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What is music therapy - the view from cognitive science (long post)


This research study is intended to explore the common ground in the fields of cognitive science and music therapy with a particular interest in dynamical systems theory and 4E cognition. Although some attempts have been made previously (Crowe, 2004, Lauzon, 2011) there is still much to be explored in this emerging area of interest. To begin this exploration, we must overcome the usual problems of language and define exactly what it is that we are talking about. This literature review will adopt the approach of a cognitive scientist exploring the core concepts of music therapy, attempting a “bridging” approach in the spirit of Aigen (2005 pp.23-28 as cited in Lauzon, 2011). “Bridging theories” attempt to bridge the gap between music therapy and other disciples, using languages and concepts from music therapy and other disciples. Bridging theories differ from “indigenous” music therapy theories in that they do not hold the music itself as the primary focus of analysis. Recontextualization theories on the other hand attempt to explain music therapy using only language and concepts from other disciplines. In adopting the perspective of a cognitive scientist, we will bear in mind the thoughts of Lauzon (2011) and Read (1990: as cited in Lauzon, 2011) and try to work from the inside out, that is, from a music therapy theoretical to a cognitive science based theoretical understanding. Cognitive science oriented constructs of interest to us will be the embodied, enactive, embedded and extended phenomenology of music therapy, as well as the coupling between a music therapist and their service user(s) as a dynamical system. In order to bridge this gap, we will need to identify phenomena that can be described homologously or may translate between the academic languages of psychology, psychodynamics and dynamical systems. Although starting from the inside-out (using the language of music therapy wherever possible), we will attempt to distil a view of music therapy from the perspective of a 4E and dynamical systems oriented cognitive scientist, as opposed to that of a music therapist or the view from nowhere (Nagel, 1989 pp.13-17) and provide a descriptive account of what emerges.

In order to clearly define our subject area, there are a few definitions and concepts that we must address. First of all, we must define ‘music therapy’ as opposed to health musicking or music as medicine, this means defining what is not music therapy. Trondalen and Bonde (2012, pp.41) differentiate between these concepts in the following manner: Music as medicine is the “use of pre-recorded music to improve patient status and medical care”, this is usually provided by medical staff other than music therapists and “may be seen as a cognitive-behaviourally oriented intervention model”. Health musicking on the other hand “can be understood as the common core of any use of musical experiences to emotional or relational states or to promote well-being” (Bonde, 2011 as cited in Trondalen and Bonde, 2012, pp.40), or as Stige himself defines it, “the appraisal and appropriation of the health affordances of the arena, agenda, agents, activities, and artefacts of a music practice” (2002 p.211). “Musiking” (Enfield & Kockelman, 2017 pp.157) defines another contrary interpretational update of Smalls (1998 pp.9) original term “musicking” where “musiking” provides “an invaluable, naturalistic empirical and theoretical platform for understanding foundations of our social agency” (Note: Smalls 1998 pp.9 deffinition being “to take part, in any capacity in a musical performance, whether by performing, by listening, by rehearsing or practicing, by providing material for performance (what is called composing), or by dancing”). Although closely related to and by no means mutually exclusive, music as medicine, health musicking and musiking are not themselves synonymous with music therapy.

Whilst music has been used as a healing practice almost ubiquitously since prehistoric times, it was in the aftermath of World War two that the modern profession was defined and the first clinical training programmes were established (Davis & Hadley, 2015). Music therapy was defined by Bruscia (1998 as cited in Frederiksen, 2019, pp.26) as a systematic process of intervention using musical experiences in order to help a client promote health although it must be said that this does not clearly differentiate it from health musicking or music as medicine. Music therapy takes many different forms and although there is no universally agreed upon definition, some professionally credentialled/academic definitions include (but are not limited to);

The use of “the expressive elements of music as the main way of interaction between you and your therapist” (Health Service Executive (Ireland), 2022),

