The science behind the healing power of music
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This message comes from Fred Hutch Cancer Center, whose discovery of bone marrow transplants has saved over a million lives worldwide. Learn how this and other breakthroughs impact the world at fredhutch.org slash look beyond. This is The Pulse, stories about the people and places at the heart of health and science. I'm Maiken Scott.

I recently tried a sound bath for the first time. It's an immersive auditory experience that helps you relax. So where are we right now? We are at the Away Spa at the W Philadelphia, and my name is Luna May, and I'm the resident sound therapy practitioner here at the spa. And I'm going to give you a massage of sound today. Hmm. So...

Wow. Okay. So what should I expect? I always say like, this is a time for us to embrace the art of listening past the passive sense of hearing, right? So to go into it with curiosity and not a need to expect anything. So it's really just about going into it, being open and ready to listen, listen to the body, listen to how the body responds to the sounds and the frequencies, listen to your breath and see what's possible there. Okay.

So I don't really have a job for the next 15 minutes or so. That's right. All you get to do is just lie back, receive, and listen. All right. And I have this beautiful bed I'm going to lie on. So let's do this. Okay. I'm going to put down the recorder. I reclined on the bed, surrounded by Luna sound bowls and a big gong. I use acrylic mallets wrapped in a rubber casing.

I'm holding one of the bowls with like a crystal wand on it. They're made of pure quartz and they're infused with different minerals from around the world that give it their unique sound and texture. And then for this one I can actually

Luna lowered the lights and put an eye mask on my face, which helped me settle in. Then she started to play beautiful music with her instruments. I listened, I felt myself really relaxed, my mind started to wander, and I quickly went into a dreamlike state, somewhat awake and somewhat asleep.

After about 20 minutes, the music stopped and Luna explained what kinds of music she had played. So what was on the sonic menu for today was Crystal Alchemy Singing Bowls, which for me have a really soft, grounding sonic texture to them.

Even though I'm actually moving about the room, the natural way these instruments express themselves kind of paint the wall. So you never really know where it's coming from. And they never sound the same. Like no two sound bath treatments sound the same. I felt really calm and refreshed. And Luna said it was probably because I went into a theta state.

Theta brainwaves are one of the five electrical pulses your brain produces. They tend to happen when you are lightly sleeping, dreaming, or in a state of deep relaxation. The whole experience felt like what I think meditation should feel like.

Because the thing is, when I try traditional meditation, I can never really relax. I'm always feeling ill at ease, like I should be doing something else. But during the sound bath, I kind of had an assignment, like I had to listen to the music and I wanted to figure out where it was coming from. And that made me relax so much more. Luna told me she had a similar experience when she first tried sound baths. Wow.

After so many years of trying to meditate and not knowing how to or doing it like quote unquote correctly, there was something so ease filled about doing it powered by sound meditation. The thing is, is like we all connect to music and our nervous systems are actually hardwired to respond with grace and ease to sound and vibration. And what this practice offers us is a really productive, efficient way to activate our parasympathetic nervous system.

There have only been a few studies on sound baths, but they seem to suggest that they can reduce stress and anxiety and relieve pain. A decade ago, mentioning something like a sound bath to a doctor or medical researcher would have probably elicited an eye roll and a lot of skepticism. But these days, more scientists are tuning into the healing power of music.

There is more brain science on this topic and new findings about using music in treating everything from Alzheimer's to epilepsy and depression. On this episode, music and its role in health and medicine.

Humans across time and cultures have long been prescribing music as a way to promote health and to heal the mind, body and spirit. From everything we know, archaeologically, anthropologically, music has been used for healing for 20,000 years or so.

That's Daniel Levitin, an award-winning musician and record producer who's shared stages with everyone from Sting to Roseanne Cash to Bobby McFerrin, just to mention a few. But Daniel is also a neuroscientist and a cognitive psychologist. Early humans didn't have the scientific method to ask, does this work? It's just what they did. And a typical healing ritual is

involved singing and dancing, and it involved a community. The power of community can't be underestimated. The power of enchantment

And entransement can't be underestimated in healing. We now understand some of the neurochemical and neurobiological basis for what happens when this kind of music healing occurs. Daniel says the healing power of music is even described in the Bible. King David, the same one that slew Goliath with the slingshot, King David, before he was king, was a well-known musician. And King Saul, from what we can tell, was depressive.

