This qualitative phenomenological study explores how individuals experience audible sound-based practices and examines their perceived bodily, emotional, and cognitive effects to inform medical education and interdisciplinary research.
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Research Article
This qualitative phenomenological study explores how individuals experience audible sound-based practices and examines their perceived bodily, emotional, and cognitive effects to inform medical education and interdisciplinary research.
Audible sound has long been embedded in human healing, learning, and cultural practices, yet its role within contemporary medical discourse remains narrowly defined and often contested. While mechanobiology has demonstrated that biological systems are responsive to mechanical forces such as vibration and oscillation, little is known about how audible sound-based practices are experienced subjectively and how participants interpret these experiences in relation to emerging scientific explanations. To address this gap, the present study explored lived experiences of audible sound-based practices and their perceived bodily, emotional, and cognitive effects. Using a qualitative phenomenological design, in-depth semi-structured interviews were conducted with 15 participants who had sustained engagement with audible sound-based practices. Data were analysed using reflexive thematic analysis. Three interrelated themes emerged. First, participants experienced sound as a bodily and tactile phenomenon characterised by internal vibration, resonance, warmth, and muscular release. Second, sound was described as facilitating emotional regulation and cognitive quieting, including reduced anxiety, mental stillness, and heightened self-awareness. Third, participants demonstrated reflective scepticism, carefully distinguishing personal benefit from scientific proof and expressing discomfort with exaggerated or universal healing claims while seeking mechanobiological or psychophysiological explanations. The findings suggest that audible sound-based practices are best understood as experiential regulatory processes rather than therapeutic cures. Importantly, participants displayed epistemic maturity, challenging assumptions that engagement with alternative practices reflects uncritical belief. For medical and health professions education, these findings support the use of sound-based practices as critical case studies for teaching bodily regulation, critical appraisal, and ethical reasoning under scientific uncertainty. Future research should integrate qualitative insight with carefully designed experimental studies to further examine audible sound within a rigorous interdisciplinary framework.
Audible sound has long occupied a significant role in human culture, healing traditions, and educational practices, yet its position within contemporary biomedical discourse remains narrow and often contested. In medical contexts, sound is typically associated with diagnostic imaging, auditory neuroscience, and high-frequency ultrasound applications, where its function is clearly defined and technologically mediated. In contrast, audible sound-based practices such as sound baths, tuning fork sessions, vibrational chanting, and resonance-focused interventions are frequently positioned outside formal medical frameworks and categorized as complementary or alternative approaches. This separation has contributed to an epistemic divide in which sound is either dismissed as unscientific or promoted through overstated therapeutic claims, leaving limited space for careful academic examination of how sound is actually experienced and understood.
Sound has been used across cultures for communication, ritual, learning, emotional regulation, and well-being long before the emergence of modern medicine1,2,3. Despite this long-standing role, contemporary biomedical discourse has largely restricted sound to highly specialized diagnostic and therapeutic applications4,5. Within these frameworks, sound is commonly conceptualized as a clinical tool rather than as an embodied experiential phenomenon. Outside formal healthcare systems, audible sound-based practices continue to be widely used in wellness and complementary health settings1,6. These practices frequently emphasize concepts such as vibration, resonance, frequency, and bodily awareness, with participants reporting perceived effects on physical sensations, emotional states, and cognitive experiences7,8. However, discussions surrounding these practices often remain polarized, with sound-based approaches either dismissed as lacking scientific credibility or promoted using claims that exceed available evidence1,6.
Recent developments in mechanobiology have created new opportunities for examining sound from a biological perspective9,10. Mechanobiological research has demonstrated that cells and tissues respond to mechanical forces such as pressure, vibration, stretch, and oscillation11,12. Through mechanotransduction processes, these forces can influence cellular signaling, tissue behavior, and biological regulation11,12. In parallel, emerging research in acoustic stimulation and sonobiology has begun investigating the effects of audible and low-frequency sound on biological systems13,14. Preliminary findings suggest that sound may influence living tissues under specific experimental conditions, although the extent, consistency, and clinical significance of these effects remain uncertain4,13. Consequently, current evidence supports biological plausibility rather than therapeutic certainty.
