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As a music lover my entire life, who could have been doing productive things to be a good citizen rather than playing albums and going to concerts, I can safely say I have never been inclined to think of music as having any practical value.
But reading the new book by Daniel Levitin, I Heard There Was a Secret Chord: Music as Medicine, made me think otherwise. Levitin, a neuroscientist who first got the public thinking about the biological machinery behind music in his 2006 book, This Is Your Brain on Music, puts the spotlight on burgeoning methods of music therapy restoring pleasure to so many people who have lost it.
Recently, over video, I told Levitin at his home in Hollywood that his book opened my eyes to the seemingly magical effects of music therapy. That led us into an engaging conversation on the secret chords that music strikes in our brains and bodies. Levitin began writing the book around the time he got some news from friend Bobby McFerrin, the many-splendored vocalist best known for his a cappella hit, “Don’t Worry, Be Happy.”
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You write that Bobby McFerrin “changed forever the way you think about music and medicine.” How so?
To begin with, I consider Bobby to be among a small number of people who are oracles. They’re human 2.0 Whatever force he’s in touch with, he just seems more evolved than the rest of us. That’s not to sound mystical or anything, but when Bobby says or does something, I pay close attention.
One day Bobby was feeling fatigued before a show in Vermont. He didn’t feel like he had the flu. He didn’t know what it was. But he was going to cancel the show. And then, because he’s Bobby and thinks more about other people than he does himself, he started imagining all these people who bought tickets. They’d probably been planning for this evening for some time. Some of them had to hire babysitters. And he didn’t want to upset that.
It was like the angel and devil on each shoulder telling him, “Stay in the hotel room, you’re sick.” “No, do the show.” Anyway, he went and did it, and once he started singing, everything changed. He no longer felt fatigued, he no longer felt unfocused, and he went through the whole show. Shortly after that, he was diagnosed with Parkinson’s disease.
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What did his decision to perform tell you?
I knew from my own work in the laboratory that dopamine does different things in different parts of the brain, but one thing it does is signal pleasure. It’s also part of the motivation network. It motivates you to do things that are pleasurable or healthful, and it helps you to coordinate movement when you’re in the throes of Parkinson’s and can’t otherwise control your movements. In Bobby’s case, it kicked his motor system into doing the amazing thing he does, and the ultimate pleasure he derives from it.
Let’s talk about a few other afflictions. How does listening to music relieve depression?
The “how” is a difficult question. We know it does. But we’re still trying to sort out the distinct mechanisms behind it. The social part, though, is a big factor. Usually, when you’re depressed, you don’t feel like being with other people. Something has happened in your life that has caused you to feel cut off from others. There’s an organic component of depression and there’s genetic predispositions toward it, but there’s usually some sort of environmental trigger that leaves you feeling misunderstood.
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So, if you listen to happy music, that’s just another bunch of people who misunderstand how you feel. You’ve got no use for them. But, put on the right sad music, and you feel understood and validated. Your emotions are validated. It’s not somebody coming in and saying, “Hey, get up off the couch, straighten up and fly right. You have a lot to live for.” That’s not somebody who gets you.
Is music curing that gash on your elbow? Not directly, but it’s enabling your body to cure it.
But when you hear a musician or band that’s feeling what you’re feeling, you find that uplifting and validating, and you realize, “This person’s been through what I’ve been through and they came out the other side, and they turned it into a beautiful work of art.” On the chemical side, when you’re feeling in tune with the music, the hormone prolactin is released. It’s released in lactate when mothers are nursing their infants, in both the mother and the infant. It soothes and tranquilizes us.
How about anxiety?
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That’s a little bit different. Anxiety typically means your heart’s racing too fast. You’re worried you might have a feeling of impending doom. We’ve found populations of neurons fire in synchrony with the music, and with certain kinds of music, subject to individual taste, that can reliably lower your respiration rate and reduce cortisol levels, which are the real chemical that’s causing that anxious fight-or-flight reaction.
On a deeper note, how can listening to music help people with Alzheimer’s disease?
Typically, what we see in Alzheimer’s cases, where people have profound memory loss, is they don’t recognize where they are or how they got there. They may not recognize their loved ones. They may not even recognize themselves in the mirror. And when that happens, they do one of two things. They either fold in on themselves because the external world makes no sense, or they become violent because the external world makes no sense.
In the latter case, they end up getting medicated, which is no good for anybody. A principle of mammalian memory is our earliest memories are the most well-preserved. If you play music for somebody with advanced memory loss, it allows them to connect with music from their youth, a part of themselves they had lost. They feel themselves again. They may still not know where they are, but at least they’re in touch with some part of themselves, and that can dramatically relieve anxiety, and in many cases, of those who reached a kind of catatonic state, it can pull them out of it for days at a time.
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Do you have to love music for it to work in healing?
No, you don’t have to love it, but you have to like it. In music therapy, people often say the music piped into public places is not what they want to hear. Your doctor can’t say, “Take two Adeles and call me in the morning.” It can’t work that way. You have to like the music. You have to choose it yourself.
Tell us about the default mode network in the brain.
It’s a network of regions in the brain we describe as the daydreaming mode. If you’re a carpenter and you’re hammering, you’re really paying attention. That’s the central executive mode. Its opposite is this daydreaming mode. It’s when you’re driving on the freeway, and you miss your exit because you know your brain was somewhere else. And it’s a mode of the brain that helps you to solve problems. Often, when you can’t solve a problem by thinking about it, you put it away. That’s the part of the brain that’s working on it. It’s related to the subconscious, although not identical, and it appears to be a healing mode because it restores a kind of homeostasis to the brain and to glucose metabolism. The brain runs on glucose, like a Tesla runs on electricity, or a Buick runs on gas. Glucose is the fuel of the brain, and it gets depleted after thinking too long or too hard, and that default mode allows it to replenish.
