Health

(Kindly note that The tables in this post have not come correctly )

Music Therapy and Psychology in Health problems -Contemporary concerns and solutions for reseacrh personnel.

Dr Suvarna Nalapat

In contemporary industrialized societies ,psychological aspects of health and illness are readily acknowledged and there is widespread acceptance of the idea that mental and physical health are intimately related.A century ago ,medical doctors tended to view health as the absence of disease and to regard illness as a physiological matter.The idea that every individual act to improve their own health by a lifestyle and a psychological means was overlooked by the medical professionals .They thought that the only way to keep healthy is by the science they offer to a diseased person(patient)to get back the lost health.In stark contrast to this earlier approach ,health is now typically defined in terms of biological,psychological,and social aspects of wellbeing .This biopsychosocial model of health is consistent with contemporary thought which recognize the importance of social psychological factors in every aspect of health and illness. A variety of factors have had an influence on the development of this new perspective.The twentyfirst century saw a increased lifespan along with increase in dementia and Alzheimers and other geriatric problems as well as lung cancer ,and other types of malignancies related to certain lifestyles.Both categories are amenable to psychological research .And psychological approaches have been applied in these areas.Psychological and social elements to definitions of health including the geographical features and social capital broadened research and integrative medical approaches came in ,displacing the autonomy of a single type of Medical knowledge(that is the modern Medicine )alone .Health psychology continues to examine factors such as gender,ethnicity and life style,socioeconomic status in relation to health.Particular emphasis is placed on stress in causing diseases.Stress is a factor in the development and experience of illness within the emerging field of psychoneuroimmunology .The growing cost of modern medical treatment which is sophisticated and costly but does not give a cost-effective cure for the disorders also has changed the old equations in favour of integrated medical practice.For any type of health sciences ,whether modern or ancient ,it would be cost-effective to prevent illness,rather than treat illness.With this in mind,health promotion has made extensive social psychological research .Application of social psychology to health does not merely address a specific problem.It has lead to development of models and theories for better understanding of health and illness in a sociocultural context.This also lead to rejection of Psychology’s traditional emphasis on dysfunction alone,and instead of that investigation of factors which promote the “Good life”” for a welfare state is emphasized ,as exemplified in the positive psychology movement .(Page 64.Applying social psychology John Cramer,Noel Sheehy,JaquellineReilly,Kren Trew ,and Orla Muldoon. Palgrave Macmillan 2003)
Following this the old Biomedical Model of disease has changed to the new Biopsychosocial Model.
In this model ,the medical research discovered links between some disorders and certain habits and lifestyles.(Example eating animal fats ,smoking etc for cancer; stress for Coronary artery disease and many others).Eliminating such behaviours ofen can prevent disease to some extent, or if already a person is ill,prevent its complications.
To prevent disease the people needs social cognition of how to achieve it.That is social as well as cognitive factors exert influence on health and illness of a person.The perceptions,attitudes,decision-making and other cognitive processes in a person determines his health-related behaviour.Two theories of social psychology on social cognition first formulated were Theory of reasoned action(TRA)and Theory of Planned behaviour(TPB).Even if there is cognition ,an individual may not be able to practice what he /she wants if the social capital is not there.
In order to interpret symptoms as a sign of a particular disease the individual need knowledge about it .That is a part of education department.Then the social condition of poverty,malnutrition,and environmental pollution etc cannot be controlled by a individual.The agroeconomy and food sufficiency,clean drinking water,disposal of waste and pure environment etc are goals of a society which wants its citizens to be healthy and to prevent communicable diseases.So an integrated approach is needed in administrative set up .At present the different departments of Government function as separate islands and a combined integrated approach from both below and above (from people,and the administrators and rulers) simultaneously has to be planned for the success of an integrated scheme.This is what I wanted to achieve by drawing attention to integration of all branches of medicine with Music therapy which is basically depending on the Psychoneuroimmunology for its actions .This is said easily,but achieved with great difficulty and slowly in a Government machinery which is highly hierarchical and Beaureaucratic. By getting co-operation of people –from panchayaths,from grassroot levels,from musicians,doctors ,and from public and media –from below this is made somewhat easier .For this one has to make a series of lectures and write articles,books on the subject so that the communication percolates to all alike.For me,the first several years of my music Therapy work had gone into this preliminary steps .

