Instant Genius - The new science of music as medicine

Episode Date: June 26, 2025

Many of us listen to music or play an instrument for pleasure thanks to the unique effect it has on our emotions. But what exactly is going on in our bodies and brains when we listen to or play music, and can we harness the profound effects it has on us to improve our health and wellbeing? In this episode, we speak to neuroscientist, musician and author Stefan Koelsch about his latest book Good Vibrations: Unlocking the Healing Power of Music. He explains exactly what’s happening in our brains when we listen to music, how playing music can help to keep our brains young, and how new research is uncovering the powerful ways in which music can help stroke patients regain their speech and mobility, reduce the amount of anaesthetics needed during surgeries and how music’s ability to bring us together can help us to lead happier, more fulfilling lives. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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It's about quality. British audio experts name audio, alongside French acoustic specialist focal, combine handcrafted tradition with cutting-edge innovation and high-end materials, delivering digital precision with analog warmth, so you can experience exceptional sound at home. Music just as the artist intended. Visit name. Hello and welcome to Instant Genius, a bite-sized masterclass 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 or play an instrument for pleasure,

thanks to the unique effect it has on our emotions. But what exactly is going on in our bodies and brains when we listen to or play music. And can we harness the profound effects that it has in us to improve our health and well-being? In this episode, we speak to neuroscientist, musician and author Stefan Kalsh, about his latest book, Good Vibrations, Unlocking the Healing Power of Music. He explains exactly what's happening in our brains when we listen to music, how playing music can help to keep our brains young, and how new research is uncovering the powerful ways in which music can help stroke patients, regain their speech and mobility, reduce the amount of anesthetics needed during surgeries,

and how music's ability to bring us together can help us to lead happier, more fulfilling lives. So welcome to the podcast. Thanks very much for joining us. Thank you for having me. So today we're talking about your book, Good Vibrations, Unlocking the Healing Power of Music. So really intriguing title. So I think let's start with the sort of most obvious question.

And that's music's strong emotional impact. So what do we know about that? Because it's a very subtle thing, isn't it? Yes. And music's strong emotional impact is one of the major factors that music can contribute to our healing, our health, our well-being. And, you know, when I did one of the very first neuroimaging studies, on music and emotions, that's now almost 25 years ago back then at the Max Plan Institute in Leipzig,

I told my directors, I want to do the study investigating emotion with music and the brain, and they asked me, but why do you want to do that with music? What do you expect to happen in the brain? It's only music. And I told them, well, I think a lot of it's going to happen in the brain, you know, because, you know, goosebumps, tears, physiological reactions to the music. there must be something in the brain connected to it. And they were very skeptic.

They said, it's not money. You cannot buy anything with it. It's not sex. It's not nutrition. You can't drink it, et cetera. Why should it, you know, do anything in your brain? And in fact, what my study, luckily that my directors let me do it, showed is that music indeed can change activity in each and every emotion structure in the brain, in the core emotional

structures in the brain. That has been replicated now by many, many other studies. Actually, this study, that study has become a milestone study in the field now. And the fact that music can change activity in so many emotional structures in the brain is key to understanding one of the most profound healing powers of music because all our miseries, our psychological disorders and diseases are tied to some dysfunction in any of these structures. And if we can balance it out with music again, we have one of the major keys that we can unlock healing powers with music. So what are some of these headline structures then that are affected? Well, many have heard of the so-called amygdala, which is, I call it the conductor of the

emotion orchestra in the rain, because it has functioned in anatomical connections. to virtually all other emotion structures in the brain. But there's so much more. It begins with the very basic, evolutionarily oldest structures in our brain, in the so-called brain stem, where we can find what I call the vitalization center in the brain. Sometimes that can activate us, motivate us, encourage us, or calm us down and relax us. And music can have direct effects on this very system by direct neural connections from the inner ear into these vitalization structures in the brain stem. That's one of the reasons why we can use music to encourage us, to motivate us when we do sports, when we have difficulties getting up in the morning, when we feel depressed.

