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From free jazz to Bach, both music therapy and self-directed listening can have multiple health benefits ...
2021-09-14 09:00:00

Sound of Body, Sound of Mind
The Science of Music Therapy

Sound of Body, Sound of Mind
Sound of Body, Sound of Mind

The well-tempered powers of music are age-old. Whether elegiac in its pathos or buoyantly uplifting, music has always been a euphonic tonic for the body and the soul. From Apollo to Florence Nightingale to the Nordoff-Robbins school of thought, music-as-therapy has a time-hallowed timbre. Music’s remarkable link to our emotions and the mind, to our synapses and somatic signals, makes it a natural remedial instrument.

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As a modern practice, however, music therapy can be understood as a goal-oriented psychological clinical intervention that can involve making, listening, discussing and largely engaging with music. In its active form, it entails playing instruments or wider forms of music-making; receptive music therapy involves a client listening and responding to music to alter mental states and bodily chemistry. Using the innate mood-influencing qualities of music, its therapeutic methodologies can help with improving emotional expression, as well as having empirically-proven physical and mental benefits. Under the right conditions, music therapy can improve heart rate and stimulate the brain, mute anxiety, muffle mental health conditions and silence stress.

Music has been used in the treatment of range of neurological conditions, including dementia. Globally, around 50 million people suffer with its deteriorating effects on memory, cognition, and emotional and social behaviour. In 2020, an interdisciplinary research team at the University of Castilla-La Mancha conducted a review into the therapeutic efficacy of music in the treatment of dementia. Promising results in the meta-analysis allowed them to conclude that passive music therapy improved the quality of life of people suffering with the syndrome by improving patients’ emotional wellbeing and cognitive functions. Combined with pharmacological and other psychosocial therapies, the positive neurological effects of listening to music allowed the Spanish research team to suggest that “music could be a powerful treatment strategy” for dementia.

While music itself can be therapeutic, there is a difference between simply self-directedly listening to music to lessen the pain of the world and clinical music therapy at large. The latter is a research-based scientific discipline administered by credentialed therapists and psychological specialists who develop medical relationships through evidence-based practice. Not to say that ‘self-medicating’ with music cannot be a source of succour, of course, merely that music therapy itself represents its own health profession conducted by trained music therapists.

Music and depression

Although I have never received music therapy in a clinical context, I have listened to music as a sonorous antidote to depression (and that in a different clinic altogether). In the solitary doldrums of cancer treatment when I was 20 and at university, in a depressive nadir I found music to be indispensable. Baroque transfusions gave me respite in the swelling undertow of chemotherapy. I was captured by J.S. Bach’s violin sonatas and partitas, particularly the adagio from the Sonata No.3 In E, BWV 1016 and the fugal drama of its lamenting counterpoints. Sitting on a drip with Bach and the other oncology patients, I felt a kind of dissonant lightness of being; temporarily reassured, inasmuch as shared grief can occasionally offer bittersweet solidarity. When the anhedonic crescendos start to take over, stridently engaging with that pain through music is at least one way of trying to vindicate your emotions.

Sometimes our heart strings need to be wrenched. The sound of anguish, inherent to melancholy music, can imbue us with a sense of emotional approbation – the sound of our connection to depression and other sufferers. When we hear the contrapuntal angst and misery of a composition, there is also a confirmation that this dismal experience exists outside of ourselves, that someone else has also felt as we do. It’s music as a community of aching solace.

However, beyond my anecdotal example, there is also empirical research into clinical music therapy and its impact on depression. A 2017 scientific review of the extant research literature, led by Daniel Leubner, explored the efficacy of music therapy for treating depression. The study found that classical music – as well as other genres – can relieve clinical depression and generate positive mental influences on its symptoms in both passive listening contexts and active participation.

