Instant Genius - How music therapy can heal our bodies and brains

Episode Date: January 24, 2025

Many of us listen to music every day, perhaps to help us relax in the evening after a hard day’s work, get us through a tough workout or maybe even to allow us to feel closer to absent loved ones. There can be no doubt that music plays a huge part in what it means to be human. In this episode, we catch up with neuroscientist and musician Daniel Levitin to talk about his latest book Music as Medicine: How We Can Harness Its Therapeutic Power. He tells us what happens in our bodies and brains when we listen to music or play an instrument, explains the unique relationship between music and memory, and details how music can be used as a powerful therapeutic tool to help patients struggling from everything from Alzheimer’s disease to post traumatic stress disorder. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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battle class in podcast form. Every Monday and Friday you'll hear world leading scientists and experts talking about the most fascinating ideas in science and technology today. I'm Jason Goodyear, commissioning editor at BBC Science Focus. Many of us listen to music every day. Perhaps to help us relax in the evening after a hard day's work, get us through a tough workout, or maybe even to allow us to feel closer to absent loved ones. There can be no doubt the music plays a huge part in what it means to be human. But now, new research is uncovering the possibilities of music as a powerful form of therapy. In this episode, we catch up with neuroscientists and musician Daniel Levitton to talk about his latest book, Music as Medicine, how we can harness its therapeutic power. He tells us what

happens in our bodies and brains when we listen to music or play an instrument, explains the unique relationship between music and memory, and details how music can be used as a powerful therapeutic tool to help patients struggling from everything from Alzheimer's disease to post-traumatic stress disorder. So welcome to the podcast. Thanks very much for joining us. Thanks for having me, Jason. So today we're talking about your latest book, Music as Medicine, how we can harness its therapeutic power. So the premise is essentially that music has a number of healing properties. And though that might be sort of a new concept to some of our listeners, it's far from being new, isn't it? Well, I think it may be new and framed that way, Jason, but we've done work in my laboratory.

We've surveyed 20,000 people, cross-section of people from all over Western Europe and North America. And what we find is that the average person uses music medicinally, although they might not frame it that way. So, for example, wake up in the morning, you have a cup of coffee to wake up, but you might also put on some stimulating music. You're going through an exercise workout, and you're worried you might not make it. You put on something with a strong beat to help motivate you, the same way you might have another swing of coffee or tea before you get on the treadmill. You go to a party. What do we serve? We serve alcohol as a social lubricant, but we play music as a social lubricant.

You want to relax at the end of the day. You're having trouble falling asleep, maybe a single malt scotch, maybe some music. So we're using music already medicinally. And what I wanted to do is kind of corroborate and ratify this daily common behavior, give it a scientific basis, and then extend it into disease like Parkinson's, chronic pain, depression, and so on. Yeah, so that's all things we'll get into in a bit. So you're both a neuroscientist and a musician. So who better to tell us what's going on in our brains when we do experience music, you know, whether listening to it or performing it ourselves.

So essentially, I guess you can say that music is sound, albeit sound that contains an awful lot of information. So can you take us on kind of a brief journey of what happens when we hear a piece of music, you know, as it enters that ear and goes into our brain? Well, all sound begins with some movement, something. like leaves rustling in the wind or a rock falling on the ground that disturbs the molecules. Sound is the vibration of molecules in the air. And so when musical instruments or voices make sounds, those molecules are moving and they impinge on our eardrums, which then wiggle in and out in response to that sound.

At that point, something quite extraordinary happens. Just that wiggling in and out gets turned into what we call it. all music by the brain. The brain takes that pattern of wiggling and separates out different frequencies, pitches, rhythms, loud or soft, the sounds of different instruments, and it pulls it all together. And these processes, Jason, are separated in the brain. The part of the brain that picks out the notes is different than the circuit and the brain that picks out the rhythms. And that's different than the one that identifies instruments. And then it all gets strung together into what we cognitive neuroscientists call a representation, something in your head that is meant to model or represent

the outside world, a representation of the song. So in the book, you mentioned something that I'd never heard before, which I think is fascinating, is that we mentioned these different sort of aspects of music, rhythm, pitch, melody, tom or tone, etc. And there are some people that can hear one, but not the other. So what's going on there? Well, I mean, it was commonly known, I think, that there are people who can only hear rhythm and nothing else, and we call them drummers. Just kidding. Just kidding. We're going to get so much hate mail. So many troll posts. I'm just kidding. I play drums myself. Some of my favorite people are drummers or animals. I'm not sure what they are. But no, what we find is that there are neurological disorders that will take out or injury can take out one specific circuit.

