Listening to Music: Similarities and Differences Between Normal and Schizophrenic People [1]

By Clarice Moura Costa

Abstract

The hypothesis that the meanings attributed to music, although broad, are not unlimited, and should be similar in two groups (people considered normal and people considered schizophrenic) was uncovered in research carried out on Music Therapy at the Institute of Psychiatry at Universidade Federal (Federal University) do Rio de Janeiro. Four recorded segments were selected to study the listening to music. Videotapes were made to record the verbal references to the segments, in order to look for similarities and differences between the two groups. An analysis of content of speech was made through the transcription of the tapes. It was possible to observe that schizophrenic and normal persons attribute similar meanings to music, although these meanings are influenced by the experiences of each one. Our findings suggest that the intervention through music is helpful in the treatment of schizophrenic patients because our interpretation of the results indicates similar "normal" responses to the music between so-called "normal" participants and schizophrenic participants.

Introduction

As part of a research project carried out on Music Therapy at the Institute of Psychiatry at Federal University of Rio de Janeiro a study was made on listening to music comparing people considered normal and people diagnosed as schizophrenic. We decided to do this investigation because we have found that schizophrenic people produce delusions and hallucinations and frequently distort the meanings of words. Could it be different when music is used instead of words? We posed the hypothesis that the meanings attributed to music, although broad, are not unlimited, and could be similar in these two groups, based on our observations in music therapy sessions.

Method

Men and women, between 18 and 35 years old, were selected as participants in this research. The schizophrenic participants were 12 in-patients at the Institute of Psychiatry. The normal group was composed of 7 participants who had never suffered from mental illness or been participated to psychiatric treatments. The socio-economic-cultural levels were controlled to make the groups equivalent on those variables.

Four fairly distinct and contrasting segments were selected for this study. The four segments were chosen to produce different moods in each segment. People were individually tested and had two minutes after listening to each segment to speak freely about what they had listened to. In the event of there being no spontaneous comments, the interviewer formulated the following questions:

What was the first idea, the first thing that came to your mind on listening to this recording?
How did you feel while listening to this recording? Why?

We recorded the interviews in videotapes in order to study similarities and differences of speech and of behaviour (mimics, attitudes, etc) between the two groups. The idea of studying the behaviour was abandoned, because it was too complex and would take too long, and we did not have enough financing to extend the study.

During the organization of the study, we made a revision of techniques of analysis of content of speech but could not find anything concerning music listening, only texts about social sciences, education, racism, etc. The technique of measurement of psychological states of Gottschalk and Gleser (undated) seemed the more adequate for our objectives, but we verified that it was unsuitable. Therefore we had to create our own method adapting techniques of Bardin (1979).

After a floating listening to several tapes, we divided the references of the participants into four categories, as shown below:

Objective perception of the musical elements
Fantasies
Memories of events of their own lives
Emotions awakened by the segments listened to.

This division is artificial because the psychic processes are interlinked. Fantasies, memories, and events have an emotional weight and they interfere with one another, but this artifice allows the comparison among the participants of the two groups. We coded the categories above (1,2,3,4) over the words of the participants. Several times we found in the same sentence more than one category. Our approach was qualitative, because the sample was too small, but even in qualitative methods is possible to establish some quantification.

First Segment � Created by the Researchers.

We expected with the provision of sound stimuli, that the listener would be provided with a sound-musical experience which evoked the beginnings of human development and which would suggest fundamental ideas of birth, breastfeeding, and the initial relationship with the mother and with the father. The predominant "atmosphere" in this segment intended to awake memories of primitive experiences in the listener.

This segment was basically an obsessive beat in two times of the three beats bar, suggesting a heartbeat, accompanied in the beginning by the sound of water. In a longitudinal progression, several sounds were heard including breathing, chewing, pre-speech sounds, coughs, mumbling, the laugh of an adult woman, the crying of a child, nursery rhymes both hummed and sung by masculine and feminine voices and again only hummed, ending with the omnipresent two-times beat. The sound produced by water and by the cardiac rhythm reinforces the evocation of these primitive experiences. The infant crying during the feminine laugh provokes a reaction of discomfort, perhaps because it suggests a rejection of the child by the mother. The lullaby, which follows, offers a memory of parental figures attempting to return calm to the child.