Despite growing scientific interest, the literature examining audible sound as a mechanobiological phenomenon remains limited. Reviews have highlighted a scarcity of studies, considerable methodological variability, and a lack of standardization across investigations4. In addition to sound-based wellness practices, sound has also contributed to a variety of innovative medical and technological applications, further demonstrating its relevance across healthcare contexts5,15. Nevertheless, most existing research focuses on biological mechanisms or experimental outcomes rather than on how audible sound is experienced and interpreted by individuals who engage in sound-based practices. As a result, an important gap exists between emerging mechanobiological explanations and the lived experiences that frequently motivate participation in these practices.
This gap has important implications for medicine and health professions education. Patients increasingly engage with complementary and alternative health practices, including audible sound-based approaches, and may discuss these experiences with healthcare professionals16,17. However, opportunities to critically examine such experiences within health professions education remain limited18,19. Understanding how individuals interpret and make meaning of their experiences does not imply endorsement of these practices. Rather, it supports critical appraisal, ethical communication, patient-centered care, and informed discussion of emerging or contested health practices16,20. Incorporating experiential perspectives may therefore strengthen educational discussions surrounding sound-based practices while promoting scientific rigor and professional reflection.
A further limitation in the literature is the lack of phenomenological research examining audible sound-based practices from the perspective of participants themselves1,21. Existing discussions often focus on theoretical mechanisms, therapeutic claims, or broader cultural interpretations, while comparatively little attention has been given to documenting how individuals experience audible sound at bodily, emotional, and cognitive levels11,13. Without such qualitative evidence, mechanobiological concepts may be overextended to support unverified claims or excluded entirely from discussions of sound-based practices. Understanding lived experience is therefore essential for clarifying what participants perceive, how they interpret those perceptions, and how they distinguish personal benefit from scientific evidence.
Phenomenological inquiry provides an appropriate framework for addressing this gap because it focuses on how individuals experience, interpret, and assign meaning to phenomena in everyday life. Previous research in sound studies, anthropology, and health professions education suggests that audible sound may be associated with bodily awareness, emotional regulation, reflective engagement, and meaning-making processes1,3,22,23,24. Systematically exploring these experiences can contribute to a more nuanced understanding of sound-based practices while avoiding assumptions regarding therapeutic efficacy or biological causality.
The purpose of the present study was therefore to explore audible sound-based practices from a phenomenological perspective by examining how individuals describe and interpret their lived experiences. Rather than evaluating clinical efficacy, the study sought to investigate bodily sensations, emotional and cognitive experiences, and participants’ perspectives regarding health, healing, and scientific credibility. By documenting these experiences, the study aims to contribute qualitative insight to an emerging interdisciplinary conversation involving mechanobiology, sound studies, complementary health practices, and health professions education20,21. In doing so, it seeks to provide greater conceptual clarity while maintaining clear distinctions between lived experience, biological plausibility, and scientific evidence.
The study was guided by three research questions. First, how do participants describe their lived bodily experiences during and after audible sound-based interventions? Second, what emotional and cognitive changes do participants associate with exposure to audible sound therapies? Third, how do participants make sense of audible sound practices in relation to health, healing, and scientific credibility?
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This study was conducted in accordance with institutional guidelines regarding research involving human participants. Ethical approval for this study was obtained from the University College Fairview Research Ethics Committee (UCF-REC) (Reference No. UCF/REC/2026/06-089; approval date: October 30, 2025). Written informed consent was obtained from each participant prior to the commencement of the study. All participants were informed of the voluntary nature of the study, their right to decline to answer any question, and their right to withdraw from the study at any stage. To ensure participant privacy and confidentiality, pseudonyms and participant codes were used in all transcripts and reports generated from this study. Audio recordings of the interviews were obtained using a Sony ICD-PX470 digital voice recorder or through Zoom. All audio recordings, transcripts, notes, and electronic files were stored on a password-protected and encrypted drive accessible only to the research team. These files will be retained for five years following completion of the study, after which they will be permanently deleted. No data from this study will be shared with third parties without participant consent or unless required by applicable regulations20.
