By Dr. Jennifer Jo Brout
Reprinted with modification from Misophonia International Magazine
Dr. Jennifer Jo Brout (Jennifer): Dori, would you tell us about music therapy in general? What is it?
Dr. Dorita Berger (Dori): Music Therapy can be better described by saying music-based treatment, because it is a treatment in which various elements of music are applied to address human health issues. Music, as many know, contains six elements, including rhythm, tonality (melody), timbre, harmony, dynamics, and form, and variations thereof. Any one or more of these can be directed toward treatment interventions to address a variety of health needs. Music-based treatments are applied to a variety of diagnoses, including ASD, Sensorimotor issues, Parkinson’s, ADHD, Alzheimer’s and various dementias, PTSD, Strokes, COMA and other conditions involving consciousness, pain management, cardiac problems, and so much more.
Jennifer: Many people confuse music therapy with “just listening to music”. Would you tell us about the difference and the overlaps?
Dori: Music-based treatment, aka music therapy, is a clinical intervention provided by a specially trained and credentialed (Board Certified, Licensed, etc.) clinician. There is a difference between music as “therapeutic”, and music therapy.
Jennifer: So, how would you describe “just listening to music”?
Dori: Music can be “therapeutic” when listened to recreationally. Listening to music may induce mood changes, memories, relaxation, release stress, help concentration and task attention, and more. But that is not “treatment” – it is like a self-medicated treatment, and yes, it’s good, but it is “in the moment.”
Jennifer: Then, how would you describe Music-based treatment?
Dori: Music-based treatment has goals and objectives for changes and functional adaptations related to an individual’s current situation to enhance better coping and responses to problems.
Jennifer: How does Music-based treatment work, then?
Dori: A music-based clinician can help you mediate fight/flight with music. Anxious people, and people with misophonia, both tend to have higher arousal systems, involving fight/flight. When a person is in fight/flight the HPA Axis (Hypothalamic-Pituitary-Adrenal) shoots catecholamine in the blood stream (cortisone, adrenalin, etc.), and other hormonal and physiological processes occur. It is generally unhealthy for the body to be frequently and excessively activated like this.
Jennifer: Oh, so you are saying that music-based treatment can affect changes in the neurological/physiological system?
Dori: Yes. Sensorimotor and Neurologic Music Therapy treats all sorts of issues in persons of all ages. In essence, ‘just listening’ does not require a music-based clinician, but music-based treatment does, because it is interactive. I approach from a physiologic perspective, with the belief that even “psychology” is physiology!
Jennifer: I am so glad to hear you say that!
Dori: I think there are several ways music-based treatment can approach interventions for people with misophonia. As we’ve talked about, we can work on utilizing music as a means of down-regulating or “calming the system”.
Jennifer: I’m remembering an article from years ago…it was an academic article entitled “What Gives You Chills” or something like that. The main point was that while there are some universal elements that apply to what make music calming and/or up-regulating, personal choice is really where one needs to begin.
Dori: Absolutely. And once, we begin working with music a person likes, we can deconstruct the elements of that music that he or she likes. Remember before I was talking about the different elements of music; rhythm, tonality (melody), timbre, harmony, dynamics, and form…
Jennifer: … and you have done so much work in this regard for people with SPD, and Autistic Spectrum Disorder etc., individuals who of course are often auditory over-responsive (which is similar to or may be a variant of misophonia).
Dori: I know music therapy can address these issues, along with movement activities. For example, I have a friend with ASD (“Asperger’s) who has a terrible, terrible stutter. He told me that when he speaks in person to someone, the visual movements he sees of the other person causes him to stutter very badly. However, when he speaks on the phone to the person, he’s better with language flow! So I suggested that he practice talking to his image in his mirror, and this changed the visual distraction. In music-based treatment, I would have us play fun instruments in front of a mirror, sing in front of the mirror, move our bodies, while singing before a mirror, and more.
Jennifer: That is really interesting Dori and this is really something that should be researched further! I have a question about art therapy. How is it different from music therapy? Do music and art therapists have different training?
