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STUDY ON SOME PSYCHOLOGICAL CRITERIA IN THE SELECTION OF MUSICAL PIECES PROPOSED FOR MUSIC THERAPY University Professor Ioan-Bradu Iamandescu, M.D., Ph.D., B.A.Psych. University of Medicine and Pharmacy “Carol Davilla”, Bucharest, Department of Medical Psychology University Assistant Ovidiu Popa-Velea, M.D., B.A.Psych. University of Medicine and Pharmacy “Carol Davilla”, Bucharest, Department of Medical Psychology Project executed within the research program of the International Center for Studies in Music and Medicine “Boris Luban-Plozza” – Bucharest I. PREAMBLE: PROJECT’S BASIS –THEME AND METHODOLOGY A. Theoretical basis Music is received and interpreted in a very personal way by the listener. There are three fundamental processes, implied in a genuine experience (“Erlebnis”) of a musical piece’s audition: - the cognitive processes: “inaugurated” with the tuning of the acoustic organ to the quality of music (perception of the pitch, the duration, the intensity, the rhythm, the timbre of the sounds, in their specific sequence – melody, and superposition harmony), and finalized through a complex cortical evaluation, implying other cognitive processes, especially thought, attention and memory. The result is either the evocation of a previously lived situation, or a (concrete or abstract) isomorphism “at present”, or combinations of different images and ideas, often having anticipative character, justifying the role of music in the development of creativity; - the affective processes: represent a reflection of the value for the listener, due equally to the music’s direct impact on the hearing organ (for example “soothing” or “irritant”, according to the intensity of perception and to specific timber combinations or to some dissonant accords) and also, to the evaluation of music’s quality, mediated by the ideational dynamic, via the superior cognitive processes (thought, imagination). Through their proportion, combined with the synchronous neuro-vegetative processes (“somato-visceral correlates”), the affective processes have a major implication in the plenary experience of the listened music. They decide, most often, the acceptation and the appreciation of the music, in a quasi-permanent “dispute” with the intellectual evaluation of music’s quality); - the volitional processes: ensure the maintenance of the attention on the musical “speech”, but, especially, cognitive processes’ focus on the evaluation of music’s quality; this focus is enhanced in musical critics. Essentially, the volitional processes ensure the premises for a certain objectivity of the appreciations and sustain subject’s concentration. It is considered that a music having a reasonable degree of acceptance from the listener (which declares being at least satisfied, or even enthusiastic) exerts a series of favorable, psychic and psychosomatic effects, on the organism. These effects were used in the frame of music therapy in two main directions: (i) prophylactic, trying to use the music in order to obtain a psychic and somatic relaxation, and (ii) curative, with large applications in psychiatry and psychosomatics. In what concerns the 1st direction, the vast majority of healthy people who find music as being the source of supreme spiritual satisfactions, have the so-called “3rd ear”(“troisième oreille”), which allows listening the music with the soul (“Hören mit der Seele”). Numerous authors (Verdeau-Pailles et al., Sengenwald, van Deest, Luban-Plozza and Iamandescu) offer numerous examples of music’s influence on the organism, justifying its introduction in the arsenal of psychotherapy and the definition given by Verdeau-Pailles (11): “music therapy is a form of psychotherapy which introduces in the therapeutical relations the music mediation”. As about the 2nd direction, it is logic to consider that the preference for certain music represents a guarantee for an action with maximal benefits on one’s health. The data in literature (7,10) sustain, as an argument in the favor of this affirmation, the releasing of endorphins and the decreasing of cortisol, whenever a pleasant music is heard, this fact having favorable consequences, via NK-cells stimulation, on the immune system, thus being stimulated anti-infectious and anti-neoplastic mechanisms. It is, at least theoretically, possible that the longevity be reached in this way, in a similar mode with the laugh effect, which generates also endorphin secretion (“who