The Oxford Handbook of Medical Ethnomusicology (Oxford Handbooks)

512 Pages·2011·8.139 MB·English

by  Benjamin Koen (editor)

The Oxford Handbook of Medical Ethnomusicology
Benjamin D. Koen (ed.)
https://doi.org/10.1093/oxfordhb/9780199756261.001.0001
Published: 2011 Online ISBN: 9780199940509 Print ISBN: 9780199756261
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The Oxford handbook of medical ethnomusicology / edited by Benjamin D. Koen ; with D
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Jacqueline Lloyd, Gregory Barz, Karen Brummel-Smith, associate editors. lo
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p. cm. fro
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Includes bibliographical references (p. ) and index. ttp
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ISBN 978–0–19–975626–1 c
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1. Music therapy. 2. Ethnomusicology. ic
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3. Alternative medicine. I. Koen, Benjamin D. .c
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The Oxford Handbook of Medical Ethnomusicology
Benjamin D. Koen (ed.)
https://doi.org/10.1093/oxfordhb/9780199756261.001.0001
Published: 2011 Online ISBN: 9780199940509 Print ISBN: 9780199756261
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Dedication  lo
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p. v With abiding love to my parents, Thelma and Leon Koen, my wife ite
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and best friend, Saba Koen, and our brilliant daughters, lu
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p. vi Naseem Serene Koen and Solya Taj Koen 8
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The Oxford Handbook of Medical Ethnomusicology
Benjamin D. Koen (ed.)
https://doi.org/10.1093/oxfordhb/9780199756261.001.0001
Published: 2011 Online ISBN: 9780199940509 Print ISBN: 9780199756261
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Acknowledgments  lo
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I must �rst express my deep and heartfelt gratitude to my fellow contributors and associate editors who m
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responded to this project with great enthusiasm, and to the innumerable people, colleagues, communities, ite
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agencies, and institutions that support our work and vision, encourage and participate in this borderless -v
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discourse, and partner with us to envision and enact a new world culture of music, health, and healing. The lum
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impetus for this volume emerged from the interdisciplinary program “Music, Medicine, and Culture: /2
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Medical Ethnomusicology and Global Perspectives on Health and Healing,” which was co-sponsored by the 0
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College of Medicine and College of Music at Florida State University, and which was funded by a grant from h
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the FSU Council on Research and Creativity that I wrote with colleague Kenneth Brummel-Smith. te
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Benjamin D. Koen 1
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The Oxford Handbook of Medical Ethnomusicology
Benjamin D. Koen (ed.)
https://doi.org/10.1093/oxfordhb/9780199756261.001.0001
Published: 2011 Online ISBN: 9780199940509 Print ISBN: 9780199756261
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CHAPTER o
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1 Introduction: Con�uence of Consciousness in Music, lo
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Medicine, and Culture  d fro
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Benjamin D. Koen, Gregory Barz, Kenneth Brummel-Smith h
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https://doi.org/10.1093/oxfordhb/9780199756261.013.0001 Pages 3–17 ://a
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Abstract m
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A new milieu of consciousness is emerging among researchers and practitioners across disciplines in ited
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music, the health sciences, and integrative, complementary, and alternative medicine, the physical o
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and social sciences, medical humanities, and the healing arts. One of the most recent expressions of e
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this consciousness is the burgeoning area of medical ethnomusicology, a new �eld of integrative 8
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research and applied practice that explores holistically the roles of music and sound phenomena and 4/c
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related praxes in any cultural and clinical context of health and healing. This article adds to the ap
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growing realization that there are multiple ways not only of understanding the intersections between r/2
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music, medicine, and culture but also of understanding what music and medicine are, what they are 31
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not, and how musical meaning and power can e�ect health and healing in varying degrees from person 06
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to person, from remedy to remedy, and from performance to performance. b
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Keywords: consciousness, health sciences, social sciences, medical humanities, medical ethnomusicology y L
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Subject: Ethnomusicology, Music ra
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Prelude
A new milieu of consciousness is emerging among researchers and practitioners across disciplines in music,
the health sciences, integrative, complementary, and alternative medicine (ICAM), the physical and social
sciences, medical humanities, and the healing arts. This con�uence of innovative thinking approaches
music, health, and healing anew by integrating knowledge from diverse research areas and domains of
human life that are conventionally viewed as disparate but are laden with potential bene�ts for improved or
vibrant quality of life, prevention of illness and disease, and even cure and healing. One of the most recent
p. 4 expressions of this consciousness is the burgeoning area of medical ethnomusicology, a new �eld of D
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integrative research and applied practice that explores holistically the roles of music and sound phenomena n
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and related praxes in any cultural and clinical context of health and healing. Broadly, these roles and praxes d
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are viewed as being intimately related to and intertwined with the biological, psychological, social, fro
emotional, and spiritual domains of life, all of which frame our experiences, beliefs, and understandings of m
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health and healing, illness and disease, and life and death (Koen in press). This volume seeks to illuminate ttp
