The researchers determined the particle emissions and the associated maximum risk of transmission when playing many different wind instruments. The results provide clues as to how cultural events can be organized with the lowest possible risk of infection even during the pandemic.

The fact that wind music is not harmless for musicians and the audience in terms of infection control is due to the fact that particles with a size of less than five micrometres largely penetrate from the instrument to the outside. They remain in the air for longer and spread further, so that they can reach high concentrations, especially in unventilated rooms. How many of these small particles are released by the wind music also depends on the instrument.

A relatively large number of viruses can come from the clarinet. It releases significantly more aerosol, which can contain pathogens such as Sars-CoV-2, than the flute, for example. The risk of infection from a clarinet and a trombone at a distance of one and a half meters is already 50 percent after four minutes. At the same distance from a flute, this risk of infection is only reached after three hours. All other instruments measured were in between. In general, however, the risk of transmission from an infected person on a wind instrument is significantly lower than with singing or speaking people if they are in their vicinity for the same amount of time.

In the study, the team also investigated how well the risk of infection could be reduced by using custom-made particle filters, similar to the fleece of FFP2 masks. They placed the prototypes of the masks on the ends of the brass instruments; wooden wind instruments were almost completely covered with the filter material. According to Oliver Schlenczek, first author of the study, masks work reliably on the bell of brass instruments to reduce the emission of infectious particles. If the listeners also wear an FFP2 mask, the risk of infection is a maximum of 0.2 percent even after an hour.

Simone Scheithauer, Director of the Institute for Hospital Hygiene and Infectiology at the University Medical Center Göttingen, is very positive about these results. On this basis, much more targeted protective measures could be recommended in future and musical cultural activities could be maintained with only minor restrictions, even in critical situations. With sufficient ventilation and the wearing of FFP2 masks, lessons, rehearsals and concerts with wind instruments can be held safely, concludes aerosol researcher Eberhard Bodenschatz from the MPI-DS.

www.ds.mpg.de/3959178/220922_aerosols_instruments

SMM -- The Swiss Society for Music Medicine (SMM) brings together under one roof specialists from the fields of medicine and a wide range of therapeutic approaches, as well as scientists and professional musicians. A central concern of the SMM is to encourage constructive dialog between these groups. However, it also wants to help musicians who are struggling with specific health restrictions or are simply interested in putting their music-making on a sustainably healthy footing.

We are proud to have doctors in our circle who can offer medical solutions for music-related illnesses at the highest level. The SMM also points those seeking help from the world of music in the direction of low-threshold therapy services. The variety of methods, schools and techniques in the therapy jungle can be confusing. The decision in favor of a technique is often a matter of chance - usually based on personal encounters or recommendations. The prerequisite for therapy should always be a medical diagnosis. The right choice then determines whether success is achieved, but also whether damage can be avoided due to the wrong choice

With the 18th symposium, the SMM would like to offer those seeking help the opportunity to get to know some of the most important body-oriented approaches in music in one place and at the same time take the opportunity to talk to their representatives without obligation. The therapists should also be able to approach each other on this day. The following forms of body-oriented approaches to music are expected to be discussed: Feldenkrais, Alexander Technique, Dispokinesis, Functional Kinetics FBL, Klein-Vogelbach, Yoga, Pilates, Spiral Dynamics and Schlaffhorst Andersen breathing therapy.

The symposium will open with an unusual world premiere. It is a work by saxophonist Fabio da Silva, who was awarded an Ober-Gerwern Master's Prize for his outstanding Master's thesis at Bern University of the Arts (HKB). "Rugueux 10" for baritone saxophone, alto flute and pre-produced sounds is a low-frequency performance in which the baritone saxophone and alto flute approach very specific frequencies microtonally. Together with the soundtrack, a play between tension and relaxation, concentration and distraction is created. The use of different multiphonics creates stronger and weaker frictions.

Various recognized and proven forms of body-oriented approaches in music will be presented on stage and at tables at the 18th SMM symposium. Keynote speakers will be Klaus Scherer (music psychologist and founder of the Geneva Center Interfacultaire en Sciences Affectives) and Eberhard Seifert (medical director of the Department of Phoniatrics at the University Clinic and Polyclinic for Ear, Nose and Throat Diseases, Head and Neck Surgery at the Inselspital Bern).

