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date: 08 March 2021

Introduction: Confluence of Consciousness in Music, Medicine, and Culture

Abstract and Keywords

A new milieu of consciousness is emerging among researchers and practitioners across disciplines in music, the health sciences, and integrative, complementary, and alternative medicine, the physical and social sciences, medical humanities, and the healing arts. One of the most recent expressions of this consciousness is the burgeoning area of medical ethnomusicology, a new field of integrative research and applied practice that explores holistically the roles of music and sound phenomena and related praxes in any cultural and clinical context of health and healing. This article adds to the growing realization that there are multiple ways not only of understanding the intersections between music, medicine, and culture but also of understanding what music and medicine are, what they are not, and how musical meaning and power can effect health and healing in varying degrees from person to person, from remedy to remedy, and from performance to performance.

Keywords: consciousness, health sciences, social sciences, medical humanities, medical ethnomusicology

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 confluence 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 benefits for improved or vibrant quality of life, prevention of illness and disease, and even cure and healing. One of the most recent expressions of this consciousness is the burgeoning area of medical ethnomusicology, a new field of (p. 4) integrative research and applied practice that explores holistically the roles of music and sound phenomena and related praxes in any cultural and clinical context of health and healing. Broadly, these roles and praxes are viewed as being intimately related to and intertwined with the biological, psychological, social, emotional, and spiritual domains of life, all of which frame our experiences, beliefs, and understandings of health and healing, illness and disease, and life and death (Koen in press). This volume seeks to illuminate the cultural dynamic that underlies any experience of music, health, and healing and to further encourage a new level of borderless discourse and collaboration among those interested in the subject.

Why this Book? Why Now?

This book is more than the first edited volume expressive of medical ethnomusicology and its potential. It is a book about relationships—relationships among individuals and between disciplines. It represents a new stage of collaborative discourse among researchers who might or might not invoke “medical ethnomusicology” as what they do, but who embrace and incorporate the knowledge that this new discipline brings to the discourse. Importantly, such knowledge, by definition, spans the globe of traditional cultural practices of music, spirituality, and medicine, including biomedical and ICAM models; it is rooted in new physics, philosophy, psychology, sociology, cognitive science, linguistics, medical anthropology, and, of course, music. This volume, then, represents a twofold process. On the one hand, it further establishes the new area of medical ethnomusicology; on the other hand, it expresses current research within and across disciplines concerned with music, culture, health, and healing, irrespective of disciplinary association.

This melding of music, culture, and healing comes at a propitious time for research. Relatively recently, medical anthropology has endeavored to discern the effects of culture on sickness, health, and healing, but it has focused more on the larger social aspects and politics of medicine. It is interesting that at the time of this writing, on the website of the Society of Medical Anthropology (http://www.medanthro.net/), a wide range of important and significant issues are listed as subjects of study, such as the experience of illness, the social relations of sickness, and the cultural and historical traditions that shape medical practice. However, the role of music and culture in healing appears nowhere on the list.

Similarly, the role of complementary and alternative medicine has expanded tremendously in the past 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 “music.” Most deal with music interventions in health care (p. 5) 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 effectual 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 efficacy of any treatment. Third, this volume is a documentation and example of the current discourse across disciplines interested in music, medicine, culture, health, and healing. Within this discourse is the rapidly growing and adaptive consciousness of its participants, which simultaneously embraces the rigor necessary to discover specific modes of action implicated in preventive and curative practices and the determination to engage in a critical and open-minded approach to the diverse and overlapping vistas of human praxis, belief, and experience that can inform and perhaps transform our understandings with respect to illness and disease and health and healing. Since this volume is intended for researchers and practitioners across multiple fields, a brief historical sketch of the place of ethnomusicology in music research that emphasizes the importance of culture and spirituality in the current discourse is necessary.

Interdisciplinary Musical Approaches

Broadly, ethnomusicology is a vast area of research and applied practice that includes all areas of music research, from historical and contemporary practices, beliefs, purposes, functions, traditions, forms, genres, and structures of music and sound of any culture to music and the brain; from the highly culture-specific to the universal. Multiple disciplines within music research often overlap with each (p. 6) other and across other academic areas interested in music, including historical musicology, ethnomusicology, medical, cognitive, and applied ethnomusicology, systematic musicology, music cognition, music therapy, music psychology, neuroscience of music, biomusicology, music education, music performance, and dance.

