Sacred and Profane in Music Therapy ^†

Abstract

The widespread belief that music has some therapeutic potential rests partly on demonstrable, practical results. But explaining how such therapy works depends on the belief system of the explainer or practitioner. This survey of the literature shows how strongly a discipline is affected by its underlying metaphysical presuppositions. Traditional explanations, from antiquity through the nineteenth century, include participation by God or the gods; music as a bearer of sacred and harmonic numbers; the doctrine of correspondences and occult sympathies; the presence of animal spirits, subtle fluids, and other non-material elements in the human compound. The official belief system of the modern medical establishment cannot allow for any of these, hence its attempt to find materialistic explanations of how music therapy works. In the late 20th century some therapists, rejecting this constraint, returned to a more spiritual approach.

“As like rejoices in like, so the harmonic constitution of man strives toward the harmony of the macrocosm; through sounding numbers, especially, the ear and the soul are seized and strengthened in a wondrous way.”

Michael Ernst Ettmüller, Disputatio effectus musicae in hominem, 1714 (cited in Kümmel 1977, p. 108).

That music has some power to heal body and soul is acommonplace in the history of ideas. Its legendary past includes Orpheus’s charming of men, beasts, and even gods, the Pythagoreans’ musical control of emotions, Plato’s belief in the moral efficacy of certain modes, and David’s exorcism of King Saul. Nor is the topos limited to the West. The Muslim and Hindu worlds have their own legends, while in imperial China, music was as essential as laws to the well-being of the state. Shamanism may preserve some even older therapeutic tradition, in which the sound and symbolism of musical instruments play an essential role (Schneider 1989, p. 63).

Modern music therapy, in contrast, is a regulated profession, tolerated if not always welcomed by the medical and psychiatric establishments. Its history and claims are well-documented; less so is the question of how exactly it is supposed to work. One might think that this was straightforward and empirical, but that is not the case: the whole subject is surrounded by doubts and equivocations. In any therapy that is not purely physical (such as amputation), the explanation of its mechanics is contingent on its metaphysics: that is, on the belief system of the person or society using it. An obvious example is faith healing, which only makes sense within a metaphysic that allows for divine intervention in response to prayer. Homeopathy is another: it rests on a belief that after diluting a substance to the point where no chemical trace remains, its healing property is actually increased. Within the materialistic belief system that is the accepted norm in the medical world, such therapies cannot possibly work, and any apparent success must be due to other causes. Likewise, every explanation of how music affects us rests on an assumption, usually unspoken, of how humans and reality itself are constituted.

The assumptions that have accompanied music therapy are often similar to those of esoteric traditions, such as the doctrine of correspondences, to which Ettmüller alludes in the opening quotation; the subtle constitution of the human being; and methods of bridging the material and the immaterial realms. This is hardly surprising, since speculative music is a perennial current within the Western esoteric tradition, and music therapy is its practical application, analogous to laboratory alchemy or ceremonial magic.

1. Gods and Numbers

The most ancient type of music therapy belongs to a traditional Western world view in which gods or spirits take a personal interest in human affairs. Plagues and diseases are to be blamed on them, or on us for somehow offending them. The healer’s job is then to appease the god, or induce the spirit to leave the sufferer alone. But the question arises of how and why music should have this effect on divine or bodiless beings. Two cases, coming from sources two millennia apart, bracket this belief and provide insight into its rationale. The first concerns a case in southern Italy in the fourth century BCE reported by Aristoxenus: an epidemic of collective madness affecting women (West 2000, p. 55). An oracle was consulted for a cure, and it recommended singing twelve paeans (hymns) each day to the god responsible for the affliction, and continuing for sixty days, making 720 paeans in all.

We might call this the highest type of music therapy, in which the gods themselves are the patients: music has an effect on them and changes their minds. How else are we to interpret Orpheus’s persuading Pluto to let Eurydice go? That God takes pleasure in music is the justification for the whole Judeo-Christian tradition of liturgical song. Even the Calvinists acknowledged this. In our second case, the Huguenot poet Guillaume Du Bartas (1544–1590) writes that when God is in one of his angry fits, “the melodious harmony, breathed by a devout heart, loosens his sinews and puts his wrath to sleep” (Heather 2000, p. 210). Du Bartas pictures God as though he has sinews and tendons like the gut strings of an instrument, which respond sympathetically to human harmony. Of course, it is allegorical, but the imagery of God’s body being in or out of tune recalls the Pythagorean doctrine of numbers as the ultimate realities, and its reflection in the harmonic construction of the World Soul (Plato, Timaeus, pp. 35–36).