And on the other hand, why music can also calm us down. or come our babies down when we sing cradle songs to them, lullabies to them, etc. There are other key emotional systems, for example, what I refer to as the pain, pleasure, and craving system in the brain. That's situated on top of the brain stem. And on the one hand, yes, music can provide pleasure. It can sound pleasurable. We might find it pleasurable to move to music, to dance with music.

to sing along with music, and the pleasure elicited by music in itself has healing effects, because it is associated with the release of a neurotransmitter called dopamine. I call it the fuel of the fun motor in the brain. And dopamine is relevant for our health and for our well-being, not only because it helps soliciting pleasure, but it's a neurotransmitter that the brain uses to keep itself young and healthy. And I say the system operates within the pain, pleasure and craving system because pleasure and pain are intimately connected in the brain.

When we are in pain but are capable of eliciting a little bit of pleasure, throw in a few pleasure molecules, a few fun molecules, if you will, we can reduce pain. And that's one of the reasons why we can use music to reduce pain. Craving can also be painful, and that's why we can use music and substance use disorders, to help patients. Of course, for these patients, it's also very important, for example, to make social connections with other individuals again. And this is something that not only patients, but also us healthy individuals makes, you know, it makes us happy. The key to happiness is to not be alone, but to experience community together with others. And music is by design, ideally suited to foster community because music has a pulse,

a tactus, and it has a scale. And that affords that we all join into the music by clapping, stomping, dancing, moving together in synchrony to the music, singing in synchrony to the music. We can, by virtue of music's pulse, we can anticipate when the next sound will fit. And due to the scale of a musical piece, we can make a pretty good guess on which pitch the next talk. that we produce might fit. And this enables us to operate as a group, to do something together. And once this happens, we are not alone anymore. The I becomes a we. And becoming a we, belonging to a group, to a tribe, is a deep human need. And when we fulfill this need with music, with dancing, with singing, with making music together, in the club,

in a stadium, then we experience happiness. It's what makes humans happy. So let's go through those in a bit more detail then. So you mentioned there the effect of music on our motivation. So I personally know this if I want to do some exercise or even if I'm doing the cleaning or if I'm a bit tired in the morning, I'll put on something, you know, is my personal taste, but something like Iggy Pop or James Brown or something like that.

So what does this sort of, the rhythm of music, what sort of effect does that have on us? Yes, there is not only the connection from the cochlear, our hearing organ, into the brainstem, but also of the so-called vestibular system, our balance organ in the brain. And this system is particularly responsive to low-frequency beats, loud sounds with low frequencies and sudden onsets. And what happens when a sudden bang occurs is that our pupils dilate, our heartbeat changes, our sweat production changes, our breathing changes. And these physiological reactions also happen when we hear a beat. And this is already part of like the foundation of our visceral reactions to music, what's happening in the Braves and Of course, a groovy beat also operates in other parts of our brains.

So we try to kind of, in a groovy beat, move along with the beat to stabilize the pulse of the music because a groovy beat often has offbeats. It doesn't go just, but it goes, yeah. And that means that there's not a sound on every pulse, not on every beat. And in a groovy beat, we kind of start moving to use our body to stabilize the beat, to stabilize our model of the beat. So on the other side of the coin, a lot of us are suffering from the negative effects of stress at the moment. And music can also help us hear. How does that work? Absolutely. I mean, when we talk about stress, there can be different forms of stress.

and the most common form of stress, is being plagued by negative moods, negative thoughts, and negative thought loops. These negative thought loops engage a mental system that can be deactivated by focusing on something else. So because our brain has difficulties thinking about two things at the same time, we can shut up one thought by engaging in another. So, for example, by engaging in tapping along with music, or breathing along with music, or singing along with music, that keeps our brain and our attention, focus on the music and busy, and thereby deactivates brain structures that generate negative thoughts and

negative thought loops. And that can significantly help coping with stress. And once we shut of these negative thoughts and thought loops, often what comes along with it, is that the positive emotion systems in our brain can breathe again, can regenerate again within a few minutes, and that can already help us lighten our mood and get into a more positive mood again. So something that you talk about, which I thought was really interesting, is this calming effect. And there's actually evidence that playing background music to somebody who's undergoing a surgical procedure can help to calm them down, you know, reduce their anxiety. Yes, that's also an effect that works via the so-called vitalization system, because it cannot only activate us, it can also