Wilkinson R.G(1996.Unhealthy societies.The afflictions of inequality. Page 1.Routledge) stated that “Medical science can address the biological pathways involved in disease ,the Pathology and the opportunities for treatment ,but to the extant that health is a social product and some forms of social organizations are healthier than others ,advances in our understanding of health will depend on social research.

Practical issues:
In medical science the gold standard for research is a empirical evidence from an RCT .(Randomised controlled study which is ideally doubleblind ,placebo controlled trial).Pre and post testing is compared and statistically significant differences between the groups attributed to the treatment.This works well in a biomedical format of disease.From a biopsychosocial model to achieve the necessary degree of control is difficult.The variables has to be selected carefully . How I eliminated bias and how I controlled my variables in Music ,I have already discussed in my previous work .
The pilot study intended at the reduction of the modifiable factors of heart disease ,(stress,anxiety and blood pressure )with vocal music using Indian Raagaas.Then ,to this project the Yoga,Ayurveda,and Chakra related theories of different indigenous medical systems were integrated and analysed to get an integrated approach .
The field of health promotion utilizes models of attitude change in publicity campaigns and community health programmes.Asking people to eat less,but nutritious food,take up regular exercise,reduce alcohol intake,stop smoking has some impact but is limited only according to Bennet and Murphy .But when it comes to using music for prevention of disease ,and for personality development and improved memory and cognition in children there is more positive response because everyone has a positive experience of peace with music and has previous experience of its feel good nature ,even without hearing about music therapy .This universal appeal for music makes it an ideal tool for integration of medicine and for social health promotion .
The TV exposure for too long is harmful because it suggests that audiences are passive and uncritical and ,soaking up whatever is exposed to induce a pernicious change in values,attitudes and behaviour.This is true of music too.A person loves one particular type of music need not be because it is good for him/her but he/she had been exposed to it too long.This problem was the first I had to tackle when all my clients chose Yesudas voice .This objection is likely to occur from the medical personnel and research workers.Therefore I wanted to have a control voice which is soft and good for therapy ,which can sing classical music well,and at the same time unfamiliar to the clients and a female voice (quite unlike Yesudas).If I get good response from the same people who love Yesudas voice,then I have proof that
1.It is not familiarity but quality of voice and the raaga that is doing the healing
2.Both the test voice and the control voice being good and soft ,both were acting as control to each other.
3.The voices were tested on 30 volunteers in controlled and uncontrolled atmosphere
4.The voices were tested on clients with a variety of illnesses
5.The voices were tested even in a big crowd where the people were at random ,uncontrolled in parameters
6.In all cases ,written feedback as psychosocial research procedure was collected
7.The selected cases were interviewed for more detailed analysis so that narrative medicine also was included
8.The MLP of selected individuals was used for study of development of musical preferences and cognition of music .
In this way equal importance was given to discipline of music .(Not only to medical science ).That is how I integrated the art and science into a whole for human wellbeing and health and a peaceful living .
Since music therapy is a communication there may arise three levels of problems related to communication.
1.Technical problems.How accurately the communication is transmitted?
2 Semantic problem.How does the transmitted symbol(language/music)convey the intended meaning?
3.Effetcive problems: How efficiently does the received meaning affect the behaviour (here the parameter stress and Blood pressure) in the desired way?
All these levels were taken care of with utmost care in our study .The infrastructure of Amritha Institute provided no problem regarding technical quality.Only when we went out and had an uncontrolled noisy atmosphere this technology was not available.Even then ,with those limitations we could achieve good results (assessed by written feedbacks) shows the efficacy of the medium of music .

The problems that are likely to be encountered has to be thought about first and a systematic plan drawn out and executed within a timespan to get away with errors and biases.Then the research would be a success.Another important thing the Music therapists should remember is that we are part of a social team working in collaboration to facilitate health of society and it is a responsible job to be undertaken with care and maximum efficiency .Documentation is important since that alone will give you an authenticity.Just by claiming that Music is universal and healing occurs with it,the scientific community will not accept you as scientists.Or give you opportunities as scientific research assistants.You have to prove it with your projects and documented evidences and sincerity .This practical side is more important than mugging up theory and answering multiple choice and essay questions.This should be born in mind by the Music therapy training institutes and their staff as well .The universities also should take care that the projects are given more importance for student training .The initial teething troubles will be erased in due course and therefore there need not be any panicky reaction about them .
One thing is certain.Integrated medical and social sciences will be the future of our welfare state for achieving its ultimate goal of health and education and friendly unpolluted environment and in that goal Music and Music therapy has a great role to play .That is not a astrological prediction,but a prediction based on the need of the hour and the social pulse as well as the problems the medical profession faces today.All these ,including a work force which will reduce unemployment of the nation are in the broad plan of this scheme .Ultimately all this planning is done for peace of all individuals,of the society ,of the nation and of the entire world of living beings.