And he would fall into these deep fits of depression, and the only thing that could bring him out was David playing the lyre. And it would lift Saul's spirits up. And this is recorded in the Old Testament, and it's what Leonard Cohen was referring to in the opening line to his song Hallelujah. I heard there was a secret chord that David played, and it pleased the Lord. Now I've heard there was a secret chord.

Daniel borrowed those lines for the title of his new book, which is called I Heard There Was a Secret Chord, Music as Medicine. It explores the healing power of music and how it affects the brain. I was listening to the symphonies of William Boyce on the way to our interview, and I find them incredibly beautiful. And it just causes my mind to wander and think about music.

Myself as just a cog in a great machine. Daniel says when we're listening to music, we often become entranced, almost lost in the moment. And brain science can explain this. Part of the story is rather new.

In the last 15 years, we've discovered something called the default mode network in the brain. This was first identified as a mode by Mark Rakel at Washington University. And then the network, the brain regions were sorted out by Vinod Menon at Stanford. And the idea is that the natural tendency of your brain is mind wandering. If you're not exerting willful control, your mind is going to wander. And so we call that the default mode.

And when we're at work or, you know, in a conversation, usually we're directing our attention to what's in front of us. And that takes up a lot of neural resources. And at some point, our attention flags and wants to go into daydreaming where you're not really in control of your thoughts. They're loosely connected. That default mode turns out to be restorative and healthful.

And if we can get to it more often, we're more productive in our work and happier in our lives. Music has been seen as a positive force for our well-being and even as a healing force for centuries. But Daniel says in the Western world, that healing aspect faded in the late 19th century. Germany and Austria were the nexus point for the first laboratories that studied human behavior in a replicable and scientific way.

And at that point, we became skeptical. If you can't show that it works with a control group, then maybe it doesn't really work. But what happened in World War II...

We had a lot of wounded veterans and the VA hospitals discovered that playing them music really helped to relieve post-traumatic stress disorder and anxiety. And so music was kind of used, but not systematically. And it was considered fringy and kind of wacky because music

You know, you didn't have the evidence for it like you had evidence for things like washing your hands, the germ theory of disease, or penicillin, or things like that. But I think what really turned the tide was Marcus Rakel, who did the first neuroimaging studies. He's at Washington University, and my mentor, Michael Posner, at University of Oregon, and

put people in brain scanners for the first time in 1998. And that gave us a tangible way, a replicable and biological way to understand the nature of thought. You could actually catch people in the act of thinking and see what their brains were doing.

And among the first studies done were people listening to music. And so that made it okay to start studying music again. What do we know about how the brain processes music? I know it's very, very complicated, but what can that process tell us about how music might impact healing, mood, and different illnesses? To begin with, music affects every part of the brain that has so far been mapped.

And it hits some parts of the brain sooner than others. The emotional centers, including the amygdala, the movement centers and the cerebellum. So just in the way that a sudden loud sound can startle you and make you jump,

so can a sudden change in music. I'm thinking of Haydn's Surprise Symphony, where everything's going along smoothly and suddenly there's a loud blast of a note. Haydn's trying to wake up the people in the audience who might have been sleeping. That startle center is pre-conscious. You just move when you hear a loud sound.

And that's part of the reason why music can be so powerful, because it's constantly, continually engaging the startle center, not necessarily startling you, but it's connected to that. Music can bring you goosebumps and it can make you want to move. Then there are the more cognitive parts of it. Rhythm, pitch, melody, harmony, loudness and softness, timbre.

the quality that separates the various instruments from one another when they're playing the same note, all those qualities I just mentioned are processed in separate circuits in the brain.

Doesn't seem like it, but they are. And they can have differential effects on us. And we can attend to them. You can attend to just the rhythm and ignore the rest. If you're that kind of person, you probably become a drummer. Just kidding. But, you know, you can clap your hands or you can sing along or you can do both, which indicates you're attending to one feature or another.

And the impact of these is what helps facilitate the different healing modalities. Do we make music in the brain, put it together in the brain in a similar way as our vision puts together a picture? On some level, you know, there's a lot of processing that we do to color and to all these things to give us the experience. I really like the way you put that. Does the brain put it together? Because...