Historically, music research in the United States and Europe was largely concerned only with so-called Western European art music or the classical traditions and considered the rest of the world's music to be savage, undeveloped, in a state of evolution, or at best “exotic.” Although this is certainly not the case today, there often remains an assumption across disciplines that the standard by which any music can be understood, appreciated, judged, analyzed, or deemed worthy of embracing is a “Western” one.1 This leads to thinking that the best music for health and healing would naturally come from “Western” models. As a result, an area like medicine, which has a long-standing interest in music's potential effectiveness to promote health, improve function, or facilitate healing, is at risk of inheriting a narrow view of what music is, thereby stripping it of its potential power.

From the early 1900s, interest in the music of diverse cultures began to increase, and this slowly led 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 by bringing in-depth understandings of music and sound phenomena, as well as multiple and diverse practices of music and healing, to bear within the ever-present frame of culture, the place where music, other specialized sonic expressions, and related praxes are assigned or empowered with a highly personal, culture-specific, or culture-transcendent meaning that can increase health and facilitate healing.

(p. 7) Scholarship on Music, Medicine, and Healing

Many of the topics and issues related to medical ethnomusicology may seem familiar to those who study music's therapeutic nature. In fact, recent scholarship that has emerged from the discipline of music therapy has often embraced approaches that apply therapeutic interventions from culture-centered or cross-cultural perspectives. Of central interest to medical ethnomusicology in this regard are the concepts of music as therapy and “musicmedicine” (see Dileo 1999 for an overview of these concepts in music therapy).

There is much to learn from the rich resources offered by the scholarship of music therapy's interactions with medicine, but a comparison of earlier therapy case studies with emergent work in medical ethnomusicology nevertheless raises complex and perhaps fundamental issues of distinction, many of which are examined in this volume. Foremost among these issues are fundamental concepts of health and healing, illness and disease, and music's potential power to effect change therein. Music therapy has historically taken a “Western” biomedical stance in conceptualizing the nature of a human being as it relates to health and disease, that is, as a physical entity or mechanism. Hence by understanding the modes of action that constitute the proper functioning of the physical body, one can achieve therapeutic effects. In contrast, traditional and long-standing practices the world over, which are among the foci of medical ethnomusicology, include, along with the physical body, the neural, psychological, emotional, and cognitive processes, sociocultural dynamics, spirituality, belief, and the metaphysical as central concerns and modes of action that play critical roles in achieving and maintaining health and, more important, can engage all aspects of a human to move beyond therapy to create healing or cure. Cook (1997), who explores “Sacred Music Therapy in North India”; Lipe (2002), who conducts a review of the music therapy literature concerned with spirituality; and Toppozada (1995), who conducts a survey of music therapists to investigate interest and training in multicultural issues, are among the recent contributions that show a stream within music therapy that shares many concerns with medical ethnomusicology (see also the chapters by Clair, West and Ironson, and Rohrbacher in this volume).

Significant 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 offers reflections on medical practices in India and Southeast Asia and from Judaic and Islamic religious traditions. Significant in this regard is Keith (p. 8) 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. Significant in this volume is Henry Stobart's chapter (2000) on the use of music in the highlands of Bolivia in the maintenance of bodily health, as well as in ritual healing. In addition, John Janzen (2000) includes a study of ngoma rituals performed throughout southern and central Africa that contribute to unique therapies by discerning appropriate spirits through the performance of music. In a related chapter, Steven Friedson (2000) presents a case study that outlines the use of music in healing trance ceremonies among the Tumbuka people of Malawi. By focusing on “dancing the disease” among the Tumbuka, Friedson attempts to explode the lingering “Western” distinction between mind and body. Penelope Gouk opens her concluding chapter, “Sister Disciplines? Music and Medicine in Historical Perspective,” with a series of questions: “Under what circumstances have particular physicians been prompted to write about music, and what topics have they considered important when they do? And apart from doctors, who else has written on music's relevance to medicine, and for what audiences has such literature been intended?” (Gouk 2000b, 171). In many ways, Gouk's questions contribute a spirit to the present volume, our own humble collection of essays. Gouk's invocation of Dorothy Schullian and Max Schoen's Music and Medicine (1948) in her title references a foundational work in the study of the therapeutic nature of music and its potential role in health and healing. The details that Gouk provides concerning the historical positioning of that text constitute a helpful overview of the state of scholarship on the topic during the mid-twentieth century. Her table 10.1, “Contributors to Schullian and Schoen,” compiles resourceful information concerning the occupations and skills brought to the chapters by authors of the original collected volume.