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the cultural dynamic that underlies any experience of music, health, and healing and to further encourage a ://a
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new level of borderless discourse and collaboration among those interested in the subject. d
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Why this Book? Why Now? .c
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This book is more than the �rst edited volume expressive of medical ethnomusicology and its potential. It is d
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a book about relationships—relationships among individuals and between disciplines. It represents a new lu
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stage of collaborative discourse among researchers who might or might not invoke “medical e
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ethnomusicology” as what they do, but who embrace and incorporate the knowledge that this new 2
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discipline brings to the discourse. Importantly, such knowledge, by de�nition, spans the globe of traditional /c
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cultural practices of music, spirituality, and medicine, including biomedical and ICAM models; it is rooted in p
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new physics, philosophy, psychology, sociology, cognitive science, linguistics, medical anthropology, and, r/2
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of course, music. This volume, then, represents a twofold process. On the one hand, it further establishes 1
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the new area of medical ethnomusicology; on the other hand, it expresses current research within and 6
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across disciplines concerned with music, culture, health, and healing, irrespective of disciplinary b
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association. a
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This melding of music, culture, and healing comes at a propitious time for research. Relatively recently, L
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medical anthropology has endeavored to discern the e�ects of culture on sickness, health, and healing, but ra
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it has focused more on the larger social aspects and politics of medicine. It is interesting that at the time of us
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this writing, on the website of the Society of Medical Anthropology (http://www.medanthro.net/), a wide r o
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range of important and signi�cant issues are listed as subjects of study, such as the experience of illness, 21
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the social relations of sickness, and the cultural and historical traditions that shape medical practice. e
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However, the role of music and culture in healing appears nowhere on the list. m
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Similarly, the role of complementary and alternative medicine has expanded tremendously in the past r 20
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decade. Research into a broad spectrum of healing modalities is in process through the establishment of the
National Center for Complementary and Alternative Medicine (http://nccam.nih.gov), a new branch of the
National Institutes of Health. A recent search on NCCAM's “CAM on PubMed” found 2,638 citations on
p. 5 “music.” Most deal with music interventions in health care and healing, but few focus on cultural
aspects. Hence the opportunity to conduct research on and expand our understanding of the interface
between culture, music, and healing has never been greater. It is our hope that this work will stimulate
further interest in this important area.
Central Themes of this Book
Three central themes that unify this volume are important to note here. First, the authors recognize the
e�ectual and dynamic interrelationships between the broad domains of human life that contextualize
health, healing, illness, and disease—namely, the biological, psychological, social, emotional, and spiritual
domains. Hence the authors have an interest in perspectives from diverse research areas that can uniquely
illuminate any aspect of health and healing. Second, this volume encourages collaborative, integrative, and
holistic research that is centrally focused on discovering new knowledge and applying that knowledge in
innovative ways that can bring about health, healing, or cure, or increase the e�cacy of any treatment. D
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Third, this volume is a documentation and example of the current discourse across disciplines interested in n
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music, medicine, culture, health, and healing. Within this discourse is the rapidly growing and adaptive d
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consciousness of its participants, which simultaneously embraces the rigor necessary to discover speci�c fro
modes of action implicated in preventive and curative practices and the determination to engage in a critical m
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and open-minded approach to the diverse and overlapping vistas of human praxis, belief, and experience ttp
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that can inform and perhaps transform our understandings with respect to illness and disease and health ://a
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and healing. Since this volume is intended for researchers and practitioners across multiple �elds, a brief d
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historical sketch of the place of ethnomusicology in music research that emphasizes the importance of ic
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culture and spirituality in the current discourse is necessary. up
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Interdisciplinary Musical Approaches ite
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Broadly, ethnomusicology is a vast area of research and applied practice that includes all areas of music e
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research, from historical and contemporary practices, beliefs, purposes, functions, traditions, forms, 2
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genres, and structures of music and sound of any culture to music and the brain; from the highly culture- /c
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p. 6 speci�c to the universal. Multiple disciplines within music research often overlap with each other and p
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across other academic areas interested in music, including historical musicology, ethnomusicology, r/2
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medical, cognitive, and applied ethnomusicology, systematic musicology, music cognition, music therapy, 1
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music psychology, neuroscience of music, biomusicology, music education, music performance, and dance. 6
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Historically, music research in the United States and Europe was largely concerned only with so-called H