Introjection and Projection

Introjection is a much stronger term than Internalisation that we come across social and human sciences and that usually means taking an idea or a view of the world.Introjection is by comparison more like swallowing of the world ,says Ian Craib (page 40 Psychoanalysis ,a critical Introduction Polity Press Blackwell.2001) like an unconscious thought (which Kleinian psychoanalysts call phantasy) .What is the use of this in practical life ? When we want to take control of an external situation we do this .That is how we hold on to what we might loose and this is how we develop an Ego as well as a superego.We make our own worldviews and by those worldviews we try to control the world in which we live .The ego is formed by that process.But ,the superego is formed by our own world view as well as the archetypal world view of all our ancestors and that makes our superego which is cultural ego ,or identity as a group,a people,a nation,a race and as a people having same language,practices,rituals etc.
In daily life of a husband and wife this control by introjection is seen as adjustments .A wife buying cigarettes or alcoholic drinks to her husband or even arranging a flirting partner for him is trying to control a threatening situation and treating a situation to show that “This belongs to me and I can control it “.Actually this eases a lot of anxiety in the wife that she might loose her husband to addictions or to another woman .It shows she has tension/stress which she is trying to control by introjection.Similarly a group trying to increase numbers by conversion,by other means to increase strength has a feeling that they will fail if they do not do so. They have tension and stress and are not peaceful.
Projection is opposite to Interjection.It is putting something in our mind to another person .The brainwash of several revolutionary political parties is for this.The projection is positively seen as a part of communication also when there is projective listening or creative listening .In this we are projecting us into the mind of another person to understand what they are saying.Example when we read Gandhi,we project us into his personality and words to understand him better .
Apart from communication,sometimes projection defends our personality too.For example,when we find someone with a bad intention,we can project all our goodness onto that person,and protect ourselves from that person’s bad intentions .Because by investing that person with qualities which he/she does not actually possess ,we give them an image which pleases them and makes them act accordingly to keep up that image ,and thus we save ourselves.This also instills good behaviour in another person and therefore is good for both .This positive way of transforming is used by teachers and parents on children for their development.Children also project their ideals on their parents and teachers and thus by projection love them more.
Harmful examples of projection are racism,homophobia,hatred to opposite sex etc.Projection is seen in hatred of paedophiles,murderers and criminals developed by society .So there are good and bad aspects in all these.The reason for splitting the world into good and bad ,liked and disliked (which is called duality) is projection and this word projection is seen in Sanskrit language of Vedantha as Adhyasa (see the commentaries on Brahmasuthra .Brahmasindhu DC Books Kottayam 2006).A split world,a split mind,a split personality is due to the splitting and projection being central to all dualities or dwaitha.And Advaitha is the philosophy of nonduality,nonprojection and seeing truth as it is ,absolute and blissful.This shows how our ancients were not only scientific but practical in making a society that is peaceful and self-sufficient and contended .All the divide and rule strategies of political ,social and religious leaders involve duality,projection and has to be discarded by a wise person .Universal language of Music is used by the rituals of all tribes for the common and universal spirit of oneness between them and hence use of music for Advaitha is timeless as far as humanity is concerned.