Returning to the south Italian epidemic and its curiously prescriptive remedy, we notice numbers that were prominent in the cosmology and musical tuning systems that were an obsessive interest in the ancient world. Sixty is the controlling number for tuning the Dorian mode, 720 for tuning the chromatic scale (being the number of parts into which a monochord string must be divided in order for each note of the scale to be a whole number of parts; see McClain 1978, p. 25). It is as though the god needed to be reminded of this, so that he would stop sending down discordant influences. Both examples imply a metaphysical rationale for using music, rather than just verbal prayer, in commerce with the divine, because the gods themselves are regulated by harmonic numbers.

In most pre-modern belief systems there is an intermediate order of beings between gods and men, called daimons, demigods, angels, spirits, genii, etc., who may be responsible for sickness and responsive to musical exorcism. The classic case is that of King Saul. As told in the First Book of Samuel (I Samuel 16:14–23), God had withdrawn his own spirit from the prophetically gifted king and sent an evil one in its place. David was brought to play the kinnor (Hebrew lyre or harp) to Saul, which caused the evil spirit to leave him. Because of its biblical authority, this legend appears in every older text on music therapy, and even in modern ones which naturally have psychological rather than spiritual explanations.

In Gilbert Rouget’s study of music and trance, he describes how in exorcism music either drives out the demon with intolerable noises, or else it acts as a vehicle for words of power, which are then the primary agent. Neither applies in Saul’s case. The Bible says specifically that David was “skillful in playing.” It says nothing about him singing. Rouget comments that “This places him in the Near-Eastern tradition… that attributes powers to music derived from complex symbolic or numerical relations with the cosmos” (Rouget 1985, p. 157). Commentators from the medieval Jewish and Arab writers up to the Renaissance agree that David’s playing caused a change in Saul’s state of soul, which induced the evil spirit to leave him and God’s spirit to return. Du Bartas, already quoted, says that David’s music restored harmony to Saul’s soul, just as our hymns do to God’s (Horden 2000, p. 20). Since a harmonious soul is an uncomfortable place for a demon to lodge in, it left him.

I mentioned the musical tuning systems that probably came from Babylon and were concealed, as Ernest McClain’s research has shown, as a running subtext to the Hebrew scriptures (McClain 2006). The Pythagoreans introduced this material into the Greek world, thereby founding the Western tradition of speculative music with its two pillars: musica mundana, commonly called the harmony of the spheres, including that of the earth and elements, and musica humana, the harmony of the human body and soul. The legends tell of Pythagoras’s discovery that musical consonance is ordered by the numbers 1,2,3, and 4, and of how he applied this knowledge in practice. Almost as famous as the story of David and Saul is that of Pythagoras and the Taorminian youth who was about burn down his mistress’s house. The youth had come from a drinking party, and the musician was playing his aulos (reed flute) in the wild Phrygian mode. Pythagoras told him to switch to the solemn Dorian mode, and the youth’s behavior changed forthwith: he calmed down and disaster was averted (Boethius 1989, pp. 5–6).

One goal of the Pythagorean enterprise was to tune the human microcosm to a macrocosm that is harmonious through and through. The method was the introduction of correct proportions into the soul via the three highest forms of perception: hearing, seeing, and thinking. Music affects the soul through the ear; geometry and architecture through the eye; paideia or education develops the intellect through the study of mathematics. Plato’s Pythagorean spokesman Timaeus explains the musical application. He says: “The sense of hearing is granted to us for the sake of harmony. And harmony, which has motions akin to the revolutions of our souls, is [given by the Muses] as a means to correct any discord which may have arisen in the courses of the soul… and rhythm too was given for the same reason” (Timaeus 47c).

2. Correspondence and Sympathy

Obviously, none of this would work without a metaphysic of multiple states or levels of being, linked by correspondences. But that is no solution in itself, for how do we suppose that the different realms or levels communicate with one another? Plotinus, explaining the efficacy of magic, uses the simile of sympathetic vibration (Enneads IV, pp. 4, 41). This happens when one plucks a string on a lyre or lute, and the string of a similar instrument vibrates in response to it. The phenomenon fascinated natural philosophers, and they applied it time and again to exemplify the effects of music on the body and soul.

