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Interview with Dr. med Ralph Spintge  [copyright free press release ]Source: Energon
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Music - a substantial real help themselves

Interview with the anesthetists, pain specialists and professor of music medicine i Hamburg, Dr. med. Ralph Spintge, (chairman of the "International Society for Music in Medicine", ISMM) about Music Medicine (answers as audio recording in MP3).

Q .: Dr. Ralph Spintge, you coined the term music medicine - what does this term mean?

A .: This term refers to the use of music in medical applications.

Q .: In parallel to traditional orthodox medical applications?

A .: That's right, as an adjuvant or as a complementary method.

Q .: How did this kind of therapeutic and supplementary treatment?

A .: We have been thinking more than twenty years ago, how we could better meet the emotional and psychological needs of our patients. I'm actually from the Anaesthesiology - so I'm anesthetist by training - and for each patient means an anesthetic, a very stressful rich experience that is associated with many fears and much pain.

Here one usually uses psychotropic drugs to dampen these fears. However, these drugs have only an insufficient effect and of course they also have side effects - like any other drug. So we have very soon tried here to help with music and that is successfully possible.

Q .: How experienced since the patient's Helping?

A .: For the patient is the music, according to the information that we ask of our patients first and foremost a psychological prop, a distraction, a chance to go in a different situation.

Teenage Techno desire for anesthesia, put yourself inside then in the situation in the disco. For the elderly, it is often simply the enjoyment of the music, so to hear a beautiful piece of classical music. For men also marching music is in demand, as a kind of internal support.

This applies to acute stress and pain situations. In the area of chronic pain, where I am mainly active today, we have to use other music and are the subjective effects to the patient other.

Q .: Are the subjective perceived aspects with the parameters objectively measurable identical?

A .: Yes. As anesthetists, we always all vital as heart function, breathing, etc. need to measure, we have also measured, what changed the music, if we give the patient and have then compared with the patients who did not receive music.

As we can see that the distribution of pain and stress hormones is reduced by music in his blood, for example, that one can induce a sleep state near the brain wave image by einspielt music for anesthetic preparation. Or that you can save as tranquilizers and painkillers in the field of pain management. So we can write a whole series of objectively measurable parameters of music benefit.

Q .: If you are talking about can save resources, then the need to be very significant effects that are attributable to the music here yes.

A .: Yes, indeed. It is as such that I as part of pain management in acute herniated discs must administer injections in the vicinity of the spinal cord in order to reduce such a herniated disc.

This procedure itself is relatively unpleasant. One can the patient to prepare or facilitate giving a sedative - or you can give him music. We have now compared. We have groups of patients with the sedative-care compared with those who were given the music and have been able to conclude that both the subjective perception as well as in the parameters objectively measurable music patients were much better off.

Today it is so that I usually only insets music for this type of procedure and no more sedative!

Q .: That is, you "treat" with music while saving on drugs?

A .: That's right. We save at least as much - to go back to the anesthesia field - that we could earn back within four years the investments that we had to use in order to operate such a thing as a music system can.

Q .: Have you had regular clinical trials?

A .: Yes. To ensure a standard that entsprich normal medical research t , we have carried out such studies, above all, as a medical theses, as music therapy diploma and as a music education diploma theses. And under this theses the mentioned parameters such as stress hormone levels and drug consumption have been measured.

Q .: Have already treated people who have experienced the same treatment with and without musical Help?

A .: Yes, especially the older generation, of course. Although the use of music in medicine is very old , it is routinely available only in very few places. And thus there are many patients who have had elsewhere treatment without music and then come to us and with music the whole thing again have now have to go through.

In our post-anesthesia questionnaire or post-treatment questionnaire that we give each patient, we also ask from: Would you because again want music next time, compared to the previous interventions? 95 percent of patients tick here Yes.

Q .: Why then say the patients if they have experienced such an intervention with music?

A .: The patients' responses are very different on one side and very similar on the other side. Very similar in the relationship that one can say that it is almost always a help. There are very few patients, such as the 2 percent who say "I would have rather taken my autogenous training" or "I would rather have prayed." The rest, by far the great majority says, "it was a help."

Q .: Is it for you as a doctor, as an agent to the patient, the music also support? You've got to do now is because with completely new devices that patients wear headphones etc.

A .: It is in any case not only for the doctor, but also for the nursing staff a clear relief. I can perhaps best illustrated by the example of gynecology. The delivery room is the area in which the midwife performs the regiment.

We made here a study with 200 women giving birth, and compared with a group receiving no music. In the beginning we had huge problems to overcome the skepticism of midwives. One of the reasons for this skepticism was, "it's extra effort for me, additional technique," etc. That is, when the study was nearing the end, turned into the exact opposite, and today the music is there no longer indispensable!

Why? Because the midwives have noted that the whole process was much more harmonious, that they were much less created. The woman is indeed now a few hours in the delivery room, and we can not always give each woman giving birth a midwife to the side. This frequency ringing decreases so markedly reduced, which is of course a pleasant side effect.

For me as a doctor, it's just nice to see that you can overcome the psychological distress of fear and pain-ridden patients and on the other side, that you can reach as a better organization, a harmonious flow in daily work happening.

F .: Music and pain - what relationship is there?

A .: Well, in pain, so for chronic pain, one is always several different methods simultaneously to move to the holistic problem of pain to the body can. For man has not just physically felt pain, he also has emotional suffering , Think. Migraines example, which can indeed push people downright insane Music has long been an integral part of our treatment regime - even indispensable!