calm us down. So, for example, when we sing lullabies to a baby, then not only the cradling and looking to the chite, but also the soothing sounds of a lullaby calm the baby down. It, by the way, already works with preterm infants, which shows us that our brain is already musical before birth, even. And, well, we can of course also use these effects when we are stressed to relax. We can use it when we have trouble sleeping. And our research and research also from many colleagues showed that before undergoing a medical procedure, for example, in operation, music can help to calm down, to reduce worries and anxieties, and even to reduce pain, and also the needs for anesthesia.

I mean, anesthetics. anesthesia, patients need to be anesthetized in any case, but music can reduce, for example, the amount of propofol that is needed to sedate a patient. So how about some very, very serious health conditions? So for example, stroke rehabilitation. So we can use music to help these patients regain speech and even issues with mobility. How does that work? Yes, there's this. There's almost miraculous phenomenon that patients with a so-called broca's aphasia, who after a stroke cannot speak anymore, can still sing. And they can even sing with words. They might not be able to say what they want. They can only utter sounds like, oh, oh, but they can sing a song.

If I ask them, can you sing happy birthday to me, then they sing it with words. Of course, often not as clear as a person without a stroke, but surprisingly clear, given that they can, you know, hardly speak when they try to. And the so-called melodic intonation therapy has used this phenomenon to help patients with this kind of aphasia, especially when it's become chronic, to speak again. they can learn via singing to speak again. So instead of just saying, I am thirsty, they are asked to sing. I am thirsty. And that helps them step by step regaining their speech again. Similar recipes, for example, can be used for stuttering and even other language disorders.

So how about mobility then? Because, you know, some people who have suffered from a stroke, their mobility is seriously impaired, or even people with things like Parkinson's disease, we can still harness the effects of music to help with these patients, can we? Yes, with Parkinson's, the effect are similarly miraculous as for the patients with brokers ofphasia. I've seen Parkinson's patients who can hardly walk anymore, but you put on some music and they start to dance. And when you see them dancing, it's very difficult to believe that once you stop the music, they can't walk anymore. Of course, it depends on the stage in which they are in,

and it can be different from patient to patient, but it's a very surprising phenomenon to see this. It may be related to the release of dopamine in the brain because when they hear the music, they find it pleasurable. It may elicit these fun molecules in the brain, which help them also move again. therapies have been developed, helping these patients with, for example, music playing while they go for a walk outside every day for like half an hour, and then even without the music being on, they're able to walk better. 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.

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With over 100 years of combined expertise, name and focal have been bringing music to listeners just as the artist intended. Since day one, this mantra has shaped every innovation in high-fi design, technology and acoustic engineering, balancing craftsmanship and tradition with pioneering thinking. Name audio. pushes cutting-edge technology to ensure digital precision whilst sustaining Pratt,

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And it's one of kind of, I guess I'd call it nostalgia. So, you know, certain couples will have a song, you know, that reminds them of a certain point in their life when they met or something. But we can also use this effect in dementia patients to sort of recall memories. Yes, another striking neurological effects that patients, for example, with other.

Alzheimer's disease, who have severe impairments with recalling episodes of their lives, but also with regard to certain facts that they memorized, but they can still remember music and they can even learn new music. I have seen patients who didn't recognize their own son or their own sister, but who still recognized the songs from their past. They were able to sing along with it, and we have a research project where we try to use these effects to help the patients. So in this project, we observe that patients can even learn new songs. Again, it depends on the stage that they are in, but it's pretty striking that in the face of severe memory deficits in other domains, these patients can still remember and learn music. And that is very important for their psychological well-being because many of the Alzheimer's patients, especially in the earlier stages, they are aware that their memories are breaking away.

Part of their identity is fading. It makes them depressed and sad. But with music, they can discover that they have this memory island where they still remember things and where they can even learn new things. With music playing in the background, the patient, can also often remember events of their past in more detail, even if the event is not related to that kind of music. That's fascinating.

