Henry has Alzheimer’s. He hardly responds to questions anymore and sometimes asks: who am I? He has been living in a nursing home for ten years. Bent over in his wheelchair, he looks apathetically into space. Until his daughter puts headphones on his ears that play music. Henry’s eyes widen, he begins to move rhythmically, sing and talk about the music from his youth. The apathy has disappeared, his face revives.
This excerpt comes true Alive Insidea 2014 documentary about the power of music therapy. And yet, despite examples like this, skepticism is never far away when it comes to the healing effects of music. Take the press release from Zing je Sterk. It is the week of informal care and the ensemble Wishful Singing is therefore starting a trial with singing informal caregivers to improve their health. Because: ‘Singing has a proven positive effect on reducing stress and strengthening the immune system’, can be read in the message from Zing je Sterk, ‘as research by brain scientist Erik Scherder shows’.
Now Scherder often appears, solicited and unsolicited, to provide all kinds of claims with a scientific edge, but such an authority argument alone is not convincing. Searching databases with scientific studies mainly produces studies with tentative conclusions. Singing ‘can have a positive effect’, but ‘more research is needed’ is usually the verdict.
‘I see that people are in better condition and need less medication. Although this is not evidence-based, it is experience-based.’
Gertie Savelkoullogopedist
Those kinds of judgments usually concern singing and music as a medical intervention. About questions such as: does music therapy help people with lung disease or people suffering from dementia, like Henry.
Distortion of results
Music is not a pill. Just as you can use scientific research to determine whether a medicine works or not, it is just as difficult with music, says neuromusicologist Artur Jaschke. He is affiliated with the University of Cambridge, ArtEZ School of the Arts, conducts clinical research at the UMCG and wrote the book in 2021 Future music about music and the brain.
“There are two problems with music health studies. One, who is being investigated? They are often choirs, so people who are already intrinsically motivated to make music.” This creates a so-called selection bias, a distortion of the results because the group studied is not representative.
“The second point,” says Jaschke, “is that effects are difficult to prove. We know from research that singing has a good influence. Your mood can improve, your self-confidence can increase and that can have an effect on your health. To show that, you need to have a control group. If you have a control group that does nothing extra, then there is a clear difference with the group that sings. But if you have a control group that plays chess or reads a book every day, then it becomes more difficult.
“We conducted research with primary school children. We saw that children who receive music at home perform just as well as children who receive music at school, but perform better than children who only receive visual arts. But these three groups together perform much better than children who receive nothing at all. By performance I mean the development of the brain, scores on the Cito test, the ability to plan, the development of working memory and empathic abilities. The results of that research contribute to the fundamental knowledge that we are slowly building up.”
Now, a mountain of evidence about the positive health benefits of singing does not yet amount to hard scientific evidence that, for example, a health insurer would be satisfied with to reimburse singing therapy. “It’s a bit like physiotherapy,” says Jaschke. “Physiotherapy took 75 years to be recognized. This will be no different with music therapy and creative therapy. But we see in daily practice, from the smallest incubator children to the oldest patients with dementia, that singing and music have a positive effect on health.”
Improve lung functions
Gertie Savelkoul has been a speech therapist for 45 years, specializing in breathing and voice problems. She is also the initiator and conductor of Zing-a-long, a choir of people with mainly lung disorders, but there are also members with MS or Parkinson’s. Savelkoul is aware of the problems with proving research into music and singing, but is convinced of the positive effect. “Measurements by the pulmonologist showed that the lung functions of the choir members improved,” she says. “I see that people are in better condition and need less medication. That is admittedly not evidence-basedbut yes experience-based.”
Sculpture Joris van Gennip
Anyone can join the choir, says Savelkoul. “Even if you can’t sing. We are looking for people, so anyone who is interested is welcome. We work on breathing and voice training for 45 minutes. Then we have a cup of tea or coffee and then we sing easy songs. That is good for breathing. The difference between speaking and singing is that when singing you lengthen the vowels and exhale longer. This calms the heart rate and lowers blood pressure if it is too high. Because you take more time to exhale, people become less short of breath and experience an improvement in their quality of life.”
What Savelkoul says is reflected in studies into the benefits of singing for lung patients. With the caveat that exercising under supervision or walking also leads to better health for lung patients. What a choir has an advantage over sports is the group dynamics. Working together towards a performance ensures that people feel seen and, in this case, heard.
