Vibroacoustic Harp Therapy for Reduction of Tension / Pain: A 10-Subject Pilot Study

by Tim Hulley, M.A., C.M.P.

Abstract

Vibroacoustic Harp Therapy (VAHT) is a therapeutic approach in which an amplified acoustic harp is played into a chair or bed with built-in vibrational speakers, thus providing a “musical massage” for the client. The purpose of this study was to test the hypothesis that the average level of tension / pain for ten clients could be significantly reduced by a 60-minute VAHT session. This hypothesis was strongly supported by the study results, as the clients’ average subjective level of tension / pain was 49.9% lower after the VAHT treatments, and their average heart rate was 10.5% lower. These results support earlier research indicating that VAHT is effective in reducing tension / pain and suggest that continued practice and research is recommended.

Introduction

Among its many uses, music has been utilized as a healing modality for thousands of years. In recent years, the term “vibrational medicine” has become increasingly popular, referring to the conscious application of vibrational frequencies to facilitate healing in living beings. Healing in this context does not necessarily mean “curing” or eliminating illness, but rather achieving greater wholeness or wellness, whether physically, emotionally, mentally, spiritually, or energetically. There are a variety of vibrational modalities, including acupuncture, crystal healing, electrotherapy, radiology, radionics, Bach Flower Remedies, psychic healing, sound or music applications, and electromagnetics (Gerber, 2001).

In 1980, Norwegian Olav Skille developed a healing method  that came to be called Vibroacoustic Therapy (VAT), described by Skille as “a form of therapy where we transfer sound directly to the human body, using loudspeakers or transducers as the active medium … built into a chair, bed, or couch” (Williams, 1997). VAT essentially produces an “internal massage” by sending previously-recorded music into a vibroacoustic device on which a client is sitting or lying. The methodology was originally utilized with severely physically and mentally impaired children, whose symptoms included high muscle tone and spasm. Later, a variety of clinical conditions were treated with VAT in several European countries, with results including the following: a reduction of muscular tension; relief of spastic conditions / pain; treatment of pulmonary disorders; increased circulation in extremities; treatment of autism; treatment of stress, anxiety, and emotional challenges; rehabilitation therapy; improved range of motion for patients with cerebral palsy; and treatment of osteoporosis. Research conducted at the National Institutes of Health in the United States and the Kaolinski Institute in Sweden has indicated that VAT has no negative side effects (Williams, 2005).

The harp, with its wide range of frequencies, long sustain of soothing tones, ethereal sound, and archetypal symbolism, is well suited for providing a healing influence (Williams, 1993). Live music has many medicinal benefits, including affecting us “both emotionally and physically … Music moves from the ear to the center of the brain and the limbic system, which governs the emotional responses of pain and pleasure as well as such involuntary processes as body temperature and blood pressure” (Bush, 1995). There is substantial research indicating that live harp music can be effective at reducing tension and pain, including a study in which live harp sessions decreased pain and anxiety for a group of vascular and thoracic patients (Aragon, Farris, & Byers, 2002), and another in which a decrease in respiratory rate and heart rate was achieved for patients in an oncology inpatient unit after therapeutic live harp music was played (Briggs, 2003).

Sarajane Williams, a harpist, nurse, and psychologist, extended the use of VAT in 1990 by using an amplified harp to play music into a vibrotactile unit, thus developing the first application of Vibroacoustic Harp Therapy. The intention of a VAHT session is to provide “vibrational stimulation, resonance and harmonization in the body, mind, and energetic field, with both non-amplified and amplified, live, naturally-occurring, acoustic sound waves” (Williams, 2005). The initial sessions were conducted at a chronic pain center in Pennsylvania, and further research has followed. In one study, the pain / tension levels of clients receiving VAHT decreased by an average of three points on a 0-9 subjective rating scale covering many areas of the body, with the greatest effects on the legs, back, and shoulders (Williams, 2005), and in another, VAHT was shown to have positive effects on heart rate variability (Dallas-Feeney, 2004). Williams has continued to pioneer the practice of VAHT, conducting hundreds of client sessions, producing a variety of research studies, and teaching workshops to educate the next generation of VAHT practitioners.

In the practice of Vibroacoustic Harp Therapy, the rhythm and vibrations of the harp music are intended to provide a strong sonic resonance to which the client can synchronize, thus bringing him or her to a deeper level of relaxation and wellness. To facilitate this process, it is especially important to understand the principles of resonance and entrainment. Practitioner and educator Jonathan Goldman describes resonance as “the frequency at which an object most naturally vibrates,” and notes that “every organ, bone and tissue in your body has its own separate resonant frequency. Together they make up a composite frequency, a harmonic that is your own personal vibratory rate” (Goldman, 1992). Entrainment is the process through which the resonant vibrations of one object bring a second object into synchrony with it. “With entrainment, a stronger external pulse does not just activate another pulse but actually causes the latter to move out of its own frequency to match it.” (Leeds, 2001) Following the “physics of entrainment”, such synchronization is most likely to occur in a therapeutic setting if the client is capable of receiving and matching the vibrations and the music is played in a consistent and rhythmic way with sufficient strength to alter the resonant vibrations of the client (Atwater, 1988).

