PART V
Part V turns to specific disciplines within the arts and humanities, providing depth and nuance on how each domain can lead to human flourishing. The chapters highlight how features of a discipline need to be understood from different perspectives (e.g., performer vs. observer) and describe specific mechanisms in greater detail as they pertain to a particular discipline. In the realm of the arts, engagement in music, visual arts, film, and theatre can all lead to higher well-being. The humanities can also lead to greater flourishing both by providing a deeper conceptual understanding of the nature of well-being and by promoting its practice. Beyond individual disciplines within the arts and humanities, it is important to study and support the interplay between the humanities and disciplines or contexts outside the humanities, such as business education and medical humanities.
CHAPTER 24
Alexandra Lamont
Abstract
This chapter draws on theory and a range of recent research literature to explain how music contributes to human flourishing. It first treats music listening and music-making as separate domains, and then brings them together to consider the world of the musician across a range of contexts. Parallels are drawn between theories of well-being and theories of emotion in music. It also includes a developmental perspective on how music is associated with well-being at different stages in life, and how culture and society work together to foster this. The chapter concludes with a consideration of the purposes and goals of engaging with music for well-being and flourishing.
Key Words: music listening, music performing, PERMA, creativity, engagement, positive emotion, negative emotion
Why Music?
Music has been associated with humanity since the dawn of the archaeological record, and many researchers have argued for a fundamental evolutionary drive for music in human culture (e.g. Cross, 2009; Tomlinson, 2013). A number of different sources of evidence support this fundamental role of music in culture: for instance, all new parents instinctively sing to their babies (Trehub et al., 1997), and music provides a way for parents and infants to bond through synchronization (Trevarthen, 1999). Research shows that adolescents engage in music listening more than any other leisure activity (North, Hargreaves, & O’Neill, 2000), and that music is the most-talked-about topic when people are getting to know strangers (Rentfrow & Gosling, 2006); sales figures for popular music around the world indicate that even in the digital age, music remains a fundamental part of many people’s lives (IFPI, 2019).
Research into the impact of music has covered a wide range of topic areas, from fine-grained analyses of why a particular chord evokes a sense of emotional release through to the broader motivations to make music or listen to particular styles. In many cultures around the world, the phrase “music” incorporates both the act of making music and that of listening. Western cultures are unusual in making a distinction between the two different activities, but this chapter will first consider research on each separately before bringing them together.
Music-Making and Flourishing
Most contemporary theorizing about well-being and flourishing emphasizes the importance of agency and involvement in engaging activities. For instance, Seligman’s PERMA framework (2011) purports that in order to engender well-being an endeavor must not only engender positive emotions but also provide the potential for engagement through a sense of flow, building relationships, stimulating a sense of meaning from the activity itself, and finally also a sense of accomplishment. Similarly Tay, Pawelski, and Keith (2018; see also Tay & Pawelski, Chapter 1 in this volume) theorize the importance of the ways humans interact with the arts for well-being in their functional analysis, defining modes of engagement and the four mechanisms of immersion, embeddedness, socialization, and reflectiveness as explaining how well-being can be generated. There is a wealth of evidence showing that music-making (including singing) leads to enhanced levels of well-being (e.g., Bailey & Davidson, 2005; Clift et al., 2010; Pérez-Aldeguer & Leganés, 2014; Vaag, Saksvik, Milch, Theorell, & Bjerkeset, 2014), yet these data are accompanied by a need to explain the different elements that may contribute.
Taking each element of PERMA in turn, it is easy to see how the framework could apply to making music. First, performing music is often a direct emotional experience that creates positive affect. Research has found that singing, either alone or in a choir, reduces tense arousal and increases energetic arousal and positive hedonic tone (Kreutz, Bongard, Rohrmann, Hodapp, & Grebe, 2004; Valentine & Evans, 2001). In Gabrielsson’s research, where he asked over 1,000 participants to report on their strongest experiences of music, 19 percent of the reports addressed performance (Gabrielsson, 2010, 2011). Performers described a range of positive emotions associated with their experience, particularly joy and happiness, rapture and euphoria, and calm and peace.