The two-lute experiment was easily explained through the belief that air is made from very fine corpuscles. The strings of the first lute propel them toward the second, and set its strings vibrating. This correctly explains the link between any musical instrument and the ear. The motion imparted to the air hits the eardrum and makes it vibrate in sympathy. Not only that: we know from experience that certain sounds can affect the whole body.

The human body is rhythmical by nature, as attested to by the heartbeat, the breath, blinking, trembling, and the longer cycles. In many eras it has seemed plausible that, like the second lute in the experiment, it can be affected by musical vibrations and pick up their rhythm. Therefore, if it is in a discordant or unhealthy state, music might retune it. For ancient, Arab, and early modern medicine, the key was in the study and regulation of the pulse, being the most tangible evidence of the body’s rhythm and a direct line to the heart. Herophilus, a physician active around 300 B.C. in Alexandria, timed different pulses against the drip of a water-clock and found them beating in musical or metrical rhythms (West 2000, p. 63). Among early modern music theorists, Gafurius, Glareanus, Ramis de Pareja, Zarlino, Thomas Campion, and Mersenne all noted the link of the pulse with tempo and rhythm (Kümmel 1977, p. 29). Robert Fludd (1574–1637), famous for his treatise on musica mundana with its memorable engravings, also wrote a whole book on diagnosis through the pulse, illustrated with musical notation (Fludd 1631).

When the ideas of Herophilus passed with the Galenic corpus into Arab medicine, the proportions between the diastole and systole of the pulse were specified as 3:1, 2:1, 3:2, 4:3, and 5:4, i.e., the proportions that provide the intervals of the twelfth, octave, fifth, fourth, and major third (Kümmel 1977, p. 29, with quotation from Avicenna). Such an apparently musical phenomenon invited a musical cure for its irregularities. Al-Kindi (died c.870) is reported as curing a stroke victim by having four lutenists playing constantly by his bedside. The patient’s pulse revived, and he regained consciousness and motion (Kümmel 1977, p. 61).

The Sufi musician and mystic Hazrat Inayat Khan (1882–1927), who brought many ideas from Islamic esotericism to the West, records a more sophisticated method. He writes of how the ancients would sing one note for half an hour and study its effects on the different centers of the body (Khan 1973, II, p. 112). Given that Inayat Khan often taught in hints rather than directives, he had probably experimented with this himself, and was suggesting it to the disciple. The principle, as he explains it, is that if the proper rhythm can be instilled, the body will function in its natural, healthy state (Khan 1973, II, p. 142).

The idea is far from obsolete. In modern times, rhythmical music has been used successfully to control a congenitally irregular heartbeat (Stebbing 1975, p. 33), and the same regularizing function has worked on other organs, too. Around the 1930s–1940s Edgar Cayce (1877–1945), the American trance medium, suggested that someone who had a “brain wreck” might be helped by electricity and music to a revivification of the cells (Winston 1972, p. 13). Given its source, this might be dismissed as a piece of occult nonsense, but seventy years later, Oliver Sacks, the popular authority on abnormal psychology, describes just such an application of music to the brain. Listening to music, he writes, helps to cure aphasia—the inability to speak—because it stimulates one region of the brain (the “left Broca’s area”) while dampening another (the “right Broca’s area”) (Sacks 2007, p. 221). Sacks then reports the astonishing fact that by this method the right hemisphere, which normally has no language ability, can be turned into a reasonably efficient linguistic organ with less than three months’ training. Music is the key, says Sacks. Perhaps disconcerted at the metaphysical implications, he adds that bursts of magnetic stimulation might have the same result, but does not say that they have been used (Sacks 2007, p. 223).

Continuing with modern examples, there is a body of research into the electro-encephalograph (EEG) data of mental patients that shows that while listening to music, their chaotic EEG readings become normal (Robertson 1996, p. 31). The University of California’s Centre for the Neurobiology of Learning and Memory has published evidence that the algorithms of brain functions (neurone column firing patterns) bear an uncanny resemblance to the algorithms of 18th century music, perhaps accounting for the reputed “Mozart effect”: that listening to classical music, especially Mozart’s, makes one more intelligent (Robertson 1996, p. 29). Even more surprising is an experiment at the School of Medicine of Ohio State University (Horden 2000, p. 6). This involved exposing a variety of cancerous tumors in vitro to different types of music and to silence. Exposed for days to so-called “primordial sounds” (probably Hindu chants), the cancers grew less than those left in silence, while those exposed to loud rock music grew bigger over the same period. The hypothesis was that incoming vibrations may be transferred to the nucleus and DNA, and that the gentle “primordial sounds” reinforced the natural vibrations of the cells.

