Pain – whether it’s barely noticeable or completely debilitating it’s something that we have all experienced in our lives.
There are many different approaches to dealing with pain. Music therapy may be used in helping clients with chronic, acute, or even procedural pain. Music may also help to reduce the amount of medications taken to decrease pain (Lee, 2016).
There are several reasons why music therapy can be so effective in pain reduction. Gate control theory of pain has been central to pain reduction in music therapy. It states, pain experiences are not linear but impulses must pass through a gate in order to reach higher processing and be perceived as pain. Several factors such as cognitive state, emotions, and past experiences can influence the gate and subsequently, the pain we feel (Campbell et al., 2020). Therefore, because multiple factors may affect this gate, we may be able to affect pain perception by modifying any of these factors. For example, the amount of anxiety we experience can affect the amount of pain we feel. If we are able to reduce the amount of anxiety in turn we may be able to decrease the level of pain perceived.
Distraction is also powerful in pain relief as the brain can only process so much information at one time and give it full attention (McCaul & Malott, 1984). If we are experiencing pain and we are also actively listening to music our brains cannot fully process the negative stimulus and we feel less pain. Preferred music can be such a powerful distraction and affect pain perception because it can grab our attention and can connect us to positive emotions and memories (Ziemba, 2014, p.19).
However, is feeling our pain important or is it best to distract ourselves? Do we miss something when we try to remove all pain in our lives? Might we be able to deal with pain more effectively by moving through it rather than distracting ourselves until it goes away? While we could get into a philosophical debate on whether or not experiencing pain allows us to also experience joy, let us examine what research has been done on the topic.
Mindfulness practice deals with feeling pain and allowing our focusing to rest there.
As defined by Jon Kabbat-Zinn, mindfulness is the, “awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally” (Kabat-Zinn, 1990, xxxvii). Although it’s been practiced in Asia for thousands of years, mindfulness was introduced in the west in 1979 when Jon Kabbat-Zin began his Mindfulness Based Stress Reduction program for people experiencing chronic pain at the University of Massachusetts Medical School. Within mindfulness practice, all sensations are recognized, including pain, without judgment, in that moment.
One study found that a mindfulness program helped individuals experience benefits related to pain, sleep, and mental health. Individuals reported that not only did their overall pain decrease but how much the pain bothered them decreased as well and that they were able to have more distance from the pain by viewing it without judgment. (Brintz et al., 2020). A meta-analysis found that, “Mindfulness meditation was associated with statistically significant improvement in depression, physical health-related quality of life, and mental health-related quality of life.” (Hilton et al., 2017).
As the pain-reducing effects of mindfulness and music therapy have become more widely known, we are now starting to see research on combining the two for effective therapy. One study found that combining mindfulness and music therapy interventions helped patients with osteosarcoma by reducing their anxiety, pain, and sleep disorders (Lui et al., 2019).
So which approach is best – distraction or focus without judgment?
As a music therapist, I have personally used music as a distraction for clients during procedures. I have also combined music with mindfulness as a way to acknowledge and move through extreme discomfort in a client experiencing postoperative pain. Perhaps it is not about which method is better but widening our view to include more options. At times, different approaches may be more or less effective due to a variety of factors and knowing our clients’ needs and capacity is key. When there is more than one way of reducing pain, we now have a choice which is a powerful thing.
– Rebecca Woodruff, MTA
Brintz, C.E., Roth, I., Faurot, K., Rao, S., & Gayloyd, S.A. (2020). Feasibility and Acceptability of an Abbreviated, Four-Week Mindfulness Program for Chronic Pain Management. Pain Medicine, 21(11), 2799–2810. https://doi.org/10.1093/pm/pnaa208
Campbell, T.S., Johnson, J.A., Zernicke, K.A. (2020). Gate Control Theory of Pain. In: Gellman, M.D. (eds) Encyclopedia of Behavioral Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-39903-0_1134
Hilton, L., Hempel, S., Ewing, B.A., Apaydin, E., Xenakis, L., Newberry, S., Colaiaco, B., Ruelaz Maher, A., Shanman, R.A., Sorbero, M.E., & Maglione, M.A. (2017). Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis. Annals of Behavioral Medicine, 51(2), 199–213. https://doi.org/10.1007/s12160-016-9844-2
Kabat-Zinn, J. (1990). Full Catastrophe Living, Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Bantam Books.
Lee, J. H. (2016). The effects of music on pain: A meta-analysis. Journal of Music Therapy, 53(4), 430-477.
Liu, H., Gao, X., & Hou, Y.. (2019). Effects of mindfulness-based stress reduction combined with music therapy on pain, anxiety, and sleep quality in patients with osteosarcoma. Brazilian Journal of Psychiatry, 41(Braz. J. Psychiatry, 2019 41(6)), 540–545. https://doi.org/10.1590/1516-4446-2018-0346
McCaul, K. D., & Malott, J. M. (1984). Distraction and coping with pain. Psychological Bulletin, 95(3), 516–533. https://doi.org/10.1037/0033-2909.95.3.516
Ziemba, Amanda Lynn, “The Efficacy of Music as a Non-Analgesic Method of Reducing Pain Perception during Cold Pressor Trials” (2014). Master’s Theses. Paper 553.