[Position Paper]

How Can Music Foster Intimacy?

By Helen Shoemark


Our first intimate relationship is with our parents.  As babies, we are deeply dependent on our parents for safety and nurturing.  The connection between us is created by our facial expressions, our body movements and our sounds.  All of these have qualities that can be explained by our innate musicality.

Keywords: musicality, communicative musicality, maternal voice, singing, infant

Editorial note: In 2016, Voices hosted a special edition to accompany the launch of a Massive Open Online Course (MOOC) on the topic of "How Music Can Change Your Life". Thirteen authors agreed to develop position papers for the MOOC, with two articles being developed to accompany each of the six topics within it. Each author has highlighted the theorists and researchers who have influenced their thinking, and included references to their own research or music practices where appropriate. These papers have been written with a particular audience in mind—that is, the learners who participate in the MOOC, who may not have had previous readings in any of the fields being canvassed. We hope that you find these articles interesting, whether reading as a MOOC learner, a regular VOICES reader, or someone who is discovering VOICES for the first time.

The noun intimacy comes from the Latin word intimare meaning, “impress,” or “make familiar,” which comes from the Latin intimus, meaning “inmost.” (Oxford Dictionary). These days, the word intimacy is often linked just to sexual closeness, but the Oxford Dictionary defines intimacy simply as “Close familiarity or friendship; closeness”, and this definition is extended with “usually affectionate or loving personal relationship with another person”. For this article, we are going to explore how music fosters the very first intimate relationship, the one between a parent and baby. Babies establish a relationship with their mothers even before birth, influencing how the mother feels about them physically and psychologically. Then at birth, the baby is completely dependent on their parents, for warmth, food and care –so, for survival. Even though we are beginning to think about fathers, the mother has been researched much more, and we know a lot about how that relationship unfolds. We also know a lot more about mother-baby communication and the musicality of that relationship. So we will focus on mothers and their babies.

Before going on, you will notice that we use the term “musicality” rather than music. As adults, we understand music in forms like songs, soundtracks, or other orchestral or band pieces. Most often we listen to them, and sometimes we play them, and learn them. But musicality is much more basic than that. Musicality is the innate musical part of each person. At birth, our musicality is already shaped by the culture of the mother, and helps us to belong to our social groups because we innately understand phrasing (Stern, 2010), timing (Jaffe, Beebe, Feldstein, Crown, & Jasnow, 2001), call and response (Beebe, Knoblauch, Rustin, & Sorter, 2005), all of which lead to experiences like moving in time together (Cirelli, Einarson & Trainor, 2014) and feeling like we simply belong to our group (Mithen, 2007).

Sound as Part of the First Intimate Relationship

Even before birth, a baby is listening and learning. It is not until the third trimester that the pathways from the ear to the brain are totally formed. This is when babies begin to recognize sounds because they can hear and process it in their brains (Kisilevsky et al., 2003). Because it is their mother who carries them, they have more exposure to her voice and therefore it becomes the most recognizable sound (DeCasper & Fifer, 1980). We also know that the fetus can learn music (Moon & Fifer, 2000), and can remember this for up to 4 weeks after they are born (Granier-Deferre, Bassereau, Ribeiro, Jacquet, & DeCasper, 2011). In some studies, premature babies have shown reactions to their mothers’ voices even at 26 weeks (Nöcker-Ribaupierre 1999). The mother’s voice is the most consistently available sound, and babies know that their mother’s voice equates to safety and nurturing care. We have known for a long time that soon after birth babies can show they have a preference for their mother’s voice (De Casper & Fifer, 1980), and a preference for their mother’s language over another language (Moon, 2011). So how is this musical?

The Music in the Relationship

Intimacy begins in infancy, before a time when babies understand words like “I love you”. We hold babies quite close to us as if we somehow know that the baby’s eyes will only focus at 10–12 inches (Graven & Browne, 2008), and, we also change our voice when we talk to babies. What we call “baby talk” is also called infant-directed speech. It is different from how we speak to another adult or even to a child. It is much more musical. For instance, we widen the range of pitches we use, particularly going much higher than we would with an adult; we tend to use short phrases and repeat them (just like a song). Babies’ brains are primed for this “baby talk”. The school of thought that says we should talk to babies as if they are adults completely misses the point that babies need all that exaggerated up and down to actually work out the meaning of what we are saying to them. The melody of our voices tells them if we are inviting them to play with us (voice goes up like a question), soothing them (voice goes down), or just helping them to be okay (voice stays flat) (Papoušek, Bornstein, Nuzzo, Papoušek, & Symmes, 1991). Spence and Freeman (1996) actually worked this out by taking all the melody out of recordings of mothers’ voices, leaving just a whisper; the babies did not recognise their mothers’ voices.