In this sampling of reports, what interests us is not their veracity, which cries out for closer scrutiny and control experiments, but the rationale behind them, which is little different from that of the older stories. It assumes that music carries a numerical message to the brain, body, or cells, which somehow causes a sympathetic vibration conducive to health. The “somehow” is the problem. An eminent French practitioner, Jean-Paul Legouilx, admitted in conversation with the music therapist Alfred Tomatis that:

“There have been experiments in the therapeutic use of music, but as far as the physiological mechanisms are concerned, I don’t think we know much about this subject. All I can suggest is that musical sounds, like other sounds, create activities in different parts of the central nervous system, and in particular the cortex, and that these activities have as their principal goal the modification of the rhythms of encephalographic activity. The activities and rhythms in turn influence the thalamus and hypothalamus where affectivity takes place.”

(Dumaurier 1978, pp. 50–51)

3. Animal Spirits

These cases show how music therapy may be explainable within a materialistic framework, but only if the patient is entirely passive. Penelope Gouk, editor of a recent sourcebook of our subject, states outright that if consciousness is playing an active role, the process simply cannot be explained by conventional biomedicine (Gouk 2000b, p. 16). Some other element must enter into the picture.

Timaeus had an answer: Sound, he says, is “a blow which passes through the ears, and is transmitted by means of the air, the brain, and the blood, to the soul, and that hearing is the vibration of this blow which begins in the head and ends in the region of the liver” (Timaeus 67b). This was not good enough for the early modern philosophers. Since they took it for granted that body and soul belong to different orders of being, their problem was to find the link between them. Marsilio Ficino (1433–1499) was the pioneer here, being as D.P. Walker says “the earliest Renaissance writer I know of to treat the ‘effects’ of music seriously and practically, and not merely as a constituent of the rhetorical topic of the laus musicae” (Walker 1985, VIII, p. 147). The essential agent of transmission was spiritus or animal spirits, a development from Aristotle’s pneuma via the Galenic system. Ficino thought of it as a fragment of an impersonal spiritus mundi that suffuses the entire cosmos (Gouk 2000b, p. 19).

To believers in this substance, more subtle than the physical elements yet not so immaterial as the soul, spiritus conveniently bridged the gap in the levels of being and explained the mysterious link between music and consciousness. In this scheme, music enters the ear and sets up a sympathetic vibration in the spiritus, which flows from the brain through the veins and nerves to the heart and other organs, and transmits its regulating vibrations to them. Since some anatomists believed that the nerves are solid strings, others that they are hollow pipes, it was easy to imagine musical vibrations traveling along them (Gouk 2000a, pp. 187–89). The process continues as the spiritus delivers its numerical message to the soul. Since the soul, in this essentially Neoplatonic scheme, is harmonically constituted, it responds with appropriate emotions.

Ficino’s care of the soul, aside from its Christian aspect, was based on attracting the influences of the planets, especially the Sun, Venus, and Jupiter. Music served the purpose by replicating the harmony of these spheres and conveying it, via the spiritus, to the soul. Ficino recommends studying the kinds of music used by peoples ruled by the benefic planets, and the songs and dances that certain planetary aspects provoke, then imitating them to catch the heavenly influence (Voss 2000, p. 166). In this he was following Plato’s mentor Damon of Athens (5th cent. B.C.), who said that modes and rhythms correspond to ethical qualities and set up particular movements in the soul, laying down patterns that reflect their own qualities. From there it is a logical step to collective music therapy, controlling the music of the state as a public health measure, as Damon and Plato recommended (West 2000, p. 57).

While every musical treatise in the early modern era paid lip service to the ancient legends of the healing power of music, the medical profession had little interest in applying it. Yet nothing could have been more dependent on harmony than the Galenic system of the four humors: blood, phlegm, yellow bile, and black bile. They corresponded to the four temperaments, the four elements, seasons, directions, colors, and all the other quaternaries in the book of correspondences. Just as all these are necessary for the cosmic order, yet none should dominate the others, so Galenic medicine blamed all disease on imbalance between the humors.