One final compilation should be introduced here. The Performance of Healing, edited by Carol Laderman and Marina Roseman (1996), includes a range of articles that positions culturally diverse practices of healing from the perspectives of both healer and those who are healed. Building from a local knowledge base of healing traditions, the individual authors in that text are particularly cognizant of the sociopolitical issues that influence contemporary practices of healing and locate it within an increasingly complex global frame. As the editors suggest, “Medical systems need to be understood from within, as experienced by healers, patients, and others whose minds and hearts have both become involved in this important human undertaking” (Laderman and Roseman 1996, 13). In tandem with the focus on local views and practices, as the title suggests, the volume emphasizes that all (p. 9) healing is performative at some level and thus can be explored through the lens of performance studies.

In addition to these compilations, which represent the multidisciplinary approaches that have both formed and informed current ethnographic research in medical ethnomusicology, two special issues of the World of Music, “Music and Healing in Transcultural Perspectives” (volume 39[1] [1997]) and a later issue, “Spirit 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, five 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 different 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): what is it to dance a disease, to drum a diagnosis, and in doing so to embody the spirits? Throughout Dancing Prophets, the role of music within a complex of beliefs about spirit possession contributes to an understanding of the intricacies of African indigenous health-care systems not only among the Tumbuka people of northern Malawi but also elsewhere in the world. In Gregory Barz's Singing for Life: Music and HIV/AIDS in Uganda (2006), the concept of medical ethnomusicology is expanded to the role of music, dance, and drama within contemporary medical interventions in East Africa. By demonstrating ways in which the decline in the HIV infection rate in Uganda corresponds directly to the use of local musical traditions that support medical initiatives, Singing for Life positions research related to medical ethnomusicology within the realm of cultural advocacy and signals new directions for activist research relationships in the field. Benjamin Koen's recent ethnography, Beyond the Roof of the World: Music, Prayer, and Healing in the Pamir Mountains (in press), takes an approach that views science and religion as complementary lenses for understanding human experience and focuses on music, prayer, meditation, and healing on two levels: it is an in-depth study of (p. 10) the music-prayer-healing matrix among the Pamiri people of Badakhshan, Tajikistan, and an examination of the culture-transcendent processes and principles that underlie diverse cultural and clinical contexts of health and healing, with an emphasis on those cultural processes that are intimately linked to spirituality and transformational cognitive states and uniquely inform the current discourse in integrative, complementary, and alternative medicine.2 Building further, this work applies these principles in teaching music-meditation-healing practices to a diversity of people who derive a host of health benefits.

Theoretical Models for Music, Medicine, and Healing

To discuss the vast range and number of theoretical models throughout history that have been and are being employed in music and healing research and applied practice would be, to say the least, a daunting task that, if taken up here, would remove us too far afield from our central theme and, indeed, would require a dedicated volume to do it justice. Moreover, several works already exist from within each discipline that discuss particular theoretical models in detail. Here we are less interested in articulating the specific challenges and unique contributions that our particular, discipline-specific theoretical models bring to the table—individual contributors do this in their chapters to show their links to the current discourse. Rather, in this introduction, we are keenly interested in conveying a sense of the confluence of thinking among researchers and practitioners across disciplines, which is forging a new theoretical framework that embraces different 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, flexibility, innovation, and rigor in the development and application of specific 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 from an absolute belief in only the physical observable world that can be tested and “verified” to the same degree of belief in a metaphysical or spiritual reality, which, by definition, defies measurement, or to some combination of these two extremes. In addition to these three positions, which give rise to a plethora of contrasting theories, two developments that are (p. 11) gaining considerable importance in the thinking of academics and are particularly relevant to the discussion of theory should be mentioned, since, in both direct and indirect ways, they are transforming the underlying philosophies from which theories are derived.