A medical research doctor in the department of neurology at University Hospital Regensburg, Leubner tells me that “listening to music, without any doubt, produces a range of demonstrable effects. To begin with, you first have to look at ‘mind and body’ as one massive system with an unthinkable amount of neural as well as chemical connections. To make things even harder, each and every one influences the whole system in some form. You can demonstrate physiological body reactions if you take the heart rate, for example,” Leubner continues. “Music with a strong and emotional sequence, filled with some high-pitched ‘drama’ in the background, and enough beats per minute, would see a significant increase in heart rate and, depending on the tested individuals, a slight increase in blood pressure.”

According to Leubner’s findings, music that emphasized slow pace and rhythm, with a medium to medium-low frequency levels, and no unexpected spikes in volume or crescendo, were the pieces that subjects reported to be primarily relaxing. As well as other genres, calm and conventional classical music was found to reduce stress and influence the release of neurotransmitters involved in stress hormone cascades. Classical music seemed to be the most frequently used for music interventions; specific compositions displayed considerably pronounced improvements in depression compared to other research attempts.

“Music can definitely increase positive emotions,” Leubner states. “From a biochemical standpoint, this is related to endorphins and neurotransmitters like serotonin and dopamine (just to name two important ones). Further research definitely has to be done in cooperation with an endocrinologist. That’s a completely different field of research and would represent quite a challenge to confirm.”

For the promotion of health and wellbeing, then, music can produce a range of verifiable reverberations on both the mind and the body; physiologically, slow music can decrease levels of the stress hormone cortisol, as well as lowering blood pressure and heart rate. The dissonance of depression, too, can be modulated by listening to various types of ambient sounds. This is where music – self-directed or as clinical therapy – can be enormously helpful.

“Music offers a simple and elegant way to treat anhedonia, the loss of pleasures in daily activities,” reported researchers at the University of Oaxaca in 2010. Led by Miguel-Angel Mayoral-Chavez, the team conducted an eight-week psychological experiment that included baroque music from J.S. Bach and Arcangelo Corelli. Reflecting on increased dopamine levels and the activation of signal pathways, their findings suggested that among other forms of treatment, “patients with low- and medium-grade depression can use music to enhance the effects of psychological support.” Curiously, in their specific case, depressed participants chose intricate and upbeat pieces (including the since debunked ‘Mozart Effect’ piece: his Sonata for Two Pianos in D major, K. 448). This is most likely because of the way in which the brain responds to cognitive complexity.

Sonic complexity and high frequencies can impact cognitive awareness. In neuroscience, this speaks to a vestigial survival skill – essentially an alarm that would warn of predators in the wild. This broad appreciation of sound also echoes another point: that classical music is not the only curative genre of music. In fact, in Daniel Leubner’s analysis of research literature on music for depression therapy, jazz was one of the three major genres used by researchers in their interventions.

Enter: free jazz

The complex therapeutic architecture of jazz, free jazz and improvisation is scientifically documented and is also attuned to the wide healing texture of music. Jazz and improvisation can decrease stress, improve communication, heal neurological damage and ameliorate mental health conditions. The indefinability of ‘jazz’ per se is connected to its complex socio-cultural history, but also certainly to its apparent improvisatory form – the dynamic play of impromptu invention and vibrant meaning making.

In the experimental elegance of free jazz there is certainly a similarity, too, with the use of rhythm and sound in clinical contexts. Extemporization between musicians, collaborating and contributing to the whole, fosters group cohesion much in the same way as patients and listeners might be. This attentiveness and liberty of the music creates a community of listeners and players, reliant on one another, listening and playing off each other and each valued as part of the gestalt.

It would be remiss not to mention here the pioneering jazz-practice of Ornette Coleman – the putative primum movens of ‘free jazz’ (broadly defined and as it came to be known). Birthing and developing this avant-garde and ‘harmolodic’ liberatory interpretation of jazz, Coleman’s music represents an imaginative force: emotionally collaborative, technically virtuosic and creatively impulsive. The music on both The Shape of Jazz to Come (1959) and Free Jazz: A Collective Improvisation (1961) is an experimental act of subversion, eschewing predetermined frameworks to generate a flux of irregularity and spontaneity.