SMM - Cultural scientist Hannah Bregler points out that professional music careers involve numerous physiological, social and psychological demands. In her work for the Hamburg Institute for Culture and Media Management, she confirms that everyday life is characterized by permanent peak performance under stressful conditions, which affects both fine motor skills and cognitive abilities. As in professional sport, the limits of performance and physical resilience are reached in everyday musical life. This is associated with considerable health risks. In both sectors, it takes years of training or practice to achieve peak performance. Everyday life in both is therefore also characterized by irregular working hours, frequent travel and constant self-criticism.

According to the author, numerous studies show how precarious the health situation in orchestras is after many years of professional activity. It has been observed that orchestra members develop chronic poor posture even at a young age. However, the importance of and responsibility for health in the musical profession is increasing, not least in order to achieve a reduction in days of absence due to illness, which, among other things, improves the economic efficiency of cultural institutions. The fact that this professional group is not a small, negligible group of people is reflected in the number of employees.

According to the German Orchestra Association, there are currently 9766 positions in German cultural orchestras. In contrast to other areas, especially sports, the topic of pain and complaints is still often taboo. There is a lack of knowledge and education on how to avoid poor posture, how to recognize symptoms early on and what treatment options are available. Awareness of this has been raised in recent years, but there is still a need for action in view of the current situation, and it is worth taking a look at competitive sport.

According to Bregler, sports psychology began early on to investigate the influence of emotions on competitive performance and how they can be used optimally before, during and after a competition or training session. Sport and emotions are inseparable, as can be seen on and off the pitch after competitions or football matches. Like performance anxiety, competition anxiety is also a phenomenon that can inhibit performance and is widespread.

An important component in avoiding complaints is the relationship between recovery and stress and its effect on performance. A balance between stress and recovery is essential in order to continuously deliver peak performance. Michael Kellmann, one of the leading sports psychologists, differentiates between passive (e.g. massage), active (e.g. a relaxed run after a competition) and proactive (e.g. social activities) approaches to recovery.

An increase in performance entails a certain degree of exhaustion and can be compensated for by extensive recovery methods, as functional exhaustion only produces a brief reduction in performance. If a systematic and individualized recovery phase is not observed after training or exhaustion, a persistent imbalance between recovery and overreaching can lead to a harmful condition that manifests itself in persistent underrecovery and non-functional overreaching (NFO).

Awareness and structural change in orchestral operations requires interaction at many different levels, from musical education at music schools and conservatoires to the working atmosphere in professional orchestras. The practices of competitive sport offer an opportunity to copy, adapt or vary successful methods according to the needs of the orchestra.

Literature:

Hannah Bregler, 2021, Prevention

for professional musicians as a management task. What the orchestra business

can learn from professional sport, Munich, GRIN Verlag,

> www.grin.com/document/1152272

SMM - Are you a musician looking for support with health issues? For advice, you can contact the advice center of the Swiss Society for Music Medicine (SMM) by e-mail (see box) and leave a telephone number or e-mail address. You will be contacted within one to two working days. SMM consultations are free, confidential and non-binding. They can be used by people of all styles, be it classical, jazz, pop, folk music or other styles. Above all, the first steps in the counseling process are the same. Anatomical, physiological and emotional circumstances are ultimately the same for everyone.

If you wish, you can already explain in the email why you are contacting the SMM. It helps our medical advisor to prepare for the conversation. However, you can also simply let us know that you wish to be contacted without providing any further details. We would be happy to offer a permanently staffed and accessible hotline. However, this would far exceed the company's resources. Our first advisor, an extremely experienced ENT specialist, is a doctor in everyday practice and is therefore unable to take telephone calls at all times.

If, for whatever reason, an initial telephone contact is the only option for you, you can first contact our secretariat. Our secretary Pascal Widmer will be happy to inform you about further steps, but is not a medical specialist. You can also find the secretary's telephone number in the box at the bottom of this page. For reasons of medical confidentiality, you should limit your contact with our secretary to questions about the formal procedure.

Our advisor will listen to you in an initial consultation, assess your situation and symptoms and, if necessary, recommend further investigations or treatment, if possible in your region of residence. You decide on further steps independently and on your own. Your data will not be stored by SMM and will certainly not be passed on.

