Introduction The topic of stress and relaxation is commonly seen in preventive medicine, self-help publications, corporate wellness programming, and is no exception in music therapy. Stress is experienced in two forms: positive and negative. Positive stress is purposeful, time-limited, and balanced by relaxation or other supportive outlets. Negative stress is ongoing, unbalanced, and without purpose. Music therapy clinicians address two kinds of stress: situational and chronic. Research for situational stress has been conducted in the areas of surgical interventions, medical procedures, and labor and delivery. Music interventions for sustained or chronic stress are conducted in the areas of cardiac care, oncology, terminal illness, general hospitalization, and well populations.
A review of literature shows that music for anxiety/stress research has generally adopted one of two approaches, a participant-centered approach in which the participant selects the music, or the experimenter-centered approach in which music is selected by the experimenter. The participant- centered method has an inherent bias as the listener may unintentionally over-evaluate the effects of the music (Elliott, D., Polman, R., & McGregor, R. 2011). Though the experimenter-centered method does not have this bias, there is also the concern of music characteristics that may impact upon how music is appraised. Clair (1996) and Standley (1996) noted in their studies that when using music to structure exercises, patient preference is important but secondary to selecting music that structurally supports the exercise. Similarly, I use the experimenter-centered method and compose my own music that can directly address these music characteristics. In this paper, I will share of my experience with how various elements of music (melody, harmony, rhythm, etc) are combined to create a meaningful outcome. This is an ante-hoc process, meaning it guides the intervention development prior to treatment implementation.
Music Therapy Research Literature Gabrielsson and Lindstrom (2001) in a review of how musical structure influences emotional expression, suggested that characteristics such as rhythm regularity, slow tempo, articulation that is legato, high pitch, narrow pitch range with stepwise ascending progressions, simple and consonant harmonies and regular rhythm may enhance the relaxing nature of music. More recently, Gomez and Danuser (2007) basing their work on Gabrielsson and Lindstrom (2001), looked at the relationship between musical structure and emotions. Questioning thirty- one participants, the majority musically trained, they found that in terms of 'low arousal,' tempo accentuation and rhythmic articulation possessed the greatest power in discriminating music from being classified as 'high arousal'.
In a research by Tan, Yowler, and Super, three studies were conducted to investigate the correlational relationships between 12 psychophysical properties of music, preference, familiarity, and degree of perceived relaxation in music. Relaxation response include decreased heart rate, respiratory rate, blood pressure, metabolism, volumetric oxygen consumption, and blood lactate levels, carbon dioxide elimination, increased alpha wave brain activity and increased heart rate variability. A total of 94 participants (14 music therapists & 80 adults) took part in these three studies. The result suggests that decreases in tempo and melodic, rhythmic, and instrumental complexity of five or fewer instruments, along with minimal dynamic changes, resulted in an increased perception of relaxation. Additionally, a moderate pitch range around C5 in a major key with both ascending and descending melodic contours increased the perception of relaxation. In addition, preference for the music had a greater impact on perceived relaxation than familiarity(Tan, Yowler, & Super, 2012).
A self-report study by Elliot, Polman and McGregor tries to determine the characteristics of relaxing-music for anxiety control and emotional labels attached to the relaxing compositions. Eighty-four Undergraduate students participants were instructed to imagine themselves in an anxiety producing situation while listening to a selection of 30 music compositions. The music samples used in the study include “classical”, “chilled dance”, “new age”, “ambience”, and “space-rock.” The order of presentation of tracks was varied for each session. Of the compositions selected, the most relaxing tracks included four that could be classified as being “classical” music, two that could be classified as being 'new age' and two classified as “chilled pop.” When participants are asked to rate the importance of various music components, “tempo” and “melody” are ranked the highest (Tan, X., Yowler, C. J., Super, D. M., Fratianne, R. B., 2012).
A study by Jennifer Fiores looked at the usage of online receptive music experience and also examine if a particular musical element was perceived as more beneficial in decreasing stress and anxiety. Participants consisted of music therapy students, and the study was conducted during the last week of classes and finals week of one academic semester. The study uses five- minute online pre-composed receptive music experience developed from the analysis of the Therapeutic Function of Music. The researcher provided the receptive listening experience online to (a) give participants control for accessing the experience when needed, (b) give them the option to listen to the music recording more than one time, and (c) so participants would not need to schedule a specific time to participate, as with traditional research studies (Fiore, J., 2018). The playback of the music varied among participants, with the total time involved ranged from 15 to 20 minutes. Measures included the Spielberger State Trait Anxiety Inventory (STAI), the Stress Overload Scale (SOS), and a post- experience survey about musical element effectiveness. Result of the study indicate that online pre-composed receptive music experience can significantly decrease students’ stress and anxiety levels. In addition, participants’ reflections about the musical elements indicated that melody was most effective and instrumentation was least effective (Fiore, J., 2018).
The above research indicate that the ideal music for stress-reduction should have tempo at or below a resting heart rate (72 bpm or less), predictable dynamics, fluid melodic movement (predominantly by step), pleasing harmonies, regular rhythm without sudden changes, and tonal qualities that include strings, flute, or piano. It is important that musical elements of rhythm, tempo, and melodic repetition support the exercises. (Robb, S. L., 2000). Music characteristics such as rhythm regularity, slow tempo, articulation that is legato, high pitch, narrow pitch range with stepwise ascending progressions, simple and consonant harmonies and regular rhythm may enhance the relaxing nature of music (Gabrielsson and Lindstrom (2001).
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