Music therapy for states of restlessness

Viola Heckel

Last update: 01.05.2023

Restlessness can be quieted through the experience of stillness, especially a fulfilled stillness – as we encounter it impressively in music – and lead to calm. The violinist Yehudi Menuhin speaks of silent stillness: “Out of silence arises everything that lives and lasts. [...] [It] connects us with the universe [...], it is the root of our own existence and thus the equilibrium in our own life.” (1) These words refer to the spiritual home of music.

The feeling of restlessness is accompanied by a partial loss of the connection with the spiritual world by which the person previously knew themselves to be supported. Music as a threshold art can provide comfort and security here. If music therapy succeeds in creating moments of inner calm, this helps the palliative patient to connect with the spiritual world and draw inner strength from it. In this way, they face the uncertainties of the future with greater equanimity and confidence.

Listening for the coming sound and/or allowing something already heard to linger are important mediators.

Patients often speak of an inner oscillation and vibration during their music therapy experiences. Their descriptions range from the physical level, e.g. a sensation of warmth as a resonance of playing the instrument directly against their body, to descriptions such as “my soul has wings again” and “my spirit is refreshed”. Or quite fundamentally after singing together with the sound of the lyre: “I feel the tones and sounds flowing through and invigorating the whole of me.”

Therapeutic recommendations

Restlessness in association with exhaustion and insomnia

Experiences raised through music therapy support patients in the alternation between connecting more strongly with their bodies and disengaging again. We can then observe how they relax or even fall asleep during the music therapy and then open their eyes with a clarified look or wake up refreshed.

  • In cases of severe exhaustion, a receptive approach is indicated initially: with lyre play and singing to the patient, as well as resonance experiences with the Tao lyre or the tenor chrotta, which are usually played by the therapist on the feet.
  • If possible, own activity with singing as well as playing the bordun lyre or kantele should be added. In doing so, the rhythmical musical processes should be heeded, such as the alternation of sounding and fading away and, when playing the instrument, a movement guided by musical breathing.

Restlessness after chemotherapy

Some patients describe an inner restlessness after chemotherapy in terms of feeling lost. They no longer feel inwardly centred. Music helps them to regain an inner orientation between the surrounding forces and the forces of the centre and to make contact with their spiritual home.

  • Receptive music therapy with music played to the patient and listening therapies with alto lyre as well as lyre and singing.

Alternatively, we know the picture of a state of frozen calm in which the patients appear calm on the outside but inwardly an anxiety-filled soul without peace of mind is revealed.

  • A therapeutic approach is helpful which encourages inner movement, gently leads the emotional constriction to widen or enables it to oscillate back and forth, e.g. listening to the kantele all around and, if possible, also the patient playing it themselves. In a similar way, the interplay of the forces of the centre and the surroundings can be stimulated with bright, long resonating tones of the cymbal.

Restlessness of patients and relatives due to diagnosis shock

In some cases it is helpful if relatives are present during music therapy. The creation of calm in everyone is then transferred to the patient (2).

  • Music with the alto lyre is suitable for playing to patients and relatives, rather open in style and not too emotionally coloured. The aim is to create a peaceful atmosphere that leads to the creation of calm.

If the restlessness is due to a moment of inner crisis, e.g. the experience that things as they have been no longer provide support, a music therapy approach that strengthens self-confidence is indicated as a priority.

  • Singing together or singing to the patient: A song that has meaning for the patient to give direction to the soul.
  • Enabling moments of self-activity: Strumming the strings of the lyre or kantele can be important. Equally, it is important to perceive and respect the individual patient situation if listening is preferred at that particular moment.

It is very helpful for patients to experience something in music which occupies them emotionally and spiritually. An example: one patient experienced inner calm after she was able to perceive the movement between high and low tones while singing a melody in music therapy. This clarifying experience for her also gave her the inner strength to raise herself up. 

Research news

Phase IV trial: Kalium phosphoricum comp. versus placebo in irritability and nervousness 
In a new clinical study, Kalium phosphoricum comp. (KPC) versus placebo was tested in 77 patients per group. In a post-hoc analysis of intra-individual differences after 6 weeks treatment, a significant advantage of KPC vs. placebo was shown for characteristic symptoms of nervous exhaustion and nervousness (p = 0.020, p = 0.045 respectively). In both groups six adverse events (AE) were assessed as causally related to treatment (severity mild or moderate). No AE resulted in discontinuation in treatment. KPC could therefore be a beneficial treatment option for symptomatic relief of neurasthenia. The study has been published open access in Current Medical Research and Opinion

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