laughs, lasts”). Meanwhile, not all music, which is attractive for a listener, has – always - positive effects on his health. It is sufficient to remind the case of the so-called “techno” music, which showed noxious effects not only to hearing (Bell, in (8)) but also to the nervous system, inclusively by the installation of a “drug effect”, in which the central element is the psychical dependence (13). For these reasons, we have come to the conclusion that, even if in certain subjects the symphonic or chamber music don’t induce an acceptance state, or at least a subjective feeling of pleasure or affective vibration, it can still produce a series of “iceberg”-like effects (Iamandescu, 2000). These content both effects that can be realized by the subject in the plan of his affective mood (pleasure, enthusiasm, melancholy, sadness, etc.) or on his intellectual and even physical efficiency, but also more subtle effects, even for a subject with developed and trained introspection capabilities, e.g somato-visceral modifications (beginning with the muscular tonus and ending with the activity of the internal organs) (7,8,9,10). All these reasons shortly presented here, as well as the objective necessity of the selection, within music therapy, of certain music, closest as possible to the scientific criteria (which we consider are yet to be developed), and able to induce maximal therapeutic effects, were a start point in the constitution of our study’s objectives. We considered as main objective of our study the research of a possible primary affinity of the healthy hearing subject for a certain type of music, depending on his basal personality traits, and on the dominance for certain mood state (anxiety, depression, optimism), but also on the psychosomatic impact of the music (feelings and sensations). This evaluation of some “primary” preferences for certain type of music will be made in subjects hearing instrumental chamber music (for piano) and not having a rich experience in the domain (people with a medium level of musical culture). Yet, they all have a medium / high intellectual level, which permits a good introspection. The preferences can be deduced from the analysis of the emotions and the sensations produced by the heard music, presuming that the subject who feels some emotions and / or feelings prefers the type of music able to produce them. B. Material The research group (100 subjects, 50 male and 50 female) will have to fulfill the condition of homogeny in what concerns the age, the sex repartition and the intellectual level (medium / high), as well as the low usage of symphonic and chamber music (subjects without experience and / or minimal experience in audition of this music). These conditions, as well as the anticipative facilities regarding the practical study appear to be best fulfilled by the students of Medicine Faculty (2nd year). Our arguments for choosing this group in this initial research are the following: the medium / high intellectual level will permit a proper appreciation of the music, regardless of the lack of training and the lack of consolidation for a certain musical preference; a degree of enough high introspection for permitting the self-analysis of the emotions and of the corporal sensations within the Musico-test questionnaire; the homogeny of the group (intellectual level, age); the low usage of the music (pieces for piano from the pre-classical, classical and romantic repertory) will facilitate a more direct expression, not-influenced by the preferences previously created; exceptions from this rule will be the admission of maximum 10 symphonic fans or piano players (an eventuality rather rare at this age (19-22 years old)) and all these exceptions will be analyzed, in order to find suggestions for future studies (inclusive on students at Music Academy – specialization piano). The “ad-hoc” questionnaire for all subjects will enclose data regarding age, sex, musical preferences (types of music – eventually opera or symphony composers), as well as the quotation of the “affective value”, for each preference (see annex 1 – Musicotest) The musical (piano) pieces, chosen for audition: The list contents: 1.Johann Sebastian Bach – “Jesus bleibt meine Freude” (Choral von kantate BWV 147); 2.Johann Sebastian Bach – The last part (“Presto”) from the “Italian Concerto”; 3.Ludwig van Beethoven – Part I from the Sonata for Piano op.110, in A flat major (until the measure 84); 4.Ludwig van Beethoven – Allegretto from the Sonata op.31 (2. “The Storm”, until the measure 290); 5.Franz Schubert – Impromptu op.90 m.2, in A flat major; 6.Franz Schubert – Impromptu op.90 m.3, in E flat major; 7.Robert Schumann – Fantesiestücke op.4, nr.1 - “Des Abends”; 8. Robert Schumann – Fantesiestücke op.4, nr.2- “Aufschwung”. C. Method The duration Each piece has the duration between 2’50” and 3’30”, the closest within the frame of 3’15”. We preferred to use integral pieces, and only exceptionally excerpts; in this latter case, the interruption of the musical discourse has been conceived to let the impression of final for the listener (e.g. part I from the Sonata op. 110 by Beethoven). The quality of music Regarding the quality of music proposed for audition, we mention the following: - - it was used a single instrument with broad possibilities of expression, the piano, in order to ensure an independent variable, able to ensure the timbre homogeny of the sonorous stimuli; we had in view the realization of some couples (with contrasting effect), from the creation of the chosen composers (Bach, Beethoven, Schubert, Schumann), anticipating the following contrasts: -Apollinian-Dionysian (Bach-Beethoven, Schubert-Schumann)*; -slow versus fast tempo; -dreamy versus exuberant, passionate character. *We would have wanted to include in the study another 4 pieces for piano, by some modern, 20 th century composers (Prokofiev, Debussy), but a certain limit of supportability for the test would have been temporally exceeded ( > 1h30’). The Musicotest questionnaire Represents a “check list” (which is mentioned at the end of this paper – annex 1), containing items referring at the type of emotions generated by the audition, as well as corporal sensations – somato-visceral correlates of these emotions. This questionnaire has been applied from one of us in a previous paper (3) (annex 2), and was able to catch a series of correlates between the emotion’s type and the “adjacent” somatization, An example is the anxiety and the fear produced by a wagnerian musical excerpt (“Schläfst du, Hagen, mein Sohn”, from “Göttesdammerung”), correlated with the increased muscular tension, and the sensation of cold, versus the warm sensation accompanying the feeling of relaxation, fondness, produced by other wagnerian musical excerpt, from Siegfrieds Idylle. The HAD (Hospital Anxiety and Depression) test This questionnaire evaluates the two main affective states, anxiety and depression, using 14 binary-type questions. The test’s value (which has an intense utilization in Germanspeaking countries) consists in outlining a relative stable mood of the subjects, inclusively during music’s audition. An eventual statistically significant correlation between a preference for certain type of music and the results of the test could have a certain value in treating some anxious and depressive syndromes. The global Schmiescheck Personality Inventory This test has utility in the diagnosis of abnormal personality structures, being related to Leonhard’s theory regarding clinical / accentuated typology. It has 88 questions, 10 answer scales, the type of answer is binary (Y / N). The critical value is 18 from 24; at a value more than 12 we can presume a certain trend to abnormality in behavior. The tree test (Koch-Storra) This projective test furnish very useful information about the personality equilibrium, helping in identifying abnormal personality structures, but also in appreciating the degree of personality maturation, being accessible to all ages. The task is very simple (“Please draw an fruit bearing tree (the best as possible)”) and meanwhile, for most of the people, attractive. For this study we took into consideration 4 parameters that can be measured by this test, namely imagination, relationship with the past, Ego strength and the resistance to external pressure. An experimented psychologist can, not only to make a qualitative interpretation, but also to quantify these parameters, making them accessible to statistical processing. Last but not least, the tree test compensates the disadvantages most of the questionnaires have, including time waste, mandatory binary answers and the big number of items. I I. PRACTICAL SECTION A. The dynamic of the sessions 1. Introduction We have to specify that our study aspire to have psycho-diagnostic information: preferences, particularities of decoding the musical message (feelings, sensations) versus personality type. Yet, the experiment has a certain psychotherapeutic value, due to the character of catharsis, the subject being invited to express his impressions on the music. Thus, the subject: ● specifies, through verbalization, his emotions and corporal feelings; ● evaluates, by the intermediate of the scholar system of marks, some famous composers (he has the illusion of being some kind of “professor” which examines... Bach, Beethoven, etc.); ● the completion of Schmiescheck Inventory gives him a certain emotional relaxation, due to the discovery of some personality traits, a true revelation of his way of being; ● the completion of Koch-Storra test (tree test) implies a true relaxation, due to the process of creation. 