“Much of the music we hear we have heard before, and because of this fact we have associated it with a host of memories with pleasant or unpleasant coloring. The hearer may not recall the exact time or occasion on which he heard the selection before and yet he may have a group of images which are definitely referred to his own past.”
Meyer[71] summarizes the appeal that music might have for listeners as 1. Emotional response, 2. Suggested associations, 3. Personification of a subject, 4. Its value as an object.
IV
Musical Taste
The selection of music for patients can be handled in many ways. The easiest and least reliable is to use the music best loved by the musician guiding the program. Such programming will undoubtedly meet with the approval of some of the patients but it is unlikely that it will meet with the approval of all. Non-psychiatric patients should be given the music they want.
Much has been written concerning specific music for certain groups of patients. There has been considerable prejudice in favor of “good music”; that is “good” in its relation to intellectual values. But music in itself can be neither good nor bad. Its execution or appropriateness for the occasion or the individual may be open to question, but the answer must come from the patient. We must keep uppermost in our minds the goal of music for bed-ridden or chronically hospitalized patients. They look to music as a morale-booster and a source of enjoyment. Most people have favorite songs, but the degree of desire for them or for any music will fluctuate with the time of day, the kind of day, and many other considerations. The taste of the patient will vary not only with age, training, nationality and home back-ground, but with such intrinsic and unfathomable things as personality and thinking habits.
“Musical taste is a folkway, a convention which behaves exactly as do folkways in other realms of activity. Accompanying this taste is the conventional ‘conscience’ which dictates what is ‘right’ and what is ‘beautiful.’ It is more or less impervious to contradiction and is disturbed at the prospect of change”[59].
The music of any given composer does not change but the audience will change as a result of the appearance of new forms of music and living. The works of the eighteenth century, with few exceptions, were loved by its contemporaries but find a small audience to-day.
The musical taste of an individual changes noticeably from childhood to maturity but the change is gradual, and except for those studying music intensively, during any one year of life the change is hardly appreciable. Even established favorites will become less desirable to the individual.
“After a certain number of repetitions, varying with both the founded experience of the listener and the complexity of the item, the enjoyment is diminished. One might here propose the hypothesis that the rate of ascent to popularity is directly in proportion to the rate of the decline ... as illustrated by the sharp rise to popular acclaim of the ephemeral popular hits and their subsequent precipitous decline into oblivion.”[59]
Among the many factors which sometimes have a great effect on musical taste, contemporary events are outstanding. During a war, the people welcome songs which sing of their prowess, impending victory, or derision of the enemy. Such songs become popular because of their literary rather than their musical content, but they affect taste indirectly, since the only test of taste lies in the songs to which people will freely listen.
Soldiers pick up foreign songs and marching songs and bring them home as souvenirs and favorites. It is now well recognized how great and prolonged such an influence can be.
Whatever the musical taste of the patient may be, and regardless of how he came by it, it should be satisfied. As soon as an individual attains the status of being a patient, there is an immediate mental depression which may continue to increase if not checked. The patient may develop anxiety, fear, self pity or boredom. There may be sensory depression from pain, unpleasant sight or disability. In addition to these saddening factors there may be undesirable response to environment, personnel, and the monotony of medical or nursing routines. All efforts should be directed at substituting joyful experiences for saddening introspection. The formula for joy is very personal. Although most people will laugh at some comic situations, the response to music cannot be predicted except upon the basis of individual desire. The person who becomes a patient may not have a fundamental change in musical taste but his appetite may be altered by variations in mood, and this is of prime importance.
“More people express a wish for music dynamically similar to the existing mood than for music of the opposite effect. The amount of enjoyment is slightly affected by the kind of mood change taking place.”[71]
It is possible for sad music to be more enjoyable to those who are receptive to it, than gay music. Nevertheless, other things being equal, gay music is apt to give a greater degree of pleasure to those who wish to hear it than sad music gives to its devotees.
The enjoyment of music depends not only upon its pleasantness, but also upon its familiarity. This recognition may be one of identity or of idiom. Most people like popular music because they are familiar with its form or tempo; or because they can hum or name it.
The musical taste of the patient can readily be determined by offering him a check-list with the names of fifty or more selections including the entire gamut of musical forms. A general idea of the popularity of classical selections can be determined from the sales records of recordings and the frequency with which certain pieces are performed by the better symphonic orchestras. The popularity of contemporary offerings can be learned from surveys published in such magazines as Variety and Down Beat or by listening to radio shows such as “The Hit Parade.”
Musical taste is closely allied to performance. If chosen selections are played improperly or without regard to certain elementary considerations, the use of music will lose its value to the patient. A brief consideration must include the effects of arrangement, tempo and volume with which the selections are played, since these have been seen to influence the effects of the selection. Many people when asked to name their favorite music will name a performer or a band rather than a specific piece because they have come to desire the characteristic style of the artists preferred, and style in an orchestra is closely related to these factors. Some listeners prefer loud music, but it must be remembered that even though sound does not become painful until the level of 125 decibels is reached, there are some people for whom the painful level is much lower, and hypersensitivity to sound is an important source of irritation. Others may be disturbed by music which is too fast, which must be taken into consideration.
The role of expectation plays an important part in taste. Most people who have been conditioned to expect the classic use of the scale and traditional harmony cannot find joy in the unusual tonal structure of the moderns as exemplified in Schönberg or even Stravinsky. Hospitalization is not the proper period of life for indoctrination in the beauties of innovations.
Musical taste is acquired and always relative, and is based as Diserens[24] has pointed out, on the “habit of hearing.” An historical illustration of this is the evolution of the consonances. The Greeks regarded the octave as the only genuine consonance. In the fifth century, the fifth and fourth intervals were admitted to this classification. In the eleventh century, the major third was accepted as such, but the minor third had to wait until the twelfth century. “In music the habit of hearing is the Law, and through it, the exception of yesterday becomes the rule of today.”
The best analysis of musical appetite can be found in the statement of St. Thomas Aquinas, “Bonum est in quod tendit appetitus”—the good is that toward which the appetite tends. We repeat there is no such thing as good music or bad music. Music may be played poorly, but the evaluation of the good in music is personal. “Pleasure, and pleasure alone, is the proper purpose of art,” said Walter Sickert. Musicians will do well to remember that since taste results from the gradual blending of emotion, experience, and education, it is better to enjoy wholeheartedly “a waltz of Lehar than to be able to make a thematic analysis of a Beethoven sonata and yet remain unmoved by it.”[36]
V
Summary
For non-psychiatric patients, musical programming should be based upon patient requests. For stimulation the important factors are rapid tempo, accentuated rhythm, and elevated volume. For sedation, slow tempo and reduced volume are indicated, as well as simple recognizable melodies. Some discussion of the selection to follow is a valuable aid to the enjoyment of listening. Live musicians should be used as often as possible.