M. Jackson Group Update – May 2024 – Music and Health

A collection of postings on a range of issues is available on our website (www.mjacksongroup.ca).  This month’s post is again from Ken Pope’s listserv, where he kindly provides daily summaries of current articles in the field.Tomorrow’s new issue of The Lancet includes an article: “Music for health” by Phillip Ball.

Here are some excerpts:

Many people (including me) will have experienced a family member or loved one who, rendered essentially non-verbal by dementia, will nonetheless sing along to the lyrics of a well-known song, often with evident delight at this reawakened ability to commune with others. Distressed babies can be soothed by gentle song when words do not work. People who stammer might find fluency in singing their speech. Some people with Parkinson’s disease can discover an otherwise unattainable ease of movement when they dance. Music and Mind: Harnessing the Arts for Health and Wellness, edited by acclaimed American singer Renée Fleming, reports all of these benefits, and many others, that music can bring, whether through listening or active participation. The book’s contributors come from a broad range of disciplines and include neuroscientists of music such as Aniruddh Patel, Daniel Levitin, and Robert Zatorre, novelists Ann Patchett (author of the 2001 novel Bel Canto) and Richard Powers, virtuoso cellist Yo-Yo Ma, and leading figures in the arts such as Deborah Rutter, President of the John F Kennedy Center for the Performing Arts inWashington, DC, USA….


As an illustrative primer on the potential of music to enhance our health, wellbeing,and societies, the book makes a compelling case and has plenty to recommend it. Music represents one of the richest resources available for probing how our brains work. It “appears to activate nearly every region of the brain that has so far been mapped”, writes Levitin: there is not just a single “music center”. Specialised neural circuits handle rhythm, pitch, melody, tempo, contour, and syntax, the last showing a strong overlap with the corresponding function in language processing. 


Remarkably, all of these functions are synthesised into a coherent whole that not only sounds meaningful but can move us enormously. Much of the basic cognitive processing involved is innate, and even some of music’s perceived emotional content seems to be universal. But our musical appreciation and tastes are filtered and shaped by cultural learning, as well as by individual personality. That imbues music with the potential for personal expression: whether as performers or listeners, we feel that “our music” says something important about who we are.


Music also raises tantalising evolutionary questions. We know of no human culture without some form of music—in this sense music is more universal than writing. Thus, music seems to be intrinsically connected to what it is to be human. But no compelling case exists for music perception per se being an adaptive trait…. As Patel suggests in the book, the identification of some aspect of brain circuitry that is specialised solely for music would offer strong (albeit notconclusive support for an adaptive function. None has yet been seen, however.


What seems less in doubt is that humans have an inherent musicality: our cognitive functions make us predisposed to be music-makers. Above all, we are pattern-seekers, looking for regularities in our experiential environment that will facilitate prediction and anticipation. Humans are uniquely adept at entraining to a rhythm, although other species such as parrots can do this to some degree. We probably hear a quality of sameness in tones an octave apart-just about all musical systems recognise the octave division of frequencies-as a by-product of the typical overtone structure of natural sounds. This helps us to automatically assign related frequencies to a single source. In such ways, the concept of musicality provides continuity between our own music-making and the music-like aspects of animal communication and perception. Interestingly, “musical aptitude” tests that assess these innate features of cognitive musicality show little correlation with real-world musical achievement.


Most importantly, the anticipatory impulse that music engages-and that musicians and composers skilfully manipulate—is linked to our neural reward circuit. As Zatorre explains, music can trigger the same dopamine-mediated pleasureresponse as sex and food. The common description of such responses as “hedonic” seems to imply a rather shallow thrill-seeking, but the emotional power of music can evidently connect to more profound feelings:  transcendence, joy, communality, grief, and catharsis.


Given the richness of our cognitive apparatus for music perception, it is understandable that music can sometimes reach where words cannot to offer a powerful channel of communication in therapies. Concetta Tomaino, Executive Director and Co-Founder of the New York-based Institute for Music and Neurologic Function, gives a moving account in the book of how music awakened responses among people living in a nursing facility for late-stage dementia, many of whom were typically either minimally responsive or highly distressed. “Don’t expect anything from these people”, she was told as a trainee music therapist. But when Tomaino began singing a well-known song, many of the residents joined in with the lyrics. Tomaino collaborated for a time with neurologist Oliver Sacks (1933-2015), whose deep interest in music as a window on (and perhaps a salve for) brain dysfunctions is documented in his 2007 book Musicophilia. As Zatorre says, it could be precisely because music connects “our most basic biology” (the reward circuits involve regions of the subcortical basal ganglia) to “our most highly developed cognition” that it can unlock mental functions in this way.


