Music as Medicine: Combating PTSD with Music & Music Therapy

This White Paper will explore how music and music therapy are being employed to facilitate healing; in particular how veterans and other sufferers are finding relief from the symptoms of PTSD through music.

Post-traumatic stress disorder, more commonly known as PTSD, can change a person’s life for the worse, and is a serious condition that afflicts many people all over the world. Treatments range from psychotherapy to medication; however, music and music therapy is also showing great promise in relieving the effects of PTSD. Numerous organizations, most notably groups that help war veterans and other military personnel, are discovering that music can be a powerful tool in relieving the effects of this crippling disorder.

What is Post-Traumatic Stress Disorder?

Post-traumatic stress disorder (initialism: PTSD) is a psychiatric condition that can occur in people with personal experiences of severe trauma, either first or secondhand (1). PTSD often develops immediately following the traumatic event/s, but some sufferers (around one in five) experience symptoms with delayed-onset, often not surfacing for years after the event/s.(1) According to the Diagnostic and Statistical Manual of Mental Disorders (the DSM), the storing of psychological trauma is a response to overwhelming personal threat, in which the psychic apparatus of the victim becomes surrendered to a situation of terror.

PTSD presents via a network cluster of frightening and afflictive symptoms, the onset of which are usually determinate of the form of the condition. Symptoms can present acutely; this means that they come into effect immediately following the event and last less than three months. They may also present chronically, where the duration of active symptoms lasts longer than three months. Finally, PTSD may present with delayed onset - meaning that at least six months have elapsed between the traumatic event or experience itself and the presentation of the first PTSD-like symptoms.

Symptoms and Subtypes of PTSD

Symptoms of PTSD may vary in frequency and severity. Symptoms include intrusive thoughts, such as the involuntary recollection of disturbing or upsetting sensory memories: visual (iconic), aural (echoic), tangible (haptic) or a combination of all three.(2) It is likely that there are further subtypes of sensory memory for olfactory and gustatory functions (smell and taste) but these are less extensively researched, despite a general public consensus that the evocative potential of these sensory systems is just as well-known. These intrusive thoughts, in their more severe forms, can present themselves as distressing dreams or flashbacks, which can appear to the sufferer so vividly that it may feel as though the sufferer is actually re-living the trauma or watching it unfold before them.(1)

Further symptoms include an avoidance of reminders of the traumatic event: including people, places, objects and situations; negative thoughts, beliefs and feelings, either back towards the sufferer themselves, towards others or both; and a combination of arousal and reactive symptoms, for example irritability and susceptibility to outbursts, difficulty concentrating, problems with sleep, reckless or self-destructive behaviors, etc. (1) Ultimately, PTSD can be categorized into three subsets of symptoms: intrusion, avoidance, and hyper-arousal. In their own ways, and in their own time, these can all cause significant disturbances in the quality of life of the sufferer, particularly in terms of raised anxiety levels, lack of ability to communicate effectively and difficulties in formulating and maintaining meaningful personal relationships as a result.

Complex post-traumatic stress disorder, or CPTSD, is closely related subtype of the condition. Other subtypes include Normal Stress Response, Acute Stress Disorder, Uncomplicated PTSD and Comorbid PTSD. CPTSD, or Complex PTSD, is also known as complex trauma disorder, and is a condition which can develop as a response to chronic, repeated, prolonged exposure to traumatic experiences. (3) In particular, it relates to traumatic situations involving either (or both) physical and/or psychological captivity or entrapment (for example those subjected to chronic child abuse, concentration camp survivors, residential school survivors, prisoners of war, victims of slavery or human trafficking, indentured servants, victims of domestic violence, victims of kidnapping, etc.).(4)

Alongside the aforementioned PTSD symptoms, sufferers can experience changes in and difficulties with emotional regulation, including dysphoria, suicidal preoccupation, self-injury, explosive or inhibited anger, compulsive or inhibited sexuality.(5) Attachment issues can also form, as well as trouble with behavioral control, particularly in children and adolescents. Additional symptoms include changes in self-perception, changes in attitudes towards a perpetrator, alterations in relations with others, and changes in systems of meaning. (5)

(1) American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-V), American Psychiatric Publishing, 2013.

(2) Rubin, David C. et al. “Memory in Posttraumatic Stress Disorder: Properties of Voluntary and Involuntary, Traumatic and Non-Traumatic Autobiographical Memories in People With and Without PTSD Symptoms.” Journal of Experimental Psychology: General, vol. 137, no. 4, 2008. pp. 591-614.

(3) Herman, Judith Lewis. “Complex PTSD: A Syndrome in Survivors of Prolonged and Repeated Trauma.” Journal of Traumatic Stress , vol. 5, no. 3, 1992. pp. 377-391.

(4) Stein, JY et al. “Does One Size Fit All? Nosological, Clinical and Scientific Implications on Variations in PTSD Criterion A.” Journal of Anxiety Disorders , vol. 43, 2016. pp. 106-117.