And then you lose the ability to process rhythm, but you retain pitch. or vice versa, or you can have atombria, the loss of timbre. You still hear the melody and the rhythm, but you can't tell if it's a violin or a piano. Or in most cases, to patients, it sounds like a bunch of clattering pots rather than Vivaldi. So how about when we actually play an instrument rather than we just listen to music, you know, we're engaging so many different areas of our brain. So playing an instrument is interesting because if you're playing an instrument properly, you're also listening. It's not that you're doing one or the other. You're listening to what you've done. You're listening to what other people are doing if you're playing with them, ideally. But then you're adding a whole set of really fascinating and complex cognitive operations. To play an instrument, you have to think ahead to what sound you want to make. So you're imagining it. And then you're allowing it to come into the world. Like a painter, imagine.

a canvas or a sculptor looking at a block and thinking, I've got to chip away everything that is not the elephant. So there's this great act of imagination when we play, what will happen, and then we play, and then our brain compares what we did to what we intended and has to make adjustments or not, and then move on. And it engages the motor system, whether you're playing the drums or the trombone, the violin, or singing, you're moving some part of your body in very precise and coordinated motions. And that act of putting an idea into a physical movement takes a lot of different brain circuits. It's, you know, we've come to realize, Jason, it's neuroprotective to play an instrument, even if you're not particularly good at it. It's healthy for the brain

to exercise all those different circuits, just like it's healthy if you're doing, working out in a gym, you don't want to just work on the leg machine. You want to do the arms, the abs, the pecks, the neck, the back. You want to exercise all your muscles if you can. And music's one of the best ways of doing that. It seems to be. I suppose there are other things that wind instruments and singing require breathing and breathing in a particular way, so it's aerobic.

The eye-hand coordination is good. I'm not saying it's the best thing there is, but it's surely one of the best. So sort of sticking with that briefly then before we move on, so a lot of people listening, so maybe they're a bit older, they're adults, and they think, well, you know, my time for this is past, you know, I could never learn an instrument now. I mean, what do you have to say about that? Well, it's certainly contrary to the evidence.

It's never too late to learn an instrument. And I want to bifurcate the conversation here into two parts. First, directly to answer your question, no, it's never too late. I know people in their 60s and 70s who start and they find it very rewarding and fulfilling. My father, who's 92, is now taking piano lessons. And he loves it. I mean, he's able to play some things that please him. It gives him a challenge, but it's a challenge that's not insurmountable.

It also gives him the interaction with a teacher, which is lovely because his social circles have dwindled, primarily because he's outlived to all of his friends. So it's never too late, but I said I wanted to bifurcate. The other part of this, we in society have this funny relationship with music that we don't have with other endeavors, which is that you often hear somebody saying, oh, well, I don't sing, or I'm never going to be a professional, so I won't do it. But I'd like to suggest that it's an oddly unique domain in that regard. Nobody says I'm never going to be a master chef, so I'm not going to bother ever entering my kitchen cooking. What would be the point of me preparing dinner tonight? I'm not a master chef.

Or why should I learn to cook better? Nobody says, I'm not going to play soccer because I'm not good enough. You know, there's this odd thing. There's this expectation that if we're going to play music, We have to be Paul McCartney or Sting or Ella Fitzgerald. And that's just crazy. So how about then you mentioned they're different artists. How about this is something that always, you know, is probably other than politics,

most likely to start arguments, is the people's taste in music. So what I find is this really fascinating? How does that differ? You know, is it a cultural thing? Is it a personality thing? Do we know anything about that? do have different musical tastes, but we have different tastes in a lot of things. Not all of us like spicy food, not all of us like sweets. We don't all like the same romantic partners. As my

grandfather used to say, if everybody liked the same thing, they'd all want to get with your grandma. So, you know, I take it as a, you know, we're human. We have different tastes. Now, the question you're asking, the scientific question is why? And do we know anything about them? they correlate with things like personality or culture or geography. And the answer to all those three questions is, yes, they do correlate, not perfectly, but pretty well. In the United States or in England, if you give me your postal code, I can tell with probably 65% accuracy what kind of music you will like. And that's due to a phenomenon called geosorting that my colleague Jason Renfro at Cambridge

