Music Therapy For People With Vegetative State (PVS)

People with vegetative state (resp. apallic syndrome) apart from intensive medical, nursery, physiotherapeutic and neuropsychological care and treatment need a very exceptional form of care and attention. They need an intensive interpersonal contact.

Music therapeutic activities like singing, humming or improvisation on musical instrumente are a possibility to communicate to people in vegetative state a feeling of security, reliability, personal attention, care and warmth through near an intensive dialogues. This is especially important, if the patient in addition to the severe physical and possibly cognitive impairments also has experienced an emotional trauma.

Interpersonal meaningful music dialogues with people with vegetative state closely tie in with deeply rooted and prenatal experiences. They resemble the intimate mother-baby-dialogue (motherese - babytalk). Thus music therapy enables people with vegetative state on the ground of these experiences to re-open their inner life to the outer world.

Furthermore music engages the reward and lust center in the brian (ventral striatum), similar to a loving gaze or a tender touch in a relaxed atmosphere. Dr. Andreas Zieger, chief physician in an neurological early rehabilitation hospital, wrote on this: "Music verifiably affects the whole brain: activating and calming on the toning structures in the brain stem." "Music affects both cortical hemispheres, the  right cortex reacts on sound, intonation, dynamics and negative emotions, while the left side takes over analytical tasks like melody, metre, rhythm, pitch and positive emotions."

People with vegetative state react on musical offerings. The music therapist closely watches the most subtle impulses like chewing and smacking movements, movements of the eye lids, changes of viewing direction, fixation of the eyes, a deepened breath (deep breathing in and out), bodily relaxtion or tension, head turning and other movements of the body. Also emotional signs like changed facial expressions, smiling or crying suggest that people with vegetative state are capable to react on their environment and can experience music as a positive life-affirming and reassuring care.

Music therapy for people with vegetative state is a very important  extension of the complexe therapeutic treatment, for it can address basic human needs, it can change and augment the emotional realitiy and can act towards overcoming anxieties and experienced traumata.

reference: Andreas Zieger, Musik als Vermittlerin neuen Lebens. Soziales Zeichen der Hoffnung für Menschen im Koma und apallischen Syndrom. In: Neander, K.-D. (Hrsg.): Musik und Pflege. München: Urban & Fischer 1999, S. 145-164.