In terms of engagement and flow, playing and performing music can induce flow in infants and young children (Custodero, 2005). In relation to adult performers, Gabrielsson and Lindström Wik (2003) found musical performances that reflected engagement with loss of self-awareness, indicative of flow: for example, “sometimes it is as if it isn’t me who is playing. The fingers move by themselves” (p. 176). Experiencing flow can also lead to enhanced motivation (e.g., Austin, Renwick, & McPherson, 2006, McPherson & Davidson, 2006; Woody & McPherson, 2010). For instance, O’Neill (1999) found that higher-achieving children reported significantly more flow experiences with music than lower achievers (see also Fritz & Avsec, 2007). Similarly, Sloboda (1991) found that adults who remembered peak experiences with music before the age of about ten were more likely to pursue involvement with music later on.
In terms of relationships, music performance works particularly effectively in terms of developing one’s own musical identity and becoming a musician (Lamont, 2002). Children define “being a musician” simply as someone who can play a musical instrument. Developing a positive musical identity is also an important motivator, as well as a result of engaging in music performance, and a lack of musical self-concept or musical identity leads many people to disengage from musical activities (e.g., Ruddock & Leong, 2005). Developing a group or social musical identity is also important. The powerful social motives for musical engagement have been studied by Faulkner and Davidson (2004) in the context of an Icelandic male choir, where members felt that singing connected them with others, as well as allowing them to communicate with others. Gabrielsson and Lindström Wik (2003) highlighted a sense of community among performers and between performers and listeners in their examples of strong experiences of performing.
The search for meaning in a positive psychology context is typically related to spirituality and religion (Wills, 2009). This aspect has received very little research focus to date in relation to music, although there are a few studies pointing to spirituality being experienced through music (e.g., Hays & Minichiello, 2005). It is likely that performers do reach a sense of transcendence and spirituality through their performances, as hinted at in some of Gabrielsson’s findings (2011), although this has yet to be fully documented. However, quality of life, which may relate to meaning in some way, is clearly found to be higher in people engaging in musical activities (Clift et al., 2010; Johnson et al., 2020).
There is also far less research in music performance that explores achievement in a well-being context. Achievement motivation is commonly explored, particularly in child learners (e.g., Austin et al., 2006), but has not been linked explicitly to well-being, and the performer’s own sense of well-being has rarely been incorporated into such studies. Some exceptions include a study by Ascenso, Williamon, and Perkins (2017), who found elements of all aspects of the PERMA model, including accomplishment, in the musical well-being of a group of professional musicians. Similarly, Lamont and Ranaweera (2019) compared amateur music-makers with amateur knitters, and confirmed all five PERMA elements in both groups (with a slight emphasis on relationships and meaning). Many performers reported a sense of flow in attempting to achieve certain technical challenges they had often set themselves, and there was a clear focus on the importance of learning and stretching oneself through music-making that seemed to be tied up with the positive benefits. Finally, Bonneville-Roussy and Vallerand (2018) proposed that the underlying feature behind evidence for PERMA in musicians is passion, particularly harmonious passion.
Music Listening and Flourishing
As suggested earlier, listening to music could be viewed as a more passive endeavor that might not perhaps embody as much potential for flourishing, and the theoretical approaches to flourishing reference far fewer of such “passive” activities. Nonetheless, relating research on music listening to PERMA shows that many elements can be addressed, and Hargreaves, Hargreaves, and North (2012) have argued persuasively that music listening has as much potential for creativity and imagination as music-making.