has studied. people tend to move to places where there are like-minded people and your taste is developed in part by your social group and the people you hang out with you hear new music or about new films or new activities from your friends and you tend to live near your friends. There's this whole cascade of things. Your politics, your values, family values,

your religion, your upbringing, to some extent influence broadly the kind of music you want to listen to. Plus personality traits like whether you're open-minded generous, agreeable, disagreeable, neurotic, outgoing. So that's part of the story, but a more neural explanation is that it has to do with what you listen to when you were young. Most of us gravitate towards the music we listened to when we were between 12 and 18 years old, and we spend the rest of our lives searching for something that either sounds like that or makes us feel like we felt when we heard that. Yeah, that's something I can definitely relate to.

So let's have a look at the link then. This is something that really interests me between music and memory, because it's so far ranging. So there's a lot going on here. So first off, something that is just incredibly impressive, say we've got a concert pianist. They'll just sit down at the piano and play Bach's entire well-tempered clavier just from memory.

How do they do that? Well, it's repetition. It's like when you were in grade school, you might have had to memorize a long poem or in the United States here we had to memorize Lincoln's Gettysburg address or something. I mean, it's just pure wrote repetition. But what makes it easier in music than in poetry or a speech is there's only 12 notes. There are particular ways in which they can go together or are likely to go together. there are these statistical properties that some notes are more likely

to follow others. And once you build up a sequence of six or seven or eight notes, the likelihood of the next note is typically constrained by music theory. And whether you know music theory or not, you've been hearing, you've implicitly learned the rules of music.

And so there's that, but it really is just repetition. I was watching a video the other day by a great actor who was saying people were always asking, how do you learn so many lines? And he said, well, it's never about, it was Matthew McConaughey, actually. He says, it's never about learning the lines.

By the time I step into a role, he says, I've been living with those lines for months. I've been saying them in every situation I can imagine I'm in so that every possible emotion has been expressed through them. And the lines are just there, right? you know, through rote repetition. In music, we tend to, I can play some piano pieces myself, and I'm not really a pianist, but I can play Beethoven's Moonlight Sonata

and the Pathetech Sonata from memory, a movement at a time. And so take the movement of the Pathetique, the second movement. I think that's 12 minutes. That's a lot of notes. But in my mind, or anyone's mind who's playing it, It's not special to me. You learn chunks.

You learn a measure. And then you learn the next measure. And then you stitch them together. And then you learn a phrase and you stitch the phrases together. And what we found from our studies in the laboratory over the last 30 years, dozens of studies, is that when musicians forget what comes next, it's always at one of those stitching points. It's where they had to stitch two things together.

It's never in the middle. And if you ask somebody to play a piece that they, It memorized and you kick some note in the middle of a phrase and you say start from there. It's very, very difficult for them. You've got to start at a stitching point. Yeah, well, at this point, I have a confession to make. I'm a classical guitar player myself. So I know exactly what you're talking about there.

When it comes to memorizing pieces, so say I haven't played something for, let's say, three years. I think, oh, you know, I wanted to play it again. I think, oh, no, I've got to remember it being difficult to read. I think, oh no, I've got to read that again, but I really want to play it, so I'll put in the effort. But once I get going, I always say my fingers remember it. Yeah. You know, what's happening there? Well, of course, your fingers aren't remembering it.

I've had many arguments with musicians about this because they do feel that it's their fingers. But if I were to scoop your brain out of your head, your fingers would no longer remember. What's happening is there are tight connections between the motor parts of your brain and motor cortex. and your fingers. And for that matter, anything else you can move, your legs, your toes, your arms. But fingers and arms, the brain is remembering those positions and it's remembering sequences. Your brain is what has stitched together, one fingering to the next, to the next. It's kept track of what you're doing with your right hand as well. And yeah, you've got a very well-traveled neural road. If you think of a forest and the deer have been going back and forth along one trail a whole lot so that it's now trampled and easy for you to walk on and there aren't weeds in the way and at some point the deer kicked all the rocks out of the way.

And now maybe it hasn't been used in a while. And so there's some low grass. But when you walk on it, you're able to press down the low grass because it was at one point a very well-worn road. And that's metaphorically what's going on in the brain. So this sort of intimate link between music and memory appears to be so strong that it can even survive the ravages of some neurodegenerative diseases. So what do we know about that? Well, the brain is massively redundant.

