Music therapy: a recognised practice in the management of pain and anxiety

Music therapy is a care practice that uses music, sounds and rhythms as therapeutic tools for psychological, sensory and neurological disorders. This safe and effective non-medicinal therapy is of great importance in the management of pain and anxiety. It is also beneficial to the well-being and quality of patient care, especially when combined with other non-drug therapies such as virtual reality therapy.

What is Music Therapy?

In the first place, as far back as antiquity, the benefits of music therapy on the soul or on mood have been studied using various instruments, rhythms and sounds. Then, the modern history of music therapy begins in the 1940s-50s. This new form of therapy is then proposed to relieve soldiers suffering from post-traumatic stress disorder.

Initially reserved for psychotherapy, the therapeutic aims of music therapy have been greatly expanded, particularly in relation to pain, stress and anxiety. Music therapy is part of a care programme (surgery, nursing care, medical imaging, etc.) and is aimed at all populations (children, adolescents, adults, the elderly).

More than a hundred studies highlight the value of music therapy in the treatment of pain and anxiety. In addition to a physiological effect on haemodynamic (cardiac deceleration) and ventilatory constants, a psychological effect by encouraging listening has also been demonstrated. Musical harmony, created by the variation of rhythms, sounds and melodies, leads to a decrease in cortisol levels, a release of endorphins, serotonin and dopamine. These actions are accompanied by a significant decrease in the consumption of anxiolytics and antidepressants.


anxiety by listening to music

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Kühlmann’s meta-analysis showed that listening to music during surgery significantly reduced perioperative anxiety and pain in adult patients. These beneficial effects have also been observed in patients before and after general anaesthesia, demonstrating the ability of music to increase brain plasticity and cause changes in synaptic connections.

Music therapy can use a wide range of techniques to make the experience as effective and enjoyable as possible. These techniques include the variation of the instrumental richness, rhythm or frequency of the sounds, which allow for the creation of a musical journey that accompanies the patient in different phases. The structure of a music therapy composition is referred to as a U-shaped sequence, when the construction of the composition gradually guides the patient into a state of relaxation and then back into a state of alertness.

Combining music therapy
to therapeutic virtual reality

In the case of therapeutic virtual reality, music therapy is one of the three pillars of the experience. This is combined with verbal support and visual immersion in a virtual reality headset.

The originality of HypnoVR’s approach is based on the know-how and experience of medical hypnosis applied to virtual reality technology. The three parameters “music, voice and image”, whatever their combination, have been specifically developed to be synergistic in order to always offer the best immersion and therapeutic effectiveness.

The architecture of the musical compositions was thus created from a demanding set of specifications defined to support the medical hypnosis session. A collective of seven professional musicians was asked to compose the melodies. They all hold a postgraduate diploma in musical composition from the Conservatoire national supérieur de musique et de danse de Paris.

What architecture for HypnoVR music compositions?

These musicians composed 12 musical themes in four different styles: classical music, electronic music, acoustic music and world music. Each style has three different musical themes of about 30 minutes each. As a result, any patient can identify a familiar theme in the panel of musical compositions, adapted to their affinities, to maximise the comfort and immersion of the session.

The architecture of the musical compositions is structured in a U-shaped sequence, with proven therapeutic effectiveness. The session starts at a fast, stimulating pace and includes a rich instrumentalisation. It continues with a progressive and imperceptible lightening of the orchestration, a slowing down of the rhythm and an adaptation of the sound intensity in coherence with the hypnotic text and the path in the immersive visual environment (descending phase of U).

What happens during a HypnoVR session

This musical accompaniment of the patient, in synergy with the hypnotic words and dreamlike visual worlds, gradually takes the patient into a state of deep and hypnotic relaxation. At the end of the session, the patient is invited to reconnect with his or her environment, to re-synchronise with the ‘here and now’ and to benefit from a new energy. In this sequence, the musical theme is gradually fleshed out with increasingly rich instrumentation and orchestration. The volume increases and the pace quickens to accompany the return to wakefulness. We are in the ascending phase of the U.

The phases of the musical compositions are in total coherence with the different sequences of the visual path and the stages of the hypnotic accompaniment. The aim is to obtain a synergy between the stimulation of visual, sound and musical sensory capacities, whose therapeutic effectiveness exceeds that of a mono-sensory stimulation.

he global therapeutic approach,
according to HypnoVR

In the HypnoVR experience, the musical environment, the hypnotic verbal accompaniment and the immersion in a dreamlike visual universe constitute the 3 pillars of digital therapy. These 3 elements are specifically designed to exploit the full potential of therapeutic virtual reality.

Verbal support

The virtual route

The musical atmosphere

The verbal support, the central element of the session, consists of a hypnotic speech. They are designed by Chloé Chauvin and Denis Graff, anaesthetists, specialists in pain management, experienced hypnopractors and co-founders of HypnoVR. They follow the structure of a medical hypnosis session and are consistent with the patient’s immersive visual journey.

The software offers a choice of fifteen different texts, which can be adapted to as many therapeutic indications as durations.

The visual world is designed as a calm and soothing virtual evolutionary journey in which the patient progresses through pleasant discoveries, encouraging a gradual letting go, in phase with the hypnotic text. The speed, light intensity and colour range are specifically calibrated during the session to focus the patient’s attention and support the hypnotic process.

Unique and customisable sessions

The variety of musical themes, the variety of visual themes and the multiplicity of texts make it possible to adapt the session to the patient and the symptom to be treated. The overall experience is unique and customisable, with over 21,000 possible scenarios.

This high level of personalisation combined with the high immersive effect and U-shaped architecture of the music therapy compositions allows the patient to experience an effective and satisfying session as part of their care pathway, whether in a hospital or doctor’s surgery.

The HypnoVR solution, developed on a solid scientific basis, certified and clinically validated, is an effective non-medicinal solution for pain and anxiety. It is devoid of the side effects of anxiolytics and analgesics and can be easily integrated into any care programme without loss of time for carers.


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  1. 1. Kühlmann AYR, de Rooij A, Kroesse LFD, et al. Meta-analysis evaluating music interventions for anxiety and pain in surgery. Br J Surg 2018;105:773-83
  2. 2. Hole J, Hirsch M, Ball E, Meads C. Music as an aid for postoperative recovery in adults: a systematic review and meta-analysis. Lancet 2015;386:1659-71;
  3. 3. Kekecs Z, Nagy T, Varga K. The effectiveness of suggestive technique in reducing postoperative side effects: a meta-analysis of randomized controlled trials. Anesth Analg 2014;119:1407-19

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