The SMM was originally founded 25 years ago as a grassroots organization for people seeking help, at a time when health challenges in everyday music-making were even more taboo than they are today and there were no specialized musicians' medical professionals in Switzerland. In the quarter of a century since then, it has built up a network of specialists in medicine and numerous forms of therapy in Switzerland. In this way, it aims to prevent specific musician-medical phenomena from being overlooked or incorrectly treated.

The SMM pursues exclusively and directly charitable purposes. It works closely with international specialist societies in the field of musicians' medicine. The members are musicians, doctors, psychologists, therapists, institutions as well as supporting members and patrons. The experts at our advice center are independent of all institutions (orchestras, music academies, associations, etc.). They have no financial interests and do not favor any form of therapy.

We also welcome a general interest in the medical aspects of music-making. Membership of the SMM benefits musicians and the music and helps people to stay healthy even in this highly competitive professional world and to maintain music as a source of joy.

SMM - The Institute offers regularly updated risk assessments and recommendations. The political assessments of the situation in Germany and Switzerland differ. However, the analysis of the Fribourg team led by Claudia Spahn and Bernhard Richter is also helpful in this country. In the latest update from mid-March, it emphasizes that vaccination remains an important and central point in the fight against the coronavirus, as infection rates remain high. It also continues to recommend the established test methods for culture. They significantly minimize the risk of infection in samples if all participants (regardless of the date of their last vaccination or recovery) are tested on a daily basis.

The World Health Organization (WHO) emphasized the importance of the 3G Plus rule and the AHA rules in a statement on 11 January. 3G-Plus means that access is only permitted for fully vaccinated or recovered persons or persons with a negative PCR test. A negative rapid antigen test is not sufficient. The German AHA rule reminds people to keep their distance, take hygiene measures and wear face masks. If these are adhered to, the current state of knowledge suggests that active singing and making music is still possible despite the more contagious Omikron variant. To reduce the risk, the Fribourg Institute recommends a daily test for all participants in a rehearsal or concert event in addition to the 3-G rule until further notice, i.e. it suggests significantly more restrictive measures than Switzerland.

Since the end of February, amateur choirs in Germany have been allowed to perform without masks again. Nevertheless, the Institute recommends that all participants be tested before the start of the rehearsal/event, even when singing together (especially if the mask can be dispensed with), until further notice.

The team writes that many people are finding it difficult to reconnect with life before coronavirus, although numerous activities are once again permitted for vaccinated people despite high infection rates. Singing in particular has the label of being dangerous. This barrier must first be overcome. The fact that singing and making music are extremely positive and important for mental health must be re-established as the risk of coronavirus decreases. Encouraging children and young people to sing and make music is a particularly important task and an ethical responsibility.

According to the institute, the main transmission of viruses that cause respiratory infections generally occurs via aerosols that are produced when coughing and sneezing and are absorbed by the other person via the mucous membranes of the nose, mouth and deep respiratory tract when inhaled and possibly via the conjunctiva of the eye. According to simulations, if an infected person coughs up viruses, it can be assumed that the viruses will still be detectable in the air after several minutes and possibly hours, even if the infected person has already moved away. It is therefore still important to observe the social distancing rule when making music to protect against droplet infection.

However, contact transmission continues to play a role: Viruses can be transmitted from surfaces if they reach the hands by touching these contaminated surfaces and the hands then touch the face without being cleaned - provided the viruses have retained their infectious properties up to this point.

Musicians of all musical genres should "take strict care to avoid any contact with others in the event of non-specific symptoms such as fever plus respiratory symptoms (dry cough, catarrh) or more typical symptoms such as acute loss of olfactory and gustatory function until the infection has been ruled out by SARS-CoV-2 PCR testing of a swab". The newer omicron variant can manifest itself with milder symptoms, but is more contagious than the previously prevalent delta variant.

Link to the mentioned paper:

> www.mh-freiburg.de/service/covid-19/risikoeinschaetzung

SMM - It is still not a matter of course for orchestras to be open about the less idyllic aspects of their social and psychological inner lives. They are all too happy to present a beautiful picture of making music together in harmony to the outside world. Health and social irritations are usually taboo.

Hans-Peter Achberger lifts this curtain with a work on patterns of dispute and conflict in art collectives that can be traced back to the creative processes. Achberger is a percussionist and member of the Philharmonia Zurich, the orchestra of the Zurich Opera House. The book he is presenting is a slightly revised version of a master's thesis. He originally wrote it as part of a course in mediation and conflict management at the European University Viadrina in Frankfurt (Oder).