Benefits for healthy people
This also applies to choir members without conditions. A frequently cited study that Savelkoul also talks about is a study by the University of Frankfurt. They took blood from choir members and saw an increase in immune substances and a decrease in the stress hormone cortisol. In other words: singing in a choir improves resistance and reduces tension in the body, which has all kinds of beneficial side effects.
Yet the benefits of singing in a choir, making music in a band, listening to music in the car or singing at home in the shower are primarily of a psychological nature. Music allows us to regulate our emotions, says Jaschke. “When we are sad, we know very well which music can make us even sadder. With music we can distract our attention from something or use it to focus. If the brain finds the zone where it can relax, it can promote psychological well-being and that has a direct impact on the body.”
‘You do it for brain development, for your well-being and not for aesthetics’
Artur Jaschkeneuromusicoloog
According to Jaschke, it is important not to listen to or make the same music over and over again. “You have to challenge yourself with different types of music, with new genres. Even though you may not initially find it beautiful or fun or aesthetically valuable. When you hear new music, your brain thinks: wait a minute, I recognize this as music, but not as the music I’m used to. The brain has to make more effort to understand and reproduce it when you sing.”
Play an instrument
Being actively involved with music, i.e. playing or singing yourself, stimulates the brain even better than listening or singing in the car. But not everyone plays an instrument. Jaschke has a message for those who do not play an instrument. Start right away, no matter how old you are. “You do it for brain development, for your well-being and not for aesthetics. You don’t have to play in the Concertgebouw. We are musical animals. When you learn how to play an instrument, you get a lot of pleasure in return and that is also good for your body.”
Brain scans of people listening to music show that the entire brain becomes active when it hears tones and timbres. Such as the temporal lobe for sound perception, the hippocampus that is involved in memory, the motor cortex that allows you to move to music and the amygdala that provides emotional responses to music.
Functioning of the brain
How the brain works can be seen on the YouTube channel of the University of the Netherlands. There, Jaschke explains the scans of people with and without brain disorders who listen to music. It can be seen that almost all parts of the brain light up. Those are the active parts.
These parts seek connection with each other. This is a problem with Henry, the man with Alzheimer’s who could speak again and remembers music from his younger years. The connection to his speech center in the frontal lobe is closed. But the parts of his brain that are not damaged become active when he hears music. When those parts encounter a blockage in the frontal lobe, they look for another way to reach the speech center. This works for Henry, so that he regains access to his speech through music. And not only that. He also gains access to the hippocampus and thus to his memories in a roundabout way.
“Music enters through the ear, then it goes everywhere via your brain stem: forward, back, left and right,” says Jaschke. “The question is whether this happens the same way for everyone. The same brain areas are activated in everyone. We know that for sure. But what we don’t know is how the pathways within the brain run. These are determined by nature in nurture. So because of what you have inherited in your genes and how you were raised. So the paths are different for everyone.”
That makes brain research complex. There is still a lot we don’t know, says Jaschke. It is one of the reasons why it remains difficult to scientifically prove the positive effects of music and many studies end with the conclusion that more research is needed.
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The Healing Powers of Music: Science or Sorcery?
Ah, music: the universal language that can make a toddler dance and a grandma weep. In the soul-stirring journey of life, we’ve all felt that electric jolt when a favorite song plays. But what really gets us singing in the shower while our shampoo bottles bear witness? The latest discussion rolls around the issue of music therapy, particularly in contexts as profound as Alzheimer’s care. Grab your headphones, folks; we’re diving deep!
A Note on Henry’s Harmonious Awakening
Meet Henry, who resides in a nursing home, battling the cruel grip of Alzheimer’s. A man who once might’ve made us laugh at a party, now he stares vacantly into the abyss. But lo and behold! With a simple pair of headphones, we witness a magical transformation. Suddenly, Henry reawakens, swaying to the beat of his youth like a Gollum finding its precious. It’s a testament to the incredible power of music—though let’s be honest; it could also be a sneaky way to avoid family dinners!
All Aboard the Music Therapy Train — or Maybe Not?
Now, before we pop the champagne and declare music therapy the next miracle cure, let’s hit pause. Despite music’s potential, skepticism is never far behind. Take the ensemble “Wishful Singing,” striking chords with informal caregivers in a bid to curb stress and fortify immune systems. Brain scientist Erik Scherder—yes, the go-to authority for science-y claims—stands in the spotlight, putting his scientifically-saturated credentials on the line.
