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Dementia

The Magic of Music

Music as therapy and 16 tracks for the blues.

Key points

  • The ancient philosophers accorded a lot of importance to music.
  • Modern music therapy took form in the aftermath of the Second World War.
  • Listening to (good) music has a number of cognitive, psychological, and physiological benefits.
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Source: Pexels

The oldest musical instruments to have been found—flutes made from bird bone and mammoth ivory—are more than 42,000 years old; and it has been argued that, by fostering social cohesion, music—from the Greek, "the art of the muses"—could have helped our species outcompete the Neanderthals. Remember that next time you stand up to your national anthem.

In the Bible, David played on his harp to make King Saul feel better: "And it came to pass, when the evil spirit from God was upon Saul, that David took a harp, and played with his hand: so Saul was refreshed, and was well, and the evil spirit departed from him."

The oral works ascribed to Homer would not have survived if they had not been set to music and sung. By his song, the lyric poet Thaletas brought civic harmony to Ancient Sparta and is even credited with ending the plague in that city. The Pythagoreans recited poetry, sang hymns to Apollo (the god of arts and music), and played on the lyre to cure illnesses of body and soul. In the Republic, Plato says that the education of the guardians of the state should consist of gymnastics for the body and music for the soul and that, once set, the curriculum should not be changed: "…when modes of music change, of the State always change with them." Aristotle concludes the Politics with, of all things, a discussion of music:

Since then music is a pleasure, and virtue consists in rejoicing and loving and hating aright, there is clearly nothing which we are so much concerned to acquire and to cultivate as the power of forming right judgments, and of taking delight in good dispositions and noble actions. Rhythm and melody supply imitations of anger and gentleness, and also of courage and temperance, and of all the qualities contrary to these, and of the other qualities of character, which hardly fall short of the actual affections…

Music Therapy

In the 10th century, the Islamic thinker Al-Farabi wrote a treatise, Meanings of the Intellect, in which he discussed music therapy. Modern music therapy took form in the aftermath of the Second World War when staff in veteran hospitals noticed that music could benefit their patients in ways that standard treatments could not. In 1959, American composer and pianist Paul Nordoff and British special education teacher Clive Robbins developed a form of collaborative music-making to engage vulnerable and isolated children, helping them to develop in the cognitive, behavioral, and social domains. Today, Nordoff Robbins is the largest music therapy charity in the U.K.

Modern music therapy aims, by the use of music, to improve health or functional outcomes. It typically involves regular meetings with a qualified music therapist and various combinations of music-related activities. In "active therapy," the individual and therapist make music using an instrument or the voice; in "passive therapy," the individual listens to music in a reflective mode. You don’t have to be musical to take part. And, of course, you don't have to take part to engage with music.

The Benefits of Music

Does music therapy work? And if so, how? Music boosts levels of dopamine, a feel-good chemical messenger in the brain. Many people use music to power through a workout. Beyond distracting from discomfort, music triggers the release of opioid hormones that relieve physical and psychological pain. But forget the workout, just dance to the music! Dancing is the best exercise, because it involves start-stop movement in all directions and engages the mind on multiple levels. Music also boosts the immune system, notably by increasing antibodies and decreasing stress hormones. Techno and heavy metal aside, music lowers heart rate and blood pressure, and even reduces recovery time following a heart episode or surgery.

From a more psychological perspective, music therapy alleviates symptoms of anxiety and depression and improves social and occupational functioning. Aside from the biological benefits, such as increased dopamine and decreased stress hormones, that I’ve just discussed, music can help us to recognize, express, and process complex or painful emotions. It elevates these emotions and gives them a sense of legitimacy, of context and perspective, of order, beauty, and meaning. For Schopenhauer, the progression of musical notes, especially the melody on top, mirrors the progress of our own inner striving. As I argue in my book, Hypersanity: Thinking Beyond Thinking, music is the school and the hospital of the emotions. It replicates the structures of emotions without however furnishing their contents, enabling us to feel the emotions without feeling or fearing the pain that they are normally associated with.

I don’t think that music has to sound uplifting to be uplifting, so long as it helps us to work with our feelings. In the Poetics, Aristotle compared the purifying or cleansing effects of tragedy on the mind of the spectator to the effect of a cathartic on the body and called this purging of the emotions "catharsis." In that much, tragedy is more comforting, because more true, than comedy, which so often rings hollow.

The benefit of music extends beyond depression and anxiety to psychosis, autism, and cognitive impairment. I’ve noticed that when people lose the faculty of speech through brain damage, the ability to sing is often preserved—along with, of all things, the ability to swear! In Alzheimer's disease, music can help with cognitive deficits, agitation, and social functioning. It assists the encoding of memories, and can, in turn, evoke vivid memories. In acquired brain injury, it can assist with the recovery of motor skills, and, through song, lend a voice to people who have lost the faculty of speech. At the other end of life, music played during pregnancy has been linked, in the newborn, to better motor and cognitive skills, faster development of language, and so on.

I remember as a teenager, lying in the blackness of the night and listening to Beethoven on my (now antiquated) Discman. I could swear that these experiences completely transformed the makeup of my mind.

16 Songs for the Blues

1. The Verve, "Bittersweet Symphony"

2. Soul Asylum, "Runaway Train"

3. Disturbed, "The Sound of Silence"

4. Abba, "Chiquitita"

5. Rolling Stones, "Paint it Black"

6. Royksopp, "I Had This Thing"

7. Eurythmics, "Here Comes the Rain Again"

8. Bruce Springsteen, "Human Touch"

9. The Verve, "Lucky Man"

10. Beethoven, Ninth Symphony (especially the second movement)

11. Beethoven, Violin Concerto

12. Mozart, The Marriage of Figaro (especially the Ouverture)

13. Ravel, Boléro

14. Berlioz, Symphonie Fantastique

15. Shostakovich, Seventh Symphony 'Leningrad' (especially the allegretto/invasion theme)

16. Gorecki, Symphony of Sorrowful Songs

References

Bible, 1 Samuel 16:23 (KJV).

Plato, Republic Bk IV. Trans. Benjamin Jowett.

Aristotle, PoliticsBk VIII. Trans. Benjamin Jowett.

Salimpoor VN et al (2011): Anatomically distinct dopamine release during anticipating and experience of peak emotion to music. Nature Neuroscience, Published online Jan. 9, 2011.

Mallik A et al (2017): Anhedonia to music and mu-opioids: Evidence from the administration of naltrexone. Scientific Reports, published online Feb. 8, 2017.

Chanda ML & Levitin DJ (2013): The neurochemistry of music. Trends in Cognitive Sciences 17 (4):179-193.

Bradt J et al. Music for stress and anxiety reduction in coronary heart disease patients. Cochrane Database Syst Rev. 2013 Dec 28;(12):CD006577.

Aalbers S et al. (2017): Music therapy for depression. The Cochrane Database of Systematic Reviews. 11: CD004517.

Sherratt K et al. (2004): Music interventions for people with dementia: a review of the literature. Aging & Mental Health 8 (1): 3–12.

Magee WL et al. (2017): Music interventions for acquired brain injury. The Cochrane Database of Systematic Reviews. 1: CD006787.

Ravindra A et al (2012): Maternal Music Exposure during Pregnancy Influences Neonatal Behaviour: An Open-Label Randomized Controlled Trial. Int J Pediatr., published online 14 Feb. 12.

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