Q .: pain can indeed make very sensitive. Is music there not something as an additional noise maybe even bother?

A .: That's right, it depends on what kind of music you are running. They must be selected according to the application situation and according to the relevant group of people. I sit in the field of pain therapy completely different structured music one when I insets for Anaesthetic preparation and monitoring, for example.

An example is the rhythm. If I have an acute stress load, an acute-stricken fear or pain patients, I have to offer him percussive and structured music. While - if I have a pain patient suffering chronic pain, then this is any more solid structure, like a musical rhythm, an additional spine in his prison. So the music must be rhythmically unstructured as possible, or you must offer a distinct change between rhythmic structure and free sounds.

Q .: If you would now produce your dream music for patients with chronic pain from your experience, how would that look?

A .: The music would be organized quite differently. They would have a top part, which I in the situation in which he finds himself psychologically, fetch the people. In other words, they would have to take into account the very high stress and pain to the patient, the tension state, the state of helplessness and helplessness. While I initially with a kind of aha pick him up there musically.

Then the music would have this condition down into the state - say - balance and Aufgeheitertsein. But since it can not stand still. For man is supposed to then be able to include as his normal daily life again.

The music has to build him up inside again. You must activate that it can satisfy the daily needs, eg at work again him extent. That is, first get out of a negative emotional state of stress, leading into a relaxation and rebuild toward positive emotions and motivation of.

Q .: Does this mean that the analgesic effect on the moment of hearing this music also acts?

A .: Yes, we also can measure such things. We have in some of our studies, after we had finished the music, simply continue to run our measurements. Stress hormone levels in the blood, blood pressure, heart rate, and the like and have been able to find that up to one hour after the end of the musical performance stopped these positive effects.

We unfortunately have to cancel these measurements for technical reasons, but there is certainly also observations that speak of effects for days.

Q .: Does the music be very long in order to have such an after-effect?

A .: No, it must not be very long, which is of course a relative term. It has a length of 8 to 14 minutes proved to be optimal.

Q .: Does this mean that if a plagued by chronic pain patient several times a day this kind of music for about 10 minutes sounds that he can expect a really significant relief?

A .: Yes, and that is also observed in our daily work. Since we our patients constantly offer music, there are also many, many patients who ask "can I also purchase this tape or this CD somewhere or where can I order me?". Then we say, of course, "you go to the bookstores or go to a particular business because gibt`s such music ".

Although one must however say that although but a help are not optimal for many patients, because the structural features that I have shown earlier, are hardly met by the existing music. We then made it so that we technically speaking, to mix different music and "add" to have the proper effect. The so far but commercially not get.

Q .: Is it to support this effect, a certain "ritualized hearing" necessary?

A .: You should create a particular situation. Where this is not to be misunderstood. This does not mean that one has to set up a small cave at home with a sofa, soft lighting and a music system. This may also mean that the workplace at lunchtime if you want to break up the painful muscle tension in the shoulders at his computer station again that his music is carried out also in this situation daily to heart as.

Q .: Can heal music?

A .: No. Music is certainly not a cure! Music is only a supportive measure to other therapeutic measures or to measures of self-help. Everyone knows that sport as healthy, physical exercise and activities are healthy at all times to treat yourself to something nice, like going to concerts and such things - we know so that we all know - only who is doing it? And who can in today's hectic? In this sense can be a real help to this music.

Q .: So Walkmann take pill?

A .: With restrictions - yes. Perhaps, rather, Walkman and pill!

Q .: What is your forecast for the future in terms of music and healthy being, music and its healing effect?

A .: I see her from a very specific point of view. We will have to take a variety of reasons more responsibility for our own health. Once out of cost considerations. Due to the age development in society, we simply can no longer buy our health insurance contributions also our health.

This setting come so today many people go to the doctor. So we will have to do more to help themselves. Here music is to our knowledge and our experience can be a real help substantially. Although one can also imagine that you are not only remains in the music, but that it also connects with visual stimuli. Keywords Multimedia, here is indeed open up completely new technical possibilities.

The man is not only an auditory nature, it is also a visual nature, he feels he tastes, he smells. And since modern life but badly strained the various senses - Keyword noise pollution, odor nuisance in the workplace, traffic and all these things - one can easily imagine that one could create a multimedia aid for humans.

Q .: There is often the spontaneous reaction, that's all esoteric, that's all nonsense.

A .: Well, if you look at what is offered in the market of music with a - i will start to formulate carefully - certain therapeutic claim, then you will find these things in most cases actually in the esoteric corner bookstore or respective publishers.

Disadvantage of this offer is just that it has not been verified to my knowledge, from a medical and medical point of view on its effectiveness. And any doctor who would as such a piece recommend music, would have never questioned whether his patients really brings the benefits that he suspects. That is, when I use a music as a support for other medical procedures, I must have checked whether they ever desired effects and what side effects it may have.

I want just one point: There are in the world literature more than 70 documented cases of - as we say - musikogener epilepsy, ie triggered Musikanhören seizures. Everyone can imagine that a patient for a heart attack by marching music for example can not be absolutely positive support. And so there is just a lot of things that need to be respected there.

Q .: Is there anything else you want to say by itself like?

A .: I would like to express one wish, which, above all, aimed at my colleagues: to use the now accumulated experience and knowledge about the essence of music in healthcare in the broadest sense yet.