Based on numerous interviews with his fellow Phiharmonia musicians, he develops an interesting model of patterns of disruption in creative and psychological interactions within the collective. The areas of friction are based on an excessive focus on certain aspects and are divided into four main groups: Firstly, fixations on outside influences play a role. These can be administrative processes, the audience, the acoustic conditions of a room or the size of the ensemble. The second area that Achberger sheds light on is the orchestra members' focus on themselves. This includes, for example, the fear of losing one's image, especially when one has to realize that the quality of one's own playing depends not least on the playing of others.

The third circle in the model is formed by excessive attention to interactions, i.e. to the "we". This includes, for example, arguments about questions of intonation or the choice of instruments and decisions about sound and interpretation. Finally, the fourth highlights the excessive focus on the other person, on the you. These include expectations of the artistic quality of the other person or possible competitive constellations, for example when it comes to questions of succession for the position of section leader.

The verdict is clear: "The classical orchestral music profession," the author concludes, "generates a dazzling array of social disorders typical of the profession, which can make living and working together in the orchestral community more difficult and cause personal suffering." (page 132)

Achberger also wonders how all these conflicts, which are often subcutaneous or pushed to one side, could be better dealt with or resolved. The recipe is basically obvious, even if it is more difficult to follow than expected. According to the author, what is needed is "a culture of exchange, of talking together about all those disruptive processes" (page 131). This requires institutionalized spaces in which "the meaningfulness of conflicts can be discussed and personal disturbances can be communicated" (ibid.). Due to their size, however, symphony orchestras are no longer in a position to act appropriately and purposefully without competent mediation.

Literature reference:

Hans-Peter Achberger: The ear-to-ear conflict. Disturbance patterns in musical interaction. Volume 19 of the Viadrina series on mediation and conflict management. Wolfgang Metzner Verlag, Frankfurt am Main, 2020.

SMM - At this year's symposium, we are delighted to welcome Geneva-based music psychology pioneer Klaus Scherer and Salzburg-based pain specialist Günther Bernatzky as keynote speakers. He is a member of the presidium of the ÖGfMM (Austrian Society for Music and Medicine). The society is younger than the SMM, having been founded in 2009. In our eastern neighbor, however, the subject of musician's medicine has been embedded in rich interdisciplinary activities since the 1970s. These were initiated by Herbert von Karajan in 1969. The conductor came from a family of doctors in Salzburg and initiated work on music psychology, music physiology and music therapy at an early stage.

Interdisciplinarity has characterized Austrian research into the effects and consequences of music ever since. In 1973, the physicist Juan G. Roederer began organizing seminars on the interaction between the brain and music in Ossiach in the province of Carinthia, and in 2001 the Research Network Man and Music was founded at the Mozarteum University in Salzburg. The "Mozart & Science" conference series launched by the International Music and Art Research Association Austria (I.M.A.R.A.A) in 2006, which brought together music psychology, neuromusicology, music therapy, music medicine and numerous other disciplines, also contributed greatly to the dialog between the specialist fields. In 2004, music psychologist Richard Parncutt also founded the "Conference on Interdisciplinary Musicology" (CIM) conference series in Graz, which has since gained worldwide recognition.

The ÖGfMM also looks beyond the boundaries of individual disciplines. It explicitly promotes the "interdisciplinary cooperation of those involved in the training and professional support of musicians, such as instrumental and vocal teachers, occupational scientists, natural scientists, instrument manufacturers, doctors, dentists, physiotherapists and related areas of the higher medical-technical specialist service, sports and musicologists, music psychologists, Alexander teachers, Feldenkrais teachers, music therapists, occupational therapists and mediators of other similar forms of therapy".

Günther Benatzky's research and teaching is also highly interdisciplinary. He is a specialist in pain physiology and therapy for various diseases (migraine, renal colic, back pain, tumor pain and others), has studied the effect of music and singing on various diseases (pain, Parkinson's, dementia, depression, old age), as well as its effect on animals. He has also helped to develop user-friendly music playback devices for the elderly and teaches musician's medicine at the Mozarteum Salzburg. We are delighted to welcome him to Switzerland.