Perception, whether it's vision or auditory, is a constructive process. What we're getting from our sense organs are little bits and pieces, representations of the world, not the world itself. And so all that's happening in the auditory system is your eardrum is wiggling in and out. That's the only information you have. You sit in an orchestra concert or in a jazz club,

Your eardrum's wiggling in and out, and from that your brain has to construct some representation of, "Oh, there's Art Blakey on the drums and Wynton Marsalis on the trumpet, and they sound different, and they're playing different things." And that wiggling in and out leads to a chain of electrochemical activity. The duration of the notes get extracted, and those are tied together into a representation of rhythm. The pitches get tied together into melody and harmony.

And eventually you have a song. It happens so fast in the brain that all you perceive, all you understand is the song itself. But if we could slow time down and look at the order of milliseconds, it's being put together. And so I would say, technically speaking, music doesn't exist in the world. It exists in the brain of the perceiver. What's in the world are molecules being disturbed. Your brain has to interpret them as music. It

It seems like it would lead to a really individualized experience. And I know people experience music very differently, but then there are things that we all agree on, like harmonies or a certain note sounding pleasant or not. There is a lot of agreement there, which is kind of surprising given what you just said. This is part of the wonderful paradox of the brain.

which is that all brains are different. No two people have identical genetics. And so everybody's experience is unique and personal to them. And yet the paradox is there are some commonalities between

Vinod Menon and I put people in a brain scanner some years ago and found that when people listen to the same music, even if they're not listening at the same time, their brainwaves synchronize with one another. More recently, it was shown that people at a concert, their brainwaves synchronize. They are literally on the same wavelength. And yet the internal experiences are described very differently.

That's neuroscientist, producer and musician Daniel Levitin. His new book is called I Heard There Was a Secret Chord, Music as Medicine. Back in the 90s, researchers stumbled on an unexplained phenomenon that suggested a possible treatment for seizures, Mozart's Sonata for Two Pianos. ♪

This sonata appeared to help prevent certain spikes in neuron activity in the brains of people with epilepsy at remarkably high rates. The phenomenon was nicknamed the Mozart effect. Today, in the place where Mozart lived and made music, his legacy lives on in the work of Walter Wurtzowa, an Austrian musician who has turned his focus to the healing power of music. Reporter Morgan Childs has more.

You might not know the name Walter Verzawa, but you're likely familiar with some of his work. In his 20s, the Viennese musician was the leader of an electronic dance music group called Edelweiss. Their biggest hit became a chart topper across Europe with a music video one NPR critic called An Alpine Fever Dream.

Several years later, Walter had another hit. This time, it was a corporate branding project. He created the instantly recognizable audio logo for Intel. ♪

But since 2015, Walter has shifted his focus from branding and Europop stardom and entered the field of what he calls music medicine. I would never talk against taking medicine, but I don't think it's real fun to take medicine. But it can be fun to listen to music.

Valter is the creator of HealthTunes, a streaming platform that provides dedicated playlists for nausea, Alzheimer's, depression, and numerous other ailments. Inside the HealthTunes app, you're prompted to select your health condition, a preferred musical genre, and how much time you have to listen.

Once you've done that, just pop on a pair of headphones and let your music therapy session begin. Falter says the idea for the platform was born out of a family health crisis. Our son, when he was five years old, had leg pertussis. It's this rare illness where the femur falls apart. Leg calve pertussis disease happens when blood supply to the thigh bone gets interrupted.

That weakens the bone, which gets taken up by the rest of the body over time. It's painful, takes years to heal. And my wife Evelyn, she said we don't want to go the route, the suggested route, two years in the hospital or surgery or metal braces. We try osteopathy, acupuncture and sound healing and a diet, very strict diet. Evelyn played singing bowls for their child and she practiced something called Healing Touch, a

a form of so-called energy healing, somewhat akin to Reiki. Whether it was the sound, the touch, the acupuncture, or just plain good luck, Walter and Evelyn's son made a relatively quick recovery. A year later, it was running, and it was like a miracle. And when the hospital, UCLA, said, what did you guys do? We've never heard about this. I realized that music is a big part of it, and it's a thank you to life and to the world.

