Music therapy in a specific country is
presented each month

Search entire Voices Fortnightly Columns Country of the Month Main Issues Moderated Discussions
powered by FreeFind

April 2004

Music Therapy in France

By Edith Lecourt |Author bio & contact info|

|Historical Introduction and How Economic, Social and Cultural Factors have Influenced in the Development of Music Therapy| |Professional Status of Music Therapy| |Where and How Music Therapists Work| |What Theoretical/Philosophical Traditions and What Research Foci Have Been Pursued| |Internet Links| |Selected References|
 

Historical Introduction and How Economic, Social and Cultural Factors have Influenced in the Development of Music Therapy

If from antiquity we find traces of therapeutic applications of music, with an emphasis on the treatment of melancholy (Lecourt, 1974, 1992, 1995), and theoretical propositions (e. g. Plato, the Boece's cosmic theory), we also know how important the use of music was during the Middle Ages. In Middle Ages the tarentism was the traditional practice of music therapy in France as it was in Italy and Spain. This practice still exists in some places. In the more recent times, music therapy in France has undergone two periods of expansion, almost a century apart. The first expansion took place from about 1820 to 1880 and the second started about 1960 (Brauner, 1959; Guilhot, Guilhot & Jost, 1964).

Before and through the Revolution of 1848, from the first to the second Empire, was, culturally, the age of romanticism and, as far as music was concerned, it was an idealistic period. The music education was introduced into the public schools, the National Academy of Music was created in Paris (Conservatoire). The idea was that the music, through harmony, has the power to unify a nation: in that aim the masses had to be educated through music and, even the insane could benefit from music. The first students of the conservatory were also the first music therapists as they were sent into hospitals to give concerts and some music education to psychiatric patients (Arveiller, 1980; Lecourt, 1992). It is very important to quote that this was the period when the consideration and the treatment of mental illnesses began and the psychiatry was created and developed by the work of Dr Philippe Pinel (1801) and his followers. Written evidence shows that during this first period music therapy had in essence two main functions - a social and educational function, and a more psychological regulating role. The social function was associated with nationalist objectives for which music constituted an instrument of national regrouping and a relational model. Musical societies, the Orpheons (choral groups and brass bands) developed throughout the nation (with musical national and international exhibitions) with the conviction that music education for the masses and workers would transform society. Beauty would win the hearts of the common people and civilize them. This music would also transform madness into sociability and reinstate patients in this new "musically harmonized" nation. In addition to its social function music wouldalso have a regulatory role: It was expected that it would calm the restless and stimulate the apathetic through mood and behavior regulation. These objectives were mainly developed through having patients listen to music (concerts organized in hospitals), but also through music education.

The second period started at the time of another revolution, 1968. Musically, it was the time of an attack on harmony and tonality (after Schönberg and the creation in France by P.Schaeffer and P.Henri of "concrete music") which took place with the introduction of sounds and noises as new elements of composition. This new perspective where the interest was taken not only in harmony, but also in disharmony, polyphony, and noises has been important for a new conception of music therapy. In the field of psychiatry, we see the anti-psychiatric movement together with the reign of psychoanalysis, and we see a period of expansion for the Lacanian movement (importance given to linguistic considerations). In this period music therapy re-emerged to a great extent from the same expectations: interest in the study of the effects of music on the behavior of individuals. Thus, music listening was used especially for mood changes (with Jost's methods) and for relaxation and analgesia (with the new research in dentistery by Dr. M.Gabai, and in the preparation of delivery initiated by Dr. J. Feijoo with first results on the fotus's sonorous perception ).

However, the main function attributed to music therapy in France is a psychotherapeutic function (i.e., how music-listening and improvisations act upon the way in which the psyche functions). Under this heading is found the structuring of the acoustic experience (from chaos to sound), its integration within a code ( process of symbolization and social dimension), the place and quality of sound, and/or music communication in relationship etc.

It is easy to understand, therefore, that during these two centuries the main applications have been developed in the field of serious personality and relationship disorders in psychiatric care of children and adults (autism, psychosis, depression, deep mental handicapped).

In 1964 Dr J. Guilhot , (psychiatrist), his wife M.A. Guilhot (psychologist), and J.Jost, (engineer) wrote a book with a perspective of music therapy in a behavioral and humanistic psychotherapy. In 1969 a Center for music therapy was founded in Paris and a team created with J. and M-A. Guilhot, J. Jost , E.Lecourt (psychologist), M.Gabai (dentist), and M.Estellet-Brun (a professional musician, organist). The main technique of music therapy at that time was receptive music therapy in individual settings and in groups. In 1972 the first association and training was created.

