Music, affective memory and psychoanalytic listening in Alzheimer's disease: scope and limits of a therapeutic resource

Abstract

This article examines the use of music in the care of people with Alzheimer's disease from a psychoanalytic perspective, arguing that musical experience offers access to affective and identity registers that remain available when verbal language no longer reaches them. The argument reconstitutes the clinical picture of the disease, revisits the ambiguous status music occupies in Freud's work, examines the hypothesis that song functions as a support for affective memory and identity, and confronts this conceptual elaboration with what the empirical literature actually sustains. It is argued that the field authorises claims regarding agitation, mood, engagement and quality of life, and does not authorise claims regarding reversal of cognitive decline, lasting preservation of memory, or any disease-modifying effect. A further distinction is drawn between music therapy — an intervention conducted by a qualified professional, with its own objectives and records — and the recreational use of music in care institutions, a legitimate practice of a different nature. It is argued that delimiting this scope does not weaken the clinical proposal: it is what makes it sustainable in the face of a disease for which no cure is available.