In relation to positive emotions, listening to music has considerable potential to engender pleasure. Brain imaging studies show that music listening stimulates the areas of the brain involved in reward/motivation, emotion, and arousal, including the ventral striatum, midbrain, amygdala, orbitofrontal cortex, and ventral medial prefrontal cortex (Blood & Zatorre, 2001; Panksepp & Bernatzky, 2002). The responses are similar to those from other “euphoria”-inducing stimuli, like food, sex, and drugs of abuse. In strong experiences of music, direct physical and physiological responses to the music, such as chills, are experienced alongside high arousal feelings of rapture and euphoria, ecstasy and intoxication (Gabrielsson, 2001). In the laboratory, manipulating musical stimuli can induce different emotional responses in listeners, and music can be used experimentally as a powerful means of mood induction (Swaminathan & Schellenberg, 2015; Westerman, Spies, Stahl, & Hesse, 1996). Enjoyment is frequently referenced as a primary reason for choosing to listen to music (Groarke & Hogan, 2016; Lamont & Webb, 2010), and positive effects can be generated even without conscious attention (Juslin, Liljeström, Västfjäll, Barradas, & Silva, 2008).
Engagement through flow certainly seems possible through listening to music; Csikszentmihalyi (2002) included music listening in his original definition of the concept. He proposed that listeners should have a high degree of attention and focus, setting aside time and space to engage fully. Gabrielsson’s (2010) listeners reported many different characteristics of engaged listening, such as focused attention and complete absorption, changes in attitude, feeling embedded in the music, and coming to hear things in a new way. Focused, self-chosen music listening provides a means to engage in reminiscence, catharsis, calming, and other intellectual outcomes associated with high levels of engagement (DeNora, 2000; Sloboda, O’Neill, & Ivaldi, 2001), and more emotionally engaged listeners seem to gain more from concert experiences (Thompson, 2006) and have greater awareness of both their own music listening behaviors and their contribution to happiness (Greasley, Lamont, & Sloboda, 2013).
Music listening and its associated activities can develop relationships and bring people together. Adolescents mostly listen to music alone (North et al., 2000), but still share a great deal of their music (Brown & Sellen, 2006). By early adulthood, many experiences of music listening are shared with others (Juslin et al., 2008; North, Hargreaves, & Hargreaves, 2004), and, as noted earlier, music provides an important channel of communication in new social settings (Rentfrow & Gosling, 2006). Developing and enhancing personal connections through musical experiences helps support relationships (Gabrielsson, 2010). The social dimension might thus provide a way into a collective musical experience that fulfills the requirements of meaning by allowing the listener to go beyond him- or herself as an individual. A further element of relationships that music listening can facilitate is the sense of identity resulting from belonging to particular musical taste cultures, and many researchers have emphasized this pursuit of identity as an important function of engagement with music (Tarrant, North, & Hargreaves, 2002; Tekman & Hortaçsu, 2002).
Corresponding to the general lack of research on the component of meaning (Seligman, Parks, & Steen, 2005), little research has explored how music listening can help develop meaning in a well-being perspective. However, music typically accompanies other activities that can be more clearly labeled as meaningful, such as religion (Sloboda, 2002). Becker (2001) described the sense of collective ecstasy experienced in religious rituals by Muslim Sufis and Pentecostal worshippers. While the primary purpose of such rituals is not musical, the music, spirituality, and group setting all combine to evoke strong emotions in those present and engaged, at both a personal and social level. The more spiritual elements of transcendence, such as offering a glimpse of God or heaven, out-of-body experiences, and feelings of pure being, are reflected in descriptions of strong musical experiences (Gabrielsson, 2010). This combination of factors may account for the power of such experiences in a range of therapeutic outcomes (Gabrielsson & Lindström, 1995).
Finally, Csikszentmihalyi’s description of focused music listening in the context of flow (2002) perhaps reflects how music listening can serve the function of accomplishment. It is possible that the sense of accomplishment that comes with knowledge of music, one of the most popular motivations to engage with music, according to Schafer, Sedlmeier, Städtler, and Huron (2013), may be associated with outcomes for well-being, but more research is needed.
