The Current - Could doctors soon prescribe music as medicine?

Episode Date: October 22, 2024

We know music can soothe the soul, but neuroscientist Daniel Levitin says it could also help heal the body and brain. Last month, he spoke with Matt Galloway about the power of music as medicine — and how it helped his friend, Joni Mitchell, recover from a brain aneurysm.

In 2017, it felt like drugs were everywhere in the news, so I started a podcast called On Drugs. We covered a lot of ground over two seasons, but there are still so many more stories to tell. I'm Jeff Turner, and I'm back with Season 3 of On Drugs. And this time, it's going to get personal. I don't know who Sober Jeff is. I don't even know if I like that guy.

On Drugs is available now wherever you get your podcasts. This is a CBC Podcast. Hello, I'm Matt Galloway and this is The Current Podcast. Hallelujah, hallelujah, hallelujah, hallelujah. Kind of makes the hair on the back of your neck stand out, doesn't it? That's the great Katie Lang, of course, and her version of Hallelujah by Leonard Cohen. Those opening lyrics inspired the title of a new book. I heard there was a secret chord, music as medicine.

We know that music has the power to soothe the soul, but we're also learning that music can help heal the body and the brain. The author of that book is Daniel Levitin, a neuroscientist at McGill University and a musician himself. Matt Galloway spoke with him last month. Here's that conversation. Lovely to start a conversation with a little bit of Katie Lang. What is going on in the brain when Katie Lang sings Hallelujah and you kind of get that

tingly feeling? I got the chills too just i mean uh yeah the um music hits every part of the brain that we've so far mapped and it activates different areas of the brain and in different ways one of the discoveries we've made having to do with the chills, the auditory system, the eardrum, basically, has direct connections to the parts of your brain that would get you to move out of the way if you heard a sudden loud noise, the so-called startle response. And that hair on the back of the neck, the shivers down the spine

are connected to all of that. How much do we know scientifically about how music affects us? Because this has been studied and people have been talking about this for a long time. Well, it goes back to Aristoxenus, the ancient Greeks and Pythagoras. I mean, with Aristotle, I mean, why does music have the ability to somehow remind you that you have a soul or make you think that even if you're a skeptic that there might be something more to this world than just us toiling away at our jobs that there there might be something that connects us all as human beings and common inhabitants of the planet.

It's something that's been studied for a long time, but when we got brain imaging, it made it tangible. You could see biologically what was going on. And I would say experimental science in the last 20 years has become more focused on having suitable controls. This is work that you do at your lab at McGill University. You've been studying how music can, I mean, one of the things you looked at is how it can help us tolerate pain. Tell me a little bit about this. How did you test that?

Well, so the first study we did was actually showing that we can't tolerate pain using music. It was an interesting upside down experiment. My colleague, Jeff Mogul, who's from Toronto and played in a boy band that was signed to A&M Records when he was a kid, he runs a pain lab at McGill. And what we found together was that if you play music with somebody that you haven't met, even for 20 minutes, it causes you to feel such empathy for them that if they're in pain, you feel pain. And we demonstrated this in an experiment that music making creates a bond between people. That launched a separate thought,

which is that, well, maybe listening to music can relieve pain. And my lab at McGill was the first to show that when you listen to music you like, your brain releases opioids, natural pain relievers. Not in the pharmaceutical levels that you might get from a Vicodin, but enough that it reduces your experience of pain. What do we know about that? Part of this is about why we like the music we do. of pain. What do we know about that? Part of this is about why we like the music we do. I mean, what kinds of music work best? Or how do you figure out what kinds of music work best that would reduce pain? Yeah, so I mean, I guess you're gonna say if we're talking about music as medicine, what's the prescription? What song, what genre do you prescribe? And what's the dose?

