getting away from the head and more in touch with the emotions. Singing therapy helps the breathing, heart, blood circulation as well as the soul. Singing is believed to also help with inner balance and self esteem.

Active participation by the individuals during therapy is the way of the future and is considered better than just passive listening, Listening can soften pain but the greater effect is believed to lie in active participation through music.

Music therapy for healthy people is believed to support self development. Therapy helps one to gain motion in the soul and gets in touch with inner feelings and express what is inside the soul.

Colours and light are also influencing the soul. There is a calming effect when color and sound meet at the same moment. People who are sick need to encounter forces which are alive, for example in nature and to be aware that one is part of the real world.

Dr Eben Alexander- Sacred Acoustics

sacred acoustics

Dr. Eben Alexander is a practicing academic neurosurgeon for more than 25 years. On November 10, 2008, he was driven into coma by a rare and mysterious bacterial meningitis-encephalitis. Alexander awoke after 7 days to the surprise of everyone. He lost his memories of his life during the coma. His memory was filled with an experience of another realm of existence which Alexander felt was stronger than the earthly reality and soon recover completely.

Together with a few others, Alexander started a sound therapy program called Sacred Acoustics which makes use of the principles of brainwave entrainment to help himself and others reach and experience expanded states of consciousness which happened to him during the 7-day coma.  

In the program, brainwave patterns are modulated to create a profoundly relaxed state.

Selected frequencies and tones were used to reduce the brain’s filtering and allows consciousness to become free. Each recording includes binaural beats, monaural beats, isochronic tones and other sound patterns which are combined to deliver a range of delta, theta and alpha rhythms to draw the brain into hypnagogia which is the transitional state between wakefulness and sleep. (Sacred Acoustics, 2017)

This program uses EEG to measure the brain’s electrical activity that is prevalent during deep meditative states and out-of-body experiences (OBE), similar to near-death experiences (NDE). Once recorded, the brainwaves are analyzed to extract specific combinations and ratios of brain states which are then converted to tonal formulas that are used to create complex combinations of monaural and binaural beat frequencies to create the higher states of consciousness desired.

Essence Sound Therapy

higher self

Essence therapy was developed by Dr. Mitchell Gaynor, a medically trained oncologist based in Manhattan who taught cancer patients to supplement conventional medicine with soothing music, diet and meditation. Gaynor became fascinated with alternative healing treatments and went into what is called integrative oncology which combines both conventional medical care with alternative treatments like sound and meditation for his patients in the clinic.

Gaynor has received remarkable results with his patients and has published a book “The Healing Power of Sound” documenting his approach and experience. Gaynor’s sound therapy includes visualization exercises to help his patients visualise their pain to make it concrete for them. The imagery will change as the therapy proceeds into one which is ultimately positive and uplifting to help individuals release their pain.   

According to Gaynor, “when we visualize images that arouse an emotion, a sense of serenity, or physical sensations, an entire cascade of physiologic changes occur, including modulation of neurotransmitters, neuropeptides, and messenger molecules that may influence the immune system”. (Gaynor 2002)

Gaynor also used a lot of Tibetan singing bowls in his therapy. His patients will tone and sing alongside the note that is created by the singing bowl. The negative emotion which was given an imagination earlier was then combined with this toning and singing to release it.

Gaynor also worked with his patients to create their own personal “life song”. “They are mantra like sounds, comprised of groups of syllables strung together in a pattern that is as unique to you as your social security number. Life songs transform our jumbled thoughts, judgements, and feelings into a harmonious pattern”. (Gaynor 2002).

“ESSENCE sound meditation is a sound meditation process that uses the voice and the singing bowl or another sound source, to create a level of awareness beyond the commonplace worries and concerns of the mind in order to awaken the spirit for self-healing”. (Gaynor 2002)

Essence to Gaynor is the “infinite, immutable, borderless self that is both whole by itself, and integrated and whole in society and the universe”. (Gaynor 2002) G.I. Gurdjieff described essence as one’s truest self or soul. Eastern spirituality and western philosophies referred to a state of awareness called “Atman, Brahman, unity consciousness, unconditioned awareness or transcendent self- in which we no longer identify with “emotions,” “mind,” “self,” or any circumscribed mental or physical reality. We move to a transpersonal plane in which we are at one with others and the universe”. (Gaynor 2002, p. 12) Music and sound therapy according to Gaynor is to support the individual reach their “essence” which is a place where self-healing can begin.