“An evidence-based profession where the planned and creative use of music-based interventions by an IACAT-accredited music therapist supports people to improve, restore or maintain health, functioning and well-being” (Irish Association of Creative Arts Therapists, 2022),

“The targeted use of music as part of the therapeutic relationship to restore, maintain and promote mental, physical and spiritual health” (Deutsche Musiktherapeutische Gesellschaft, 2022)

“An established psychological clinical intervention delivered by HCPC registered music therapists to help people whose lives have been affected by injury, illness or disability through supporting their psychological, emotional, cognitive, physical, communicative and social needs” (British association of music therapy, 2022), and

“The clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional” (American music therapy association, 2022).

Some of the most common aspects of music therapy across the definitions are that it is an ‘evidence-based’ therapy and that it must be delivered by an accredited music therapist (someone who has received a certain quality of training in the field) with either listening to, moving to, creating, re-creating or discussing music and musical experiences as the primary modality of therapeutic intervention (‘moving to’ in a context not to be confused with that of dance therapy). Many different theoretical approaches and specializations within the field have also emerged over the years. Some of these include (but are not limited to);

Neurologic music therapy (Thaut & Hoemberg, 2014), which is a set of twenty specific clinical interventions/practices focused on physical and neurologic rehabilitation after traumatic brain injury or for neurodegenerative disorders,

The Nordoff-Robbins approach (Nordoff & Robbins, 1983), where the innate musicality and expression of the child is central to the facilitation of development with “musical interactions as the basis of therapeutic relationship” (Guerrero, Marcus & Turry, 2015),

The Bonny method of guided imagery and music, which is “a depth approach to music psychotherapy in which specifically programmed classical music is used to generate a dynamic unfolding of inner experiences” where “the music facilitates a consistent, continuous dialogue with the unconscious in which the ego holds its own reality while allowing the unconscious to do the same” (Hanks, 1985 as cited in Goldberg 1995).

Community music therapy, which is “context-sensitive and resource oriented, focusing on collaborative music making and attending to the voices of disadvantaged people” (Stige, 2015)

Psychodynamic approaches to music therapy, which whilst not a clearly delineated, homogeneous field, is a widely implemented orientation within the discipline (Isenberg, 2015). This uses the theoretical concepts of classical psychotherapeutic approaches but primarily through the medium of music rather than words (although it is still common practice to talk during psychodynamic music therapy sessions) and includes psychoanalytic, psychodynamic and insight-oriented approaches (Isenberg, 2015).

In this section, we will outline the core concepts that are present across the theoretical orientations and practical approaches to music therapy. While it must be said that it is the use of music itself that is the defining feature of music therapy, to attempt to describe what music is and give a detailed account of the phenomenon as it appears in this context would be beyond the scope of this paper. Rather we will focus on the therapeutic aspects of music therapy and on the dynamic interaction between therapist and service user. Although not all music therapy techniques could be considered psychotherapeutic (see neurologic music therapy (Thaut & Hoemburg 2014)), and a great many more could be debated about (see music therapy in education (Wilson, 1991)), in general, music therapy is considered a branch of the creative arts therapies which are psychotherapeutically oriented (De Witte et al, 2021). While not giving an exhaustive account of the field, we will examine the paradigm of an evidence-based discipline, the concept of a therapeutic alliance and the phenomena of entrainment and the iso-principle.

When it comes to the evidence base for music therapy or any given ‘evidence based’ approach, the generally accepted gold standards are Cochrane reviews (Vink & Bruinsma, 2003). Cochrane reviews have shown music therapy to be somewhat inconclusive due to a lack of available studies but none-the-less may provide beneficial outcomes for depression (Albers et al, 2017), schizophrenia or schizophrenia-like illnesses (Gold et al, 2005) autism spectrum disorders (Gold et al, 2006), acquired brain injury (Bradt et al, 2010) and end-of-life care (Bradt & Dileo, 2010) among other areas. The inconclusiveness of these studies, while primarily blamed on the lack of available data may also be related to notable problems associated with the use of the “evidence-based” paradigm itself when applied psychotherapy and other such subjective phenomena.

