The Effectiveness of Music Therapy on Reducing Alexithymia Symptoms and Improvement of Peer Relationships

Document Type : Original Article


Department of Psychology, University of Isfahan, Isfahan, Iran



Introduction: Individuals with alexithymia are under the pressure of correlated physio-emotional stress that would not come out as speech. These problems prevent emotion regulation and make people incompatible in life.
Method: The purpose of this study was examining the effectiveness of music therapy on reducing symptoms of alexithymia and enhancing peer relationships. The method was quasi-experimental with two experimental and control groups. Through multi-stage sampling, one hundred and eighty girls were screened for alexithymia’s symptoms. Thirty of the 57 identified children, were selected randomly and assigned into control (n=15) and experimental (n=15) groups (mean 11.8 Years old) randomly in Isfahan, Iran. The instruments were the Rieffe’s Alexithymia Questionnaire for children and Sociometry for evaluating peer relationships. The music therapy was nine sessions which was done for the experimental group. Data was analysed with the repeated measure ANCOVA.
Results: The results indicated that music therapy had a significant positive effect on reducing alexithymia in the experiment group (ES = -0.34, (OP = -0.92), while there was no significant change in the control group (p >0.05). The results stayed stable after two months follow-up. Although the results showed peer relationships, the helper dimension improved; other peer relationships, the popularity, and rejection, were not influenced significantly.
Conclusion: In conclusion, music therapy positively affects reducing alexithymia symptoms of female preadolescents. Thus, using music therapy for reducing alexithymia symptoms is suggested. 


