Music therapy and existential health

Tatjana Schnell: The Psychology of Meaning in Life. Routledge, 2021

For the field of music therapy, the question of how we define and understand “health” is a fundamental concern. While it is widely acknowledged that there are many perspectives on what health entails, one particular dimension—existential health—is especially relevant to the work music therapists engage in. We therefore need to develop a deeper understanding of what constitutes such existential health. A key aspect of this is how we experience meaning in life.

Dimensions of Subjectively Perceived Health

When I describe music as a "cultural immunogen," I am referring to four specific “antigens” that health-musicking can offer: (1) vitality/emotional regulation, (2) agency, (3) belonging, and (4) the dimension of meaning. I have often thought of this last dimension in terms of how music can generate meaningful experiences, sometimes even transcendent ones, offering moments of access to deeply held values. Yet I am also aware that the other three dimensions contribute significantly to a meaningful life: vitality, our capacity for action, and our sense of belonging all play important roles. Moreover, using musical memories to shape a self-narrative can foster a sense of coherence in life.

A Comprehensive Empirical Framework

Tatjana Schnell, professor of existential psychology at the MF Norwegian School of Theology, Religion and Society in Oslo, summarizes her extensive research in The Psychology of Meaning in Life. She also draws on a vast array of empirical studies that investigate what people perceive as meaningful, what sources provide meaning, and what strengthens this experience. One striking insight is that the enjoyment we get from music does not, in itself, constitute existential meaning. There is a crucial difference between hedonic meaning—pleasure-based—and eudaimonic meaning, which requires investment and deepening over time.

What stood out to me while reading was the strong empirical link between perceived meaning in life and health. As I will discuss, there is compelling evidence showing that a meaningful life is associated with reduced stress and increased resilience to illness. This opens up important possibilities for arguing that music therapy—particularly when involving the four musical “antigens” mentioned earlier—can result in significant health benefits. Music, as we will see, can be understood as an existential resource, a source of resonance and life-meaning that motivates us to care for our lives.

What Is Meaning in Life?

A few key points: meaning is not something that objectively exists “out there,” but something we assign to an object, an action, or an event, within a specific context. Meaning must be made. What is meaningful to one person may seem meaningless to another. What gives me meaning today might not have the same impact tomorrow. Meaning is dynamic, subjective, and relational.

Meaning in life consists of multiple dimensions. It is shaped by the direction we take in life, the goals we pursue, and how we evaluate our lives as more or less meaningful. Schnell notes that a lack of meaning does not necessarily lead to a crisis—unlike Viktor Frankl’s existential psychology, which posited that the will to meaning is a fundamental human drive. Research shows that many people live with an indifferent relationship to existential questions; they do not worry about the meaning of life. This raises a further question for us: what is the added value of living a meaningful life?

Four Dimensions of Meaning in Life

Schnell identifies four primary dimensions of perceived meaning in life:

1. Coherence – The extent to which our experiences, actions, and goals form a coherent narrative. When Schnell discusses therapeutic interventions to support meaning-making, one method is writing one’s life story. Here, writing a musical autobiography may become a meaningful approach in music therapy. Italian musicologist Maurizio Disoteo emphasizes that such musical memory work is not just about recalling past experiences but about exploring how these encounters with music have shaped us.

2. Significance – Whether our actions have consequences or make a difference. Music does not hold the same level of significance for everyone. Some might say “life is meaningless without music,” while others engage with it more casually. For musicians and fans who have invested time and identity in music, its absence could have profound implications for their sense of meaning.

3. Orientation – Having direction and purpose in life. Schnell emphasizes that we live in a “multi-optional” society, constantly faced with choices. Deep engagement with music—for example, learning an instrument—requires focused effort and the deliberate exclusion of other options. Again, we see the connection between time investment and the eudaimonic form of happiness.

4. Belonging – Perhaps the most important source of life meaning. Schnell distinguishes between social belonging and existential belonging—a deep sense of being “at home in the world.” This existential belonging can counter what Irvin Yalom calls “existential isolation.” Music can play a critical role here by providing resonant experiences that affirm connection, as suggested in Hartmut Rosa’s theory of resonance.