The Tomatis approach

Tomatis

This therapy approach was developed by Dr Alfred Tomatis, an ENT specialist in the 50’s and 60’s. Tomatis observed that people with hearing damage caused by noise started developing motor, speech and psychological problems. Initially Tomatis worked with singers who had lost certain frequencies from their voices. He found that the dead spots in the voice exactly matched the dead spots on the audiogram, and by correcting the hearing with the electronic ear he could restore the missing frequencies to the voice. Tomatis concluded the following 3 laws:

  1. The voice is made up of what the ear can hear.
  2. If the hearing changes, the voice is immediately and unconsciously modified.
  3. It is possible to permanently transform phonation when auditive stimulation is maintained over a certain time. (the law of permanence)

It was believed by Tomatis that after birth, the ear’s role is to energise the neo-cortex of the brain, the area where the central nervous system is located. If there is malfunction of the ear, the nervous system will be hindered to process information, which could damage communication, expression and social behaviour. The inner ear may be an important relay for all sensory information that the body sends to the brain since touch, vision and hearing are all interpreted through the vestibular-cochlea system (the part of the inner ear concerned with balance and body orientation is the vestibular and the part concerned with hearing is the cochlea). Tomatis believed that the ear also plays a significant role in speech as it controls the voice.

Through its action on the vestibule, the Tomatis therapy has a beneficial effect on both gross and fine motor functions. To help integrate the various senses, the children will be asked to walk on the balance beam while listening to the sounds and music. Auditory stimuli is used to help children regulate and control their movements. Mozart’s music, the Gregorian chants and also mothers’ voice are used.   

The sounds are transmitted using a hearing apparatus with ear and bone conduction. In sound conduction, the sounds are transmitted using headphone and in bone conduction, the sounds are transmitted by a piece at the top of the head. In bone conduction, the sounds travel 20x faster than ear conduction. “As humans, we always hear and listen through both bone and air conduction when listening to ourselves and only air conduction when listening to others. If the sound is travelling via bone conduction, the message is transmitted via the head bone through a vibrator, located in the frame of the headphone and rests on the middle on top of the person’s head, carrying the sound directly to the inner ear”. (“Tomatis® Sound Therapy”, 2017) The auditory stimuli reaches the brain first through bone conduction and surprises the brain before it reaches through the ears. In this surprise, the attention mechanism in the brain is triggered and now becomes alert to anticipate the auditory signal which is to later come from the ears.  

The ear and the brain are intricately connected and as the ear expands its functions so the brain expands its capabilities and states of awareness. The ear is connected to 7 of the 12 cranial nerves. Through auditory pathways the ear affects the entire nervous system. Stimulation of the tiny inner ear muscles helps to build stronger multi-sensory pathways in the brain, improving its ability to process sound and enhance communication and cognitive abilities.

In the musical pieces used in Tomatis therapy, musical contrasts in terms of timbre and intensity are suddenly and quickly alternated. Ear muscles are subjected to constant inner gymnastics. The whole auditory system is stimulated by these changes. High frequency sounds from the cochlea stimulates the brain and its neurons more than the low frequency sounds.  

Tomatis believed that the high frequency sounds in the range of 8,000 to 16,000 Hz will have a positive effect on the central nervous system and individuals will feel more energised, able to concentrate better, learn better and feel calmer at the same time. Low-frequency sounds have the opposite effects. This has implications for a wide range of brain disorders from depression to epilepsy,

The Tomatis method has been found to be very helpful for autistic individuals due to their high sensitivity to sounds. Autistic individuals are not able to process the auditory signals well, they often have to cover their ears to cut themselves off from the world as a form of protection.  According to Pierre Sollier, Director at the Tomatis Mozart Center in California, “about 60% of autistic children seem to respond positively to it”. (“The Tomatis Method – Henry Spink Foundation”, 2017)

Nordoff-Robbins (Creative Music Therapy)

nordoff_robbins_low_res

I will be sharing a series of music therapy approaches which I have researched for my Masters’ dissertation and which resonated with me. They will all be grouped in the folder “Music Therapy Approaches” which you can click on to see. I have researched and studied these various therapy approaches and synthesise them according to my own impulses and experience into my personal approach which I will share in later posts.

One of the therapy approaches which resonated deeply with me is the Nordoff-Robbins’s Creative Music Therapy.

This is a music therapy approach developed from the 17 year collaboration between Paul Nordoff and Clive Robbins beginning in 1958. It was originally devised as a therapy for children with psychological, physical, or developmental disabilities. Its early development was influenced by anthroposophy. This approach is also known as Creative Music Therapy.   

The Nordoff-Robbins approach to music therapy is based on the belief that regardless of illnesses and disabilities, everyone possesses a sensitivity to music that can be utilized for personal growth and development. In this form of treatment, individuals take an active role in creating music together with their therapists. Music is created during clinical improvisations together with the individual and not for the individual.

