Title: Musical Bibliotherapy
Motto: A proper life is our greatest and most glorious work of art (Montaigne)
Author: Mező,Tibor, poet, therapy assistant

					SUMMARY

I am trying to find the place of a complex art therapy method within medicine. The name of this therapy is musical bibliotherapy, for which I apply the activity scheme of small groups. This sort of therapy means a natural combination of receptive music therapy and receptive bibliotherapy. In the course of this therapy, inducing reactions in the person who is reading, listening to music or talking takes priority over the piece of art or its analysis. The piece of art is a mere tool in the hand of the patient to get closer to his momentary self. The effectiveness of musical bibliotherapy is based on the association of ideas. It is not only thoughts and ideas that we can associate but pieces of art as well. This can be done on the basis of similar features which usually arise from an analogy of atmosphere. This method is very important in treating mental disorders with the help of sociotherapy. Musical bibliotherapy results in a synthesis in using the left and right cerebral hemispheres and a many-sided development of the personality. It develops the personality through Aesthetic exhilaration and changes the patient’s attitude with the help of the evocative strength of extensive observation.

The PLACE OF MUSICAL BIBLIOTHERAPY IN THE SYSTEM OF HEALING

Complex personality means a combination of the biological, psychic and social state of a human being. If there is a disorder in one of these fields, there are different healing methods at hand that can be classified within pharmaco-, psycho-, or sociotherapy. Musical bibliotherapy is a combined method of art therapy and it cannot be expressly classified in any of the above mentioned fields. The main cause of this lies in the dual nature of this therapy. It stands at the border of culture and medicine in the first place. It uses a social-traditional way of activity that can both be a means of healing, rehabilitation and prevention for patients, and it can serve the cultural needs of healthy people as well. The activity scheme of this therapy is also special as action, reaction and correction take turns in it. Action takes place in the field of sociotherapy as it is necessary to take part in the social-traditional activity, preconceptional reaction and motivation. Reaction consists of intellectual, emotional and empirical (behavioural) mechanisms, which are finally followed by correction in the interpersonal relationship. The personality is so much involved during reaction and correction that we can speak about psychotherapeutic effects. Combined usage of music and literature as therapeutic means at the same session has been mentioned in literature as musical reading (1). This lecture would like to show its details and results. I used musical bibliotherapy as a sociotherapeutic method in medical rehabilitation in Gálfi Béla Medical and Rehabilitation Centre in the Social and Rehabilitation Institute for Addicts in Dolina, between 10 May 2001 and 19 December 2002. I tried to make my patients aware that without proper social skills like talking, behaviour and lifestyle, people would be unable to keep in touch.

THE FEATURES OF THE MUSICAL BIBLIOTHERAPEUTIC GROUP

A system that works has a theory and a practice. Musical bibliotherapy was mainly used in small groups. We had 50 weekly sessions (60 minutes each time) for 19 months. There were altogether 41 participants, some of them only visiting (23 people participated in up to 1-3 sessions). We had 18 regular participants (8 women, 10 men, 20-65 years of age). The average number of participants was 5. 56, the lowest number of participants was 3, the highest 12. Thirteen people participated in more than 8 sessions. The group was an open group of volunteers but it can be worked upon medical indication as well. The group was heterogeneous according to sex, age and diagnosis. No co-therapist was present. We had patients with alcohol-dependence, schizophrenia, personality disorders and epilepsy.

	The group-task had two identical parts of verbal and non-verbal nature. The session started with listening to a piece of music and reading a piece of literature. This was followed by discussing the experiences and ideas that arose while receiving the pieces of art and associating them to the participants’ individual life experience. Thus a natural combination of receptive music therapy and receptive bibliotherapy took place with the therapist having chosen the topic. The choice of topics comprised the system of therapeutic aims as well. 
During the sessions we worked with 36 different topics in the following order:

1.	Affection and love
2.	Understanding and accepting ourselves
3.	Manifestations of humanity
4.	Character and its development
5.	The meaning of life
6.	Irony and humour
7.	Conflict
8.	Sensible behaviour
9.	Poverty and how to overcome it
10.	Conflicts between generations
11.	Affection
12.	„Something crops up”
13.	Who am I? What do I want?
14.	Losing reality
15.	Play
16.	Building personality
17.	Speaking about pain and sorrow
18.	Happiness and suffering
19.	Tradition
20.	Being chased
21.	Love
22.	Career
23.	Domination and power
24.	Desire
25.	Change
26.	Declaration
27.	Minor things
28.	Family and career
29.	Travel
30.	Patience
31.	Conflict with our past
32.	Friendship
33.	Starting point
34.	Orientation
35.	Peripheries
36.	Revolt

The choice of topic for the sessions was linear, because no piece of art that introduced a topic emerged again in the same context. This is the reason why the method is successful in dealing with people who live together. The pieces of music chosen were classical music (30), folk music (5), pop music (3), and music from films (2). The pieces of literature were taken from classical authors (33) and contemporary authors (19). According to genre we had lyrical poetry (40) and prose (14).

The leader of the group has to be familiar with literature and music and he has to be able to make the members of the group accept the pieces of art he likes. This ability is important, otherwise the group might reject the topic (the piece of art). A supportive attitude helps the change of attitude in individuals.