In knowledge acquisition and in communication we need projection or projective identification .But except as a method of knowledge ,use of it in society as propaganda will lead to divide and rule.Therefore,use of it has to be very judicial and with proper caution .Bion made a grid which is like a coat of arms ,with multiple functions .The vertical axis describe a process of working ,or the activity of a natural scientist.That is a process of Observation,development of a theory from observation,a process of induction,and laws that can be tested.The vertical axis is thus a description of growth of human thought .
Row A is raw material of experience/raw data collected by senses and called by Bion as Beta elements.
Row B or Alpha elements are the primitive elements o fthought from basic data of mind.These are hypothetical entities.The rows following these are real .
Row C is materials presented by patient/Client in a session ,dream materials,and produced from association of alpha and beta elements
Row D are preconceptions which enable mental growth.A preconception is waiting to get some material to get attached to.When this happen we experience that as understanding the meaning of something of the patient’s material.In this way the preconception becomes a conception.(Row E).
From that row ,there is a purification and generalization.From conception we move to concept(Row F) which involves loosing whatever that mask truth.
The concepts are able to be arranged in more organized form ,as abstract hierarchical form involving observed regularities from which hypothesis can be derived (Row G) and abstract formulae of Algebraic Calculus (Row H).
The horizontal axis deal with different uses to which thoughts can be put.
1 A tentative hypothesis about what might be going on between patient and analyst
2. The second column is relevant when analyst makes a comment to reassure him or herself that he/she knows what is going on.In groups the patience to sit and wait for what is going to emerge may be less and levels of anxiety may grow rapidly unless all members have same degree of patience to wait and watch and the same confidence in what is being done.This is a danger for all team research as I have often experienced .
3.The third column Notation,is noting something that is happening in a particular session.The group discussions on such things is good
4.4th stage is drawing the client’s attention to the analyst’s hypothesis.Inquiry and action columns (marked 5 and 6)and beyond upto n contain the more positive interpretations .Column 5 pursue the inquiry further,column 6 involve confronting the client with the irrefutable facts about himself/herself.
Grid of Bion 1962
1
Definitory
hypothesis 2
ѱ 3
Notation 4
attention 5
Inquiry 6
Action ……n
A
βelement A1 A2
B
αelement B1
B2 B3 B4 B5 B6 …Bn