1.   Berthoz, S., et al., Effect of impaired recognition and expression of emotions on frontocingulate cortices: an fMRI study of men with alexithymia. Am J Psychiatry, 2002. 159(6): p. 961-7.
2.   Meriau, K., et al., A neural network reflecting individual differences in cognitive processing of emotions during perceptual decision making. Neuroimage, 2006. 33(3): p. 1016-27.
3.   Mantani, T., et al., Reduced activation of posterior cingulate cortex during imagery in subjects with high degrees of alexithymia: a functional magnetic resonance imaging study. Biol Psychiatry, 2005. 57(9): p. 982-90.
4.   Bird, G., et al., Empathic brain responses in insula are modulated by levels of alexithymia but not autism. Brain, 2010. 133(Pt 5): p. 1515-25.
5.   Peles, E., S. Schreiber, and M. Adelson, Variables associated with perceived sleep disorders in methadone maintenance treatment (MMT) patients. Drug Alcohol Depend, 2006. 82(2): p. 103-10.
6.   Porcelli, P., et al., Alexithymia as predictor of treatment outcome in patients with functional gastrointestinal disorders. Psychosom Med, 2003. 65(5): p. 911-8.
7.   Porcelli, P., et al., Alexithymia and functional gastrointestinal disorders. A comparison with inflammatory bowel disease. Psychother Psychosom, 1999. 68(5): p. 263-9.
8.   Karami, J., Explanation of self-differentiation in accordance with attachment styles and alexithymia. International Journal of Behavioral Sciences, 2014. 8(2): p. 139-147.
9.   Peretz, I. and R.J. Zatorre, Brain organization for music processing. Annu Rev Psychol, 2005. 56: p. 89-114.
10. Elefant, C., Agami, A., Integration of children with and without special needs, in the Music Therapy Conference. 2001: Levinky College
11. Møller, A.S., H. Odell-Miller, and T. Wigram, Indications in Music Therapy: Evidence from Assessment That Can Identify the Expectations of Music Therapy as a Treatment for Autistic Spectrum Disorder (ASD); Meeting the Challenge of Evidence Based Practice. British Journal of Music Therapy, 2002. 16(1): p. 11-28.
12. Pérez-Aldeguer, S., Effects of music activities on peer relations in multicultural primary school
classrooms. 2013, Gdansk: The Academy of Music Gdansk.
13. Gaston, E., Music Therapy. 1968, New York: McMillan.
14. Asendorpf, J.B., J.J. Denissen, and M.A. van Aken, Inhibited and aggressive preschool children at 23 years of age: personality and social transitions into adulthood. Dev Psychol, 2008. 44(4): p. 997-1011.
15. Peters, J.S., Music therapy: An introduction. 1987: Charles C Thomas, Publisher.
16. Lathom, W.B., Survey of current functions of a music therapist. J Music Ther, 1982. 19(1): p. 2-27.
17. Lotter, C. and W. van Staden, Verbal affordances of active and receptive music therapy methods in major depressive disorder and schizophrenia-spectrum disorder. The Arts in Psychotherapy, 2019. 64: p. 59-68.
18. Goerlich, K.S., et al., Hearing feelings: affective categorization of music and speech in alexithymia, an ERP study. PLoS One, 2011. 6(5): p. e19501.
19. Bruscia, K., Readings on music therapy theory. 2012: Barcelona Publishers Gilsum, NH.
20. Edwards, J., Music therapy and parent-infant bonding. 2011: Oxford University Press.
21. Amiri, S., Developmental relationship among social status, adapted behaviour, social skills, and conduct Disorder. Quarterly of Psychological Sciences, 2003. 6(21): p. 59-93.
22. Amiri, S., A Developmental Study of Oppositional Disorder in Social Status Groups. Journal of Iranian Psychologists, 2004. 6(2): p. 159-193.
23. Amiri, S., Academic achievement in socio-metric groups. Journal of Psychology, 2005. 9(2): p. 139-150.
24. Amiri, S., study of social skills in four different social status groups. Journal of Research in University of Isfahan, 2007. 4(1): p. 103-120.
25. Kouvava, S., et al., The influence of musical games and role-play activities upon primary school children's self-concept and peer relationships. Procedia-Social and Behavioral Sciences, 2011. 29: p. 1660-1667.
26. Allen, R. and P. Heaton, Autism, music, and the therapeutic potential of music in alexithymia. Music Perception, 2010. 27(4): p. 251-261.
27. Hartup, W.W. and Z. Rubin, Relationships and development. 2013: psychology press.
28. Pepler, D.J. and W.M. Craig, Assessing children's peer relationships. Child Psychology and Psychiatry Review, 1998. 3(4): p. 176-182.
29. Hejazi, E., The quality of friendship, friendship reciprocity and resilience. International Journal of Behavioral Sciences, 2011. 4(4): p. 319-325.
30. Theorell, T.P., et al., Musical activity and emotional competence–a twin study. Frontiers in Psychology, 2014. 5: p. 774.
31. Bergmann, T., Music therapy for people with autism spectrum disorder. 2016.
32. Flower, C. and A. Oldfield, Music therapy with children and their families. 2008: Jessica Kingsley Publishers.
33. Oldfield, A., Interactive music therapy: A positive approach: music therapy at a child development centre. 2006: Jessica Kingsley Publishers.
34. Heal, M., et al., Music Therapy in Health and Education. 1993: J. Kingsley.
35. Klassen, J.A., et al., Music for pain and anxiety in children undergoing medical procedures: a systematic review of randomized controlled trials. Ambulatory Pediatrics, 2008. 8(2): p. 117-128.
36. Hill, E., S. Berthoz, and U. Frith, Brief report: Cognitive processing of own emotions in individuals with autistic spectrum disorder and in their relatives. Journal of autism and developmental disorders, 2004. 34(2): p. 229-235.
37. Rieffe, C., M.M. Terwogt, and K. Kotronopoulou, Awareness of single and multiple emotions in high-functioning children with autism. Journal of autism and developmental disorders, 2007. 37(3): p. 455-465.
38. Silani, G., et al., Levels of emotional awareness and autism: an fMRI study. Social neuroscience, 2008. 3(2): p. 97-112.
39. Cassity, M. and J.E. Cassity, Multimodal psychiatric music therapy for adults, adolescents and children: a clinical manual. 2006: Jessica Kingsley Publishers.
40. Rieffe, C., H. Nasiri, and M. Latifian, Alexithymia and its relationship with physical complaints and emotional competency in children and adolescents. Iranian Journal of Psychiatry and Clinical Psychology, 2009. 15(3): p. 248-257.
41. Rieffe, C., P. Oosterveld, and M.M. Terwogt, An alexithymia questionnaire for children: Factorial and concurrent validation results. Personality and individual differences, 2006. 40(1): p. 123-133.
42. Coie, J.D., K.A. Dodge, and H. Coppotelli, Dimensions and types of social status: A cross-age perspective. Developmental psychology, 1982. 18(4): p. 557.
43. Tan, M. and N. Khetrapal, Music inspired framework for remediating emotional deficits in autism. Procedia Computer Science, 2016. 88: p. 469-474.
44. Windle, E., et al., The experiences of patients in the synchrony group music therapy trial for long-term depression. The Arts in Psychotherapy, 2020. 67: p. 101580.
45. Bensimon, M., D. Amir, and Y. Wolf, A pendulum between trauma and life: Group music therapy with post-traumatized soldiers. The Arts in Psychotherapy, 2012. 39(4): p. 223-233.
46. Erkkilä, J., et al., The effect of improvisational music therapy on the treatment of depression: protocol for a randomised controlled trial. BMC psychiatry, 2008. 8(1): p. 1-9.
47. Aalbers, S., et al., Development of an improvisational music therapy intervention for young adults with depressive symptoms: An intervention mapping study. The Arts in Psychotherapy, 2019. 65: p. 101584.
48. Honkalampi, K., et al., The prevalence of alexithymia and its relationship with Youth Self-Report problem scales among Finnish adolescents. Comprehensive psychiatry, 2009. 50(3): p. 263-268.
49. Hense, C., K.S. McFerran, and P. McGorry, Constructing a grounded theory of young people's recovery of musical identity in mental illness. The Arts in Psychotherapy, 2014. 41(5): p. 594-603.