It has a lot of different parallel circuits that do the same thing. So when we see people with Alzheimer's or dementia who retain music, for one thing the music is buried deep down in the brain deeper than other things like your memory for phone numbers or even for friends and what year it is so that is able to hold on longer in the face of the generation and also music engages so many different circuits for rhythm and melody and timbre and harmony lyrics there are a lot of different ways into that that circuit or a set of circuits Ambition comes in all shapes and sizes. At First Citizens Bank, we roll with your goals because we're built for what you're building. Fit for your ambition for Citizens Bank. It's peak pollination season, and my business is scaling fast.

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handles the spreadsheets. Learn more at M365, copilot.com slash work. Let's move on to sort of the therapeutic application of music. So how does that apply? Say if somebody is suffering with Alzheimer's or dementia, how can we help them by using music? Well, one way is if they play an instrument if they're musicians, you know, encourage them to keep playing. Famously, Glenn Campbell and Tony Bennett here in the U.S., continued to play and perform after they had Alzheimer's, and it was a way for them to feel normal in a world that felt very abnormal to them. It was a way for them to feel oriented. And that had a calming, relaxing influence on them because nothing else in the world made. It was making sense to them. For those who don't play an instrument, and I'm not just talking performers,

I mean, even if you just play casually, to continue to play with Alzheimer's is certainly possible and recommended. For those who don't play, listening to music from your youth can be very orienting and calming because it's familiar in a sea of unfamiliarity. So also in the book, you mentioned a wonderful story of you helping out with Joni Mitchell's rehabilitation after she had an aneurysm. So can you tell us a bit about that story, please? Well, so Joni had an aneurysm burst in March of 2015, which caused a brain bleed, and she went to the hospital, and she was in a coma for a while. She was brought home six months later and was unable to walk, was unable to talk. And I think the doctors just figured the brain damage was so severe that she would never recover. and I had known Joni for many years before we met in the 90s and we'd become friends and by coincidence

when she was working on an album of her so-called Desert Island discs, you know, her favorite songs, she had invited me over for several long evenings of listening to her record collection while she kind of mused out loud what she would put on it, what she wouldn't. And so in thinking about what might be good for Joni, whether or not she was going to recover, just what would soothe her, it was obvious to me that she should be listening to that CD. That was kind of a gift she had left herself unknowingly. These are my favorite songs. So I got the nurses to play that CD that was part of a Starbucks record label artist choice series. And it had E.PF and Steely Dan and Chuck Berry and one of her own songs, Harlem in Havana.

and I told the nurses, an important part of this is do you have to get the patient's consent? Don't just play music. Ask her, do you want to hear music? And although she couldn't talk, she could nod her head or shake her head, yes or no. And she did, not always, but sometimes. And they played it for her. And it seemed to bring her attention to a focus, just hearing that. And over the course of the next few months, we played her that CD. and then the artists that were on the CD,

Miles Davis, Herbie Hancock, other artists we knew she liked. And we started her on a program of physical therapy, cognitive therapy, and speech therapy. And, you know, within a few years, she was speaking and moving again. And it was gradual, but she was able to go out to shows. And we went together to one of Chick-Korea's last shows before he died in Los Angeles. And that as her followers know, she played the Newport Jazz Festival and she played the Hollywood Bowl last October. So she's not, if not fully recovered, remarkably and extraordinarily recovered. And as a scientist, I want to not overstate the data.

This is not an experiment. We don't have a bunch of people that got music therapy and with equivalent aneurysms and a bunch of people that didn't. but my hunch is that the music played a role in, if not the recovery itself, in her motivation to recover. So let's have a look at another thing that you talk about then, which is the use of music and people with mobility issues, let's say. So things like Parkinson's. So what do we know about that? So Parkinson's is really the easiest case to explain, Jason, in that the disease causes degradation and circuits that help us to maintain smooth, continuous, movements in the basal ganglia and the substantia nigra and these structures allow us to walk smoothly and people with Parkinson's have difficulty walking smoothly. Part of it is that they lack

the internal clock that allows you to gauge your steps in a smooth and continuous way, the timing of them. But music has a timer intrinsic to it, music with beat, maybe not spa music, but most music does. And so that beat serves as an external clock that we believe allows Arkansas patients to synchronize. And indeed, when they listen to music with the beat, they can walk smoothly and continuously without any trouble. And after a course of training that way,

they can just imagine the music and walk. So another really interesting one is the use of music therapy to sort of manage pain. So this is something I think a lot of people will find very surprising. You know, it's a kind of a disconnect between what we know and how we think about what we know. So typically, if you go to the dentist's office, they're going to play you music in headphones while they're drilling you. And so they figured out that music somehow raises the pain threshold a little bit. And my lab was the first to show why this works, which is that when you listen to music, opioids are produced in your brain.