Dori: I am not really qualified to talk about training of art therapists, except to note that art therapy is more a psychologically-based treatment – express your feelings through color, design, etc. Music expression does that also, but with the clinician who also participates with the client in music making.
Jennifer: I know that you also research in the field and write books. Would you tell us about that?
Dori: My books and research involve behavior characteristics of particular neurologic and sensorimotor difficulties. I have four published books. See Ms. Berger’s bio below for information on her books.
Jennifer: That’s amazing Dori. I don’t know how you find the time to write all of these books! I want to thank you very much Dori. Please feel free to add any comments you would like.
Dori: Thank you for your interest in my work, my background, and me. So much is taken for granted, for lack of awareness, so I thank you for the work you are doing to bring about awareness of misophonia, which I think everyone experiences, at one time or another!
Jennifer: Dori, thank you so much for your time and for all of the great work that you do!
ABOUT OUR INTERVIEW SUBJECT:
DORITA BERGER, PHD, MT-BC, LCAT, has more than 20 years of experience as a Sensorimotor Music Therapist specializing in treating auditory and allied sensory factors in Autism Spectrum and related neurophysiologic diagnoses in all age groups. Dr. Berger has several published books lauded internationally, and peer- reviewed Journal articles and research on the role of music in human adaptation.
Dr. Berger received a Fulbright Visiting Professorship to teach Music Therapy in the Ukraine, a Global Education Grant to teach and lecture in Argentina (where she was born), and in Italy, and is sought nationally and internationally to lecture and teach about the role of music-based treatment in sensory processing and behavioral disorders. Dr. Berger’s authored books include “The Music Effect: Music Physiology and Clinical Applications” (2006) co-authored with Virginia Tech’s Professor Emeritus, Dr. Daniel J. Schneck; “Music Therapy, Sensory Integration and The Autistic Child”, (2002), which has also been issued in the Korean Language (2012), and has been designated as one of the year’s best academic books by the National Academy of Sciences in Korea (2013); and “Toward The Zen Of Performance: Music Improvisation Therapy For Developing Self-Confidence In The Performer”: (1999). Dr. Berger’s 4th book, Eurhythmics for Autism and Other Neurophysiologic Diagnoses: A Sensorimotor Music-Based Treatment Approach was released in 2015. In addition to teaching and lecturing, Dr. Berger, formerly from Norwalk, CT, is Clinical Director at Rhythm and Rehab Music Therapy Clinical Services in Durham, North Carolina.
This piece was originally published in Misophonia International Magazine. Reprinted with the author’s kind permission.
Dr. Jennifer Jo Brout is a New York State Certified School Psychologist, a Connecticut Professional Licensed Counselor, and she also holds a Doctorate in School/Clinical-Child Psychology. She graduated from New York University, Columbia University, and Ferkauf School of Psychology (at Albert Einstein School of Medicine) respectively. She is also the mother of adult triplets, and is a Misophonia sufferer herself.
Disappointed by her own experiences with the state of the field when seeking help for her own child in 1999, Dr. Brout began efforts to establish better research practice, improved diagnosis, and innovative clinical practice related to Misophonia (under the name “auditory over-resposivity).
Dr. Brout has been at the forefront of research in this area for over 18 years, having established the Sensation and Emotion Network (SENetwork) in 2007, along with Sensory Processing and Emotion Regulation Program at Duke University in 2008. She has also worked Dr. Lucy Miller at the Sensory Processing Disorder Foundation since 1999 and is a member of their scientific work-group (and a recipient of their Advocacy Award). Dr. Brout continues to bring together multi-disciplinary teams of highly esteemed academic researchers and clinicians in order to share resources, eventually culminating in research papers, academic conferences, and evidence-based translational treatment.
She established the IMRN in order to lead the way toward a new paradigm of research that bypasses lack of governmental funding and paves the way toward better relationships between Misophonia sufferers and those who research and treat them. She is also proud to be the SPD and Misophonia Advocate for the Advocacy Organization A2A, Adversity to Advocacy.