So I made this non-profit, HealthTunes. Parkinson's, cancer, addiction, burnout, jet lag. The HealthTunes app doesn't claim to cure any of these maladies, but it does provide playlists for two dozen physical and mental health conditions whose symptoms may improve with musical intervention, according to the more than 300 scientific articles linked on its website. Many of those articles focus on the so-called Mozart effect.

Not to be confused with the other Mozart effect, the debunked 1990s pop science idea that listening to Mozart could make you and your baby smarter. This Mozart effect concerns one specific piece of music, Mozart's Sonata for Two Pianos, K. 448. K. 448

Over the past three decades, some studies have shown that the piece appears to prevent abnormal spikes in the brain that are associated with epilepsy and may interfere with memory. But what do we actually know about the Mozart effect, or how it works, or if it really works? To find out, I talked to someone who studies the effects of music on the brain. I'm Barbara Yobst. I'm the chair of neurology at Dartmouth University.

And I do research in epilepsy, brain stimulation, and music and epilepsy.

Barbara has been at Dartmouth for 27 years, but she's originally from Bayreuth, Germany, home to the famous Richard Wagner Festival. I always had an interest in music, which I think came from where I grew up. Back in the 90s, when researchers first observed the Mozart effect, her interest was piqued. So to test the effect themselves, she and her colleagues created recordings of brainwave activity in people with epilepsy while they listened to music.

First of all, we had white noise. Then we had pieces that had the same frequency pattern than the Mozart piece and pieces that were very dissimilar to the Mozart piece.

but only this K448 kind of reduced these interictal epileptiform discharges. Not even Barbara knows what it is about this one piece of music that reduces those discharges. She told me she can't say she has any definitive theory to explain the mechanism at play. Last year, a meta-analysis conducted at the University of Vienna claimed there wasn't enough evidence that the effect exists at all.

Barbara stands by her research, but cautiously. We need to be careful with such claims like it's treating epilepsy.

What we have shown, it reduces these abnormal potentials in the brain. Doesn't mean you have less seizures. It doesn't mean it cures your epilepsy. It just means you have less of those abnormal potentials in your brain. And that's probably good. Barbara is currently designing a new study to test the effect of the music on seizures.

But in the meantime, for the quarter of people living with epilepsy who are drug-resistant, there aren't a ton of non-invasive treatment options. That means, for an entrepreneur like Walter, the possibility of a musical treatment is too good to pass up. Nobody really knows why that piece of music works, and we're researching more and more.

We know that it works, and I have a theory why it works, and I'm applying for grants to research it. His theory is that the piece works thanks to what's called brainwave entrainment, the hypothesis that the brain's electrocortical activity can change to match the frequency of an external stimulus. He says HealthTunes is currently testing that hypothesis in its own study. Barbara has researched brainwave entrainment herself and was not able to identify a definite effect.

But, she notes, her sample size was small. I would love to get AI involved and it would be so great to find that secret sauce and produce hundreds of pieces of music, maybe even generatives in the moment if somebody has a seizure.

to produce music which would help the patients. But there's another reason Vulture says listening to music can be good medicine, regardless of gaps in the research. It's just fun. So I gave it a try. On a recent afternoon, in the midst of a stressful week, I popped into an empty room in my office and opened up the HealthTunes app. First, you're prompted to choose from a range of conditions, including epilepsy, addiction, and PTSD. I chose burnout.

Then I was presented with a list of musical genres, so I chose the treatment, classic rock. Then I put on a pair of headphones, closed my eyes, and let myself be healed by Foreigners Cold as Ice. Foreigners Cold as Ice You're willing to say

Does listening to Foreigner really help when you're burnt out? Maybe. It's not like cold as ice holds the key to wellness. But studies indicate that taking time to listen to music is linked to lower rates of stress and burnout. It can be classical or classic rock. What's really important, Walter says, is that you like what you're listening to. There's a lot of music out there, and you have to find the right music for your mood.

Or we can help you to find the right music for certain diagnosis, but we shouldn't judge music. That story was reported by Morgan Chai. Coming up, we'll tap into the connection between rhythm and movement and talk about how music powers exercise.