One development emerges from the physical sciences, the other from the humanities—namely, theoretical frames from modern physics, quantum and string theory in particular, on the one hand, and the importance of more deeply understanding the complex nature of culture and diversity, on the other hand. With respect to the former, theories that explore the provocative and evanescent nature of waves, particles, matter, and their processes of transformation are particularly important to music and healing research because music, at its most fundamental physical level, is a constellation of sound waves, which are described in terms of frequency, amplitude, waveform, duration, and direction. The potential links between the fleeting but profound vibratory substance of music and sound and that of the body and mind are leading to a range of new questions that require new theoretical models by which to approach them—questions that circle around the central notion that music can facilitate multiple types of transformation. For countless people throughout the world, music's capacity to transform one's body or being is well known and intentionally engaged. Whether it is through something as typical as music's ability to propel a memory laden with its specific meanings and palpable emotions from the depths of the subconscious into the forefront of conscious awareness or through the more select and rare experience of ecstasy, trance, or other altered states of consciousness where one can experience the sublime, transform the mind and body, or become healed of an illness, virtually all people can claim a personal experience where music has changed them in some meaningful way.

In considering the latter development, culture and diversity in music and health, the key point to emphasize is the centrality of the individual, who, while existing within a broader cultural sphere, is a unique cultural landscape that can best be understood on its own terms. The importance of understanding the delicate nature of the individual is well illustrated by the placebo effect, as well as by the contrary and harming nocebo effect. For instance, given two patients with identical conditions of hypertension, why does a placebo assuage or cure the condition in one patient but not in another? Or if one considers the potential of a nocebo effect, why does one patient psychologically interpret statistical data about a disease in a way that is debilitating, increasing the presence of the disease in the body and perhaps even leading to a premature death, while another patient immediately and perhaps unconsciously engages an elusive, intangible internal capacity to overcome the disease, if not for a complete cure, then at least to defy the so-called odds in which the first patient believed? The unique and individual cultural landscape of a person's being, comprising the thoughts, bodily attributes, emotions, relationships, beliefs, and spiritual capacities that form the complex of the self, is the matrix within which the placebo and nocebo effects are determined. Moreover, two key points are of special importance in the growing new paradigm. First, music can effect changes in all these components that constitute the self, and this ability gives it a distinctive (p. 12) status as one of the most important and promising preventive practices and non-pharmacological interventions; and second, music has a broad spectrum of effects that range from the palliative and therapeutic to the curing, healing, and transformational (see further Koen in press).

This volume expresses a unique constellation of theories and approaches that are best viewed as existing within the broad frame of unity in diversity. The diversity exists at the level of discipline-specific theories, methods, subject groups, and modes of expression and dissemination of knowledge. Rather than shoehorning authors' language into a neat box of common style, we have chosen to maintain a flow of expression that mirrors the current dialectic across academic areas and cultures, requiring that participants in this discourse become conversant with each other in a spirit of mutual learning while not losing each other in their own specialized jargon. The unity exists on the level of the contributors' common goal of promoting health and healing, an awareness of music's potential and broad range of efficacy as an intervention, and a recognition of the importance of integrative and collaborative approaches to research and application that must account for culture and a holistic understanding of what constitutes a human being. Currently, the interaction among these many factors is helping extend further the network of relationships that are active in exploring the healing arts anew. We can expect that a process of research, reflection and review, modification and innovation, and further research will continue to enrich our collective understanding of the untapped potential that music holds for health and healing and will thus give rise to new models of this potential and new ways to more fully embrace it.

Music, Medicine, and Culture

“Music” is as diverse as the number of people who exist. Throughout history, the potential transformational power of music and related practices has been central to cultures across the planet, and music has been far more than a tool for evoking the relaxation response. It has been a context for and vehicle of expressing the most deeply embedded beliefs and aspirations of human life and a way to create or re-create a balanced and healthy state of being within individuals, families, and societies.