Recipients of VAHT often experience plucked notes in particular areas of their body, and these can change over the course of a therapeutic treatment. Chords often produce a stronger sensation and more entrainment. Sometimes vibration is only felt on one side of the body, and in these cases it is not uncommon for clients to regain sensations in the other side via the therapeutic process (Williams, 2005).

For the current study, the researcher assembled a vibroacoustic device and conducted VAHT sessions with ten participants. In addition to learning from published materials by Sarajane Williams, he was influenced by Carl Rogers’ “client-centered” therapeutic approach. Rogers advocated for catering the therapeutic process to the needs of the individual being treated, since “it is the client who knows what hurts, what directions to go, what problems are crucial, what experiences have been deeply buried" (Rogers, 1961). In this study, the comfort and preferences of the clients were considered in each step of the process. This is apparent in the following sections, particularly the Treatment Procedure section.

Method

The treatment procedure for this study was derived from VAHT sessions described in Williams’ textbook, “Good Vibrations: Principles of Vibroacoustic Harp”. Similarly, the subjective rating scale used in this study had been utilized in previous research demonstrating the beneficial effects of VAHT (Williams, 2005). The rating scale was used to record the difference in the “tension / pain” of participants’ pre- and post-treatment, defined in this case as “tension OR pain”, a combination of both conditions as experienced by the client.

Participants

Ten subjects were invited to participate in this study, all women ranging in age from mid-30’s to mid-60’s. They were friends and acquaintances of the researcher, and each had expressed interest in this therapeutic modality. The participants reported a variety of physical conditions or symptoms prior to their sessions, including muscle tension, Fibromyalgia, high blood pressure, Post Traumatic Stress Disorder, anxiety, and general body stiffness. None of the subjects had previously experienced VAHT.

Equipment

A 36-string Dusty Strings folk harp was used to deliver the sound to a Somatron vibrotactile mattress pad embedded in a “zero gravity” recliner chair. The sounds of the harp were picked up by a built-in microphone and amplified by a Fishman acoustic pre-amp prior to being sent to an AudioSource stereo power amplifier. An AudioSource graphic equalizer completed the setup by boosting the bass signals to enable them to produce sufficient vibration when sent to the vibrotactile device.

Measures

The participants’ levels of tension / pain were recorded using a subjective rating scale that had been validated by previous research studies. The scale allowed each client to assess her level of tension / pain on a scale of 0-9 in each of eleven areas of the body: 1) hands / arms; 2) face; 3) head; 4) neck; 5) shoulders; 6) back; 7) chest; 8) abdomen; 9) hips / thighs; 10) lower legs; and 11) feet. Additionally, each client was guided to take a measurement of her resting heart rate.

The treatment methodology also included identifying which harp tones the participant experienced as pleasurable (see Step #9 below), and recording these in the session notes.

Treatment Procedure

For each participant, a 60-minute VAHT session was provided, consisting of the following progression of steps:

1.       Greet the client and establish rapport. “A therapeutic relationship is perhaps the most integral part of any therapy that is offered.” (Williams, 2005)

2.       Describe the history and applications of VAHT, and discuss how it might be helpful in treating the specific needs of the client. Answer any questions the client may have about the session.

3.       Briefly discuss the client’s medical history relevant to the VAHT session. Discuss conditions for which VAHT is contra-indicated, such as a history of seizure disorders, cardiovascular disorders, pacemakers, hypotension, extreme neurosis, psychosis, or active internal / external bleeding (other than menstruation).

4.       Provide for the comfort of the client, by offering tea or water, a blanket and/or eye mask during the session, pillows, tissues if needed, and the lighting of candles. Explain how to tilt back the recliner chair, and demonstrate this if necessary.

5.       Support the client’s safety by starting with the volume all the way DOWN on the amplifier that supplies sound to the vibroacoustic chair, before turning on the electronic equipment. Let the client know that he or she is welcome to stop or modify the session at any time.

6.       Measure the client’s pre-treatment levels of tension / pain on a 0-9 scale by asking him or her to assess this for each of these body areas: hands / arms, face, head, neck, shoulders, back, chest, abdomen, hips / thighs, lower legs, and feet. Assist the client in measuring their heart rate. Record these measurements in the session notes.

7.       Inquire about the client’s musical preferences, to better understand their relationship to sound, and for possible input into the harp playing in Step #11. Record these in the session notes.