To ensure participant protection and well-being throughout the study, several measures were implemented. All interviews were conducted in a comfortable environment designed to minimize participant discomfort. Participants were informed of the purpose of the interviews and advised that the interviews would not be used to evaluate the effectiveness of sound-based practices as a form of therapy. Should any participant experience discomfort during or after the interview, a protocol was in place to manage participant distress. No adverse events or participant complaints occurred during the study.
Interview transcripts were created using NotebookLM software. According to the software developer, the software is capable of transcribing audio-recorded interviews. The transcripts were subsequently reviewed manually to ensure that the transcribed content accurately reflected the original audio recordings. Following transcript preparation, reflexive thematic analysis was conducted using ATLAS.ti 25 software. Although the qualitative data analysis software provided tools to assist with data organization and coding, the researchers remained responsible for all analytical decisions and interpretation of the interview transcripts. Ethical principles, including respect for persons, beneficence, non-maleficence, justice, and responsible stewardship of data, were adhered to throughout the study20.
Research Design
Given the contested and emerging nature of audible sound-based practices, a phenomenological research design was employed to explore experiences associated with these practices as an embodied phenomenon that remains incompletely understood. Phenomenology seeks to examine a phenomenon as it is experienced by participants, focusing on perception, meaning, and lived experience rather than evaluating the phenomenon itself25,26. Because audible sound-based practices remain an emerging area of inquiry with no established consensus regarding their purpose or effects, phenomenology provided an appropriate framework for exploring participants’ experiences without making assumptions regarding their use or efficacy as a treatment modality25.
Epistemological Positioning
This study was informed by the understanding that experiences are contextual, subjective, and inherently interpretable26,27. Within this perspective, the researcher’s background and interpretive lens are recognized as important components of the research process28. The primary researcher is an academic with interests in phenomenology, educational research, and interdisciplinary research related to health and the body. Although the researcher is familiar with audible sound-based practices and their proposed mechanisms, the researcher does not use these practices as a therapeutic modality. Accordingly, the experiences reported by participants were approached as phenomena worthy of exploration and understanding rather than as evidence supporting therapeutic efficacy or biological validity.
Reflexivity was considered throughout the study to minimize undue influence on the data collection and analysis processes. Following each interview, the researcher recorded reflexive memos documenting observations, preliminary interpretations, and assumptions regarding participant experiences. These memos served as part of an audit trail, documenting the considerations that informed data coding and theme development. Through this process, efforts were made to ensure that the findings remained grounded in participants’ experiences rather than researcher assumptions. This approach acknowledges the role of the researcher as both interpreter and observer of participant experiences20,28,29,30. Given the interdisciplinary and sometimes contested nature of audible sound-based practices, an interpretive phenomenological approach was considered appropriate for understanding these experiences within the unique personal and social contexts of individual participants.
Participants and Sampling Strategy
A purposive sampling strategy was employed to ensure that participants had sufficient experience with the phenomenon of audible sound-based practices31. Fifteen participants who met predefined inclusion criteria were recruited for the study. To be eligible, participants were required to have attended at least three audible sound-based practice sessions, demonstrate a willingness and ability to describe their experiences in detail, and represent diverse professional and educational backgrounds.
Participants were recruited between November 2025 and January 2026 through advertisements posted in Facebook groups, WhatsApp communities, and Telegram channels focused on sound-based wellness, meditation, mindfulness, and related health practices. These online communities included individuals with either prior experience of or an interest in audible sound-based practices. Individuals who expressed interest in participating were provided with information about the study and subsequently screened through email and messaging platforms to determine eligibility.