In summary, from a theoretical perspective, music listening can potentially affect happiness through the pursuit of all of Seligman’s (2011) routes: pleasure, in terms of boosting positive emotions; engagement, in terms of highly intense focused music listening which changes the way listeners think and feel; relationships with others through shared experiences; meaning, broadly conceived of as spirituality and aesthetics; and finally, accomplishment through engagement with music and knowledge around music. Much research has explored music’s power to affect emotions in broadly positive ways. Less is known about engagement, although this is a dimension that has been shown to vary among people (Greasley & Lamont, 2011), and very little research has explicitly explored meaning or accomplishment in relation to specific instances of music listening. However, Groarke and Hogan (2016) confirmed Greasley and Lamont’s (2011) finding of individual differences in the emphasis placed on different functions of music. They found at least four different types of emphasis in reasons for choosing music listening, prioritizing creation of personal space (for the end goal of entertainment), reminiscence (for emotional effects, particularly reduction of boredom or fear), transportation (relaxation, stress reduction, and connections leading to personal meaning), or strong emotional experience (leading to social connections and personal growth). This framework provides considerable potential for future exploration in bringing together diverse fields with more explanatory power.
From the field of music psychology, another recent popular model for explanations of emotional responses to music is that proposed by Juslin (Juslin, 2013; Juslin, Barradas, Ovsiannikow, Limmo, & Thompson, 2016; Juslin & Västfjäll, 2008). Juslin identified a number of underlying mechanisms (currently nine) to explain how music induces emotions. The most primitive response in his BRECVEMAC framework is the brainstem response (B) to sound or pleasant sounds, held to be an evolutionary response relating to arousal. Rhythmic entrainment (R) reflects the listener locking in to a common periodicity in the music, through heart rate, breathing, or actions. Evaluative conditioning (E) reflects repeated pairing of the musical stimulus, at a fairly general level, with particular emotions, such as the use of horns to evoke jolly hunting scenes. Emotional contagion (C) concerns the mimicking of the emotion perceived in the music by the listener, in a fairly automatic manner. Visual imagery (V) reflects the shapes in the music and visual patterns in the listener’s mind that are stimulated by the music. Episodic memory (E) refers to the idea that particular pieces of music become associated with specific moments in listeners’ lives, which tend to evoke emotions such as nostalgia. Musical expectancy (M) concerns the patterns embodied within the music that evoke tension and release, such as harmonic prolongation (Meyer, 1956). These combine to produce the aesthetic response (A), and finally, cognitive appraisal (C) is a multidimensional assessment of the implications of the music for the listener’s current goals or plans.
The BRECVEMAC approach can be aligned quite closely with PERMA. Brainstem responses can lead straightforwardly to positive emotions, while engagement results from generating musical expectancies. Relationships are fostered through rhythmic entrainment and emotional contagion at a fairly basic level and through episodic memory at an individual life-span level. Meaning comes from wider connections with others through evaluative conditioning, and accomplishment arises through the achievement of the aesthetic response. BRECVEMAC was not developed to explain well-being per se, but its synergy with the PERMA framework perhaps explains why music listening is so popular and emotionally engaging.
The Case of Negative Emotion in Music
Much of the theorizing in flourishing prioritizes positive emotions, with approaches such as PERMA or Fredrickson’s (2001) broaden-and-build theory continuing a fundamental point established by Diener (1984) that positive affect and the absence of negative affect are critical in well-being. However, second wave positive psychology has more recently emphasized the importance of acknowledging the negatives in human experience (Lomas & Ivtzan, 2016). Similarly, in music, much research has prioritized positive emotions as the motivators for engaging with music (Groarke & Hogan, 2016; Mas-Herrero, Marco-Pallares, Lorenzo-Seva, Zatorre, & Rodriguez-Fornells, 2013; Saarikallio & Erkkilä, 2007). However, there are two distinct areas where negative emotions arise in music: music performance anxiety and listening to sad music.