We saw that the normal participants always referred to more than one of the sound elements, which composed the segment, and nearly half of the schizophrenic participants referred to only one element, which we interpreted as either a blockage of communication of what was perceived or a blockage of perception, itself, or both the hypotheses. Meanwhile, we also observed that in both groups, the references to the sound elements are pertinent to the actual segment.

We observed that the schizophrenic patients showed a certain poverty in their fantasies, even when expressed by prolix discourse. The majority of patients focused on one or two of the sound elements only, creating quite restricted fantasies from these with a poorness of imagery. For schizophrenic patients, it was not possible to notice any attempts to find a global meaning for this segment, which seemed to be seen as being composed of unrelated parts. On the other hand, the majority of the normal participants associated several elements to give a single meaning to the segment.

Only one normal participant and nearly thirty percent of the schizophrenics spoke about past facts of their personal life. However, the normal participant did so in a casual manner, while the schizophrenics confined themselves to memories enveloped by powerful emotional energy, the majority of these brought on by the crying of the child or by the water.

In relation to the expression of sentiments, the normal participants were curious, intrigued, "expecting something", with the exception of one participant who appeared to be clearly unhappy. Nearly all the schizophrenic participants revealed profoundly negative emotions, although a few tried to deny these unpleasant feelings in the first responses. They expressed them afterwards, over the course of the testing.

Through the obtained data, it was noted that the schizophrenic participants did not formulate an interpretation that brought together the diverse sound-musical elements, which constituted this segment. We observed that the participants referred to each one of these elements in a static and isolated way, without integrating them in a global interpretation. It is important to emphasize that the elements most referred to were the crying and the water, followed by the heartbeats. It is interesting to note that the fantasies and memories were released after these three elements, in particular the crying and the sounds of water. We also observed the predominance of negative feelings evoked by the listening, referred to in a very strong manner.

As for the group of normal participants, the attempt to formulate a global and integrated interpretation of the diverse sound-music elements heard was shown, although the water and the heartbeats had been the mentioned the most. Situations of their own lives through listening to this segment were not evoked and the fantasies referred to diverse elements which when all together formed stories related to life (the passages, the phases, the dynamics). We also observed the predominance of negative sentiments within this group, albeit referred to in a lighter way, linked to expectation, curiosity and the difficulty of giving a meaning to everything.

The data obtained seemed to suggest that differences existed between the two groups in relation to the attribution of meaning to the segment heard. There were, nevertheless, similarities between the two groups, in relation to the negative emotion awaken by the listening, expressed as being directly linked to the music ("I didnt like it", "It leaves me tense", etc.) as present in the fantasies and memories which nearly always referred to unpleasant and difficult circumstances.

Examples of comments:

Participant 8 (schizophrenic) "The first thing that crossed my mind, when I was listening to this music, was the perception that someone was beating his feet, transmitting a music through feet and then...I had a perception that there was a person moaning or complaining"

Participant 4 (normal) "It seemed more a heart beating, it seemed more a life". "A life with the sound of water, after the water the heart began to beat, then she (a girl) grew up, began to breath, began to learn things, to enjoy things, then she saw that nothing made sense and began to cry, asking help to forget that life. That person helped her, making her sleep, going away". "It seems to be a person who doesnt enjoy life, who is afraid of it"

Second Segment A Percussion Group from a "Samba School"

We expected to situate the listeners in their cultural universe, by representing an important event for the Brazilian people Carnival. The cathartic atmosphere generated by a strong and organised rhythm, which induces dancing and movement, might provoke memories of experiences and relationships with the social environment.

This segment led to comments about carnival, parties, beer, happiness, without any significant fantasies in any of the groups. The feelings attributed to the segment were predominantly positive, although some "schizophrenic" people recall painful recollections connected to carnival.