2. The sessions 1. There are two sessions in a day of the study. Each session evaluates 10-12 subjects and is preceded by a briefing, which includes information about the listening of the music (two contrasting pieces for piano of the same composer); It is requested the completion of the Musicotest questionnaire, after the first round, and the quotation of the subjective value of the “pairs” of pieces, during the second round (evaluation II); 2. The sequences of both sessions are as follows: a) Session I: the audition of the pieces, two by two (approximately 3,5 minutes each), interrupted 4 times for quotation (in the check list of the Musicotest) of the emotions and corporal sensations: for instance - pieces nr.1 and 2, then evaluation I, pieces nr.3 and 4, then evaluation I, pieces nr.5 and 6, then evaluation I, pieces nr.7, 8, then evaluation I); b) Session II: the resumption of the audition, for the 8 pieces; it is requested the global appreciation of the music heard: for instance – pieces nr.1,2, then evaluation II (marks); pieces nr.3,4, then evaluation II (marks), etc.; 3.The questionnaires Schmiescheck and HAD are given to the subject, to be fulfilled at home; also, he is told to draw a tree on a A4 sheet of paper, the way he likes the best, under psychologist’s surveillance; 4.After the completion of the Schmiescheck and HAD tests and the drawing of the tree, the answers are analyzed, and the subjects are framed in some personality types, postulated by these tests; 5.The processing of the results that we have obtained implies the delimitation of two categories of data: Data furnished by the subjects and with direct referral to the musical pieces heard: a. the subjective qualifications given to them, considering “pairs” of composers and also “pairs” of contrasting pieces, for each composer .The maximal qualifications were taken into consideration; b. the direct impressions, mentioned in the “check list” of the Musicotest (emotions and corporal sensations). The total somatization score and the types of emotions and / or corporal sensations are noted. Data concerning the personality traits of the tested subjects: a. the score obtained at the HAD test, regarding the degree of anxiety and / or depression during the audition; b. data furnished by the tree test (as projective test): imagination, psychological antecedents, Ego strength, resistance to external pressure; c. the typological classification of the subjects, using the Schmiescheck Inventory (it will be, subsequently, correlated with the other results). B. Diagnostic deductions and therapeutical suggestions 1. The direct answers to the musical pieces listened a) The results of the check list completion We will take into consideration (with the keeping of each protocol for an eventual future analyze of the predominance of a certain emotion): emotions’ type – positive or negative; the total score of the symptoms (somatization). b) The appreciation by using qualifications (“marks”) for the listened music We will take into consideration the answers concerning the “atmosphere” (given by the tempo and style). The notations given are a = slow motion pieces, b = fast motion pieces, and the sequence is a1b1, a2b2, a3b3, a4b4, where the numbers represent the composer, each of them having an affective dominant: Apollinian (Bach - 1, Schubert - 3), Dionysian (Beethoven - 2, Schumann - 4). The codification of the marks for each subject will be made on two levels: - the greatest sum of the marks obtained, separately, by the two types of music (i.e. Σ a versus Σ b) express the preference for a slow, respectively fast tempo; - the average of notes a + b, for each couple from 1...5, the greatest expressing the preference for a certain composer (whose identity is known by the subject only at the end of the experiment). For the entire group of subjects we will