Music Is Medicine: What It Does to Your Brain (Dementia, Trauma & Healing) | Dan Levitin

1. RCDr. Rangan Chatterjee0:00

   Music can be considered a powerful form of medicine. What is music actually doing to our brains, and how can we therefore consider it as a potential form of therapy for all kinds of different conditions such as Parkinson's or MS or stuttering or Alzheimer's? I think just understanding some of the physiology would be really, really helpful.

2. DLDr. Daniel Levitin0:25

   Right. So in the same way that medicine, drugs, caffeine, barbiturates, drugs for schizophrenia, drugs for depression, in the same way that they don't all hit the same part of the brain, music doesn't-- not every piece of music hits the same part of the brain. Different musics hit different parts of the brain. And I think perhaps the b-best way to unpack this, uh, conceptually is to take the case that you mentioned first, which is Parkinson's. So in Parkinsonism, uh, what happens is the disease degrades circuits in a region of the brain called the basal ganglia. Uh, and those circuits, uh, use dopamine to help them process the timing of what we call voluntary movements. So an involuntary movement is coughing or, or swallowing or hiccupping, uh, startle reflex. But a voluntary movement is almost everything else we do. We feed ourselves, we walk, uh, we exercise. Those are voluntary movements. And in Parkinson's, inevitably, many patients lose the ability to walk because that timing circuit has been degraded, the part that tells them to put one foot in front of the other with a certain timing. 'Cause if you don't, you end up with both feet in the air at the same time, or more commonly, both feet planted in the ground and you can't move either one. So music that has the same tempo as the walking speed, the gait, of a Parkinson's patient, uh, activates regions of the brain that are spared, and within a few seconds, the brain synchronizes to the beat of the music. And a Parkinson's patient listening to that can suddenly start to walk as long as the music's playing. And there's a form of therapy called rhythmic auditory stimulation therapy for Parkinson's, where they listen to music twenty minutes a day for a couple of weeks, and then they don't even need the music anymore be- because they've, they've built supplementary circuits to help them walk.

3. RCDr. Rangan Chatterjee2:32

   Yeah. It, it's absolutely fascinating, this idea that music has its own internal momentum. And it made me think of something that I think many of us experience. So let's say in my family, for example, we could be listening to a tune in the car on the way home, right? So then we stop the car, and we come in. Let's say we've been shopping, and we unload the shopping bags. The music is not on anymore, right? The car's stopped. The car's in the drive. And I found this with my kids sometimes that maybe five or ten minutes later, we start singing the same part of that song at the same time. It's as if we hit the chorus at the same time, as if what you're saying about this internal momentum is that this is actually going on inside of us even when we're not listening to the music. Is that kind of one of the things that you're talking about here?

4. DLDr. Daniel Levitin3:28

   Very much so. And this question, we call this auditory imagery. This is the, the very first experiment I did when I was still in graduate school, was asking people to remember songs that they hadn't heard in a while. And they sang them at the exact tempo of the song. Our, our memory for timing is exquisite. And, um, we've now seen in a number of studies if you start playing a song and you turn it off-- This happens to me when I drive through a tunnel.

5. RCDr. Rangan Chatterjee3:58

   Mm-hmm.

6. DLDr. Daniel Levitin3:58

   Uh, a-and, and, and the satellite radio can no longer reach, right? Uh, terrestrial radio still g- can reach, but the satellite doesn't. So when I emerge from the end of the tunnel, um, al-almost always, I'm at the same part of the song that, that the satellite radio is. Uh, and that's not just me. This is a common phenomenon because, um, we have timing circuits in the brain that govern everything from the release of hormones and digestive fluids and, you know, melatonin at night to help you sleep and orexin in the morning to help you wake up and all of these kinds of things. The, the timing circuits are, are millions of years old evolutionarily.

7. RCDr. Rangan Chatterjee4:40

   Yeah. I read in your book that music came before language in terms of our evolution, which is really interesting to think about, isn't it? If music really did come before language, what does that tell us about us and about the role that music can play in our lives?