We noticed, through the data obtained, that both the schizophrenic and the normal participants referred to the second segment in a similar way, either in the perception of the music itself, or the few fantasies associated with it, and the emotion predominantly positive.

In relation to the recollections evoked by listening to the segment, a few differences between the two groups could be observed: the normal participants evoked banal circumstances linked to the Carnival, whereas the schizophrenic participants referred to the situations of illness, hospital admissions and the resulting difficulties in taking part in this collective catharsis.

Participant 3 (schizophrenic) "Samba". "I wished to dance, not here alone, that is why I didnt dance. When there is someone else...". "Listening to this kind of music, we even think were home, it doesnt seem that we are in a hospital".

Participant 5 (normal) "Cheerful". "Reminds Carnival, party, samba, those things". "I watch on TV, but there, in that mess, no, I never liked it, neither when I was a child". "I dont like Carnival, but I like to listen to the music".

Third Segment A Fragment of "Dies Irae" from the Contemporary Composer Penderecki:

We hoped that the listener, due to the unforeseen nature of the sound segment, would have aroused feelings of anxiety, insecurity and tension. The characteristics of this segment could provoke a feeling of expectation when one faces an "unknown future".

This segment was a musical composition without any notes of tension and rest of traditional harmony that stimulates the listener to live emotional situations vicariously. There are only a few moments of diminishing tension, in which a masculine choir sings a passage suggesting a liturgical chant.

The schizophrenic participants, as well as the normal participants, alluded to the sung parts, correlating them to sacred music. Over half of them did not make any references to past situations. The remainder remembered religious experiences. Only one schizophrenic participant did not make any reference to emotion or sentiments. Nearly all of them referred to fear, terror, haunting, although sometimes they were not able to express clearly the emotion experienced.

Some of the normal participants made casual references to events such as opera, music heard on TV and so on. All participants of the normal group made references to unpleasant feelings in relation to this segment. Only one referred to a feeling of peace connected to the part evocative of chant.

All the normal participants and only half of the schizophrenic participants fantasised about the segment. The content that emerged was always connected to death, terror, and macabre and religious rituals.

Similarities in the reactions of the two groups to the listening to this segment in all the studied aspects were observed: perception of the music itself, fantasies and memories, and corresponding negative affects.

Participant 9 (schizophrenic) "This is opera, it isnt, an opera?". "This one reminds me terror movies, these things". "Opera, horror movies, I dont like this stuff".

Participant 6 (normal) "This is an opera? The woman yelling there." "It makes me remember those black masses, old times movies... about barbarian times". "Unpleasant". "The woman yelling there.... Awful thing."

Fourth Segment A Fragment of Concert n. 25 (K503) by Mozart:

This final segment sought to offer the listener the experience of feelings of tranquillity, security, relaxation and confidence. It is a fragment of a classical piano concert in C major which, in opposition to the last one, has a structure with notes of tension and rest.

The comments referring to the perception of this segment in the two groups were according to what was listened to. It brought references to old time parties or balls, weddings, dancers and to the national anthem (maybe because of the perfect fourth interval present in the theme, and in the Brazilian national anthem) and it provoked a sense of well being. In relation to the fantasies aroused by the listening, similarities between the two groups (parties, pomp, people dancing, old films, etc) were observed. The positive emotion referred to by participants in both groups can be underlined.

Participant 10 - (schizophrenic) "It seems marriage, it seems like a wedding, looks like a magnificent party, everyone in long gowns, all those ostentation, those old movies that we still watch." "I liked it, I think that this music is beautiful."

Participant 5 (normal) "Classical music." "It is old music." "It is usually sung in wedding ceremonies, balls, parties, with a lot of people, it is happy music." "It doesnt communicate depression, it communicate joy, this one I liked."

As an example we can compare the comments about the four segments of one schizophrenic and one normal participant.

The schizophrenic participant shows clearly symptoms of psychosis in his comments about the four segments:

Segment I created by the researchers: "It was that girl, it wasnt, that one who get out before I got in?" "I thought she was crying". "I felt something, fear, fear". "A fear that sometimes happens to me."

