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Music and psychoanalysis may at first appear strange bedfellows. Their juxtaposition prompts several questions, for example, can music be psychoanalytically theorized? How do the psychodynamics of composers influence their musical compositions? What motivates listeners' responses to music? What role do music and musical associations play in psychoanalysis? Can music be therapy?

Francesco Barale and Vera Minazzi claim that the principle task of psychoanalysis has progressively shifted from Freudian interpretation to the “aesthetics of reception” in the analyst. A close reading of Freud will reveal that he was vitally concerned with the analytic stance: he admonished the analyst to creatively engage with the patient, “bend[ing] his unconscious like a receptive organ” toward the unconscious of his patient in order to grasp the meaning of the patient's communication. Contemporaneous and post-Freudian analysts subsequently identified compelling parallels between psychoanalytic and creative processes; for example, a likeness between the psychoanalytic attitude and musical listening. Theodor Reik described the analyst's unconscious and his stance of passive reception as a musical instrument through which the patient's unconscious communications resonate.

Psychoanalytic theorists recognize the capacity of music to convey a wide array of emotions that evoke in the listener powerful, preverbal feeling states. Mauro Mancia coined the phrase, the “sound archives of the transference,” to describe affective and procedural (i.e., nonverbal) memories, with which analysts are primarily concerned. Musical analogies abound in descriptions of the psychoanalytic process. For example, Wilfred Bion admonishes the analyst to be “in unison” with his patient. Thomas Ogden describes the therapeutic process as the “music of what happens”; an attuned analyst listens, not just to the words, but also with a “musical ear” for his patient's verbal utterances in order to grasp their underlying nuance, structure, and meaning.

David Beres goes even further in his analogy between psychoanalytic and creative processes, suggesting that one can be understood in terms of the other. He describes a process whereby conscious control of the ego is relinquished, in the former process in the service of regression, and in the latter in the service of the inspirational creative act. Whereas the analyzed addresses himself to the analyst in all his fantasy incarnations, the creative artist is perhaps unconsciously addressing himself to a fantasy audience; whereas the analyzed may enter a state of abreaction in which previously unexpressed emotion is discharged, the artist may enter a state of ecstasy or flow, or other intense emotion, which paves the way for spontaneous creative outpourings. Hans Sachs argues that both of these processes attempt to “tame the chaos,” or as William Wordsworth explained, the creative act of poetry is “emotion recollected in tranquillity.”

A “successful” analysis and a “successful” creative work are only possible with a reliving of emotional experience, in which the forbidden and the repressed are remembered and enacted, and upon which an aesthetic is superimposed. In this way, one's regressive primal fantasies are transformed into a collective mythology and folklore, and creative impulses are transformed into the formal aesthetic of a poem, a treatise, an artwork, or a sonata. Arnold Schoenberg captured the quintessential relationship between psyche and art when he said: “Art is a cry of distress from those who live out within themselves the destiny of humanity … Inside them turns the movement of the world; only an echo of it leaks out—the work of art.” Freud expressed a similar idea: “It is … not easy to form any conception of the abundance of the unconscious trains of thought, all striving to find expression, which are active in our minds.”

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