Ever since the dissemination of the 1995 APA task force white paper, the use of the term ‘evidence based’ has become both a standard and a marketing tool for a long list of therapeutic techniques (Shean, 2015, Shedler, 2015). This paper (APA, 1995) aimed to empirically validate therapeutic techniques to “legitimize the science of psychotherapy” (Shean, 2015) through the use of randomized control trials (RCT’s) which are often cited as the pinnacle of experimentation in the scientific method (particularly when it comes to psychiatric drug testing). As Shean (2015) notes however, this approach is ill suited to the practice of psychotherapy as it’s clinical populations often have a high rate of co-morbidities and rarely fit into the homogeneous diagnostic categories demanded by RCT inclusion criteria and are not representative of the population at large, tending to draw self-selected participants from university campuses. The symptom focus of RCT’s also neglects the “complexities of human functioning across relationships, situations and time” which are so integral to the practice of therapy (the psychotherapies in particular) and even the length of time spent in therapy during RCT’s (generally an average of 16 or fewer sessions) does not reflect the reality of long term therapeutic intervention that is the standard practice, not being “consistent with evidence for a significant psychotherapy dose-response relationship” (Sligman, 1995, Westen et al., 2004 as cited in Shean 2015). Other issues raised by Shean (2015) in this regard are the “allegiance effect” which negates the use of double-blind testing of one approach to another, the “problem of circularity” where participants must be matched on “relevant variables and therapeutic approaches must be sufficiently structured to be administered from a manual”, something that is simply not possible to do for many psychotherapeutic techniques (in particular those of a person-centred approach). Shean (2015) comments that the empirical demands of objectivity, implicit in the physical sciences are ill suited to the subjective nature of therapy and do not sit well within the bounds of traditional verifiability. Shedler (2010, as cited in Shean, 2015) identifies

The key features that distinguish dynamic psychotherapy as: a focus on affect and expression of emotion; exploration of attempts to avoid distressing thoughts and feelings; identification of recurring themes and patterns; discussion of past experiences with a developmental focus; focus on interpersonal relations; focus on the therapy relationship; and exploration of fantasy life

cannot be reduced to a simple manual or prescribed technical approach. Shedler (2015) further corroborates this with an even more scathing review of the ‘evidence-based’ paradigm in psychotherapeutic evaluation. Schedler (2015) further claims that “One could argue… as the term is now applied to psychotherapy, is a perversion of every founding principle of evidence-based medicine” reasoning “statistically significant does not mean effective”, “research continues, treatment benefits do not”, “most patients are never counted”, “control groups are shams”, “the superiority of evidence-based therapy is a myth” and “data are supressed”.

This indeed does paint a rather unflattering picture of music therapy yet the baby should not be thrown out with the bathwater (or the “evidence-based” paradigm in this case) as countless therapists, service users and other medical professionals have seen first-hand the benefits of music therapy (this author included). In a large meta-analysis of empirical studies across the creative arts therapies, De Witte et al (2021) put together an “in depth analysis of the therapeutic factors and mechanisms of change” and found music therapy to be dependent on such concepts as “working in the here and now within a positive therapeutic alliance in a safe, predictable environment” relying on “group cohesiveness, feelings of togetherness and bonding, altruism, validating feedback by others, and interpersonal learning” where “participants in music therapy experience a sense of personal connection, pro-social skills, meaning, agency, motivation, and emotional release and relief”. Considering the intangibility of these currently accepted mechanisms for change and therapeutic outcome from within the field, it is no doubt that randomized control trials cannot capture an adequate picture.