Body-oriented work in music

The motto of the 18th SMM symposium is "One goal - many paths", body-oriented approaches in music. The keynotes by Günther Bernatzky and Klaus Scherer will provide insights into bodywork and its various methods. The range of body therapies in music is almost unmanageable. It can therefore be difficult to find out which method might be the most suitable for those seeking help. The symposium offers the unique opportunity to get to know numerous forms of bodywork in everyday musical life in the form of short lectures and presentations as well as in personal discussions at a table fair. More information can be found in this music magazine on page 39 of the SMPV.

The 18th SMM Symposium will take place on October 23 at the Stapferhaus Lenzburg. Details and a registration form can be found at:

> www.musik-medizin.ch/aktuelles-symposium

SMM - When a person is said to have to "swallow empty", this indicates that they are tense and possibly overwhelmed in a situation. In German, this phenomenon is metaphorically described as "Kloss im Hals" (a lump in the throat). Musicians are all too familiar with situations like this when they find themselves on stage and are confronted with expectations of a perfect performance. The physiological side effects of stage fright are more than noticeable. Even well-prepared professionals can notice in such anxiety-inducing moments how their motor skills and cognitive perceptiveness are impaired without being able to influence them. It is therefore surprising that science is not yet able to explain the interplay between physiological states and cognitive attitudes.

Based on interviews with 258 pianists, neuropsychology researchers Shinichi Furuya, Reiko Ishimaru and Noriko Nagata from Japan's Kwansei Gakuin Institute have identified eight behavioral, psychological and physiological factors that contribute to the phenomenon. These include attention distracted by the presence of the audience, an inability to recall motor sequences as a matter of course, perceptual disorders (such as tunnel vision), neuroticism and memory failure.

According to the team, two hypotheses to explain the phenomenon are commonly discussed. One - let's call it the distraction hypothesis - explains the impaired performance by the fact that under stress, attention is diverted from the actual task to irrelevant events. The second - the hypothesis of conscious monitoring - assumes that performance is impaired because well-practiced processes no longer run automatically as they do in relaxed situations, but are subjected to explicit control again, laden with anxiety. The urgent feeling of not failing in such a situation leads to the conscious control of movement sequences being sought.

The Japanese team's data suggest that it is mainly distraction that determines the reactions. However, the team does not conceal the fact that other studies have suggested that both phenomena play a role - both the distracted focus and the need to control movement sequences that take place in flow under normal conditions.

Assistance must be defined individually for those affected. The catalog of possible measures includes behavioral therapies, the written formulation of fears before such a situation, coaching or mental training. Exercises to better control muscle tension can also be helpful. For example, uneconomical muscle strain when playing the piano can be reduced by practising sequences of movements with different rhythms. This can counteract excessive attention, which can lead to unnecessary muscle tension, for example, and thus impair temporal precision when playing the piano. The team is skeptical about drug treatment. For example, taking beta blockers could even increase the risk of motor misbehavior - because they dampen the activities of the sympathetic nervous system.

Original article

Shinichi Furuya, Reiko Ishimaru, Noriko Nagata: "Factors of choking under pressure in musicians", Plos One, January 2021, https://doi.org/10.1371/journal.pone.0244082

SMM - The ability to hear absolutely has been strikingly re-evaluated in recent decades. Since the 19th century, it has been romanticized as a distinguishing feature given by nature or God to "true" music professionals. It was almost taken for granted that absolute listeners were more accurate in their perception and reproduction of music than non-absolute listeners. Accuracy, in turn, was unquestioningly regarded as a sign of quality. More accurate playing was often equated with more expressive playing. According to the narrative, absolute listeners were therefore regarded as a separate caste of virtuosos of emotional expression.

However, these simple connections between emotionality, precision and absolute hearing are increasingly being questioned today. A dissertation by neuroscientist Teresa Wenhart, supervised by music physiologist Eckhart Altenmüller, makes a significant contribution to this. Recently, the author writes in the summary of the work, two studies have reported an increase in autistic personality traits in musicians with absolute pitch. Several case studies and studies with small samples had found frequent occurrences of absolute pitch in autistic people. In addition, similar brain connectivity in terms of over- and under-connectivity of the brain has been reported in several studies of both populations. However, it is still unclear how this coincidence can be explained. Irritating for the traditional narrative of the connections between music, absolute pitch and emotionality is that the ability for cognitive empathy is not at all or only weakly developed in the case of autimus, as a study by Bons, Egon van den Broek and Floor Scheepers ("Motor, emotional, and cognitive empathy in children and adolescents with autism spectrum disorder and conduct disorder", Journal of abnormal child psychology. Volume 41, Number 3, April 2013, pp. 425-443).