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Western European art music or the classical traditions and considered the rest of the world's music to be rtle
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savage, undeveloped, in a state of evolution, or at best “exotic.” Although this is certainly not the case L
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today, there often remains an assumption across disciplines that the standard by which any music can be ra
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understood, appreciated, judged, analyzed, or deemed worthy of embracing is a “Western” one.1 This leads us
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to thinking that the best music for health and healing would naturally come from “Western” models. As a r o
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result, an area like medicine, which has a long-standing interest in music's potential e�ectiveness to 21
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promote health, improve function, or facilitate healing, is at risk of inheriting a narrow view of what music e
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is, thereby stripping it of its potential power. m
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From the early 1900s, interest in the music of diverse cultures began to increase, and this slowly led r 20
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musicologists and anthropologists with broad backgrounds in the sciences and humanities to establish the
scholarly discipline of ethnomusicology, which views all music and cultures of the world as worthy of
rigorous examination. The cultural context, then, including values, beliefs, thoughts, behaviors, and
practices at individual, group, and universal levels, is one of the central concerns of ethnomusicology. This
is but one strong link with medicine, where cultural issues are ever increasing in importance. Additionally,
from its beginnings, ethnomusicology has had a stream of research dedicated to the investigation of music
and healing, which has employed methodologies ranging from the entirely ethnographic to approaches that
integrate philosophies and methods from disciplines across the sciences and humanities.
Nearly a century of ethnomusicological research into music and healing shows not only how culturally
diverse practices of specialized music function as tools for therapy, but that music is most often practiced as
a means of healing or cure—a way for a person or patient to transform from illness or disease to health and
homeostasis. Such specialized music almost always emerges from a spiritual or religious ontology and from
a ritual or ceremonial practice. Moreover, such healing music is often combined with or functions as prayer
or meditation and constitutes a preventive and/or curative practice within a broader complex of local
medical practices (see the chapter by Koen in this volume). These practices often include a combination of
biomedical, naturopathic, and traditional approaches. Building upon these aspects, medical
ethnomusicology further strengthens the course of integrative, complementary, and alternative medicine
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by bringing in-depth understandings of music and sound phenomena, as well as multiple and diverse w
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practices of music and healing, to bear within the ever-present frame of culture, the place where music, lo
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other specialized sonic expressions, and related praxes are assigned or empowered with a highly personal, ed
culture-speci�c, or culture-transcendent meaning that can increase health and facilitate healing. fro
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Scholarship on Music, Medicine, and Healing ://a
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Many of the topics and issues related to medical ethnomusicology may seem familiar to those who study .o
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music's therapeutic nature. In fact, recent scholarship that has emerged from the discipline of music .c
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therapy has often embraced approaches that apply therapeutic interventions from culture-centered or /e
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cross-cultural perspectives. Of central interest to medical ethnomusicology in this regard are the concepts ite
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of music as therapy and “musicmedicine” (see Dileo 1999 for an overview of these concepts in music -vo
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therapy). m
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There is much to learn from the rich resources o�ered by the scholarship of music therapy's interactions 20
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with medicine, but a comparison of earlier therapy case studies with emergent work in medical /ch
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ethnomusicology nevertheless raises complex and perhaps fundamental issues of distinction, many of te
which are examined in this volume. Foremost among these issues are fundamental concepts of health and r/21
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healing, illness and disease, and music's potential power to e�ect change therein. Music therapy has 15
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historically taken a “Western” biomedical stance in conceptualizing the nature of a human being as it 3
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relates to health and disease, that is, as a physical entity or mechanism. Hence by understanding the modes y
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of action that constitute the proper functioning of the physical body, one can achieve therapeutic e�ects. In a
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contrast, traditional and long-standing practices the world over, which are among the foci of medical y
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ethnomusicology, include, along with the physical body, the neural, psychological, emotional, and cognitive ibra
processes, sociocultural dynamics, spirituality, belief, and the metaphysical as central concerns and modes ry u
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of action that play critical roles in achieving and maintaining health and, more important, can engage all er o
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aspects of a human to move beyond therapy to create healing or cure. Cook (1997), who explores “Sacred 2
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Music Therapy in North India”; Lipe (2002), who conducts a review of the music therapy literature S
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concerned with spirituality; and Toppozada (1995), who conducts a survey of music therapists to investigate te
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interest and training in multicultural issues, are among the recent contributions that show a stream within be
music therapy that shares many concerns with medical ethnomusicology (see also the chapters by Clair, r 20
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West and Ironson, and Rohrbacher in this volume).