8.       Establish the appropriate volume level for the client. Turn on the electronic equipment, and then ease the volume up to one-quarter while gently plucking the most resonant strings on the harp. Finally, allow the client to take over the controls and choose the desired volume (he or she can alter this at any time during the session).

9.       Test the suitability of each harp tone for the client, by plucking each string in the lowest octave of the harp from low-C to the next-highest-C, and asking the client how he or she feels about the tone, on a 5-point scale ranging from very positive to very negative. Record these preferences in the session notes.

10.   Facilitate initial relaxation. Spend a minute or so preparing the client to receive the vibroacoustic treatment, using a simple method such as sounding a crystal bowl, a guided breathing technique, or any other appropriate method.

11.   Improvise on the harp for 25-35 minutes, focusing primarily on the tones rated as neutral-to-very positive by the client. (Occasionally mix in other tones to support an integration of full-spectrum sound.) Play the music at a steady “meditative” pace, approximately 60 beats per minute. Before beginning, let the client know that the ringing of a small chime will indicate that the harp playing has completed.

12.   Signal the completion of the improvisation. Let the client know that he or she can take their time in returning to full consciousness and opening their eyes.

13.   Allow the client to debrief the experience, and listen actively and reflectively. Answer any questions as necessary. “Be open and prepared to deal psychologically with whatever information is released” (Williams, 1993).

14.   Measure the client’s post-treatment levels of tension / pain on a 0-9 scale by asking him or her to assess this for each of the body areas outlined in Step #6.

15.   Let the client know that the session is complete. Thank him or her for their participation.

Results

The average post-treatment levels of participants’ tension / pain were 49.9% lower than the pre-treatment levels. Using a two-tailed t-test to analyze this result produced p=0.0001, indicating a statistically significant reduction in tension / pain level. Participants experienced the greatest decrease in tension / pain in their feet (66.7%), followed by the head (62.9%), face (61.8%), shoulders (59.7%), and back (53.0%). The average client reduction in tension / pain was at least 36.7% in all of the body areas, and only one client experienced less than a 39.2% decrease.

The participants’ average post-treatment heart rate (64.0 bpm) was 10.5% lower than the pre-treatment heart rate (71.1 bpm). Using a paired t-test to analyze this result produced p=0.002, indicating a statistically significant reduction in average heart rate.

The participants experienced the low-C tone as the most pleasurable (38% above neutral), followed by next-highest-C (27%), D (25%), F (18%), and G (17%). The tone rated least pleasurable was E (5% below neutral), and it was the only tone rated below neutral.

Discussion

Reducing Tension / Pain

The results strongly indicate that the Vibroacoustic Harp Therapy sessions were successful in reducing the levels of tension / pain in the study participants, thus supporting the primary hypothesis. Only one of the ten participants had a decrease of less than 39.2%, and even that person did experience a reduction (15.8%). Among the body regions most affected by the therapy, the feet had the greatest reduction in tension / pain. Here are some of the terms that participants used to describe their feet after the treatment: “lighter”, “less congested”, “melancholy”, and “a palpable feeling of energy moving.” The other highly-affected body regions were consistent with the results of previous VAHT studies (head, face, shoulders, and back).

The success of these sessions in reducing the levels of tension / pain was most likely due to a combination of factors involved in the treatment process, including the comfortable recliner chair, soft lighting, initial relaxation, harp playing based on individual note preferences, resonance of the vibroacoustic mattress pad, and debriefing at the end of the treatment. In this case the process was standardized to provide a consistent experience for the participants, but in clinical treatments some of the elements could be varied according to the needs of individual clients. A good approach might be to have a standard framework for the sessions, while allowing for adjustments or variations to be made at the time of treatment.

The conditions for the first two sessions were a little different than the following eight, as the therapeutic process was being refined. A new, more comfortable recliner chair was purchased after the first session, and a dimmer switch was installed after the second (to produce softer overhead lighting). These changes were guided by client feedback, which enabled the therapeutic setting and process to be catered to current and future clients.

Lowering Heart Rate

The typical adult resting heart rate is between 60 and 80 beats per minute, and in this study the participants’ average heart rate was reduced from the middle of this range (71.1 bpm) to near the bottom (64.0 bpm). A heart rate of 60 bpm or below is typical of a highly relaxed or meditative state, and from these results it could be inferred that the clients’ heart rates entrained to the 60 bpm meditative music being played during their sessions. It seems that the prerequisites for the “physics of entrainment” were met, as the clients were able to synchronize and the music was rhythmic and strong enough to lead them to entrain to its pace.