He'd had some surgery on his knee, and they wanted to give him a little pick-me-up of a bespoke music track, a piece of music made specifically for him. That's still to come on The Pulse. This message comes from Carvana. Discover your car's worth with Carvana Value Tracker. Stay up to date when your car's value changes. Always know your car's worth with Carvana Value Tracker.

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Neuroscientist, musician and author Daniel Levitin says music can be an effective tool for patients with all kinds of degenerative illnesses, for example, movement disorders. So let's take Parkinson's disease, which is increasingly common because we're living longer and it's a disease that's associated with aging. And many Parkinson's patients lose the ability to walk smoothly or to maintain a steady gait.

They'll freeze while they're walking or they can't get started. And this is because of degradation in the circuits that govern movement in the basal ganglia, a loss of dopamine there. And if we play the music that's at the tempo of their gait, their walking speed, there are redundant circuits that can synchronize to that beat, just like you would stamp your foot or snap your fingers, what we call entrainment. And those circuits go

kickstart the movement again. They get people moving and they can maintain a steady gait as long as the music is playing and even after the music stops because they are able to imagine the beat in their brains. And so this is a huge thing for people with Parkinson's whose loss of mobility prevents them from getting good exercise and oxygenated blood and is a huge quality of life decrement, not being able to move around.

And there are videos on YouTube of Parkinson's patients listening to music and being able to give up their walker and the person they were holding on to. And is the mechanism that the beat kind of just kicks the brain into gear or what is actually happening there? The mechanism is that there are populations of neurons that fire in synchrony with the beat of music. And so those neurons firing in synchrony as a network,

are able to train your movement center to move in synchrony. We have automatic connections between our ear and our motion sense, our motion planning. And the reason is the startle reflex. If you hear a sudden loud noise, you've got to get out of the way without thinking. Because if it's an avalanche or a tiger coming to attack you, you can't stop and try to analyze the problem. So as soon as sound hits your eardrum and you...

It goes immediately to motor centers in the cortex and in the so-called reptilian brain. Are we designed to respond to rhythm given that, you know, when we're formed in the womb, we're hearing the rhythm of the heart and that's sort of our start into this world? Rhythm is a huge thing. Now, not all of us are equally rhythmic. Yeah.

Some people really have trouble clapping their hands or finding the beat. There's a lot of variability in humans. But generally speaking, rhythm is an important cue. If you think back to mammals, a kind of rhythmic sound, if you're like a rabbit living underground or a mole or something, and you've tunneled underground and that's your home.

and there's some rhythmic thumping of a twig against the top of the ground. You're going to habituate to that after a certain amount of time because you realize it's not a threat. It's the non-rhythmic stuff that usually indicates a danger. The punctuated sound of an attack or a sudden singular event that can indicate danger. And so rhythm we tend to find soothing. The rhythm of a heartbeat, the rhythm of breathing, the rhythm of most music.

That's neuroscientist Daniel Levitin. His new book is called I Heard There Was a Secret Chord, Music as Medicine.

Exercise is really important for our health. And if you ask most people at the gym, music is really important for their exercise. And people often have very specific tastes when it comes to their playlists. Bad Bunny is a big one. It makes me want to dance and be active. So I think that's why it makes me want to move. Seventy Soul Rock.

But music choices for exercise go beyond individual taste.

Natalia Melman-Petruzzella teaches an exercise program called Intensati. It involves choreographed kickboxing and aerobic exercises set tightly to music.

And the beat and rhythms will make or break this workout. You will actually feel if the music is off or if it's really on. So like if you're doing like four punches and then the music skips to like the sixth count or there's like half of a phrase, your body jerks a little bit. You feel like there's something wrong. You're not really moving together. You get out of the moment. You get it.

Music keeps us moving, it keeps us motivated, but there's more to it yet. Researchers are trying to figure out how exactly music affects a workout and why. Alan Yu has more. Costas Karajorges grew up in an apartment in a neighbourhood called Brixton in South London. We were located immediately above a second-hand record store.

So every morning I was jolted out of bed by the sound of a subwoofer

People heard the music and reacted to it. Costas is a musician. He started playing the piano when he was 14 and other instruments before that. He was also a track and field athlete when he was in school.