So we've mostly concentrated on listening. But how about playing music, you know? Is it true that playing an instrumental or singing can keep your brain healthy, for example? Yeah, there are two studies suggesting that playing an instrument can keep our brains a little bit younger. In one of these studies, there were three groups analyzed a group of professional musicians, amateur musicians, and non-musicians. And their anatomical brain images were analyzed with a so-called brain age algorithm. And this algorithm computes the age of the brain.

And this is not always the same as the actual age of that person. So for example, for an Alzheimer patient who comes in in our laboratory, he's 60 years old, and the age that we measure of his brain image shows us an age of, let's say, 67 or 68. So the brain is already much younger than the person actually is. And you can do the same with comparing the brain ages of musicians and non-musicians and professional musicians. And that study discovered that the brains of amateur musicians are a few years younger than the brains of non-musicians. A trend was also observed for the professional musicians, but much less pronounced than for the amateur musicians. And the reason is perhaps that amateur musicians make music without the stress that many professional musicians have.

They really just make it for the fun and the pleasure. We've done a similar study in which we found a similar trend, not as strong as in the previous study. But the neurophysiological explanation is that this fun molecule, dopamine, which is released when we synchronize our movements, when we have fun, when we experience pleasure, keeps our brains not only healthy, but also young. So you mentioned earlier the social aspect of music. So sort of coming off the back of that, so here in the UK, community choirs, have become really popular at the moment. I mean, can we use things like that as a form of therapy? I'm absolutely convinced that yes, a resounding yes, to that question, is the correct answer.

Because singing not only combines, you know, making music, it also includes singing together. So the communal aspect is it includes breathing, which is, you know, better. beneficial, if you have any kind of lung disease, pulmonary disorders, etc. It keeps the elderly, because often it's elderly persons who join these choirs, but not always, it gets them out of the house, which is a type of physical activity, also very beneficial. What usually makes people, or let's say the most profound effects of this choir singing, is experiencing community. Because when I go into the choir and I sing together with the others, I'm part of a group.

I make social connections. I become part of the social network. This communal experience is something that makes us humans happy. We crave it. It's a deep human need. Studies have shown that humans who are isolated become more sick and they die sooner. And there's this recent Harvard study that analyzed individuals over the course of several decades in order to find out what is it that makes human happy.

And the bottom line of this study is very simple. It's human connection. It's experiencing community with other individuals. That's what we need and what makes us happy. And the neurophysiological basis and the neurochemical basis is probably release of endogenous opioids. So, for example, endorphins is a part of these neurochemicals that many know endorphins from their stimulating and euphorizing effects. It's also probably one of the brain molecules that makes us happy. So we've talked about several different ways in which music

can influence and improve our health. But what about the future, you know, what's kind of on your hit list that you'd like to study next? I'm actually very interested in the neurochemical and neurophysological correlates of social bonding with music. So for example, yes, we presume it's endorphins and endogenous opioids that play a role for

social bonding with music, but the evidence is still scant. We need much more insights, which receptors are involved, which neurochemicals are actually involved, how does it actually work? Is it just the synchronization? Is it more? Which brain structures are involved? What are actually the happiness centers in the brain?

What is actually the social bonding network in the brain? You would think neuroscientists know all this already because isn't that one of the most important things to know about the brain? But the answer is surprisingly, no. We hardly know about what makes human beings. happy and, you know, about the brain correlates of what humans makes humans happy. And we know hardly about the neural networks underlying social attachment and social bonding. Thousands of studies on fear and depression, only a handful of studies on love, social bonding and attachment.

Thank you very much for listening to this episode of Instant Genius, brought to you from the team behind BBC Science Focus. That was Stefan Kalsh. To discover more about the topics we just discussed, check out his book, Good Vibrations, Unlocking the Healing Power of Music. If you liked what you just heard, then please do consider subscribe to Instant Genius on your preferred podcast platform. If you'd like to see our guests and hosts in person, then please also check out our YouTube channel at Science Focus. 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 analog warmth. Alongside French acoustic specialist Focal, 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.