Since the critical period for the formation of absolute pitch overlaps with a period of detail-oriented perception during normal child development, a detail-oriented "cognitive style" typical of autism, that is, "the predisposition to process incoming sensory information in a particular way, could serve as a common framework for explaining the similarities."

Wenhrt examined a total of 64 music professionals, using electroencephalography, measurements of autistic symptoms and auditory and visual experiments, among other things. In general, absolute-hearing listeners showed more autistic characteristics than relative-hearing listeners. The observed effects suggest that absolute-hearing listeners tend to have more detail-oriented processing and less contextual integration than relative-hearing listeners.

This is also evident in the brain structures. According to Wenhart, a typical human brain has an efficient network of strongly interconnected modules (segregation) and few cross-connections between these modules (integration). In her study, however, absolute-hearing subjects showed largely reduced integration and segregation as well as reduced interhemispheric connections compared to relative-hearing subjects.

The study suggests that absolute pitch and autism may be linked by similarities in cognitive style and brain connectivity. According to Wenhart, inconsistencies in the results also reflect the heterogeneity of absolute hearing as a phenomenon.

Literature:

Teresa Wenhart: Absolute pitch ability, cognitive style and autistic traits: a neuropsychological and electrophysiological study. Dissertation (University of Veterinary Medicine Hannover), Hannover, 2019.

SMM -- After concert activities were reduced in the spring and resumed after the summer vacation, some SMM therapy practices recorded a surprising influx. Musicians had obviously neglected their over-scheduled instrumental and sports activities during the forced break and were no longer in shape to cope with the new challenges.

There is a danger that this will happen again with the renewed halt to concert life. This is exacerbated by the fact that it is impossible to plan. At the moment, no one knows when the strict federal and cantonal measures will be lifted again. However, the impossibility of planning is one of the biggest obstacles to maintaining routines and determination.

After this summer's experiences, it seems certain that the end of the enforced break will bring major challenges. Performances in orchestras are likely to be particularly intense - not least due to the need to catch up. This can mean that the weight of your own instrument, for example, can cause unfamiliar physical problems. Increased tension can accentuate pain that could previously be kept below a threshold of disability with regular therapy, music-specific exercises or sporting activity. Uncertainty about technical and motor skills on the instrument can create performance anxiety and thus stress, which in turn significantly increases the risk of tension and cramps.

We know the risk from a comparable situation: students tend to increase their practice times considerably in the short term before exams. This shock to the body can then lead to the body going on strike at the very moment when maximum presence, top physical condition, precision and virtuosity are required for an exam. In addition, the lack of a concert routine - which many of you otherwise take for granted - can also lead to performance anxiety and nervousness after a long break.

In sports circles today, it is taken for granted that individual "fitness" must also be carefully planned and maintained outside of everyday competition. Making music at a professional level is comparable to top-class sport, especially when it comes to physical demands. However, musicians still lack an awareness of problems comparable to that in the world of sport.

Naturopath Samuel Büchel works in Spiez and at the Wallner practice in Bern, which is located in the immediate vicinity of the Bern Symphony Orchestra's concert venue. He is familiar with the worries and needs of orchestra musicians and advises them to use the time as calmly as possible in order to be ready for the restart of concert life. Anyone who is already undergoing therapy or regular physical exercises should not discontinue them under any circumstances. After a break, pain can occur when resuming a concert that would not occur under normal conditions.

Perhaps you would like to use your forced break to start a new over-routine? Try out new fitness and movement exercises or musician-specific activities and physical exercises and integrate them into your everyday life as a musician? Perhaps you've been meaning to work intensively on your sound, breath or embouchure for a while? Bring more ease into your fine motor movements or finally tackle your stage fright?

Alone or with professional support - now would be the time to realize such plans and to treat yourself to these development opportunities. We look forward to hopefully seeing and hearing you live on stage again soon, dear musicians!