And the funny thing is that music is so subjective and so personal it's not like there is a single healing song or a list of healing songs we now know that music can boost your immune system through modulating levels of serotonin which in turn increase the production of t-cells and natural killer cells that travel to the site of an infection. So from a wellness standpoint, music that you like, it's not about genre. It's not like heavy metal is bad or classical is good. What we find in brain scans, Matt, is that the differences between genre pale in comparison, when you look at brain activity, to the similarity of the way it makes you feel. So very divergent songs can produce almost identical brain activity in the amygdala,

the limbic system, the parts of the brain that make you feel pleasure. What's happening in the brains of people who have Parkinson's or multiple sclerosis or Tourette's that would allow music to help with movement? So let's unpack those one at a time. Parkinson's is a neurodegenerative disease, and it damages circuits in a structure called the basal ganglia that help us to coordinate smooth, continuous movement when we're walking. Those circuits are degraded, and Parkinson's patients either freeze or they

start walking and then speed up and almost fall over because they're running rather than walking or they can't even get started. Music, because it has a tempo, a steady beat, causes certain neurons in the brain to fire in synchrony with that beat. And so you've got supplementary circuits in the brain that were not damaged by the Parkinson's that are now keeping time. And so in that way, the music acts as an external timekeeper, allowing Parkinson's patients to walk smoothly. And with rhythmic auditory stimulation, Parkinson's patients can not only learn to walk while the And with rhythmic auditory stimulation, Parkinson's patients can not only learn to walk while the music's playing, but can retrain the brain so they can walk even without

music. And the effects of the training can last for months. That's amazing. MS, what's happening there? Similar things with motor control movements in MS. MS has a different cause. There's an insulating sheath around neurons called myelin. Neurons are sending electrical signals. You need to have an insulator, just like the wires in your house, or you short circuit. And myelin is a fatty white substance, which is why we refer to it as white matter. That gets degraded. And yet there are circuits that are not demyelinated and music is able to activate them. You mentioned Tourette's and stuttering. Tourette's disease is often accompanied by tics, uncontrollable body movements. Similar to Parkinson's, you've got a problem with a timekeeper. You've got a problem

with a brain circuit that's not keeping time and doing things in the right order. And music can overcome that by activating circuits that are undamaged. And eventually, as Torontoan Norman Doidge has shown, the brain can retrain itself. I want to play an example of somebody who grew up with a stutter. And if you listen to their music now, perhaps you would have no idea of that. This is Kendrick Lamar. That's Kendrick Lamar from his album Good Kid, Mad City. He is not the only musician who is credited with helping, using music to overcome a stutter. But it's just, it's remarkable to listen to that and think that's what he was able to do.

Just extraordinary. And, you know, Elvis Presley stuttered when he spoke. James Earl Jones, the great actor, just passed away. He stuttered when he spoke. You would hear it in interviews. James Earl Jones, the great actor, just passed away. He stuttered when he spoke. You would hear it in interviews. And there's something about music that would allow those individuals to not override that, but compensate for that. Well, so stuttering is an inability of the brain to put things in the right order and at the right time.

Music has, of course, its own internal momentum. It has a schedule. Music has, of course, its own internal momentum. It has a schedule. And we have fortunately evolved populations of neurons that fire in synchrony with the music, keep a kind of an internal clock going. And so it's like having this richly elaborated metronome in your head that's telling you when things need to happen. We take for granted that we have an internal clock. For somebody like Kendrick

to be able to sing like that, a lot of the work is being done for him by the timekeeping of the drumbeat. Now, James Earl Jones had a little harder time because he didn't have music. But I read that the way he approached memorizing his lines was he would memorize them with a rhythm, almost like a Shakespearean rhythm. And that would give him that internal metronome. Yeah. There are amazing stories in this book of people who have used music to overcome extraordinary things, including brain injuries. I want to play something from someone you know and have played

music with. brain injuries. I want to play something from someone you know and have played music with. Motherless children have a hard time There's all that weeping and all that crying Motherless children have a hard time When the mother is gone Father will do the best he can Daniel Levitin, who are we listening to right there? That's Roseanne Cash, who suffered, well, she had a Chiari malformation. Part of her brain needed to be operated on to remove it.

