The Dangers of Overestimating Music Therapy

It's comforting to believe that songs can help dementia patients recall their lost selves. But music can also harm as much as it helps, creating false memories, confusion, and distress.
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Henry’s back in the news.

On November 18, 2011, a video was uploaded to YouTube. We follow a woman down a corridor of what looks like a long-term care facility. We learn that she is a recreation therapist as she tells us about the power of music to reach a female patient who seemed all but unreachable. But we never see that patient. Instead we see a name: HENRY.

Henry is a patient at the facility: a black man, quite advanced in years, hunched over in his wheelchair, baseball cap on, unresponsive. His daughter comes to visit him, but he doesn’t recognize her. Ten years earlier he began to experience seizures. Before that, his daughter says, he was “fun-loving, singing. Every occasion he would come out with a song.” But that’s not the man we see at first.

Another cut. Henry sports a different shirt. He has a lapel microphone on. The recreation therapist speaks to another person about the type of music the therapist would like for Henry: religious music, “because he enjoys music and is always quoting the Bible, so I’d rather have that for him.”

Then comes the talking head, none other than Oliver Sacks, M.D., preeminent author on music and neuroscience, who narrates what happens next. The therapist appears: “Henry, I’ve found your music.”

Headphones attached to an iPod are placed on his ears—an iPod, Sacks says, “containing, we know, his favorite music.” As the music plays, Henry’s eyes, previously listless, grow large. His body begins to move. He quietly sings along.

And when the headphones are removed, he talks and talks and talks. The music appears to have awakened him from a deep sleep. Henry is made new.

Nearly three years and 1.4 million views later, we discover that Henry’s story is part of a larger project. “Music can conjure up memories from the past, transport us to another place and make us feel incredible joy or profound sadness. A new documentary called Alive Inside takes a look at how music is changing the lives of some older Americans.” This was the pitch for the June 30, 2014, show Katie Couric aired to promote “a joyous cinematic exploration of music’s capacity to reawaken our souls and uncover the deepest parts of our humanity.”

Alive Inside won the Audience Award at the 2014 Sundance Film Festival, and based on its trailer, it’s easy to imagine how viewers watch the transformations on screen and leave feeling elated that an iPod can miraculously help Alzheimer’s and dementia patients recover their lost selves. And it will soon be coming to a city near you.

I teach a course on music, neuroscience, and ethics, and Henry featured prominently in one of our class discussions last year. Most of my students see nothing but the upside when they witness Henry’s change from catatonia to euphoria. And testimonials about the impact of personalized playlists provide further support to the notion that well-chosen music can profoundly affect a patient’s life in exclusively positive ways.

So at the risk of being a skunk at the garden party, let me raise some concerns about these therapeutic interventions, lest we all become irrationally exuberant about the power of music in the lives of those we love.

Go back to the original video. At 3'45", Henry talks about what music means to him and identifies Cab Calloway—a performer not known for religious music—as one of his favorite artists. At 4'30", he sings his favorite Cab Calloway song: I’ll Be Home for Christmas.

But I’ve not been able to turn up a recording of Calloway singing this song. In looking at two different books about the songwriter and bandleader, I found no mention of the 1943 song that Bing Crosby made famous. Out of more than 300 different versions compiled by a website devoted to cover songs, Cab Calloway is not mentioned. Calloway did perform on A Jazzy Christmas at the Cotton Club, but unless his Harlem Hospitality incorporates the tune, the song isn’t represented on that album by Calloway.

Presented by

Steve Swayne is the chair of Dartmouth College's Department of Music. He has previously taught at the San Francisco Conservatory of Music and at the University of California, Berkeley.

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