Interview with a Music Therapist

I finally had a chance the other day to conduct an interview with a Music Therapist who works with both children and adults. She had some really interesting stories and comments about her experiences. For privacy reasons I will not copy-and-paste the interview transcript, however I will include some questions and a summary of her responses (in addition to my personal comments) below.

 

How would you define Music Therapy in the context of the work you do? 

For this question, she references the definition used by the World Music Therapy Federationis: 


“Music therapy is the professional use of music and its elements as an intervention in medical, educational, and everyday environments with individuals, groups, families, or communities who seek to optimize their quality of life and improve their physical, social, communicative, emotional, intellectual, and spiritual health and wellbeing. Research, practice, education, and clinical training in music therapy are based on professional standards according to cultural, social, and political contexts”

She works in both an oncology and a children setting. In the former, her work helps to encourage communication, increase energy, reduce pain (physical and emotional), and promote a sense of self peace. In the latter, her work helps to develop learning and socialization. It’s really amazing how many different parts of the brain can be accessed simply with music and proper technique.




Please tell us a little bit about a typical “day in the life”: What type(s) of music therapy are you involved with? Can you describe a particularly notable case?

In her work, she deals with all different types of patients who are both self-referred, and referred by doctors. Some examples of her work include stimulating patients in a coma, working with patients who are depressed and even encouraging patients with lung injuries to sing, as this encourages increased breath usage. Sessions can include both active components (making music) and listening components (listening to music). The children she works with tend to have developmental delays such as autism. With them she focuses primarily on developing gross motor skills by using percussive instruments.

 How, in your experience, do different age groups respond differently to music therapy?

While children are generally easy to work with, and respond naturally to music, she notes that adults can sometimes be resistant at first. She told me an interesting story about some patients who couldn’t remember family members’ names due to dementia and the side effects of certain medications, but yet could recall lyrics of a song when musically stimulated. Recalling lyrics can often allow people to recall other memories that were connected with the music. Think about when you feel nostalgic when listening to a certain song.


What in your experience, generally speaking, do your patients tend to best respond to: the notes themselves, the expression/emotion of the music, or the memories/thoughts triggered by music?

Children tend to respond best to “structurally predictable” children’s music. If you go back to some of my earlier posts, you can see why our brains “like” such music so much. This plays back into the ITPRA theory mentioned earlier. However, for adults the music functions more as a retrieval cue for deeper memories of their past. Not only will adults recall early memories associated with the music, but also they will sometimes simply break down emotionally when listening to a certain song. She mentioned one patient to me who started crying when listening to a piece of music but could not explain why. Clearly it had a deep impact on the patient, whatever the reason may be.

This interview is not only insightful and informative, but also reminds us of the significance of music in our lives. Music stimulates pretty much every section of the brain. Hopefully after this interview, you can get a better a sense of just how many different applications music can have.

The therpeutic power of "emotionless" music: does it exist?

Before speaking at all to the title of this blog entry, please visit the following link and try the interactive demos. I also suggest you read the related article linked to at the top of that page:

http://www.nytimes.com/interactive/2011/04/18/science/20110419-music-expression.html?nl=todaysheadlines&emc=thab1

So we're dealing with a couple different questions at hand.

Test 1) Does timing and volume effect musical expression?

This may seem like an obvious "yes," and indeed it is. I think a more interesting question to consider is how does timing and volume effect musical expression? So what if some notes are shorter and some notes are longer? Who cares if one note is slightly louder than another note? These seemingly insignificant nuances can actually play a critical role in your music-listening life. Imagine you've had a rough day and you just want to relax to your soothing yet intense recording of a movement by Haydn. Now imagine the movement with no dynamics and no expression within gestures. You might get the melody stuck in your head, but that's about it. Besides what can be taken from the note patterns themselves, there is no perceivable emotion in the piece. You will hear the music but likely make no emotional connection and hence not really feel any better. It is the emotional "camaraderie" that you have with a piece that connects you to it. These minute differences in volume and timing  enable (or disable) you from making this emotional connection.

Test 2) Does magnifying a performer's musical expression bring out a greater emotional response in the listener?
 
According to Levitin's trials, the answer to this question is no. Natural human expression (unmagnified digitally) seems to bring out the most emotion. This seems to me to imply that we have a "threshold" for connecting emotionally to music. In the same way that we don't respond emotionally to music devoid of any expression, we also don't connect emotionally to music that has too much expression. One way to think about this is to compare it to a spoof of a horror movie. When we watch horror movies, we tend to get spooked. We are able to fully engage our emotional selves in the movie because we can relate to the human thoughts and feelings being evoked on screen. In a spoof however, characters tend to be over-dramatic, often comically so. Such over-dramatic reactions are not "realistic" and hence we do not relate to them on a emotional level. Thus we derive less emotional meaning out of the spoof than the movie itself. 


Test 3) Can expressiveness in music be randomly distributed and achieve the same listener response?

