Musical Expression of Psychopathology

MUSICAL EXPRESSION OF PSYCHOPATHOLOGY MARTIN KANTOR, M.D.* and HENRY PINSKER, M.D.1 Music is a mental activity which may be distinct from other forms of thought. According to Reik [1], "Music expresses what all men feel much more than what they think . . . emotions rather than ideas. ... It does not emerge from the flow of conscious thought, but from the stream of pre-consciousness." However, most of his book, The Haunting Melody, deals with the analytic exploration of musical themes as a form of association to be understood as all other associations . In an exhaustive review of papers relevant to psychiatry and music, Noy [2] found that "musical activity is everywhere perceived as an instrument used by the ego to accomplish mastering of various threatening forces." Kohut [3] quotes Freud as suggesting that in the case of really musical people, the musical value of the tune alone may account for its suddenly emerging into consciousness. The experience of a composer is presented in a quotation from Roger Sessions in a paper by Linn [4]: It must not be forgotten that, for the composer, notes, chords, melodic intervals —all the musical materials—are far more real, far more expressive, than words; that, let us say, a "leading tone" or a chord of the subdominant are for him not only notes, but sensations, full of meaning and capable of infinite nuances of modifications; in that when he speaks or thinks in terms of them he is using words which, however obscure and dry they may sound to the uninitiated, are for him fraught with dynamic sense. Apart from such clear relationships as the sad affect expressed in Tschaikovsky's Pathétique Symphony or the gloomy preoccupation with death often expressed in Mahler's music as well as his words [5], little has been established about the relationship between musical thinking and other aspects of mental or emotional life. * Clinical associate in psychiatry, Mount Sinai School of Medicine of the City University of New York, assistant attending psychiatrist, Beth Israel Medical Center, New York, New York 10003. t Associate clinical professor of psychiatry, Mount Sinai School of Medicine of the City University of New York, attending psychiatrist, Beth Israel Medical Center, New York, New York 10003. Perspectives in Biology and Medicine · Winter 1973 | 263 In the concluding section of his review Noy says, "It is evident that psychoanalysis has much contributed to the understanding of art and music. But one may ask: Is there an opposite effect too? May the study of music contribute to psychoanalytic knowledge in general?" Studies which begin with the music rather than with the musician or the listener are almost unknown. Friedman [6] has shown how regressive transformations explained as primary process reworking of the original material were important in serious music. An exploration of the music of Anton Dvorak reveals an illustration of what may be a manifestation of psychopathology expressed in music. In Dvorak's works is found a recurrent phrase which attains a prominent place in at least five of his major works. It also occurs in some of his lesser-known works. Musical material based on this recurrent phrase is presented in Figure 1 in as simplified form as possible so that the recurrent basic pattern or motif can be easily identified. It is not necessary to be able to read music to see the process of repetition. One need only observe the location of the notes. For purposes of clarity, all the themes have been put in the same key and rhythms have been omitted. Repeated notes complicate the pattern in some instances. As they are generally not accented (i.e., they are less important) and since they in no way break the pattern by their presence, they are written in smaller size so that the eye can easily identify the recurrent motif. Figure 2 shows Fig. ? 264 [ Martin Kantor and Henry Pinsker · Psychopathology in Music Fig. 2 12 themes (there are more), mostly from major works which repeat the same motif. Considering that creative people tend to repeat themselves, is it justifiable to attach importance to the recurrent use of this fragment? It is not unusual for a painter to portray...