To close this section, as previously mentioned, it should also be noted that not all forms of music therapy are strictly psychotherapeutic. Neurologic music therapy (Thaut & Hoemberg, 2014) being a notable exception and one which is actually well suited to RCT’s and the medical model of an evidence-based paradigm due to its often prescriptive and technical structure. The MATADOC tool (Magee et al, 2016), is another notable exception, being a “standardized measure for assessment of auditory responsiveness in PDOC” (pervasive disorders of consciousness), and in a pilot study conducted by Bodine et al (2021), was found to possibly be “an appropriate assessment to confirm or refute a questionable diagnosis”.

The most researched, positive indicator of outcome across the psychotherapies is that of the therapeutic alliance (De Witte et al, 2021). The origins of this concept date back to Freud (1913, as cited in Frederiksen, 2019 pp.22) and his emphasis on “conscious and positive transference as a precondition for success in psychoanalytic treatment”. Frederiksen (2019 pp.23) also notes that this was considerably built upon by Rogers (1951), Winnicot (2005) and Bowlby (1988). Hougaard (1994) developed perhaps the most commonly cited conceptualization, distinguishing between the “personal alliance” and “task related alliance”. The therapeutic alliance can be thought of as “the specific type of relationship between the patient and therapist, which takes place in a setting oriented towards the patient’s change and development” (Frederiksen, 2019 pp.23). De Witte et al (2021) found that “music therapy enhances therapeutic alliance and group processes through playful musical interactions, shared musical experiences, musical attunement, musical synchronicity and musical dialogue”. One could possibly consider this to be a somewhat well-suited context for the practice of Stiges (2002 pp.211) definition of health musicking. It may be possible to differentiate between ‘music therapy’ and ‘health musicking’ here* by noting that music therapy considers the overarching field of the use of music as a therapeutic tool, medium or catalyst by a music therapist, while health musicking, taken in the context of music therapy, is the process of musical interaction between therapist and service in virtue of which the therapeutic alliance is strengthened, thus promoting health.

*also differentiating ‘health musicking’ from ‘music therapy’ is the fact that health musicking can occur in any context with a musical engagement, whilst music therapy must be conducted by a music therapist in an appropriate setting.

Entrainment is a ubiquitous phenomenon of self-organising systems in the physical world, it is “the formation of regular, predictable patterns in time and/or space through interactions within or between systems that manifest potential symmetries” (Collier & Burch, 2000). According to Collier and Burch (2000), “entrainment can be either forced or spontaneous” and results from “forces that are self-organizing”, “the result of rhythmic entrainment is a simplification of the entrained system, in the sense that the information required to describe it is reduced” and “more complex cases can direct energy more efficiently than similar forced systems, allowing more effect for less effort”. What began as an experimental quirk accidentally discovered by Christian Huygens in 1657, fast grew into an entire field of enquiry making its way into pop culture with YouTube videos of the soda can mounted metronomes described by Pantaleone (2002). When it comes to biological systems, examples of entrainment can be found in the circadian rhythm which “actively synchronizes the temporal sequence of biological functions with the environment” (Roenneberg et al, 2003), the spontaneous activity of pacemaker cells in the heart (Hennis et al, 2021) and even in the simple act of tapping your foot to the beat of a song. The entire dimension of rhythm, or “the perception of metrical structure” in music in fact may be said to be predicated on the phenomenon of entrainment (Large & Kolen, 1994), or conversely as Cummins (2012) puts it, “Rhythm… may fruitfully be defined as an affordance for the entrainment of movement”.

When it comes to music therapy, entrainment is a central concept and has both psychologic and physiologic dimensions. Clayton (2012) describes it in musical research as “the process of interaction between independent rhythmical systems”, Thaut et al (2015) describe it in neurologic music therapy as “a temporal locking in which one’s system’s motion or signal frequency entrains the frequency of another system” and Dimaio (2010) describes it in humanistic music therapy as “a “pull” exerting from one vibrating object to another vibrating object”.