   
   

A Hierarchical Model of Meaning

Schnell’s model of meaning is organized hierarchically, from foundational perceptual orientations at the bottom to overarching sources of meaning at the top. This model illustrates how what we hold to be meaningful influences the goals we set, the actions we take, and even what we pay attention to. Vertical integration occurs when these levels align; horizontal integration means that activities across the same level (e.g., values and goals) are consistent.

A person who sees music as a central source of meaning might set goals like joining a choir or attending concerts. These goals then guide behavior and perception—for instance, paying attention to musical values or performance styles that align with their worldview. Joining a choir might also fulfill the need for social belonging, illustrating both vertical and horizontal integration of meaning.

Multiple Sources of Meaning

Schnell has identified 26 potential sources of meaning, including generativity—activities aimed at helping others or contributing to something beyond the self. Other sources include religion, spirituality, nature, social responsibility, self-knowledge, and health. Research suggests that having at least three or four sources of meaning is beneficial. Relying too heavily on a single source can increase vulnerability to life crises and burnout.

Breadth, Balance, and Depth

Breadth refers to having multiple sources of meaning. Balance is about how these sources interact—when one is threatened, others can compensate. Depth is linked to the experience of self-transcendence: going beyond individual needs and contributing to something larger. This aligns with Maslow’s later revision of his hierarchy of needs, where he emphasized overcoming egocentricity in favor of connection and service to others—a view shared by Viktor Frankl.

Meaning and Health

Schnell devotes an entire chapter to the relationship between meaning, health, and illness. She documents robust links between a meaningful life and both mental and physical health. Those who experience life as meaningful report lower stress, stronger resilience, and fewer symptoms. They are more optimistic, self-efficacious, socially integrated, and compassionate toward themselves.

Physiologically, studies show moderate correlations between meaningfulness and markers like natural killer (NK) cell count and heart rate variability. People who find life meaningful also report better subjective health and fewer functional limitations. Large-scale national studies confirm that meaning in life significantly reduces mortality risk.

Motivation and Moderation

How does meaning in life affect health? Through two main mechanisms: motivation and moderation. People who find their lives meaningful are more motivated to care for their health. Aaron Antonovsky’s concept of the “sense of coherence” provides a useful framework here, especially the component of meaningfulness as a primary motivator for resilience against stress.

Moderating the Impact of Stress

The second mechanism—moderation—describes how meaning in life serves as a buffer against stress. When people perceive their lives as meaningful, they tend to evaluate adverse events less negatively and experience fewer negative health effects as a result. They are better able to interpret challenges as part of a larger life narrative, which fosters resilience. This moderating effect overlaps with what Antonovsky referred to as “comprehensibility”—the sense that life events are structured, predictable, and explicable. Meaning helps integrate difficult experiences into a broader context that can reduce their psychological burden.

Tatjana Schnell uses the metaphor of a trampoline: people who experience meaning in life can bounce back more effectively after being thrown off balance. They land more softly, so to speak, even when facing severe stressors. This resilience is not just about enduring hardship, but about preserving—or even enhancing—one’s psychological well-being through adversity.

Existential Health and Music Therapy

This has profound implications for music therapy. If meaning in life can strengthen both mental and physical health through motivation and moderation, then supporting meaning-making processes should be considered a vital therapeutic goal. Music therapy, as a practice grounded in relationship and resonance, is uniquely positioned to do this. Through musical engagement, clients can:

• Reaffirm core values by choosing or creating music that expresses what matters most to them.

• Experience coherence by telling their stories through sound and song, connecting past and present.

• Find direction and purpose by setting musical goals, developing skills, or contributing to community music-making.

• Strengthen belonging through shared music experiences that foster emotional connection and social integration.

  
  

In this way, music becomes not only a cultural immunogen, but a source of existential support—a resource that can sustain life meaning and contribute to health on multiple levels.

Beyond the Individual: Cultural and Societal Perspectives

Schnell emphasizes that meaning in life is not just an individual pursuit; it is also deeply embedded in culture. Societal structures, values, and opportunities either support or hinder people’s access to sources of meaning. A society that overemphasizes consumerism, competition, and individual achievement may undermine the deeper forms of eudaimonic meaning that promote health and flourishing.

Music therapists often work with individuals whose capacity to engage with meaning has been eroded by illness, trauma, or exclusion. But they also work within institutions and systems that reflect broader cultural values. In this context, music therapy can be seen as both a personal and political act—one that affirms the right to a meaningful life and seeks to counteract alienation, fragmentation, and existential isolation.