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And does music give us entry into the default mode network?
Yes, that’s right. Though probably not James Brown or electronic dance music.
What’s the significance of the default mode in music and healing?
Well, here we’ve got to do some hand-waving. During sleep, for example, there’s a lot of cellular housekeeping going on, getting rid of dead cells, purifying the bloodstream, organizing the thoughts of the day and consolidating them into memories. And that’s also what happens in a waking state during the daydreaming mode. There’s something healing and restorative about it. We’re not exactly sure how. But music can take us there.
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Listening to or playing music allows patients to feel better. Music takes their minds off their mental or physical pains. But can music actually cure them?
I would say it can, in the same sense penicillin can. Penicillin doesn’t cure the disease. Penicillin kills the bacteria that was causing the disease. Surgery doesn’t cure cancer. It gets rid of the cancer. Music boosts the immune system, in particular immunoglobulin IgA, a substance that travels to the site of mucosal infections by reducing cortisol. When you’re stressed, cortisol shuts down the immune system, because cortisol usually spikes in response to an explicit proximal threat, like a lion running toward you. Over thousands of years of evolution, the cortisol system figured out that if you’re going to have to fight a lion, you’ve got to preserve all your resources to fight or to flee.
Your doctor can’t say, “Take two Adeles and call me in the morning.” It can’t work that way.
So, what does preserving your resources mean at a physiological and metabolic level? It means shutting down your digestive system. That can wait till later. Shutting down your libido, because you don’t have time for that now. Shutting down your immune system. That’s why people with chronic stress have compromised immune systems. And if you can reduce psychological and physical stress, you’re enabling your body’s immune system to do what it’s meant to do. Music can promote IgA levels. They can promote cytokine production, the production of natural killer cells, T cells, plus, they can increase serotonin, which boosts your mood, which in turn, can create this cascade of neurochemical activity. So, is it curing that gash on your elbow? Not directly, but it’s enabling your body to cure it.
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You tell the stories in I Heard There Was a Secret Chord of Joni Mitchell, who suffered a brain aneurysm, damaging a large portion of her brain’s right hemisphere; jazz pianist Keith Jarrett, who suffered two strokes leaving the left side of his body partly paralyzed; and jazz guitarist Pat Martino, who had a large tumor surgically removed from his brain. In each case, these great musicians were aided in their convalescence by listening to music, often their own, and in Jarrett’s case, playing the piano with his one functional hand. Although recovery from brain trauma is not an exact science, you write, music was a catalyst in their recoveries. Which makes sense because music was literally their lives. It’s so incredible they found it inside them again. But what’s an example of remarkable recovery in people who are not musicians?
Well, the plural of anecdote is not data, but I think of soldiers in music therapy classes that focus on songwriting. The soldiers suffer severe cases of post-traumatic stress disorder not amenable to talk therapy or drug therapy. They take all the pain and trauma and horrific visual and sensory imagery and put it out there in the world in a song; it’s no longer inside them. One of the ways talk therapy works is it allows you to not keep the trauma locked inside yourself. You’re presenting it to someone who ideally is a sympathetic, empathetic individual—the therapist—and getting it outside of you helps to make it objective, less fearful to you. Putting it in a song seems to be an even more powerful way to get the monster outside of you.
Music can be more engaging than talk therapy—psychologically, emotionally, spiritually.
Do you have a personal experience of music as medicine?
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Right now, I’m thinking of my father, who I saw yesterday. He’s 92 and has short-term memory loss. He just got out of the hospital after a week with coronavirus, severe oxygen depletion, and fluid in the lungs. At home, he looked utterly transformed from the man he was in the hospital. He was listening to music from his teenage years. He was listening to Frank Sinatra and Bing Crosby and Ethel Merman and Benny Goodman. I got to his house at 4 o’clock and he’d been listening for four hours straight and was just so happy. He has a blood pulse oximeter on him all the time. And when he listens to music, he breathes more deeply. The music is making him do it automatically because it’s physiologically stimulating.
How about medicine for you yourself?
When I can’t focus, I put music on. Sometimes I meditate to it. Sometimes I just put it on and close my eyes for 10 minutes. And when I’m feeling blue, or don’t know how I’m feeling, I can usually find the thing that helps me go, “Yeah, that’s how I feel.”
If you could only play one album to lift your spirits, what would it be?
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That’s an impossible question. Today it would be Alex de Grassi’s Slow Circle. Or it could be Bill Evans’ Sunday at the Village Vanguard. It might be Steely Dan’s Countdown to Ecstasy, something I can listen to all the way through over and over again and never get tired of.
My takeaway from reading I Heard There Was a Secret Chord is that music has a holistic effect on our brains and bodies. And the secret of the physiological changes induced by music, which we’ve been talking about, is pleasure. Think that’s fair?
I think that’s exactly right. But pleasure is not one thing. Neurobiology shows pleasure is a cascade of physiological responses that absolutely help in recovery. If we were to create a taxonomy of pleasure, there would be anticipatory pleasure, which is, “I see that cupcake and I suddenly feel good because I know I’m going to eat it.” Which is different than taking the first bite, the pleasure of consumption. Well, music is anticipation and consumption pleasure inextricably bound.
Ultimately, what’s special about music therapy?
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Music is special because it’s engaging. For some people, it’s more engaging than talk therapy—psychologically, emotionally, spiritually. It’s something that you can control the dose of. You can always turn it off or turn it louder or softer. And you can always choose the type of music you want to hear.
Lead image: CURAphotography / Shutterstock