consider, analogously, the following parameters: - Σa _____ A= n , and B = Σb _____ n , where n = number of subjects and A and B are the average qualification given to the two types of excerpts; - a1 + b1, x 100, a2 + b_______ 2, x 100, etc., that is the average percentage n n ________ obtained by each of the five composers, expressing an approximate preference for that composer. Both personality type (given by Schmiescheck and tree test results) and anxiety and depression level (expressed by HAD test results) will be correlated with data referring to the positive and negative psychic and psychosomatic effects of the audition: 1.Types of emotions (Musicotest) (positive, negative) 2.Total score of somatization (Σ CSV); 3.Types of somato-visceral correlations (corporeal sensations) (CSV) 4.subject’s preference for a slow or fast tempo; 5.subject’s preference for a certain composer: (Bach – BA, Beethoven – BE, Schubert - FS, Schumann – RS). Making the correlations between these series of results, we can obtain a matrix, like the one presented below: Figure 1 Data furnished by the audition Emotions -positive -negative 1.Bach a b Listened pieces 2.Beethoven 3.Schubert a b a b 4.Schumann a b Somatovisceral correlations (CSV) -total score (Σ CSV); -enumeration (specification) Preferences (marks) a+b Σa= Σb= Average a = Average b = For simplifying the interpretation we will use in the interpretation of diagnosis’ consequences the following categories of results: 1.the total score of the emotions felt; 2.the total score of the bodily sensations; 3.the average of the preferences for a certain tempo (slow vs. fast, i.e. Σ a / 8 vs. Σ b / 8); 4.the preferred composer (the maximum a + b). 2.The results of the psychological tests Each test expresses the amplitude of some basic traits, whose determination was made due to the interpretation of the answers. In the evaluation of the specific personality factors for the subjects in the study we will use the essence of each test, as follows: 1.The scales of the Schmiescheck test : demonstrativeness, over-exactness, overperseverance, impulsiveness, hyperthymia, dysthymia, cyclothymia, exaltation, anxiety, emotivity; 2.The anxiety score in HAD questionnaire; 3.The depression score in HAD questionnaire; 4.The subjective evaluation of the imagination, psychological antecedents, Ego strength, resistance to external pressure in Koch-Storra test. The results of the psychological testing will be written in a table, represented in figure 2: Figure 2 Test, parameters measured HAD test anxiety depression asthenia Schmiescheck test demonstrativeness over-exactness over-perseverance impulsiveness, hyperthymia dysthymia, cyclothymia Results (score) ● emotivity ● exaltation Koch-Storra test Imagination Relationship with the past Ego strength Resistance to external pressure These results will be correlated with the 4 categories of values mentioned, referring to the data furnished by the audition of the musical excerpts. 3.The statistic processing of the two series of results, furnished by the musical audition and of the psychological testing We will use the following statistic formula for the measuring of the simple correlation coefficient: Σ [ (xi – x0) (yi – y0) fi ] r = _____________________________________ Σ (xi – x0)2 fi Σ (yi – y0)2 fi where xi , yi = current value of the variables (anxiety, depression, score of the musical preference); x0 , y0 = average value of the variable; fi = frequence of apparition for some value. In the 2nd phase, it is compared the value Z, correspondent to the coefficient “r”, with the Z = value Uα = U0,05 = 1,96. Thus, for statistical significance it is necessary that ___ σz Z > Uα _ 1__ n-3 ________ If this condition is fulfilled, the difference is statistically significant at a error limit of α = 0,05. Because during the data processing, some other correlations can appear, some of them surprising, the use of professional statisticians could be in view. In a long run, the development of the study and the partial results could furnish new perspectives of this theme, making necessary the extraction of other correlations that the correlations previewed at the beginning. C. Conclusions We will draw the conclusions, depending on the nature of the obtained results. In the optimistic variant, they will be positive, emphasizing the presence of correlations between the variables concerning the (global) attitude of the subject towards the music heard, on a hand – and the psychological variables, on