Twenty-one individuals expressed interest in participating in the study. Six individuals were excluded during screening. Three individuals had participated in fewer than three audible sound-based sessions, two were unable to discuss their experiences in sufficient detail, and one declined participation prior to the scheduled interview because of time constraints. Fifteen individuals met the eligibility criteria and provided informed consent to participate in the study.
Although recruitment through online communities may have introduced self-selection bias, this approach was considered appropriate for phenomenological and qualitative research because it facilitated access to individuals with direct and sustained experience of the phenomenon under investigation25,31. Qualitative research prioritizes the depth, richness, and contextual understanding of participant experiences rather than statistical representativeness25,31. Consequently, the objective of the sampling strategy was to obtain reflective and information-rich accounts of audible sound-based practices rather than to generate findings that are generalizable to a wider population.
Given the aims of phenomenological inquiry, participants were selected on the basis of their ability to provide detailed accounts of their lived experiences. In addition to direct experience with audible sound-based practices, participants were required to demonstrate a willingness and capacity for reflection. Efforts were also made to recruit individuals from diverse professional and educational backgrounds to enrich the range of perspectives represented in the study. Such diversity supports phenomenological inquiry by facilitating a broader exploration of lived experience while maintaining focus on the phenomenon under investigation17,25,26.
The final sample consisted of fifteen participants. This sample size was considered appropriate for phenomenological research, which emphasizes depth of inquiry and richness of description rather than statistical representation17,25,26. The relatively small sample enabled in-depth exploration of participants’ experiences with audible sound-based practices. Participant demographic characteristics and prior experience with audible sound-based practices are summarized in Table 1.
| Participant Code | Gender | Age Group (Years) | Duration of Exposure to Audible Sound-Based Practices |
| P1 | Female | 30–39 | 2–3 years |
| P2 | Male | 40–49 | 4–5 years |
| P3 | Female | 30–39 | 1–2 years |
| P4 | Female | 50–59 | 6–8 years |
| P5 | Male | 40–49 | 3–4 years |
| P6 | Female | 30–39 | 2–3 years |
| P7 | Male | 50–59 | 8–10 years |
| P8 | Female | 40–49 | 4–6 years |
| P9 | Female | 30–39 | 1–2 years |
| P10 | Male | 60–69 | Over 10 years |
| P11 | Female | 40–49 | 5–7 years |
| P12 | Male | 30–39 | 2–3 years |
| P13 | Female | 50–59 | 6–8 years |
| P14 | Male | 40–49 | 3–5 years |
| P15 | Female | 30–39 | 1–2 years |
Table 1: Demographic characteristics and prior experience of study participants. This table summarizes participant demographic characteristics, including gender, age group, and duration of engagement with audible sound-based practices. Participants were purposively recruited based on prior experience with audible sound-based interventions and their ability to provide detailed reflections on associated bodily, emotional, and cognitive experiences. The sample comprised 15 participants representing a range of ages, genders, and durations of engagement.
The participant group comprised nine females and six males, providing a balanced range of gender perspectives without overrepresentation of any single group. Participants ranged in age from their early 30s to their late 60s, with most participants between 30 and 49 years of age. This age distribution is consistent with adult populations who are more likely to engage in sustained self-reflective wellness and experiential practices and who can articulate embodied, emotional, and cognitive experiences in depth.
All participants reported a minimum of one year of engagement with audible sound-based practices, with several reporting involvement extending beyond five years. This level of exposure ensured that participants’ accounts reflected repeated and sustained experiences rather than novelty effects. Consequently, participants were able to describe changes over time, compare different sessions, and articulate nuanced perceptions of bodily sensations, emotional regulation, and cognitive shifts associated with sound-based interventions.