A powerful but puzzling dynamic persists between music and healing, the underlying processes of which most often elude practitioner, patient, and skeptical researcher alike. Beyond the multidimensional, evanescent, and ineffable nature of music and sound phenomena, which seem to evade comprehensive measurement, the central reason that the modes of action of musical and related interventions often remain obscure, be they in the context of traditional, ceremonial healing or in clinical research and practice, is that music is a cultural phenomenon with infinitely (p. 13) diverse, power-laden meanings that are present at individual, group, and global levels of culture. Neglecting the cultural components in music and healing research can lead to overgeneralization and the leap from the universal level, or the “universals in music” and sound, which do exist, to the “warm and fuzzy” but false notion that the monolithic “music” is a “universal language” that is uniformly interpreted and understood by all people, all the time, irrespective of cultural context, individual beliefs, or worldview. That is not to say that music or a particular kind of music could not achieve “universal-language” status if a universal meaning were conveyed and understood universally. Indeed, it follows that as the understanding of cultural diversity deepens in the minds of people, and as a global culture further develops, music that is expressive of these social dynamics will have a more global and eventually universal meaning. Moreover, notwithstanding the primacy of culture in understanding musical meaning, there are vast and profound universal underpinnings in much of the world's music that are linked to our common human heritage on this planet (see the chapter by Locke and Koen in this volume). Furthermore, we recognize the culture-transcendent, perhaps universal sonic and vibratory dimensions of music, which, most notably in the ancient cultures of China, Greece, the Middle East, Tibet, and India, are believed to have efficacy in health and healing.

Just as music is culturally contextualized and its meaning far from uniform, so too are “medicine” and “medical,” a key point that medical anthropology has expounded for academia. Within a multiplicity of understandings among traditional, biomedical, and ICAM practices, they also share a common goal—to create health and healing. From this perspective, medical ethnomusicology emphasizes this commonality by drawing on the core meaning of the term “medical,” which is to heal, to cure, to make whole. The new discipline, like the broader ICAM movement, is also primarily focused on and has an orientation toward health and healing, prevention and cure, rather than illness and disease. To approach a deeper understanding of music's potential power to promote health or healing within diverse cultural and clinical contexts, multiple ontologies, epistemologies, and methodologies must be considered. A current challenge in health science research concerned with music's role in healing is to gain an in-depth understanding of music's cultural meaning and its often-inseparable connection to religious/spiritual beliefs and practices and to social and ecological structures, as well as its physical components and forms, and then to understand how these factors can effect both positive and negative changes in individuals and groups. Simultaneously, a challenge in music research concerned with health and healing is to approach the subject from a holistic perspective that embraces multiple etiologies and beliefs about health and healing—including those of local participants, practitioners, the researcher, biomedical science, and complementary and alternative medicine.

Culture is a double-edged sword—at once a great illuminator of universal principles and processes that undergird diverse practices of music and healing, as well as a veil to them. Hence, although cultural factors are emphasized here, it is only because they have been largely ignored in research. What is needed is a balanced integration of knowledge, not a tipping of the scales to an extreme where culture and (p. 14) tradition rule at the expense of rigorous inquiry, or where a desire to be “objective” subjugates critical thinking to a narrow gaze that has lost its spirit of creativity, innovation, and sense of awe, wonder, and the potential that surrounds and permeates all life.

The convergence of academic and public interest around music, spirituality, culture, health, and healing comes at a time in human history when the forces that propel the dynamic and interwoven processes of integration and disintegration have reached an extreme level. On the one hand, there are myriad discoveries and developments in virtually every domain of human experience that integrate knowledge, people, systems, and cultural diversity to the benefit of many—enabling a quality of life previously unimaginable and promoting health and healing in the biological, psychological, social, emotional, and spiritual domains of life. On the other hand, destructive practices and fanatical ideologies, with their corollary symptoms, diseases, and ill effects, pervade the daily lives of the vast majority of humanity. It is at the intersection of these processes that the authors of this volume aim to stimulate further research and promote the holistic paradigm that links their multiple disciplines to each other and offers a fresh potential to sustain health and create healing throughout all dimensions of life, from the individual to the global level.

Concluding Thoughts

This volume adds to the growing realization that there are multiple ways not only of understanding the intersections between music, medicine, and culture but also of understanding what music and medicine are, what they are not, and how musical meaning and power can effect health and healing in varying degrees from person to person, from remedy to remedy, and from performance to performance.