Islamic medicine was also Galenic, so it was natural for Arab music theorists to correlate the four strings of the oud (Arab lute) with the four humors. According to the encyclopedia of the Brethren of Purity (c.1000), playing on each string affects its corresponding humor, “augmenting it and increasing its vigor and effect” (Ikhwan 1978, chp. 10). This in turn moderates the effects of the opposite humor. For instance, if someone is suffering from irascibility, caused by an excess of yellow bile, one can strengthen the contrary humor, the phlegmatic, by playing on the third string at the right time of day or night. This is why, say the Brethren, musical philosophers use music in hospitals at certain times, and also why the oud has four strings, no more and no less. It seems a naïve theory, because any competent oud player is going to use all four strings, but to give it the benefit of the doubt, I suspect that it is really about modes. Since the oud was tuned in fourths, each string serves as the tonic or final of a certain mode. If so, we are back with the Pythagorean belief that each mode has a specific effect on the soul, though as far as ever from any explanation of why this should be so. All the modes use the same intervals, and it is those intervals that constitute the primordial harmony; they just use them in a different order.

Renaissance music theorists, notably Giuseppe Zarlino (1517–1590) in his Istituzioni harmoniche of 1558, recognized the humoral system as the basis for musica humana, the harmony that should prevail in body, spiritus, and soul, but said almost nothing about how to instill it. By this time, Ficino’s musical magic was out of favor, probably because, like theurgy, it carried the danger of evoking demons (Gouk 2000b, p. 19). Zarlino’s contemporary Giambattista della Porta (1535–1615), for instance, writing at the end of the century, agrees with Ficino that to use music therapeutically one must know the science of correspondences, but his methods no longer have a cosmic dimension. His “natural magic” situates the curative power of music in the instruments themselves. Their materials of wood, skin, and gut preserve the qualities they had when alive, and these are somehow transmitted to the sufferer. Porta says that in curing the Taorminian youth Pythagoras must have used a cithara made from ivy or almond wood, which work against intoxication! Likewise, to repel the plague one could make an instrument out of laurel wood, because the perfume of laurel leaves is effective against the plague (Pennuto 2010, p. 115). That Porta and many of his contemporaries were content with such beliefs, without seeking a plausible mechanism and without the slightest experimental proof, is part and parcel of their world view.

In the early modern period there was much talk of the powers of music, but virtually no empirical evidence for them. The exception was tarantism, well-established as a recurrent phenomenon in southern Italy. Athanasius Kircher (1602–1680), who wrote the definitive treatise on the tarantula spider and the cure of its bite through dancing, had the process well worked out. When someone is suffering from tarantism, and music is played, this is what happens:

• The strings of the instruments set the air in motion in their own mode.
• The air moves the spirits, thinning them out.
• The thinned spirits act on the muscles, arteries, and fibers, so that they release the poison.
• The resultant warmth induces the patient to dance.
• Heat and relaxation of the body follow; the pores open, and the venomous breath exhales through them (Burnett 2010, p. 21).

It was not so easy, though, because Kircher believed as firmly as Porta in correspondences. You had to find the right mode and the right tune to match the type of tarantula responsible, and wave a cloth of the same color as the spider, without which the sufferer would remain catatonic (Gentilcore 2000, pp. 261–62). Incidentally, these prescriptions are based on the homoeopathic principle of like curing like, rather than the allopathic principle of cure through contraries exemplified by the Brethren of Purity’s methods and predominant today. The latter would presumably treat the sufferer with the opposite color and tune, whatever those might be.

4. Fluids and Passions

The doctrine of correspondences went into occultation with the end of the seventeenth century and Newton’s new and demonstrable theory of universal gravitation. Eighteenth-century medicine, still Galenic, knew that music-making stimulates the pulse and thereby rebalances the humors. It also believed in animal spirits, though only as a relic of Ficino’s grand spiritus mundi. Joseph-Louis Roger’s died 1761) treatise of 1758 credits music with the power to cure nervous ailments, especially melancholy, and to relieve physical pain by drawing attention away from it. As vehicle, he posits an invisible “nervous fluid” that carries musical vibrations throughout the body, and which, through the animal spirits, acts on the soul (Roger [1758] 1803, p. 206). Then comes his rueful confession:

“But since these explanation do not abolish the difficulty, only defer it, and since… there remains an inexplicable problem, that of the union of soul and body, we leave these hypotheses and observe the effects that lie within our competence. These are: (1) the passions of the soul that music excites in us; (2) the maladies cured by the action of music on the soul.”

