Hatay, Türkiye
Renan Koen and Hatay Psychological Association Music-based Therapy Addressing Trauma
This is a photograph of one of the doctors for purposes of demonstration. It is not an image of a patient, and none of the photographs shown here are of patients.
Renan Koen is a composer, pianist, soprano, and music therapist. She has performed extensively internationally, including in the United States at Carnegie Hall. Following the earthquakes, she has performed throughout Hatay and with the Antakya Symphony in the ruins of Saints Peter and Paul Church. In her capacity as a music therapist, she partnered with doctors at the Hatay Psychological Association (HPA) to investigate the psychological and neurophysiological effects of sound collages on earthquake survivors’ healing processes.
HPA’s study considered whether Koen’s music therapy could influence post-traumatic stress, cognitive flexibility, psychological resilience, anxiety, depression, and EEG activity. The findings indicated that the music therapy led to improvements in cognitive flexibility, and reduced anxiety and depression.
Therapist: Renan Koen
Psychologists: Gulsen Filazoglu Cokluk, Esra Savaş Fatih Bal, and Mehmet Hanifi Kokaçya at HPA (Mustafa Kemal University, Hatay)
Image credits: Renan Koen, HPA
Principles
Koen believes that we have a sound memory that begins in the womb. As such, she does not introduce externally selected music to an individual, she asks questions to explore the person’s memory – the sounds of the homes she lived in, her mother and father’s voices, the languages spoken around her, lullabies, the sounds of the birds on her streets – the sounds she loved and those she feared. Koen’s experience as a composer then comes into play, and for each person, Koen creates a sound collage. These are not playlists in which favorite pieces of music are placed one after another. They are compositions created from material drawn from that individual’s own memories.
Koen works to create a space in which a person can work with disturbing elements within memories. Koen seeks to identify sounds that may bring a person happiness, tranquility or a sense of vitality, and to make these sounds accessible. She filters disturbing sounds to a proportion of twenty-five percent, and those associated with happiness and tranquility at seventy-five percent. Her intention is not to overwhelm the person, but to create a space in which it becomes possible to work with that material.
These images show a spectogram of a patient listening to her sound collage. A spectogram is a visual representation which shows the range of frequencies of the music as they vary over time. To read a spectrogram, you look at a 3D visual graph of sound where the horizontal axis shows time, the vertical axis shows frequency (pitch), and color or brightness shows amplitude (volume).
This image shows one of many EEG recordings collected before and after the therapeutic interventions. The findings following the interventions indicated the strongest improvements in areas of cognitive flexibility, anxiety and depression with less uniform improvements in psychological resilience and self-related functioning.
Psychological assessments were also conducted around emotional awareness, regulation, cognitive reframing, and future-oriented processing within an individualized listening experience. They included the PTSD Checklist for DSM-5, Cognitive Flexibility Inventory, Resilience Scale for Adults, Beck Anxiety Inventory, and Beck Depression Inventory.
Post-traumatic stress findings were more complex, and were interpreted as potentially reflecting activation and processing of traumatic material rather than straightforward symptom deterioration. The findings suggest that the intervention may influence trauma processing in multiple ways but that longer-term follow-up would be necessary to determine whether these short-term fluctuations translate into sustained symptom reduction.
The images above show a demonstration of an EEG performed, in this case, on one of the doctors.
These images are of Koen performing, including at the ruins of the St. Peter and Paul Greek Orthodox Church in Antakya with the Antakya Symphony.