One highlight was the First World Congress of Music Therapy in Paris, in 1974, at the historical Hospital Salpétrière (fourty countries were represented), and with an Exhibition of paintings of the period of musicalist painters in the church of this hospital. This was the result of a previous meeting of a little international group in Berlin (H. Willms, D. Breitenfeld, A. Fenwick, E. Lecourt .), were the idea of a world congress emerged, and Edith Lecourt was finally charged to organize it in Paris, in the French music therapy. And it was the beginning of a great period of exchanges of international information. We invited foreign colleagues like J. Alvin, A. Schmölz, C. Bang, R. Benenzon, J. Moreno etc. to know more what was going on about music therapy in the world.

In 1980 a scission took place in the original team and a new association was created Association Française de Musicothérapie with P. Pennec (psychiatrist), J. Pennec, (musictherapist), E. Lecourt, J.Verdeau-Paillès (psychiatrist), F.Rougeul (psychiatrist), L.Azinala (music teacher), and some other clinicians. This association is a professional one. After the scission the first association was named the Centre International de Musicothérapie, directed by J.Jost and his team (his daughter S.Braun is now at the head). Other regional associations is also created since that time (Bordeaux, Lille, Nantes, Metz etc.). As a consequence of the scission there were two world congresses in Paris in 1983, one was organized in March by Jacques Jost, and the other was organized in July by Edith Lecourt. These different associations have recently created a French Federation of Music Therapy to unify the profession and to realize a register of trained music therapists.

Professional Status of Music Therapy

French music therapists are generally professionals from other disciplines (physicians, psychologists, educators, nurses, special educators, music teachers, professional musicians) with a postgraduate training in music therapy. This training is offered by universities and in private institutes and associations. During the history of music therapy, and even now, the move is generally from private to public sphere. The goal is a public access to music therapy both to practices and training courses. As a consequence the private practice is yet quite undeveloped in our country. In France we have a well established welfare system and this is why our goal is to contribute as music therapists to this system. Our national health assurance will soon define some categories of psychotherapies to be covered even in private practice (music therapy practices in health centers are always covered but as part of the treatment). At the same time a national register of psychotherapists is going to be realized, in order to control these activities.

These new decisions of the state will have consequences on the development of music therapy in France, especially concerning the status of the music therapists. They will have to choose to be officially a type of psychotherapy and have the training decided for that by the state, or to join another category of helpers not included in the health system (or being devided between these two possibilities).

We began the training in music therapy in 1972 in our first association, and then the new associations appeared and we worked to create a more official training in universities (which are all state universities in France). We have now four university courses in music therapy. And this year, 2004, we create, in the LMD European program, a Master of arts therapies at the University René Descartes, with music therapy as one of the specializations offered. The Ph.D's with research on music therapy have been pursued either in psychology or in educational and social sciences departments in Paris. Research are realized in university laboratories (mainly in University René Descartes-Paris 5). The training program in the University René Descartes is attuned with the European consortium of Arts Therapies Education (ECARTE).

Where and How Music Therapists Work

Since 1970, specialized music therapy teams and departments have been set up in hospitals such as La Roche sur Yon, Limoux, Clermont-Ferrand, Nantes, Lille, Lyon, Paris, Montpellier etc. This institutional development was realized by teams of musically educated care workers (mainly physicians, psychologists, nurses, educators) coming together for training, and beginning together to set up this practices with their patients. These teams were then supervised in their hospitals by experienced music therapists.

About 600 music therapists have been trained in France but many don't practice or do no more practice music therapy. The register we are going to realize will tell how many are yet practicing. In France music therapy is widely implemented in general healthcare: in general psychiatry (with adults and children), in work with mentally and physically handicapped, in elderly care settings, in work with patients with Alzheimer's disease and in palliative care settings. During the last ten years applications in special education and with people with social difficulties have much improved. The methods are related to pathologies in six principal methods (Lecourt, Pennec, Verdeau-Paillès, 1998). Nowadays we use improvisation and active music therapy as often as receptive music therapy and they are in many cases combined.