8. DLDr. Daniel Levitin5:09

   Well, to be fair, uh, this is a controversial notion. Uh, Steven Pinker famously would claim that music is tricking a, a system that evolved for language. But the evidence that music came first is that the oldest artifacts we find in human and Neanderthal burial sites are musical instruments. Uh, the parts of the brain that process music exclusively are phylogenetically older. They're evolutionarily older.

9. RCDr. Rangan Chatterjee5:39

   Oh.

10. DLDr. Daniel Levitin5:40

    And we know this because the cortex built from the center out, and so their music centers are deeper in. They're the most resistant to brain damage, whether it's caused by a trauma, uh, or a tumor or, or a stroke, music remains intact. And-You know, that's, that's just some of the evidence that music was around first, and yeah, what that means is, um, that music may be a more powerful way to achieve certain things than language. If I was out at the coast looking at the waves, and the sun were to set over the ocean, the, the sensation of calm, the colors, and the rage of the waves, I'm trying to describe them as best I can in words, but if I put on the right piece of music, maybe Beethoven's Sixth Symphony, you know exactly what I'm feeling. Um, music has that power, uh, for emotional communication, and that's reflected in a bunch of neurochemical systems that are selectively responsive to music.

11. RCDr. Rangan Chatterjee6:58

    Mm-hmm.

12. DLDr. Daniel Levitin6:58

    Dopamine, uh, dopaminergic, serotonergic. Uh, we know that music can help relieve pain. My lab was the first to show that when you listen to music you like, opioids are produced in the brain, endogenous mu opioids, which are analgesics.

13. RCDr. Rangan Chatterjee7:15

    Yeah. Which really goes back to that opening point, doesn't it, about music being medicine? We know through that lens of endogenous opioids, people will talk about the runner's high, won't they? They'll talk about exercise is good for you because, of course, there are many reasons for that, but one of them is because of the endogenous opioids. But music is doing the same thing, yet even though we know intuitively that the right kind of music can make us feel better, I don't think yet we've got to the point, certainly in a mainstream way, where music is thought of as therapy or thought of as medicine. And I guess my hope and p- perhaps your hope when writing this book is that, you know, that might be something you can change?

14. DLDr. Daniel Levitin8:04

    Absolutely. I mean, that's the reason I wrote the book. Uh, I read about four thousand peer-reviewed articles and synthesized the information in what I thought was a fair and balanced way, trying to make the case for things where the evidence is in, and then, you know, being frank where we don't have enough evidence. Uh, and so this, my personal background in this is that when you and I first met, I had just worked for five years with the National Institutes of Health here in the US, uh, to develop a Music As Medicine grant program, and they gave away forty million dollars in research funds, and then I began working with the White House Science office under the Biden administration to help promote the idea of Music As Medicine to lawmakers so that they could legislate government support for it. And the result of those efforts have been, um, remarkable. One is that the, in, in the US, in the state of New Jersey, uh, Blue Cross and Blue Shield, private insurers there now cover music therapy. The state of Massachusetts, uh, on the day I launched my book, sent a representative of the governor's office to my talk to tell us that Massachusetts was now giving out vouchers for free music therapy. And then just three weeks ago, the Netherlands launched a Music As Medicine initiative through the, the royal family. The, the king and the queen-

15. RCDr. Rangan Chatterjee9:39

    Wow

16. DLDr. Daniel Levitin9:40

    ... announced an initiative on Music As Medicine, and I spoke there to help kick it off. So things are coming together.

17. RCDr. Rangan Chatterjee9:47

    That concept, music as therapy, I guess there are specific conditions where you will need a specific therapist to try and integrate music into your life in a certain way, which I definitely want to talk about, but in a much bigger and maybe more universal way, I think one of the messages from this book is that many of us perhaps have a deficiency of music in our lives, and perhaps correcting that deficiency might have all kinds of benefits. Would you-- Is that fair, would you say?

