Mass Media & Mental Health

Chair:  Dr. Miguel Angel Materazzi (Argentina)
Co-Chair:   Dra. Irene Jakab (USA)
Secretary:   Dr. Pedro Ruggero (USA)


Dr. Inés-Josefina PUIG

Whenever you feel sad, just start singing
Whenever you have fun, just start crying,
Whenever you feel empty, real empty
Just start looking
Jaime Sabines, “A paper left blank” [1]

As the first imprint of environment, human psyche receives sound. A primordial sound within the womb is the mother’s heartbeat. There is also sound whenever a mother either sings, speaks or loves –and, also, if she is crying. Sound is a vibration and a wave transmitted through space: by crossing over space, sound reaches the baby as a caress. Besides being wave and vibration, sound is also a touch, a caressing touch that, initially, goes all over the skin determining the container and the contents, the inside and the outside thus being a outer investment that is going to set the bases for a specifying of a bodily scheme gradually. Most probably, human voice must be the first element that makes the time-space orientation easier inasmuch as human voice is endowed with cadence and rhythm, the reach of which allows to ascertain distances. Human voice, and especially a mother’s voice is going to be the medium or instrument likely to have the promptest access to a baby’s inside even though the difference between inner world and outside world is not fixed still.

In his book “El ombligo y la voz” (The Navel and The Voice), the French psychoanalyst Denis Vasse[2] states: “Navel is a shutter. Voice is a subversion of the shutter. Whenever a voice either mentions or calls, voice goes through the shutter without, however, interrupt it (…) Any voice, be it listened to or spoken, evicts a person from the body he or she has been confined into through space and time, and takes him or her to live within the language (…) So, at the same time, voice witnesses that there is a limit but helps us to get rid of it.

Should we understand the voice in this sense, voice is located in an intermediate space between the organic realm and the organization, within a span between the biological body and the body of language or, if you prefer, the body social. So, neither the biological body nor the body of language could be thought of without the voice, even though voice itself does not pertain fully to none of them”.

Says further D. Vasse: “That has been an actual process can be displaced toward symbolic equations that –provided the mother favors them, smooth the loss of the original mother. In a sense, the use of a transitional object is an infans’ first creative action, an event that not only shows an ego aptitude –for example, the aptitude to grasp, but also evidences the subjective experience the infans performs on the basis of such aptitudes”.

So, if he/she so wishes, an infans can either tone down or avoid some perceptive ranges but he/she cannot cancel the voice register because, should the infant’s hearing, for any possible reason, could not perceive the maternal sound, his/her whole body will work as an extended, unending perceptive territory.

Now, if human voice is both cadence and caress, is it possible that music could not be so?

As far as I know, music –especially when song is involved, could produce a phenomenon we could call an enchantment, similar to the register of the unconscious primary process insofar as, whenever a subject is listening to music, the subject that already possessed an organized psychism is able to get transported through time and, maybe, losing the register of the present. Whoever listens to music is most likely to travel through time and space without leaving the place he/she is at that time. Music causes emotion, memories, evocation, and, at times, even though music is unable to product memories because memories are a more immature psychic organization that works on the basis of experiences, at least music can bring back to life the bodily sensation perceived previously. An idea could be repressed –our body, however will be able to perceive the emotion that a determined music awoke in the past.

Frequently, music evokes feelings and knowledge that, perhaps, are not even thought of.

Christopher Bollas[3] quotes Edith Jacobson: “Whenever any mother lies a baby on his/her stomach, takes the baby out of the cradle, changes the baby’s diaper, takes the baby in her arms or sits the baby on her lap, rocks, caresses, kisses, nurses the baby, smiles to, speaks to, and sings to the baby, she not only gives the baby all kinds of libidinal gratifications but also stimulates as well as prepares the baby for him/her to learn how to sit, stand up, crawl, walk, and so on –that is developing an Ego functional activity (1965, page 37)”.

Personally, I would add: she also stimulates the baby to sing.

