This article investigates the rationale and implications for using music therapy with children who have been traumatised by war. An overview of trauma related issues is provided, focusing on the impact of war on children. The article moves from theorising on the relevance of music and music therapy for this population to a discussion of specific music therapy aims. It highlights the unique and valuable role of music therapy in helping to address the needs of children who have been traumatised by war.
After the horrific sounds of killing and shelling, of rape and torture, comes the deafening silence of trauma (The Mostar Music Centre, 2004)
War can have a profound effect on a child's life. After the war is technically over "comes the deafening silence of trauma". From out of the silence, children begin the long process of reforming their shattered concept of self, others and the world. This article illustrates some of the complex issues involved in trauma and neglect in a post war environment. It explores how the needs of children who have been traumatised may be unravelled and addressed through music therapy. Informed from a wide variety of literature and case vignettes, this article is the author's attempt to conceptualise and make sense of her experience as a music therapist at the Pavarotti Music Centre, Mostar, Bosnia-Hercegrovinia.
The word "trauma" comes from the Greek "trauma, traumatos" meaning "wound". The Oxford English Reference Dictionary defines psychological trauma as "an emotional shock following a stressful event, sometimes leading to long-term neurosis, or a distressing or emotionally disturbing experience" (Pearsall and Trumble, 1996, p. 1533). According to Carlson (1997), the defining features of trauma are that it is a sudden, uncontrollable, and negative experience. The degree to which an event is traumatising is influenced by an individual's perception and understanding of the event (Carlson, 1997).
Different perspectives on trauma have implications for and inform the music therapy approach. To broaden one's understanding of trauma related difficulties, consideration of current theoretical approaches such as the neurodevelopmental and psychoanalytical perspectives is warranted.
Trauma and Neurodevelopment
The neurodevelopmental perspective on trauma has received increasing support in recent years. Research has demonstrated that trauma may have a long-term effect on neurodevelopment, particularly in children (Diehl, 2000; Heim, Newport, Heit, Graham, Wilcox, Bonsall, Miller & Nemeroff, 2000; Perry, 1997a; Perry, 1997b; Pery, 1999; Perry, Pollard, Blackey, Daker & Vigilante, 1996; Van der Kolk, 1994; Van der Kolk, Van der Hart & Burbrige, 1995). Trauma during childhood can permanently influence the organisation of the brain, resulting in changes in physiological, emotional, behavioural, cognitive and social functioning (Perry, 1999; Perry et al., 1996).
Janet (as cited in Van der Kolk & Fisler, 1995) postulated that traumatic memories are stored differently from other memories: more as dissociated imprints of emotions and senses, or "implicit memory", rather than as verbal, logical cognitions, or "explicit memory". Recent research has linked these changes in memory storage to abnormalities in the neuroendocrine and limbic systems (Van der Kolk & Fisler, 1995; Van der Kolk, Van der Hart & Burbridge, 1995). Individuals who have been traumatised need to integrate memory functions into their general experiential schemas. In this way they can begin to put the experience into perspective, find meaning, form a narrative, and lessen the overwhelming emotional and somatosensory responses (Diehl, 2040; Van der Kolk & Fisler, 1995, Van der Kolk, Van der Hart & Burbridge, 1995).
The psychoanalytic perspective provides a different framework through which to view the same symptom pictures and goals for recovery. …