What Theoretical/Philosophical Traditions and What Research Foci Have Been Pursued

The historical background of music therapy in France shows how from the beginning a link was created with psychiatry. And, as a consequence, it is also dependent on philosophical and theoretical movements in psychiatry: psychiatry/anti-psychiatry, biological/psychoanalytical and now also cognitive orientations, illness/trouble and new handicap etc. But the main conceptual orientation is connected with freudian psychoanalysis even if more recently some lacanians have manifested interest. Some well known psychoanalysts such as François Perrier, Guy Rosolato (with the concept of demarcation signifier), and Alain Didier-Weil has entered in the debate about music and sometimes also about music therapy. The debate with psychoanalysts about verbal and musical codes, for example, about music as a defense to verbal expression in therapy, expression or elaboration, emotional catharsis or a process of symbolization etc., has been sometimes very acute.

Music as part of the culture for handicapped people is an idea largely developed by André Fertier (composer, musician and music therapist) as a right to accessibility to culture for every one. With the same idea two main associations organize musical animations in child hospitals. But they do not consider their work as music therapy.

Lecourt's (1985) second thesis in psychology La musique, le groupe et l'inconscient [Music, group and unconscious] brought her theory to an official position which she could further develop, being University Professor in psychology (first in Strasbourg for six years and since 1993 in Paris, in the Sorbonne, the University René Descartes-Paris 5). Two main axes emerged in the search to analyze to what extent music is linked to the psychic functioning.

The first axe is the analysis of the processes going from acoustic to symbolization (cognitive and affective processes). This is especially important in the work with autistic, psychotic patients whose sonorous construction is not achieved. The music therapist has to help this necessary construction conducting to human communication. The second axe is the polyphonic structure of music as complementary to the verbal sonorous structure, and linked to the psychic group structure at the unconscious level (two especial research projects were realized on sound and music in dreams, and on internal music). This last focus combined the anthropological development of music structures and the psychoanalytical theory of group analysis and of the group dimension of the psyche. These two focus were developed through researches on some pathologies (autism, psychosis), on especial individual music therapy observations, and by the construction of a protocol of research, a setting for group observations through recorded improvisations named "communication sonore" which permits to distinguish sonorous phenomenon as group constructions at different period of the life of a clinical group.

These researches - during twenty years - offered some concepts suitable to give a comprehensive model of some music therapy practices. Together with theses research, some tools were proposed such as a "psychomusical assessment" by J. Verdeau-Paillès, a "sonorous and musical assessment of patients with autistic behaviors" by E. Lecourt, an assessment of method of music therapy by members of the AFM, and some others trials to clarify our work.

Qualitative and quantitative methodologies are applied for these researches. Ph. D. in psychology on music therapy practices have been realized: on Alzheimer patients, on abused children, on teenagers with school difficulties, on group practices with children or with adults. A research is now pursued on the method of analytic family music therapy, another on cultural aspects of the sonorous human experience (next results will be on french/japanese comparison). These researches are made at the University René Descartes - Paris 5, they have no private financial support.

Internet Links

Association

Association Française de Musicothérapie : http://www.musicotherapie-afm.net

Journal

La `Revue de Musicothérapie (since 1980) : http://www.musicotherapie-afm.net/revue/revue.php

Universities

University René Descartes-Paris 5: http://www.cfc.univ-paris5.fr

University of Nantes: http://www.fc.univ-nantes.fr

University Paul Valery-Montpellier 3: http://www.univ-montp3.fr/sufco

Music Therapists

Nantes Institute of Music Therapy : www.musicotherapie-nantes.com

Edith Lecourt home page : in preparation (for questions : edith.lecourt@univ-paris5.fr)

André Fertier : www.cemaforre.asso.fr

Selected References

Arveiller J. (1980). Des musicothérapies. Issy-les-Moulineaux : L.A.P.

Assabgui J. (1990). La musicothérapie. Paris : Grancher.

Brauner A. (1959). Les bases d'une pédagogie de l'arriération mentale: De la musicalité. Paris : Sabri.

Ducourneau G. (1989). Musicothérapie, clinique, technique, formation. Toulouse: Privat.

Gabai M., Jost J. (1972). La détente psychomusicale en odontosotmatologie. Paris: Maloine.

Guilhot J. and M-A., Jost J. (1964). Musique, psychologie et psychothérapie. Paris: E.S.F.

Guilhot J. and M.A., Jost J., Lecourt E. (1973). La musicothérapie et les méthodes nouvelles d'association des techniques. Paris: Editions Sociales Françaises. (also in Italian).

Jost J. (1990). Equilibre et santé par la musicothérapie. Paris: Albin Michel.