The touching aspect of the Nordoff-Robbins approach is that it helps children with special needs to combat social isolation or of overcoming limitations associated with illness, disability or trauma. This helps in the growing sense of community within the children instead of limited by the pathology and stigma of their illnesses. “For the child who is intellectually impaired, music and musical activities can be vivid, intelligible experiences that require no abstract thought. For the emotionally immature or disturbed child the experience of the emotional language of music is inviting: the self-subsistence of its melodies and forms provides security for him. Musical activity can motivate the physically disabled child to use his limbs or voice expressively; its rhythmic-melodic structures then support his activity and induce an order in his control that promotes coordination”. (Nordoff and Robbins 1973) To these children, music provides an empowering “sphere of experience” (Nordoff and Robbins 1973) in which the children finds communication with the outside world and “freedom, in varying degrees, from the malfunctions that restrict their lives”. (Nordoff and Robbins 1973) Dissonant and dramatic music has also been found to engage psychotic and mentally challenged children. (Nordoff and Robbins 1973).

According to Nordoff and Robbins, engagement in active music-making, when skilfully offered, guided and supported, can enable the children to go beyond what people assumed they could do. Musical improvisation demonstrates the children’s capacities for expression and interaction. This is not a method but rather the cultivating of a musical attitude which recognises the potential in everyone (regardless of pathology, illness, disability, trauma or social isolation) for engagement in active and communicative music-making, developing a sense of self as well as a capacity for satisfying social interaction.

Music when it expresses emotions allows children and also adults a chance to see themselves as they are. Now one no longer feels the emotions internally but can hear them externally as well. In active music making, the children with special needs has a chance to experience their inner self and become aware of it. The child can know and experience what type of child he or she is. An island child? A land child? Or a seashore child for example? There will come a point where the child makes a connection between his or her own feelings and the musical sounds they make. Slowly the child can begin to create expressions of his or her own self through musical elements. This is the process of finding the child’s personal identity and bringing it out to the world through music. (Nordoff Robbins, 2015)

In therapy, when the child is improvising creatively with musical elements under his control, “the vital life of feeling becomes united with perceiving, with intelligent comprehension and with action- and all are integrated by the essential individuality of the child in communicative expressiveness”. (Nordoff and Robbins 1973)

Through the process of guiding and structuring a rhythmically chaotic drum beating to one of consistency and regularity, the children learn to “order their being as they order their beating, realizing order and purpose in themselves as they find these qualities in the music”. (Nordoff and Robbins 1973) One of the strengths in the Nordoff-Robbins approach is the identity-building aspect and how it gives hope and self-confidence to older children. Younger children use the various musical structures and elements to discover themselves.

Improvisation is done in a flowing process with immediate contact with the children in a playful atmosphere. Much of the music is improvised and thus focused moment-by-moment on the children and their involvement. Therapists today using the Nordoff-Robbins approach will also make use of existing music or compose music together with the children. In some situations where relevant it is also useful to work towards performance of some kind together with the children.

Improvisation in the Nordoff-Robbins approach is a way to meet the child where he or she is and then changing along the way to support the child’s development. Communication starts by meeting the child where his inner condition is. Improvisation can become a “language of communication between him and an individual child”. (Nordoff and Robbins 1973) “The music his fingers draw from the instrument arises from his impressions of the child: facial expression, glance, posture, behaviour, condition- all express that presence his music will reflect and go out to meet”. (Nordoff and Robbins 1973) There is much searching on the part of the therapist to keep contacting and meeting the individual. The playing for eg the timing, rhythms, etc follow the impulses from the child. In improvisation, a space is created for the child’s personality to surface to become who he or she truly is from the inside. This is very much like the space created in Carl Rogers’s deep empathic listening.  The improvisations “constantly meet the changing forms of the child’s response”. (Nordoff and Robbins 1973)

A huge array of musical styles and idioms are used to search and to meet the child where he or she is at and this may change over the therapy session. There is a constant process of searching through the musical language to connect with the child. New and unfamiliar modes provide strong stimulation and are different from what the child is used to listening. Such new and unusual musical language creates wakefulness in the child. These awakening experiences can set the child into movement and increase his or her attention span.  According to Nordoff and Robbins, “the deliberate, judicious use of dissonant harmonies had a liberating effect on the children”. (Nordoff and Robbins 1973)

Familiar modes, harmonies and musical forms generally create dreaminess in the child. (Nordoff Robbins, 2015) Nordoff and Robbins (1973) studied these musical elements: intervals, consonance-dissonance, rhythms, vibrato and scale-forms which led to the development of musical improvisation as a basic technique for individual therapy.

A wide variety of simple musical instruments is used in this approach. Drums and cymbals are used as a diagnostic tool to assess the children. The young child may be at the piano together with therapist to feel enveloped and safe so that not much independence is required from the child. Drumming can lead the children into a musical-emotional involvement which is freeing for them and eventually leads into singing.

Games, stories and musical plays have been developed for children to create the playful atmosphere during the musical improvisations. Nordoff and Robbins (1973) also developed a working game that combines music therapy, speech exercises, ring-game activities and some elements of drama therapy.

According to Nordoff and Robbins, timeout is sometimes needed for the children to consolidate the various new experiences to allow these experiences to flow into other aspects of their life. This is balanced with the striving impulses given during therapy to help the children develop.  

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