another hand. In such an eventuality, a series of musical pieces could be extract, according to the results and subjects’ preferences, for therapeutical use. In the case of a lack of significant correlations, we will re-analyze the conditions of the experiment, beginning with the selected music and tests, and ending with the practical circumstances of the experiment. Anyway, the authors of this study, both doctors and psychologists, intend, in the next future, to extend the field of interest of such a project to the psychosomatic patients. Depending on the suggestions made by interested persons we will re-think and re-organize such a study, extending the network of collaborators to other psychologists and musicologists. III. THEORETICAL AND PRACTICAL CONSIDERATIONS ON THE RESULTS 1.The relationship between the statistical data and the literature data The selection of the musical pieces in view of therapeutic use was made, generally, without a psychological (psychometric) testing of the subjects, only depending on the dominant mood, in healthy subjects, or on the clinical syndrome, in subjects come from the sphere of psychiatry, neurology or psychosomatics This mode of selection has the stamp of the subjectivity of the therapist, even if his musical culture (eventually the musical professional formation) or his intentions (the most used criteria) are at the highest level. Of course, even starting from such bases, the practice of the music therapy validated some positive results, true efficient “musical prescriptions”, e.g. those by Paperte, quoted by (5) (Bolero – “clearly excitant” and Debussy’s “Claire de lune” as “sedative poetical music”) or some piano pieces by Mompou, proposed for the control of anxiety and insomnia, as well as the “Goldberg Variations” by Bach. In aphasic patients, the prescription of famous musical pieces, together with a text previously known by the patient contributes, through the reawakening of a chain of conditional reflexes, at a faster recovery of the speech (10). In what concerns the study we propose, it starts from a premise which, within the range of our information, was not applied into practice, i.e. the selection of the musical pieces proposed for music therapy, according to the preferences expressed by the subject, his psycho-somatic reaction to the music heard, psycho-behavioral traits, internal impulses and his eventual predisposition. In our project, the selection itself starts from the choice of contrasting pieces, belonging to the principal symphonic and chamber music currents (exception modern music). 2.The limits of the study Beside the justified objections that can be brought to the study after the completion of its results, we consider that a series of limits can be foreseen, from this moment of beginning: - the duration of the experiment (1h30’) can be appreciated as exhausting by some subjects; - these pieces for piano in chamber style were chosen using disputable criteria, like the melodic accessibility, tending to cancel the advantage of the lack of familiarity, especially in young subjects; - the proposed variables – the tempo and atmosphere contrast – may not cover the entire qualities of the music (e.g. the passionate outbreaks from Schumann’s “Aufschwung” or the forceful, yet retained vibrations from the first part of the sonata op.110 by Beethoven); - the appreciations Apollinian-Dionysian are somehow subjective, as qualifications for the chosen composers, this being a reason for not quoting them in the initial part of the study; - the order of presentation can influence the subject, encouraging the remembering of the latest feelings / sensations; - the variable capacity of subjects’ introspection, as well as the eventual fluctuations of concentration can create errors; - the choosing of the tests, although had in view a relative brief (and convenient exploration), has still the risk of irrelevant conclusion. The development of the study in two phases (one at home) creates supplementary practical difficulties and doubts; - the choosing of the subjects as being young university students restricts the possibilities of enlarging the application at other population categories. In our study the selection of music with definite anti-stress properties remained the main objective. 