Let’s stop bashing ‘Alive Inside’

Perhaps you have seen Alive Inside, the film about music’s ability to counteract memory loss. Alive Inside is controversial among music therapists because it shows people listening to recordings and not experiencing music actively with a therapist. I understand why some therapists object. But the film is valuable, and so is recorded music as part of therapy when handled properly. Let me explain.


Like so many people, I was deeply moved by Alive Inside. I saw the film with friends and family and took part in two panels that screened it for the Massachusetts Alzheimer’s Association and the Reel Abilities Film Festival in Boston. Filmmaker Michael Rossato-Bennett was present for both. All of these viewings have brought me deeper into the beauty of the case studies the film presents. They show the power of music to reach across the divide of pathology.


Leaders of the American Music Therapy Association have offered a strong critique of Alive Inside, emphasizing that the film does not depict music therapy. As our professional association, they are the stewards of the integrity of our work. I support their position that passive music listening programs are not comparable to engaged, active music making with therapeutic outcomes. 


The controversy around this film reminds me of what happened after the publication of a 1993 “Mozart effect” study. It claimed that listening to music could improve certain kinds of brain function. It got a lot of media coverage and was accompanied by a remarkable surge in subscriptions to symphony orchestras and purchases of classical music recordings for family life. This was a positive outcome for music, even when the research was refuted. We have the same opportunity with Alive Inside. We as a profession can leverage this beautiful film and the wonderfully warm interest of the general public in the power of music toward a deeper understanding and reliance on music therapy. 


Here’s my hope. People in assisted living residencies and in skilled nursing homes have lots and lots of time on their hands. In an ideal world, each resident would have access to a private music therapy session and a group session daily, if indicated by clinical assessment. Even with these resources, residents would still have lots of idle time. As depicted in the film, when they are not stimulated and engaged, they become detached and vacant. They become less and less of themselves. 


The opportunity for passive listening experiences could help fill those hours. And a music therapist is ideally suited to arrange the playlists for each individual. The playlists would be based on a clinical assessment that identifies preferences (and non-preferences), styles and genres.


As music can do harm, it is important that music therapists be involved in choosing playlists. By harm, I mean the emotional distress that can come when music awakens certain memories. An example is the “Anniversary Waltz” that was ubiquitously played during World War II and for decades afterwards. A song with that power can disrupt the well being of persons with cognitive impairments. The confusion they already have can turn into distress if a song triggers memories and they do not see their loved ones or anything familiar in their surroundings. This is an example of why a skilled music therapist would benefit these listening programs. As Michael Rossato-Bennett said in Boston, he wants to see these tools put in the hands of music therapists. It is the ideal opportunity for music to be of service throughout the long days of people living in skilled nursing facilities.

-- Kathleen M. Howland


Kathleen M. Howland, Ph.D.,  is a certified music therapist (MT-BC, NMT/F) and speech therapist (CCC-SLP). She teaches undergraduate and graduate courses at Berklee College of