It was Trevarthen and Malloch (2000) who wrote that to achieve an intimate relationship, the mother and baby must have experiences of intersubjectivity. This means that one person presents their state, how they feel, and the person they are interacting with actually understands how they feel, and responds in a way which says that they understand. A parent and baby can do this without words but through much more fundamental levels of interaction. You could say that intersubjectivity is understanding without words. So what do they use? Musicality. What Trevarthen and Malloch worked out though is that this musicality presents itself not just in sound, but in gesture and facial expression too.

Baby gestures are whole body actions. Their bodies moves towards and away from the other person; their muscle tone might be relaxed or tense. Their limbs might move in nice fluid patterns or in jerky or jittery actions. All of these are understood by the other person. Babies will also use facial expressions, moving their eyebrows, eyes, nostrils, lips, and mouths to show happiness, contentment, agitation, distress, and anger (Sullivan & Lewis, 2003). At around 9–12 weeks after birth, babies begin to use their voices in ways other than crying. They begin with little sounds in the back of their throats leading to lovely open sounds and gurgles, all of which adults interpret to having meaning. By now, parents are accustomed to interpreting meaning from the gesture and facial expression, and even if they are not conscious of it, they react to their baby as if each gesture, facial movement and sound combine to produce a meaningful expression. The interaction generated by the giving and taking of all that meaning is called Communicative Musicality.

Communicative Musicality

Malloch and Trevarthen are both highly skilled researchers who used their observations of mothers and babies to construct a theory about the very intimate nature of successful interaction. They then tested it using modern scientific assessments to confirm the veracity of their theory.

Fundamentally Malloch and Trevarthen believe that a secure relationship between mother and baby allows for and is generated by intimacy. What does this look like or sound like? In his micro-analysis, Malloch found that the expression of this fine-tuned interaction occurs in timing, pitch contour and vocal timbre that occur within and between vocalizations of the mother and the baby (Malloch, 1999). It consists of the elements of pulse (like a regular beat in and between the mother’s and baby’s vocalisations), quality (the pitch and timbre contours), and narrative (the combination of pulse and quality).

Malloch noted that the rhythm, melody, and timbre of a mother's voice are all sub-consciously controlled in predictable ways. Even more remarkable, is that they not only match the early preferences of the baby, but they are modified as the baby matures (Trehub, Unyk, & Trainor, 1993). The baby and parent listen to one another's sounds, creating co-operative patterns of vocalisations. Malloch’s micro-analyses of these vocalisations reveal that beyond encouraging expression from their mother, the baby seeks sounds that are appropriately timed and have the right intonation (Nadel, Carchon, Marcelli, & Réserbat-Plantey, 1999). Indeed, in optimal interaction, expressive phrases are precisely alternated or synchronised between the baby and the adult (Tronick, Als, & Brazelton, 1980). That is, they are in time with each other. This attunement between mother and baby is critical. If it is lacking, as often occurs in maternal post-natal depression (Papoušek, 2007), then attachment is at risk.

Other Schools of Thought About Mother-Baby Intimacy

Daniel Stern talked about the musical qualities of this first relationship. Closely aligned to Communicative Musicality, Stern believed that our experience is dynamic, i.e., happens over time, with an energy suggesting movement forward (Stern, 2010). He also noted that experience happens in space, whether that is physical or mental. He called all these dynamic components forms of vitality. Stern suggested that the intimate interaction of mother and baby is moving together in time and space, sharing the beat and creating rhythms and phrases of starting and finishing in almost dance of interaction.

In another associated concept, Feldman and colleagues described the intimate relationship of mother and baby in terms of synchrony. This means that when mother and baby are interacting, they co-ordinate everything from hormones to behaviour to heart beat (Feldman, Magori-Cohen, Galili, Singer, & Louzoun, 2011). Just like in music, successful interaction is where mother and baby are matched in their gestures, expressions and sounds. Feldman has found that this interaction synchrony is vital in the 3–6 month age when it supports the development of complex processes that continue to develop through to adolescence (Feldman, 2007). The old adage, “timing is everything,” is actually true.

We are eager to understand the healthy and so-called normal patterns of this fundamental relationship, so that we better understand how to treat or support people when mental health problems, medical issues, or other risk factors challenge that. The use of theoretical frameworks allow us to dismantle the observed components and make sense of them. One such model is Communicative Musicality.