Toward an Existentially-Informed Practice

Drawing on Tatjana Schnell’s research, we can begin to formulate a more existentially-informed approach to music therapy. This involves paying attention to:

• The sources of meaning available to each client.

• How music therapy can enhance coherence, significance, orientation, and belonging.

• The ways in which musical engagement fosters self-transcendence, allowing individuals to connect with something beyond themselves.

• How the therapeutic relationship itself can be a source of meaning, especially when grounded in authenticity, attunement, and mutual respect.

  
  

This orientation invites music therapists to see their work not only in terms of symptom reduction or functional improvement, but as a practice that helps individuals live with greater purpose, connection, and existential vitality.

Resonance, Music, and the Experience of Meaning

Hartmut Rosa’s theory of resonance offers a compelling framework for understanding how music can support the experience of meaning in life. Rosa (2019) describes resonance as a mode of being in the world characterized by a responsive, affective, and reciprocal relationship with people, activities, and environments. Resonance stands in contrast to alienation, where individuals feel disconnected, indifferent, or overwhelmed by the world around them.

In Rosa’s view, resonance involves being touched and transformed—an experience that is often evoked through music. When clients in music therapy feel a piece of music “resonate” with their inner experience, they are not just expressing themselves; they are entering into a dynamic relationship that affirms their existence and opens new possibilities for understanding, connection, and growth (Rosa, 2019).

Tatjana Schnell (2021) notes that self-transcendence is a key dimension of meaning in life—an orientation that moves beyond the self toward others, the world, or something greater. Resonance can be understood as the experiential correlate of self-transcendence: in moments of deep musical connection, clients often report feeling part of something larger, be it a community, a shared history, or the mystery of life itself. In this way, resonance becomes both a pathway to meaning and a therapeutic process in its own right.

Music Therapy as a Cultural Immunogen

In health psychology, the term cultural immunogen refers to culturally available resources that protect and promote health. These include values, practices, and symbols that support a coherent sense of identity and purpose. Music, especially when engaged with therapeutically, functions as a powerful cultural immunogen. It can:

• Provide continuity and structure in times of chaos and change.

• Reconnect individuals to personal and collective narratives.

• Offer symbolic language for emotional and existential expression.

• Foster communal rituals that sustain social bonds and shared meanings.

  
  

When individuals lose access to meaningful cultural resources—due to illness, marginalization, or socio-political upheaval—music therapy can help re-open channels of resonance and restore access to meaning. This not only supports existential health, but may also moderate the impact of stress, enhance motivation, and ultimately contribute to physical and psychological well-being.

Concluding Reflections: Meaning as a Therapeutic Horizon

Tatjana Schnell’s model of meaning in life—comprising coherence, significance, orientation, and belonging—offers a rich and nuanced framework for understanding the existential dimensions of music therapy. By aligning this model with insights from health psychology and resonance theory, we can begin to envision music therapy as an existential practice: one that helps clients navigate life with purpose, connection, and vitality (Schnell, 2021; Rosa, 2019; Ruud, 2020).

Such a practice does not prescribe what is meaningful, but rather creates conditions where meaning can be explored, discovered, and cultivated through sound, silence, and shared presence. In doing so, music therapy affirms the deeply human need for resonance and self-transcendence—and helps ensure that this need is met, even in the face of suffering and uncertainty.

Music, then, is not only a tool for therapy. It is a medium of meaning, a cultural immunogen, and a source of existential sustenance in a world that is often fragmented and fast. By tuning into the resonances that matter most to our clients, music therapists can help them find their voice—not just musically, but existentially.

References

• Antonovsky, A. (1987). Unraveling the Mystery of Health: How People Manage Stress and Stay Well. Jossey-Bass.

·       Daniele Branca 2016. Narrazioni e autobiografie musicali. Identita, cura e formazione. Roma: Editoriale Anicia.

·       Maurizio Disoteo 2022. La musica scrive la vita. Note per una musicologia autobiografica. Milano: Mimesis edizioni.

• Rosa, H. (2019). Resonance: A Sociology of Our Relationship to the World (J. C. Wagner, Trans.). Polity Press.

• Ruud, E. (2020). Toward a Sociology of Music Therapy. Musicking as a Cultural Immunogen. Dallas, TX: Barcelona Publishers.