Kupperschmitt J. (2000). La musicothérapie en psychiatrie adulte. Paris : L'Harmattan.

Lapoujage C., Lecourt pp.19-29.E. (1996). A Resquise Francesa em Musicoterapia. Revista Brasileira de Musicoterapia. I, 1.

Lecourt (1971). La musicothérapie, historique et perspectives. Expression et Signe, décembre, pp.186-198.

Lecourt E. (1974). Dépression et musique, deux études de cas. Annales de Psychothérapie, V, supplément au N°9, pp.25-33 (in German : Musik und Depression, Musik + Medizin. 2, pp.31-34 and 3, 43-46.)

Lecourt E. (1977). La pratique de la musicothérapie. Paris : E.S.F. (in german 1979, Salzburg: O. Müller Verlag.)

Lecourt E. (1982). A propos de l'histoire de la musicothérapie en France. Revue de Musicothérapie. Vol. 2(4), 43-51.

Lecourt e. (1986). La recherche française en musicothérapie au cours des XIX et XX siècles. Revue Internationale de Musique Française, 20, 89-102.

Lecourt E. (1988). La musicothérapie. Paris : P.U.F. (in Italian : La Musicoterapia. Assisi: Cittadella Ed., 1992. In English see Barcelona Ed.)

Lecourt E. (1990). La envoltura musical, In D.Anzieu :Las envolturas psiquicas, pp.209-232. Avellaneda (Brasil) : Amorrortu Ed.

Lecourt E. (1991). Off-Beat Music Therapy : a Psychoanalytic Approach to Autism. In K.E.Bruscia : Case Studies in Music Therapy, pp.73-98. Phoenixville: Barcelona Publishers.

Lecourt E. (1992). Freud et le sonore, le tic-tac du désir. Paris : L'Harmattan. (in portuguese : Freud e o universo sonoro - o tique-taque do desejo. University of Doinania, Brasil: UFG. 1997).

Lecourt E. (1992). The functions of Music Therapy in France in the XIX° and XX°_ Centuries. The Arts in Psychotherapy, an International Journal. 19,2, 123-126.

Lecourt E. (1992). Mélancolie et musique. Psychologie Médicale. 24,6, 615-617.

Lecourt E. (1993). Analyse de groupe et musicothérapie, le groupe et le sonore. Paris : E.S.F. (in Italian: Analisi di Guppo e musicoterapia, il gruppo et il "sonoro". Assisi: La Cittadella, 1996).

Lecourt E. (1994). L'expérience musicale, résonances psychanalytiques. Paris : L'Harmattan.

Lecourt E. (1995). "Chante-plore", musique et dépression en musicothérapie. Revue de Musicothérapie. XVI, 5, 1-5 and 31-33.

Lecourt E. (1996). Research in Music Therapy on a Multi-disciplinary Background. In I.N.Pedersen and L.O Bonde (Eds) : Music Therapy within Multi-disciplinary Teams. Proceeding of the 3rd European Music Therapy Conference, pp.41-46. Aalborg: Aalborg Universitetsforlag.

Lecourt E. (1997). Apertura hacia un enfoque metapsicologico de la musica, In P.Del Campo : La musica como proceso humano. Salamanca : AMARU Ed.

Lecourt E., Pennec P., Verdeau-Paillès J. (1998). Musicothérapies. Encycl.Méd.Chir. (Elsevier, Paris), Psychiatrie, 37-817-G-10.

Lecourt E. (2001). Traumas de guerre et musique. Revue de Musicothérapie. XXI, 4, 5-17.`

Lecourt E. (2002). La musicothérapie, le groupe, et la musicothérapie analytique de groupe. Revue de Psychothérapie Psychanalytique de Groupe. 37, 97-110.

Lecourt E. (2005). Découvrir la musicothérapie. Paris: Editions Eyrolles.

Pinel P. (1801). Traité médico-philosophique sur l'aliénation mentale. Paris : Brosson J.A.

Pistone D. (1980). Les cadres politico-sociaux de la vie musicale. Revue Internationale de Musique Française, 3, 315-320.

Verdeau-Paillès J. (1981) Le bilan psycho-musical et la personnalité. Courlay : Fuzeau.

Verdeau-Paillès J. , M.Kieffer (1994). Expression corporelle, musique et psychothérapie. Courlay : J.M.Fuzeau.

Verdeau-Paillès J., Guiraud-Caladou J-M. (1976). Les techniques psychomusicales actives de groupe et leur application en psychiatrie. Paris : Doin.