Segment II percussion group from a samba school: "The beat of this thing here, this and this (pointing at percussion instruments)" "I feel like enjoying, looking at the others who play". "When the bateria [sic drum group] comes, I only look".

Segment III a fragment of "Dies Irae" by Penderecki: "It must be that girl... that who was here and went out". "It seems like those movies of abandoned houses". "Like these things of bats". "Yesterday I dreamed about cemetery". "It is scary, isnt it?" "I felt a bit scared".

Segment IV a fragment of Concert n.25 by Mozart: "This one I know what it is, it is a waltz". "Those orchestra instruments" (points at percussion instruments). "I felt like I was looking the man and the woman dancing". "Ballet is the same thing". "He and she dancing". "Im enjoying it".

We can see the concrete thought of this participant. He thinks that the voice he heard in the first and third segments were of a girl who had left the room. He presents in these two segments, negative feelings, which he expresses as fear.

In the second and fourth segments, he believes that the music was performed by the musical instruments that were in the room. He affirms his positive feelings: "Im enjoying".

The normal participant was a very religious person who tried to find positive aspects in all segments:

Segment I created by the researchers: "The first thing I thought was water running, then this constant beating, I was very mindful to it" "I dont know how I felt, I was in expectation, but the sound of the water running gave me a certain tranquillity" "I thought those varied moments very interesting."

Segment II percussion group from a samba school: "Glad! We feel very Brazilian". "Sometimes Brazilian people dont mind about their roots, which is samba, their own expression, and dont see all the value of it." "At the moment I listened to the samba I thought of Brazilian people, and I think that God takes care of them"

Segment III fragment of "Dies Irae" by Penderecki: "The music is slower." "It is a liturgical piece." "In old times we could see this very serious liturgy, plenty of sentimentalism" "High pitch moments were too strong". "These moments dont mean too much for me, this isnt the way I try usually to find God". "I dont know, I had a feeling of rejection on those high pitch moments" "I wanted this music to finish soon"

Segment IV fragment of Concert n.25 by Mozart "The image to me is people walking on a road, with high and low moments of life. Music rising and going down shows that". "I have this piece of music recorded and I like to listen to it when I have too much work. I like to stop working and listen to this music, it gives me peace". "It helps me to relax at the moments of trouble". "I liked this one because it is part of my life".

This participant, unlike the others, tries to give to the four segments a religious interpretation. Listening to the samba school and the segment of Penderecki, she thinks of God. In the IVth segment she tries to find an interpretation of life. Even in the segments that she doesnt enjoy, she looks for something that could give her peace water running in segment I, and the chant in segment III. Nevertheless she reveals, as everyone else, a clear dislike in segment III ("I had a feeling of rejection" "I wanted this music to finish soon") and a possible negative feeling on segment I ("I was in expectation"). The segment II seems pleasant and the segment IV clearly gives her a great satisfaction.

Our findings suggest that there are similarities between normal and schizophrenic persons in relation to the experience of musical listening. The perception of musical elements, fantasies and mainly emotions related to the segments were similar. The emotion awoken by listening to the first and third segments were negative in the two groups, and were positive in the second and fourth segments in both groups.

Nevertheless, the groups presented some differences. The schizophrenic participants made more reference to personal experiences and remembrances evoked by the music and made few fantasies about it, while the normal persons fantasized more over the music itself, with few references to their own life.

We could observe in both groups, through the various points considered, that music produces fantasies, memories, and emotions, broad but not unlimited, independently of the listeners mental state. These emotions, fantasies, remembrances are related to the affective-emotional area and influenced by the experiences of each one. These findings indicate that relationship; communication and interaction through music between music therapist and client are possible.

Notes

[1]This experiment was made by the music therapist Martha Negreiros de Sampaio Vianna, the psychiatrist Leonardo Ferreira de Azevedo and myself.

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Listening to Music: Similarities and Differences Between Normal and Schizophrenic People[1]