About neuroscience and music (mainly classical). Exploring the relationship of music and the brain based on experience of two careers.

July 6, 2014


Byron Janis is a magnificent pianist. I admire his recordings and treasure my old vinyl disk of his Strauss Burleske with Reiner and the Chicago Symphony. So I was intrigued when a board member asked me as Gretna Music's "resident" (not "renowned") neurologist to comment on Janis' "A Healing Art" in the WSJ (May 8). 

Almost immediately popping into the cloud above my head was an image of a pot of chicken soup, still considered ‘therapeutic’ for just about any ailment. Indeed, sometimes it is -- when you need hydration, nutrients, electrolytes, warmth, loving care from friends and relatives. 

Janis’ pot contains a variety of good stuff: broad generalizations, aims, and assertions like, “the ancients’ drums, rattles and digeridoos--had huge diagnostic and healing properties,” or music “enhances the brain’s ability to facilitate healing,” or “music is believed to recruit uninjured parts of the brain to compensate for parts that have been injured, and help those parts that are injured recover.” 

And Janis throws into his pot anecdotes like “music brought back all the joys the house had known,” or “slowly brought back her ability to speak,” and “many told me how much music had helped their recovery,” or “patients went from being catatonic to fully functional.”

Janis describes a program at Walter Reed National Military Medical Center where, according to the hospital, "working with actual instruments, patients learn, play, compose and record music." The program "aims to enhance the healing process . . . enrich the lives of patients, visitors and staff and help relieve the stress often associated with a hospital setting." Novel idea. Good aims. Maybe we could (hoho) try it in schools?

'All of the above' are good intentions and maybe some will take off. I have no doubt that music can help some people sometimes feel better. Music can soothe or boost emotions. For many people it provides instant comforting familiarity. It can trigger memories and bring to mind forgotten words or verses. Like William Styron (Darkness Visible) I turn to music sometimes when I feel sad. And I hope (with no evidence) that playing (actually practicing hard and thoughtfully) my flute every day improves my physical and mental health and may delay (for how long?) Alzheimer's or vascular disasters. 

Some Parkinson patients can move or walk better to music. And we think that teaching music in early education is more effective for developing young brains than trying to teach statistics or philosophy to pre-kindergartners. And it seems self-evident that teaching children to play the violin in a small group is better education in the long term for some of them than busing the class to a symphony concert. I am all for having a piano, Yamaha or Steinway, in every home, all children learning music, and hope that we can eventually prove that music heals in many ways.

As he disclosed in the WSJ, Janis serves as Presidential Advisor for the Yamaha Music and Wellness Institute (YMWI). Associated, I presume, with Yamaha Corp, manufacturer of musical instruments, YMWI states its "ultimate goal is to enable individuals of all ages, regardless of prior experience, to discover the joy and personal benefits of playing a musical instrument" (for sale by Yamaha). YMWI president, the actual "renowned" neurologist referenced by Janis, Dr. Barry Bittman, has been among a group of authors who published a small amount of "peer-reviewed scientific research focusing on stress reduction from psychosocial to genomic levels utilizing novel creative music expression strategies."

But whether, and how, music may be therapeutic is a huge, complex, daunting challenge. What modes of therapy in what conditions? There are far more hopes, aims, claims, programs, "unequivocal" beliefs, "ultimate goals," articles like this--and apparently conflicting interests--than science bearing on the issue. 

Most medical and "alternative" therapies are used for decades before anyone thinks to test their effectiveness, many enriching the therapists more than the patients, at least after their hope wears off. In previous centuries people fervently believed in the efficacy of leeches, phlebotomy, tonsillectomy. These therapies are still used--but only in specific circumstances, not as universal cures, of everything for everyone. We need to learn the specifics of music therapy too. That's the "challenge" Julene Johnson refers to in a recent PBS Special Report. 

The field or Discipline of "Music Therapy," taught in universities, is "the evidence-based use of music in clinical situations that help people reach desired health outcomes." What actually happens too often is application of the term "music therapy" to any attempts, rarely "evidence-based" to improve lives using music. (Warning: What qualifies me with an ancient board certification in Neurology to pronounce judgment on the entire new discipline of Music Therapy that I know little about? Answer: Not much! But I know what "evidence-based" means.)

The questions must be specific, far more so than "Can Music Heal?" Scientists are working, each with a very narrow piece of the puzzle. Among dozens or hundreds of variables, you must isolate one (say starting piano lessons at age 5 vs. age 8), level all other variables, study large enough groups for valid statistics, and carefully measure the outcome. (Doing so they have found that the earlier age group developed larger corpus callosums in their brains. Note that is not evidence that proves a larger corpus callosum is a good thing or therapeutic, just that early experience can influence the structure of a developing brain.) 

Despite the fact we all think music is good -- err, what kind of music?  Schubert? Phil Dirt and the Dozers? Pit Bull? digeridoos?  -- its therapeutic potential is not self-evident and must be studied and proved in each instance. 

We don’t even know the relative contributions, to musicianship or appreciation, of nature vs. nurture. Are three generations of the Preucil family outstanding musicians because it is in their genes or because all were expected to start practicing at the age of 3 years? (Ans: It's likely that both are necessary, neither alone is sufficient. See * below.)

Yes, we need cheerleaders, like PBS reports, to engage more people and stimulate more research, programs, efforts, etc. All that should come---if the planet survives. 

I do think an easier armchair argument can be made that music (of most kinds) and early music education promote a better (and healthier) humanity than do some sports, especially American football, or the gratuitous violence in films.

* Wonderful example of good brain science anyone can understand.

No comments:

Post a Comment