Wolfgang Böhler* - The Swiss Society for Music Medicine (SMM) brings together under one roof specialists from the fields of medicine and a wide range of therapeutic approaches, as well as scientists and professional musicians. A central concern of the SMM is to encourage constructive dialog between these groups. However, it also wants to help musicians who are struggling with specific health restrictions or are simply interested in putting their music-making on a sustainably healthy footing.

We are proud to have doctors in our circle who can offer medical solutions for music-related illnesses at the highest level. In everyday life, however, people seeking help from the world of music are usually closer to trusted individuals with low-threshold therapy services than medical specialists, who generally have to cope with the hectic pace of clinics or surgeries. The variety of methods, schools and techniques in the therapy jungle can be confusing. The decision in favor of a technique is then often a matter of chance - usually based on personal encounters or recommendations.

With the 18th symposium, the SMM would like to offer those seeking help the opportunity to get to know some of the most important body-oriented approaches in music in one place and at the same time take the opportunity to talk to their representatives without obligation. The therapists should also be able to approach each other on this day. A motto that the American epistemologist Nelson Goodman once coined for philosophy should apply here: those offering therapies should no longer be judged according to which schools and world views they represent, but for which problems they develop solutions.

A world premiere to kick things off

We are delighted to announce that we will be opening the symposium with an unusual world premiere. It is a highly interesting work by the clarinettist and saxophonist Fabio da Silva, who is currently studying at the HKB. Rugueux 2, a game between live performance and pre-produced sounds for baritone saxophone and bass clarinet, is a low-frequency performance accompanied by a pre-produced tape. The instruments, which mix very well, especially in the low frequencies, approach microtonally specific frequencies. Multiple sounds are filtered, creating stronger and weaker frictions.

*The music psychologist and music producer Wolfgang Böhler has been President of the SMM since January of this year.

In cooperation with the Swiss Performers' Foundation SIS, the Bern University of the Arts HKB, the Swiss Music Pedagogical Association SMPV and the Swiss Association of Music Schools VMS.

Various recognized and proven forms of body-oriented approaches in music will be presented on stage and at tables. Keynote speakers are Klaus Scherer (music psychologist and founder of the Geneva Center Interfacul-taire en Sciences Affectives) and Günther Bernatzky (founder of the Salzburg Pain Institute and board member of the Austrian Society for Music and Medicine).

Saturday, October 24, 2020, 9.50 a.m. - 5 p.m., Bern University of the Arts, Papiermühlestrasse 13a, 3014 Bern. Costs: SMM members, students and employees of the BUA: CHF 30; non-members CHF 90; first-year students free admission.

The protection concept of the symposium will be adapted to the current pandemic situation and the corresponding cantonal and national regulations and recommendations in a timely manner. There may therefore be changes to the program at short notice.

Information and registration: Phone 032 636 17 71 or www.musik-medizin.ch, registration deadline: October 10, 2020.

More info:

> www.musik-medizin.ch/aktuelles-symposium

Interview: Cornelia Suhner - Our founder and Honorary President Pia Bucher, a kinesiologist for many years, has been directly affected by the massive restrictions on therapy services. In this interview, she gives examples of what this means for professionals like her, both professionally and privately.

Pia Bucher, you are a complementary therapist and work with musicians. What issues do they come to you for therapy with?

In the music industry, you are exposed to numerous stress factors that can lead to job-specific physical and psychological complaints. Typical issues include stress during performances, criticism, time pressure, muscle tension, posture, breathing and, in the case of brass players, embouchure dysfunctions. In the case of focal dystonia, we work together with SMM specialists on an interdisciplinary basis.

Why did you specialize in music as a kinesio-logist?

As a professional musician myself, I struggled with focal dystonia and had to give up my career for medical reasons. I therefore decided to found a musician's medical institution: that was the birth of SMM in 1997. My aim was to provide help at an early stage and to offer a central point of contact and advice for musicians' medicine in Switzerland. At that time, I completed body-oriented further training and training as a kinesiologist.

Music Kinesiology MK is a special field of applied kinesiology that deals with practical music issues and stress reduction in musicians. After many years of experience as a stage performer and instrumental teacher, this was the right approach for me. My work today - supplemented by further training in music medicine - includes retraining for brass dystonia and performance coaching for musicians.

Due to the professional ban in force until the end of April, there are severe restrictions on the care of clients. Protective measures and practice hygiene are still mandatory. How have you personally experienced the lockdown?