‘I see that people are in better condition and need less medication. Although this is not evidence-based, it is experience-based.’
— Gertie Savelkoul, logopedist
That’s Not a Pill, That’s a Song!
But what’s the trouble with music research? Neuromusicologist Artur Jaschke, ever the intellectual, points out the pitfalls: studies often involve choirs packed with people already motivated to sing. This brings in what we call a “selection bias”—a fancy way of saying it’s a bit like measuring the fitness of a couch potato by examining Olympic athletes. Not the best comparison, is it?
The Music Mystery: What is Proven?
Then there’s the ‘proving’ part. Picture a control group sauntering through life doing… absolutely nothing! It’s like trying to compare apples and oranges by tossing in a cat for good measure. If music serves as a pick-me-up for lung patients, does belting out show tunes mean a trip to the doctor is off the table? Well, Gertie Savelkoul firmly believes singing improves lung function without requiring precise scientific evidence—she goes for the “experience-based” approach, which sounds rather adventurous!
The Group Effect: It’s All About Connection
Not to forget, there’s a social aspect that comes with communal singing. Choirs work like magic because they offer companionship and support—just don’t expect a standing ovation for your off-key rendition of “Bohemian Rhapsody.” And hey, while singing can stir feelings and boost the immune system, it’s safe to say that binge-watching cat videos probably won’t do the same.
Scientific Evidence: Or Lack Thereof
All in all, the notion that music aids in psychiatric well-being is more than just wishful thinking. Science shows that musical engagement can improve mood, confidence, and even brain activity. But before we start belting out Barry Manilow in the doctor’s office, remember: “more research is needed” is the kicker upon which so many illustrious studies conclude.
‘You do it for brain development, for your well-being and not for aesthetics.’
— Artur Jaschke, neuromusicologist
Time to Play: Instruments as Brain Fuel
And ladies and gentlemen, if you’re not already strumming a guitar like it’s 1999, allow me to share this nugget: playing an instrument is even better than mere listening. Yes, please learn how to play your childhood piano that’s currently doubling as a glorified coffee table. Music is meant to be felt, and the brain just loves a good workout.
The Final Note: Music’s Whimsical Nature
Ultimately, we’re none the wiser in determining the inner workings of the brain when it comes to music. What we do know is music finds a way to resonate with us all in different ways, much like that awful karaoke rendition of “I Will Survive” that haunts your memories. Years from now, will we finally have that gold-plated proof? Maybe. Until then, let’s keep singing, engaging, and dancing our way into the unknown.
In Conclusion: Your Time to Shine
So go on! Put on your most embarrassing playlist, grab your families, or your friends, and create some noise—happy noise! Remember, if Henry can regain his groove, so can you. And who knows? You might just find that karaoke night might just be the next big therapy session!
Relationship between music and mental health
All, the relationship between music and well-being is complex and multifaceted. While various anecdotes and small studies suggest a strong connection between music and positive mental health outcomes, the larger scientific community continues to scrutinize the effectiveness of music therapy as a standalone treatment for conditions like Alzheimer’s and other cognitive disorders.
Experts like Jaschke emphasize the importance of varied musical experiences, advocating for the exploration of new genres to engage the brain actively. Playing instruments, singing, or simply listening to diverse types of music can stimulate various areas of the brain, enhancing cognitive functions and emotional responses. Music engages the brain’s temporal lobe, hippocampus, motor cortex, and amygdala, forming a comprehensive network of interaction that contributes to mental wellness.
While there is substantial anecdotal evidence supporting music therapy’s benefits—including positively impacting mood and memory—establishing its efficacy through rigorous scientific studies is fraught with challenges. The complexities of individual brain functioning, differences in upbringing, and the inherent social aspects of music can all influence outcomes, making it difficult to derive universally applicable conclusions.
Despite the hurdles, the message remains clear: music is a powerful force that transcends mere entertainment. Its capacity to engage the brain, evoke emotions, and potentially aid in recovery or coping strategies cannot be dismissed. The world of music therapy is still evolving, with researchers and practitioners pushing the boundaries of our understanding, offering hope to countless individuals seeking solace in harmonies.
So whether Henry in his nursing home finds joy in melodies from his past, or a community choir brings warmth and togetherness to its singers, the healing properties of music continue to resonate across generations—challenging us to listen, learn, and perhaps even take up an instrument or two. Here’s to the healing powers of music—a beautiful mystery that sparks joy, ignites memories, and nourishes the soul.