And this connection between music and movement that he observed on the street fascinated him. He is now a sport and exercise psychologist, a professor at Brunel University London, and author of the book Applying Music in Exercise and Sport. Costas says music basically distracts you from feeling tired during low and moderate intensity exercise.

When you get worn out from exercise, your muscles and organs send signals to the brain to tell you that you are tired. Think of that system as having limited bandwidth. Just like the internet, the bandwidth is limited. Music can take up some of the bandwidth that your brain would otherwise need to realize you are tired.

And because of that, people will rate the same exercise as being less difficult by around 10% if they have music to listen to. That's for low to moderate intensity exercise that makes you sweat but not exhausted, like biking at around 10 miles per hour. The benefit of music does not really apply for high intensity exercise to the same degree.

When your lungs and heart are working at close to maximum capacity, the signals that you are tired will overwhelm the brain's information processing capacity. We're unable to focus on pleasant external stimuli, such as music or a beautiful scene if we're running through the valleys or the fields of our local park. And we're forced to focus on internal fatigue patterns.

related symptoms. Of course, this is our body's own protection mechanism that prevents us from engendering physiological harm. He says the research shows that broadly, music with a medium to fast tempo, around 120 to 140 beats per minute, works best for pushing you through a workout.

He says the genre does not matter so much, so people should pick whatever they like to listen to, though they may want to avoid jarring or avant-garde music styles. For example, Physical by Olivia Newton-John is in the desired BPM range. But so is the prelude to the first act of the opera Carmen. ♪

Some of the studies show that with music, athletes can run for longer before getting tired, run more intensely, and even grip harder. Costas says the research has advanced to the point where he works with professional athletes and teams to build special music programs for them.

One prominent example was for the 2012 Olympic Games in London. The management team of British hurdler Dai Green called Costas for help. Jumping over hurdles at high speed takes a lot of agility and precision, but Dai was not in top form back then. He'd had some surgery on his knee and they wanted to give him a little pick-me-up

of a bespoke music track, a piece of music made specifically for him. Costas worked with Dai to find out what kind of music he likes and then applied his research about what rhythm and tempo would be best. The BBC did a story about the process, which includes a bit of the special song. Now World Hurdles champion Dai Green is taking it one step further.

He's been linked up with his favourite music producer, Red Light. Between them and a professor who specialises in the psychology of music, they're creating a special track for Dai to listen to in the final moments before his Olympic races. Dai Green ultimately finished fourth at the 2012 London Olympics, a fraction of a second short of a bronze medal.

Costas says there's a lot of interest in music as a tool to psych people up for exercise or to keep them going. It's an area that is exploding with scientific interest at the moment. One emerging line of research is how music can help people who are not elite athletes exercise, people who are not naturally driven to engaging in exercise and find it hard to stay motivated.

Costas did several studies with Jasmine Hutchinson, a professor of sport and exercise psychology at Springfield College in Massachusetts. We felt that the music research could have a bigger impact in focusing on perhaps people where they may not naturally want to exercise, they may be deconditioned. Recently, they worked with an exercise physiologist at a hospital in Massachusetts.

and they studied a group of patients in their 60s who already do group exercises at a diabetes clinic. They had the people try exercising without music, with music, and with a music video.

The patients did not say that music made the exercises any easier, but they did enjoy it more. So if you enjoy something more, you'll be hopefully more likely to come back and do it again. This summer, Jasmine will start a similar study that will observe patients for a few weeks to see if music can make a difference to their exercise habits.

This research can help elite athletes do better in races. And maybe it could also make exercise more fun for people who struggle with it now. That story was reported by Alan Yu.

You're listening to The Pulse. I'm Maiken Scott. You can find us wherever you get your podcasts. Coming up, why we can remember so many songs and lyrics. It's a very complex stimulus. It's got rhythm, pitch, melody, harmony, timbre. Music, memory, and our brains. That's next on The Pulse. This is The Pulse. I'm Maiken Scott. We're talking about the role of music in medicine and health.

