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The Music Effect. Music Physiology and Clinical Applications

br2006_071Schneck, Daniel & Berger, Dorita (2006). The Music Effect. Music Physiology and Clinical Applications. London: Jessica Kingsley Publishers.

“The music effect is not about a particular composer, musical style, geographic location, language, or performance group. It is, at once, about all of these” (p. 249).

This book is written by two people with very different educational backgrounds. Dr. Schneck is a fellow of the American Institute for Medical and Biological Engineering and Dorita S. Berger, MA, is a Board Certified music therapist. They have in common that both play music and perform professionally, and together they integrate various theories from scientific reality and music aesthetic into music physiology. We have already seen them working together in 2001 in Berger’s book Music Therapy, Sensory Integration and the Autistic Child published by Jessica Kingsley, and this time their collaboration results in a book that is about the attributes of scientific reality (physics) as embedded into the six musical elements of periodicity, melody, harmony, dynamics, timbre, and form. And about how these elements define emotion, evoke responses, alter physiological and mental function, and the manner in which they can be combined to effect profound emotional sensations and responses. As central to clinical applications the fear spiral and entrainment are thoroughly elaborated on.

Structure of the Book

In order to understand the theoretical framework of the book the reader is led through complex learning of the human body and of music. After an introduction in chapter one, the reader is in chapter two and three presented to “What is this thing called music?” and “Principles of physics and the elements of music”. In chapter four to six focus is no longer on music, and the reader is introduced to “Principles of physiology and the elements of sensory information-processing”, “Fear and the instinct for survival: what happens when the set-points go away?” and “Physiological entrainment.” Thus, the first half of the book is theoretical material about music and physiology. It forms the foundation for applying these principles in clinical music therapy and for examining separately each of the six elements of music. In the part about physiology the reader has been presented to five very different clients and how they react the first time they enter a music therapy room. These five clients have one thing in common: their behaviour is elicited by fear, “As is true for all animals and humans, the major emotion driving behavioural symptoms and responses are fear” (p. 98). In chapter seven to ten we come back to these five clients and the central point in the chapter is explained in relation to the clinical practice and the six elements of music. Chapter eleven, with the title “Nature expressed through nurture”, describes that the relationship among the participants, affecting therapist and client alike, completes the integration of nature (emotion, instinct, anatomy, physiology, etc.) with nurture (cognition, reason, psychology, entrainment, expression, etc.) and yields adaptation (p. 245).

Schneck & Berger’s final thoughts are that

It is our belief that by integrating knowledge of:

  • human anatomy and physiology
  • the physics of sound vibrations and their interactions with living systems
  • personality characteristics
  • information-processing networks in the brain and sensory systems

with knowledge of how these are expressed through and affected by the elements of music, the scientific and music therapy communities can more efficiently and effectively address clinical issues of physiological, psycho-emotional, social, and cognitive functional adaptation” (p. 247).

In chapter twelve we leave the five clients that have become more and more present and familiar through out the book and are told a very realistic story about their continuation (or ending) of music therapy.


Before I read this book I thought it was possible to explain entrainment in a couple of sentences. I have now realized that the term is much more complex. In chapter six several types and mechanisms of physiological entrainment is described, and Schneck & Berger states that “while therapeutic music temporarily alters a state of being or level of consciousness, in the here-and-now, music therapy seeks to alter states of function permanently, both in the here-and-now and in the hereafter, by instigating actual changes in conditioned responses that had been maintained through previously established, errant homeostatic set-points” (p. 136). It is thus stated that there is a direct symbiotic relationship between music and human physiological function. The goal in therapy therefore is to eventually alter physiological function; “but first, the intent is to better the effect to the music, which in turn will better the emotion and physiology thereby opening up the lines of communication that can make change possible”. I find this point very relevant to music therapy and understand it in the way that the music therapist need to know the principles of music physiology in order to be able to work with communication and create mutual trust and confidence in the relationship with the client.

With a background as music therapist and researcher with elderly persons, I find the theory on music physiology very important to the work with clients in geriatrics or clients with neurodegenerative diseases, and I therefore disagree when the authors write that “inaccuracy, in processing of pitch, prosody, and phrase in aging populations becomes in many cases a contending element in effectively deriving positive therapy results through music” (p. 184). I agree when they write that music does not depend on semantic interpretation and does not need the “thinking brain” in order to reach and influence activity within the inner realms of the human physiological apparatus (p. 115) and therefore can truncate the fear spiral. I see this as an extremely relevant argument for applying music therapy with e.g. persons suffering from dementia although sensory information-processing is less effective or even disturbed with this client group.

In relation to clinical work with clients with brain injuries The Music Effect is already integrated as an essential part of the theoretical framework in a master thesis from Aalborg University (Lykkegaard, 2006). Nordic Journal readers that prefer an introduction to the book in Danish language will in this thesis find the central ideas of the book translated into Danish and described in detail in the chapter about “Music in the body” p. 13-36!

Genre and Recommendations

The Music Effect gives indispensable knowledge to clinicians on music physiology. It is not an easy readable book. The reader is loaded with heavy theory, but is successfully helped by the authors when they point out and return to central issues, and especially when they as a red thread trough the book include the 5 case descriptions that give a very clear illustration of themes and goals. The book offers thorough and scientific explanations on the effect of music on physiology and relates these to clinical music therapy work. This makes it an essential and very important resource for music therapy students and educators, as well as clinicians and anyone with an interest in music and physiology.


Lykkegaard, C. (2006) Musik i kroppen – om musik, krop og bevægelse i musikterapi med personer med erhvervet hjerneskade [Body music – about music, human body and movement with persons with brain injury]. Master thesis, Institute for Communication and Psychology, Aalborg University.

Berger, D. (2001) Music Therapy, Sensory Integration and the Autistic Child. London: Jessica Kingsley Publishers.

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