In the movement away from the previous tonal symbolism of jazz and towards the atonal play Coleman instantiates in the 1960s, jazz opens itself out further through dissonance and greater improvisational autonomy. It becomes less about a representational music and more of a collaborative engagement; a double quartet exploring ways of expressing tonal units, patterns of rhythm, and attempts to transgress fixed meaning.

In an interview at the Bonnaroo Music Festival in 2007, Coleman said, that “making music is like a form of religion for me, because it soothes your heart and increases the pleasure of the brain. And, most of all, it’s very enjoyable to express something that you can only hear and can’t see […] And everyone gets the same benefit – that’s a pretty good equalisation there […] I think that improvising is even freer because everyone gets a different feeling from improvising.” Speaking more like a physician than a musician, Coleman continued: “My real concern for the things that I would like to perfect in music is to heal the suffering and the pain… the solitude… and when you are depressed, music seems to be a very good dose of light that causes people to feel a lot better.”

Indeed, in active forms of music therapy, patients are often encouraged to explore their authentic selves through a musical medium. Sometimes therapists provide access to resources that they have never experienced before – often instruments in which they have no formal training. This generates a free creative zone where patients pick up guitars, drums, pianos, and search deeply into themselves; by exploring the most profound levels of introspection, they are encouraged to convey what they feel to be their most real and personal truths, expressed in sound. Coleman, too, used to play a violin untrained and with a left-handed gestural technique.

The joy of improvisation

In a free jazz context, or in improvised music therapy, the style of playing is entirely open and unspecific. Together, the improvisers step into unfamiliar territory, acting both separately and together – as individuals, as a group, both retreating into the personal and entering into the communal. This spontaneity can often seem conversational, while the loose structure and heightened state of listening increases focus and attention. This musical realm garners a sense of freedom from the body, from ingrained thought patterns, and unlocks latent creativity and self-expression.

As has been documented, this relational connection to music and jazz involves a series of flows that mirror the procedures used in therapeutic contexts. In “Musical improvisation and health: a review”– a 2014 article published in the journal Psychology of Well-Being – Raymond MacDonald and Graeme Wilson of the University of Edinburgh explored the psychological phenomenon of improvisation in music therapy. They define musical improvisation as “a spontaneous, social, creative, nonverbal process unfolding in real time”.

Within the context of music therapy, active musical improvisation appears to have an array of health benefits in specific cases. These include: the healing of neurological damage, a decrease in stress and anxiety, restorative effects for mental health conditions, and ameliorated communication and attention behaviours in children with autism. According to MacDonald and Wilson, “improvisation may be expected to have direct benefits for psychological symptoms or conditions such as depression and low mood, or physiological processes such as rehabilitation or levels of stress.” In their research, musical improvisation has four unique characteristics that explain its effects. Namely, “its potential to link conscious with unconscious processes; the demands on attention of absorption in a creative process; the non-verbal social and creative interaction experienced; and the capacity for expressing difficult or repressed emotions without having to articulate these verbally.”

Though free jazz expression exists in a context that differs to the goals of this type of music therapy, the types of improvisational interactions are remarkably similar. Their findings reveal that the similarity of these processes suggests that improvising, in and of itself, could offer innate benefits to health and wellbeing more broadly.

The health-promoting credentials of music are also part of the emotional explorations and detachments it encourages. Whether though depression or dementia, jazz or Bach, music therapy or self-directed listening, in music we are simultaneously focused and distracted – one of neurobiology’s mesmeric paradoxes.

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Enis Yucekoralp

is a freelance writer based in London. He has a diverse range of interests and concerns, but his long reads can be found in “The Independent” while his poetry has appeared in “3AM Magazine”. He holds an M.Phil. in English from the University of Cambridge.