The expressiveness cannot be completely and truly random. For instance, if certain musical "strong beats" (meant to be emphasized) are played quietly and "weak beats" played loudly, the piece will just sound 'off.' A non-musician won't be able to explain exactly why, but he or she will be able to identify that something about the beat isn't quite right. With that said, there is a certain amount of variability of how the music is expressed from artist to artist within the confines of sensible interpretation. That's why we like some recordings more than others, or some conductors more than others. Imagine if only one recording in the world existed of Beethoven's 1st symphony.


Test 4) Which is more expressive: a change in volume, or a change in note duration? 

Levitin's studies show that change in timing is the more effective of the two. We must keep in mind however that this of course also has to do with how much the timing is altered or how significant the difference in volume is. Either way, this test really speaks to the power of artistic license: all the composer does is write his musical intentions down on a sheet of paper; it is up to each individual artist to take the license to interpret the work and express it as he or she feels fit. 

So in thinking about all of this in the context of music therapy, an interesting question arises: what really "does the trick" with music therapy patients: the notes themselves, or the expression and emotion behind the notes? Or maybe a combination of both? Perhaps this will become clearer as my studies in this fascinating field continue.

Music as Therapy: an introduction

This term, I will be focusing my studies on Music Therapy. To "break into the business" of researching this area, I read a chapter on the topic from Daniel Levitin's new book The World in Six Songs. Interestingly enough, he references both the "Music Perception Journal" and Huron's Sweet Anticipation , both of which I have blogged about in the past.

The American Music Therapy Association defines music therapy as: "evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional."

One disclaimer that Levitin makes about music therapy is that many of the studies done are not kosher to scientific methodology standards. That is, some researchers may publish studies on music used as therapy but did not necessarily control the experiment properly. It will be important for me to keep this in mind throughout my study.


With that said, some amazing feats have been attributed to music therapy. Some seniors who are unable to walk seem to all of a sudden be able to move around to the beat when they hear a song from their youth. On a more basic level, someone who is just in a "bad mood" seems to all of a sudden feel better just by virtue of a certain pattern of sound frequencies (making up their favorite song) entering their ears. Music can act as a retrieval cue for many different memories as well as a means of changing the hormonal balance in our bodies.


Music has an incredible ability to change the chemistry in the brain associated with health, stress, and even the immune system. The amount of Immunoglobin A (IgA), a crucial antibody for fighting colds and infections, has been shown to increase as a result of music therapy.

Some studies have shown that listening to Techno music increases levels of norepinephrine, growth hormone, ACTH, and certain endorphins ("feel good" hormones)- all of which play a role in the immune system. Another interesting study suggested that listening to Bach in a major key can be beneficial to the immune system while listening to Bach in a minor key is less so. 

The Psychology of Muscles and Music Perception

I read an article in a recent issue of the Music Perception Journal about music and the muscles.

Usually when we associate music with body movement, we think about how music influences the way we move our bodies. During a happy song, we tend to smile and during a sad song we tend make a very serious expression. When a song has a lively beat to it we tend to nod our heads to the music and when a piece is emotionally powerful we tend to shake our heads subtly as the music intensifies.

Now let's think about all of this a different way. Results of recent experimentation reveal that perhaps muscle movement  affects and informs how we listen to music (not just the other way around). In one experiment, half of the participants were asked to listen to French baroque music while holding pens between their teeth (activating 'smiling muscles'), nodding their heads, and exerting pressure from their hand to the underside of a table (a positive movement). The other half listened to French baroque music while holding pens between their lips (activating 'frowning muscles', shaking their heads, and pushing down on a table surface (a negative movement).

Sure enough when asked how they liked the same music, the group which was activating positive "happy" muscle groups yielded stronger reports of enjoying the music than did the group using negative "sad" muscles. Nobody reported being familiar with the music in advance.

So I guess next time you're at a concert that you think is boring, try smiling and maybe you'll like it more : )

The 10,000 Hours Theory

While some may argue that professional musicians were born with the talent, others claim that talent comes from practice...LOTS of practice. While Dan Levitin acknowledges both sides of this coin, he asserts that in order to be an expert musician, one must put in at least 10,000 hours of practice. This is the equivalent of practicing for 3 hours a day over 10 years. The 10,000 hours theory is supported by many different experiments across a wide variety of fields- not just music.

This process can be made easier, according to Levitin, if you care about what you're doing. Learning requires memory and when you're learning a piece of music, the brain will tag certain memories of the piece (ie how you play certain sections or how the piece works harmonically) as "important" if you emotionally attach to sed memories when you practice. Also, if you like the piece you are working on, you will be more likely to pay attention to the smaller details. Levitin does also acknowledge that some people might practice more or less efficiently than others which obviously plays a role in all of this.

One idea of my own is that latent learning  may be involved in becoming an expert musician. In fact, it probably is. In laymen's terms, latent learning refers to when you absorb a certain idea or concept "subconsciously" at one point but it is expressed much later. For instance, you probably didn't consciously "memorize" how to use a hammer to hit a nail. Yet, if you were presented with a hammer and a nail now, you'd immediately know what to do. When playing pieces of music a particular way, you may have never formally been taught to "lean into" a certain note or to be in a certain position when playing a piece. Yet, you've seen the piece done this way in your past and now it seems to be instinctual that that's just what you "do" when you perform the piece.  Again, I would not say for sure that latent learning is responsible for this but it is an interesting idea nonetheless!