THE WORKING MECHANISM OF MUSICAL BIBLIOTHERAPY

In trying to make you understand how musical therapy works I have three different goals. Firstly, I am trying to find out how musical bibliotherapy is able to affect the thoughts and emotions of the patient, because if it does, there is the hope for changing his behaviour as well. Secondly, I accept the limits of my job competence, and I am going to avoid tending towards physiology or psychotherapy, using only sociotherapy. ,

	The idea that the piece of art heals the patients with mental disorders is incorrect simplification. This idea is supported by the assumption that the piece of art is some material and you can predict the way it will affect the patient’s behaviour. But in reality, musical bibliotherapy consists of three different controlled activities that are in relationship with, and that follow eachother. These activities are reading, listening to music and discussion. While reading and listening to music, the patient follows their own thoughts and emotions that arise in them with attention. Discussion serves the verbalisation of their thoughts and emotions. These can be compared to experiences that come from earlier phases of his life. These thoughts and feelings and the recalled experiences are the innermost features of the personality, the results of its activity, its values, and self-reflections. In the scheme of activity, all these can be seen as reactions. Having chosen the piece of literature/music, the therapist gives his patient a tool to help them get to their momentary self. This means, that during the therapy it is not the piece of art or its analysis that helps, but creating reactions. The main importance is that of the person who reads, listens to music or discusses their experience. This person starts to discover themselves in a spiritual sense, and their fellow group members and the therapist help them in the process (correction). In the healing process the patient acquires skills in understanding arts, understanding himself and observing the world. The components of their personality needed for their resocialisation can be harmoniously co-ordinated and controlled.
	The basic question of musical bibliotherapy is how we can ensure a surge of thoughts and emotions that are easy to design and control in order to reach a better condition of the patient. First of all, we need an organic form of using the two different branches of art, that is music and literature. The solution is space of association of ideas. The link between the two different pieces of art is based on association of ideas. Association is a word of Latin origin, whose root is ‘socius’, meaning ‘companion’. In psychology and literature, an association between ideas happens on the basis of similarity of features and analogies. But association can be made not only between ideas but different pieces of art as well. The pieces of art we want to associate with each other are read and listened to (we hand out copies of the lecture for individual reading or studying). We point out their similarity or difference, and they make us have new associations, ideas and memories. Association has a beginning and an endpoint. We start out from the associating meaning and arrive at the associated meaning. The similarity of the two pieces can be understood from an optional, easily explainable point of view. For example, a poem by Lőrinc Szabó made me think of Béla Bartók’s Three études (Op. 18). These two pieces are quite distant but they can be associated with each other on the basis of the vigour of the language and the liveliness of the music. It is mainly a similarity in mood that makes the harmony of association between acoustic and visual impressions. Besides, there can be a similarity of structure or rhythm, or a common topic that can be described with the help of the means of both music and literature. E.g. music can be composed for the given text, there can be an emotional-spiritual-cultural relationship, etc. (It must be noted, that two abstracts taken from literature can get into an associative relationship as well. Musical bibliotherapy has emerged from thematic associative bibliotherapy).

	Reading and listening to music have a regulating effect anyway. Representing structures that came in to being during the process of creation, the elements of the pieces of art we hear or read serve as examples. Correction is made possible by the therapist’s exact knowledge of the piece of art and the common wisdom of the group. A vast number of associations are possible within the associative space, and the rules of association can be easily recognised as they are universal. 

	Choosing the topic is extremely important within the regulating mechanisms, as this is the way we can approach the aim of the therapy. Topic is the main element of the task set to the group. The topic is chosen according to the group’s needs, the components of the piece of art and the experience of the person who chooses it. When planning a session, we have to consider the following: 1. What is the problem that will help develop the personality of group members (preconceptional reaction), and as such will meet the greatest possible interest? 2. What is the piece of art that contributes the most to the solution of the chosen problem? When we have chosen the topic, we have to motivate the members of the group; the topic must be adjusted to the needs and general condition of the group and the given task. We want to adjust a complicated system, a piece of art, to the psychic-cognitive state of the group so we must propose some aspects for observation. A new topic should be taken to each session in order to keep up the interest of the members, to keep up a high intellectual level and to help interpret our existence in the real world.

	Mental disorders usually do not cease verbal abilities, you can have a talk with most patients, you can impress them with the help of words and sounds, so combined methods are fairly widespread. The study of Dr. Árpád Baráth shows the outlines, measures and main empirical results of a complex experiment in art therapy (music + poetry). (2). The people participating in the experiments were groups of university students. The results verify the starting hypothesis, according to which receiving some aesthetic value intensely for ten minutes is enough and it can be effective enough to cause a significant change of mood in the participants – the author claims.
	
Musical bibliotherapy results in a synthesis in using the left and right cerebral hemispheres and a many-sided development of the personality. It develops the personality through Aesthetic exhilaration and changes the patient’s attitude with the help of the evocative strength of extensive observation. Using music and literature brings the national and international features of culture into therapy as literature is language-bound but music is a universal system of signs. Following music and becoming a reader brings about pedagogical and educational changes in both the individual and the society.

LITERATURE

1.	Pető, Zoltán (editor): Szárnyra kapva (Taking Wing) Szeged, 2002. Creative strength of arts and folk arts in healing pp 11-34.
2.	Baráth, Árpád: A zene és költészet „gyógyító” hatásai („Healing” effects of music and poetry). An outline and results of a complex experiment in art therapy. In Pszichoterápia 1996. May pp 177-182.