C
Dream,
Thought,
Myths
C1
C2 C3 C4 C5 C6 …Cn

D
Pre-conception D1 D2 D3 D4 D5 D6 …Dn

E
Conception
E1 E2 E3 E4 E5 E6 …En

F
Concept
F1 F2 F3 F4 F5 F6 …Fn

G
Scientific
Deductive
system G2
H
Algebraic
Calculus

The columns are actually a list of interventions rather than the psychoanalytic personification of scientific methods.The place for irrefutable facts in psychoanalysis and science are doubtful though Bion use such a term.The possibility of clarity of meaning at logical levels as we proceed is evident from the grid.
By the last process algebra and calculus we come to the conclusion all thought process is essentially an abstract process.The Symington’s claim that Bion’s model of thought is a fluctuation between paranoid –schizoid and depressive position.The reason they say is that the starting point is not existence but absence (Not bhava but abhava as Sankara would have said in Sanskrit).
Page 102 (Ian Craib)says that absence of an organ like breast is what beta element mean.To make up for that absence thinking as a symbol but the absence is felt as a persecution,as long as one thinks about it as a lack or absence of something.Since the lack or absence is a thought of persecution,it is paranoid and a trial to transform this persecution feeling.This is in terms of absence of breast ,in the case of a cancer patient.
But apply this to other types of lack or absence /Abhava of opportunities etc in various social,religious beliefs we will find the significance of what is going on around us .
I don’t want to give examples since that might hurt people who has been believing that they are right in everything they do.But ,I would be happy if they do some retrospection and find out where their political,social,philosophical and other revolutionary thoughts start and where their religions start .Lack or persecution from a God who sends the man from his garden,of a class which deny everything to them, of a sex that persecute opposite sex –and so on.All start from a paranoid-schizoid persecutionist view of world and then a feeble attempt to redress it.The Advaitha on the other hand tell us that we are Athman and we haven’t lost anything,except that a covering has occurred over our minds which can be removed by proper thinking,and education and those who have patience and willingness can follow a regime of life and education to see that truth and enjoy supreme bliss .
In music therapy we deal with individual as well as group therapy.That is individual and group psychology is taken into consideration .A group or a mass of people ,at random come for Kutcheri or music concerts.The people may be a professional group belonging to a particular institution or a particular organization and they have a group psychology .The group processes are ability to think in groups.The group discussions and the training to open up before others is thus essential for a trainee so that he/she can assess the psychology of both individuals/colleagues as well as a random or professional group.By relationships and discussions in a group we get an idea of possible doubts and objections that can arise and we get a opportunity to defend our data and our analysis which is a important point in our research and treatment .Some groups have a defence against a new discipline or a new way of teaching and evaluation .Such groups are very much against the modern methods of learning and teaching .Similarly some groups are reluctant and opposed to singing a Vivadi Raga in music and making them understand that there is no Vivadi but only balancing .The philosophical and mathematical and other proofs even if we give they do not understand ,since they are not receptive to abstract maths and philosophy.The only way then is to sing and demonstrate that the Vivadi can be sung with beauty and exceptional attraction and it gives a special aesthetics and healing to clients.The Melakartha Raga sung properly by a person with suswara can be used for this purpose.The group psychology is only slowly and steadily won over and do not expect to achieve it overnight.I had patiently waited more than ten years for this to happen .But it did happen is what matters.Not the time interval. One who has patience can wait not ten years but an entire lifetime to achieve and give what is truth and energy and bliss to all alike.
The Basic assumption groups have certain unconscious relationships between group members that defend against both intellectual and emotional learning.The three important features of such Basic assumption group relations are dependency,pairing and fight-flight .
Dependency:- The group members depend upon the group leader to lead them ,control,organize work and take no responsibility inwhat is going on.This is a problem in every nation and every institution where each member/citizen has to be a responsible member in group work/team work.The leader is expected to bear all responsibilities for the work,for the mistakes and faults and when he/she asks for more responsible behaviour the subordinates quarrel with authority and become rebellious .Paradoxically the dependency group appears in a situation where it is least appropriate-in a university seminar or class.This is where everybody should engage in thinking .The working of each brain is precious for making group successful .
When this happens what to do ? That is the best challenge for an administrative leader in a professional teaching and service institution.I had faced this in the Blood Bank of Calicut Medical college and could successfully tackle it with the Indian ethics in management in Gita and Ziel-oriented project planning .At the end of six months the entire staff of Blood Bank had been thinking with me about what to be done next and how to tackle each problem and that was a moment of real happiness for me.
Pairing:- A relationship between two members of a group that seems to relieve others of the group from responsibility of participating is called by this term by Bion.This may be between same sex or opposite sex members.The group starts to feel that this couple will rescue the entire department/group from all its problems as if they are a Messiah .Ofcourse this is only a phantasy of the group but this happens always as all of you might have experienced in your professional surroundings.
In teaching situations two teachers ,or two mature and wise students /postgraduates will always dominate the discussions frequently arguing with one another and supporting each other if some one else argue with one of them.This makes all others silent witnesses of what is going on and is not a good feature for a group discussion.All should get equal opportunity to express views in a democratic set up and all should participate in discussion .Only then the group will succeed to achieve what they really should achieve.
Fight-Flight:-
This is a group form of defencive projection.The group will find an external enemy or an internal scapegoat for all its shortcomings and victimize that person .The criticism and attack on that enemy enable an internal cohesion and feeling of identity within the group ,or if the scapegoat is within the group ,among the rest of the group members.The enemy carries all the blames for failures of the group .This I need not elaborate since any person who have worked in a institution/organization might have seen or have been part of this behaviour there .Or at least you might have witnessed this several times in group politics .
Menzeis –Lyth (1989) shows how in a teaching hospital ,anxieties within it being very primitive dealing with death and illness, are dealt with by a Beaureaucratic organization.In organizations and in politics when there is something creating anxiety ,the system is changed for something else but the anxieties are not removed.They are shifted from up to downward strata in hierarchical organizations.Whether in a matter of dependency,fight-flight or pairing in Beauraecracy to alleviate anxiety,individuals within the group inhibit their own creative thinking processes and collective work become difficult .The contrast between a well-defended ,highly anxious group and a group that can mobilize individuals in a collective creative process is immense .
I will give two examples here.
1 .A client comes to a patient and goes into deep coma in the hospital ,because of negligence of the duty nurse and doctor who refused to give intravenous glucose to him ,though he was having hypoglycemia on admission.The Doctor who had seen the patient earlier was on a discussion /seminar and the duty nurse insisted that without his permission she will not give glucose IV .The doctor was late after his seminar and teaching session to reach the department and by that time precious time was lost and the patient who came walking to the casualty was in deep coma.Then there had been an afterthought among the staff doctors/nurses that in case the patient die a legal problem might come up against those who are responsible and they sent a PG trainee and collected all the case sheets ,references that the patient’s wife had with her .And after that the doctor never turned up .The Principal and Superintendent came to know of such a patient in the wards and when they put up an enquiry ,the Professor and Head of Department of Medicine had to take up the responsibility of the patient .For five days the patient was in coma and all investigations and questions to the family were directed to make it look like a suicide. All sorts of allegations including drug addiction,alcoholism, possibility of HIV/AIDS and even a homicide by the wife was thought of as possibilities.But the patient came back to normal after 5 days and when he was told what had happened ,he being a doctor working in the same hospital,collected the copy of the casesheet that had gone to the Record Library and asked his wife to take enough photocopies and keep.He knew his colleagues and their psychology well.They were afraid of a legal procedure against negligence and not bothered about what happens to their poor colleague. Whether he lives or not was immaterial .But they should save their skin.
2. A client with cancer needs a prolonged treatment regime and the medicines are costly .The patient’s parents are poor .They are struggling to make both ends meet. The drug companies are competing for market and are giving commissions to doctors for getting more markets for their product .Only with the doctor’s prescription the stores give medicines and if he writes only costly ones the poro patients find it difficult to get them.The ups and downs in social status have made this problem permanent in India ,at least in Kerala ,where I have worked.When this is pointed out do you think the entire group of doctors,though they know this happening will agree to it? And even those doctors who are not part of this game will not come in open to criticize their colleagues who are doing this .This sort of defence mechanisms ,pairing between organizations(like doctors and drug stores and marketing people etc) exists and many are silent as pointed out in fight-flight situation.Only the dominant speak .
This social psychology of group and organizations are harmful to entire society .
Can we deal with it musically ? We can introduce humanitarianism into science and by that address such social issues is what my Music therapy project aims at.And I think my attempts are partly being successful .