Music performance anxiety affects around half of all performing musicians (Kenny & Asher, 2016). Most of the research has focused on identifying symptoms and cognitive or medical interventions. Interestingly, some of the characteristics of positive strong emotional experiences of listening or performing are also found in less positive instances of music performance anxiety: increased heart rate/pounding chest, excessive sweating, dry mouth, nausea, trembling hands, and cognitive symptoms such as loss of concentration and negative thoughts about the performance (Lehmann, Sloboda, & Woody, 2007). The difference here is the cognitive appraisal of those symptoms to indicate threat and negativity (Juslin & Vastfjäll, 2008). However, it appears that music performance anxiety is not a more extreme version of a rush of adrenaline that might facilitate performance, or performance “boost” (Simoens, Puttonen, & Tervaniemi, 2015). Performers feel that anxiety results from perceived pressure, while the more facilitative boost results from perceived support. The most successful approaches to treating performance anxiety as a trait focus on cognitive and behavioral measures, and flow has occasionally been referred to as a desirable state that might help reduce anxiety (Wilson & Roland, 2002). Positive psychology and the strengths approach championed by Linley (e.g., Linley, Nielsen, Gillett, & Biswas-Diener, 2010) has the potential to help those experiencing performance anxiety (Lamont, 2012), although research is still required to support this assertion. What also seems paradoxical is that performers, both amateur and professional, continue to engage in an activity which they know will cause them genuinely negative emotions: with a lack of research it can only be assumed that the benefits outweigh the disadvantages in the longer term, similarly to other challenge-based activities.
When considering emotions in music listening, an important distinction must be made between emotions portrayed by the music itself and those experienced by the listener (Lundqvist, Carlsson, Hilmersson, & Juslin, 2009). It is generally accepted that these are not contiguous, but overlap to differing degrees. Listeners are typically able to recognize emotions that they do not themselves experience, and as shown earlier, performers are also able to convey emotions they do not experience. However, music exhibiting a certain emotional tone is likely to influence its listeners and to evoke emotions in them. Listening to sad music is an apparent paradox which has puzzled researchers over the past decade or so, with various explanations being proposed. Huron (2011) initially argued for a hormonal component in that listening to music produced prolactin, a hormone generating a sense of solace. However, more recent evidence suggests that listening to sad music generates a state of emotional arousal, and sadness is experienced alongside enjoyment and being moved (Eerola, Vuoskoski, & Kautiainen, 2016; Vuoskoski & Eerola, 2017).
Hanser et al. (2016) discovered that listening to music was reported to be the most popular source of consolation in times of loss and sadness, and that the music induced a sense of being moved and a mixture of both positive and negative emotions. This use of music as consolation (cf. Saarikallio, 2011) is in some ways redemptive, and clearly has positive benefits. It was found in listeners who preferred either classical or popular music, and many chose “solace” music, which they counted among their favorite music. The description of the way people chose to listen to music for consolation reflects many of Csikszentmihalyi’s (2002) flow characteristics: turning up the volume, listening alone, and shutting out the environment. However, there is some evidence that listening to sad music can create higher levels of depression in listeners (Garrido & Schubert, 2015), particularly those with higher levels of depressive mood and negative social comparisons (ter Bogt, Canale, Lenzi, Vieno, & van den Eijnden, 2019). While most people feel they would benefit from listening to sad music, people with higher levels of rumination did not systematically report this (Garrido & Schubert, 2015), which suggests that we do not always engage in a search for positive emotion.
A More Integrated Approach
One similarity between PERMA and BRECVEMAC lies in the fact that they identify a number of different mechanisms or principles which in practice operate together. Seligman, Parks, and Steen (2005) have argued that activities need to try to incorporate as many of the PERMA elements as possible and that balanced well-being relies on all of them being met in some way or another (see also Sirgy & Wu, 2009). Juslin et al. (2014) attempted to isolate features of BRECVEMAC in a laboratory setting. They manipulated the musical features of a single sequence (randomly altering loudness levels, selecting a deliberately sad musical structure, inserting a familiar excerpt, or violating melodic and harmonic expectations) to deliberately evoke four of the different mechanisms (brainstem reflex, emotional contagion, episodic memory, and musical expectancy). Participants experienced the intended emotions (surprise, sadness, happiness/nostalgia, and irritation) from these manipulations, but also experienced unanticipated responses. For instance, the version of the piece designed to evoke sadness through emotional contagion also evoked nostalgia. This impossibility of isolating features clearly highlights the multifaceted nature of emotional responses to music.
