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Timeline: Music And Pain

U.S. Public Domain
This is an archival photograph of YMCA entertainers performing for 89th division troops during World War I. Paula Lind Ayers "song-physician" was one of these entertainers.

The ancient King of Israel, Saul, was said to have suffered from intense insomnia and a troubled mind. He employed a young musician named David, to play the lyre and help him find peace, rest and sleep. The story of David and Saul demonstrates that we’ve always understood the healing qualities of music; it’s ability to alleviate pain and ease the mind. However, it’s only been in the past few decades that we’ve truly begun to study music’s true palliative power.


During World War I many of those who fought seemed to suffer from a mysterious post-combat illness. The soldiers reported amnesia, dizziness, tremors, headaches, tinnitus and attention deficits; basically all the signs of a brain injury without any of the physical markers. Physicians used the term “shell shock” to describe what these patients had in common. There was no physical treatment for what was considered to be a psychological issue. So, enter the singer, actor Paula Lind Ayers. In 1919, she was hailed the “girl who sings away shell shock.”

Paula was a YMCA Entertainer, a type of early USO that performed in hospitals and convalescent camps overseas during the war. She stumbled into a “career as a song-physician,” singing to shell shocked soldiers and easing their tension. She would begin with simple lullabies and gentle songs and then gradually transition to something more rousing and spirited. In an interview she stated,

"I watch for signs of improvement, and when it seems wise, go on to other songs. And soon most of the boys are singing with me."

Paula Ayers is perfectly describing the methodology used in modern musical therapy.

Professor Suzaane Hanser at the Berklee College of Music is a board certified music therapist. Suzanne writes that music therapy protocol is designed to perform several functions; to distract the listener from pain or anxiety and comfort them with familiar music while providing a basis for rhythmic breathing and the systematic release of body tension. The goal is to have the patient rely less on medication and to improve respiration, blood pressure and heart rate through musical practice.

How is this possible? How and why does it work? In 1965 Ronald Melzack and Patrick Wall published an article called “Pain Mechanisms: A New Theory” in Science Magazine. They suggested “the gate control theory of pain.” It’s evident that how we feel, our expectations, our emotions somehow effect our perception of pain. If we expect something to hurt, it usually does. If we’re upset it hurts more; if we’re calm it hurts less. This theory suggests that there is a cognitive “gate” that can either allow signals through to the brain or can block them. Helping a patient relax and find a place of calm, distracting them with enjoyable sounds and music can override the pain signals and provide relief.

The problem with a great deal of palliative care is that the implementation of pharmaceuticals and therapy can actually cause pain and anxiety. For example, radiofrequency lesioning is a procedure that uses needles to block nerves and relieve pain. However, the process itself can be very painful and can induce quite a bit of anxiety in the patient. Music Therapy is now being used as a means to make these painful procedures more tolerable and less invasive for the patient.  

There is so much more research to do and so much more to know in this growing field of music therapy, but we want to hear from you. Comment below and share stories from your experience of these healing and calming qualities of music.

Timeline is an exploration into the development of Western music.

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