Tone Preferences

The most favorable tones experienced by the participants in this study were the low- and next-higher-C. As clients typically enjoy the lower, more vibratory tones as experienced through the vibroacoustic device, it makes sense that they would prefer the low-C tone, which produces the greatest vibration. However, the likeability of the next-highest-C tone suggests the presence of other factors, since this was the highest and presumably least vibratory tone in the rated spectrum. The next most highly rated tones were D (the second note in the C scale), F (fourth), and G (fifth). A possible explanation for this pattern of tone preferences has esoteric origins. Researcher Wilfried Krüger found that “one of the deepest secrets of the Pythagorean secret teachings, the sacred Tetraktys … comprised the four intervals of the octave, fifth, fourth, and second, according to whose governing laws … the life of the world and creation itself unfolds” (Hamel, 1976). This is an interesting interpretation that warrants further exploration.

Subjective Responses

A variety of subjective responses were expressed by the study participants, including some of the most common responses from a previous study: localized tension reduction; overall relaxation; increased body awareness, sensation, and tingling; feeling restored and nurtured; positive imagery and associations; and affective release including tears and laughter (Williams, 2000). One participant experienced the high tones on the harp as “summery” with “birds and butterflies” while feeling that the low notes provided grounding, bringing her “right down into the Earth.” Another saw “soft, curvy lines” of blue, green, and purple. Yet another felt “cooler in [her] shoulders” after the treatment. Some participants expressed feelings of oneness, such as “that feeling of being part of everything – as the music is vibrating within you.” Another described the experience as “vibration so palpable that it reminds you that you are more than this body – a comfortable, loving vibration to sink into.” Similarly, one person felt “a sense of confidence in the universe – that everything is going to come out all right.” Such responses are consistent with Sarajane Williams’ observation that “when the client is flooded with vibratory stimulation, he/she becomes relaxed, abstract thinking slows, and awareness expands” (Williams, 2005). Or as Guided Imagery and Music therapist Carol Bush suggests, “Through contact with significant material and the emotional release that is made possible [by listening to music], a renewed sense of rejuvenation and hope is often felt” (Bush, 1995).

Implications for Therapeutic Practice

The current study suggests that Vibroacoustic Harp Therapy can be effective at reducing the tension or pain of clients for whom it is provided. Beyond this, the possibilities for VAHT are highly promising, especially in the area of holistic health. As Olav Skille said, “We can say that the low frequencies massage the body and that music is massaging the soul. In VAT both the well and ill parts of the body receive the same stimuli – in this way we try to create total harmony in body and soul” (Williams, 1997). Indeed, the vibrations of music and sound operate on many levels when delivered through a vibroacoustic treatment, and affect both the client and the practitioner. Although the practice of VAHT has been occurring since 1990, in many ways practitioners have only just begun to tap the wellspring of holistic possibilities.

Here are some of the ways in which this researcher could expand his approach to Vibroacoustic Harp Therapy: 1) continue to develop and refine the therapeutic process using a client-centered approach;  2) incorporate theoretical models into the treatment process, such as the chakras, Chinese 5-element system, energy meridians, Reiki, and resonant frequencies of various organs and systems of the body; 3) explore the effects of various tones or intervals on health and wellness; and 4) explore the role of consciousness in the treatment process, since sound is a “carrier wave of consciousness” (Goldman quoting Steven Halpern, 1992).

Future Research

The current study could be expanded or new VAHT research ideas generated by making the following modifications: 1) utilize larger sample sizes, with both women and men as participants; 2) distinguish tension and pain as individual variables with separate treatment goals; 3) utilize control groups to isolate the factors involved in the treatment efficacy (e.g. live music vs. recorded music, music vs. no music, or music with vibroacoustics vs. music without vibroacoustics); 4) develop increasingly creative and effective ways to gather and categorize subjective results; and 5) develop and utilize other objective measurements, such as blood pressure and brainwave activity.

Publishing therapeutic results is important both in building a public awareness of vibroacoustic therapies and in further developing their effectiveness. Perhaps Olav Skille said it best, exhorting vibroacoustic practitioners to “publish your experiences! Remember, all data are valuable in order to let us see the overall picture of how music will influence our physical and mental well-being” (Williams, 1997).

 

References

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Briggs, T. (2003). Live harp music reduces anxiety of patients hospitalized with cancer, The Harp Therapy Journal, 1, 4, 15.

Bush, C.A. (1995). Healing Imagery & Music: Pathways to the Inner Self. Portland, OR: Rudra Press.

Dallas-Feeney, S. (2004). Pilot study demonstrates positive effects of vibroacoustic harp therapy on heart rate variability. The Harp Therapy Journal, 9(1), 1, 4, 6-7, 9.

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Williams, S. (2005). Good Vibrations: Principles of Vibroacoustic Harp Therapy. Macungie, PA: Silva Vocat Music.

Williams, S. (2000). Subjective Responses to Vibroacoustic Therapy. The Harp Therapy Journal, Fall Issue.