Signi�cant scholarship has emerged recently that documents the various roles of music in historical
therapeutic roles. In Peregrine Horden's collected volume of essays, Music as Medicine (2000), for example,
select musical solutions to medical issues are documented from antiquity to modern times. At many points
in this volume, historical distinctions between music and medicine are shown to be problematic, and
documentary evidence is used to demonstrate that music and medicine are coextensive. Although it focuses
primarily on European performative traditions, the volume o�ers re�ections on medical practices in India
p. 8 and Southeast Asia and from Judaic and Islamic religious traditions. Signi�cant in this regard is Keith
Howard's contribution on the use and function of music in shamanic rituals in Siberia, Korea, and elsewhere
(2000). Throughout his chapter, Howard focuses on the generation of altered states, such as those that
occur in ecstasy and trance, and the ways in which these states are manifested by direct musical stimuli.
Horden's volume is a welcome addition to scholarship on music and medicine not only for its
documentation of central historical concepts (for example, tarantism, shamanism, and melancholia) but
also for its positioning of a certain degree of skepticism within the volume.
Penelope Gouk's Musical Healing in Cultural Contexts (2000a), a notable collection of essays, moves further
into globalizing the coupling of music and medicine. Signi�cant in this volume is Henry Stobart's chapter
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(2000) on the use of music in the highlands of Bolivia in the maintenance of bodily health, as well as in o
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ritual healing. In addition, John Janzen (2000) includes a study of ngoma rituals performed throughout nlo
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southern and central Africa that contribute to unique therapies by discerning appropriate spirits through de
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the performance of music. In a related chapter, Steven Friedson (2000) presents a case study that outlines fro
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the use of music in healing trance ceremonies among the Tumbuka people of Malawi. By focusing on h
“dancing the disease” among the Tumbuka, Friedson attempts to explode the lingering “Western” ttps
distinction between mind and body. Penelope Gouk opens her concluding chapter, “Sister Disciplines? Music ://ac
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and Medicine in Historical Perspective,” with a series of questions: “Under what circumstances have e
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particular physicians been prompted to write about music, and what topics have they considered important ic
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when they do? And apart from doctors, who else has written on music's relevance to medicine, and for what p
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audiences has such literature been intended?” (Gouk 2000b, 171). In many ways, Gouk's questions m
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contribute a spirit to the present volume, our own humble collection of essays. Gouk's invocation of Dorothy d
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Schullian and Max Schoen's Music and Medicine (1948) in her title references a foundational work in the d-v
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study of the therapeutic nature of music and its potential role in health and healing. The details that Gouk lu
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provides concerning the historical positioning of that text constitute a helpful overview of the state of /2
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scholarship on the topic during the mid-twentieth century. Her table 10.1, “Contributors to Schullian and 20
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Schoen,” compiles resourceful information concerning the occupations and skills brought to the chapters /ch
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by authors of the original collected volume. pte
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One �nal compilation should be introduced here. The Performance of Healing, edited by Carol Laderman and 31
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Marina Roseman (1996), includes a range of articles that positions culturally diverse practices of healing 06
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from the perspectives of both healer and those who are healed. Building from a local knowledge base of b
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healing traditions, the individual authors in that text are particularly cognizant of the sociopolitical issues H
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that in�uence contemporary practices of healing and locate it within an increasingly complex global frame. rtle
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As the editors suggest, “Medical systems need to be understood from within, as experienced by healers, Lib
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patients, and others whose minds and hearts have both become involved in this important human ry
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undertaking” (Laderman and Roseman 1996, 13). In tandem with the focus on local views and practices, as s
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p. 9 the title suggests, the volume emphasizes that all healing is performative at some level and thus can be r on
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explored through the lens of performance studies. 1
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In addition to these compilations, which represent the multidisciplinary approaches that have both formed tem
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and informed current ethnographic research in medical ethnomusicology, two special issues of the World of e
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Music, “Music and Healing in Transcultural Perspectives” (volume 39[1] [1997]) and a later issue, “Spirit 0
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Practices in a Global Ecumene” (volume 42[2] [2000]), which is a continuation of that discussion of ritual
and ceremonial practices, are notable for their focus on local beliefs and practices that exist in diverse