From a methodological perspective, diversity in age, gender, and duration of engagement enhanced the breadth of experiential perspectives while remaining consistent with phenomenological principles that prioritize depth and richness of lived experience over statistical representativeness. The inclusion of participants with varying levels of experience strengthened the study’s ability to capture both early interpretive responses and longer-term meaning-making processes, thereby supporting credible and trustworthy insights into audible sound as an experiential phenomenon.
Data Collection Procedures
Between January 2026 and March 2026, individual semi-structured interviews were conducted with participants. Interviews were conducted either in person or remotely according to participant preference. A total of fifteen interviews were completed, of which six were conducted in person and nine were conducted remotely via an online meeting platform. Interviews ranged from approximately 45 to 75 min in duration, as documented in the completed COREQ checklist (Supplementary File 1). Semi-structured interviews were selected to ensure consistency across participants while maintaining sufficient flexibility to explore individual experiences and perspectives related to audible sound-based practices32. The interview guide used for the study is provided in Supplementary File 2. The guide included questions exploring participant background, bodily experiences, emotional and cognitive responses, perceptions of health and healing, and meaning-making processes related to audible sound-based practices (Supplementary File 2).
All interviews were audio-recorded with participant consent to ensure accurate capture of the discussion. In-person interviews were recorded using a digital voice recorder, whereas remote interviews were recorded using the recording function of the online meeting platform. Audio recordings were transcribed verbatim following each interview.
The semi-structured interview format enabled the research questions to be explored consistently across participants while allowing flexibility to pursue relevant topics that emerged during the interviews32. Interview questions focused on participants’ bodily sensations, emotional experiences, cognitive responses, and perceptions associated with audible sound-based practices. Follow-up questions were used, when appropriate, to obtain clarification and elicit richer descriptions of participant experiences32.
Field notes were recorded following each interview to document contextual observations and preliminary reflections. Participants were subsequently provided with copies of their interview transcripts for review. Any clarifications provided by participants were incorporated into the transcripts. No participant expressed disagreement with the content of their transcript24. Representative anonymized transcript excerpts are provided in Supplementary File 3.
The interview transcripts and field notes were used for subsequent analysis. Together, these data sources supported the completeness, credibility, and authenticity of the findings20,24.
Data Analysis
Data were analyzed using reflexive thematic analysis following the principles described by Braun and Clarke29,30. Coding and theme development were conducted by a single researcher consistent with a reflexive thematic analysis approach (Supplementary File 1). Interview transcripts were read repeatedly to facilitate familiarity with the data. During the initial stage of analysis, inductive coding was conducted to identify participants’ experiences, interpretations, and meanings associated with audible sound-based practices. Particular attention was paid to participants’ descriptions of bodily sensations, emotions, thoughts, and the meanings they attributed to their experiences33. Related codes were subsequently grouped and refined into themes that reflected shared patterns across participant accounts29,30. A summary of the thematic coding framework and code definitions is provided in Supplementary File 4. The final themes and their supporting coded excerpts are presented in Supplementary File 5.
Interview transcripts, participant-reviewed clarifications, and field notes were analyzed together to provide a comprehensive understanding of participant experiences24. Throughout the analytical process, reflexive memos were maintained to document emerging interpretations, analytical decisions, and reflections regarding the data29,30. These memos contributed to an audit trail and supported the confirmability of the findings20,24. Examples of reflexive memos and audit trail documentation are provided in Supplementary File 620,24. Themes were reviewed and refined iteratively to ensure that they accurately reflected the experiences described by participants and remained grounded in the data29,30.
The combination of verbatim transcription, participant transcript review, field notes, and reflexive memoing contributed to the completeness, credibility, and trustworthiness of the findings20,24.
Ensuring Trustworthiness and Rigor
To enhance the trustworthiness of the study, strategies were implemented in accordance with the criteria proposed by Lincoln and Guba24. Credibility was supported through prolonged engagement with the data, repeated review of interview transcripts, and the use of rich, detailed descriptions of participant experiences. Emerging themes were continuously compared with the original data to ensure that interpretations accurately reflected participant perspectives.