painkillers, natural analgesics. And so we believe that part of the story is that listening to music creates this soothing analgesic drug in your brain and that explains why people who are listening to music, not just in a dentist's office, but in a surgical room, pre-surgery, feel more relaxed, going into the surgery and recover more quickly, why people with backache sometimes find massage helpful and it may not be just the massage, but a lot of places that do back massages are playing music at the same time. And experiments have shown music is a part of it. By the way, acupuncture, which has very weak scientific evidence, but a lot of people who swear by it, acupuncture seems to activate the opioid system too. So if we go move on to sort of psychological

effects, so I don't know about over there in the States, but Over the last, I don't know, 10 years or so, community choirs have become really, really popular over here in the UK. And you think, well, that's kind of obvious. It's the togetherness. You know, it's a nice feeling. Perhaps people are lonely and they want to get involved with something. But there's more to them, that isn't there? You talk about things like PTSD.

So, well, community choirs are a great thing, particularly intergenerational ones. My previous book was The Changing Mind, which was about aging success. successfully. And I think one of the tragedies of modern life is that young people don't know many older people and vice versa, but an intergenerational choir is a good way to get to know people that are a couple of generations apart. It helps the older mind stay relevant and tuned in and the younger mind to gain some wisdom just by knowing older people, assuming the older people have wisdom. And when they don't all, setting that aside, the choir experience is aerobic. You're singing, you're bringing in, breathing out, you're synchronizing with others that releases a hormone

called oxytocin that helps us feel bonded to one another and more trustful. And then you asked specifically about PTSD. We've studied PTSD and soldiers mostly. And coming back from more, they may have experienced real trauma that interferes with their life. Most promising therapy, I know for this is songwriting with soldiers program. It's actually the name of an organization. organization. There are organizations like this all over the world where soldiers are paired with professional songwriters and they write a song about their experience, even if they're not musicians or songwriters. They write a song. And psychologically, that takes the trauma outside of your head and your body and it puts it out there in the world, something you can look at

objectively, which is really quite close to His Holiness to Dalai Lama's view of what you should do with anger. You should not negate your anger or tamp it down, but put it out there and meditate on it so that it's not in you and consuming you, allow it to exist in the world, but not exist in you. So we've covered an awful lot of different sort of areas there. So by way of summary, what do you think the future holds the use of music therapy? You know, are we only going to understand it more? Is it going to come more prevalent? Are we only just scratching the surface? Well, I think there's always a lot to know in science, and so there's a lot more to know about the underlying mechanisms, the neurochemistry, the neural circuits, science is a never-ending endeavor. There's no scientific question that's settled, not even something as simple as gravity. So going back to Newton hundreds of years ago, we still haven't sorted it out. But on the practical side, I'm hoping that the NHS will take notice. I wrote the book in part so that public policymakers would see that this is something that can save the health system

a great deal of money. Music is a lot cheaper than drug addiction, for example. The cost of the opioid crisis could have been mitigated, for example, but also to get it on the table, not just because it's cost effective, but because it's organic. Music therapies are non-addictive, and first and foremost, they're effective. And in many cases, more effective than anything else for. doing. Thank you for listening to this episode of Instant Genius, brought to you from the team behind BBC Science Focus. That was neuroscientist and musician Daniel Levitin. To discover more about the topics we've just discussed, check out his latest book, Music as Medicine, How We Can Harness its Therapeutic Power. If you liked what you just heard, then please do consider subscribing to Instant Genius on your

preferred podcast platform. The current issue of BBC Science Focus magazine is out now. pick up a copy wherever you buy your favourite magazines or download us on your app store of choice. You can also find us on Apple News or online at sciencefocus.com. This podcast is sponsored by Name, Audio and Focal. The texture and emotional depth of music can be lost through digital sources or poor signal. Name Audio believes you can have digital precision with analogue warmth. Alongside French acoustic specialist vocal, Name creates high-end audio systems, combining innovation with craftsmanship, so you can listen to music, just as the artist intended. Discover more at name audio.com.