She lost her ability to play music after her brain surgery. And it's something that, of course, was very hauntingly distressing for her. But the miracle of it all, or the science of it, depending on how you look at it, is that she was able to retrain herself in just a fraction of the time it took to learn the stuff in the first place. And we see this over and over again. What might take you 30 years to learn the first time, you can relearn in a month. And in her case, she sat down with her elementary piano books and she had to retrain her fingers to move because the part of her brain that was operated on, the cerebellum, governs movement. What does Roseanne Cash's story tell us about the ability of the brain to heal and the role of music in that? us about the ability of the brain to heal and the role of music in that? Because you will often hear stories from people of a family member who had a stroke or some element of neurological damage.

They seem different. You play music and suddenly it's like they came back to who they were. What's going on there? Well, so for one thing, it's a myth that we don't grow new neurons and we don't make new connections. We're growing new neurons all the time when we're making new neural connections all our lives. Every time you learn something, taste something new, do something new, that learning creates new pathways in the brain. That's what learning is to a neuroscientist. It's the creation of new pathways. When you hear about people who recover with music, it's because music is such a rich stimulus. It has rhythm and pitches and loudness profiles and the different timbres of different

sounds. It's got a beat, it's got meter. And historical context and memory tied to it as well, right? It just takes you back to that moment when you heard that song the first time. tied to it as well, right? It just takes you back to that moment when you heard that song the first time. It really does. And so music is able to activate a lot of different pathways in the brain all at once, auditory pathways, memory pathways, emotional pathways, as we were talking about earlier, direct access to your movement centers. Music is the only art form that makes you want to move, whether you want to move or not. And so in terms of recovery, what we're talking about with neuroplasticity is rewiring the brain to do what it did before, but with new pathways. In 2017, it felt like drugs were everywhere in the news.

So I started a podcast called On Drugs. We covered a lot of ground over two seasons, but there are still so many more stories to tell. I'm Jeff Turner, and I'm back with season three of On Drugs. And this time, it's going to get personal. I don't know who Sober Jeff is. I don't even know if I like that guy. On Drugs is available now wherever you get your podcasts. On Drugs is available now wherever you get your podcasts. In 2015, your friend, the great Joni Mitchell, suffered a brain aneurysm,

and you were involved in helping to choose the music that might help her recover. And some of the choices that you made, I think, might be surprising to some people. Have a listen. Why did you think that Chuck Berry, Johnny B. Goode, would be instrumental in helping Joni Mitchell recover? Instrumental, I see what you did there. Matt, you're giving me a little too much credit, because I didn't actually choose the music. In the early 2000s, Starbucks created their own record label, and they put out CDs called

Artist's Choice, and they asked musicians for their Desert Island discs. artist's choice and they asked musicians for their desert island discs and Joni was one of the first artists who was asked to create you know a cd of what would you want on a desert island and she very generously involved me in the conversation she had me over to her house for several late nights across a period of weeks listening to records we just spun records and cds and she was sort of talking out loud, should I include this? Should I include that? What about this? What do you think about that? And it's not that she really wanted my advice, I think. She just liked the company. Playing music together is so much more rewarding than playing it by yourself. But Chuck Berry was on her Desert

Island disc. And after she got back home from the hospital and being in a coma, I spoke with her nurses and I said, play her the music on that Desert Island disc. That is the stuff she, by her own description, loves the most. That's in her DNA in some ways. It's in her musical DNA. Yeah. It's what she perks up to. And it was extraordinary because she had been not very communicative when she got back. She'd been in a coma. And the music reached deep down inside of her and reminded her of who she was and what she liked.