3. Theoretical and practical perspectives Because the presentation of these perspectives has the character of some genuine conclusions, we will enumerate them briefly: 1.It would permit the instauration of some more or less objective (“measurable”) criteria, for the selection of the musical “substance” of music therapy. In addition an objective is not only to evaluate the receptivity for good symphonic and chamber music, in a therapeutic purpose, but also to find a good anti-stress music for healthy subjects; 2.It furnishes a series of practical circumstances in which the receptivity (affinity) for certain music can be evaluated; 3.It permits to the musical world to estimate the preferences of the public for a certain type of music or for a certain composer; 4.It offers the premises for a more complete evaluation (eventually with the aid of more complex neuro-physiological devices) of the psychosomatic impact of music; 5.In the plan of this psychosomatic impact of music, our study tends to establish the best formula for selection, according with the next algorithm: a)the psychological testing of the subjects (using on a hand the Schmiescheck and HAD questionnaires, on another hand the Koch-Storra test); b)the subjects’ questioning on their preferences for a certain composer or for a certain musical style (in symphonic and chamber genre), for a certain tempo (fast or slow) or for a certain atmosphere (shiny, meditative vs. heroic, dramatic, etc.); c)the degree in which music produces bodily sensations (the degree of somatization). In the case of the impossibility of performing (a), it is suggested that performing points (b) and (c) could be, in some situations, adequate (together with a careful anamnesis and observation). 6.We consider this study as aspiring to a beginning of using as objective as possible criteria for the selection of music for music therapy. Paraphrasing a very popular proverb in Romania (“Omul potrivit la locul potrivit” – The right man in the right place”) we could affirm that a main purpose of this study would be to choose “the right music for the right person”. We hope that the results of our study and also our endeavor will contaminate other researchers in our attempt to select musical pieces for music therapy, on the basis of objective psychological criteria. ”Per aspera ad astra”. IV. BIBLIOGRAPHY 1.Harrer, G. – “Grundlagender Musiktherapie und Musikpsychologie”, Stuttgart, 1982. 2.Iamandescu, I.B. – “Impactul psihosomatic al muzicii, premiză a muzicoterapiei” ([The psychosomatic impact of music – premise for the music therapy]), in I.B.Iamandescu (ed.) “Elemente de psihosomatică generală şi aplicată” [Elements of general and applied psychosomatics], Infomedica Publishing House, Bucharest, 1999. 3.Iamandescu, I.B. – “Musicotest W – Tentative d’ evaluation de l’impacte psychophysiologique de la musique” ([Musicotest W – Attempt of evaluation of music’s psychophysiological impact]), Rev.Roumaine Psychol., 1997, 41, 1, 87-94. 4.Iamandescu, I.B. – “Utilizarea muzicoterapiei la bolnavii chirurgicali” ([The usage of music therapy in surgical patients]), Medicina Modernă, 2000, 7, 3, 127-131. 5.Luban-Plozza, B., Laederach-Hofmann, K., Knaak, L., Dickhaut, H.H. – “Der Arzt als Arznei”, Deutscher Ärzte-Verlag GmbH, Köln, 1996. 6.Luban-Plozza, B., Iamandescu, I.B. – “Dimensiunile psihologice ale muzicii. Introducere în muzicoterapie”, Ed.Romcartexim, Bucureşti, 1997. 7.Miluk-Kobasa, B., Obminski, Z., Stupnicki, R., Golec, L. – “Effects of music on salivary cortisol in patients exposed to presurgical stress”, Exp.Clin.Endocrinol., 1994, 102 (2), 11820. 8.Sengenwald, B. – “Gundüberlegung zur Wirkungweise von Musik”, Dipomarbeit, Darmstadt, 1995. 9.Spingte, R., Droh, R. – “Musik-Medizin”, Fischer Verlag, Stuttgart, 1992. 10.Van Deest, H. – “Heilen mit Musik. Deutscher Taschenbuch”, Verlag Thieme, München, Stuttgart, 1997. 11.Verdeau-Paillès, Jacqueline – “Parmi les psychothérapies, la musicothérapie et sa specificité”, Revue L’Encéphale, 1991, XVII, 43-49. 12. Verdeau-Paillès, Jacqueline, Luban-Plozza, B., Delli Ponti, M. – “La troisième oreille et la pensée musicale”, Fuzeau, Paris, 1995. 13.Willems, H. – “Musiktherapie bei psychiatrischen Erkrankungen”, Fiscger Verlag, Stuttgart, 1975. Annex 1 MUSICOTEST W Sensations emotions and Regarding the 1st excerpt I.SENSATIONS 1.warmth 2.cold 3.chilly 4.headache 5.dizziness 6.itch 7.palpitations 8.shivers 9.nausea 10.faint 11.tension 12.stifling II.EMOTIONS A. positive 1.Quiet 2.Serenity 3.Tenderness 4.Delicacy 5.Joy 6.Elan 7.Exaltation 8.Triumph B.negative 1.Fear 2.Restlessness 3.Anxiety 4.Fright 5.Melancholy 6.Sadness 7.Despondency 8.Bad expectations 9.Anger 10.Grimness Regarding the 2nd excerpt