Communicative Musicality and How it Informs Interventions for People in Need

Understanding successful interaction in musical terms is very appealing to music therapists working with babies and their families. As a therapy, words are not useful for babies, but we know that there is meaning in the melody of our voices and in our singing (Papoušek et al., 1991; Trehub et al., 1993) and there is predictability in little melodic phrases and songs (Nakata & Trehub, 2004; Trainor & Heinmiller, 1998). The music therapist and baby can establish a strong connection without talking and create the opportunity for change through just “doing” (Morgan, 1998). In working with parents, the music therapist can support them to find their voices, and understand just how important it is in their baby’s well-being (Shoemark, Hanson-Abromeit, & Stewart, 2015).

Shoemark worked with Malloch to test what happens when a music therapist consciously applies the principals of Communicative Musicality for newborn babies in the Neonatal Intensive Care Unit. Shoemark designed an intervention in which she used all the aspects of Communicative Musicality very purposefully to keep babies engaged with her. They found that having a music therapist interact in this way with a baby three times per week actually maintained a healthy pattern of infant neurodevelopment (development of their brain) (Malloch et al., 2012). Because Shoemark purposefully employed the principles as an intervention, rather than them occurring naturally, she renamed the intervention Contingent Singing (Shoemark & Grocke, 2010). She was able to pull it apart so that she could teach other therapists to use it with the same intention. She then went on to apply this knowledge back into the mother-baby relationship, helping mothers to find their voice to nurture and support their babies in hospital (Shoemark & Arnup, 2014; Shoemark, in review).

The conscious application of Communicative Musicality for mother and baby in hospital seems to be a full circle moment. For a family where their experience of each other is so altered, singing and other intimate uses of their voice can be used by parents to re-establish that intersubjective experience, where timing, timbre, and narrative can be experienced in moments. Each day, amidst the trauma of major medical care, parents can feel that their baby comes to know them and they come to know their baby, and that fundamental intimacy so vital to life, to can be established.


Beebe, B., Knoblauch, S., Rustin, J., & Sorter, D. (2005). Forms of intersubjectivity in infant research and adult treatment. New York: Other Press.

Cirelli, L.K., Einarson, K. M., & Trainor, L. J. (2014). Interpersonal synchrony increases prosocial behavior in infants. Developmental Science, 17(6),1003–1011. doi: 10.1111/desc.12193

DeCasper, A., & Fifer, W. (1980). Of human bonding: Newborns prefer their mothers' voices. Science, 208, 1174–1176. doi: 10.1126/science.7375928

Feldman, R. (2007). Parent–infant synchrony and the construction of shared timing; Physiological precursors, developmental outcomes, and risk conditions. Journal of Child Psychology and Psychiatry, 48, 329–354. doi: 10.1111/j.1469-7610.2006.01701.x

Feldman, R., Magori-Cohen, R., Galili, G., Singer, M., & Louzoun, Y. (2011). Mother and infant coordinate heart rhythms through episodes of interaction synchrony. Infant behavior & development, 34, 569–577. doi: 10.1016/j.infbeh.2011.06.008

Granier-Deferre, C., Bassereau, S., Ribeiro, A., Jacquet, A-Y., & DeCasper, A.J. (2011). A melodic contour repeatedly experienced by human near-term fetuses elicits a profound cardiac reaction one month after birth. PLoS ONE, 6(2), e17304. doi: 10.1371/journal.pone.0017304

Graven, S.N., & Browne, J. (2008). Visual development in the human fetus, infant and young child. Newborn and Infant Nursing Review, 8(4), 194–201. doi: 10.1053/j.nainr.2008.10.011

Intimacy (n.d.) In Oxford Dictionaries: Language Matters. Retrieved from http://www.oxforddictionaries.com/definition/english/intimate

Kisilevsky, B.S., Hains,S.M., Lee, K., Xie,X., Huang,H., Ye,H.H.,…Wang, Z.(2003). Effects of experience on fetal voice recognition. Psychological science, 14, 220–224. doi: 10.1111/1467-9280.02435

Jaffe, J., Beebe, B., Feldstein, S., Crown, C., & Jasnow, M. (2001). Rhythms of dialogue in infancy: Co-ordinated timing in development. Monographs of the Society for Research in Child Development, 66(2), vi–131.