The field of neurologic music therapy was founded on the phenomenon of entrainment (Thaut, 2015), firstly through the use of auditory rhythmic patterns to improve spatial and force parameters of physical rehabilitation from movement disorders, and then to cognitive and speech and language rehabilitative procedures. In terms of motor rehabilitation, Thaut (2015) describes how “the firing of auditory neurons, triggered by auditory rhythms and music, entrain the firing patterns of motor neurons” and that “auditory stimulation primes the motor system towards a state of readiness to move” where “rhythmic stimuli create stable anticipatory time scales of templates” for motor planning and execution. Outside of strictly motor control, rhythmic entrainment has specific applications in speech rehabilitation after stroke, fluency disorders like stuttering, and cognitive rehabilitation in areas such as memory, among others (Thaut, 2015).

Dimaio (2010) defines a special case “music therapy entrainment” as an end-of-life pain management technique, broken down into a five-stage process consisting of “assessment, goal formulation, creating auditory images, externalization of pain and therapeutic resonance, and, finally, ISO-continued application and evaluation”. Dimaio (2010) understood music therapy entrainment to enable her service users to learn a “new language” and “to communicate the meaning of their pain and dying process with loved ones, and that it “can influence more than a person’s perception of pain; it can affect his or her dying process and family’s grief”. Dimaio’s (2010) interpretation of music therapy entrainment relies heavily on the ISO-principle which we will examine in detail in the next section. It should be noted however that many other music therapy based pain management interpretations of entrainment exist, notably, Eagle & Harsh (1988) and Rider (1985). Rider (1985), in a study on “the effect of different types of music on pain relief, muscle relaxation and pain relief injury in a population of spinal pain patients” (N=23), found that “entrainment music… was significantly the most effective condition in reducing pain and EMG levels”. Although a clear distinction between entrainment music and the other conditions was not given, other than that a live acoustic guitar rather than pre-recorded music was involved.

Kim et al (2018) taxonomize 4 types of rhythmic entrainment in music therapy; perceptual, motor, social and physiological, describing how

perceptual entrainment concerns the cognitive representation of a periodic auditory signal, motor entrainment affects voluntary and involuntary synchronization of movements to a musical beat… social entrainment requires a shared music making, music listening, or dancing activity with others… autonomic physiological entrainment has been defined as “a process whereby an emotion is evoked by a piece of music because a powerful external rhythm in the music influences some internal bodily rhythm of the listener (for example heart rate), such that the latter rhythm adjusts toward and eventually ‘locks in’ to a common periodicity” (Juslin, 2013 as cited in Kim et al, 2018).

Kim et al (2018) confirmed the findings suggested by Rider (1985) and the experience of Dimaio (2010) using what they termed “dynamic rhythmic entrainment” or the “ISO-principle”.

The iso-principle dates back to the very foundational roots of music therapy itself, and the ground-breaking work of Ira Altshuler (1948), regarded as “a milestone in the professionalisation of music therapy” (Gouk, 2001) the iso-principle is still regarded by some as “the heart of much current music therapy practice” (Bunt, 1994 pp.34). Considered a special case of entrainment (Kim et al, 2018), the iso-principle has been described as “the step-wise “vectoring” or directed movement of music to the desired goal; e.g. from sad to cheerful, or restless to tranquil, or bored to stimulated” (Shatin, 1970). Heiderscheit and Madson (2015) note that despite it’s commonplace use in contemporary practice “the current descriptions and clinical illustrations regarding its use… are scarce”. Sparse studies, often simply offering a definition with little explanation, “contemporary literature indicates that its definition may have become much more than its original intent” (Heiderscheit & Madson, 2015). Goldschmidt (2020 pp.1) notes the problem of multiple definitions and synonymous terms, distilling

the iso-principle can be broadly defined as using one or more elements of music to meet a patients current state, then changing said musical element(s) to lead them to a different state (Altschuler, 1954; Heiderscheit & Madson, 2015; Yinger & Lownds, 2018). The given state being changed can be mood, pain level, arousal, or a number of other states.