I mean, people will see that video of her when she performed at Newport and played Both Sides Now and will burst into tears because of what that song means, but also because of what she has gone through. How much of that, the recovery, how much of that has to do with music? It sounds obvious to ask somebody about that, given what she means to music, but it feels like the recovery was driven by music. Well, you really nailed it with Why We're Moved to Tears. I mean, the song Both Sides Now is talking about looking at life from two different sides. When she recorded it with the London Symphony Orchestra and the arrangement by Vince Mendoza later in her life, and she had that husky, deep, Eartha Kitt voice instead of the angelic Anjanoo voice,

you were hearing the both sides now. I've looked at love from both sides now, not from a 22-year-old, but from a 62-year-old, right? And now we are hearing it from somebody in her 70s who's just recovered from a serious brain injury, very, very moving. I have to say, although music was a catalyst, Joni has such a powerful will and indomitable spirit

that I don't know that simply music would have recovered most people to the extent that she recovered. It really was a force of her own determination that got her to where she's going to be playing the Hollywood Bowl this fall. I mean, there's obviously, and this is the work that you're doing, scientific kind of evidence that is being accumulated around this. But given what we've been talking about, is there kind of a, I mean, and this is the secret core thing, like kind of a spiritual element to this that you still don't understand, something that exists outside of our grasp, but we know it, the hair on your arm stands up when you hear that.

Matt, it's all outside our grasp. There's nothing in the grasp. I mean, we're kind of hand-waving and saying, well, this is what's going on in the brain. But the ability to say this is what's going on in the brain is something that's important for doctors and health insurers to be able to say, yeah, this is real. I think so much of it is, for want of a better word, ineffable, mystical even. I mean, the ancient question, how is it that music, just a collection of frequencies, can make you feel so many things and remember so many things? How would you want this to be used in future? In the best case scenario, and incorporating it in a more intentional way, how do you think music could be used as medicine in the future? I think in the not too distant future, we're going to see, right now all the streaming companies have recommended lists, and they're pretty dumb.

They don't really work for me. But I think this is a golden age for music. There are 100,000 new songs being uploaded every day. And you have access to everything. 200 million songs as of last count across the major streaming services. And so finding the right thing for you is the trick. And so I think AI will help there, not in writing music, but in helping to select music based on the features of the music that you've liked before and help you discover new music. And on a more practical level, what I see is health insurance companies and governments and doctors and clinicians realizing that instead of prescribing drugs,

which can be harsh on the body and have side effects, we can be doing what people have been doing for 20,000 years, but with a more targeted scientific basis. And that is to use music for helping with injury, recovery, treating depression, all the other things we've been talking about. One of the things you say in the book is that it's never too late for you to learn how to actually play something, to pick up an instrument and learn how to play it. I'm so glad you brought that up because I do think all of us are musicians,

whether we play an instrument or not. We are a musical species. We're wired for music. Infants start musical babbling around the time they start linguistic babbling, and many infants sing before they can speak. So we are musical, but we're told that in our current society, well, if you don't play well, you shouldn't play at all. And that's ridiculous. Absolutely ridiculous. Playing an instrument has been shown to be neuroprotective and it is never too late to start. My grandmother, when she was 80, she was an immigrant to the United States. Around her 80th birthday, she shared with my mother and I that every morning since 1939, she sang God Bless America.

She was so grateful for a country to take her in. A song written by another immigrant, by the way, Irving Berlin. And so my mother and I bought her a little keyboard and we put masking tape on the keys so that she could play 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. And she just loved playing it. And she learned at some point to take the tape off the keys because she'd memorized it. And during a year or so, she'd worked out a rudimentary harmony with her left hand. She learned to play the piano at age 80. It gave her a sense of purpose, a sense of agency and accomplishment, even at 80. And she played that keyboard every morning until she died at 97. We'll leave that there. Daniel Levitin, thank you very much. Thank you, Matt.

That was Matt Galloway speaking with Daniel Levitin, a professor emeritus of psychology, neuroscience, and music at McGill University. His latest book is called I Heard There Was a Secret Chord, Music as Medicine. For more CBC Podcasts, go to cbc.ca slash podcasts.