If music be the food of life – play on ?

The processes and outcomes of musical engagement and participation are related to health and wellbeing in a number of ways, however, the use of music and musical experiences in integrated health care is still in its infancy. The present issue of EuJIM includes three articles that illustrate the potential. Several concepts are used, and some clarity is warranted. Different conceptual frameworks have been suggested to understand the interplay of music, health and wellbeing. For example, MacDonald, Kreutz & Miell (1) have suggested that the field of music and health can be understood as a cross-field integration of related “music disciplines that all utilize music for reasons of positive outcome” (ibid, p. 7): Music education, Music Therapy, Community music and Everyday uses of music. These disciplines use the following characteristics of music for different purposes: Music is: ubiquitous, emotional, engaging, distracting, physical, ambiguous, social, communicative, and it affects behaviour and identities (ibid.). Another conceptual framework is based on the concept of “health musicking” (2,3,4). “Musicking” (5) includes all the ways a person can engage with music, be it as musician, singer, dancer, arranger, listener, collector, connoisseur, fan etc. “Health musicking” encompasses all sorts of “affirmative, corrective or transformative emotional and relational experiences through musicking”, independent of their nature as therapeutic or not, professionally assisted or not. The field can be divided into four quadrants, each with specific characteristics and goals. The figure is inspired by the American philosopher Ken Wilber who developed the quadrants, as equally important perspectives on life and its phenomena. The axes are: inner/outer and individual/social. A few words about each quadrant in the context of the present journal issue: Individual and group music therapy in clinical settings has “the formation and development of identity through musicking” as its goal; Music Medicine in- and outside hospitals is “the professional use of music and sound to help individuals; Community music activities in hospitals, residence homes etc. aims at developing “communities and values through musicking”; while the planning of new, hopefully integrative hospitals must also focus on “the shaping and sharing of musical environments”, because this is where decisions about the hospital’s sound milieu is made (6). Some of the concepts used here need further clarification: music intervention, music medicine, music therapy, music therapy in medicine, and community music (therapy) (7). “Music intervention” is used as an umbrella term that covers all the other, more specific intervention forms. “Music Medicine “ (or “music in medicine”) is a concept denoting the systematic use of carefully selected music to facilitate e.g. reduction of pain and anxiety, relaxation or distraction. Typically, the patient listens to recorded music (playlists), but live music is also (and even more) effective. In “Music therapy”, the relationship between a patient and a therapist is crucial. Music is the medium through which the healing, relational experiences are promoted to facilitate e.g. pain management, enhanced coping, emotion regulation and social engagement. Song writing, singing, improvisation and music and imagery experiences are typical methods. “Music therapy in medicine” is the specific use of music therapy in medical settings, while “Community music” in hospitals is the non-clinical use of band playing, choir singing, concerts and other musical events to promote joy and social cohesion among patients, relatives and hospital staff. These activities are often led by a music therapist, but they can also be led by professional or amateur musicians or musically skilled doctors and nurses.