As we become increasingly aware and comfortable approaching questions that are focused on the performance of healing and the culture of health, new questions emerge that demand new foci on the meanings of music, ritual, belief, religion, and spirituality to individuals and communities. In addition, as we embrace the need to traverse the walls that are typically built to define and prescribe disciplinary borders that encircle music, medicine, health care, and religion, we also are more frequently challenged to demonstrate meaningful engagement with the multivalent issues of health and healing presented to us by the individuals and communities with whom we are privileged to work. In many, if not all, countries, cultures, and communities, the reality of multiple engagements of music and health within a plurality of social contexts is fully present. For many individuals and communities documented in this volume, distinct manifestations of medicine, healing, and health care are coupled with musical performances and spirituality in order to inform and (p. 15) transform individual and collective worldviews, and this emerges nowhere more clearly than within prayer, dance, and song.

Moving beyond mere invocation of medical ethnomusicology must, however, take into account cultural understandings and interpretations of disease and illness and health and healing while focusing on the performative nature of diagnosis, treatment, and healing. This engagement can lead us to much deeper understandings of how disease, loss, grief, pain, and suffering are made meaningful, and how health and healing can be created and maintained. If the impact of the inaugural conference on medical ethnomusicology held at Florida State University in 2004, the subsequent Flute Summit for Health and Healing in 2006, and the resultant projects and collaborations are any indication, there is tremendous interest in a disciplinary approach that we have begun to introduce here. Despite this rapid growth of interest, there is not—nor could there be—a unified theory for medical ethnomusicology at this time, except at the broadest level that we have indicated in our central themes. What the contributors to this volume of essays all suspect will begin to emerge from forums and panels that focus on the performance of health care and healing in cultural and clinical contexts will be ongoing conversations and ongoing engagement of the integration necessary for an appropriate subject of inquiry to be constituted and grounded in collaborative studies between music and medicine, whether in the field, lab, clinic, home, or hospital. Indeed, any place where someone is moving toward health or healing, illness or disease, life or death, our growing cooperative endeavors to serve the needs of the moment point out a new level of engagement across disciplines that bodes well for future research and practice.

Early contributions to the creation of medical ethnomusicology as an academic discipline (see Roseman 2005; Koen 2005, 2006, in press; and Barz 2006) attest to the formative and even experimental methodologies that show a spirit of intellectual courage that is often at the heart of emerging disciplines. That most medical ethnomusicological studies have heretofore valued collaborative field-based research reflects the potential for emergent studies not only to be rooted in the interdiscipline but, perhaps more important, to be of value to the interdiscipline. In order to approach music's contributions to what anthropologist and physician Arthur Kleinman refers to as a “sacred clinical reality” (1980, 241) within a “culture-biology dialectic” (1988, 48) from a perspective that is inherently performative, preventive, curative, and grounded in science, religion, and the arts, this volume yields a plurality of disciplinary voices and a diversity of academic analytical techniques in order to value the emergence within ethnomusicological, biomedical, and ICAM studies of new and unique responses. Within these diverse methodological approaches, however, there are rich data and illuminating ethnographic research that, when combined, demonstrate the need for continued rigorous scientific experimentation and creative, open-minded reflection and discourse. The strength of medical ethnomusicology will surely lie in its imaginative responses to health, hope, and healing through the arts.

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Notes:

(1.) “Western” here refers to the ethnocentric worldview that emerged from the dominant cultures and institutions established in Europe and the United States, not Native American cultures, which also fall within the “Western” geographic area, but which most often go unmentioned when the term “Western” is invoked.

(2.) In addition, a few other scholars should be mentioned here. The first is Margarita Mazo's pioneering work to establish the first program in cognitive ethnomusicology, which nurtured initial developments in formalizing medical ethnomusicology. Further, Mazo's ongoing research that interrelates domains of music, brain function, culture, and emotion has opened new methodologies that integrate the rigors of cognitive science with the rigors of ethnomusicology. Equally important is an electrocardiogram (ECG) experiment that Mazo carried out in 1975 in a remote village of Vologda Province in northern European Russia. This study explored the physiological effect of listening to Russian lament. Preliminary results were telling, but unfortunately, government authorities confiscated her research when she left the Soviet Union in 1979, and it has remained unpublished. Judith Becker's Deep Listeners has provided one approach where the neural architecture of the brain can be more easily linked not only to trance states but also to correlates in bodily, emotional, and spiritual states, all of which can play key roles in health and healing. Kay Kaufman-Shelemay's recent work exploring the transformations of pain within and across domains of biology and culture is opening new connections across disciplines and within ethnomusicology.