The ‘iso-principle’ is a term that indigenous to music therapy (Goldschmidt, 2020, pp1) and according to Galinska (2015),

derives from the so-called isopathic music therapy of Aristotle, as opposed to allopathic Pythagorean therapy, operating according to the principle of contraria contrariis curantur (which can be derived from the Pythagorean principles of harmony as compliance opposites).

To give a practical example of the iso-principle, a therapist would engage a person experiencing lethargy with slow and sluggish music (matched to emotional (e.g. a-tonal) and physiological states (eg tempo matched to breath rate) to facilitate entrainment). Then, whilst maintaining entrainment the therapist slowly changes the music over time by manipulating certain musical elements (for example faster tempo or rhythm, a more expressive range of pitch or harmony or key change). The therapist aims to move the state of the individual to a space where they may experience a more aroused physical and mental state (this technique can be used across multiple physical and mental states).

The iso-principle should not be mistaken for the (more Pythagorean) ‘compensation principle’, which by definition contrasts with the state of the service user (Bonde & Wigram, 2002 as cited in Goldschmidt, 2020). Still making use of entrainment, “the compensation principle is different to the iso-principle in that instead of meeting a client in their current state musically, one immediately plays the music of the intended destination bodily state” (Goldschmidt, 2020 pp.7) e.g. playing calm music to sooth an overstimulated individual.

Crowe (2004) was frustrated with the “reductionist paradigm” of music therapy research and the mismatch between what the studies said and what results she observed when working with her clients. She found that traditional scientific paradigm of reductionism, determinism, objectivism and the assumption of context free phenomena “clearly has limitations, as evidenced by its inability to either explain or prove the efficacy of music therapy interventions. This led her to explore complexity science and the idea of dynamical systems where

Relationships between ‘parts’ are dynamic, ever-changing, because they involve complex networks of feedback and feedforward loops. It becomes difficult, if not meaningless, to identify of isolate individual causes… Such nonlinear evolution means it is impossible to accurately predict the behaviour of complex systems (deQuincy, 2002 pp.30-31 as cited in Crowe, 2004).

Crowe (2002) continues to outline the concepts of deterministic chaos, order and form, nonlinearity, wholeness and emergent properties and uses these to outline how music behaves as a dynamical system. She (Crowe, 2002) states that “a single … tone with its overtone series is by itself a complex physical vibration”, “music has a nonlinear quality where the whole is greater than the sum of its parts”, using a symphony orchestra as an example, and how music is incredibly sensitive to initial conditions, citing Helen Bonnys (1973) observation that for her Guided Imagery in Music (GIM) technique, even specific performances of pieces had to be chosen as “the individuals performing the music – could make a noticeable difference in client response” (Crowe, 2002). Crowe then explains how the production of music relies on a delicate balance between auditory and motor feedback and how attractors can be seen in music, either through the fixed-point attractor of harmonic cadence, possible torus attractors present in the coupling of tones in intervals and finally with the idea that music itself is a strange attractor as it can be defined as a “collection of fractals in time”.

Crowe (2002) describes the “purposeful interaction of music directed by the music therapist and human functioning” as “an immensely complex dynamical system, where the therapeutic benefits are emergent properties” and describes health as “a balanced and harmonious relationship between and within all aspects of human functioning”, concluding

This complex dynamical system – music and the music therapist using music with intention – brings individuals to health by supplying vast amounts of information, complexity, that keeps individuals in the edge of chaos dynamics and allows the creation of the emergent property of health.

A suite of implications for music therapy practice and research are then drawn, “First, music therapy must be addressed in its wholeness” (Crowe, 2002) and viewed as “an on-going process not an end product”, “Secondly… small factors can have huge effects through amplified or iterative feedback”, this means that “we can never prove what factor in the music therapy process does or does not impact the process” i.e. we cannot separately investigate how individual rhythms, tones, forms etc impact therapy. Crowe concludes “we can never completely know how and why music therapy works because complexity science implies there will always be missing information that, through feedback, may be profoundly affecting the outcome”. Calling for a greater use of “intuition”, in research, Crowe (2002) believes that “new music therapy research will demonstrate relationships between factors without being required to prove that one factor caused the other”.