Separating out the dimensions of performing or music-making and music listening also belies the complexity of how music works in flourishing. For the performer, music listening is a near-constant. Some intriguing work has explored how emotions might be experienced in the live performance setting. Van Zijl and Sloboda (2011) found that personal involvement with emotions varied at different stages of preparation for a performance. Emotional playing featured in the earlier stages of preparation, while an expressive performance was found to comprise more detached and conscious communication, with a smaller proportion of experienced emotion. Hearing the music while preparing the performance seems likely to have contributed to some of the emotional response, but successful communication of such emotion through performance required more detachment.
Another factor which is missed in part by treating listening and music-making separately relates to the type of music. Most of the research on motivations for music listening and the functions of music listening for the listener tends to ignore the details of the music which evokes the response, and very few studies address even styles of music, let alone specific pieces. The research on music performance largely ignores aspects of the music beyond the broad style within which the performer is working: for instance, jazz contains more improvisation and necessitates more communication and interaction between performers and a shared goal for a given performance, while classical music is more closely linked to the musical score and an interpretation which may be led by one or more of the performers but does not require the input of all those performing.
At a style level, there certainly are differences in engagement with different musical styles. For instance, younger adults prefer hip-hop/rap, DJ-based music, dance/house, R&B, indie and current chart pop, while older adults prefer classical, sixties pop, musicals, and opera (North & Hargreaves, 2007). Bonneville-Roussy, Rentfrox, Xu, and Potter (2013) found similar age trends. Preferences for Contemporary and Intense music peaked in adolescence and declined with age, preferences for Sophisticated and Unpretentious music were lowest in adolescence and increased with age, and preference for Mellow music remained relatively stable (see also Bonneville-Roussy, Stillwell, Kosinski, & Rust, 2017). However, style preference is rarely linked to any consideration of the well-being or flourishing elements of musical engagement (cf. Knox & MacDonald, 2016), beyond a small body of research focusing on the converse, i.e., the potentially negative effects of liking particularly “extreme” forms of music such as metal, rap, and hip-hop. This research tends to be motivated by the premise that aggressive music may generate violent emotions, but often finds that people drawn to such music experience very positive emotional responses to it (e.g., Thompson, Geeves, & Olsen, 2019), and long-term exposure to violent music does not generally desensitize people to violence (Sun, Lu, Williams, & Thompson, 2019). It thus seems likely that experience with such styles mediates any potential negative effects.
For performers, lifestyle is a major component of differences in well-being between different styles of music. It seems likely that classical performers experience a host of health problems, including burnout and psychological pressure (Pecen, Collins, & MacNamara, 2016), irregular sleep schedules (Vaag, Saksvik-Lehouillier, Bjørngaard, & Bjerkeset, 2016), and poor health habits (Panebianco-Warrens, Fletcher, & Kreutz, 2014). Vaag et al.’s research found classical, contemporary, rock, and country musicians all experienced a high prevalence of insomnia, while solo and lead performers, vocalists, keyboard players, and traditional musicians experienced greater anxiety and depression (Vaag, Bjørngaard, & Bjerkeset, 2016). Differences in the types of musicians affected by different health and well-being suggest that there are no clear patterns of negative results according to genre. However, a recent survey by Kenny and Asher (2016) suggests that metal and punk musicians were most at risk of accidental death or suicide, rap and hip-hop musicians were more likely to be murdered, rock musicians were more likely to experience accidental death, and health-related outcomes such as cancer or heart disease were most prevalent among folk, jazz, and blues musicians. The lifestyle associated with particular genres thus has particular consequences for flourishing or lack of flourishing.