18. DLDr. Daniel Levitin10:25

    I would, and, um, just to get back to this notion that you raised that music may have preceded language and the query, you know, what, what does this mean? Um, mu-- If you look at contemporary hunter-gatherer societies, they, um, they all have music as part of the... woven into the fabric-

19. RCDr. Rangan Chatterjee10:50

    Yeah

20. DLDr. Daniel Levitin10:50

    ... of daily life, for rituals, for ceremonies, mothers singing to infants, um, work songs. And it seems as though, you know, we assume that hunter-gatherers are, that have been isolated from the West are living the way we were forty thousand or sixty thousand years ago. And so we assume, it's, anthropologists, archeologists assume that that's the way things were. We always had music. And in our own recent history, my grandparents, uh, were children before there was electricity, so there was no radio. If you wanted to hear music, you had to play it yourself.

21. RCDr. Rangan Chatterjee11:34

    Wow.

22. DLDr. Daniel Levitin11:34

    And most people played an instrument in their generation, and nobody cared about whether they were any good or not. You know, not good enough. That, that, you never had that conversation. Entertainment in the evening was you'd sit around with the family, and you'd play guitars that you made out of cigar boxes, or you'd play on cheap pianos that you found and... Or you would just sing. Sing and sing and sing, uh, all night long. And you go back to hunter-gatherers. There's, they're, they tend to have their sleep divided-Where they'll sleep when it first gets dark, but they wake from midnight to 3:00 and they sing around a fire to ward off predators with the s- strength of their voices. So this music being part of our lives in a rich way, uh, is part of our evolutionary history, and what really put an end to it was the development of concert halls in Europe about 500 years ago.

23. RCDr. Rangan Chatterjee12:26

    Mm-hmm.

24. DLDr. Daniel Levitin12:26

    Where we created a class of performers on a stage and a class of listeners.

25. RCDr. Rangan Chatterjee12:32

    Mm-hmm.

26. DLDr. Daniel Levitin12:32

    And pretty soon, over the intervening years, it became, "Oh, well, I'm not good enough. I, I'm never gonna be an Ella Fitzgerald or an Adele, so I won't bother to sing." But it's peculiar. Nobody says, um, "I'm, I'm never gonna be a professional soccer player, so why should I even play?" Or, "I'm never gonna be a Winston Churchill, so why should I ever talk?" But with music, we say, "If I'm not gonna be an expert at it, I don't wanna do it. I don't wanna learn the instrument. It seems like a waste of time," which is, I think, a ridiculous argument. It's enriching.

27. RCDr. Rangan Chatterjee13:11

    Yeah. I love this, this idea that it used to be something that we all did, humanity did. You did it with your tribe, with your community, with your family. But then my favorite chapter in your book is the final one, Music, Medicine, Mystery, and Possibility. It was so evocative, Dan, about what music is. And, and we all know that it does something to us that you can't always explain with words, can you?

28. DLDr. Daniel Levitin13:45

    You know, if music just made you wanna dance, uh, or be social, if it, if it acted as the same kind of icebreaker that alcohol does or party games do, that would be pretty good. But for those of us who are sensitive to it, it can evoke a sense of awe, a kind of spiritual or metaphysical state where we feel connected to the larger scope of humanity and to the universe at large. Music can invoke that. Other things can, meditation, hallucinogenic drugs, uh, you know, various, uh, tragedies cause or joys cause us to enter that state. But the more we enter the state of awe, the more we can relax because we see ourselves as small parts of a very complex universe, and whatever's bothering us pales by comparison to the enormity of things that are bothering other entities. I, I talk in my, in the book that you and I last spoke about, the, um, Changing Mind.

29. RCDr. Rangan Chatterjee15:05

    Mm-hmm.

30. DLDr. Daniel Levitin15:05

    I relate the story of a, um, an experience I had with the Dalai Lama, whose picture is on the wall here behind me, um, where a woman came to him, a pilgrim. She had traveled for weeks barefoot to get to him for advice, and she was falling apart. Um, she had a lot of problems. Her family was sick. Uh, and he helped her to meditate on the notion that there is no, in the, in the grand scheme of things, in the Tibetan Buddhist tradition, there is no "I." We are all connected.

Episode duration: 1:25:16