1.3.2 - A music systems theory of music therapy

Lauzon (2011) poses the questions, “why is music effective as therapy?”, as “I am moved by another person making music… what happens to her, to me, when music happens” and settling on “what happens when music happens?”. Reasoning that music therapy must be effective due to its modern international expansion, Lauzon (2011) offers a definition of music as “sound as time-ordered, trans-verbal play”, further clarifying

Sound is what is heard. Time is the “indefinite continued progress of existence and events in the past, present, and future regarded as a whole (Oxford). Ordered is methodical arrangement. Trans is the going beyond, the travelling to the other side of verbal, the language of words. Play is free action, considered as active spontaneity, rather than reactivity (Winnicot, 2005).

Lauzon goes invokes the concept of “music states” and generates a detailed framework for these “music states” which are the fundamental properties of “the way music basically is in the human organism at any given time”. These fundamental properties are music states as (1) Responsive, “some music states are caused by states of the world”(2) Expressive, “some music states cause action” (3) Relational, “Some music states cause other music states” (4) Emotional, “Some music states have quality” (5) Cognitive, “Some music states are about things in the world” (6) Neurological “Some kinds of music states are systematically correlated with certain kinds of brain states” and (7) Changing “Some music states are correlated to personal growth”.

Drawing heavily on Kennys (2014) “ecology of being in music therapy”, Lauzon (2011) approaches the enquiry through a view of “we are” as opposed to “I think” and attempts a general systems theory of music therapy with “musical beings” having “music systems” which are “maintained by the mutual interactions of its parts”. Understanding music as a “non-discursive experiential symbol making system”, Lauzon (2011) differentiates three “structural and functional” musical systems (“a dynamic morphology”) within a musical being, “(1) rhythmos, (2) tonos (3) harmonia”. Each system has the following attributes:

(1) Rhythmos “is manifest in the basic periodicities and cycles of a human life, particularly through the voice” where “ordered wholeness is essential”, it is “an open system in steady-state”, “has the capacity for creative self-reorganization in the face of challenge”, “is a co-ordinating interface in a hierarchical structure” and has “periodicity”.

(2) Tonos “organizes humans as sound generating beings”, “is a building block of melody, and being less dependent on cultural meaning than melody” “is a system with ordered wholeness”, “maintains itself in a changing environment”, “creates itself in a changing environment” and “is a co-ordinating interface with hierarchical reality”

(3) Harmonia, “the joining or fitting of things together, even the material peg with which they were joined” (Homer, Od. V. 248 as cited in Lauzon 2011), “is a whole with irreducible properties”, “maintains in a changing environment”, “creates in response to the challenge of the environment” and “is a co-ordinating interface in natures hierarchy”.

Lauzon (2011) concludes by describing each of the seven musical states with the lens’ of the three systems concepts, creating an indigenous systems theory of music therapy by making “sense of music states by providing a music-centred language to describe the core operations of a dynamic natural system” and offers and answer to the question “why is music effective as therapy” with the answer “we are made as music is made, with music systems” and “to be effective, the music therapist works with these music systems”.

Having outlined various definitions of music therapy, examined its core concepts and taking a brief look at dynamical systems explanations of what happens during music therapy we are left with one notable conclusion. Despite providing a framework for understanding music therapy from a systems perspective, we do not have a clear view of what Bunt (1994 pp.34) described as “the heart of much current music therapy practice” – the iso-principle. With this in mind, we shall use what tools we have at our disposal to document and describe what we may about this incredible phenomenon that seems to bridge the ethereal divide between mind and body. That will be the topic for our next essay.

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