(Roger [1758] 1803, p. 218)

Roger stands, in this brief survey, for all the music theorists of the Enlightenment who abandoned metaphysical speculation, and although they used the word “soul” (âme, Seele, anima, etc.) did not mean the immortal, harmonic entity of Neoplatonism but merely the impalpable receptacle of emotions. Baroque aesthetics associated music with the imitation of affects or “passions of the mind,” which in Gouk’s words “were thought to lie midway between the reason and the sense, and were responsible for the bringing about alterations in the body’s humors” (Gouk 2000a, p. 185). Since no one understood the mechanics of this rebalancing or alteration, physicians killed many patients through drawing off the only accessible humor: blood.

Franz Anton Mesmer’s (1734–1815) system of animal magnetism, although discredited by the Académie des Sciences, surely did less mischief. Mesmer discarded the theory of the four humors in favor of a materialized version of the spiritus mundi: a single imponderable substance or universal magnetic fluid that carries influences from the planets to the earth and its creatures (Horden 2000, p. 327). Illness, in Mesmer’s system, arises from disorder in one’s bodily magnetism. The cure is through restoring order to it, just as iron filings scattered on a piece of paper form regular and pleasing patterns when a magnet is held beneath it. Music served as an adjunct to Mesmer’s ritualistic treatments. He would play on the glass harmonica in a violet-draped room, the better to direct the magnetic fluid. The preferred method was to induce a “crisis” in the patient with screams, tears, convulsions, and catalepsy, after which his or her magnetic state would return to normal.

I find it interesting that Mesmer’s treatment paralleled the musical form of which his contemporaries Haydn, Mozart, and Beethoven never tired. In what we call the development section of their symphonic and sonata movements, the music typically reaches a point of audible crisis and distance from its original key. In movements of the Sturm und Drang type, such as these composers’ minor-key works, this verges on chaos. Resolution comes dramatically with a return to the opening theme and the home key, which remains stable to the end. Perhaps an archetypal pattern of human experience underlies both the musical and the mesmeric phenomena, and this accounts for the satisfaction we feel in such works. At any rate, many people would agree that the music of Mesmer’s period is therapeutic in itself.

Towards the end of the 18th century, the idea of music as the objective depiction of feelings changed to one of music as the subjective expression of the composer’s own emotions. Hans-Jürgen Möller quotes Johann Georg Sulzer’s (1720–1779) theory that music works through the direct connection between passions and tones, every passion announcing itself in its own tone and awakening the same passion in the listener’s heart (Möller 1971, p. 39). No one tried to explain the mechanics anymore. It was sufficient to accept the reality of the soul, as a kind of materia prima that could be shaped by music. With this came the vitalist concept of nature as alive and, in its own way, passional, with a Lebenskraft, a will, that could likewise be expressed in tone. New methods of diagnosis and therapy such as magnetism, Mesmerism, homeopathy, phrenology, physiognomy, and galvanism all flourished on this soil (Möller 1971, p. 44).

In consequence, music therapy at last became a valid subject for scientific experiment and application. It began in asylums, following a more humane attitude towards the insane, as well as a growing respect for music as something with a deep and mysterious link to the psyche. In the 1820s, Jean-Étienne-Dominique Esquirol (1772–1840), the director of the Salpêtrière hospital for the insane in Paris, provided musical treatments to all the patients. He believed that music stabilizes the mind by causing pleasant impressions and memories, but the results were disappointing (Möller 1971, p. 41). Perhaps his approach was too passive, for in other asylums, especially the one in Illenau (Baden) from 1842 to 1940, music became a prized vehicle for curing the Gemüth, meaning approximately “condition of soul” (Kramer 2000, pp. 346–48). Disorder of the Gemüth was thought to come from “arrhythmia”, which could be rectified by active, rhythmical activities such as music, gymnastics, and a regular routine. Its effects were taken for granted in the medical literature. Without questioning the mechanism, it was agreed that musical relations were imprinted on the listener’s soul, thus altering its state (Kramer 2000, p. 350). This implies that there is something inherently right about musical vibrations that brings benefit when reproduced by the psycho-physical organism. The old doctrines of sympathetic vibration and correspondences had simply taken on a new guise.

In France, too, the nineteenth century saw music therapy continuing in the asylums of Salpêtrière and Charenton. It was a time of experimentation and the testing of new scientific hypotheses that tried to break out of the atomic model. Among them was the proliferation of “fluids” beside Mesmer’s magnetic fluid, to include the electric fluid, the galvanic fluid, and the luminous and caloric fluids as carriers of light and heat. Around the mid-century, Antoine Joseph (called “Hector”) Chomet (born 1808) and the Marquis de Pontécoulant (1794–1882) added to these a fluide sonore, a sonorous fluid, to account for the propagation of sound and its power over mind and body (Godwin 1995, pp. 141–43). These scientists had read all the older theorists and had no doubt of music’s past and potential power, only stripping it of anything occult or supernatural.