Dependability was supported through maintenance of an audit trail documenting methodological and analytical decisions throughout the study. Reflective memos were used to document researcher assumptions and interpretations during data analysis. Transferability was enhanced through detailed descriptions of participants, study settings, and experiential contexts, allowing readers to evaluate the applicability of the findings to other settings24.
Analytical transparency was further strengthened through discussions among members of the research team regarding interpretation, reflexivity, and theme refinement. Coding and theme development were conducted by a single researcher consistent with reflexive thematic analysis (Supplementary File 1). These discussions helped ensure that interpretations remained grounded in participant accounts rather than researcher expectations. Additional details regarding the procedures used to enhance trustworthiness are provided in Supplementary File 124,32. Representative coded excerpts supporting theme development are provided in Supplementary File 5.
Table 1 summarizes the strategies used to enhance each aspect of trustworthiness. A completed COREQ checklist is also provided in Supplementary File 1 to further document the measures taken to support the rigor, credibility, and transparency of the study.
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Figure 1 presents the thematic relationships among the three research questions, major themes, and associated experiential codes derived from the reflexive thematic analysis. No formal subthemes were identified during the analysis. Instead, the themes were supported by clusters of related codes that captured recurring patterns across participants’ lived experiences. The figure illustrates how participants’ accounts progressed from bodily awareness and emotional regulation to reflective consi...
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The findings related to the research questions indicate that audible sound-based practices are experienced primarily as embodied and regulatory experiences rather than as curative interventions targeting specific disease conditions. Across all three research questions, participants described audible sound in relation to bodily, emotional, cognitive, and meaning-making experiences, without attributing curative effects or disease-specific therapeutic outcomes to these practices. These findings are consistent with the liter...
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Conflict of Interest:
The authors declare that they have no conflicts of interest.
The authors thank Eostre Sdn. Bhd. for facilitating access to participants for this study. The authors also sincerely thank all participants for their time, openness, and willingness to share their experiences, which made this research possible.
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| Name | Company | Catalog Number | Comments |
|---|---|---|---|
| Audio Recording Device | Sony Corporation | ICD-PX470 | Used to record in-person participant interviews. |
| Computer | Dell Technologies | N/A | Used for interview transcription, data storage, coding, and analysis. |
| Online Interview Platform | Zoom Video Communications, Inc. | N/A | Used to conduct and record remote interviews. |
| Transcription Software | Google LLC | NotebookLM | Used to generate initial interview transcripts from audio recordings. |
| Qualitative Data Analysis Software | ATLAS.ti Scientific Software Development GmbH | ATLAS.ti 25 | Used for coding, data management, memoing, and reflexive thematic analysis. |
| Field Notes Template | Author-generated | N/A | Used to document contextual observations, methodological notes, and reflexive reflections following interviews. |
| Reflexive Memo Template | Author-generated | N/A | Used to document analytical decisions, emerging interpretations, and researcher reflexivity during analysis. |
| Informed Consent Form | Author-generated | N/A | Used to obtain written informed consent prior to participation. |
| Participant Information Sheet | Author-generated | N/A | Used to provide study information and participant rights before enrollment. |
| Participant Screening Form | Author-generated | N/A | Used to assess eligibility against predefined inclusion criteria. |
| Recruitment Advertisement | Author-generated | N/A | Used to recruit participants through Facebook, WhatsApp, and Telegram communities. |
| Semi-Structured Interview Guide (Supplementary File 1) | Author-generated | N/A | Used to ensure consistency across participant interviews while allowing exploratory follow-up questions. |
| Participant Transcript Review Form | Author-generated | N/A | Used during transcript verification and participant clarification procedures. |
| COREQ Checklist (Supplementary File 2) | Tong A, Sainsbury P, Craig J | N/A | Used to document reporting quality and methodological transparency. |
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