One positive sign was the sudden calm in everyday life and the deceleration. In the world of music, the usual everyday stress and pressure was suddenly gone: no concerts, rehearsals, auditions and no more traveling. Therapy sessions were suddenly no longer urgent - there were no more "acute cries for help" due to performance stress or musical complaints. My clients took much more time to practise and deepen the new practice structures, to rehearse concerts in peace... Where necessary, further measures could be discussed over the phone.

Have the topics and questions of those affected changed during the lockdown?

Corona has paralyzed the music scene - there is a great deal of uncertainty.

Many freelancers are experiencing existential hardship due to the loss of income.

New topics are: financial situation, existential fears and future prospects or the stress of unfamiliar online teaching or face-to-face teaching with distancing rules.

What consequences and after-effects do you expect for your clients and for you as a therapist?

A general rethink is taking place. Innovative concepts are in demand. The challenge demands flexibility and creativity in all areas.

Can you take anything from your therapeutic or personal experiences during this time into the "new normal"?

Slowing down is a valuable enrichment. It creates space to try out new possibilities or initiate your own creative processes. Innovative impulses - such as online training or supplementary forms of teaching - give rise to trust and confidence in the potential of digitalization.

Website of Pia Bucher:

> www.sana-musica.ch

Felicitas Sigrist -- The measures required to combat the coronavirus pandemic are having the same effect on many musicians as a professional ban through no fault of their own. Long-prepared events and regular commitments have been abruptly canceled - and for some, all sources of income have been lost. With the expected economic slump, the music industry is likely to recover only slowly. In this stressful situation, not only economic but also psychological effects are to be expected.

People often initially react to shocking changes/strokes of fate with bewilderment. They then take action to secure their existence until they finally find emotional coping strategies. In this phase of imminent threat, acute stress reactions such as impulse outbursts, panic, anger or grief can occur. Some people develop excessive fears about the risk of contracting the coronavirus and need appropriate psychological help.

More often than such acute reactions, psychological disorders are to be expected in the medium term if the emergency situation persists and little can be done to influence it. The consolation that the drastic measures can be overcome collectively will also fade with the easing of measures. Helplessness, feelings of powerlessness and even unemployment are risk factors for mental illness. On the one hand, previously compensated complaints, such as tinnitus or chronic pain, can intensify. On the other hand, depression, substance abuse and suicidal crises can increase. If those affected or their relatives observe increased behavioral patterns such as circling thoughts, sleep disorders, loss of concentration, emotional numbness, social withdrawal, irritability and difficulty with impulse control, it is important to seek help. This is especially true when thoughts of being tired of life become apparent. The SMM counseling center can make an initial assessment of the problem and provide professional support.

"Crises are opportunities", they say. Many people can grow from crises - this is called post-traumatic growth. However, expecting this in advance is cynical and trivializes hardship. There are also people who are broken by crises. Requirements and resilience are individual. Resilience to cope with the impending period of uncertainty can be demonstrably promoted with supposedly banal everyday habits: maintaining a daily structure, sleeping regularly and sufficiently, eating a balanced diet and exercising - just 150 minutes of moderate-intensity exercise per week has an antidepressant effect. Social contacts are helpful, as long as not only the current distress is discussed, but also positive things are exchanged, which steers thoughts in a different direction. It is important to be able to talk authentically about your own emotional state, but to limit yourself to a circle of trusted people. Various methods of mindfulness practice have proven to be effective in dealing with crises more calmly. These teach the ability to focus on the present moment and not allow thoughts of the past or future to dominate and weigh you down. In medical terms, this reduces the physiological symptoms of stress and causes less long-term damage to health.

The break in the performance calendar can be used to review and, if necessary, optimize your own music-making. Have habits, postures or playing techniques crept in that could cause long-term health problems? An analysis with the help of a specialist with knowledge of music physiology is also useful as a preventative measure - the advice center can also put you in touch with specialists for this.

As we have already seen in the two months since the lockdown, the need for music has not diminished. Music enables something essential: contact even without physical contact - a feeling of connection even at a distance.

Dr. med. Felicitas Sigrist

... is a psychiatrist and music psychotherapist and heads the SMM's counseling center for musician medicine. She can be contacted at beratung@musik-medizin.ch.