Ch. Bollas now defines as a transformation object an infans’ primary subjective experience about the object, and a trace that such early link has left in adult life –that is, an identification emerging from “a symbiotic gathering wherein, first, the object is known as an existing recurrent experience –not precisely because it has been considered as an object representation, i.e. a kind of knowledge that is more existential than representative (…) The rhythms of such a process give much more expression to the nature of this object-relation than the qualities of this object as such”.

Paradoxically, music also allows us to have access to the time-space register which is proper of the secondary process of thought inasmuch as, quite early in life, music, by marking rhythms, limits spaces. Whoever listens to music has his/her attention captured, and his/her attention stimulated within a cognitive as well as emotive process. So, cortex and the limbic brain are stimulated; while the released serotonin allows us to register that pleasant sensation human beings are so fond of –so pleasant that, very often it entices subjects to undertake repeated searches aimed at finding anew an award apt at ratifying a first satisfaction experience –an experience that has been either lost or neither attained at.

So, music would be a primary, as well as a secondary process simultaneously –joining atemporality with temporality, spatiality with non-spatiality.

From his/her surroundings, an infans receives the loving sound of his/her mother even though he/she is also able to perceive either shouts or any other unpleasant sound registers. Anyhow, this satisfactory experience linked to the loving voice of either Mom or Dad must be so strong that it calms him/her while transporting him/her to moments full of satisfaction and quiet. Any human subject acting as a baby caretaker tends to give calming and soothing sounds even though such sounds do not last as long as they should while baby is yelling in anguish. It is, however, an observable fact that, during an initial contact, any adult decided to calming an infans will try and impart a rhythmic cadence to voice spontaneously.

Music, as the art to combine sounds, if used since infancy repeatedly at more or less regular intervals could bring babies a self-calming award resource that would be a beforehand equivalent to being cradled by supporting, containing arms.

As far as I understand, the psychic organization of severe psychic sufferers, subjects suffering from what we could call pathologies of our modern times, that organization is missing enough integrated ego aspects, reason for which those aspects work as a crucible full of multiple, more or less autonomous identifications.

Such partial identifications usually correspond to a type of immature psychic apparatus, fragmented among its Ego, Id, and Superego corresponding portions (this is how I understand the borderline organizations psychism). Those immature areas of the psychic apparatus cause a subject to function anarchically, as he/she was tugging at each separate area –which gives us the phenomenistic impression that such a subject’s behavior is disruptive (and, quite often, the behavior in question is disruptive).

I understand that music, especially what is called song-along, or when we sing a song, could operate as an organizer of psychism. How could that organizer operate? Early enough, as I already mentioned, this would contribute to a delimitation of time and space –hence, contributing to both a capacity for awaiting, and tolerance to frustration. Owing its rhythm and vibration characteristics, song could favor both the constitution and register of the bodily scheme. Inasmuch as music experience is rewarding it could help self-soothing the occasional “emptiness feelings” an infans is likely to experience –so, music would stand for a transference of the motherly function –it can be said that something similar happens with a psychoanalyst’s voice that a patient not only hears but also perceives as a whole at regular intervals as this occurs within the analytical setting.

On the basis of this gratifying, self-soothing experience, subjects endowed with a fragile ego, the fragments of which are multiple, could find in music a calming experience apt at reducing the emptiness feeling. Thus, it could be said that getting high with dream-driving opiates, pain-killing cannabinaceous, stimulants that make a subject active and temporarily apt at escaping from grief are desperate intents to either get again or, perhaps, get for the first time a mythical experience in satisfaction. So, why wouldn’t we offer music as an alternative to such a despair? Indeed, music could be offered, in an organized, important way since a child’s first sociocultural contacts in school –that is, not merely as an unimportant hour within the usual school schedule.

I consider that both practicing and listening to music could be instated as a valuable preventive activity within the scope of M.A. Materazzi’s[4] community Unspecific Prevention Permanent Program –i.e. not just as another therapeutic tool as music therapy is.

