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The effect of music upon psychical function can be understood more easily by employing the structural formulations of ego, id, and superego. With respect to the id aspect music can be regarded primarily as a cathartic experience. Tensions produced by repressed wishes are allowed release. Rhythm has affinity with infantile sexual experience. From the ego standpoint music can be thought of as a mode of mastery. The form which music must take and the rules of composition satisfy superego demands. One can envisage a primary and a secondary musical process similar to the primary and secondary processes.
Music may relieve tensions by permitting a regression to a primitive narcissistic equilibrium. A case history is detailed which illustrates how an increasing desire for musical expression enabled a patient to discharge tensions which were without any fantasy content. Music allows a controlled and limited regression in schizoid states and in certain cases of schizophrenia by providing a nonverbal experience which does not overtax the ego. The value of music as therapy in the different phases of schizophrenic illness is discussed.