Why do we like music? Why do we like performing music? Why is pop music popular?

The book I have been basing my last couple blogs on, titled This is Your Brain on Music, was written by professor Daniel Levitin of McGill University. The other day, he gave a very interesting presentation on the topic of music cognition. I attended this lecture and took copious notes. Below I will highlight some amazing points he addressed about why we like music.

For one thing, in many of my posts I have referenced the fact that our brains are always trying to determine what will come next when we listen to music. Levitin explained that one reason we like music so much is that since we are always trying to subconsciously "guess" what will come next, we are constantly being rewarded when we guess correctly. Yet when we guess incorrectly, often what ends up resulting in the music is something even better or more exciting than we predicted, so we still get the sense of gratification.

The area of our brain that is mostly responsible for this musical anticipation is called Brodmann Area- 47 located in the prefrontal cortex. Melodies and chords tend to have a "trajectory that composers both use and verge away from " (Levitin). As I just explained, either way we get still get that sense of reward. The primary area of the brain responsible for giving us this pleasurable rewarding feeling is the nucleus accumbens and its mediation of the chemical dopamine.

That's the nitty-gritty of it. Yet there are other practical applications as to why we like music. We associate certain music, with certain memories and certain emotions (good or bad). As Levitin noted, the areas of the brain that process vibrato on the violin are the same areas that process a person crying. Hence, violin music is often associated with sadness.

Some people get a particular pleasure out of performing with other people. Levitin amusingly mentioned that the chemical Oxytocin is released in people's brains when they are singing together. This is the same chemical that is released when people are experiencing sexual pleasure. Levitin pointed out that the chemical composition of the brain when you're singing in a choir is similar to that of when you are undergoing sexual gratification.

Finally, Levitin talked about how "pop" music earns its title. Why is pop music popular? More generally, why do so many people like X genre of music so much?

In this video: http://www.youtube.com/watch?v=5pidokakU4I, you can see how many of the current songs out there that everybody knows use the exact same four chords in the same pattern: I-V-vi-IV. Thinking about what was said earlier about rewards, why do you think people like all these different songs if they all use the same chord progession??

Levitin comically noted that when a person touches you in the same place over and over again it becomes an irritant. Yet, when they touch you in different places, you tend to like it. All 'references' aside, this fact applies very directly to music. In all of the pop songs in the video above, the chord progression is the same. So our brain gets a sense of reward from accurately  being able to "predict" what chord will sound next given that common pattern we're used to. Yet, each song has its own variations in melody, lyrics, and rhythm. So that aspect of each song is something new to us. The combination of the brain both being able to predict what is happening while also being happily surprised by something new results in great chemical reward. Hence, people tend to like pop music, making it "popular". Even if you don't like pop music (perhaps you prefer theater or classical), the above explanation can really be applied to any genre. The big idea is that music is combination of what we expect and what we are surprised by. This is a very "happy"- happy medium
for the brain.

In response to the question "Why do people like some genres more than others?", Levitin joked: "Why do some people like spicy foods while others can't stand spice?" This is an area that is still being researched which does not currently have a sound scientific explanation.

Processing music: a Top-Down and Bottom-Up Approach

So you're listening to music. As I've mentioned before, all this means is that air molecules are vibrating in certain ways and beating against aural membrane in given patterns. But how do we make thoughtful sense of this physical phenomenon? Our brains, upon receiving musical input, extract it into features (pitch, rhythm etc.) and then integrate the features to form broader musical concepts.

So let's say the stimulus here is an outside source such as music playing from your headphones. Certain neural networks extract what you hear into features such as rhythm and pitch. This is called bottom-up processing: we are only concerned at this stage with what's coming directly from stimulus. Bottom-up processing isn't about preconceived notions or other ideas we have about the stimulus. This type of processing is simply, cut-and-dry, about what we are processing directly from the stimulus.

As you listen to this music, your frontal cortex is constantly predicting what will come next and forming new expectations based on what you've already heard. For instance when listening to a pop song, you somehow "know" when the chorus is about to happen. When you listen to a symphony you somehow "know" when the movement is about to end. If you've heard the song before, you know for sure what will come next when you listen to it again. Bringing this "bias" to the table when listening to music is referred to as top-down processing: what you already know is influencing how you perceive the stimulus.

So when we listen to music, both top-down and bottom-up processing are hard at work. As your brain analyzes the individual features of what you're listening to (extraction), you are processing bottom-up. However, the constructed representation of the music, as well as inferences made about it, are thanks to top-down processing. Schemas (mentioned in previous post) also result from top-down processing.

Think of it like this:

Bottom Up: Sensory input gets sent and sorted in Brain (extraction)
Top Down: Brain affects perceived input and makes sense of it (integration)