Should severely disturbed subjects could be aware of this simple resource, and could use it, they probably would use it at any moment they were in need of but not just as an entertainment: just as a scientifically constructed and validated mechanism.

Within the medical realm, what is the reason why an antidepressive medication is promptly administered to an anxious subject instead of prescribing him/her to spend some time either singing or listening to his/her favorite music? And there is more to it: why both, sound and music are not combined with the practice of a physical activity –such as dance or folk dancing for instance inasmuch as dancing also combines rhythm, time, and space? It is a well-known fact that, if those experiences prove to be gratifying, on a periodical basis, they will cause an instant release of serotonin at the same time as a more lasting improvement of anxiety and depression, should this experience be sufficiently prolonged.

Frequently, borderline organizations also involve attention deficit, eating disorder, impulsive behaviors, substance use. As far as I am concerned, I understand that music –either played or listened to, the practice of dancing, and, in general any physical, rhythmic exercise are likely to offer resources apt at functioning as an antidote against those disorders. I have already mentioned aspects related to rhythm, pause, time, space, and tolerance to frustration as an expression of aspects borderline organizations are missing.

I propose a regular practice of music, either practiced or perceived, as a vital lead during the education training of a person, and, even, during his/her working life. Could it be too bold an idea imaging that businesses include the weekly practice of one or two hours of music within the working hours? Besides, if sustained and repeated, such a practice could work as a preventive resource against possible, future cognitive disorders inasmuch as it could reduce the allostatic burden –in terms of Bauleo & Alvano[5], that is the incidence of the stressing working factor.

Besides, learning songs, and sharing a musical space could contribute to offering a recourse aimed at uniting the violent drives that are human beings’ proper insofar as those drives can be influenced by culture whenever culture tries and fulfils its mediation role. Of course, violence is inherent to human nature and culture, and there have been cultures that were more violent than other ones.

Our postmodern society of the beginning of the 21st century features repeated attacks against those elements that, in a way, try to deal with aggressive expressions. It could be a chance fact or not but we can say that the current, urban communication style not only diminishes but also attacks wait in favor of the ephemeral immediacy. Awaiting for a kind of social organization apt at guaranteeing that some hierarchy is given to healthy resources such as the abovementioned resources could be deemed to be too Utopian?

It is my contention that using and taking advantage of those three resources, namely music, dance, and physical exercise, more than being either Utopian or dream-like would be economical… and a real attack to drug dealing while working as a preventive and therapeutic tool to the service of community.

For any reason, in science fiction stories, whenever human beings from either the past or the future are depicted as being quiet and peaceful, such tranquility is linked to either State’s or private organization control mechanisms. Reference can be made to movies based on novels: “The Time Machine”, by H.G. Wells where two populations were included: the Morlok, a population who lived deep down into the earth, and the Eloi who lived on the surface, enjoying peacefulness and all available pleasures but, actually, they were raised as cattle to feed the Morlok; “1984” by George Orwell –Big Brother is watching you, the enemy located in Eurasia, Mr. Samuel Goldstein the repository of hatred… and the so-called Ministry of Love, a life where the regulation of emotions was the prime factor to dominating subjects through fear. And, more recently, “The Island” dealing with a cloned population (who ignored they had been cloned by a specialized company financed by millionaires dreaming with eternal life). By means of a supposed lottery they believed they could win a trip to the Island –a paradise-like place that supposedly was the only unpolluted site on earth while, actually the Island did not exist –instead going to the Island meant being killed: clones had been created to become organ donors so that fresh organs could be transplanted to the sick but rich people who had entered the program.

So, according to the teaching of sci-fi novels and movies, it could be considered that quietness, in human beings, could only be a certain unconsciousness about the risky conditions they live in instead of being the results of a favorable evolution achieved through culture.