You know how sometimes you hear a song you haven't heard in a long time, and not only do you remember the notes and the lyrics, but it brings you back to a very specific moment and memories start to flood in. Neuroscientist Daniel Levitin says music is easy to remember because it has so many attributes. It's a very complex stimulus. It's got rhythm, pitch, melody, harmony.

timbre. You know, melodies are a memory aid and that's one of the reasons they're sticky. And when you put words in there, especially with the mutually reinforcing cues of rhyme and rhythm and meter,

you've got a formula for a successful memory. And this powerful connection between music and memory can be used in treating patients with severe memory loss. One of the great tragedies of Alzheimer's and other forms of dementia is

an agitation that occurs from not knowing where you are or how you got there, looking in the mirror and not recognizing yourself. So a complete loss of a sense of self. But if we play people in this condition music from their youth...

They still remember it. They can sing along. They remember those songs. The music from the ages of, say, 10 to 20 holds a privileged spot in our memories. And it's deep enough down that it's one of the last things to go. It's why Tony Bennett was able to still sing with advanced Alzheimer's, why Glen Campbell was able to tour with Alzheimer's. And so in patients like these, one of the big problems for caregivers is the agitation and aggression they feel, understandably.

And the music completely neutralizes that, restoring a sense of self. Daniel says music therapy can be helpful in a clinical setting to treat depression. Intractable depression, depression that's not...

amenable to talk therapy or drug therapy. Music therapy can be very helpful there. And perhaps surprisingly, it's sad songs that seem to have the most beneficial effect for depressed people. Now, why would that be? Yeah. If you're depressed...

It's probably because you feel in some way misunderstood or that you're in a state that nobody else understands. But the right sad song can come on and you go, yeah, that's how I feel. It doesn't even need to have words, but with a few chords, music can express things we can't put into words. That's its purpose, really.

And you hear those notes and you go, yeah, that's how I feel. Oh, somebody else feels that way. Now I'm no longer sitting at the edge of the abyss by myself. There's somebody sitting next to me.

And they know how I feel and they've been through it. And they came out the other side and turned it into a beautiful work of art. What is at play when people find relief from pain through listening to music? Is it that the music is distracting us or is there some other mechanism at play?

There's probably a bunch of things going on here. Chronic pain is a huge problem. In the United States, it's a $680 million annual drain on the economy. 80% of doctor visits are because something hurts. Really, the only way we know how to cure pain is using things we've been using for thousands of years. We either give you the bark of a tree or its synthetic equivalent, which is aspirin,

Or we give you some kind of derivative of a poppy, you know, an opiate. And it turns out that the brain produces its own opioids. And our lab was the first to show that when you listen to pleasing music, opioids are produced while you listen to it. We call them endogenous opioids. They're inside the brain. Now, they're not released in pharmaceutical levels, but they're released in high enough levels that you could probably...

dramatically reduce the amount of pill that you're taking, whether it's aspirin or Advil or an opiate. And distraction's part of it too. It's not just the brain's own endogenous opioids, but music can be distracting in a pleasant way. And it can elevate mood. We know that listening to music can increase the production of serotonin,

which is the thing we try to increase with Prozac and various other SSRIs. And it can increase dopamine, which is a neurochemical that motivates you to want to do things and seek pleasure. That's neuroscientist Daniel Levitin. His new book is I Heard There Was a Secret Chord, Music as Medicine. Music as Medicine

Music has been used in therapy settings for decades. It can allow people to access and express emotions or to find a creative outlet to describe their feelings.

The Pulse worked with a group of youth correspondents who looked into a Philadelphia program called Beyond the Bars. It started as a way to teach incarcerated teenagers the musical arts as a form of expression and navigating emotions. But it has expanded to community centers and schools throughout the city. Nora Dorn has more. ♪

Beyond the Bars uses techniques for music therapy to help students tie music and social-emotional learning together. Music activates a lot of parts of the brain that aren't activated just through talking. That's Brian Decker, a certified music therapist in Philadelphia. It really activates all these different motor neurons that are just all these different parts that are going. And so that's in one way, it's very engaging, you know, in a way that talk therapy might not for certain people.

Brian says that music therapy can also be very effective for people who struggle with communicating. Music also connects to certain songs or might be really connected to unlock emotions and things. Like certain songs make us think of a loved one. So I think the power that music has to unlock that affect is pretty powerful. Like one shot, one shot, slice, da-da-da-da, you know, up here.