Malloch, S. (1999). Mother and infants and communicative musicality. Musicae Scientiae, 3(1) Suppl 29-57. doi: 10.1177/10298649000030S104

Malloch, S., Shoemark, H., Črnčec, R., Newnham, C., Paul, C., Prior, M., …& Burnham, D. (2012). Music therapy with hospitalised infants – the art and science of intersubjectivity, Infant Mental Health Journal, 33, 386-399. doi: 10.1002/imhj.21346

Mithen, S. (2007). The singing Neanderthals: The origins of music, language, mind and body. Cambridge, MA: Harvard University Press.

Moon, C. (2011). The role of early auditory development in attachment and communication. Clinics in Perinatology, 38, 657–669. doi: 10.1016/j.clp.2011.08.009

Moon, C. and Fifer, W. (2000). Evidence of transnatal auditory learning. Journal of Perinatology, 20, 37–44. doi: 10.1038/sj.jp.7200448

Morgan, A. (1998). Moving along to things left undone. Infant Mental Health Journal, 19, 324–332. doi: 10.1002/(SICI)1097-0355(199823)19:3<324::AID-IMHJ9>3.0.CO;2-L

Nadel, J., Carchon, I., Marcelli, D., & Réserbat-Plantey, D. (1999). Expectancies for social contingency in 2-month-olds. Developmental Science, 2(2), 164–173. doi: 10.1111/1467-7687.00065

Nakata, T., & Trehub, S. (2004). Infants' responsiveness to maternal speech and singing. Infant Behavior and Development, 27, 455–64. doi: 10.1016/j.infbeh.2004.03.002

Nöcker-Ribaupierre, M. (1999). Short and long-term effects of the maternal voice on the behaviours of very low birth weight infants and their mothers as a basis for the bonding process. In R. Rebollo-Pratt and D. Erdonmez (Eds.), MusicMedicine 3. (pp.153-161). Melbourne: University of Melbourne Press.

Papoušek, M. (2007) Communication in early infancy: An arena of intersubjective learning. Infant Behavior and Development, 30, 258-266. doi: 10.1016/j.infbeh.2007.02.003

Papoušek, M., Bornstein, M., Nuzzo, C., Papoušek, H., & Symmes, D. (1991). Infant responses to prototypical melodic contours in parental speech. Infant Behavior & Development, 13, 539–545. doi: 10.1016/0163-6383(90)90022-Z

Stern, D. (2010). Forms of vitality: Exploring dynamic experience in psychology, the arts, psychotherapy and development. London: Oxford University Press. doi: 10.1093/med:psych/9780199586066.001.0001

Shoemark, H. (in review). Parental voice as platform for family education in the NICU.

Shoemark, H., & Arnup, S. (2014). A survey of how mothers think about and use voice with their hospitalized newborn infant. Journal of Neonatal Nursing, 20,115–121. doi: 10.1016/j.jnn.2013.09.007

Shoemark, H., & Grocke, D. (2010). The markers of interplay between the music therapist and the medically fragile newborn infant. Journal of Music Therapy, 47, 306-334. doi: 10.1093/jmt/47.4.306

Shoemark, H., Hanson-Abromeit, D., & Stewart, L. (2015). Constructing optimal experience for the hospitalized newborn through neuro-based music therapy. Frontiers in Human Neuroscience, 9 (487). doi: 10.3389/fnhum.2015.00487

Spence, M., & Freeman M. (1996). Newborn infants prefer the maternal low-pass filtered voice, but not the maternal whispered voice. Infant Behavior & Development, 19, 199 – 212. doi: 10.1016/S0163-6383(96)90019-3

Sullivan, M., & Lewis, M. (2003). Emotional expressions of young infants and children: a practitioner's primer. Infants and Young Children, 16, 120 - 142. doi: 10.1097/00001163-200304000-00005

Trainor, L., & Heinmiller, B. M. (1998). The development of evaluative responses to music: Infants prefer to listen to consonance over dissonance. Infant Behavior and Development, 21, 77–88. doi: 10.1016/S0163-6383(98)90055-8

Trehub, S., Unyk, A., & Trainor, L. (1993). Maternal singing in cross-cultural perspective. Infant Behavior & development, 16, 285–295. doi: 10.1016/0163-6383(93)80036-8

Trevarthen, C., & Malloch, S. (2000). The dance of wellbeing: Defining the musical therapeutic effect. Nordic Journal of Music Therapy, 9(2), 3–17. doi: 10.1080/08098130009477996

Tronick, E., Als, H., & Brazelton, T. (1980). Monadic phases: A structural descriptive analysis of infant-mother face-to-face interaction. Merrill-Palmer Quarterly of Behaviour and Development, 26, 1–4.