At an individual level, the work on strong emotional experiences of music helps to redress this balance, but its conclusions are that there is very little about the music itself that can explain why it evokes such strong memories. Episodic memories which connect the listener to autobiographical events or people do account for individual listeners’ personal engagement with specific pieces, but research has shown that this is likely to be highly variable (Hanser et al., 2016), even within relatively homogenous populations (Lamont & Webb, 2010). There is some evidence that generalized acoustical features can be found from the individual pieces listeners choose in situations such as pain relief (Knox, Beveridge, Mitchell, & MacDonald, 2011). Conversely, often performers have little choice in the pieces they play, so the focus at a more general level is perhaps warranted, but exploring strong experiences of performance makes it very clear that performers do have similarly strong connections to specific pieces that perhaps merit more attention in future work (Gabrielsson, 2011).
The Goals of Engagement with Music
This chapter has highlighted many positive outcomes of involvement with music, as well as some that are less positive. However, on balance, the positive effects of either or both music-making and listening can provide powerful motivators for engagement with music in a range of applied settings, particularly when people are undergoing challenging circumstances. This relates most closely to the cognitive appraisal element of BRECVEMAC and the functional aspects of Tay et al.’s (2018) model in terms of the functions which music can serve.
In acute short-term situations, music can be used as a relatively straightforward means of emotion regulation to enhance positive mood and provide distraction, as well as boosting people’s sense of control. For instance, Dingle and Carter (2017) provided preliminary evidence that music listening was as effective as cognitive behavioral therapy to manage emotional states and cravings in smoking cessation. Similarly, Hallett and Lamont (2019) found listening to music helped participants maintain their longer-term exercise goals in a short-term decision-making situation: favorite inspirational music helped participants decide to undertake a planned exercise session as effectively as implementation intentions, and more effectively than controls. In induced-pain situations such as the cold-pressor task, music diminishes perceptions of pain (Choi, Park, & Lee, 2018), and in short-term settings such as post-operatively, music listening can be effective to divert attention (Finlay, Wilson, Gaston, Al-Duhaili, & Power, 2016).
Considering chronic conditions, music also has considerable potential to aid or ameliorate in a range of settings. Managing longer-term pain is an area that has received a great deal of attention in the literature, with evidence that music listening can also reduce pain intensity, unpleasantness, and anxiety levels in the short term (Finlay, 2014). Undergoing painful treatments for ongoing health conditions such as cancer can also be ameliorated through regular involvement in singing (Fancourt et al., 2016), and these positive impacts are also found for caregivers and bereaved caregivers as well as cancer patients. Singing has similarly been found to be beneficial for mothers experiencing postnatal depression (Perkins, Yorke, & Fancourt, 2018). Conditions more likely to affect older participants have also been aided through music, such as living with Alzheimer’s disease and Parkinson’s disease (Garrido, Dunne, Perz, Chang, & Stevens, 2018) and stroke rehabilitation (Särkämo, 2018), as well as tackling social isolation and loneliness in an aging cohort (Hays & Minichiello, 2005; Johnson et al., 2018; Lamont, Murray, Hale, & Wright-Bevans, 2018).
Returning to the theories of music and flourishing, the fact that musical activities of all kinds have the potential to evoke emotion and affect the participants in many different ways has been proposed as a main factor in its powerful potential. Särkämo (2018) outlines how music stimulates a widely distributed neural network which is related to emotion, arousal, and cognitive function. Lamont and Ranaweera (2019) introduced the new idea of repeated experience and a temporal dynamic approach to PERMA found in their data on musicians and knitters. Both began with initial phases of learning and teaching, through repetition of the process toward outcomes, and finally toward an overall sense of purpose, and most elements of PERMA were observed throughout, However, there were differences. While knitters had more social connections in the outcomes, musicians had stronger social connections in the learning and purpose phases. Longer-term engagement with music through these processes seems to be responsible for enabling participants to experience the “build” effect (Fredrickson, 2001) to enhance well-being over time. Music thus seems to have particular impact on flourishing due to its rich potential to engage on many levels and over time.
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