Beyond the Bars uses this connection to music to help students express themselves. Matt Jernigan, the program coordinator, says techniques for music therapy help the students grow. You can take these small things from music therapy within reason and really help someone kind of see themselves and like develop some more self-efficacy, some more confidence. And this method really has an impact on students. We talked to a few teens at Beyond the Bars in West Philly.

I had a really bad day at school, and it was just like a really depressing day for me that day. And so I went into the after-school program. We started playing the keyboard, and then it's just like all of that emotion just went away. I'm able to express emotions and not be scared of anything.

Miguel, a 16-year-old rapper who goes by Susan, SZN, found his musical voice through poetry. I liked poetry a lot as a kid, so for me it didn't seem too far. I feel like I've been able to understand myself a little bit more. I'm normally a quiet person, but whenever I'm in this

music mode or whatnot, I definitely feel more confident. Beyond the bars can be a crucial experience for teens. Investing in these students can help them to dream big and realize potential within themselves and their community.

Matt Jernigan says seeing students learning to express themselves through music is a reason to keep the program going. We want to give these kids what we might not have had. We want to give them experience that we've always dreamed of. We want them to feel like they can keep coming back to get more. So I would say that's the dream for Beyond the Bars.

That story was reported by youth correspondent Nora Dorn, with production help from Amelia Kandub and Miguel Perez. Special thanks to youth media instructor Kay Midler. We're talking about music and medicine, and I wanted to ask neuroscientist Daniel Levitin where he sees this field and this research going. Well, I think the two things that are on the horizon for the next few years are, first, health care companies investing

insurance companies and HMOs and hospitals and clinics realizing that music is a cost-effective and medically effective way to treat a variety of injuries, illnesses, and ailments. Maybe not all by itself, but as an adjunct. And it's non-addictive. So one thing is I think health insurance companies and healthcare providers are going to come around. The other thing I foresee is

is that AI and tech companies and streaming companies are going to work together. So many people already wear some sort of a device, a smartwatch or smart ring, that is monitoring their heart rate and their respiration rate. And they subscribe to streaming services that can recommend music to them. I know for a fact, having talked to all the major players in Silicon Valley,

and the streaming services that they're looking at in the next few years you know with your permission of course if your heart rate starts to spike and you're not exercising so it suggests that you're in a stressful situation it could automatically play you music that's known to relax you and ai will help it choose the music from the 200 million songs that are available and

to find music that relaxes you. And it'll send you a song and it'll be monitoring your heart rate. If your blood pressure doesn't go down, it'll choose another song and it'll learn. The AI will learn what songs work for you and what situations.

or to help motivate you through an exercise workout. So I foresee that as a very real opt-in, non-obligatory possibility. Where the kind of, you know, my Spotify will create the playlist based on my mood and what's going on with me. Exactly. I don't know if that's great or terrifying. Yeah.

Well, I wouldn't mind if I'm having trouble sleeping. Yeah. If Spotify or Apple Music or Pandora or Amazon Music knew that I'm having trouble sleeping and knew what music would relax me, and instead of me having to get up and fumble with my phone and find it, it'll just play it. It would say...

It seems like you're having trouble sleeping. Yeah, would you like me to play something? Yes, please. And then it'll know when I fall asleep and so it'll know when to stop playing it so it doesn't wake me up later. Ah, there we go, when it suddenly starts playing ACDC or something. Exactly. It's funny you mention that because we did a survey of 20,000 people

and asked what kind of music they used to relax to. And, you know, this was some time ago, people would say Enya or Bach, things like that. But there was this cluster of people who said they listened to ACDC to wind down. And then I looked at what they used to energize and wake up, and it was Swedish death metal. Oh. So, by comparison...

ACDC is so calm. Yes. Hell's bells. Yes. Such a melodic, sweet song. Daniel Levitin is a neuroscientist, cognitive psychologist, and musician. His latest book is called I Heard There Was a Secret Chord, Music as Medicine.

That's our show for this week. The Pulse is a production of WHYY in Philadelphia, made possible with support from our founding sponsor, the Sutherland Family, and the Commonwealth Fund. You can follow us wherever you get your podcasts. Our health and science reporters are Alan Yu and Liz Tong. Charlie Kyer is our engineer. Our producers are Nicole Curry and Lindsay Lazarski. I'm Maiken Scott. Thank you for listening.

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