As knowledge of non-European philosophies grew, it became apparent that others had arrived at a similar understanding, perhaps long before. In the natural philosophy of Hinduism, sound is not carried by air, but by prana or ether, a fifth element not unlike the imponderable fluids. The Theosophical Society was a main channel for such ideas into the West. Its co-founder H.P. Blavatsky (1831–1891), in her synthesis of science and comparative religion, taught that the whole universe is in a state of vibration, from the atom up to the incalculable cosmic cycles (Blavatsky 1888, I, p. 455). Along with other Theosophical notions, universal vibration has since become a cliché of New Age thought. When post-quantum physics uses the metaphor of “strings” to express an arcane mathematical hypothesis about sub-atomic particles, it is taken as proof that the cosmos is inherently musical. But such ideas are more conducive to mysticism than to the hard work of therapy.

5. The Pythagorean Y

One exception was in the Anthroposophy of Rudolf Steiner (1861–1925), which alone among modern esoteric movements paid any attention to the mentally disabled. To this day, Anthroposophy is unique in its practical applications of an occult metaphysic, derived from Steiner’s own clairvoyance. Waldorf education, in which music and eurhythmy play an important role, is based on Steiner’s theories of the etheric and astral bodies; Biodynamic agriculture, on cooperation with the elementals (gnomes, undines, sylphs, and salamanders).

Steiner’s explanation of how music therapy works, like much of his philosophy, is based on a threefold analysis of the human being. He treats music as a threefold compound of melody, rhythm, and harmony, of which harmony affects the feeling, melody the conceptual mind, and rhythm the will and movement (Steiner 1975, pp. 137–39). In disabled children, the balance of the three functions is disturbed, and the Anthroposophical therapist aims to restore it by finding and instilling the right balance. One therapist describes treatment in special rooms with appropriately colored lighting, and special music played on special instruments (Stebbing 1975, p. 44). Steiner himself spoke of how the shape of a tree’s leaves indicates whether its wood is suitable for high- or low-pitched instruments (Steiner 1975, p. 91). There are echoes here of the Galenic balancing of the four humors, of Mesmer’s rituals, and of Renaissance natural magic with its doctrine of signatures, as well as an ethnocentric bias towards harmonically based Western music.

A Latin poem by Maximinus, called The Pythagorean Y, symbolizes with the forked letter Upsilon the choice of the easy road of sensual indulgence, leading to disaster and shame, or the hard road of virtue, leading to rest and renown (translated in Guthrie 1987, p. 158). Minus the moralizing element, it serves here to illustrate the predicament of music therapy in the modern era. Anthroposophy is the extreme example of one path, which makes no secret of its spiritual principles. But such ideas are totally unacceptable to the other path, which today’s music therapists are obliged to follow if they desire official recognition. Ted Gioa writes disconsolately that “As an adjunct form of treating the patient’s inner life, music therapy has been forced to take on the jargon and world view of each new school of psychological theory as it gains influence and power” (Gioa 2006, p. 128). Penelope Gouk, as an impartial scholarly observer, writes of how there is no space there for the soul or invisible entities. What music therapy can achieve is limited by “cultural negotiation” within the anti-metaphysical model of reality (Gouk 2000b, p. 16). If the mechanics are discussed, it is with regard to neuroscience on the one hand, and behavioral psychology on the other. Instead of “soul,” with its religious connotations, there is the broader term “mind.” As for emotions, the official model attributes them to neurochemical causes, and if it cannot explain them yet, falls back on what critics of scientism calls “promissory materialism”: the belief that if something (such as the human mind) is currently inexplicable by materialistic science, it will surely be explained in the future (Sheldrake 2012, p. 9).

When Gioa contrasts the night-long ceremonies of the nine-day Navajo healing ritual with hospital music therapy scheduled in 15 min sessions, it is no wonder that the latter struggles to prove its effectiveness (Gioa 2006, p. 126). I will mention, anecdotally, that one of my students who entered a career in music therapy in the United States found that for every hour of contact with patients, he spent several hours on paperwork. During the sessions he was required to collect data on such things as how many times the patient looked away to the left or right. The insurance companies demanded quantitative measures of success, otherwise they would not pay for the therapy. My student found the whole discipline so bloodless and bureaucratic that he quit.