In my therapeutic experience as a psychiatrist and a psychoanalyst, when performing an interpretation, I sometimes include fragments of songs that had been significant for the subject under treatment, according to his or her history and sociocultural context. Without mentioning my being off key at times, until now results have been satisfactory. Thus, I propose a permanent learning of songs as a method for the cognitive stimulation likely to prevent gradual, pathological oblivion. This simple method could be easily applied in any organized community.

It is my contention that music is always waiting for us, and proposes us to set out and find it. In our capacity as Health professionals devoted to take care of the well-being and the quality of life –our life as well as our patients’ own, let us go and find it.

In this connection, I would like quoting Mario Benedetti, an Uruguayan poet:


If you could be able to get inserted within music
and relax therein while the world
keeps being a combustible thunder
perhaps you could stop death,
with no powerful motives at that,
only because she is a bore and never surrenders

If you could be able to install yourself within music,
being a violin, a guitar, or a harpsichord
and selecting happy hallucinations
or shy, temporary questions
then the soul would sound like a dream
or like the miracle of a bird suspended in the air

Nobody, however, has been able to get inserted
like a spy between two modulations,
in that odd span between strumming:
music will keep pertaining to others, forever,
other people who get around me at night
until I thread the needle of insomnia

(“Insomnia and light sleep”)

(Translations mine)


  • Bauleo, A., Alvano, S.A. “Avatars de la clínica”, Buenos Aires, Mediciencia, 2004.
  • Benedetti, M. “Insomnios y duermevelas”, Buenos Aires, Planeta-Seix Barral, 2003.
  • Bollas, Ch., “La sombra del objeto”, Buenos Aires, Amorrortu, 1991.
  • Materazzi, M.A., Programa preventivo permanente. In: Materazzi, M.A. “Salud Mental: enfoque transdisciplinario”, Buenos Aires, Salerno, 2004
  • Vasse, D., “El ombligo y la voz”, Buenos Aires, Amorrortu, 1977.
  • Winnicott, D.W., “Sostén e interpretación, Buenos Aires, Paidós, 1996.

For further reading

  • Aulagnier, P. “Un intéprete en busca de sentido”, México DF, Siglo XXI, 1997.
  • Aulagnier, P. “El aprendiz de historiador y el maestro brujo”, Buenos Aires, Amorrortu, 1997.
  • Castoriadis-Aulagnier, P. “La violencia de la interpretación”, Buenos Aires, Amorrortu, 2001.
  • Freud, S. “Análisis terminable e interminable”, Vol. 23, Buenos Aires, Amorrortu, 1997.
  • García Badaracco, J.E., “Comunidad terapéutica psicoanalítica de estructura multifamiliar”, Madrid, Tecnipublicaciones, 1989.
  • Green, A. “Narcisismo de vida, narcisismo de muerte”, Buenos Aires, Amorrortu, 1999.
  • Meissner, W.W. “The Borderline Spectrum”, New York-London, Jason Aronson, 1984.
  • Puig, J.J. “Algunas contribuciones sobre la obra de P. Aulagnier, A. Green y J.E. García Badaracco ¿El psicoanálisis no es para todos?”, a monograph submitted to the Sociedad Psicoanalítica Argentina, Buenos Aires, 2004.
  • Puig, I.J. “La organización borderline”, Neurociencias y Humanidades, on-line journal of the FINTECO Foundation, Buenos Aires, 2005.

[1] Sabines, J. “Papel en blanco” , a poem quoted in Mario Benedetti, “Insomnios y duermevelas”, Buenos Aires, Planeta-Seix Barral, 2003.
[2] Vasse, D., “El ombligo y la voz”, Buenos Aires, Amorrortu, 1977.
[3] Bollas, Ch., “La sombra del objeto”, Buenos Aires, Amorrortu, 1991.
[4] Materazzi, M.A., Programa Preventivo Permanente. In: Materazzi, M.A. et al, “Salud Mental: enfoque transdisciplinario”, Buenos Aires, Salerno, 2004.
[5] Bauleo, A., Alvano, S.A. “Avatars de la clínica”, Buenos Aires, Mediciencia, 2004.




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