health systems. In addition, �ve seminal works for medical ethnomusicology prescribe an essential focus on
the art of medicine and the performance of healing. Marina Roseman's Healing Sounds from the Malaysian
Rainforest (1991) is foundational for the work of many who are now concerned with medical
ethnomusicology. In Roseman's ethnography, music's role in healing among the Temiar people of the rain
forests of peninsular Malaysia is central. Roseman's work stands out as a benchmark that demonstrates the
multifaceted nature of music's transformative power across the spiritual, corporeal, and emotional
domains. The publication of Roseman's powerful study was quickly followed by John Janzen's study of the
cultural phenomenon known throughout Bantu-speaking sub-Saharan Africa as ngoma. In Ngoma:
Discourses of Healing in Central and Southern Africa (1992), Janzen compares di�erent ways in which the
practice of ngoma—a cover term for drum, dance, song, and performance—provides the site for ritual
healing among disparate communities in Africa. For Janzen, musical performance (often signaled by
drumming) facilitates an altered state of being often viewed locally as a kind of spirit possession, and it is
within this “healing institution” that the practice of ngoma is made meaningful. Also situated within an
African context is Steven Friedson's Dancing Prophets: Musical Experience in Tumbuka Healing, which opens
with provocative questions that relate to the fundamental issues of medical ethnomusicology (1996, xi):
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what is it to dance a disease, to drum a diagnosis, and in doing so to embody the spirits? Throughout w
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Dancing Prophets, the role of music within a complex of beliefs about spirit possession contributes to an lo
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understanding of the intricacies of African indigenous health-care systems not only among the Tumbuka ed
people of northern Malawi but also elsewhere in the world. In Gregory Barz's Singing for Life: Music and fro
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HIV/AIDS in Uganda (2006), the concept of medical ethnomusicology is expanded to the role of music, dance, http
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and drama within contemporary medical interventions in East Africa. By demonstrating ways in which the ://a
decline in the HIV infection rate in Uganda corresponds directly to the use of local musical traditions that ca
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support medical initiatives, Singing for Life positions research related to medical ethnomusicology within m
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the realm of cultural advocacy and signals new directions for activist research relationships in the �eld. .o
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Benjamin Koen's recent ethnography, Beyond the Roof of the World: Music, Prayer, and Healing in the Pamir .c
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Mountains (in press), takes an approach that views science and religion as complementary lenses for /e
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understanding human experience and focuses on music, prayer, meditation, and healing on two levels: it is ite
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p. 10 an in-depth study of the music-prayer-healing matrix among the Pamiri people of Badakhshan, -v
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Tajikistan, and an examination of the culture-transcendent processes and principles that underlie diverse m
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cultural and clinical contexts of health and healing, with an emphasis on those cultural processes that are /28
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intimately linked to spirituality and transformational cognitive states and uniquely inform the current 04
discourse in integrative, complementary, and alternative medicine.2 Building further, this work applies /cha
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these principles in teaching music-meditation-healing practices to a diversity of people who derive a host te
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Theoretical Models for Music, Medicine, and Healing b
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To discuss the vast range and number of theoretical models throughout history that have been and are being L
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employed in music and healing research and applied practice would be, to say the least, a daunting task that, ra
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if taken up here, would remove us too far a�eld from our central theme and, indeed, would require a us
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dedicated volume to do it justice. Moreover, several works already exist from within each discipline that r o
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discuss particular theoretical models in detail. Here we are less interested in articulating the speci�c 21
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challenges and unique contributions that our particular, discipline-speci�c theoretical models bring to the e
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table—individual contributors do this in their chapters to show their links to the current discourse. Rather, m
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in this introduction, we are keenly interested in conveying a sense of the con�uence of thinking among er 2
researchers and practitioners across disciplines, which is forging a new theoretical framework that 02
2
embraces di�erent models to achieve a common goal. The two key components of this new theoretical
framework are the inclusion of culture and the ability to collaborate—both of which accommodate diversity,
�exibility, innovation, and rigor in the development and application of speci�c research models.
As researchers, practitioners, and healers concerned with music, medicine, health, and healing the world
over, we are repeatedly confronted with a host of ancient and newly born theories that articulate a number
of concepts about how music, sound, and related sociocultural factors and practices, as well as physical and
metaphysical forces, are believed to facilitate health and healing. At the outset, it should be emphasized that
theory, as an aspect of epistemology, is a manifestation of an underlying philosophical frame that can range