The Illenau doctors, in contrast, were working in the congenial atmosphere of German Romanticism, with its exaltation of the nature and power of music. For poets such as Novalis, music serves as a solace for the universal ill of the soul’s exile on this earth. For Schopenhauer, it brings direct knowledge of the reality behind appearances. While such notions have long since lost their influence in the scientific world, they survive in esoteric circles. In the late 1960s the psychical researcher Scott Rogo (1950–1990), who was no occultist, collected a mass of evidence for music heard in out-of-the body and near-death experiences, and by others in the presence of death (Rogo 1970, pp. 51–72). An unbiased reading of these accounts raises the question of what exactly causes musical perception, but that would take us too far afield.

Music therapy in the twentieth century was divided between two metaphysical models that grew ever further apart. In the USA the scientistic and behaviorist way prevailed, but it was never so dominant in Europe, and especially not in the German-speaking lands, perhaps due to the influences of Rudolf Steiner and Carl Gustav Jung (1875–1961). Möller mentions the view of music as expression of a “higher reality”. In this way of thinking, akin to the Platonic anamnesis, the therapeutic power of music consists of awakening memories: in Steinerian terms, memories of the state between death and rebirth; in Jungian terms, memories of the archetypes of the collective unconscious. Although Jung, like Freud, was unmusical, his approach to the psyche and its healing attracted music therapists who reject the materialistic approach but find Steiner too eccentric. The Swede Aleks Pontvik, for example, founded a school of music therapy in the 1940s, mediated through Jung and Hans Kayser (1891–1964, creator of the neo-Pythagorean discipline of Harmonik). Pontvik held that music’s effects follow the laws of number, manifesting cosmic forces that even the unmusical can experience. The client should concentrate on “the objective representation of the regular structure of the work in itself” (Pontvik 1948, p. 11) without trying to impose any personal or emotional associations on it. Not surprisingly, Pontvik’s therapy used only the music of J.S. Bach, plus isolated chords and intervals, on the principle that these harmonic Urformen, mediated by the ear, can rebalance the body–soul complex (Möller 1971, p. 66). Another influential therapist was Gertrude Katja Loos (1906–2000), who although unattached to any system spoke as freely of the Seele as any romantic. For Loos, “Music therapy is a matricentric therapy, i.e., it is nurturing and permissive, play-oriented in contrast to goal-oriented. It aims more at maturation than interpretation” (Loos 2006, p. 271). At the age of 80 she started a new project of music therapy for aged and dying patients, helping them, as she says, to let go, and taking for granted that they were going somewhere else. These two, Pontvik and Loos, represent complementary sides of the same therapeutic trend, one more masculine, the other more feminine in style.

Such therapies raise no challenge to religious beliefs or a spiritual orientation; instead, they readily combine with and fortify them. This seems to be a rising trend in the new century. In the 2008 Oxford Handbook of Medical Ethnomusicology, there are chapters on religion and spirituality, prayer, and meditation. One contributor, Harold G. Koenig, counts close to 1300 research studies published in the previous decade on the connections between religion and health; he calls it a major research area, strongly resisted by Western biomedical science for nearly a hundred years (Koen 2008, p. 47). The editor, Benjamin D. Koen, describes a “Human Certainty Principle” (HCP) which certainly has no place in behaviorist psychology. He calls it a knowing at the intersection of precognition and manifestation, which leads to a holistic perspective that includes the mental, emotional, social, and spiritual aspects of humans, and seems to work best in “music-prayer dynamics” (Koen 2008, p. 110). Such a holistic approach was also Ted Gioa’s solution to the impasse in the discipline: that it could only be cured if it broke out of its scientistic straitjacket and embraces drumming (discouraged in hospitals because it annoys the other patients), song, social music-making, shamanism, and even magic (Gioa 2006, p. 128).

These three collective volumes on music therapy published by academic presses (those edited by Horden, Gouk, and Koen) all make room for the holistic, non-materialist approach to music therapy. Students of esotericism will recognize in this growing trend the syncretic use of formerly esoteric principles without framing them into a doctrine, which is a defining mark of the New Age. Yet it is being done in a responsible, scholarly manner, neither credulous nor disdainful. Not surprisingly, this is happening while the sciences are facing discoveries that the dominant mindset is unable to accommodate, as is evident to anyone who keeps abreast of current cosmology, physics, biology, and psychology. Music therapy is a minor but exemplary case of how a discipline is affected by its metaphysics, and by collective beliefs in what is possible, and what is not.