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

December 10, 2015

Is Music the Ultimate Placebo?

by Carl Ellenberger, MD


What theory explains why homo sapiens, almost alone among species (excepting a few exotic birds on YouTube), have made music since the ‘origin’ of their species?

That is a common question and subject of books, periodically pondered and researched without definitive results. One intuitive answer is that music confers a selective (evolutionary) advantage onto those humans who make it or listen. Exactly what that advantage may be remains elusive. A few possibilities include:

1. Music is sexy and promotes procreation. Someone who can sing and dance might be a more attractive mate and produce more offspring.

2. Music enhances social cohesion that increases survival. A part of that is nurturing of infants and children. Lullabies may help motherly love keep infants alive.

3. Music can be learned easily by the young developing brain, as can all languages, before the brain can handle more complex tasks, like philosophy and physics. It exercises the brain early (in 'pre-school') to develop certain abilities and skills when it is most receptive (plastic), gaining capacities that peers, coming later to education, may never acquire. "Perfect pitch" is a trivial example. (A corollary: so deeply hardwired into the brain these abilities remain through life and are the last to succumb to degenerative processes like Alzheimer's so they can be excavated and exploited in therapy.)

4. Music generates a true and salutary placebo response in the brain.
“Placebos are drugs, devices or other treatments that are physically and pharmacologically inert. Placebo interventions do not, by definition, have any direct therapeutic effects on the body. However, all treatments are delivered in a context that includes social and physical cues, verbal suggestions and treatment history. This context is actively interpreted by the brain can elicit expectations, memories and emotions….” * (my emphases)
Studies reliably show a success rate of around 30%, or higher, if the therapist is caring and convincing (the "context"). The context of acupuncture, for example, includes ritual, tradition ('proven over centuries'), positive expectations, value (it's not cheap), and perceived competence of a skilled practitioner exhaustively trained in an ‘ancient art.’ The needles don’t even have to puncture, just prick, so long as the patient experiences the context.

The placebo response is not a product of trickery or deception; it accompanies actual physiological/chemical changes in the brain, such as production of endorphins and dopamine, and changes in blood flow and connectivity, similar to changes evoked by other means like talk therapy, medications, and indeed, music. Wounds aren't healed, causes aren't eliminated and the effects are usually temporary, but patients come away feeling better -- as I do on the descending escalator in Disney Hall or walking home from the Gretna Playhouse after concerts.

The idea that music may generate something like a placebo response came to me as I read John Eliot Gardiner’s magnificent, Bach: Music in the Castle of Heaven. Monteverdi wrote L’Orfeo in 1607 during a time when “the emotional life of human beings was becoming a topic of the utmost fascination – with philosophers and playwrights trying to define the role of passions in human destiny, and with painters as varied as Velázquez, Caravaggio and Rembrandt all intent on portraying the inner life of men and women . . . . Monteverdi made the decisive creative leap – from a pastoral play, intended to be sung and not spoken throughout, to a musical-drama with emotions generated and intensified by music . . . ." (my emphasis)


This idea, however, may not support, at least in the views of some,** the theory that music indeed gives humans a selective adaptive advantage. We would probably be much the same humans without it, but it does give to life comfort and pleasure as does making and viewing art, burning fossil fuels, wearing fine clothes, and drinking a fine wine, all longstanding drives, not likely to disappear.

5. I should also mention another theory that musical sounds were homo sapiens' first language, carried over from pre-human ancestors, common to us and to those who now play in Bernie Krause's The Great Animal Orchestra. Providing better communication, spoken language prevailed many millennia ago and music, outmoded, became an unnecessary skill (or "frill") among humans, "auditory cheesecake," according to psychologist, Steven Pinker. I always wonder whether some of the sounds I hear coming from my grandson's earbuds are examples of the final throes of musics' extinction.


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