Music and Mind describes the diverse benefits of music for the brain and body. Musical training has been reported to improve memory, executive function, and neuroplasticity. Music therapy has been shown to help withchronic pain and anxiety management, emotional health in hospital settings, attention focus in children, and more. Singing in a choir or group offers a sense of community and enhances self-esteem. One of the tragedies of the COVID-19 pandemic (to which many of the contributions in this book allude) was that, because of the dangers of aerosol dispersal of the virus, such shared activities were curtailed as a high-risk activity. Even then, music remained a vehicle for virtual or socially distanced connection in the pandemic, from the free online concerts given by many musicians to the collaborative harmonising on Shanty Tok. Italian citizens serenading one another from their balconies during the first lockdown in Europe was one of the most poignant scenes of the early pandemic.


That our brains are changed by musical activity is nothing unusual in itself, but they seem to do so in ways that are particularly valuable. The interhemispheric communication music encourages can boost the connectivity of the corpus callosum. Musical training in children can improve coordination skills, memory, and sociality. Here the claims can easily slide into hype: the notorious “Mozart effect” on infant cognition reported in 1993 led to a veritable industry of CDs promising to make your baby a genius using Eine Kleine Nachtmusik, even though the cognitive effects proved to be small, short-lived, and not even specific to music, let alone to Mozart. Yet this phenomenon probably gained so much traction precisely because of our valid intuition that engaging with music is good for the brain.


Quite how to turn all this into effective health-care interventions is another matter. Fleming points out that for a long time there was “a perceived lack of seriousness to the notion that arts can contribute to health care” and a sense that it was “soft”, if not indeed woolly, science. Yet as the book makes clear, we have moved beyond such dismissals, thanks partly to the “hard” evidence from neuroscience. Music and Mind gives a sense of the scope of current efforts and the different populations involved. Research and interventions include studies of the effects of singing on the cardiovascular function of older patients; the value of music in boosting the performance of “failing” schools and pupils through the Kennedy Center’s Turnaround Arts programme and the Philadelphia-based music education scheme Play On Philly; dance classes for people with Parkinson’s disease; and music therapy for cancer patients, people with mental health issues, learning disabilities, and age-related memory impairment. Since 2017 the US National Institutes of Health (NIH) has run a trans-NIH Music and Health Working Group involving its institutes for neurological disorders, mental health, drug and alcohol misuse,biomedical imaging, child health and development, ageing, and more.


Yet still, meaningful relationships between music and wellbeing can be hard to quantify. “There is still much research needed to understand the effects of music on the brain to establish effective music-based treatments for age-related illnesses[such as dementias]”, a team at the NIH’s National Institute on Aging in Bethesda, MD, USA, caution. “Researchers must be aware of what questions they are answering and, importantly, what questions they are not.” Music, writes neurobiologist Nina Kraus, “doesn’t lend itself easily to the clinical trial blueprintappropriate for drug studies”. Inconvenient for researchers, perhaps, but as Kraus says, that in itself reflects on the multifaceted nature of music. To the book’s final, timely recommendations to “strengthen the research foundation of neuroarts” and “honor and support the many arts practices that promote health and well-being”, I would add the broader objective to make music in all its diversity widely accessible to all, and—in contrast to the unfortunate trend of regarding music as an optional extra—to secure it as an essential component of the school curriculum to support the flourishing of children and young people.


Ken Pope

Speaking the Unspoken: Breaking the Silence, Myths, and Taboos That HurtTherapists and Patients by Ken Pope, Nayeli Y. Chavez-Dueñas, Hector Y.Adames, Janet L. Sonne, and Beverly A. Greene (APA, 2023) Succeeding as a Therapist: How to Create a Thriving Practice in a Changing World by Hector Y. Adames, Nayeli Y. Chavez-Dueñas, Melba J.T. Vasquez, & KenPope (APA, 2022) Ethics in Psychotherapy & Counseling: A Practical Guide, 6th Edition by Ken Pope,Melba J.T. Vasquez, Nayeli Y. Chavez-Dueñas, & Hector Y. Adames (Wiley,2021)


“Don’t play the saxophone. Let it play you.”—Charlie Parker