The best Therapist is the one who understands that therapy begins where the theory ends.It is practice and constant experience that leads to theory for an expert therapist .And there is no magic formula or set of instructions /or prescriptions .Each individual being a unique person the therapist must be able to expect a new challenge in each patient .The psychotherapy is considered as a mutual search for both therapist and patient.The same is true for Music therapy practitioners too.It is a matter of enabling a person to think and feel .Not a process to know. If one feels that one knows self ,then no more effort from us to know Athman and it will make us stagnant. We are just like babies who find our way to our mother’s breast ,the moment we are born.Just like that music and language make us drawn to them .That is why it is called the breast milk of mother Saraswathy.The patient root around in search for selfhealing ,for a meaning and therapist help in the search just by being there as a moral support.Because music is inherent in each individual and role of therapist is just to make the patient feel for that search of self in him/her for healing .It is not a treatment or a cure but a healing by our own musical self .It brings about a change or transformation in the client as well as in the therapist .No body gets cured of any illness but they discover that they were not so ill,as they thought .Human psyche is full of paradoxes and in medical models of modern medicine this factor is never attended to in wholistic manner.By introducing music therapy research protocols in medical curriculum we can make it more wholistic and humanistic and addressing problems in a better way for benefit of the nation,of society,the discipline itself ,nothing to speak of the doctor/nurse/student community and the general public as clients.A total social transformation can happen if we seriously apply this model into our social life and science.The decision whether one needs music therapy or not has to come from the client or the family members and never from the therapist .

Some one was asking me if only University educated musicians and doctors can do music therapy what about musicians who have no academic degree and yet wants to contribute their share? They can definitely contribute in tehri own way .
1 Making their music the best –both with technical perfection of notes and Raaga and with careful protection of the softness of voice and having the bhavas of love,compassion and devotion in songs they are contributing their share to music therapy practice .Probably they do contribute a major share among masses making an awareness of the effects of music and contributing to the MLP of each individual in society .
2.Each Kutchery is a group therapy and so is a bhajan .By being able to do a performance like that ,in front of a huge crowd ,each artist is able to understand their own uniqueness,the uniqueness of their art ,their own individuality and the individuality of the audience as a group.If individual therapy is that of hospitals and university educated postgraduates in a collaborative teamwork and research ,the group therapy is more effective with popular singers with good knowledge of the art and a good voice and a feel for the pulse of the audience .The strength of music is best demonstrated by such individuals in public eye .
3.They can contribute much to the society and its development and inculcation of values into society by their personality and popularity .They are the right persons to be models for the society as group therapists .Live performance of such artists in hospitals,clinics etc can be organized to help the cause .

Each and every one ,musicians,music lovers and organizers of concerts,doctors,other medical ,paramedical staff and university people and educationists and public figures can contribute their share in the social reformation programmes using music because there is no one who does not love or like music of some sort .